The nervous system is a complex communication network that allows your body to interact with its

environment and maintain internal balance, encompassing the brain, spinal cord, and nerves. It receives
sensory information, processes it, and initiates responses, controlling everything from thoughts and
emotions to basic bodily functions.

The nervous system is the body's command center, responsible for receiving, processing, and
transmitting information throughout the body.

The nervous system detects and responds to changes inside and outside the body. Together with
the endocrine system, it controls many vital aspects of body function and maintains
homeostasis.

The nervous system consists of the brain, the spinal cord and peripheral nerves.

Response to changes in the internal environment regulates essential involuntary functions, such
as respiration and blood pressure. Response to changes in the external environment maintains
posture and other voluntary activities.

• voluntary – the somatic nervous system (movement of voluntary muscles)

• involuntary – the autonomic nervous system (functioning of smooth and cardiac muscle and glands).
The autonomic nervous system has two divisions: sympathetic and parasympathetic

Cells and tissues of the nervous system: The nervous system consists of neurones, which
conduct nerve impulses and are supported by unique connective tissue cells known as neuroglia.

• Key Components:

• Central Nervous System (CNS): The brain and spinal cord form the CNS, which acts as
the control center for the body.

• Peripheral Nervous System (PNS): The nerves outside the CNS make up the PNS,
connecting the CNS to the rest of the body.

• Functions:

• Sensory Input: Detects changes in the internal and external environment.

• Integration: Processes sensory information and initiates appropriate responses.

• Motor Output: Transmits signals to muscles and glands, enabling movement and other
bodily functions.

• Homeostasis: Regulates and maintains a stable internal environment.

• Coordination: Coordinates various bodily functions, including breathing, heartbeat, and

digestion.

• Subdivisions:
• Autonomic Nervous System (ANS): Controls involuntary functions like heart rate,
breathing, and digestion.

• Somatic Nervous System: Controls voluntary movements.

Neurones: Each neurone consists of a cell body and its processes, one axon and many dendrites.
Neurones are commonly referred to as nerve cells. Bundles of axons bound together are called nerves.
Neurones cannot divide, and for survival they need a continuous supply of oxygen and glucose.

Neurones generate and transmit electrical impulses called action potentials. The initial strength of the
impulse is maintained throughout the length of the neurone. Some neurones initiate nerve impulses
while others act as ‘relay stations’ where impulses are passed on and sometimes redirected.

Nerve impulses can be initiated in response to stimuli from:

• outside the body, e.g. touch, light waves

• inside the body, e.g. a change in the concentration of carbon dioxide in the blood alters respiration; a
thought may result in voluntary movement.

Transmission of nerve signals is both electrical and chemical

Nerves: A nerve consists of numerous neurones collected into bundles (bundles of nerve fibres in the
central nervous system are known as tracts). Each bundle has several coverings of protective connective
tissue: Endoneurium/Perineurium/ Epineurium

Sensory or afferent nerves: Sensory nerves carry information from the body to the spinal cord. The
impulses may then pass to the brain or to connector neurones of reflex arcs in the spinal cord.

Autonomic afferent nerves: These originate in internal organs, glands and tissues, e.g. baroreceptors
involved in the control of blood pressure , chemoreceptors involved in the control of respiration, and are
associated with reflex regulation of involuntary activity and visceral pain.

Motor or efferent nerves: Motor nerves originate in the brain, spinal cord and autonomic ganglia. They
transmit impulses to the effector organs: muscles and glands. There are two types:

• somatic nerves – involved in voluntary and reflex skeletal muscle contraction

• autonomic nerves (sympathetic and parasympathetic) – involved in cardiac and smooth muscle
contraction and glandular secretion.
Central Nervous System:

The central nervous system consists of the brain and the spinal cord.

The meninges and cerebrospinal fluid (CSF)

The meninges: The brain and spinal cord are completely surrounded by three layers of tissue, the
meninges, lying between the skull and the brain, and between the vertebral foramina and the spinal
cord. Named from outside inwards they are the:

• dura mater

• arachnoid mater

• pia mater

The dura and arachnoid maters are separated by a potential space, the subdural space. The arachnoid
and pia maters are separated by the subarachnoid space, containing cerebrospinal fluid.

Ventricles of the brain and the cerebrospinal fluid

The brain contains four irregular-shaped cavities, or ventricles, containing cerebrospinal fluid (CSF)

They are:

• right and left lateral ventricles

• third ventricle

• fourth ventricle.

Cerebrospinal fluid (CSF):Cerebrospinal fluid is secreted into each ventricle of the brain by choroid
plexuses.

Functions of cerebrospinal fluid: CSF supports and protects the brain and spinal cord by maintaining a
uniform pressure around these vital structures and acting as a cushion or shock absorber between the
brain and the skull.
It keeps the brain and spinal cord moist and there may be exchange of nutrients and waste products
between CSF and nerve cells

Brain: The brain constitutes about one-fifth of the body weight and lies within the cranial cavity. The
parts are

cerebrum

thalamus

hypothalamus

midbrain

pons

medulla oblongata

cerebellum
Cerebrum: This is the largest part of the brain and it occupies the anterior and middle cranial fossae.
Deep within the brain the hemispheres are connected by a mass of white matter (nerve fibres) called the
corpus callosum. For descriptive purposes each hemisphere of the cerebrum is divided into lobes which
take the names of the bones of the cranium under which they lie:

• frontal

• parietal

• temporal

• occipital

Thalamus: This consists of two masses of grey and white matter situated within the cerebral
hemispheres just below the corpus callosum, one on each side of the third ventricle. It is thought to be
involved in the processing of some emotions and complex.

Hypothalamus: The hypothalamus is a small but important structure which weighs around 7 g and
consists of a number of nuclei. It is situated below and in front of the thalamus, immediately above the
pituitary gland. Through these connections, the hypothalamus controls the output of hormones from
both lobes of the pituitary gland.

Midbrain: The midbrain is the area of the brain situated around the cerebral aqueduct between the
cerebrum above and the pons below. It consists of nuclei and nerve fibres (tracts), which connect the
cerebrum with lower parts of the brain and with the spinal cord.
Pons: The pons is situated in front of the cerebellum, below the midbrain and above the medulla
oblongata. It consists mainly of nerve fibres (white matter) that form a bridge between the two
hemispheres of the cerebellum, and of fibres passing between the higher levels of the brain and the
spinal cord.

Medulla oblongata: The medulla oblongata, or simply the medulla, extends from the pons above and is
continuous with the spinal cord below. It is about 2.5 cm long and it lies just within the cranium above
the foramen magnum.

Cerebellum: The cerebellum (Fig. 7.25) is situated behind the pons and immediately below the posterior
portion of the cerebrum occupying the posterior cranial fossa. It is ovoid in shape and has two
hemispheres, separated by a narrow median strip called the vermis. Grey matter forms the surface of
the cerebellum, and the white matter lies deeply.

Spinal cord: The spinal cord is the elongated, almost cylindrical part of the central nervous system, which
is suspended in the vertebral canal surrounded by the meninges and cerebrospinal fluid. The spinal cord
is continuous above with the medulla oblongata and extends from the upper border of the atlas to the
lower border of the 1st lumbar vertebra. A specimen of cerebrospinal fluid can be taken using a
procedure called lumbar puncture.

Peripheral nervous system: This part of the nervous system consists of:

31 pairs of spinal nerves

12 pairs of cranial nerves

The Autonomic nervous system

Most of the nerves of the peripheral nervous system are composed of sensory nerve fibres transmitting
afferent impulses from sensory organs to the brain, and motor nerve fibres transmitting efferent
impulses from the brain to the effector organs, e.g. skeletal muscles, smooth muscle and glands

Spinal nerves

There are 31 pairs of spinal nerves that leave the vertebral canal by passing through the intervertebral
foramina formed by adjacent vertebrae. They are named and grouped according to the vertebrae with
which they are associated.• 8 cervical• 12 thoracic• 5 lumbar• 5 sacral• 1 coccygeal.

Nerve roots: The spinal nerves arise from both sides of the spinal cord and emerge through the
intervertebral foramina. Each nerve is formed by the union of a motor (anterior) and a
sensory(posterior) nerve root and is, therefore, a mixed nerve

COMMON CONDITIONS:

Hydrocephalus: In this condition the volume of CSF is abnormally high and is usually accompanied by
increased ICP

Head injuries: Damage to the brain may be serious even when there is no outward sign of injury

Traumatic intracranial haemorrhage: Haemorrhage may occur causing secondary brain damage at the
site of injury, on the opposite side of the brain or diffusely throughout the brain. If bleeding continues,
the expanding haematoma increases the ICP, compressing the brain.

Meningitis: Inflammation of the meninges may occur following a compound fracture of the skull that is
accompanied by leakage of CSF and blood from the site, providing a route of entry for microbes.

Cerebral hypoxia: Hypoxia may be due to:

• disturbances in the autoregulation of blood supply to the brain

• conditions affecting cerebral blood vessels.

Stroke (cerebrovascular disease): It occurs when blood flow to the brain is suddenly interrupted, causing
hypoxia. The effects include paralysis of a limb or one side of the body and disturbances of speech and
vision

Cerebral infarction: This is caused by atheroma complicated by thrombosis (p. 112) or blockage of an
artery by an embolus from, e.g., infective endocarditis.

Intracerebral haemorrhage: Prolonged hypertension leads to the formation of multiple microaneurysms

in the walls of very small arteries in the brain. Rupture of one or more of these, due to continuing rise in
blood pressure, is usually the cause of intracerebral haemorrhage

Subarachnoid haemorrhage: This is usually due to rupture of a berry aneurysm on one of the major
cerebral arteries, or bleeding from a congenitally malformed blood vessel (Fig. 7.50B). The blood may
remain localised but usually spreads in the subarachnoid space round the brain and spinal cord, causing
a general increase in ICP without distortion of the brain

Dementia: Dementia is caused by progressive, irreversible degeneration of the cerebral cortex and
results in mental deterioration, usually over several years. There is gradual impairment of memory
(especially short term), intellect and reasoning but consciousness is not affected. Emotional lability and
personality change may also occur.

Parkinson’s disease: In this disease there is gradual degeneration of dopamine releasing neurones in the
extrapyramidal system. This leads to lack of control and coordination of muscle movement

Bacterial meningitis: The term ‘meningitis’ usually refers to inflammation of the subarachnoid space and
is most commonly transmitted through contact with an infected individual. Bacterial meningitis is usually
preceded by a mild upper respiratory tract infection during which a few bacteria enter the bloodstream
and are carried to the meninges.

Viral meningitis: This is the most common form of meningitis and is usually a relatively mild infection
followed by complete recovery

Alzheimer’s disease: This condition is the commonest form of dementia in developed countries. The
aetiology is unknown although genetic factors may be involved.

Bell’s palsy: Compression of a facial nerve in the temporal bone foramen causes paralysis of facial
muscles with drooping and loss of facial expression on the affected side.