CHAPTER 12

Nervous System
Mir Saleem, MD, MS

Combining Forms

alges/o sense of pain

astr/o star
centr/o center
cerebell/o cerebellum
cerebr/o cerebrum
clon/o rapid contracting and relaxing
concuss/o to shake violently
dur/o dura mater
neur/o nerve

Combining Forms

encephal/o brain
esthes/o sensation, feeling
gli/o glue
medull/o medulla
mening/o meninges
meningi/o meninges
ment/o mind
myel/o spinal cord

Combining Forms

peripher/o away from center

plegi/o paralysis
poli/o gray matter
pont/o pons
radicul/o nerve root
thalam/o thalamus
thec/o sheath (meninges)
ton/o tone
ventricul/o ventricle

Suffixes

paresis
plegia
phasia
taxia

weakness
paralysis
speech
muscle coordination

Anatomy and Physiology

Anatomy and
Physiology

Anatomy and Physiology

It is center for:
Thoughts
Memory
Judgment
Emotion
It processes
Sensory and
motor functions

Anatomy and Physiology

Diencephalon:
Thalamus:
Process sensory information

Hypothalamus:
Controls body temperature, appetite, sleep,
sexual desire, and emotions, and autonomic
nervous system

Cerebellum:
Coordinating voluntary body movements
Maintaining balance and equilibrium

Anatomy and Physiology

Brain Stem:
Midbrain
Acts as pathway for impulses between brain
and spinal cord

Pons
Means bridge
Connects cerebellum to rest of brain

Medulla oblongata
Most inferior portion of brain
Connects brain to spinal cord

Anatomy and
Physiology
Spinal Cord
Ascending tracts
carry sensory
information up to
brain
Descending tracts
carry motor
commands down
from brain to
peripheral nerve

Anatomy and Physiology

Meninges
Protective membrane sac
Encases entire CNS

Anatomy and Physiology

Peripheral Nervous System
Consists of:
12 pairs of cranial nerves
31 pairs of spinal nerves
Cranial nerves
Arise from brain
Spinal nerves
Split off from spinal cord
One pair (left and right) exit between
each pair of vertebrae

Anatomy and Physiology

CN I Olfactory

sense of smell

CN II Optic

sense of sight

CN
III

Oculomotor

controls eye muscles and pupil of

eye

CN
IV

Trochlear

controls oblique muscles of eye

CN V Trigeminal
CN
VI

Abducens

facial sensation and controls

muscles for chewing
controls eyeball muscles to turn
eye to side

Anatomy and Physiology

CN
VII

Facial

CN
Vestibulocochlear
VIII

controls facial muscles for

expression, salivation, and taste
on ant. two-thirds of tongue
sense of equilibrium and hearing

CN
IX

sensation from pharynx and

Glossopharyngeal
taste on one-third of tongue

CN
X

Vagus

supplies most organs in

abdominal and thoracic cavities

CN
XI

Accessory

controls neck & shoulder

muscles

CN
XII

Hypoglossal

controls tongue muscles

Anatomy
and
Physiology

Anatomy and Physiology

Autonomic Nervous System (ANS):
Control of involuntary or unconscious
bodily functions
Sympathetic branch
Stimulates body in times of stress and crisis
Increases heart rate, dilates airways, increases
blood pressure, inhibits digestion, and
stimulates production of adrenaline

Parasympathetic branch
Serves as counterbalance for sympathetic
nerves
Causes heart rate to slow down, lowers blood
pressure, and stimulates digestion

Anatomy and Physiology

Somatic Nerves
Mainly involved with conscious and
voluntary activities of body
Serve skin and skeletal muscles

Carry information from sensory

receptors of skin
Such as touch, temperature,
pressure, and pain

Carry motor commands to skeletal

muscles

Signs and Symptoms

absence
seizure

epileptic seizure characterized by loss of

awareness and absence of activity

analgesia

absence of pain

anesthesia

lack of feeling or sensation

aphasia

inability to communicate verbally or in

writing

ataxia

lack of muscle coordination

aura

sensations occurring prior to epileptic

seizure or migraine; e.g., seeing colors

cephalalgia

a headache

Signs and Symptoms

coma

state of profound unconsciousness

conscious

awake and aware of surroundings

convulsion

alternating between strong involuntary

muscle contractions and relaxations

delirium

confusion, disorientation, and agitation

dementia

impaired intellectual function

dysphasia

difficulty communicating verbally or in

writing

focal seizure

seizure in only one limb or body part

hemiparesis

weakness on one side of body

Signs and Symptoms

hemiplegia

paralysis on one side of body

hyperesthesia

abnormally heightened sense of feeling,

pain or touch

monoparesis

muscle weakness in a single limb

monoplegia

paralysis of one limb

neuralgia

nerve pain

palsy

loss of ability to control movements

paralysis

temporary or permanent loss of

voluntary movement

paraplegia

paralysis of lower portion of body

Signs and Symptoms

paresthesia

abnormal sensations such as burning or

tingling

quadriplegia

paralysis of all four limbs

seizure

sudden, uncontrollable onset of

symptoms; such as in epileptic seizure

aware of surroundings only part of the

semiconscious
time
syncope

Fainting

tonic-clonic
seizure

epileptic seizure with strong muscle

spasms; formerly called grand mal

tremor

involuntary repetitive alternating

movements

Brain Pathology
Alzheimer's
disease

disorder characterized by progressive

dementia, disorientation, apathy, and
loss of memory

cerebral
aneurysm

ballooning of cerebral artery; may

cause stroke

cerebral
contusion

bruising of brain from impact;

symptoms last longer than 24 hrs;
include unconsciousness, dizziness,
vomiting, unequal pupils

cerebral palsy
(CP)

brain damage results from defect,

trauma, or oxygen deprivation at time
of birth

Brain Pathology
concussion

mild traumatic brain injury from impact

stroke

infarct due to loss of blood supply to

brain; may be due to hemorrhage,
thrombus, embolus, or compression;

epilepsy

seizures and loss of consciousness caused

by uncontrolled electrical activity of brain

hydrocephalus

accumulation of cerebrospinal fluid within

brain ventricles

migraine

specific type of headache with severe

pain, light sensitivity, dizziness, and
nausea

Brain Pathology
Parkinson's
disease

chronic disorder of brain with tremors,

weakness, muscle rigidity, & shuffling
gait

Reye's
syndrome

acute encephalopathy and organ

damage; follows viral infection and
associated with taking aspirin

transient
ischemic
attack (TIA)

temporary interference with blood

supply to brain; may lead to a CVA

Spinal Cord Pathology

amyotrophic lateral degeneration of motor neurons of
sclerosis (ALS)
spinal cord (Lou Gehrig's disease)
myelitis

inflammation of the spinal cord

poliomyelitis

viral infection affecting spinal cord;

paralysis may be mild and temporary
or severe and permanent

spina bifida

congenital defect where lamina of

vertebra do not meet or close to form
spinal canal

myelomeningocele

protrusion of meninges and spinal

cord through opening left by spina
bifida defect

Nerves
Bell's palsy

one-sided facial paralysis caused by virus

Guillain-Barr
syndrome
(GBS)

temporary loss of myelin sheath; may be

autoimmune; starts in legs and
progresses upward

multiple
loss of myelin sheath; results in
sclerosis (MS) weakness and numbness
myasthenia
gravis

muscular weakness and fatigue due to

insufficient neurotransmitter at synapses

neuropathy

general term for disease or damage to a

nerve

radiculopathy

condition caused by herniated disc

putting pressure on a nerve root

Meninges
epidural
hematoma

mass of blood in
space outside dura
mater

meningitis

inflammation of the
meninges

subdural
hematoma

mass of blood
forming inside
subdural space; due
to torn meningeal
blood vessel; space
occupying lesion

Diagnostic Tests
cerebrospinal
fluid analysis

examination of CSF; may

detect infections and blood

CT scan

A detailed image of brain

and surrounding tissue

cerebral
angiography

X-ray of cerebral blood

vessels after injection of
radiopaque dye

myelography

X-ray of spinal cord after

injection of radiopaque dye
into spinal canal

Diagnostic Tests
positron
emission
tomography
(PET)

use of positive radionuclides to

construct an image of the
brain; image reveals metabolic
activity of brain areas

electroencep
records the electrical activity of
halography
brain
(EEG)
lumbar
puncture

puncture to remove CSF for

examination

nerve
conduction
velocity

measures speed at which an

impulse travels along a nerve;
reveals nerve damage

Medical & Surgical Procedures

nerve block

anesthetic injection into nerve area to

block nerve impulses on that nerve;
used to treat chronic pain

removes blockage of major artery in

carotid
neck that carries blood to brain by
endarterectomy
removing inner lining of the artery
laminectomy

removes part of vertebra; relieves

pressure on spinal nerve

tractotomy

surgical cut of nerve tract; treats

severe chronic pain

Pharmacology
analgesic

treats minor to moderate pain,

non-narcotic

anesthetic

produces loss of sensation or

consciousness

anticonvulsant

reduces nerve excitability to

prevent seizures

dopaminergic drugs

treats Parkinson's disease

hypnotic

promotes sleep

narcotic analgesic

treats severe pain

sedative

calming or relaxing effect