NERVOUS SYSTEM

The network of nerve cells and fibers which transmits nerve impulses
between parts of the body.
Consist of;
Central nervous System (CNS) and peripheral nervous system(PNS)
The CNS is the processing center of the body and consists of the brain
and the spinal cord. Both are protected by three layers of membranes
known as meninges.
Most systems and organs of the body control just one function, but the
CNS does many jobs at the same time. It controls all voluntary
movement, such as speech and walking and involuntary movements
such as blinking and breathing. It is also the core of our thoughts,
perceptions and emotions.
The PNS consists of the nerves and ganglia outside the brain and spinal
cord. It is divided into somatic nervous system and the autonomic
nervous system.
CENTRAL NERVOUS SYSTEM (CNS)
Brain and spinal cord
Carry into and from spinal cord - 31 spinal nerves (pair)
12 cranial nerves
Autonomic nerves - Sympathetic - fighter flight (stress),
Parasympathetic (rest and digest)

CRANIAL NERVES
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Functions: Sensation, integration, reaction

Olfactory Nerve: Perception of smell from the nasal cavity

Optic Nerve: vision of retina
Oculomotor nerve: Constricts pupil, accommodates lens
Trochlear nerve: Assists in turning of the eye inferior laterally
Trigeminal Nerve: Sensation from cornea, skin of scalp eyelid, nose and
mucosa of nasal cavity
Abducens Nerve: To turn the eye laterally
Facial Nerve: Taste, facial expression
Vestibulo cochlear Nerve: Vestibular sensation from the semicircular
ducts
Glossopharyngeal Nerve: Swallowing taste perception
Vagus Nerve: Connects lungs to stomach
Spinal Accessory Nerve: Motor supply to the sternocleidomastoid
(muscles behind neck) and trapezius muscles
Hypoglossal Nerve: Motor supply to the intrinsic and extrinsic muscles
of the tongue
Nervous System - CELLS
1. Neurons: which possess information
2. Neuroglia: Which provide the neurons with mechanical and
metabolic support
Neuron
Dendrites: receives signal
Cell body: nucleus, within cell body
Axon: Carries signal from cell body
Myelin sheath: Insulation around axon

Parts of Brain
-Cerebrum (cortex and medulla)
-Cerebellum
-Diencephalon
-Thalamus
-Hypothalamus
-Brain stem
-Mild brain
-Pons
-Medulla oblongata
Central lobes
1. Frontal, 2. Parietal, 3. Temporal, 4. Occipital

Parts of brain and Functions

Cerebrum -Thinking, reasoning, sensation, movement, memory
Thalamus - Relay Station for body sensations pain
Hypothalamus -Body temperature, sleep, appetite, emotions
Cerebellum -Co- ordination of voluntary movements
Pons -Connection of nerve fiber tracts
Medulla Oblongata- Nerve fiber crossover contains centers to regulate
heart blood vessels and respiratory system

Meninges (outer covering of brain)

The Meninges are three layers of protective tissue
1.Duramater (outer)
2.Arachnoid mater (middle)
3.Pia mater (inner)
Functions
Cover and protect brain and spinal cord
protect blood vessels
Contains cerebrospinal fluid
Cerebrospinal fluid: Fills the space between the arachnoid mater and
pia mater as well as the internal cavities of the brain (Ventricles) and
spinal cord
Functions: shock absorption, support, nourishment
Spinal cord: Spinal cord housed within vertebrate form medulla
oblongata to second lumbar

Pathology
Congenital Disorder
1. Hydrocephalus
It is caused by the excessive amounts of cerebrospinal fluid in the
ventricles of brain
 Circulation is impaired in the brain and further it compresses the
internal structures
● Treatment: surgical creation of ventriculo-peritoneal shunt,
Shunt - Artificial pathway

2. Spina Bifida
● It is a developmental birth defect that cause incomplete
development of spinal cord and its covering
● types - Spinal bifida occulta, spina bifida manifesta
● spina bifida manifesta ---> Myelomeningocele/Spina Bifida
cystica, Meningocele.
Infectious Disorders
1. Meningitis (Leptomeningitis)
 Inflammation of meningeal layers
 Caused by bacteria and virus
 Sign and symptoms: Meningeal irritation, headache,
photophobia
2. Shingle
 Viral infection affecting peripheral nerve
 Caused by herpes Zoster virus
Degenerative Movement and Seizure Disorder
1. Alzheimer's Disease
 most common type of dementia
 results in damage to neurons
 causes - Mostly unknown, perhaps genetic defect,
autoimmune reaction, virus
  Symptoms - Memory loss, speech disturbances, confusion,
restlessness, inability to complete activities of daily living
 Treatment: no care, drug has modest activities of daily living

2. Amyotrophic Lateral sclerosis (ALS)

 Disease of the nerve cells in the brain and spinal cord that
control voluntary muscle movement
 ALS is known as Lou Gehrig’s disease
 In about 10% of causes, ALS is caused by a genetic defect in
the remaining cases the cause is unknown
 Symptoms: difficulty in breathing, swallowing, muscle
spasm, paralysis, voice changes, weight loss, muscle
contraction and weakness
3. Multiple Sclerosis
 Common neurologic condition
 Demyelination of central nervous system replaced by
sclerotic tissue
 Affects young adults 20 - 40 years of old
 results in myelin destruction and gliosis of white matter
spasm, paralysis, voice changes, weight loss, muscle
contraction and weakness.
4. Myasthenia Gravis (Graves muscle weakness)
 Autoimmune neuromuscular condition antibodies block
neurotransmission to muscle cells
 Symptoms: muscle weakness and fatigability may be
localized or generalized
5. Parkinson’s Disease (Parkinsonism)
 o Decreased secretion of dopamine, typically occur after age
40 cause - unknown
o Symptoms - Muscle rigidity and weakness, bradykinesia -
slow voluntary movements, bradykinesia - slow voluntary
movements, shuffling gait, depression
o Treatment: Dopamine replacement

Epilepsy
 Recurrent seizure activity
 Seizure - Abnormal sudden discharges of electrical activity with in
the brain
 It is chronic brain disorder characterized by recurrent seizure
activity
1. Types tonic - clonic - grand mal or ictal seizure
2. Absence seizures - petit mal
Aura is a peculiar sensation experienced by the affecting
person before the onset of seizure

Neoplastic Disorders
1.Brian tumor
2. Glioma, meningioma, astrocytoma, oligo dentro cytoma (glial cells
affecting tumor) ependymoma

Traumatic Disorders
1.Cerebral concussion: It’s a type of traumatic brain injury caused
by the mild blow to the head
Changes are reversible, patient recovering within 24 hours
 2.Cerebral contusion
 There will be bruising of the brain tissue as a result of direct
trauma to the head
 there will be cerebral edema increased intracranial pressure,
cerebral hematoma
 Changes are irreversible

Vascular Disorder
1. Transient Ischemic Attack (TIA)
Temporary reduction of blood flow to brain that produce stroke like
symptoms but no lasting damage
Often warning sign of cerebrovascular accident
2. Cerebral Vascular Accident (CVA) or stroke
 Infarction of brain due to lack of blood/ oxygen flow
 necrosis of tissue with total occlusion of vessel
 Reasons - thrombotic - A clot
 Embolic – (mass travelling through blood eg: fat/lipids, blood
clot) A circulatory clot (that maybe air bubble, infectious
material)
 Hemorrhagic - rupture of blood vessel
Ataxia - Impaired balance of coordination
Paresis - A condition of muscular weakness caused by nerve
damage or disease
Palsy/Plegia
1. Monoplegia - one sided paralysis
2. Hemiplegia - anyone half paralysis of body either right or left
3. Paraplegia - Either upper part or lower part
 4. Quadriplegia - Four limbs paralysis
5. Bell’s Palsy - Unilateral facial paralysis

PROCEDURES
Laboratory Test
1.Cerebrospinal Fluid Analysis
Fluid is removed by a procedure lumbar puncture (LP) or spinal
tapping it is the removal of small amount of fluid that protect the brain
and spinal cord
The fluid is tested to detect any infection, hemorrhage or bleeding
Clinical Procedures
X-ray
Cerebral angiography
Computed Tomography (CT Scan)
Myelography imaging
PET - (Positron Emission Tomography)
Scan that provide 2 and 3 dimensional picture of brain activity by
measuring radioactive isotopes injected into blood
Other procedures
ELECTROENCEPHALOGRAPHY (EEG)
It is the recording of electrical activities of brain mainly done in seizure
brain tumor cases
Lumbar (Spinal) Puncture
Stereotactic Radiosurgery
Uses gamma knife (high energy radiation beams) to treat deep and
inaccessible brain tumors and blood vessels passes without any surgical
incision
Electromyography EMG
Used to diagnose nerve and muscle dysfunction and spinal cord
disorder
ABBREVIATIONS
ANS - Autonomic Nervous System
CNS - Central Nervous System
CSF - Cerebrospinal Fluid
CVA - Cerebrovascular accident or stroke
EEG - Electro encephalogram
PNS - Peripheral nervous system
TIA - Transient Ischemic attack