Nervous System



Nervous System





Introduction to the Nervous System


The nervous system is the major controlling, regulatory, and communicating system in the body. It is the center of all mental activity, including thought, learning, and memory. Together with the endocrine system, the nervous system is responsible for regulating and maintaining homeostasis. Through its receptors, the nervous system keeps us in touch with our environment, both external and internal.


Like other systems in the body, the nervous system is composed of organs, principally the brain, spinal cord, nerves, and ganglia. These, in turn, consist of various tissues, including nerve, blood, and connective tissues. Together these carry out the complex activities of the nervous system.



Functions of the Nervous System


The various activities of the nervous system can be grouped together as three general functions:



Together these functions keep us in touch with our environments, maintain homeostasis, and account for thought, learning, and memory.


Millions of sensory receptors detect changes, called stimuli, that occur inside and outside the body. They monitor such things as temperature, light, and sound from the external environment. Inside the body, the internal environment, receptors detect variations in pressure, pH, carbon dioxide concentration, and the levels of various electrolytes. All of this gathered information is called sensory input.


Sensory input is converted into electrical signals called nerve impulses that are transmitted to the brain. In the brain the signals are brought together to create sensations, produce thoughts, or add to memory. Decisions are made each moment on the basis of sensory input. This is called integration.


Based on the sensory input and integration, the nervous system responds by sending signals to muscles, causing them to contract, or to glands, causing them to produce secretions. Muscles and glands are called effectors because they cause an effect in response to directions from the nervous system. This is the motor output or motor function.



Organization of the Nervous System


There is really only one nervous system in the body, although terminology seems to indicate otherwise. Although each subdivision of the system is also called a “nervous system,” all of these smaller systems belong to the single, highly integrated nervous system. Each subdivision has structural and functional characteristics that distinguish it from the others. The nervous system as a whole is divided into two subdivisions: the central nervous system (CNS) and the peripheral nervous system (PNS) (Figure 9-1).





Peripheral Nervous System


The organs of the PNS are the nerves and ganglia. Nerves are bundles of nerve fibers, much as muscles are bundles of muscle fibers. Cranial nerves (12 pairs) and spinal nerves (31 pairs) extend from the CNS to peripheral organs, such as muscles and glands. Ganglia are collections, or small knots, of nerve cell bodies outside the CNS.


The PNS is further subdivided into an afferent (sensory) division and an efferent (motor) division. The afferent or sensory division transmits impulses from peripheral organs to the CNS. The efferent or motor division transmits impulses from the CNS out to the peripheral organs to cause an effect or action.


Finally, the efferent or motor division is again subdivided into the somatic nervous system and the autonomic nervous system (ANS). The somatic nervous system, also called the somatomotor or somatic efferent nervous system, supplies motor impulses to the skeletal muscles. Because these nerves permit conscious control of the skeletal muscles, the somatic nervous system is sometimes called the voluntary nervous system. The ANS, also called the visceral efferent nervous system, supplies motor impulses to cardiac muscle, smooth muscle, and glandular epithelium. It is further subdivided into sympathetic and parasympathetic divisions. Because the ANS regulates involuntary or automatic functions, it is sometimes called the involuntary nervous system.



Highlight on Conditions Affecting the Nervous System




Amyotrophic lateral sclerosis (a-my-oh-TROF-ick LAT-er-al sclair-OH-sis) A neurologic disease caused by degeneration of motor neurons of the spinal cord, medulla, and cortex; marked by progressive muscular weakness and atrophy with spasticity and exaggerated reflexes; mental capabilities are not impaired; also called Lou Gehrig disease or motor neuron disease


Bell palsy (BELL PAUL-zee) Neuropathy of the seventh cranial nerve (facial) that causes paralysis of the muscles on one side of the face with sagging of the mouth on the affected side of the face


Cerebral concussion (seh-REE-brull kon-KUSH-un) Loss of consciousness as the result of a blow to the head; usually clears within 24 hours; no evidence of permanent structural damage to the brain tissue


Cerebral contusion (seh-REE-brull kon-TOO-shun) Bruising of brain tissue as a result of direct trauma to the head; neurologic problems persist longer than 24 hours


Cerebral palsy (seh-REE-brull PAWL-zee) Partial paralysis and lack of muscular coordination caused by damage to the cerebrum during fetal life, birth, or infancy


Cerebrovascular accident (CVA) (seh-ree-broh-VAS-kyoo-lar AK-sih-dent) Most common brain disorder; may be caused by decreased blood supply to the brain or rupture of a blood vessel in the brain; commonly called a stroke


Multiple sclerosis (MS) (MULL-tih-pull skler-OH-sis) A disorder in which there is progressive destruction of the myelin sheaths of central nervous system neurons, interfering with their ability to transmit impulses; characterized by progressive loss of function interspersed with periods of remission; cause is unknown and there is no satisfactory treatment


Reye syndrome (RS) (RYE SIN-drohm) Brain dysfunction that occurs primarily in children and teenagers and is characterized by edema of the brain that leads to disorientation, lethargy, and personality changes and may progress to a coma; seems to occur after chickenpox and influenza, and taking aspirin is a risk factor


Shingles (SHING-gulls) Viral disease affecting peripheral nerves; characterized by blisters and pain spread over the skin in a bandlike pattern that follows the affected nerves; caused by the same herpes virus that causes chickenpox


Tic douloureux (TICK doo-loo-ROO) A painful disorder of the fifth cranial nerve (trigeminal) that is characterized by sudden, intense, sharp pain in the face and forehead on the affected side; also known as trigeminal neuralgia


Transient ischemic attack (TIA) (TRANS-ee-ent iss-KEE-mik ah-TACK) An episode of temporary cerebral dysfunction caused by impaired blood flow to the brain; the onset is sudden, and the attack is of short duration and leaves no long-lasting neurologic impairment; common causes are blood clots and atherosclerosis image



Nerve Tissue


Although the nervous system is complex, there are only two main types of cells in nerve tissue. The actual nerve cell is the neuron. It is the “conducting” cell that transmits impulses. It is the structural unit of the nervous system. The other type of cell is the neuroglia or glial cell. The word neuroglia means “nerve glue.” These cells are nonconductive and provide a support system for the neurons. They are a special type of “connective tissue” for the nervous system.



Neurons


Neurons, or nerve cells, carry out the functions of the nervous system by conducting nerve impulses. They are highly specialized and amitotic. This means that if a neuron is destroyed, it cannot be replaced because neurons do not undergo mitosis.


Each neuron has three basic parts:



Figure 9-2 illustrates a typical neuron. The main part of the neuron is the cell body or soma. In many ways the cell body is similar to other types of cells. It has a nucleus with at least one nucleolus and contains many of the typical cytoplasmic organelles. It lacks centrioles, however. Because centrioles function in cell division, the fact that neurons lack these organelles is consistent with the amitotic nature of the cell.



Dendrites and axons are cytoplasmic extensions, or processes, that project from the cell body. They are sometimes referred to as fibers. Dendrites are usually, but not always, short and branching, which increases their surface area to receive signals from other neurons. The number of dendrites on a neuron varies. They are called afferent processes because they transmit impulses to the neuron cell body. Only one axon projects from each cell body. It is usually elongated, and because it carries impulses away from the cell body, it is called an efferent process.


An axon may have infrequent branches called axon collaterals. Axons and axon collaterals terminate in many short branches or telodendria (tell-oh-DEN-dree-ah). The distal ends of the telodendria are slightly enlarged to form synaptic bulbs. Many axons are surrounded by a segmented, white, fatty substance called myelin (MY-eh-lin) or the myelin sheath. Myelinated fibers make up the white matter in the CNS, whereas cell bodies and unmyelinated fibers make up the gray matter. The unmyelinated regions between the myelin segments are called the nodes of Ranvier (nodes of ron-vee-AY). In the PNS the myelin is produced by Schwann cells. The cytoplasm, nucleus, and outer cell membrane of the Schwann cell form a tight covering around the myelin and around the axon itself at the nodes of Ranvier. This covering is the neurilemma (noo-rih-LEM-mah), which plays an important role in the regeneration of nerve fibers. In the CNS, oligodendrocytes (ah-lee-go-DEN-droh-sites) produce myelin, but there is no neurilemma, which is why fibers within the CNS do not regenerate. The structure of an axon and its coverings is illustrated in Figure 9-2.


Functionally, neurons are classified as afferent, efferent, or interneurons (association neurons) according to the direction in which they transmit impulses relative to the CNS (Table 9-1). Afferent, or sensory, neurons carry impulses from peripheral sense receptors to the CNS. They usually have long dendrites and relatively short axons. Efferent, or motor, neurons transmit impulses from the CNS to effector organs, such as muscles and glands. Efferent neurons usually have short dendrites and long axons. Interneurons, or association neurons, are located entirely within the CNS, where they form the connecting link between the afferent and efferent neurons. They have short dendrites and may have either a short or a long axon.




Highlight on the Nervous System




Brain tumors: Because neurons are not capable of mitosis, primary malignant tumors of the brain are tumors of the glial cells rather than of the neurons themselves. These tumors, called gliomas, have extensive roots, making them extremely difficult to remove.


Blood-brain barrier: Neuroglia, particularly astrocytes, form a wall around the outside of the blood vessels in the nervous system. This astrocyte wall plus the blood vessel wall form the blood-brain barrier. Water, oxygen, carbon dioxide, alcohol, and a few other substances are able to pass through this barrier and move between the blood and brain tissue. Other substances, such as toxins, pathogens, and certain drugs, cannot pass through this barrier. This is a protective mechanism to keep harmful substances out of the brain. It has clinical significance because drugs such as penicillin that may be used to treat disorders in other parts of the body have no effect on the brain because they do not cross the blood-brain barrier.


Anesthetics: Some anesthetics produce their effects by inhibiting the diffusion of sodium through the cell membrane and thus blocking the initiation and conduction of nerve impulses.


Meningitis: Meningitis is an acute inflammation of the pia mater and the arachnoid. It is most commonly caused by bacteria. However, viral infections, fungal infections, and tumors may also cause inflammation of the meninges. Depending on the primary cause, meningitis may be mild or it may progress to a severe and life-threatening condition.


Left and right brain: In most people (approximately 90%), the left cerebral hemisphere dominates for language and mathematic abilities. It is the reasoning and analytic side of the brain. The right cerebral hemisphere is involved with motor skills, intuition, emotion, art, and music appreciation. It is the poetic and creative side of the brain. These people are generally right-handed. In about 10% of the people, these sides are reversed. In some cases, neither hemisphere dominates. This may result in “confusion” and learning disabilities.


Parkinson disease: Parkinson disease is a condition in which the basal ganglia do not produce enough of the inhibitory transmitter dopamine. Without dopamine, there is an excess of excitatory signals that affect certain voluntary muscles, producing rigidity and tremors.


Emotions: The limbic system consists of scattered but interconnected regions of gray matter in the cerebral hemispheres and diencephalon. The limbic system is involved in memory and in emotions such as sadness, happiness, anger, and fear. It is our emotional brain.


Hydrocephalus: In hydrocephalus, an obstruction in the normal flow of cerebrospinal fluid (CSF) causes the fluid to accumulate in the ventricles. The obstruction may be a congenital defect or an acquired lesion such as a tumor. As the fluid accumulates, it causes the ventricles to enlarge and CSF pressure to increase. When this happens in an infant, before the cranial bones ossify, the cranium enlarges. In an older child or adult, the pressure damages the soft brain tissue.


Lumbar puncture: A lumbar puncture is the withdrawal of some CSF from the subarachnoid space in the lumbar region of the spinal cord. The extension of the meninges beyond the end of the cord makes it possible to do this without injury to the spinal cord. The needle is usually inserted just above or just below the fourth lumbar vertebra, and the spinal cord ends at the first lumbar vertebra. The CSF that is removed can be tested for abnormal characteristics that may indicate an injury or infection.


Carpal tunnel syndrome: Carpal tunnel syndrome is a common occupational injury to the hand and wrist that is associated with repetitive hand motions. It is also associated with several diseases, including arthritis, diabetes, and gout. Symptoms, which include tingling of the thumb and fingers, result from the compression of the median nerve because of inflammation and swelling of the tendons within the carpal tunnel. image




Nerve Impulses


The functional characteristics of neurons are excitability and conductivity. Excitability is the ability to respond to a stimulus; conductivity is the ability to transmit an impulse from one point to another. All the functions associated with the nervous system, including thought, learning, and memory, are based on these two characteristics. These functional characteristics are the result of structural features of the cell membrane.



Resting Membrane


A resting membrane is the cell membrane of a nonconducting, or resting, neuron. The membrane is impermeable to the passive diffusion of sodium (Na+) and potassium (K+) ions. An active transport mechanism, the sodium-potassium pump, maintains a difference in concentration of these ions on the two sides of the membrane. Sodium ions are concentrated in the extracellular fluid, whereas the potassium ions are inside the cell. The intracellular fluid also contains proteins and other negatively charged ions. The result is a polarized membrane with more positive charges outside the cell and more negative charges inside the cell. This difference in charges on the two sides of the resting membrane is the resting membrane potential. Electrical measurements show the resting membrane potential to be about −70 millivolts (mV), which means that the inside of the membrane is 70 mV less positive (more negative) than the outside.



Stimulation of a Neuron


A stimulus is a physical, chemical, or electrical event that alters the permeability of the neuron cell membrane. This allows sodium ions to move inside the cell, then potassium ions move to the outside. This ionic movement briefly changes the polarization of the membrane.


This response to a stimulus—namely, depolarization, reverse polarization, and repolarization—is called the action potential. Electrical measurements show the action potential to peak at approximately +30 mV (Figure 9-3). At the conclusion of the action potential, the sodium-potassium pump actively transports sodium ions out of the cell and potassium ions into the cell to completely restore resting conditions.


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Apr 16, 2017 | Posted by in NURSING | Comments Off on Nervous System

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