PHYSIOLOGY HIGHER FUNCTIONS OF THE NERVOUS SYSTEM & SLEEP PHYSIOLOGY

Dr. Bunag| May 7, 2015

*Anatomic basis of interconnections: presence of

Black – ppt
COMMISSURES (anterior and posterior)
*Blue – audio
*** Red – Berne and levy SUBDIVISIONS:
*Nervous system is concerned with higher functions. It is
 Frontal Lobe
mainly directed to the cerebral cortex.
 Parietal Lobe
 Temporal Lobe
INTRODUCTION  Occipital Lobe
Higher functions of the nervous system:
FRONTAL LOBE
- Interactions:
 Parts of the cerebral cortex - Planning and execution of motor behavior
 Cerebral cortex and other parts of the brain - Generation of speech (Left hemisphere: Broca’s
area)
 Parietal to frontal: somatosensory-movement
*Left hemisphere: Speech center- Broca’s area
 Temporal to hippocampus- learning and memory
- Major role: personality and emotional behavior
*Higher functions of NS- 2 basic categories: (1) Motor; (2) (prefrontal cortex)
Sensory. However, they are not totally dependent on each  Bilateral Lesions (Disease or Surgery)-
other, but, they are somehow related. For instance, Deficits:
regulation of motor behavior is controlled by sensory 1. Attention
information. How this happens? Something has to do with 2. Difficulty in planning
complex architecture of NS that is based on 3. Difficulty in problem solving
INTERCONNECTIONS. Parts of the cerebral cortex can interact 4. Inappropriate social behavior
with each other- connections of the 4 lobes and other parts
of the brain like the cerebellum which is concerned with
*Major function: motor movement/behavior
balance.
*Miscellaneous functions (because of interconnections):
*Basis of interconnections: presence of COMMISSURES (e.g.
generation of speech, regulation of personality and emotional
Parietal lobe- concerned with somatosensory information
behavior
(conveyance of sensory information in relation to parts of the
body as a whole); Frontal lobe- regulation of movement PARIETAL LOBE
*Because of the interconnection between the parietal and - Processing and perception of sensory information
frontal lobe, somatosensory information from the parietal  Connections with FRONTAL LOBE:
lobe will be able to regulate the motor functions of frontal Somatosensory information  affecting
lobe. voluntary motor activity
 Connections with OCCIPITAL & FRONTAL
CEREABRAL CORTEX LOBES: visual information  parietal
DIVISIONS: association centers  guides voluntary
movements
 Left Cerebral Hemisphere  Connections with LANGUAGE CENTERS
 Right Cerebral Hemisphere (Wernicke’s Area): transfer of
somatosensory information
Coordination of activity: Interconnections via CEREBRAL
- Determination of spatial context
COMMISURES
*Major function: sensory information
*These 2 cerebral hemispheres are quite dependent on each
other which have something to do with INTERCONNECTIONS.
*Miscellaneous function: spatial context- able to identify the  Motor cortex
position of the whole or any part of the body in relation to  Somatosensory cortex
space  Visual cortex
 Auditory cortex
 Vestibular cortex
 Temporal lobe association areas
OCCIPITAL LOBE
 Olfactory cortex
- Primary function: Visual processing and perception
*EPILEPSY- basic problem is seizure
 Connections with FRONTAL EYE FIELDS:
affect eye movements *If an attack occurs only once- SEIZURE; if it becomes
 Connections with MIDBRAIN: assists in recurrent- establish diagnosis of EPILEPSY
control of near vision via:
 Divergent eye movements All of which *Epilepsy has something to do with abnormal electric activity
 Pupillary constriction occur when the of neurons. Its manifestations is based on where the
eyes adjust for
 Accommodation electrical discharge is located- PRIMARY FOCUS.
near vision
*Major function: VISION  Motor cortex- abnormal movements (jerking
movement of limbs- upper and/or lower)
TEMPORAL LOBE  Somatosensory cortex- abnormality in sensation
 Vision cortex- hallucinations (flashes of lights or
- Processing and perception of information lead to
bright colors)
sounds and vestibular function (balance)
 Auditory cortex- hearing buzzing sounds, voices
- Higher order visual processing (VISUAL AREAS)
 Vestibular cortex- everything is spinning around you
 Recognition of faces (INFRATEMPORAL
 Temporal lobe- complex behavior
CORTEX)
 Olfactory cortex- abnormal smell perception
 Passage of visual pathway (MEYER’S LOOP)

**Lesions: Damage to parts of visual fields

PHYLOGENIC SUBDIVISIONS
*** Meyer’s loop, which forms part of the optic pathway,
1. ARCHICORTEX- 4 cortical layers
passes through the temporal lobe. Therefore, temporal lobe
*Located in the lower part
lesions can damage vision in part of the visual fields
2. PALEOCORTEX- 4 to 5 cortical layers
- Understanding of language (PART OF WERNICKE’S *Anterior lobe
AREA) 3. NEOCORTEX (90%)- 6 cortical layers
- Participation in emotional behavior and regulation of *Most important- majority
autonomic nervous (MEDIAL ASPECT BELONGS TO Middle part
LIMBIC SYSTEM) Posterior lobe
- Involvement in learning and memory (HIPPOCAMPAL
*Basis: Layering
FORMATION)
NEOCORTEX: CELL TYPES
*Major function: HEARING and BALANCE
1. PYRAMIDAL CELLS (75%)
*Miscellaneous function: understanding of language,
 Large triangular cell body, long apical
emotional behavior and autonomic NS regulation, learning
dendrite and several basal dendrites
and memory
 Neurotransmitters: GLUTAMATE &
CLINICAL CORRELATION ASPARTATE (EXCITATORY)

SEIZURES- manifestations of seizures: location of primary 2. STELLATE CELLS (GRANULE CELLS) (25%)
focus  Interneurons

2
  Small soma & numerous small dendrites - EEG WAVES: Excitatory & Inhibitory synaptic
 GAMMA-AMINO BUTYRIC ACID potentials of cortical neurons (reflective of the
(EXCITATORY & INHIBITORY) activity of pyramidal cells)
*sign does not indicate excitation or inhibition
*Messengers- neurotransmitters
*** In an electrocorticogram, electrical activity of the cortex
*If the information they carry to the next neuron causes an is recorded via electrodes placed on the surface of the brain.
increase in activity of neurons- EXCITATORY (Glutamate and These are both called field potentials because they detect the
Aspartate) electrical field generated by large groups of relatively distant
neurons. The EEG waves arederived from the excitatory and
*INTERNEURONS- connecting or bridging cells- connect inhibitory synaptic potentials that occur in cortical neurons.
primary sensory area with a final motor area (sensory - Significance in Clinical Neurology: Diagnostic
controls motor) tool(EPILEPSY)

BRODMANN’S AREAS OF THE CEREBRAL CORTEX NORMAL EEG WAVES

1, 2 & 3 Primary Somatosensory Cortex Different frequencies based on:

4 Primary Motor Cortex 1. State of wakefulness

6 Premotor & Supplementary Motor Cortex *Awake- eyes closed(alpha) or open(beta)
Sleep- shallow or deep
17 Primary Visual Cortex
2. Age of subject
41 & 42 Primary Auditory Cortex 3. Location of recording electrodes
*Basis: CYTOARCHITECTURAL ANALYSIS 4. Absence or presence of drugs or diseases

*Brodmann established a specific subdivision of the cerebral

cortex based on cytoarchitectural analysis. It is concerned
with higher functions.
ALPHA RHYTHM
*Total of 52 Brodmann’s area- either sensory or motor
function - Normal awake and relaxed adult with EYES CLOSED
- Recordings: PARIETAL & OCCIPITAL LOBES
ELECTROENCEPHALOGRAM (EEG) - 8-13 Hz
- Recording of neuronal electrical activity of the
BETA RHYTHM
cerebral cortex (skull: ELECTRODES)
- What do you measure? FIELD POTENTIAL TRACINGS: - Normal awake and relaxed adult with EYES OPEN
detect ELECTRICAL FIELD generated by LARGE - Less synchronized (DESYNCHRONIZED)
GROUP OF DISTANT NEURONS - 13-30 Hz

3
DELTA RHYTHM

- Stage 3 (Slow-wave Sleep): (+) Sleep spindles

 Sleep Spindles: burst of activity (12-14 Hz)
- Stage 4 (Slow-wave sleep): (-) Sleep spindles
- Dominant during coma
- 0.5-2 Hz

THETA RHYTHM

- Stage 1 (Slow-wave sleep)

- Interspersed with Alpha waves
- 3-7 Hz (Lower frequency)

*For standardization, memorize the values found in the book.

Lecturers might use clinical books based on their specialty.
But if you will take the board exams, use the current official CLINICAL CLASSIFICATION OF EPILEPSY
textbook- Berne & Levy!!! Some topics can also be found in
Guyton. Kung medyomagkaibayungbinanggit or pinakita ng PARTIAL GENERALIZED
lecturer with what is written on the textbook and quiz ng
Involvement: portion of the Begins locally  both
lecturer, anggagamitinniyo ay angkanyang lecture notes.
brain hemispheres
Kapag board exams, official textbook.
Symptoms depend on: Convulsive or non-
convulsive
EPILEPSY 1. Site of primary
focus
- Abnormal (sudden and excessive) synchronous 2. Extent of spread
discharge of cerebral neurons
(+) consciousness (-) consciousness
- Variety of events:
1. Loss of consciousness- generalized epilepsy Progresses and spreads 
*That’s why you get information from the generalized
informant who saw the actual attack *Clinical Classification- depends on the manifestations and
2. Abnormal movements EEG findings
*Jerking movements
Grand mal- entire body participants *Hallmark on partial epilepsy: CONSCIOUSNESS is retained
3. Atypical or Odd behavior
 Complex partial seizure spreads  generalized
*Smacking movement, chewing movements
Minsan during the actual attack, biglangnapa- PARTIAL EPILEPSY
umm jingle, or worse, biglangnapa-BM
(AUTOMATISMS) SIMPLE or ELEMENTARY COMPLEX PARTIAL
4. Distorted Perceptions
Abnormal Electrical activity: Complex sensory
*Hallucinations- visual or auditory, tactile, odor primary focus hallucinations and mental
distortion
(-) spread
- Clinical manifestations- based on site of primary
focus: Abnormal activity: Motor
 Motor cortex- abnormal movements or a Dysfunctions:automatisms
 Single limb or
generalized convulsion muscle group  Chewing
 Parietal or Occipital lobes- Hallucinations  Sensory distortions movements
(Visual, Auditory, Olfactory)  Diarrhea and/or
urination
(+) consciousness (-) consciousness

4
EEG tracings are not distinguishable to be able to identify o Regulation of hearing and vestibular
simplex or complex partial epilepsy functions and miscellaneous functions
(learning and memory)
GENERALIZED EPILEPSY
PHYLOGENIC SUBDIVISIONS OF CEREBRAL CORTEX
TONIC-CLONIC or GRAND ABSENCE or PETIT MAL
MAL 1. Archicortex
2. Paleocortex
Continuous Brief, abrupt & self-limiting
3. Neocortex
contraction(tonic phase) loss of consciousness
rapid contraction &  Cells:
relaxation(clonic phase)  Pyramidal Cells (excitation)
 Stellate Cells (excitation &
Period of confusion and Stares & rapid eye-blinking
exhaustion (3-5 sec) inhibition)

*Grand mal- most dramatic- entire body participates

BRODMANN’S AREAS
EEG FINDINGS IN SPECIFIC FORMS OF EPILEPSY
 1, 2 & 3- Somatosensory functions
 4 & 5- Motor functions
 17- Visual functions
 41 & 42- Auditory functions

ELECTROENCEPHALOGRAM

- Electrical activity of cerebral neurons

- Wave patterns: ALPHA, BETA, DELTA, THETA
- Role of EEG in the diagnosis of epilepsy

EPILEPSY- abnormal electrical activity of cerebral neurons

*Characteristics of Grand Mal- multiple spikes
__________________________________________________
A. Grand Mal
Left- tonic phase “Time is free, but it’s priceless. You can’t own it, but you can use it. Once
Right- clonic phase you’ve lost it you can never get it back.”
B. Absence of Petit Mal– displays spikes and wave activity
So why rush everything just to get what you want or be who you want to
C. Most common form of focal or partial- coming from
be? Just relax value every moment, take every time in the world and give
temporal lobe  TEMPORAL LOBE EPILEPSY time to the persons who are worth spending with.
D. FOCAL or PARTIAL SEIZURES
You know who they are
So you better start now.
SUMMARY
MAJOR LOBES OF THE CEREBRAL CORTEX:
Note takers:
1. Frontal Lobe Galletes, Chermayne Tate
o Regulation of motor, behavior, speech, Mendoza, Melissa Jane
personality & emotional behavior
Tumbaga, Kariza
2. Parietal Lobe
o Regulation of sensory functions (visual)
3. Occipital Lobe
o Regulation of visual functions
4. Temporal Lobe
5
Quiz:
IDENTIFICATION
1. Classification of epilepsy that involves only a
portion of the brain.
2. The neurotransmitter in Pyramidal Cells
3. Broadmann’s area 6
4. EEG waves in normal awake and relaxed adult
with eyes open
5. EEG waves in normal awake and relaxed adult
with eyes closed
6. EEG wave that is dominant during coma
7. Stage in Grand Mal epilepsy that is
characterized by rapid contraction and
relaxation
8. These cells are actually interneurons
characterized by small soma and numerous
small dendrites.

MATCHING TYPE:

1. Involved in generation of speech ( left A. FRONTAL LOBE

hemisphere: Broca’s Area) B. PARIETAL LOBE
2. Its medial aspect belongs to the Limbic system C. TEMPORAL LOBE
3. It involves higher order visual processing D. OCCIPITAL LOBE
which includes recognition of faces
4. This lobe has a connection with the midbrain
thus assisting in control of near vision.
5. It involves determination of spatial context.
6. Bilateral lesions on this lobe causes
inappropriate social behaviour
7. This involves passage of visual pathway
(MEYER’S LOOP)
8. Involves processing and perception of sensory
information

Answers:
IDENTIFICATION:
1. Partial Epilepsy Answers: matching type
2. Glutamate
1.A 2.B 3.C 4.D 5.B 6. A 7.C 8.B
3. Premotor and supplementary motor cortex
4. Beta Rhythm
5. Alpha Rhythm
6. Delta Rhythm
7. Clonic Phase
8. Stellate Cells/ Granular Cells