Vous êtes sur la page 1sur 2

Anatomy and Physiology Overview The nervous system is the master controlling and communicating system of the body.

Every thought, action, and emotion reflects its activity. Its signalling device, or means of communicating with body cells, is electrical impulses, which are rapid and specific and cause almost immediate responses. To carry out its normal role, the nervous system has 3 overlapping functions : (1) Much like a sentry, it uses its millions of sensory receptors to monitor changes occurring both inside and outside the body. These changes are called stimuli and the gathered information is called sensory input. (2) It processes and interprets the sensory input and makes the decision about what should be done at each moment a process called integration. (3) It then effects a response by activating muscles or glands via motor output. The nervous system consists of two divisions: the central nervous system (CNS), including the brain and spinal cord, and the peripheral nervous system, made up of the cranial and spinal nerves. The peripheral nervous system can be further divided into the somatic, or voluntary, nervous system, and the autonomic, or involuntary, nervous system. The function of the nervous system is to control all motor, sensory, autonomic, cognitive, and behavioural activities. The nervous system has approximately 10 million sensory neurons that send information about the internal and external environment to the brain and 500,000 motor neurons that control the muscles and glands. The brain itself contains more than 20 billion nerve cells that link the motor and sensory pathways, monitor the bodys processes, respond to the internal and external environment, maintain homeostasis, and direct all psychological, biologic, and physical activity through complex chemical and electrical messages (Bradley, Daroff, Fenichel &Marsden, 2000). ANATOMY OF THE NERVOUS SYSTEM Cells of the Nervous System The basic functional unit of the brain is the neuron. It is composed of a cell body, a dendrite, and an axon. The dendrite is a branch-type structure with synapses for receiving electrochemical messages. The axon is a long projection that carries impulses away from the cell body. Nerve cell bodies occurring in clusters are called ganglia or nuclei. A cluster of cell bodies with the same function is called a center (eg, the respiratory center). Neuroglial cells, another type of nerve cell, support, protect, and nourish neurons. Anatomy of the Central Nervous System Anatomy of Brain y The brain is the communication and control center of the body. It receives, processes, and evaluates many kinds of input decides on the response or action to be taken and then initiates the response. Responses or action to be taken and then initiates the response. Responses include both, involuntary activity that required to maintain homeostasis in the body and voluntary actions. With both reflex and voluntary activities, the individual is often not aware of the amount and diversity of input received or the integration or assessment of that input, but knows only of the response. The brain is the largest and most complex part of the nervous system. It is composed of more than 100 billion neurons and associated fibers. The brain tissues have a gelatine-like consistency. This semi-solid organ weighs about 1400 g (approximately 3 pounds) in the adult human. The brain is divided into three major areas: the cerebrum, the brain stem, and the cerebellum. The cerebrum is composed of two hemispheres, the thalamus, the hypothalamus, and the basal ganglia.Additionally, connections for the olfactory (cranial nerve I) and optic (cranial nerve III) nerves are found in the cerebrum. The brain stem includes the midbrain, pons, medulla, and connections for cranial nerves II and IV through XII. The cerebellum is located under the cerebrum and behind the brain stem The brain accounts for approximately 2% of the total body weight; it weighs approximately 1,400 g in an average young adult (Hickey, 2003). In the elderly, the average brain weighs approximately 1,200 g.

y y

Cerebrum. The cerebrum consists of two hemispheres that are incompletely separated by the great longitudinal fissure. This sulcus separates the cerebrum into the right and left hemispheres. The two hemispheres are joined at the lower portion of the fissure by the corpus callosum. The outside surface of the hemispheres has a wrinkled appearance that is the result of many folded layers or convolutions called gyri, which increase the surface area of the brain, accounting for the high level of activity carried out by such a small-appearing organ. The external or outer portion of the cerebrum (the cerebral cortex) is made up of gray matter approximately 2 to 5 mm in depth; it contains billions of neurons/cell bodies, giving it a gray appearance. White matter makes up the innermost layer and is composed of nerve fibers and neuroglia (support tissue) that form tracts or pathways connecting various parts of the brain with one another (transverse and association pathways) and the cortex to lower portions of the brain and spinal cord (projection fibers). The cerebral hemispheres are divided into pairs of frontal, parietal, temporal, and occipital lobes. The four lobes are as follows Frontalthe largest lobe. The major functions of this lobe are concentration, abstract thought, information storage or memory, and motor function. It also contains Brocas area, critical for motor control of speech. The frontal lobe is also responsible in large part for an individuals affect, judgment, personality, and inhibitions. Parietala predominantly sensory lobe. The primary sensory cortex, which analyzes sensory information and relays the interpretation of this information to the thalamus and other cortical areas, is located in the parietal lobe. It is also essential to an individuals awareness of the body in space, as well as orientation in space and spatial relations. Temporalcontains the auditory receptive areas. Contains a vital area called the interpretive area that provides integration of somatization, visual, and auditory areas and plays the most dominant role of any area of the cortex in cerebration. Occipitalthe posterior lobe of the cerebral hemisphere is responsible for visual interpretation.

The corpus callosum is a thick collection of nerve fibers that connects the two hemispheres of the brain and is responsible for the transmission of information from one side of the brain to the other. The basal ganglia are masses of nuclei located deep in the cerebral hemispheres that are responsible for control of fine motor movements, including those of the hands and lower extremities. The thalamus lies on either side of the third ventricle and acts primarily as a relay station for all sensation except smell. All memory, sensation, and pain impulses also pass through this section of the brain. The hypothalamus is located anterior and inferior to the thalamus. The hypothalamus lies immediately beneath and lateral to the lower portion of the wall of the third ventricle.The hypothalamus plays an important role in the endocrine system because it regulates the pituitary secretion of hormones that influence metabolism, reproduction, stress response, and urine production. It works with the pituitary to maintain fluid balance and maintains temperature regulation by promoting vasoconstriction or vasodilatation The brain can be subdivided into several distinct regions: The cerebral hemispheres form the largest part of the brain, occupying the anterior and middle cranial fossae in the skull and extending backwards over the tentorium cerebelli. They are made up of the cerebral cortex, the basal ganglia, tracts of synaptic connections, and the ventricles containing CSF. The Diencephalon includes the thalamus, hyopthalamus, epithalamus and subthalamus, and forms the central core of the brain. It is surrounded by the cerebral hemispheres. The Midbrain is located at the junction of the middle and posterior cranial fossae. The Pons sits in the anterior part of the posterior cranial fossa- the fibres within the structure connect one cerebral hemisphere with its opposite cerebellar hemisphere. The Medulla Oblongata is continuous with the spinal cord, and is responsible for automatic control of the respiratory and cardiovascular systems. The Cerebellum overlies the pons and medulla, extending beneath the tentorium cerebelli and occupying most of the posterior cranial fossa. It is mainly concerned with motor functions that regulate muscle tone, coordination, and posture.

y y y y y y

STRUCTURES PROTECTING THE BRAIN The brain is contained in the rigid skull, which protects it from injury. The major bones of the skull are the frontal, temporal, parietal, and occipital bones. These bones join at the suture lines The meninges (fibrous connective tissues that cover the brain and spinal cord) provide protection, support, and nourishment to the brain and spinal cord. The layers of the meninges are the dura, arachnoid, and pia mater Dura materthe outermost layer; covers the brain and the spinal cord. It is tough, thick, inelastic, fibrous, and gray. Arachnoidthe middle membrane; an extremely thin, delicate membrane that closely resembles a spider web (hence the name arachnoid). It appears white because it has no blood supply. The arachnoid layer contains the choroid plexus, which is responsible for the production of cerebrospinal fluid (CSF). This membrane also has unique fingerlike projections, arachnoid villi, that absorb CSF Pia materthe innermost membrane; a thin, transparent layer that hugs the brain closely and extends into every fold of the brains surface. CEREBRAL CIRCULATION The cerebral circulation receives approximately 15% of the cardiac output, or 750 mL per minute. The brain does not store nutrients and has a high metabolic demand that requires the high blood flow. The brains blood pathway is unique because it flows against gravity; its arteries fill from below and the veins drain from above. In contrast to other organs that may tolerate decreases in blood flow because of their adequate collateral circulation, the brain lacks additional collateral blood flow, which may result in irreversible tissue damage when blood flow is occluded for even short periods of time. Arteries. Two internal carotid arteries and two vertebral arteries and their extensive system of branches provide the blood supply to the brain. The internal carotids arise from the bifurcation of the common carotid and supply much of the anterior circulation of the brain. The vertebral arteries branch from the subclavian arteries, flow back and upward on either side of the cervical vertebrae, and enter the cranium through the foramen magnum. The vertebrobasilar arteries supply most of the posterior circulation of the brain. At the base of the brain surrounding the pituitary gland, a ring of arteries is formed between the vertebral and internal carotid arterial chains. This ring is called the circle of Willis and is formed from the branches of the internal carotid arteries, anterior and middle cerebral arteries, and anterior and posterior communicating arteries. Functionally, the posterior portion of the circulation and the anterior or carotid circulation usually remain separate. The arteries of the circle of Willis can provide collateral circulation if one or more of the four vessels supplying it become occluded or are ligated. Veins. Venous drainage for the brain does not follow the arterial circulation as in other body structures. The veins reach the brains surface, join larger veins, then cross the subarachnoid space and empty into the dural sinuses, which are the vascular channels lying within the tough dura mater. The network of the sinuses carries venous outflow from the brain and empties into the internal jugular vein, returning the blood to the heart. BLOODBRAIN BARRIER The CNS is inaccessible to many substances that circulate in the blood plasma (eg, dyes, medications, and antibiotics). After being injected into the blood, many substances cannot reach the neurons of the CNS because of the bloodbrain barrier. This barrier is formed by the endothelial cells of the brains capillaries, which form continuous tight junctions, creating a barrier to macromolecules and many compounds. All substances entering the CSF must filter through the capillary endothelial cells and astrocytes (Hickey, 2003). ANATOMY OF THE SPINAL CORD The spinal cord and medulla form a continuous structure extending from the cerebral hemispheres and serving as the connection between the brain and the periphery. Approximately 45 cm (18 in) long and about the thickness of a finger, it extends from the foramen magnum at the base of the skull to the lower border of the first lumbar vertebra, where it tapers to a fibrous band called the conus medullaris. Continuing below the second lumbar space are the nerve roots that extend beyond the conus, which are called the cauda equina because they resemble a horses tail. Similar to the brain, the spinal cord consists of gray and white matter. Gray matter in the brain is external and white matter is internal; in the spinal cord, gray matter is in the center and is surrounded on all sides by white matter. The spinal cord is surrounded by the meninges, dura, arachnoid, and pia layers. Between the dura mater and the vertebral canal is the epidural space. The spinal cord is an H-shaped structure with nerve cell bodies (gray matter) surrounded by ascending and descending tracts (white matter). The lower portion of the H is broader than the upper portion and corresponds to the anterior horns. The anterior horns contain cells with fibers that form the anterior (motor) root end and are essential for the voluntary and reflex activity of the muscles they innervate. The thinner posterior (upper horns) portion contains cells with fibers that enter over the posterior (sensory) root end and thus serve as a relay station in the sensory/reflex pathway. The thoracic region of the spinal cord has a projection from each side at the crossbar of the H of gray matter called the lateral horn. It contains the cells that give rise to the autonomic fibers of the sympathetic division. The fibers leave the spinal cord through the anterior roots in the thoracic and upper lumbar segments. Vertebral Column. The bones of the vertebral column surround and protect the spinal cord and normally consist of 7 cervical, 12 thoracic, and 5 lumbar vertebrae, as well as the sacrum (a fused mass of five vertebrae), and terminate in the coccyx.