29-1

The Nervous System

PowerPoint presentation to accompany:

Medical Assisting
Third Edition

Booth, Whicker, Wyman, Pugh, Thompson

2009 The McGraw-Hill Companies, Inc. All rights reserved

29-2

Learning Outcomes
29.1 Explain the difference between the central
nervous system and the peripheral nervous
system.
29.2 Describe the functions of the nervous system.
29.3 Describe the structure of a neuron.
29.4 Describe the function of a nerve impulse and how
a nerve impulse is created.

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Learning Outcomes (cont.)

29.5 Describe the structure and function of a synapse.
29.6 Describe the function of the blood-brain barrier.
29.7 Describe the structure and functions of meninges.
29.8 Describe the structure and functions of the spinal
cord.

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Learning Outcomes (cont.)

29.9 Describe the location and function of
cerebrospinal fluid.
29.10 Define reflex and list the parts of a reflex arc.
29.11 List the major divisions of the brain and give the
general functions of each.
29.12 Explain the functions of the cranial and spinal
nerves.
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Learning Outcomes (cont.)

29.13 Describe the differences between the somatic
nervous system and autonomic nervous system.
29.14 Explain the two divisions of the autonomic
nervous system.
29.15 Describe the causes, signs and symptoms, and
treatments of various diseases and disorders of
the nervous system.

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Introduction

Highly complex system

of two parts

Central nervous
system (CNS)

Peripheral nervous
system (PNS)

Controls all other organ

systems and is
important for
maintaining balance
within those systems

Disorders
Disorders are
are numerous
numerous and
and often
often
difficult
difficult to
to diagnose
diagnose and
and treat
treat
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General Functions of the NS

CNS

Brain
Spinal cord

PNS

Peripheral nerves
Two sections

Somatic nervous system

(SNS)
Skeletal or voluntary
muscles
Autonomic nervous system
(ANS)
Automatic functions

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General Functions (cont.)

Three types of neurons

Afferent or sensory nerves

Efferent or motor nerves

Sensory information from environment or inside body

to CNS for interpretation
Impulses from CNS to PNS to allow for movement or
action

Interneruons

Interpretive neurons between afferent and efferent

nerves in the CNS
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Apply Your Knowledge

Match the following:

ANSWER:

B Somatic nervous system

___

A. Motor nerves

C Autonomic nervous system

___

B. Governs skeletal or voluntary muscles

A Afferent nerves
___

C. Governs respiratory and GI systems

E Efferent nerves
___

D. Go-betweens or interpreters

D Interneurons
___

E. Sensory nerves

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Neuron Structure

Functional cells of NS

Transmit electrochemical
messages called nerve
impulses to

Other neurons
Effectors (muscles or
glands)
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Neuron Structure (cont.)

Neurons lose their ability to divide

If destroyed, not replaced

Neuralgia

Support cells for neurons that can divide

Astrocytes anchor blood vessels to nerves
Microglia act as phagocytes
Oligodendrocytes assist with production of
myelin sheath
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Neuron Structure (cont.)

Neurons
Neurons have
have cell
cell
body
body processes
processes called
called
nerve
nerve fibers
fibers that
that
extend
extend from
from the
the cell
cell
body.
body.

Dendrites short

Receive nerve impulses

for the neuron

Axons long

Send nerve impulses

away from the cell body

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Neuron Structure (cont.)

White matter axons with myelin

sheath

Dendrites

Schwann cells neurological cells

Schwann
cells

Axon

Wrap around some axons

Cell membranes contain myelin
Myelin insulates axons and enables
axons to send nerve impulses more
quickly

Gray matter axons without

myelin sheath
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Apply Your Knowledge

True or False:

ANSWER:
They are the muscles or glands.

___
F Effectors are neurons.
F Neurons can reproduce.
___

Neurons cannot reproduce.

T Astrocytes anchor blood vessels to nerve cells.

___
T Microglia act as phagocytes.
___

They take part in

Oligodendrocytes are reproductive cells. myelin production.
T Repolarization is the return to the resting state.
___
F
___

GOOD JOB!

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Nerve Impulse

Membrane potential

Neuron cell membrane at rest is in a polarized state

As Na+ and K+ move into the cell, the membrane becomes

depolarized

Inside of cell membrane is negative

Outside of cell membrane is positive due to more Na+ and K+

Inside becomes more positive

Action potential (nerve impulse) is created

Repolarization occurs when K+ and later Na+ move to the

outside of the cell membrane

Return of the cell to polarized (resting) state

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Nerve Impulse (cont.)

Impulse travels down axon to synaptic knob

Vesicles or small sacs in synaptic knob

Produce chemicals called neurotransmitters

Neurotransmitters are released by synaptic knob

Allow impulse transmission to postsynaptic structures

Dendrites
Cell bodies
Axons of other neurons

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Nerve Impulse (cont.)

Functions of neurotransmitters

Cause muscles to contract or relax

Cause glands to secrete products

Activate or inhibit neurons

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Apply Your Knowledge

What is the function of neurotransmitters?
ANSWER: Neurotransmitters cause muscles to
contract or relax, cause glands to secret products,
activate neurons to send nerve impulses, or inhibit
neurons from sending them.

Right
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Central Nervous System

Includes the spinal cord and brain

Blood-brain barrier

Protects layers of the membranes of the CNS

Formed by tight capillaries

Prevents unwanted substances from entering the CNS

tissues
Inflammation can make more permeable

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CNS (cont.)

Meninges protect brain and spinal cord

Dura mater

Arachnoid mater

Tough outer layer

Middle layer (web-like)

Pia mater

Innermost and most

delicate
Directly on top of brain
and spinal cord
Holds blood vessels on the
surface of these structures
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CNS (cont.)

Epidural space

Subdural space

Above dura mater

Below dura mater

Subarachnoid space

Between arachnoid mater and pia mater

Contains cerebrospinal fluid (CSF)
Cushions CNS
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CNS: Spinal Cord

Slender structure continuous with the

brain

Descends into the vertebral canal and

ends around the level of the first or
second lumbar vertebra

31 spinal segments:

8 cervical segments
12 thoracic segments
5 lumbar segments
5 sacral segments
1 coccygeal segment
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CNS: Spinal Cord (cont.)

Cervical enlargement

Motor neurons that control

muscles of the arms

Lumbar enlargement

Motor neurons that control

muscles of the legs

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CNS: Spinal Cord (cont.)

Gray matter

Inner tissue with darker color

Contains neuron cell bodies and their dendrites

Divisions are called horns

Central canal runs down the entire length of the

spinal cord through the center of the gray
Spinal
matter
Cord/Nerve
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CNS: Spinal Cord (cont.)

White matter

Outer tissue

Contains myelinated axons

Divisions are called columns (funiculi)

Columns contain groups of axons called nerve

tracts
Spinal
Cord/Nerve

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CNS: Spinal Cord (cont.)

One function of the spinal cord is to carry sensory

information to and from the brain

Ascending tracts

Carry sensory information up to the brain

Descending tracts

Carry motor information down from the brain to muscles

and glands

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CNS: Spinal Cord (cont.)

Reflexes

Another function of the spinal cord is to participate in

reflexes
Reflex a predictable, automatic response to stimuli
Receptor

Sensory Neurons

Interneurons
Effectors

Motor Neurons
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CNS: Brain

Four sections

Cerebrum
Diencephalons
Brain stem
Cerebellum

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CNS: Brain Cerebrum

Largest section
Two cerebral hemispheres

Connected by a thick bundle of nerve fibers called

the corpus callosum
Longitudinal fissure between hemispheres

Sulci grooves on surface

Gyri or convolutions bumps of brain matter
between sulci
Brain
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CNS: Brain Cerebrum (cont.)

Lobes

Frontal

Motor areas for voluntary

body movements
Somatosensory interprets
sensations

Temporal

Parietal

Parietal

Frontal

Auditory interprets sounds

Occipital

Temporal

Occipital

Interprets what a person sees

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CNS: Brain Cerebrum (cont.)

Cortex

Outer layer gray

matter

Interconnected
cavities within the
brain

Filled with CSF

Contains about 75%

of all neurons

Inner layer white matter

Functions

Ventricles

Interpret sensory information

Initiate body movements
Stores memories and creates emotions
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CNS: Brain Diencephalon

Between the cerebral hemispheres superior to

the brain stem

Thalamus

Relay station for sensory information going to the

cerebral cortex for interpretation

Hypothalamus

Maintains homeostasis by regulating vital activities

Brain

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CNS: Brain Brain Stem

Connects the cerebrum to

the spinal cord
Midbrain

Just beneath
diencephalon
Controls both visual
and auditory reflexes

Medulla oblongata

Pons

Rounded bulge on
underside of brain stem
Between midbrain and
medulla oblongata
Regulates respiration

Inferior portion of brain

stem
Directly connected to spinal
cord
Controls many vital
activities, such as heart rate,
blood pressure, and
breathing

Brain

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CNS: Brain Cerebellum

Location

Inferior to the occipital lobes of the cerebrum

Posterior to the pons and medulla oblongata

Coordinates

Complex skeletal muscle contractions that are

needed for body movements
Fine movements
Brain

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Preventing Brain and Spinal Cord

Injuries

Wear appropriate
protective gear for
sports

Avoid diving into

unknown waters

Always wear seat belts

Follow safety rules on

playgrounds

Children should be in
car seats appropriate
for age and weight

Know how to get help

quickly in emergencies

Follow traffic rules and

signs while walking,
biking, or driving

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29-38

Apply Your Knowledge

SUPER!

Match the following:

H Meninges
___

A. Carry motor information from brain

D Ascending tracts
___

B. Stores memories and creates emotions

A Descending tracts
___

C. Grooves on the surface of the cerebrum

B Cerebral cortex
___

D. Carry sensory information to the brain

F Hypothalamus
___

E. Predictable, automatic response to stimuli

C Sulci
___

F. Maintains homeostasis

G Cerebellum
___

G. Coordinates skeletal muscle contractions

E Reflexes
___

H. Protects the brain and spinal cord

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Peripheral Nervous System

Nerves that branch

off the CNS

Peripheral nerves

Two types:
Cranial nerves
Spinal nerves

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PNS: Cranial Nerves

I.

Olfactory nerves

Carry smell information to the brain for interpretation

II. Optic nerves

Carry visual information to the brain for interpretation

III. Oculomotor nerves

Found within the muscles that move the eyeball, eyelid,

and iris

IV. Trochlear nerves

Act in the muscles that move the eyeball.

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PNS: Cranial Nerves (cont.)

V. Trigeminal nerves

Carry sensory information from the surface of the

eye, the scalp, facial skin, the lining of the gums,
and the palate to the brain for interpretation
Also found within the muscles needed for
chewing

VI. Abducens nerves

Act in the muscles that move the eyeball

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PNS: Cranial Nerves (cont.)

Facial nerves

VII.

Found in the muscles of facial expression as

well as in the salivary and tear glands
Also carry sensory information from the
tongue

VIII. Vestibulocochlear nerves

Carry hearing and equilibrium information

from the inner ear to the brain for
interpretation
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PNS: Cranial Nerves (cont.)

IX. Glossopharyngeal nerves

X.

Carry sensory information from the throat and

tongue to the brain for interpretation
Also act in the muscles of the throat

Vagus nerves

Carry sensory information from the thoracic and

abdominal organs to the brain for interpretation
Also found within the muscles in the throat,
stomach, intestines, and heart
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PNS: Cranial Nerves (cont.)

XI. Accessory nerves

Found within the muscles of the throat, neck,

back, and voice box

XII. Hypoglossal nerves

Found within the muscles of the tongue

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PNS: Spinal Nerves

Peripheral nerves originating from the spinal

cord
31 pairs of spinal nerves

8 pairs of cervical nerves (C1 through C8)

12 pairs of thoracic nerves (T1 through T12)
5 pairs of lumbar nerves (L1 through L5)
5 pairs of sacral nerves (S1 through S5)
Spinal
1 pair of coccygeal nerves (C0)
Nerves
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PNS: Spinal Nerves (cont.)

Main portions of spinal nerves fuse to form

nerve plexuses

Cervical supply skin and muscles of neck

Phrenic nerve originates from this plexus

Controls diaphragm

Brachial control muscles in the arms

Lumbosacral lower abdomen, external genitalia,
buttocks, thighs, legs, and feet

Sciatic nerve originates from this plexus

Controls muscles of legs

Spinal
Nerves

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PNS: Somatic Nervous System

Nerves that connect the CNS to skin and skeletal

muscle
Voluntary nervous system

Controls skeletal muscles, which are under voluntary

control

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PNS: Autonomic Nervous System

Nerves that connect the CNS to organs and other

structures
Involuntary nervous system
Motor neurons located in ganglia

Neuron cell bodies outside the CNS

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PNS: Autonomic Nervous System (cont.)

Sympathetic division

Fight or flight Prepares body for stressful or

emergency situations
Neurons release neurotransmitter norepinephrine

Increases heart and breathing rates

Slows down muscles of the stomach and intestines
Dilates pupils
Constricts blood vessels increases blood pressure

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PNS: Autonomic Nervous System (cont.)

Parasympathetic division

Prepares body for rest and digesting

Controls most of the bodys organs
Releases acetylcholine

Slows heart and breathing rates

Constricts pupils
Activates muscles of stomach and intestine

No communication with blood vessels

Sympathetic and parasympathetic divisions are

antagonistic
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Apply Your Knowledge

What is the difference between the sympathetic and
parasympathetic nervous systems?
ANSWER: The sympathetic nervous system prepares the
body for stress. It releases norepinephrine, causing an
increase in heart and respiratory rate, slows down the GI
system, and dilates pupils. The sympathetic system also
controls constriction of blood vessels.
The parasympathetic system prepares the body for resting
and digesting. It releases acetylcholine, which slows heart
and respiratory rate, constricts pupils and stimulates the GI
system. It has no effect on most blood vessels.
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Neurologic Testing

Typical neurologic examination

State of consciousness
Reflex activity
Speech patterns
Motor patterns

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Neurologic Testing: Diagnostic Procedures

Lumbar puncture

Computerized
tomography (CT) scan

Magnetic resonance
imaging (MRI)

Electroencephalogram
(EEG)

Positron emission
tomography (PET) scan

X-ray

Cerebral angiography

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Neurologic Testing Cranial Nerve Tests

Olfactory nerves (Cranial nerve I)

Cranial nerves III, IV, and VI

Have patient smell various substances

Have patient track movement of finger

Cranial nerve V

Have patient clench teeth, feel jaw muscles

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Neurologic Testing Cranial Nerve Tests (cont.)

Cranial nerve VII

Check patients facial expression

Cranial nerve XII

Have patient extend his tongue and move it from

side to side

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Neurologic Testing: Reflex Testing

Areflexia

Hyporeflexia

Absence of a reflex

Decreased reflex

Hyperreflexia

Stronger-than-normal reflex
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Neurologic Testing: Reflex Testing

Biceps reflex

Knee reflex

Absence indicates spinal cord damage in the

cervical region

Absence may indicate damage to lumbar or

femoral nerves

Abdominal reflexes

Used to evaluate damage to thoracic spinal nerves

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Apply Your Knowledge

Match the following:

ANSWER:

C State of consciousness
___
A Reflex activity
___
D Speech patterns
___
B Motor patterns
___

A. Determines the health of

peripheral nerves
B. Loss of balance, abnormal
posture
C. Stupor, delirium, vegetative
D. Loss of ability to form words

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Common Diseases and Disorders

Disease/Disorder Description
Alzheimers
disease

Progressive, degenerative disease of

the brain

Amyotrophic
lateral sclerosis
(ALS)

Lou Gehrigs disease

Degeneration of neurons in the spinal
cord and brain

Bells palsy

Weak or paralyzed facial muscles

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Common Diseases and Disorders (cont.)

Disease/Disorder Description
Brain tumors and Abnormal growths
cancers
Can be primary or secondary tumors
Most common gliomas
Epilepsy and
seizures

Occurs as a result of bursts of

electrical signals that disrupt normal
brain functioning

Guillain-Barr
Syndrome

Bodys immune system attacks the

PNS
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Common Diseases and Disorders (cont.)

Disease/Disorder Description
Headaches
Tension
Migraines
Cluster

Episodic or chronic
With aura/without aura
Form of migraines; occurs in groups

Meningitis

Inflammation of meninges

Multiple
sclerosis (MS)

Chronic disease of CNS

Myelin is destroyed
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Common Diseases and Disorders (cont.)

Disease/Disorder Description
Neuralgias

Disorders causing nerve pain

Parkinsons
disease

Progressive and degenerative motor

system disorder

Sciatica

Damage to sciatic nerve

Stroke

Brain cells die because of an

inadequate blood flow; brain attack

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Apply Your Knowledge

True or false:

ANSWER:

Bravo!

T Alzheimers disease is a progressive degenerative disease of

___
the brain.
F Epilepsy is due to degenerative neurons in the spinal cord
___
and brain.

Due to a burst of electrical signals that disrupt brain function.

F Neuralgias are motor system disorders.

___
They are group of disorders referred to as nerve pain.

T Stroke occurs when brain cells die because of inadequate

___
blood flow.
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In Summary

Functions of the nervous system

Detecting and interpreting sensory information

Making decision about that information
Responding to and carrying out motor functions

Neurons are responsible for functions

Divisions

CNS brain and spinal cord

PNS cranial and spinal nerves
Knowledge of this system is essential when assisting the
physician during a neurologic exam
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End of Chapter

Activity of the nervous

system improves the
capacity for activity,
just as exercising a
muscle makes it
stronger.
~ Dr. Ralph Gerard
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