Clinical Neuroscience

Topic1: Organization of Nervous System (Dr. Poblete)

Overview:
A. Central Nervous System
1. Brain
- Supratentorial structures
o
Cerebrum
- Infratentorial structures
o
Cerebellum
foramen magnum
o
Brainstem
separates the lowermost
portion of medulla from the

Midbrain

Pons spinal cord

Medulla
2.

B.

Spinal cord
- Begins after the f. magnum and ends at L1 (conus
medullaris)
- Covered by meninges
- Has 31 spinal nerves
o
8 cervical (although there are only 7 cervical segments)
o
12 thoracic
o
5 lumbar (conus medullaris)
o
5 sacral (conus medullaris)
o
1 coccygeal

Peripheral Nervous System

Has 3 functions
o
Motor
o
Sensory
o
Parasympathetic
Based on the cranial nerve (CN) netter na lang
CN
1
2

Olfactory bulb/tract
olfactory nerves
Optic

Extraocular muscles

Trochlear

5
6
7

Sensory and motor to face

Extraocular muscles
Facial movement; taste
(tongue)
Hearing
Pharyngeal muscles
Pharyngeal muscles
SCM
Tongue

8
9
10
11
12

Notes
Cerebrum level
Found beneath
cerebrum
(supratentorial)
(Infratentorial)
Located in midbrain
- Only CN exiting
from the back
- Located in midbrain
Pons

Medulla

Lecture per se:

A. PNS
Cervical enlargement
Lumbar enlargement

Roots
contribute

L1-S2

Lumbosacral
plexus

BRAINSTEM:
Medulla cell layers
Anterior
Basalis
Motor pathway

From cerebrum

crura cerebri

Neurotransmitter: Ach
Postganglionic: short
Neurotransmitter: Ach

Middle
Tectum
thalamic nucleus
specific for hearing
send projections to
superior colliculi,
via inferior
quadrigeminal
brachium
relay center for
auditory pathway
inferior colliculi

Posterior
Tegmentum
Has nuclei of cranial
nerves;
substantia nigra
periaqueductal grey

Exit of CN4
Ventral to cerebral
aqueduct

Emphasis:
1.
Thalamus above midbrain/hypothalamus
Level of cerebrum, deviates of diencephalon
Encloses 3rd ventricle
Sensory pathways (afferent) on the way to
Cerebral cortex w/o passing thalamus?
V-shaped: Int. Medullary Lamina
Ant.MedialLat. Nucleus (relay nucleus)
2.
Fornix above midbrain
3.
Corpus callosum connects frontal L lobe to frontal R lobe
Association fibers or commissural fibers
4.
Cingulate gyrus part of limbic system w/c goes to (#5)
5.
Hypothalamus supra = origin of releasing hormone
Autonomic, endocrine fxn
Amygdala: limbic system
6.
Pituitary infra
7.
Optic chiasm
C. Neurons and Ganglia
Neurons have 2 types of cells
Neurons generate electrical impulses
Nerve cell body/soma/perikaryon
Dendrite (afferent)
Function: membrane is electrically active, forming
Synapses
a.
b.
c.
d.
e. pyramidal cells
f. purkinje
neuroglia astrocytes > oligodendrites > microglia
(BBB)
( myelin)
(phagocytic)

Spinal Nerves
C5-T1

Neurotransmitter: Ach
Postganglionic: long
Neurotransmitter: norepinephrine
Except sympathetic to sweat glands
which secrete Ach

Brachial plexus:
- Nerve roots c5-T1
- To upper extremities
- Sensory/motor/autonomic damage
(Manifests in upper extremities)
- L1-S2 roots
- All belong to PNS
- Conus medullaris at L1 (lumbar puncture
done below L1)

Nerves can regenerate

CNS cant regenerate
B. ANS
Somatic Nervous System = voluntary control
Autonomic Nervous System = Internal Organs/glands
Smooth, cardiac, glands
Endocrine, homeostatic organs

Originate from CNS, has peripheral components

Sympathetic
Thoracolumbar (paravertebral
ganglia) = origin of sympathetic
autonomic outflow
Lateral horn
Intermediolateral cell column (IML)
uses Ach neurotransmitter to send
sympathetic preganglionic signals to
paravertebral ganglia
Preganglionic: short

Parasympathetic
From brainstem and sacral (called:
craniosacral)
CN 3: pupilllary constriction
CN 7: salivation
CN 9: salivation (parotid gland)
CN 10: vagus (controls thoracic
organs)

Preganglionic: long

Blood brain barrier (BBB) Astrocytes have end feet also known as glial
feet which are attached to the basement membrane of capillaries (via
TIGHT JUNCTIONS).
D. White vs. Gray Matter
White Matter (axons, myelinated)
association fibers: horizontal
commissural fibers: ventral
projection fibers: ascending/descending fibers
Gray Matter (mostly nerve cell bodies: soma, perkaryon)
nuclei (CNS)
ganglion (PNS)
E. Cerebellum
Surface: focal areas w/ focal functions
Association area: integrate sensory info and initiate motor movements
Important: 2 hemispheres, 1 midline (vermis), and 1 floculonodular lobe
Cerebrovestibular pathway: cortex white nuclei
Nuclei (lateral to medial):
Dentate, Emboliform, Globus, Fastigius
Impulses: cortex nuclei exits cerebellum
Brainstem: Sup. Colliculi: cerebellum connected via peduncles
Inf. Colliculi
Superior peduncle oculomotor/trigeminal n. (pons/mdbrain)
Middle peduncle
hypoglossal n. (medulla)
Inferior peduncle
F. Basal Ganglia
1. caudate

2.
3.
4.

lenticular nucleus and globus pallidus

internal capsule-between caudate
subthalamic nucleus
substancia nigra

G. Limbic system
Hippocampus: belongs to limbic
Fornix attached to mamillary bodies
H. Spinal Cord
Outer white = posterior, lateral, anterior column
Inner gray =
IML = autonomic
Post. Gray horn = sensory
Ant. Gray horn = motor
Rexed Laminae
1-6 dorsal gray horn
7-9 ventral gray
I. Motor Pathway
J. Ventricles
K. CSF
L. Meninges
Subarachnoid space and Ventricles have CSF
M. Blood Supply and Venous Drainage
Internal Carotid & Vertebral arteries = most important arteries
Venous drainages = sinuses are derivations of dura