Chapter 8 The Nervous System

Think of the nervous system as a computer – lots of twisted wires (nerve fibers) that all come together to form
a power cable (bundle) which sends and receives signals. It all works together to enable the computer (body) to
take in a message – send it to the circuit board (brain) – translate it so the computer (our mind) can act on the
information it has received.

This system of nerves in our body is the most intricate and complicated of our systems.

1. Made up of brain, spinal cord and nerves.

2. Functions to regulate and coordinate all of our body functions and picks up change in our environment
both internally and externally.
3. Center of all thought, learning and memory processes.

Our nervous system is made up of 2 parts

CNS (central nervous system) and PNS (peripheral nervous system)

1. PNS
a. Controls consciousness
b. Processes and stores any sensory or motor information we receive
c. Made up of ganglia (a mass of nerve cell bodies inside the CNS) and nerves (bundle of nerve fibers)
 Nerves transmit the impulses to and from the brain and spinal cord to the body
d. Contains afferent (sensory) nerves which carry information from body to CNS; efferent (motor) nerves
which carry information from the CNS to muscles and glands and this causes the organ they target to
react to the command.
 e. It house the somatic nervous system which gives us the voluntary control over skeletal muscles and the
autonomic nervous system which gives us involuntary control over smooth muscles, cardiac muscles
along with glandular activity.
 ANS houses two types of nerves – sympathetic control involuntary functions such as raising heart
rate and blood pressure – it is what works the “fight or flight response” when we have a difficult
situation. Parasympathetic – involuntary body functions like slowing the heart rate and increasing
peristalsis. Returns body to a normal state.

2. CNS
1. Brain and spinal cord – surround by bone
2. The brain sits in the cranium (skull) and the spinal cord runs through the spinal column and is protected
by the vertebrae. They also have the protection of the meninges and CFS.
3. The meninges has 3 layers – dura mater, arachnoid membrane and the pia mater
Under the dura mater is the subdural space which contains fluid and the epidural space right outside
the dura mater houses fat and connective tissues that act as a cushion as well. Just beneath the
arachnoid space is the subarachnoid space and it houses the CSF which is a shock absorber. All of these
work to protect the brain and spinal cord by working to circulate the CSF to maintain a constant
balance. If not hydrocephalous may develop.

Cells in the nervous system

Two types
1. neurons which are the functional unit and transmit the impulses. It has 3 parts – cell body, an axon
and one, or more, dendrites
2. the cell body has the nucleus and cytoplasm
3. the axon is like a thread that extends from the cell and it carries impulses from the body of the cell
a. some have a myelin sheath and look white (white matter); others do not and they look gray (gray
matter)
 4. dendrites – lots of little fingers coming from the cell body. These axon and dendrites don’t connect –
the space between the two is called a synapse and this is where the neurotransmitters start or stop
impulses between nerves.

In this whole make up are neuroglia cells which do different things to protect the nervous system
1. astrocytes – largest and most numerous – they form the blood brain barrier by wrapping themselves
around the capillaries of the brain – this protects the brain from harmful germs
2. microglia – small and phagocytic – they eat up debris within the nerve tissue; these increase in
number when there is injury or infection and they will head toward they affected area.
3. Oligodendrocytes – small and less of them – they surround the axons of our neurons to form the
myelin sheath which is an electrical insulator and this helps to speed up conduction of the impulses.

The Brain
Coordinates our physical and mental activity. It has four major divisions.

The cerebrum
1. Largest
2. Consciousness, voluntary movements, memory, emotions and sensations are controlled here.
3. Cerebral cortex is the surface which has gyri and sulci on it. There is a right and left side known as
hemispheres.
The cerebellum
1. Maintains balance, movement and muscle tone
2. Attached to brain stem
The diencephalon
1. Between the midbrain and cerebellum is the diencephalon which is actually made up of
a. the thalamus which receives all (except smell) sensory stimuli and sends it to the cerebral cortex
 b. the hypothalamus which works with the ANS, the endocrine system, sleep, appetite and temperature
c. and the pinal body (gland) melatonin and is thought to work with the body’s biological clock.
The brain stem
1. contains the midbrain, pons and medulla oblongata
2. it acts as the road between the brain and spinal cord for nerve impulses to travel. It controls our breathing,
blood pressure and heart rate.

PATHOLOGICAL CONDITIONS
Problems with the nervous system can be related to any number of things; some can be congenital (occurring
before/during birth) or functional. They can be related to trauma or disease processes. They can all be
devastating to the people involved.

1. Alzheimer’s – it is progressive and non-curable. It robs a person of physical, emotional and mental
functions. Chemical and structural changes take place in the brain but no single cause. It is a diagnosis of
exclusion.
a. Usually occurs in those over 65, although younger people are affected.
b. Begins with minor things.
c. Has three stages
 Stage one: 1-3 yrs. Short term memory is affected and the person may have trouble paying
attention; the person may try to cover up the changes.
 Stage two: 2-10 yrs. Loses ability to write and perform simple task, may not be able to identify
objects by touch, can’t communicate well; aphasia can/may develop; safety is an issue.
 Stage 3: 8-10 yrs. Disorientation and no communication skills; incontinent and may develop rigidity;
dependent on others.
d. Can use antidepressants and tranquilizers as well as tacrine hydrochloride to treat.
e. Family and care-givers need a lot of help and they need a lot of education in how to handle sometimes
difficult family members.
2. ALS (Lou Gehrig’s disease) amyotrophic lateral sclerosis – wasting and weakening of muscles; it is
progressive.
a. Involves the brain stem – trouble with tongue and face, speech, chewing and swallowing; have trouble
clearing throat and breathing.
b. Become totally dependent on others.
c. No cure, eventually leads to death as body shuts down.

3. Anencephaly – present at birth, it is a cellular development problem; absence of brain/spinal cord.

Incompatible with life.

4. Cerebral concussion/contusion
a. Concussion – interruption of function and loss of consciousness – fall
 Headache, blurred vision, confusion among other problems
 Need to watch for increased ICP or ICB
b. Contusion – venous hemorrhages (bruises) caused by the brain hitting the skull – whiplash
 Swelling of brain tissue
 can experience loss of consciousness
 Need to watch for increased ICP and altered consciousness

5. Cerebral palsy – brain damage at birth, no control of voluntary muscles

a. Involves cerebrum
 Four types – spastic, ataxic, athetoid, mixed
b. Can have severe mental retardation as well as seizures and hearing/speech problems

6. CVA (stroke) cerebrovascular accident – a specific part of brain is involved; there is ischemia to the brain
with a decrease in blood flow to that area.
7. Huntington’s chorea – inherited
a. Rapid, jerky and involuntary movements
b. Increasing dementia
c. No cure
d. Can sit still, have problems with speech because of lack of muscle control in tongue, posture begins to
look “funny”
e. Will eventually involve diaphragm – risk of choking leading to malnutrition and chance of aspiration
f. Supportive care of all involved

8. MS (multiple sclerosis) – degenerative inflammatory disease which attacks the myelin sheath
a. Causes the sheath to harden which interrupts impulses
b. More often males than females
c. Initial manifestation of symptoms can be fast or gradual
d. Two types – exacerbation or chronic.
e. Poor coordination, Numbness/weakness, Incontinence and facial pain/numbness
f. At risk for seizures, dementia and falls
g. No cure but treatment can reduce inflammation to help slow symptoms

9. Narcolepsy – falling asleep for no reason; suffer from sleepiness during the day and cataplexy

10.Shingles – herpes zoster; if you have had chicken pox the virus is lying dormant in your system and can flair
up at any time.
a. Usually affects adults over 50 and includes severe pain and itching.
b. May have fever and can last up do a month in some
Diagnostic

1. Babinski’s reflex – normal in infants, not normal in adults

a. In adults can indicate motor neuron disease/injury

2. Craniotomy – opening the skull to release pressure, decrease swelling, drain fluid or for surgical procedures