NEURO ANATOMI

Ratih Vierda

1
 Introduction

• The central nervous system (CNS) consists of the

brain and spinal cord.
• The brainstem connects the brain to the spinal cord.
• Communication to the peripheral nervous system
(PNS) is by way of the spinal cord.

2
Nervous System Subdivisions

3
 Brain
• Functions of the brain: • Major parts of the brain:
• Interprets sensations • Cerebrum
• Determines perception • Frontal lobes
• Stores memory • Parietal lobes
• Reasoning • Occipital lobes
• Makes decisions • Temporal lobes
• Coordinates muscular • Insula
movements • Diencephalon
• Regulates visceral activities • Cerebellum
• Determines personality • Brainstem
• Midbrain
• Pons 4
• Medulla oblongata
 The Brain
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Gyrus

Skull Sulcus

Meninges
Cerebrum Corpus
callosum
Diencephalon

Midbrain Fornix

Brainstem Pons

Medulla Cerebellum
oblongata

Spinal cord
(a)

Fornix

Cerebrum
Midbrain

Corpus Pons
callosum
Transverse fissure

Diencephalon
Cerebellum

Medulla oblongata

Spinal cord

5
(b)
b: © Martin M. Rotker/Photo Researchers, Inc.
 Brain Development
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• Neural tube
• Three primary vesicles: Prosencephalon (forebrain)

• Forebrain Mesencephalon (midbrain)

(Prosencephalon) Rhombencephalon (hindbrain)

• Midbrain
(Mesencephalon) Neural tube
• Hindbrain
(a)
(Rhombencephalon)
• Five secondary vesicles: Telencephalon Cerebral
• Telencephalon Diencephalon hemispheres

• Diencephalon
Diencephalon
Mesencephalon
Midbrain
• Mesencephalon Metencephalon
Pons and Cerebellum
• Metencephalon Myelencephalon Medulla
• Myelencephalon Neural tube
oblongata
Spinal cord

(b) (c)
6
Brain Development

7
 Structure of the Cerebrum
• Corpus callosum
• Connects cerebral Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Central sulcus
hemispheres (a Gyrus
Parietal lobe

commissure) Sulcus

• Gyri Frontal lobe

Lateral sulcus

• Bumps or convolutions
Occipital lobe

Temporal lobe Transverse

• Sulci fissure
Cerebellar
hemisphere
• Grooves in gray matter
(a)

Central sulcus
• Central sulcus of Parietal lobe

Rolando
• Fissures Central sulcus
Longitudinal
Occipital lobe
• Longitudinal: separates the fissure
Parietal lobe
Frontal lobe
Insula

cerebral hemispheres Occipital lobe Retracted

temporal lobe

• Transverse: separates (b) (c)

cerebrum from cerebellum

• Lateral fissure of Sylvius 8
 Lobes of the Cerebrum
• Five (5) lobes bilaterally: Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Frontal lobe Central sulcus

• Parietal lobe Parietal lobe

• Temporal lobe
• Occipital lobe
• Insula aka ‘Island of Reil’
Occipital lobe
Frontal lobe
Insula
Retracted
temporal lobe

(c)

9
 Functions of the Cerebrum
• Interpreting impulses
• Initiating voluntary movements
• Storing information as memory
• Retrieving stored information
• Reasoning
• Seat of intelligence and personality

10
 Functional Regions of the
Cerebral Cortex
• Cerebral cortex
• Thin layer of gray matter that constitutes the
outermost portion of cerebrum
• Contains 75% of all neurons in the nervous system
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Central sulcus
Motor areas involved with the control
Sensory areas involved with
of voluntary muscles
cutaneous and other senses

Concentration, planning,
problem solving

Frontal eye field

Parietal lobe
Auditory area
Sensory speech area
Front lobe ( Wernicke’s area)

Occipital lobe
Motor speech area
(Broca’s area) Combining
visual images,
visual recognition
Lateral sulcus
of objects
Visual area
Interpretation of auditory patterns
Cerebellum
11
Temporal lobe Brainstem
Functions of the Cerebral Lobes

12
 Motor Areas
(pre-central sulcus)
• Primary motor areas Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Frontal lobes Motor areas involved with the control

Central sulcus

• Control voluntary muscles

Sensory areas involved with
of voluntary muscles
cutaneous and other senses

Concentration, planning,
problem solving

• Broca’s area
Frontal eye field
Parietal lobe
Auditory area
Sensory speech area

• Anterior to primary motor Front lobe ( Wernicke’s area)

Occipital lobe
Motor speech area
cortex (Broca’s area) Combining
visual images,
visual recognition

• Usually in left hemisphere

Lateral sulcus
of objects
Visual area
Interpretation of auditory patterns

• Controls muscles needed Cerebellum

for speech Temporal lobe Brainstem

• Frontal eye field

• Above Broca’s area
• Controls voluntary
movements of eyes and 13
eyelids
 Motor Areas
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Trunk Pelvis Trunk

Arm Neck Pelvis
Thigh
Forearm Forearm Arm Thigh

Thumb,
Leg
fingers, Hand, fingers,
and hand and thumb Leg

Upper Foot and

Foot and face toes
Facial
toes
expression Genitals
Lips

Salivation Teeth and

Vocalization gums
Mastication
Tongue and
Swallowing pharynx

Longitudinal Longitudinal
fissure fissure
(a) Motor area (b) Sensory area

Frontal lobe

Motor area

Sensory area

Central sulcus Parietal lobe

14
 Sensory Areas
(post-central sulcus)
• Cutaneous sensory area • Sensory area for taste
• Parietal lobe • Near base of the central
• Interprets sensations on sulcus
skin • Sensory area for smell
• Arises from centers deep
• Visual area within the cerebrum
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Central sulcus
• Occipital lobe Motor areas involved with the control
of voluntary muscles
Sensory areas involved with
cutaneous and other senses
• Interprets vision Concentration, planning,
problem solving

Frontal eye field

Parietal lobe
Auditory area

• Auditory area
Sensory speech area
Front lobe ( Wernicke’s area)

Occipital lobe

• Temporal lobe Motor speech area

(Broca’s area) Combining

• Interprets hearing
visual images,
Lateral sulcus visual recognition
of objects
Visual area
Interpretation of auditory patterns
Cerebellum

Temporal lobe Brainstem 15

 Sensory Areas
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Trunk Pelvis Trunk

Arm Neck Pelvis
Thigh
Forearm Forearm Arm Thigh

Thumb,
Leg
fingers, Hand, fingers,
and hand and thumb Leg

Upper Foot and

Foot and face toes
Facial
toes
expression Genitals
Lips

Salivation Teeth and

Vocalization gums
Mastication
Tongue and
Swallowing pharynx

Longitudinal Longitudinal
fissure fissure
(a) Motor area (b) Sensory area

Frontal lobe

Motor area

Sensory area

Central sulcus Parietal lobe

16
 Association Areas
• Regions that are not primary motor or primary sensory areas
• Widespread throughout the cerebral cortex
• Analyze and interpret sensory experiences
• Provide memory, reasoning, verbalization, judgment, emotions

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Central sulcus
Motor areas involved with the control
Sensory areas involved with
of voluntary muscles
cutaneous and other senses

Concentration, planning,
problem solving

Frontal eye field

Parietal lobe
Auditory area
Sensory speech area
Front lobe ( Wernicke’s area)

Occipital lobe
Motor speech area
(Broca’s area) Combining
visual images,
visual recognition
Lateral sulcus
of objects
Visual area
Interpretation of auditory patterns
Cerebellum

Temporal lobe Brainstem

17
 Association Areas
• Frontal lobe association areas • Temporal lobe association areas
• Concentrating • Interpret complex sensory
• Planning experiences
• Complex problem solving • Store memories of visual scenes,
music, and complex patterns
• Parietal lobe association areas
• Understanding speech • Occipital lobe association areas
• Choosing words to express • Analyze and combine visual
thought images with other sensory
experiences

18
 Hemisphere Dominance
• The left hemisphere is dominant in most individuals

• Dominant hemisphere controls: • Nondominant hemisphere controls:

• Speech • Nonverbal tasks
• Writing • Motor tasks
• Reading • Understanding and interpreting
• Verbal skills musical and visual patterns
• Analytical skills • Provides emotional and
• Computational skills intuitive thought processes

19
 Memory
• Short term memory • Long term memory
• Working memory • Changes structure
• Closed neuronal circuit or function of neurons
• Circuit is stimulated over • Enhances synaptic
and over transmission
• When impulse flow ceases,
memory does also unless it
enters long-term memory via
memory consolidation

20
 Basal Nuclei
• Masses of gray matter Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Deep within cerebral Longitudinal

fissure

hemispheres Caudate Right cerebral

• Caudate nucleus,
nucleus hemisphere

Basal Putamen
nuclei

putamen, and globus Globus

pallidus

pallidus
• Produce dopamine Thalamus
Cerebellum

• Control certain Hypothalamus

Brainstem
muscular activities Spinal cord

• Primarily by
inhibiting motor
functions
21
 Diencephalon
• Between cerebral hemispheres and above the brainstem
• Surrounds the third ventricle
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Superior
colliculus

• Thalamus Corpora quadrigemina

Optic chiasma
Inferior
colliculus

• Epithalamus
Optic nerve

Pituitary gland
Thalamus

• Hypothalamus
Mammillary body
Third
Optic tract
ventricle

• Optic tracts Pons Cerebral

peduncles
Pineal gland

• Optic chiasm Pyramidal tract

Fourth
ventricle

• Infundibulum Olive
Cerebellar
peduncles

• Posterior pituitary Medulla

oblongata

• Mammillary bodies Spinal cord

• Pineal gland (a) (b)

22
 Diencephalon
• Thalamus
• Gateway for sensory impulses heading to cerebral cortex
• Sensory relay station
• Receives all sensory impulses (except smell)
• Channels impulses to appropriate part of cerebral cortex
for interpretation
• Hypothalamus
• Maintains homeostasis by regulating visceral activities
(such as HR, BP, temperature, H2O & electrolyte
balance, hunger, thirst, sleep & wakefulness)
• Links nervous and endocrine systems (hence some
say the neuroendocrine system 23
 Diencephalon
The Limbic System
• Consists of: • Functions:
• Portions of frontal lobe • Controls emotional
• Portions of temporal lobe experiences & produces
• Hypothalamus feelings like rage, anger,
• Thalamus pleasure
• Basal nuclei • survival behavior
• Other deep nuclei • Interprets sensory
impulses associated with
smell
24
 Brainstem
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Hypothalamus
Diencephalon
Three parts: Thalamus

1. Midbrain
2. Pons Corpus
callosum
3. Medulla Oblongata

Corpora
quadrigemina

Midbrain
Cerebral
aqueduct
Pons

Reticular
formation
Medulla
oblongata Spinal cord 25
 Midbrain
• Between diencephalon and
pons
• Contains bundles of fibers that Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Superior
colliculus
join lower parts of brainstem Corpora quadrigemina
Inferior
Optic chiasma colliculus
and spinal cord with higher part Optic nerve

Pituitary gland

of brain Mammillary body

Thalamus

Third

• Cerebral aqueduct
Optic tract
ventricle

• Cerebral peduncles (bundles Pons Cerebral

peduncles
Pineal gland

of nerve fibers) Pyramidal tract

Fourth
ventricle

• Corpora quadrigemina Olive

Cerebellar

(centers for visual and auditory peduncles

Medulla

reflexes) oblongata

Spinal cord

(a) (b)

26
 Pons
• Rounded bulge on underside of
brainstem Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Superior

• Between medulla oblongata and Corpora quadrigemina

colliculus

Inferior

midbrain Optic nerve

Optic chiasma colliculus

• Helps regulate rate and Pituitary gland

Mammillary body
Thalamus

Third
depth of breathing Optic tract
ventricle

• Relays nerve impulses to and Pons Cerebral

peduncles
Pineal gland
from medulla oblongata and Fourth
Pyramidal tract ventricle
cerebellum Olive
Cerebellar
peduncles

Medulla
oblongata

Spinal cord

(a) (b)

27
 Medulla Oblongata
• Enlarged continuation of
spinal cord Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Superior

• Conducts ascending and Corpora quadrigemina

colliculus

Inferior

descending impulses Optic nerve

Optic chiasma colliculus

Pituitary gland
between brain and spinal Mammillary body
Thalamus

Third
Optic tract
cord ventricle

• Contains cardiac, Pons Cerebral

peduncles
Pineal gland

vasomotor, and respiratory Pyramidal tract

Fourth
ventricle

control centers Olive

Cerebellar

• Contains various nonvital peduncles

Medulla
reflex control centers oblongata

(coughing, sneezing, Spinal cord

swallowing, and vomiting) (a) (b)

28
 Reticular Formation
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• Complex network of nerve Hypothalamus

Diencephalon
fibers scattered throughout the Thalamus

brain stem
• Extends into the Corpus
diencephalon callosum

• Connects to centers of
hypothalamus, basal nuclei,
cerebellum, and cerebrum Corpora
quadrigemina
• Filters incoming sensory
information Midbrain
Cerebral
• Arouses cerebral cortex intoPons aqueduct

state of wakefulness
Reticular
formation
Medulla
oblongata Spinal cord
29
 Types of Sleep
• Slow wave • Rapid Eye Movement (REM)
• Non-REM sleep • Paradoxical sleep
• Person is tired • Some areas of brain
• Decreasing activity of active
reticular system • Heart and respiratory
• Restful rates irregular
• Dreamless • Dreaming occurs
• Reduced blood pressure
and respiratory rate
• Ranges from light to heavy
• Alternates with REM sleep
30
 Cerebellum
• Inferior to occipital lobes
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• Posterior to pons and medulla Longitudinal

fissure

oblongata
• Two hemispheres Thalamus
Corpus callosum

• Vermis connects hemispheres

• Cerebellar cortex (gray matter) Superior peduncle
• Arbor vitae (white matter) Pons
Cerebellum

• Cerebellar peduncles (nerve fiber Middle peduncle

Inferior peduncle

tracts) Medulla oblongata

• Integrates sensory information

concerning position of body parts
• Coordinates skeletal muscle
activity
• Maintains posture

31
Major Parts of the Brain

32
 Cranial Nerves
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Olfactory bulb Olfactory (I)

Olfactory tract
Optic (II)

Optic tract Oculomotor (III)

Trochlear (IV)

Trigeminal (V)
Vestibulocochlear (VIII) Abducens (VI)

Hypoglossal (XII) Facial (VII)

Vagus (X) Glossopharyngeal (IX)

Accessory (XI)

33
 Cranial Nerves
• Remember:
• Cranial nerves are designated ‘C N’
• Cranial nerves are designated with Roman
numerals (I – XII)

34
CN I Olfactory Olfactory Smell
epithelium
CN II Optic Retina Vision
CN III Occulomotor Midbrain Eye movement;
accommodation
CN IV Trochlear Midbrain Eye movement
(superior oblique)
CN V Trigeminal Pons Sensation to face;
chewing
CN VI Abducens Pons Eye movement
( lateral rectus)
CN VII Facial Pons Facial expression;
taste to anterior
2/3 of tongue
CN VIII Vestibulocochlear Pons Hearing & balance
CN IX Glossopharyngeal Medulla Salivation;
swallowing; taste
to posterior 1/3 of
tongue
CN X Vagus Medulla Digestion; taste to
pharynx
CN XI Accessory Medulla Movement of
trapezius & SCM
CN XII Hypoglossal Medulla Movement of
tongue
Functions of Cranial Nerves

36
 Meninges
• The meninges
• Membranes of CNS
• Protect the CNS Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Skin

• Three (3) layers: Scalp

Cranium
Subcutaneous tissue
Bone of skull

• Dura mater Cerebrum Dural sinus (superior

sagittal sinus)

• “Tough mother” Tentorium

cerebelli
Arachnoid
granulation

• Venous sinuses
Dura mater
Cerebellum
Arachnoid Meninges
mater

• Falx Vertebra

Spinal cord
Pia mater
Subarachnoid space

• Arachnoid mater Meninges

Falx cerebri
Gray matter
Cerebrum

• “Spiderweb-like”
White matter
(a) (b)

• Space contains
cerebrospinal
fluid (CSF)
• Pia mater
• “Faithful mother”

37
 Meninges of the Spinal Cord
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Spinal cord

Ventral root
Subarachnoid
Pia mater space
Dorsal root

Spinal nerve Arachnoid mater

Epidural space
Dorsal root Dura mater
ganglion
Dorsal root

Dorsal branch
Spinal
(dorsal ramus)
nerve
Ventral branch
Dorsal root (ventral ramus)
ganglion
Spinal cord
Ventral root
Epidural
space
Thoracic
vertebra Body of
vertebra
(a) (b)
38
 Ventricles
and Cerebrospinal Fluid
• There are four (4) ventricles
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• The ventricles are interconnected

cavities within cerebral hemispheres Lateral ventricle

and brain stem Interventricular

foramen

• The ventricles are continuous with Third ventricle

the central canal of the spinal cord Cerebral

aqueduct

• They are filled with cerebrospinal Fourth ventricle

fluid (CSF)
To central canal
of spinal cord
(a)
• The four (4) ventricles are: Interventricular

• Lateral ventricles (2) foramen

• Known as the first and Lateral

ventricle

second ventricles Third ventricle

• Third ventricle Cerebral

• Fourth ventricle
aqueduct

Fourth
• Interventricular foramen 39
ventricle

• Cerebral aqueduct (b)

To central canal
of spinal cord
 Cerebrospinal Fluid
• Secreted by the choroid plexus Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Circulates in ventricles, central Arachnoid

granulations

canal of spinal cord, and the Blood-filled

dural sinus
subarachnoid space Choroid plexuses
of third ventricle
• Completely surrounds the brain Pia mater
Third ventricle
and spinal cord Cerebral aqueduct
Subarachnoid space
Arachnoid mater
• Excess or wasted CSF is Fourth ventricle
Dura mater

absorbed by the arachnoid villi Choroid plexus of

fourth ventricle

• Clear fluid similar to blood

plasma Central canal of spinal cord
Pia mater

• Volume is only about 120 ml. Subarachnoid space

• Nutritive and protective Filum terminale

Arachnoid mater
• Helps maintain stable ion Dura mater

concentrations in the CNS

40
 Spinal Cord
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• Extends downward
through vertebral canal Foramen
Brainstem

magnum
• Begins at the foramen Cervical Cervical
enlargement enlargement
magnum and terminates at
the first and second lumbar Spinal cord

vertebrae (L1/L2) Vertebral

canal
interspace
Lumbar
Lumbar
enlargement
enlargement
Conus Conus
medullaris medullaris
Cauda
equina
Filum
terminale

42
(a) (b)
 Structure of the Spinal Cord
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Posterior horn
Posterior funiculus
White matter Posterior median
sulcus
Gray matter
Gray commissure
Lateral funiculus

Dorsal root Central canal

of spinal nerve
Anterior
Dorsal root funiculus
ganglion

Ventral root Anterior Anterior Portion of

of spinal nerve horn median spinal nerve
(a) fissure
43
 Functions of Spinal Cord

• Conduit for nerve impulses to and from the brain

and brainstem

• Center for spinal reflexes

44
 Reflex Arcs
• Reflexes are automatic, subconscious responses to stimuli within
or outside the body
• Simple reflex arc (sensory – motor)
• Most common reflex arc (sensory – association – motor)

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Sensory or Motor or
afferent neuron Central efferent neuron
Nervous
System

Receptor Effector
(muscle or gland)
45
12
(a)
Reflex Arcs

46
 General Components of a
Spinal Reflex
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Spinal cord
Interneuron Dorsal
1
Receptor 3

Cell body
2 White matter
of sensory
Sensory neuron neuron Gray matter

4 Ventral Central
Motor neuron canal

5
Effector
(muscle
or gland) 47
(b)
 Patellar Reflex
• Example is the knee-jerk reflex
• Simple monosynaptic reflex
• Helps maintain an upright posture & prevents overstretching
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Axon of sensory Spinal cord

neuron

Cell body of Effector (quadriceps femoris

sensory neuron Cell body of muscle group)
motor neuron
Receptor associated with
dendrites of sensory neuron
Axon of motor
neuron Patella

Direction of impulse Patellar ligament

48
 Withdrawal Reflex
• Prevents or limits tissue damage
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Cell body of sensory neuron

Axon of sensory neuron

Direction
of impulse Interneuron

Spinal cord
Effector (flexor Axon of
muscle contracts motor neuron Cell body of
and withdraws part motor neuron
being stimulated)
Dendrite of
sensory
neuron
Pain
receptor
in skin 49
Tack
 Crossed Extensor Reflex
•Contralateral reflex
•Maintain balance
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Interneuron

+ = Stimulation
– = Inhibition
+ –
– +

Sensory neuron Extensor

Extensor
relaxes
contracts

Flexor
relaxes
Motor Motor
neurons neurons

Flexor contracts

50
17
 Tracts of the Spinal Cord
• Ascending tracts conduct sensory impulses to the brain
• Descending tracts conduct motor impulses from the brain
to motor neurons reaching muscles and glands
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Fasciculus gracilis
Dorsal column
Fasciculus cuneatus

Posterior spinocerebellar tract

Lateral corticospinal tract
Lateral reticulospinal tract
Rubrospinal tract

Anterior spinocerebellar tract

Lateral spinothalamic tract
Anterolateral
system Anterior spinothalamic tract
Anterior reticulospinal tract

Medial reticulospinal tract Anterior

corticospinal 51
tract
 Ascending Tracts
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• Major ascending (sensory) Sensory

cortex of
spinal cord tracts: cerebrum

• Fasciculus gracilis and Cerebrum

(frontal
section)
fasciculus cuneatus Thalamus

• Spinothalamic tracts
Midbrain
• Lateral and anterior Spinothalamic
tract

• Spinocerebellar tracts Brainstem

(transverse

• Posterior and sections)

Pons Fasciculus
cuneatus
anterior tract
Sensory
Medulla impulse
from skin
temperature
or pain
Spinal cord
receptors
(transverse section)
Sensory fibers
cross over 52
 Descending Tracts
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• Major descending (motor) spinal Motor cortex

of cerebrum

cord tracts:
Cerebrum

• Corticospinal tracts (frontal

section)

• Lateral and anterior

Corticospinal
tract

• Reticulospinal tracts Midbrain

• Lateral, anterior and

medial Brainstem
(transverse

• Rubrospinal tract
sections)

Pons

Motor fibers
cross over
Medulla
oblongata

Spinal cord
(transverse section)

Motor
impulse to
53
skeletal
muscle
Nerve Tracts of the Spinal
Cord

54
 Peripheral Nervous System

• Cranial nerves arising from the brain

• Somatic fibers connecting to the skin and skeletal muscles
• Autonomic fibers connecting to viscera

• Spinal nerves arising from the spinal cord

• Somatic fibers connecting to the skin and skeletal muscles
• Autonomic fibers connecting to viscera

55
Structure of a Peripheral Nerve
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Fascicle Peripheral nerve

Epineurium

Motor neuron
ending

Axon

Perineurium

Endoneurium

Node of Ranvier

Schwann cell Sensory receptor

56
Myelin sheath

Neurilemma
 Nerve and Nerve Fiber
Classification
• Sensory nerves
• Conduct impulses into brain or spinal cord

• Motor nerves
• Conduct impulses to muscles or glands

• Mixed (both sensory and motor) nerves

• Contain both sensory nerve fibers and motor nerve
fibers
• Most nerves are mixed nerves
• ALL spinal nerves are mixed nerves (except the first
pair)
57
 Nerve Fiber Classification
• General somatic efferent (GSE) fibers • General somatic afferent (GSA) fibers
• Carry motor impulses from CNS to • Carry sensory impulses to CNS from
skeletal muscles skin and skeletal muscles

• General visceral efferent (GVE) fibers • General visceral afferent (GVA) fibers
• Carry motor impulses away from • Carry sensory impulses to CNS from
CNS to smooth muscles and glands blood vessels and internal organs

58
 Nerve Fiber Classification
• Special somatic efferent (SSE) fibers
• Carry motor impulses from brain to muscles used
in chewing, swallowing, speaking and forming facial
expressions

• Special visceral afferent (SVA) fibers

• Carry sensory impulses to brain from olfactory and
taste receptors

• Special somatic afferent (SSA) fibers

• Carry sensory impulses to brain from receptors of
sight, hearing and equilibrium
59
 Spinal Nerves
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• ALL are mixed nerves

(except the first pair) Posterior

• 31 pairs of spinal nerves:

view
C1
C2
C3
C4 Cervical

• 8 cervical nerves C5
C6
C7
C8
nerves

• (C1 to C8)
T1
T2
T3

• 12 thoracic nerves
T4
T5
T6

• (T1 to T12)
Thoracic
T7 nerves
T8

• 5 lumbar nerves T9
T10

• (L1 to L5)
T11

T12
L1

• 5 sacral nerves Cauda equina L2

L3 Lumbar
nerves

• (S1 to S5)
L4
L5

S1

• 1 coccygeal nerve S4
S5
S2
S3 Sacral
nerves

• (Co or Cc)
Co Coccygeal
nerve
60
 Spinal Nerves
• Dorsal root (aka posterior Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Dorsal root
root) Dorsal branch
of spinal nerve
Ventral branch

• Sensory root Dorsal root

ganglion
of spinal nerve

• Axons of sensory Dorsal root

Posterior
Ventral root
Paravertebral
ganglion
median sulcus
neurons are in the Posterior

dorsal root ganglion horn

Visceral branch

• Dorsal root ganglion (b)

of spinal nerve

• Aka DRG Lateral horn Ventral branch

of spinal nerve (ventral ramus)

• Cell bodies of sensory Anterior

horn Dorsal branch
of spinal nerve (dorsal ramus)
Central
neurons whose axons canal
Anterior
Spinal nerve

Paravertebral
conduct impulses inward median
fissure ganglion
Visceral branch
from peripheral body parts
(a) Ventral root of spinal nerve

61
 Dermatome
• An area of skin that the sensory nerve fibers of a
particular spinal nerve innervate
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

C2

C2 C3
C3 C4
C5
C4 C6
C5 C7
C8
T1
T1

C6

T1 T12
L1

T12 L5
S1
S2
L1 S3
S4
S2 L2 S5
C6 C0
S3
C7 L3
L1

L2
L4
C8

L3

L5

S1
L4

L5
62
(a) (b)
 Spinal Nerves
• Ventral root (aka anterior root) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Motor root
Dorsal root Dorsal branch
of spinal nerve
Ventral branch

• Axons of motor neurons Dorsal root

ganglion
of spinal nerve

whose cell bodies are in the Dorsal root

Posterior
Ventral root
Paravertebral
ganglion
median sulcus
spinal cord Posterior
horn

• Spinal nerve Visceral branch

of spinal nerve

• Union of ventral root (b)

Lateral horn Ventral branch

and dorsal roots Anterior
of spinal nerve (ventral ramus)

horn
• Hence we now have
Dorsal branch
Central of spinal nerve (dorsal ramus)
canal
Spinal nerve

a “mixed” nerve Anterior

median Paravertebral
ganglion
fissure
Visceral branch
(a) Ventral root of spinal nerve

63
 Nerve Plexuses
• Nerve plexus
• Complex networks formed by anterior branches (ventral rami) of spinal
nerves
• The fibers of various spinal nerves are sorted and recombined
• There are three (3) nerve plexuses:

• (1) Cervical plexus

• Formed by anterior branches of C1-C4 spinal nerves
• Lies deep in the neck
• Supply to muscles and skin of the neck
• C3-C4-C5 nerve roots contribute to phrenic nerves bilaterally

64
 Plexuses
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Posterior view

C1
C2
C3 Cervical plexus
C4 (C1–C4)
C5
C6
C7 Brachial plexus
C8 (C5–T1)
T1
Musculocutaneous
nerve T2
T3
Axillary nerve
Radial nerve T4
Median nerve T5
Ulnar nerve
T6
Phrenic nerve Intercostal
T7 nerves

T8
T9
T10
T11
T12
L1
Cauda equina
L2
L3
L4 Lumbosacral plexus
Femoral (T12–S5)
nerve L5
S1
S2
S3
Obturator nerve S4
S5
Co
Sciatic nerve
65
 Brachial Plexus
• (2) Brachial plexus
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

C5
Ventral rami: C5, C6, C7, C8, T1
C6
Trunks: upper, middle, lower

• Formed by anterior branches C5-T1

C7
Anterior divisions
C5 C8
Posterior divisions
T1

• Lies deep within shoulders

Dorsal
scapular n.
C6

• There are five (5) branches: C7

• 1. Musculocutaneous nerve Suprascapular n.

Lateral pectoral n. C8
Axillary n.
Humerus

• Supply muscles of anterior Medial pectoral n.

Lower subscapular n. T1

arms and skin of forearms Thoracodorsal n.

Musculocutaneous n.

• 2. Ulnar and 3. Median nerves Median n. Median n.

• Supply muscles of forearms

Ulnar n.
Axillary n.
Radial n.
Musculocutaneous n.
(a)

and hands
• Supply skin of hands Radial n.
Ulnar n.

• 4. Radial nerve Ulna

• Supply posterior muscles of Radius

arms and skin of forearms and

hands
• 5. Axillary nerve
• Supply muscles and skin of
anterior, lateral, and posterior (b)
66
78
arms
 Lumbosacral Plexus
• (3) Lumbosacral plexus
• Formed by the anterior branches Ventral
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

rami

of L1-S5 roots Anterior

divisions

• Can be a lumbar (L1-L5) plexus

Posterior
divisions L1 Superior
gluteal n.

and a sacral (S1-S5) plexus L2

Obturator n.
Inferior
gluteal n.
Sacral
Pudendal n.

• Extends from lumbar region into L3 Femoral n.

plexus

Posterior
pelvic cavity Lateral
L4
Sciatic n.
cutaneous n.

• Obturator nerve
femoral
cutaneous n. Saphenous n.
L5
Femoral n.

• Supply motor impulses to Obturator n.

Tibial n.
S1

adductors of thighs Superior

S2

S3
Common
fibular
(peroneal) n.

• Femoral nerve
gluteal n.
Inferior S4
gluteal n.

• Supply motor impulses to

Common S5
fibular
Sciatic n.
(peroneal) n.
Tibial n.

muscles of anterior thigh and Pudendal n.

sensory impulses from skin of (a) (b) (c)

thighs and legs

• Sciatic nerve
• Supply muscles and skin of
thighs, legs and feet 67
 Autonomic Nervous System
• Functions without conscious effort
• Controls visceral activities
• Regulates smooth muscle, cardiac muscle, and glands
• Efferent fibers typically lead to ganglia outside of the CNS

• Two autonomic divisions regulate:

• Sympathetic division (speeds up)
• Prepares body for ‘fight or flight’ situations
• Parasympathetic division (slows down)
• Prepares body for ‘resting and digesting’ activities

68
 Autonomic Nerve Fibers
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Interneurons

• All of the neurons are

motor (efferent) Dorsal root
ganglion
Dorsal root ganglion

Sensory
neuron Sensory

• Preganglionic fibers Spinal cord

Preganglionic Somatic motor neuron
neuron

• Axons of preganglionic Autonomic

ganglion
fiber

Postganglionic
neurons fiber

• Neuron cell bodies in Viscera

CNS Skin

• Postganglionic fibers Skeletal

muscle

• Axons of postganglionic (a) Autonomic pathway (b) Somatic pathway

neurons
• Neuron cell bodies in
ganglia 69
 Sympathetic Division
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Thoracolumbar division – Spinal cord

location of preganglionic Ventral root Dorsal root

neurons Dorsal root

Sympathetic
ganglion
trunk

• Preganglionic fibers leave Paravertebral

sympathetic
Pia mater
Arachnoid
spinal nerves through white rami ganglion mater

and enter paravertebral ganglia

Spinal nerves
Dura
mater

Transverse
• Paraverterbral ganglia and process

fibers that connect them make

up the sympathetic trunk Vertebral notch
(forms part of
Body of
intervertebral
vertebra
foramen)
70
 Sympathetic Division
• Postganglionic fibers
extend from sympathetic Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

ganglia to visceral organs

Preganglionic Postganglionic Gray
neuron neuron Dorsal root ramus
ganglion
Spinal cord White
Dorsal root

• Postganglionic fibers usually

ramus
Posterior horn
Sympathetic trunk

Lateral horn
pass through gray rami and Anterior horn
Dorsal branch of
spinal nerve

return to a spinal nerve before Ventral root

Spinal
nerve
Ventral branch of
spinal nerve

proceeding to an effector Paravertebral

sympathetic
ganglion
Visceral effector
(intestine)

To visceral effectors
(smooth muscle
of blood vessels,
arrector pili
Collateral muscles, and

• Exception: preganglionic fibers to ganglion sweat glands)

adrenal medulla do not synapse

with postganglionic neurons
71
Sympathetic Division
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Lacrimal gland
Eye

Parotid gland,
submandibular and
sublingual glands

Blood vessels

Heart

Celiac and
Trachea
pulmonary
plexuses

Lungs

Skin Celiac
ganglion

Liver
Fibers to Superior Gallbladder
skin, blood vessels, mesenteric Stomach
and adipose tissue ganglion

Pancreas

Small intestine

Large intestine
Inferior
Spinal mesenteric
cord ganglion

Adrenal gland
Kidney
Sympathetic
chain ganglia

Urinary
Preganglionic Postganglionic bladder
neuron neuron

Penis
Ovary 72
Uterus

Scrotum
 Parasympathetic Division
• Craniosacral division – • Preganglionic fibers of the
location of preganglionic head are included in nerves III,
neurons VII, and IX

• Ganglia are near or

within various organs • Preganglionic fibers of
• Terminal ganglia thorax and abdomen are parts
of nerve X

• Short postganglionic
fibers
• Continue to specific
muscles or glands
73
Parasympathetic Division
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Sphenopalatine Lacrimal
ganglion gland
Cranial Ciliary ganglion Eye
nerve III
Submandibular
and sublingual
Submandibular glands
Cranial ganglion
nerve
VII Parotid
Otic ganglion gland
Cranial
nerve IX
Heart
Cranial nerve X
(Vagus)
Trachea

Lung

Cardiac and
pulmonary
plexuses

Liver
Gallbladder
Celiac Stomach
plexus
Spleen

Pancreas
Superior
hypogastric
plexus Small intestine

Large intestine
Spinal Inferior
cord hypogastric
plexus

Kidney

Pelvic
nerves

Urinary
bladder

Preganglionic Postganglionic
Scrotum Uterus
74
neuron neuron
Penis Ovary
 Autonomic Neurotransmitters
• Cholinergic fibers Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Release acetylcholine
ACh = acetylcholine (cholinergic)
Brain
NE = norepinephrine (adrenergic)
• Preganglionic Visceral
effectors
sympathetic and Cranial Preganglionic fiber (axon) ACh
ACh
parasympathetic fibers parasympathetic
neurons
Ganglion
• Postganglionic
parasympathetic fibers
ACh
Postganglionic fiber (axon)
NE
Paravertebral
ganglion
Sympathetic neurons
• Adrenergic fibers ACh

• Release Collateral
NE

ganglion
norepinephrine
• Most Sacral
parasympathetic
neurons ACh ACh
postganglionic
sympathetic
fibers
75
 Actions of Autonomic
Neurotransmitters
• Result from binding to protein receptors in the
membrane of effector cells:
• Cholinergic receptors • Adrenergic receptors
• Bind acetylcholine (Ach) • Bind epinephrine
• Muscarinic and norepinephrine
• Excitatory • Alpha and beta
• Slow • Both elicit different
• Nicotinic responses on various
• Excitatory effectors
• Rapid

76
 Control of Autonomic
Activity
• Controlled largely by CNS

• Medulla oblongata regulates cardiac, vasomotor and

respiratory activities

• Hypothalamus regulates visceral functions, such as

body temperature, hunger, thirst, and water and
electrolyte balance

• Limbic system and cerebral cortex control emotional

responses 77
 Lifespan Changes
• Brain cells begin to die before birth
• Over average lifetime, brain shrinks 10%
• Most cell death occurs in temporal lobes
• By age 90, frontal cortex has lost half its neurons
• Number of dendritic branches decreases
• Decreased levels of neurotransmitters
• Fading memory
• Slowed responses and reflexes
• Increased risk of falling
• Changes in sleep patterns that result in fewer sleeping hours

78