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Outline of presentation
 Organization of the nervous system

 The brain and cranial nerves

The spinal cord and spinal nerves

Nervous System


 The autonomic nervous system

By: Yossef T.

Functions of the Nervous System

Introduction
Sensory input – gathering information, this sensory
information is carried into the brain and spinal cord
 Most complex of eleven body systems through cranial and spinal nerves.
 Accounts about 3% of total body wt. (2kg) ➢ To monitor changes occurring inside and outside
 Differ from other body system b/c many of the body detect internal stimuli, such as an
its cells are extremely long. increase in blood acidity
 Enables the body to react to continuous Integration To process and interpret sensory input
changes in its internal & external and decide if action is needed
environments Motor output
 •Controls & integrates various activities of ➢A response to integrated stimuli
the body, such as circulation & respiration
➢ The information is carried out side the brain and
spinal cord
3 ➢4The response activates muscles or glands

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The Nervous System The Nervous System

 Two divisions:
▪ Structurally into CNS & PNS
▪ Functionally into somatic nervous system (SNS) &
autonomic nervous system (ANS)

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The Nervous System Organization of Nervous System

 The master controlling and communicating system of
the body
 3 overlapping Functions
 Sensory receptors to monitor changes inside/outside the body
 e.g. sensory input
 Processes or interprets sensory input,
 e.g. integration
 Motor output – response to stimuli

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The Nervous System The Nervous System

Divided into 2 parts: CNS and PNS Peripheral Nervous System (PNS):
 Central nervous system (CNS)  Two Functional Divisions
▪ Consists of brain and spinal cord • Sensory (afferent) division (“carrying toward”)
▪ Integration and command center of the nervous system ➢ E.g. Sensory afferent fibers – carry impulses from skin,
▪ It receives incoming sensory signals, interprets these signals, and skeletal muscles, and joints to the brain
dictates motor responses based on past experiences, reflexes, and
➢ E.g. Visceral afferent fibers – transmit impulses from
current conditions.
visceral organs to the brain
 Peripheral nervous system (PNS)
▪ Consists of nerves (bundles of axons) and ganglia. • Motor (efferent) division (“carrying away”)
▪ Spinal nerves: carry impulses to and from spinal cord ➢ Transmits impulses from the CNS to effector organs
▪ Cranial nerves: carry impulses to and from brain (muscles and glands)
▪ Ganglia: areas where the cell bodies of neurons are clustered
▪ Serve as lines of communication
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Embryonic Development of Nervous System

The Nervous System During the first 26 days of
Motor Division: Two Main Parts development:
I. Somatic nervous system ➢ Ectoderm thickens forming
➢ Somatic motor nerve fibers (axons) that conduct impulses from
the neural plate
the CNS to skeletal muscles ➢ The neural plate invaginates,
➢ Voluntary nervous system (conscious control of skeletal muscle) forming the neural folds
II. Autonomic nervous system (ANS) ➢ Superior edges fuse forming
neural tube which detaches
➢ Visceralmotor nerve fibers that regulate the activity of from the ectoderm and sinks
smooth muscle, cardiac muscle, and glands deeper
➢ Involuntary nervous system
➢ Neural tube differentiates
➢ Consists of 2 subdivisions: into the CNS
a) sympathetic ➢ Brain forms from neural tube
b) Parasympathetic (rostrally) as well as spinal
Note. a and b usually work in opposition of each other, cord (caudally)
e.g. one stimulates, while the other inhibits ➢ Neural crest cells give rise to
some neurons destined to
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reside in ganglia
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…Formation of Primary Brain Vesicles …Formation of secondary

Brain Vesicles
 The anterior end of the neural tube  In week 5 of embryonic
expands and constricts to form the development, secondary brain
three primary brain vesicles
vesicles form
I. Prosencephalon ➔forebrain
I. Telencephalon and diencephalon
II. Mesencephalon➔midbrain arise from the forebrai
III. Rhombencephalon➔hindbrain II. Mesencephalon remains
 Remainder of neural tube becomes undivided
the spinal cord III. Metencephalon and
myelencephalon arise from the
hindbrain

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…Formation of secondary Brain Vesicles Fates of the secondary brain vesicles…

Fates of the secondary brain
vesicles:
 Telencephalon – cerebrum:
cortex, white matter, and
basal nuclei
 Diencephalon – thalamus,
hypothalamus, and
epithalamus
 Mesencephalon – brain
stem: midbrain
 Metencephalon – brain
stem: pons
 Myelencephalon – brain
stem: medulla oblongata
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Fates of the secondary brain vesicles… Fates of the secondary brain vesicles…

Adult structures derived from the neural canal

 Telencephalon – lateral ventricles
 Diencephalon – third ventricle
 Mesencephalon – cerebral aqueduct
 Metencephalon and myelencephalon – fourth ventricle

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Space Restriction and Brain Development

Space Restriction and Brain Development

 Flexures:
✓ midbrain and cervical, which bend the forebrain toward
the brain stem
 Cerebral hemispheres:
✓ grow posteriorly and laterally and envelop the
diencephalon and midbrain
✓ continued growth causes the surface to crease and fold
producing convolutions thus increasing the surface area

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Histology of Nervous Tissue Histology of Nervous Tissue

 The two principal cell types of the nervous system are:  Supporting Cells: Neuroglia (“Nerve Glue”)
➢ Neurons – the excitable nerve cells that transmit electrical ➢ Often called glial cells
signals ➢ Tend to have a smaller size and dark staining nuclei
➢ Supporting cells – smaller cells that surround and wrap the ➢ Outnumber neurons in the CNS 10:1
more delicate neurons
➢ Make up ½ the mass of the brain
➢ 6 types of glial cells: 4 in CNS, 2 in PNS
➢ All 6 types;
✓ Provide a supportive scaffolding for neurons
✓ Segregate and insulate neurons
✓ Guide young neurons to their proper connections
✓ Promote health and growth of neurons

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Histology of Nervous Tissue Histology of Nervous Tissue

 Neuroglia  Neuroglia in the CNS
I. Astrocytes
▪ Most abundant, versatile, and highly branched glial cells
▪ Radiating processes cling to neurons and their synaptic endings,
and cover capillaries

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Neuroglia in the CNS… Neuroglia in the CNS…

I. Astrocytes I. Astrocytes
Functionally, they: Functionally, they:
▪ Create “blood-brain barrier ▪ Aid synapse formation
▪ Support and brace neurons ▪ Connected by gap junctions, astrocytes can themselves respond to
▪ Anchor neurons to their nutrient supplies and supply nutrients nearby nerve impulses.
themselves to neurons ▪ Stimulate the formation of scar tissue secondary to CNS injury
▪ Guide migration of young neurons

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Histology of Nervous Tissue Histology of Nervous Tissue

II. Microglia Cells: Immune defense III. Ependymal Cells: Cerebral Spinal Fluid
▪ Microglia – small, ovoid cells with spiny processes ▪ Line the ventricles of the brain and the spinal cord canal
▪ Processes touch nearby neurons ▪ Often ciliated
▪ Migrate toward neurons when they are in trouble and ▪ Range in shape from squamous to columnar
“transform” into macrophage-like cell that phagocytize ▪ Play a role in production, transport, and circulation of the
microorgansims and neural debris CSF (cerebral spinal fluid )
▪ Important because cells of the immune system are denied
access to the CNS

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Histology of Nervous Tissue Histology of Nervous Tissue

IV. Oligodendrocytes
V. Schwann Cells, and Satellite Cells
▪ Branched cells that wrap around CNS nerve fibers
▪ Schwann cells (neurolemmocytes) – surround fibers of
▪ Create myelin sheath around axons of neurons in the CNS. the PNS & forming myelin sheaths.
▪ Myelinated axons transmit impulses faster than ▪ Satellite cells Surround neuron cell bodies within ganglia
unmyelinated axons of PNS. Function is similar to that of astrocytes
➔these are the 2 types of neuroglia in the PNS

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Neurons (Nerve Cells)

Histology of Nervous Tissue
Neurons (Nerve Cells)
▪ Structural units of the nervous system ▪ Most neurons consist of three parts
▪ Conduct nerve impulses from one part of the body to • Cell body (perikaryon)
another • Dendrites
Characteristics: • Axon
▪ Extreme longevity- can function for up to 100+ years!
▪ Amitotic- lose ability to divide. Can not be replaced
✓ Exceptions: olfactory and hippocampal (memory) cells
▪ High metabolic rate. Require abundant supplies of O2
& glucose

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Cell body (perikaryon or soma) Dendrites

▪ The control center of the neuron
▪ Contains ▪ Numerous short processes that extend from the
• a large nucleus with a well-developed nucleolus,
lysosomes, Mitochondria, Golgi complex, free ribosomes perikaryon.
▪ Cytoplasm of Cell body also contains
• Chromatophilic substance or Nissl bodies ▪Divide like the branches of a tree
•prominent clusters of rough endoplasmic reticulum ▪Are unmyelinated
•Neurofibrils – intermediate filaments & microtubules
•lipofuscin - a pigment , consists of residual bodies left from ▪Carrying input from other neurons.
lysosomal digestion that occurs as clumps of yellowish brown
granules
▪ Nerve fiber - is a general term for any neuronal process
(axon or dendrites)

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Axon Axon Con’

▪ A cylindrical process varies in length and diameter ▪ Axolemma - The plasma membrane of the axon
according to the type of neuron ▪ Axoplasm = cytoplasm of axon
▪ Initial segment - The region of the axon b/n the apex
▪ Originates from the axon hillock, a pyramid-shaped of the axon hillock and the beginning of the myelin
region, arising from the perikaryon sheath
▪ Node of ranvier – part of axon not covered by
▪ Each neuron has only one axon myelinsheath
▪ axon carries impulses from the cell body ▪ Terminal arborizations - many small branches at the
ends of axons
▪ axon can be myelinated or unmyelinated ▪ Bouton (end bulbs) - a swollen end that contains
▪ Collateral branches branch of Axons closer to the neuro trnsmitters
➔forms a functional connection (synapse) with another
cell bodies neuron or other cell.
➔connect to other groups of cells
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Neurotransmitters Classification of Neurons

▪ Chemical messengers Based on function
▪ can be excitatory or inhibitory
▪ More than 100 neurotransmitters Sensory (afferent) neurons
e.g. acetylcholine , norepinephrine • convey impulses from receptors to the CNS.

Motor (efferent) neurons

Myelin sheath • convey impulses from the CNS or ganglia to effector cells.
▪ a multilayered lipid and protein covering around some
Interneurons (intercalated neurons)
axons
• form a communicating and integrating network b/n
Function
the sensory and motor neurons.
▪ insulates axons
• most numerous, more than 99.9%
▪ increases the speed of nerve impulse conduction

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Classification of Neurons
Based on structure
▪ According to the number of processes extending from the cell
body
1. Multipolar neurons
- which have one axon & two or many dendrites
- eg. Motor neurons and interneurons

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Classification of Neurons Con’ Classification of Neurons Con’

2. Bipolar neurons 3. Unipolar or pseudounipolar neurons
▪ with one dendrite and one axon ▪ Have a single process that bifurcates close to the perikaryon
▪ are rare , associated with the receptors for the special ▪ The longer branch extending to a peripheral ending and the
sense organs e.g sensory neurons in the retina and other toward the CNS
nose ▪ Sensory neurons located close to the CNS
▪ e.g. Found in dorsal root ganglia

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Classification of
Neurons Con’ Synapses
▪ Neurons communicate with other neurons and
with effector cells by synapses.

Types:
▪ Axosomatic
▪Axodendritic
▪Axoaxonic

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Central Nervous System(CNS) Protection of the Central Nervous System

▪ Scalp and skin
▪Principal structures of the CNS are: ▪ Skull and vertebral column
• Brain and ▪ Meninges
• Spinal cord ▪ Cerebrospinal fluid (CSF)
▪ Blood-brain barrier
Terms
Ganglion - a collection of cell bodies located outside the CNS
Nucleus - a collection of cell bodies located inside the CNS
Nerve – group of fibers(axons) outside of CNS
Tract - group of fibers inside CNS

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Meninges Meninges
▪ are a connective tissue membranes that cover and ▪ Dura mater
protect the brain and spinal cord
➢ The cranial dura mater is a double-layered structure
▪ They are three layers from outside to inside ✓ Periosteum- thicker outer layer adheres tightly to the
respectively cranium.
▪ Dura mater (outer layer) ✓ Meningeal layer- the inner layer and it extends up to
S2.
▪ Arachnoid mater (Middle layer)
 Two layers are fused except to enclose the dural sinuses
▪ Pia mater (Inner layer)
 Superior sagittal sinus - largest sinus
• Subarachnoid space - space b/n pia & arachnoid, contains CSF ➢ The spinal dura mater is single layered and is similar to the
• Potential spaces- menigeal layer of the cranial dura mater.
– Epidural space
– subdural space

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Meninges Meninges
 The brain’s dura mater extends inward to form flat partitions
▪ Dura mater that
✓ subdivide the cranial cavity and
➢ The cranial dura mater is a double-layered structure
✓ limit movement of the brain within the cranium.
✓ Periosteum- thicker outer layer adheres tightly to the
 These partitions, include:
cranium.
✓ Meningeal layer- the inner layer and it extends up to 1. Falx cerebri: it lies in the longitudinal fissure between the

S2. cerebral hemispheres. It attaches anteriorly to the crista galli

of the ethmoid bone.
 Two layers are fused except to enclose the dural sinuses
2. Falx cerebelli: Continuing inferiorly from the posterior
 Superior sagittal sinus - largest sinus part of the falx cerebri. It runs along the vermis of the
➢ The spinal dura mater is single layered and is similar to the cerebellum in the posterior cranial fossa.
menigeal layer of the cranial dura mater. 3. Tentorium cerebelli. Resembling a tent over the
cerebellum, this almost horizontal sheet lies in the
transverse fissure between the cerebrum and cerebellum.
The transverse sinus is enclosed by the tentorium cerebelli.
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Meninges Meninges
▪ Arachnoid layer/ Middle Web-like layer
▪ Forms a loose brain covering
▪ Subarachnoid space; Filled with CSF and large blood vessels
▪ Arachnoid villi
✓ Projections of the arachnoid membrane
✓ Protrude superiorly
✓ Allow CSF to be absorbed into Dural blood sinuses
▪ Pia mater/ Internal layer
▪ Clings to the surface of the brain
✓ Follows all convolutions of the cortex
▪ Highly vascular & delicate connective tissue
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The Ventricular System & CSF

Cerebrospinal Fluid (CSF)  Ventricles are a series of interconnecting chambers in each
▪ Similar to blood plasma composition Cerebral Hemisphere, Diencephalon, & Brain Stem.

▪ Formed by the choroid plexus about 500 ml per day  Ventricular System consist of:
▪ Forms a watery cushion to protect the brain  Left & right lateral ventricles (separated by septum
pellucidum) third ventricle & fourth ventricle.
▪ Circulated in arachnoid space, ventricles, and central canal of
the spinal cord
 Communication b/n ventricles thru:
 Function  Interventricular foramen (of Monro)

▪ Protection (buoyancy) - the brain & spinal cord  Cerebral Aqueduct

▪ transports nutrients, chemical messengers, & waste  Foramen of Magndie

▪ diagnostic role  Foramina of Luschika

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Ventricles and Location of

Ventricles and Location of the Cerebrospinal Fluid
the Cerebrospinal Fluid

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Hydrocephalus in a Newborn Blood-Brain Barrier

▪ Hydrocephalus ▪ Separate bloodborne substances from neurons.
✓ CSF accumulates and exerts pressure on the brain if not ▪ It is formed by:
allowed to drain
– Continuous endothelium of capillary walls (the least
permeable)
– Relatively thick basal lamina
– Bulbous feet of astrocytes
▪ Excludes many potentially harmful substances
▪ It is ineffective against some substances
✓ Fats and fat soluble molecules
✓ Respiratory gases, Alcohol, Nicotine & Anesthesia

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Central Nervous System (CNS)

▪ CNS develops from the embryonic neural tube
➢ The neural tube becomes the brain and spinal cord
➢ The opening of the neural tube becomes the ventricles
✓ Four chambers within the brain
Central Nervous System
✓ Filled with cerebrospinal fluid (CNS)

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Regions of the Brain Regions of the Brain: Cerebrum

▪ Cerebral Hemispheres (Cerebrum)
 The Brain
- lies within the cranial vault ▪ Paired (left and right) superior parts of the brain
- It consists of: ▪ are connected internally by the corpus callosum
. Cerebrum ▪ It accounts for about 80%
. Diencephalons ▪ The surface is made of ridges (gyri) and grooves (sulci)
. Brain stem ▪ Meninges called the falx cerebri extends into the
. Cerebellum longitudinal fissure.
 Based on embryonic dev’t, subdivided as: ▪ Each hemisphere contains a central cavity, called the
- Forebrain (cerebrum and diencephalons) lateral ventricle
- Midbrain ▪ is responsible for the higher mental functions including
- Hindbrain (cerebellum, pons, and medulla). memory and reason

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Regions of the Brain: Cerebrum

Cerebral Hemispheres (Cerebrum) Regions of the Brain: Cerebrum
 It is composed of a superficial cerebral cortex of gray matter,
the cerebral white matter internal to it, and the deep gray matter
of the cerebrum within the white matter.
I. Cerebral cortex
 The surface layer is composed of gray matter (nerve cell
bodies.)
 Gray matter is formed by neurons, dendrites & their unmyelinated
fibers.
 It is the “executive suite” of the nervous system, the home
of the “conscious mind.”
 Has numerous folds and grooves called convolutions.
 The elevated folds of the convolutions are the cerebral gyri
(singular, gyrus)
 The grooves are the cerebral sulci (singular, sulcus).
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Regions of the Brain: Cerebrum

II. White matter… Regions of the Brain: Cerebrum
 Beneath the cerebral cortex
 It is formed mostly by myelinated axons and bundled into
large tracts interconnecting different regions of the CNS.
 The fibers are classified as:
1. Commissural fibers interconnect corresponding gray
areas of the right and left cerebral hemispheres.
E.g. Corpus callosum; is the largest commissure.
2. Association fibers connect different parts of the same
hemisphere.
3. Projection fibers either descend from the cerebral cortex
to more caudal parts of the CNS or ascend to the cortex
from lower regions.
 E.g. internal capsule & corona radiata

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Cortical Areas of the Cerebrum Con’ Cortical Areas of the Cerebrum Con’
Sensory areas:
▪ Cerebral cortex has three functional areas: o Receive & process info. from sensory structures.
✓ Sensory area: which allow conscious awareness of o Parts of cortex that receive sensory inputs from thalamus are
sensation; called primary sensory areas (eg. Postcentral gyrus).
✓ Motor area: which control voluntary motor functions o Senses of vision➔ primary visual cortex (occipital pole: A17),
✓ Association area; which integrate diverse information to o Senses of audition ➔primary auditory cortex: (A 41 & 42) &
enable purposeful action o Senses of pain, temperature, touch➔ primary
somatosensory cortex (A3,1,2 ➔ PCG).
NB. In general, the two hemispheres receive information from
opposite sides of the body
➔ For example Rt primary somatosensory cortex receives
information from Lt limbs & vice versa.

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Cortical Areas of the Cerebrum Cortical Areas of the Cerebrum Con’

2. Motor areas:
▪ located in both cerebral hemispheres.
▪ shaped like a pair of headphones stretching from ear to
ear.
➔ related to control of voluntary movements, especially fine
movements performed by the hand.
• Rt half of motor area controls Lt side of the body & vice
versa.
Two areas of cortex are commonly referred to as
motor:
1. Primary Motor Cortex:➔ executes voluntary
movements
2. Supplementary motor areas/premotor cortex, which
select or plan voluntary motor movements.
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Cortical Areas of the Cerebrum Cortical Areas of the Cerebrum Con’

3. Association areas:
▪ Interpretation of sensory info./function to produce a
meaningful perceptual experience of the world➔ abstract
thinking & understanding language.

▪ Sensory Association areas are found in parietal, temporal,

& occipital lobes.
▪ language abilities localized in association areas of parietal-
temporal-occipital complex, typically in Lt hemisphere.

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Cortical Areas of the Cerebrum

Regions of the Brain: Cerebrum Frontal lobe:
Lobes of the cerebrum
▪ From the central sulcus to the frontal pole
Fissures (deep grooves) divide the cerebrum into lobes
• Higher level of cognitive functions ➔ like reasoning &
 The central sulcus (fissure of Rolando) judgment.
 b/n the frontal lobe and the parietal lobe. • Frontal lobe contains cortical areas involved in control of
 The lateral sulcus (fissure of Sylvius) voluntary muscle movement, such as those for speech
▪ b/n the frontal and temporal lobes. & swallowing.
▪ Surface lobes of the cerebrum
▪ Frontal lobe
▪ Parietal lobe
▪ Occipital lobe
▪ Temporal lobe &
▪ Insula
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Cortical Areas of the Cerebrum

Cortical Areas of the Cerebrum Temporal lobe:
Parietal lobe: ➢ located below the parietal lobe and the posterior
➢From the central sulcus to the occipital lobe
portion of the frontal lobe.
➢Lies superior to the temporal lobe and posterior to the
➢ is separated from frontal lobe by the lateral sulcus.
central sulcus.
➢ extends from the temporal pole to the occipital lobe,
Functions :
➢Receives and integrates somatosensory information. ➢ extends from the lateral sulcus to the collateral sulcus.

➢Such as touch, pressure, vibration, pain & temperature. ➢ contains auditory centers that receive sensory fibers

➢The postcentral gyrus or the primary sensory area from the cochlea of the ear
(B3, 1 & 2) is immediately posterior to central sulcus. Primary Auditory Area (B41 & 42):
 is the area where sound first reaches the brain ➔ known
as primary auditory area.
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Brain Stem
Cortical Areas of the Cerebrum • Made up of:-
– Medulla oblongata
Occipital lobe:
– Pons &
➢ lies posterior to the parieto-occipital sulcus and – Midbrain
superior to the cerebellum • It occupies posterior cranial fossa
• Connect spinal cord with forebrain
➢ forms the posterior portion of the cerebrum.

➢ contains the visual cortex

➢ The principal function of the occipital lobe is

concerned with vision.

Primary visual area (B17):
Secondary /Association Visual Areas (B18 & 19):

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Brain Stem Brain Stem

 The brainstem has three broad functions:

1) Serves as a conduit for ascending & descending tracts

2) Contains important reflex centers associated with the

control of respiration and cardiovascular system and
– It deals with autonomic functions (heart rate, blood
pressure, respiration, reflex arc, vomiting, bowel
movement)

3) Contains the important nuclei of CN III to XII.

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Cerebellum/Little Brain Cerebellum/Little Brain

▪ The 2nd largest part of brain
• Location: • Important role in integration of sensory perception &
motor control.
– Posterior cranial fossa • To coordinate motor control of movement, there are many
– Inferior to occipital lobe & Tentorium Cerebelli; posterior neural pathways linking cerebellum with:
to Pons & Medulla oblongata ✓ Cerebral motor cortex (which sends info. to muscles),
– Posterior to 4th ventricle, pons &medulla ✓ Spinocerebellar tract (which provides proprioceptive
feedback on body position in space) &
• Overlaps posterior surface of midbrain, pons & medulla
✓ Vestibular System.
• Consists of two hemispheres, connected by the Vermis (central
portion).
➔Cerebellum integrates these pathways using constant
feedback on body position to fine-tune motor movements.

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Cerebellar Peduncles Blood supply of brain

• Cerebellum Connected to posterior part of brain stem by three
bundles of nerve fibers ➔ Cerebellar Peduncles (CPs). ▪ Two pairs of vessels
✓ Vertebral and
1. Superior Cerebellar
Peduncle (SCP): ✓Internal carotid arteries
➔Connect ➔ interconnected in the cranial
Cerebellum with
Midbrain cavity to produce an arterial circle
2. Middle Cerebellar (of Willis).
Peduncle (MCP):
➔Is the largest &
Connects Cerebellum
with the Pons
3. Inferior Cerebellar
Peduncle:➔Connect
Cerebellum with the
Medulla
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Blood supply of brain Blood supply of brain

Vertebral arteries
▪ arises from the first part of each
subclavian artery
▪ Branches
✓ anterior spinal artery
✓ posterior spinal artery
✓ posterior inferior cerebellar
artery

Internal carotid arteries

 Branches
• ophthalmic artery,
• posterior communicating artery
• middle cerebral artery and
• anterior cerebral artery

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Spinal Cord Spinal Cord

➢ The spinal cord is roughly cylindrical in

shape.

➢ It extends from foramen magnum upto

L1 (adult), L3 (child).

➢ It occupies the upper 2/3rd of the

vertebral column.

➢ Is about 45 cm in length

➢ Is surrounded by

✓ the meninges, CSF & vertebral bones

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Spinal Cord Anatomy Spinal Cord Anatomy

Has 2 enlargements:
➢In the cervical (C3-T2)
➢Lumbosacral (L1-S3) region

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Spinal Cord Anatomy… Spinal Cord Anatomy…

 Surface structures and sulci
 underlie the pia mater and include.
1.Ventral/ anterior median fissure
 is a deep ventral midline groove underlying the ventral
spinal artery
2. Dorsal/ posterior median sulcus
 is a shallow dorsal midline groove that is continuous with
the dorsal median septum
3.Ventral lateral sulcus
 is a shallow groove from which the ventral rootlets emerge.
4. Dorsal lateral sulcus
◦ is a shallow groove into which the dorsal rootlets enter

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Spinal Cord Anatomy…

➢ Structures suspend and anchor the spinal cord within the
dural sac:
1. Denticulate ligaments
2. Filum terminale &
3. Spinal nerve roots Peripheral Nervous System
(PNS)

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Peripheral Nervous System (PNS)

Peripheral Nervous System (PNS)
▪ Portion of the nervous system outside the CNS.
▪ Unlike the CNS, the PNS is not protected by bone,
leaving it exposed to toxins & mechanical injuries.
▪ Functionally, the PNS is divided into somatic nervous
system & autonomic nervous system.
▪ The PNS functions to convey impulses to and from the
brain or spinal cord.

▪ Fig. Functional organization of the peripheral nervous system (PNS)

and its relation to central nervous system (CNS). 96

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Peripheral Nervous System (PNS) Peripheral Nervous System (PNS)

The Autonomic Nervous System (ANS) Consist The motor part of the ANS consists of two
of: branches
➢ Sensory neurons- convey information from autonomic ➢ sympathetic division
sensory receptors, located primarily in visceral organs ➢ parasympathetic division.
to CNS

➢ Motor neurons- conduct impulse from CNS to

smooth muscle, cardiac muscle and glands- involuntary ➔With few exceptions, effectors receive nerves from both
divisions, and usually they have opposing actions

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Peripheral Nervous System (PNS) Peripheral Nervous System (PNS)

❖ Sympathetic Nervous System Both ANS divisions share the same general structure.
 “Fight or Flight” • Autonomic pathways always consist of 2 neurons in series.
 Exercise, excitement, emergency, embarrassment and ➔They synapse in an autonomic ganglion
ejaculation ✓ The 1st neuron in the autonomic pathway is the preganglionic
❖ Parasympathetic Nervous System neuron,
 “Rest and Digest” ➔Cell body in CNS, myelinated, and projects to the
 Digestion, defecation, and diuresis and erection of clitoris autonomic ganglion.
and penis ✓ While the 2nd neuron is the postganglionic neuron.
➔Cell body in autonomic ganglion, unmyelinated, and
projects to the effector.

99 100

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Sympathetic vs Parasympathetic Sympathetic vs Parasympathetic

Point of CNS T1 -L2 Brainstem,

Origin (thoracolumbar) S2 - S4
(craniosacral)

Site of Peripheral Paravertebral – in On or near target

Ganglia sympathetic chain tissue
Length of Short Long
preganglionic fiber
Length of Long Short
postganglionic fiber

101 102

Sympathetic vs Parasympathetic Sympathetic vs Parasympathetic

103 104

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Peripheral Nervous System (PNS)

PNS: Structure of a Nerve
▪ The PNS includes
▪ Endoneurium surrounds
• 12 pairs of Cranial nerves each fiber
• 31 pairs of Spinal nerves & ▪ Groups of fibers are bound
• Ganglia outside the central nervous system into fascicles by
perineurium
▪ Nerve = bundle of neuron fibers
▪ Fascicles are bound
▪ Neuron fibers are bundled by connective tissue together by epineurium

105 106

PNS: Cranial Nerves PNS: Cranial Nerves…

▪ Cranial nerves
▪ 12 pairs of cranial nerves.
▪ All are distributed in the head & neck, except CN-X (extend
to thoracic and abdominal cavities)
▪ All nerves except CN-XI originate from the brain.
▪ The cranial nerves are designated by roman numerals
▪ Their names indicate the structures innervated or the
principal functions of the nerves

107 108

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PNS: Cranial Nerves

Cranial nerves exiting the cranial cavity thru foramen

109 110

Classification of cranial nerves Cranial Nerve I: Olfactory

According to their functional neuronal components:  Arises from the olfactory epithelium
▪ Some have only sensory neurons:  Passes through the cribriform plate of the ethmoid bone
• CN -I, the olfactory nerve, concerned with smell  Fibers run through the olfactory bulb and terminate in
• CN -II, the optic nerve, which deals with vision the primary olfactory cortex
• CN –VIII, the vestibulo-cochlear nerve, concerned with  Functions solely by carrying afferent impulses for the
hearing and equilibrium. sense of smell
▪ Some others are composed only of motor neurons:
• CN –III, CN –IV, CN –VI, CN –XI & CN –XII.
▪ Others are composed of mixed neurons:
• CN –V, CN –VII, CN –IX & CN –X.

111

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Cranial Nerve I: Olfactory Cranial Nerve II: Optic

 Arises from the retina of the eye
 Optic nerves pass through the optic canals and
converge at the optic chiasm
 They continue to the thalamus where they synapse
 From there, the optic radiation fibers run to the
visual cortex
 Functions solely by carrying afferent impulses for
vision

Figure I from Table 13.2

Cranial Nerve II: Optic Cranial Nerve III: Oculomotor

 Fibers extend from the ventral midbrain, pass through
the superior orbital fissure, and go to the extrinsic
eye muscles
 Functions in raising the eyelid, directing the eyeball,
constricting the iris, and controlling lens shape
 The latter 2 functions are parasympathetically
controlled
 Parasympathetic cell bodies are in the ciliary ganglia

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Cranial Nerve III: Oculomotor Cranial Nerve IV: Trochlear

 Fibers emerge from the dorsal midbrain and enter the
orbits via the superior orbital fissures; innervate the
superior oblique muscle
 Primarily a motor nerve that directs the eyeball

Cranial Nerve IV: Trochlear Cranial Nerve V: Trigeminal

 Composed of three divisions
 Ophthalmic (V1)
 Maxillary (V2)
 Mandibular (V3)

 Fibers run from the face to the pons via superior orbital fissure
(V1), foramen rotundum (V2), & foramen ovale (V3)

 Conveys sensory impulses from various areas of the face (V1)

and (V2), and supplies motor fibers (V3) for mastication

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Cranial Nerve V: Trigeminal Cranial Nerve VI: Abducens

 Fibers leave the inferior pons and enter the orbit via the
superior orbital fissure
 Primarily a motor nerve innervating the lateral rectus
muscle (abducts the eye; thus the name abducens)

Cranial Nerve VII: Facial Cranial Nerve VII: Facial

 Fibers leave the pons, travel through the internal acoustic
meatus, and emerge through the stylomastoid foramen to
the lateral aspect of the face
 Motor functions include;
 Facial expression
 Transmittal of parasympathetic impulses to lacrimal and
salivary glands (submandibular and sublingual glands)
 Sensory function
 is taste from taste buds of anterior two-thirds of the
tongue

Figure VII from Table 13.2

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Cranial Nerve VIII: Facial Nerve Cranial Nerve VIII: Vestibulocochlear

Bell’s palsy:  Fibers arise from the hearing and equilibrium apparatus of the
 Paralysis of facial muscles on affected side
and loss of taste sensation inner ear, pass through the internal acoustic meatus, and enter
 Caused by herpes simplex I virus the brainstem at the pons-medulla border
 Corner of mouth sags
 Two divisions – cochlear (hearing) and vestibular (balance)
 Tears drip continuously and eye cannot
be completely closed (dry eye may occur)  Functions are solely sensory – equilibrium and hearing
 Paralysis of buccinators lead to accumulation of food in the
vestibule
 Test by asking patients to smile or to whistle
• loss of muscle tone causes the normal skin folds
disappear on the side of the lesion

Cranial Nerve VIII: Vestibulocochlear Cranial Nerve IX: Glossopharyngeal

 Fibers emerge from the medulla, leave the skull via the jugular
foramen, and run to the throat

 CN IX is a mixed nerve with motor and sensory functions

 Motor – innervates part of the tongue and pharynx, and

provides motor fibers to the parotid salivary gland

 Sensory – fibers conduct taste and general sensory impulses

from the tongue and pharynx

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Cranial Nerve IX: Glossopharyngeal Cranial Nerve X: Vagus

 The only cranial nerve that extends beyond the head and neck
 Fibers emerge from the medulla & leave via the jugular
foramen
 The vagus is a mixed nerve
 Most motor fibers are parasympathetic fibers to the heart,
lungs, and visceral organs
 Its sensory function is in taste
 Paralysis leads to hoarseness
 Total destruction incompatible with life

CN X: Vagus Cranial Nerve XI: Accessory

 Formed from a cranial root emerging from the medulla and
a spinal root arising from the superior region of the spinal
cord
 The spinal root passes upward into the cranium via the
foramen magnum
 The accessory nerve leaves the cranium via the jugular
foramen
 Primarily a motor nerve

 Supplies fibers to the larynx, pharynx, and soft palate

 Innervates the trapezius and sternocleidomastoid, which

move the head and neck

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Cranial Nerve XII: Hypoglossal

Cranial Nerve XI: Accessory
 Fibers arise from the medulla and exit the skull via the
hypoglossal canal

 Innervates both extrinsic (except?) and intrinsic

muscles of the tongue, which contribute to swallowing
and speech

 If damaged, difficulties in speech and swallowing;

inability to protrude tongue

Cranial Nerve XII: Hypoglossal PNS: Distribution of Cranial Nerves

136

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Summary of Function of Cranial Nerves Spinal nerves(SN)

 31 pairs of spinal nerves connecting the spinal cord.
 All are mixed nerves have both sensory and motor
neurons
▪ 8 pairs of cervical nerves (C1-C8)
▪ 12 pairs of thoracic nerves (T1-T12)
▪ 5 pairs of lumbar nerves (L1-L5)
▪ 5 pairs of sacral nerves (S1-S5)
▪ 1 pair of coccygeal nerves (Co1)

138

Components and branches of SN

Components and branches of SN

The SN is formed by the union of dorsal and ventral roots

resulting in a mixed nerve.
1. Dorsal root
➢ Cell bodies – located in the dorsal root ganglion
➢ conveys sensory input from the body
2.Ventral root
➢ convey motor output to visceral and somatic motor
neurons.
➢ joins the dorsal roots to form the spinal nerve
▪ AND then the spinal nerve branched in to dorsal (
supply dorsal part of the body) and ventral rami
139 140

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Spinal nerve plexus Cervical plexus

Nerve plexus ▪ Formed by the anterior rami of the nerves C1 - C4 and a
•A network of ventral rami (except T2-T12) form nerve plexuses
portion of C5.
•No plexus formed in thoracic region of spinal cord
➢ Branches of this innervate the skin and muscles of the neck,
4 Major Nerve Plexuses and portions of the head and upper part of the shoulders.
• Cervical plexus  E.g. Fibers from C3, C4, and C5 unite to form the phrenic nerve
• Brachial plexus (C3-C5) which innervates the diaphragm thereby causing it to
• Lumbar plexus
contract during inspiration
• Sacral plexus

141 142

Brachial plexus
Brachial plexus
• Formed by ventral rami of spinal nerves C5-T1 • Formed by ventral rami of spinal nerves C5-T1
• Five ventral rami form • Five ventral rami form
– three trunks that separate into – three trunks that separate into
– six divisions that then form
– six divisions that then form
– cords that give rise to nerves
– cords that give rise to nerves
• Major nerves
• Major nerves – Axillary
– Axillary – Radial
– Radial – Musculocutaneous
– Musculocutaneous – Ulnar
– Ulnar – Median
– Median

143 144

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Brachial plexus Lumbar plexus

 It’s formed by the anterior rami of spinal nerves (L1 - L4)
It’s formed by the anterior rami ➔C5 – C8 and T1  Major nerves include
❖ Five major nerves  Femoral nerve
➢ Axillary- deltoid , teres minor  Obturator nerve

➢ Radial- posterior compartments of the arm & forearm

➢ Musculocutaneous- anterior compartments of the arm
➢Ulnar -innervates muscles of anterior medial
compartments of the forearm
➢Median nerves- anterior lateral compartments of the
forearm and some portion of the hand

145 146

Lumbar plexus Sacral plexus

 Sacral plexus: formed by ventral rami of L4-S4
Obturator nerve  Major nerve = Sciatic nerve (actually 2 nerves in one sheath)
 Motor components  Tibial nerve
 Innervate adductor group and gracilis in thigh  Common fibular (peroneal) n.
 Sensory: Skin of the superior middle side of thigh
Femoral nerve
 Motor components
 Innervates flexors of hip
 Iliopsoas (Iliacus and psoas), rectus femoris
 Innervates extensors of knee
 Quadriceps group-Vastus and rectus femoris
 Sensory: Skin- anterior and lateral thigh; medial leg and foot
147 148

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The sciatic nerve The sciatic nerve

▪ Is the thickest & largest nerve in the body.
▪ Innervates posterior thigh and entire lower leg
Common fibular nerve
▪ It’s composed of two nerves-  Branches are deep and superficial fibular (peroneal) nerves
✓ tibial & common fibular nerves. Innervates
Tibial nerve  anterior and lateral muscles of the leg and foot
Innervates Skin distribution: lateral and anterior leg and dorsum of the
o Hamstring muscles foot
 susceptible to injury because of its superficial location at the
o Posterior leg muscles
head and neck of the fibula
Branches in foot to form - Foot drop (unable to hold foot horizontal)
o medial plantar nerve - Toes drag while walking
o lateral plantar nerve
If injured, paralyzed calf muscles cannot plantar flex foot;
shuffling gait develops
150

Other Nerves of the Lumbosacral Plexus

Coccygeal Plexus
 Nerves that innervate the skin of the suprapubic area, external
genitalia, superior medial thigh, posterior thigh • S4-S5; coccygeal nerve
 Iliohypogastric nerve
 Innervates muscles of abdominal wall and pubic region • Muscles of pelvic floor
 Genitofemoral nerve
• Sensory information from skin over coccyx
 Skin of scrotum (males) and labia (females); inferior abdominal
muscles
Pudendal nerve
 Innervates muscles and skin of the perineum
 region encompassing external genitalia and anus
 External anal sphincter
 Stimulates muscle involved in developing an erection
 Involved in voluntary control of urination
 The “shameful” nerve
151 152

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