1. Neurology
Chapter 10

2. Neurology
The medical specialty that studies the anatomy and physiology of the nervous system.

3. Figure 10-1 Nervous system.

4. Anatomy and Physiology
Nervous System
Found in every part of the body from the head to the tips of the fingers and toes
Divided into central nervous system (CNS) and peripheral nervous system (PNS)
CNS contains brain and spinal cord.
PNS contains cranial nerves and spinal nerves; can be divided into somatic and autonomic nervous systems.

5. Figure 10-2 Divisions of the nervous system.

6. Horse’s tail
When looking at the nervous system, the brain and the spinal cord are the main players. But also, we have these nerves coming off of the spinal cord that intervene throughout the body.
Cervical nerves (C1 – 8)
Thoracic nerves (T1 – 12)
Lumbar nerves (L1 – 5)
Sacral nerves (S1 – 5)
When looking at this, the cauda equina (cquada egwina) right there in the sacral nerves – it translates to be horses tail – and that is what it looks like – a big bushy horses tail of nerves coming out of the sacral area. The sciatic nerve is a large nerve that runs down the back of the leg. The femoral nerve coming off the lumbar area and runs down inside of the thigh to the bottom of the leg. Also see the different plexus(es) – the cervical, brachial and the lumbosacral plexus.

7. Anatomy of the Central Nervous System
Brain
Located within the bony cranium
Fills the cranial cavity
Consists of the cerebrum (and its lobes), thalamus, hypothalamus, ventricles, brainstem, and cerebellum
Surrounded by the meninges, three layers of membranes

9. Anatomy of the Central Nervous System
Cerebrum
Largest and most obvious part of the brain
The cerebrum is divided into lobes.
Each lobe has the same name as the cranial bone that is above it.

10. Anatomy of the Central Nervous System
Thalamus
Located near the center of the cerebrum
Acts as a relay station, receiving sensory information from the cranial nerves and the spinal nerves and sending it to the midbrain and cerebrum

11. Anatomy of the Central Nervous System
Hypothalamus
Located below the thalamus
Regulates body temperature and sensations of hunger and thirst

12. Anatomy of the Central Nervous System
Brainstem
Pons is the middle part of the brainstem; relays nerve impulses from the spinal cord to the midbrain, hypothalamus, thalamus, and cerebrum.
Medulla oblongata contains centers that set the respiratory rate and control the heart rate.

13. Anatomy of the Central Nervous System
10-1
Anatomy of the Central Nervous System
Cerebellum
Receives sensory information to help maintain balance
Coordinates movements

14. Anatomy of the Central Nervous System
Spinal Cord
Part of the central nervous system
A long, narrow column of neural tissue within the spinal cavity (or spinal canal)
Protected by the vertebrae

15. Figure Spinal cord.

16. Anatomy of the Peripheral Nervous System
Spinal Nerves
Part of the peripheral nervous system
There are 31 pairs that originate at regular intervals along the spinal cord.

17. Anatomy of the Peripheral Nervous System
Autonomic Nervous System
Controls the involuntary contractions of cardiac muscle in the heart, as well as smooth muscles around organs, glands, and other structures
Can be broken down into two divisions:
Parasympathetic division
Sympathetic division

18. Anatomy of the Peripheral Nervous System
Parasympathetic Division
Active during “rest and digest” activities
Decreases heart rate, blood pressure, and metabolic rate
Changes the diameter of the pupils in response to the level of light
Increases peristalsis in the GI tract
Causes secretion of saliva, digestive enzymes, and insulin

19. Anatomy of the Peripheral Nervous System
Sympathetic Division
Active when body is active or exercising
Increases mental alertness
Dilates pupils to optimize vision
Increases heart rate and metabolic rate
Raises blood pressure
Increases air flow to the lungs
Increases respiratory rate
Causes release of stored glucose to meet increased energy needs
Prepares the body for “fight or flight”

20. Anatomy of the Peripheral Nervous System
Somatic Nervous System
Controls the voluntary movements of skeletal muscles
Motor commands are the result of conscious thoughts in the brain.

21. Anatomy of the Peripheral Nervous System
Neurons and Neuroglia
Neural tissue is made up of two categories of cells: neurons and neuroglia.
A neuron, an individual nerve cell, is the functional unit of the nervous system.
Nerves are bundles of individual nerve cells (neurons).
Neuroglia perform specialized tasks to help neurons do their work.

22. Physiology of a Neuron and Neurotransmitters
A neuron is the functional unit of the nervous system and consists of three parts:
Dendrites
Cell body
Axon

23. Figure Neuron.

24. Pronunciation/Word Parts
Neurotransmitter
Location
Pronunciation/Word Parts
acetylcholine
Neurotransmitter between neurons of the parasympathetic division. It is also in the somatic nervous system in synapses between a motor neuron and a voluntary skeletal muscle.
acetylcholine (as-eh-til-KOH-leen)
dopamine
Neurotransmitter in the brain between neurons in the cerebral cortex, hypothalamus, midbrain, and limbic system. Produced by the substantia nigra of the midbrain.
dopamine (DOH-pah-meen)
endorphins
Neuromodulators in the brain between neurons in the
hypothalamus, thalamus, and brainstem. They are one of several natural pain relievers produced by the brain.
endorphins (en-DOR-finz)
epinephrine
Hormone secreted by the adrenal gland and released into the blood. It stimulates neurons in the sympathetic division during times of anxiety, fear, or anger to prepare the body for “fight or flight.”
epinephrine (ep-ih-NEF-rin)
norepinephrine
Neurotransmitter of the sympathetic division. It is also found between neurons in the cerebral cortex, hypothalamus, cerebellum, brainstem, and spinal cord. It is also a hormone secreted by the adrenal gland.
norepinephrine (nor-ep-ih-NEF-rin)
serotonin
Neurotransmitter between neurons of the limbic system, hypothalamus, and cerebellum in the brain, and in the spinal cord
serotonin (sair-oh-TOH-nin)

25. Diseases Brain Amnesia- partial or total loss of memory.
Aphasia-loss of ability to communicate verbally or in writing.
Brain tumor-benign or malignant tumor of any area of the brain

26. Diseases
Brain
Cerebral palsy (CP)- caused by a lack of O2 to parts of the infants’ brain during birth
Cerebrovascular accident (CVA)-disruption or blockage of blood flow to the brain.
-hemiplegia is paralysis on one side of the body
Dementia- disease which causes a progressive deterioration in mental function
Hematoma-localized collection of blood that forms in the brain because of trauma.
- subdural hematoma- forms under the dura mater.

27. Figure 10-12 Cerebrovascular accident.

28. Figure 10-13 Patient with a cerebrovascular accident.

29. Figure 10-19 Subdural hematoma.

30. Diseases Brain Dyslexia-difficulty reading and writing words.
dys- = painful difficult; abnormal
lex/o- = word
-ia = condition; state; thing
Encephalitis-inflammation & infection of the brain caused by a virus
Epilepsy- condition where the brain spontaneously sends out electrical impulses in an abnormal, uncontrolled way.

31. Diseases
Brain
Parkinson's disease-degenerative disease due to an imbalance in the levels of the neurotransmitters in the brain.
Syncope- temporary loss of consciousness

32. Figure 10-21 Parkinson's disease.

33. Figure 10-24 Spinal cord injury.

34. Diseases
Nerves
Anesthesia- condition in which sensation of any type has been lost.
An- without
Esthes/o- feeling; sensation
-ia condition;state

35. Diseases Nerves (con't)
Multiple sclerosis (MS)- breakdown of the myelin sheath. Autoimmune disease
Neuralgia
Neuropathy
neur/o- = nerve
-pathy = disease

36. Figure 10-28 Electroencephalography (EEG).
10-3

37. Medical and Surgical Procedures
Medical Procedures
Glasgow Coma Scale (GCS)
Lumbar puncture (LP)- procedure to obtain cerebrospinal fluid. AKA spinal tap
Cerebral angiography- procedure where dye is injected into the carotid artery and x-ray is taken

38. Figure 10-30 Lumbar puncture.

39. Figure Arteriogram.
10-3

40. Medical and Surgical Procedures
Biopsy
Carotid endarterectomy-procedure to remove plaque from the carotid artery