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The Central Nervous System (CNS)

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Nervous System

The nervous system is a complex network of nerves and cells that carry messages to and from the
brain and spinal cord to various parts of the body.

The nervous system includes both the Central nervous system and Peripheral nervous system. The
Central nervous system is made up of the brain and spinal cord and The Peripheral nervous system is
made up of the Somatic and the Autonomic nervous systems.

1. The Central Nervous System (CNS)

The central nervous system is divided into two major parts: The brain and the spinal cord

 The Brain

The brain has three major divisions, subdivided into six major parts

1. Forebrain
a. Cerebrum
b. Diencephalon

2. Midbrain
a. Mesencephalon

3. Hindbrain
a. Pons
b. Medulla
c. Cerebellum
a. Cerebrum
 The cerebrum consists of a right and left hemisphere and constitutes the largest part of the
human brain. The right and left hemispheres are connected by a deep groove, which houses a
band of 200 million neurons(nerve cells) called the corpus callosum.
 Because each hemisphere controls different functions, information is processed through the
corpus callosum so that each hemisphere is aware of the activity of the other.
 The surface of the cerebrum consists of gray matter and is called the cerebral cortex.
 The gray matter is so called because the neuron cell bodies of which it is composed look gray
to the eye. These gray matter cell bodies are thought to be the actual thinking structures of the
brain.
 Another pair of masses of gray matter called basal ganglia is found deep within the cerebral
hemispheres.
 They are responsible for: certain subconscious aspects of voluntary movement, such as
swinging the arms when walking, gesturing while speaking, and regulating muscle tone
(Scanlon & Sanders, 2006).
 The cerebral cortex is identified by numerous folds, called gyri, and deep grooves between
the folds, called sulci. This extensive folding extends the surface area of the cerebral cortex,
and thus permits the presence of millions more neurons than would be possible without it (as
is the case in the brains of some animals, such as dogs and cats).

 Each hemisphere of the cerebral cortex is divided into the


 Frontal lobe
 Parietal lobe
 Temporal lobe
 Occipital lobe.
The Frontal Lobe
Voluntary body movement is controlled by the impulses through the frontal lobes. The right frontal
lobe controls motor activity on the left side of the body and the left frontal lobe controls motor
activity on the right side of the body. Movements that permit speaking are also controlled by the
frontal lobe, usually only on the left side (Scanlon & Sanders, 2006).
The frontal lobe may also play a role in the emotional experience, as evidenced by changes in mood
and character after damage to this area. The alterations include fear, aggressiveness, depression, rage,
euphoria, irritability, and apathy and are likely related to a frontal lobe connection to the limbic
system. The frontal lobe may also be involved (indirectly through association fibers linked to
primary sensory areas) in thinking and perceptual interpretation of information

The Parietal Lobe

Somato-sensory input occurs in the parietal lobe area of the brain. These include touch, pain and
pressure, taste, temperature, perception of joint and body position, and visceral sensations. The
parietal lobes also contain association fibers linked to the primary sensory areas through which
interpretation of sensory-perceptual information is made. Language interpretation is associated with
the left hemisphere of the parietal lobe.

The Temporal Lobes

The upper anterior temporal lobe is concerned with auditory functions, while the lower part is
dedicated to short-term memory. The sense of smell has a connection to the temporal lobes, as the
impulses carried by the olfactory nerves end in this area of the brain (Scanlon & Sanders, 2006). The
temporal lobes also play a role in the expression of emotions through an interconnection with the
limbic system. The left temporal lobe, along with the left parietal lobe, is involved in language
interpretation.

The Occipital Lobes

The occipital lobes are the primary area of visual reception and interpretation. Visual perception,
which gives individuals the ability to judge spatial relationships such as distance and to see in three
dimensions, is also processed in this area (Scanlon & Sanders, 2006). Language interpretation is
influenced by the occipital lobes through an association with the visual experience

a. Diencephalon

The second part of the forebrain is the diencephalon, which connects the cerebrum with lower
structures of the brain.

The major components of the diencephalon include:


i. Thalamus
ii. The hypothalamus
iii. The limbic system.

i) Thalamus

The thalamus integrates all sensory input (except smell) on its way to the cortex. This helps the
cerebral cortex interpret the whole picture very rapidly, rather than experiencing each sensation
individually.
The thalamus is also involved in temporarily blocking minor sensations, so that an individual can
concentrate on one important event when necessary. For example, an individual who is studying for
an examination may be unaware of the clock ticking in the room, or even of another person walking
into the room, because the thalamus has temporarily blocked these incoming sensations from the
cortex (Scanlon & Sanders, 2006).

ii) Hypothalamus

The hypothalamus is located just below the thalamus and just above the pituitary gland and has a
number of diverse functions.

 Regulation of the Pituitary Gland.


The pituitary gland consists of two lobes:
 The posterior lobe
 The anterior lobe.

a. The posterior lobe of the pituitary gland is actually extended tissue from the
hypothalamus. The posterior lobe stores antidiuretic hormone (which helps to maintain
blood pressure through regulation of water retention) and oxytocin (the hormone
responsible for stimulation of the uterus during labor, and the release of milk from the
mammary glands). Both of these hormones are produced in the hypothalamus. When the
hypothalamus detects the body’s need for these hormones, it sends nerve impulses to the
posterior pituitary for their release.

b. The anterior lobe of the pituitary gland consists of glandular tissue that produces a
number of hormones used by the body. These hormones are regulated by “releasing
factors” from the hypothalamus. When the hormones are required by the body, the
releasing factors stimulate the release of the hormone from the anterior pituitary and the
hormone in turn stimulates its target organ to carry out its specific functions.

 Direct Neural Control over the Actions of the Autonomic Nervous System.
The hypothalamus regulates the appropriate visceral responses during various emotional
states.

 Regulation of Appetite.
Appetite is regulated through response to blood nutrient levels.

 Regulation of Temperature.
The hypothalamus senses internal temperature changes in the blood that flows through the
brain. It receives information through sensory input from the skin about external temperature
changes. The hypothalamus then uses this information to promote certain types of responses
(e.g., sweating or shivering) that help to maintain body temperature within the normal range
(Scanlon & Sanders, 2006).

Limbic System

The part of the brain known as the limbic system consists of portions of the cerebrum and the
diencephalon.
The major components include the :
 Cortical
 Subcortical structures
 The fiber tracts

The system is composed of the


 Amygdala,
 Mammillary body,
 Olfactory tract,
 Hypothalamus,
 Cingulate gyrus,
 Septum pellucidum,
 Thalamus,
 Hippocampus, and
 Neuronal connecting pathways, such as the fornix.

This system has been called “the emotional brain” and is associated with feelings of fear and
anxiety; anger, rage, and aggression; love, joy, and hope; and with sexuality and social behavior

Mesencephalon

Structures of major importance in the mesencephalon, or midbrain, include nuclei and fiber
tracts. The mesencephalon extends from the pons to the hypothalamus and is responsible for
integration of various reflexes, including visual reflexes (e.g., automatically turning away
from a dangerous object when it comes into view), auditory reflexes (e.g., automatically
turning toward a sound that is heard), and righting reflexes (e.g., automatically keeping the
head upright and maintaining balance) (Scanlon & Sanders, 2006).

Pons

The pons is a bulbous structure that lies between the midbrain and the medulla. It is composed of
large bundles of fibers and forms a major connection between the cerebellum and the brainstem. It
also contains the central connections of cranial nerves V through VIII and centers for respiration and
skeletal muscle tone.

Medulla

The medulla is the connecting structure between the spinal cord and the pons and all of the ascending
and descending fiber tracts pass through it. The vital centers are contained in the medulla, and it is
responsible for regulation of heart rate, blood pressure, and respiration. Also in the medulla are reflex
centers for swallowing, sneezing, coughing, and vomiting (Scanlon & Sanders, 2006). It also
contains nuclei for cranial nerves IX through XII. The medulla, pons, and midbrain form the
structure known as the brainstem.

Cerebellum

The cerebellum is separated from the brainstem by the fourth ventricle but has connections to the
brainstem through bundles of fiber tracts. It is situated just below the occipital lobes of the cerebrum
The functions of the cerebellum are concerned with involuntary movement, such as muscular tone
and coordination and the maintenance of posture and equilibrium.

Structure and Function of the Brain

Structure Primary Function

The Forebrain

Composed of two hemispheres separated by a deep groove that houses a


band of 200 million neurons called the corpus callosum. The outer shell is
called the cortex. It is extensively folded and consists of billions of
A. Cerebrum neurons. The left hemisphere appears to deal with logic and solving
problems. The right hemisphere may be called the “creative” brain and is
associated with affect, behavior, and spatial-perceptual functions. Each
hemisphere is divided into four lobes.
Voluntary body movement, including movements that permit speaking,
i) Frontal
thinking and judgment formation, and expression of feelings.
Perception and interpretation of most sensory information (including
ii) Parietal lobe
touch, pain, taste, and body position
iii)Temporal Hearing, short-term memory, and sense of smell; expression of emotions
lobe through connection with limbic system

iv) Occipital lobe Visual reception and interpretation

B. Diencephalon Connects cerebrum with lower brain structures


Integrates all sensory input (except smell) on way to cortex; some
i)Thalamus
involvement with emotions and mood
Regulates anterior and posterior lobes of pituitary gland; exerts control
ii) Hypothalamus over actions of the autonomic nervous system; regulates appetite and
temperature
Consists of medially placed cortical and subcortical structures and the
fiber tracts connecting them with one another and with the hypothalamus.
iii) Limbic system It is sometimes called the “emotional brain”—associated with feelings of
fear and anxiety; anger and aggression; love, joy, and hope; and with
sexuality and social behavior
The Midbrain

i)Mesencephalon Responsible for visual, auditory, and balance (“righting”) reflexes

The Hindbrain

Regulation of respiration and skeletal muscle tone; ascending and


i) Pons descending tracts connect brain stem with cerebellum and cortex.
Pathway for all ascending and descending fiber tracts; contains vital
ii)Medulla centers that regulate heart rate, blood pressure, and respiration; reflex
centers for swallowing, sneezing, coughing, and vomiting.
Regulates muscle tone and coordination and maintains posture and
iii) Cerebellum
equilibrium

Nerve Tissue

The tissue of the central nervous system (CNS) consists of nerve cells called neurons that generate
and transmit electrochemical impulses.
 The structure of a neuron is composed of a cell body, an axon, and dendrites.
 The cell body contains the nucleus and is essential for the continued life of the neuron.
 The dendrites are processes that transmit impulses toward the cell body
 The axon transmits impulses away from the cell body.

The axons and dendrites are covered by layers of cells called neuroglia that form a coating, or
“sheath,” of myelin. Myelin is a phospholipid that provides insulation against short circuiting of the
neurons during their electrical activity and increases the velocity of the impulse.

The white matter of the brain and spinal cord is so called because of the whitish appearance of the
myelin sheath over the axons and dendrites. The gray matter is composed of cell bodies that contain
no myelin.

The three classes of neurons include

 Afferent (sensory)
 Efferent (motor)
 Inter-neurons

The afferent neurons carry impulses from receptors in the internal and external periphery to the CNS,
where they are then interpreted into various sensations.

The efferent neurons carry impulses from the CNS to effectors in the periphery, such as muscles (that
respond by contracting) and glands (that respond by secreting).

Inter-neurons exist entirely within the CNS, and 99 percent of all nerve cells belong to this group.
They may carry only sensory or motor impulses, or they may serve as integrators in the pathways
between afferent and efferent neurons. They account in large part for thinking, feelings, learning,
language, and memory.

Synapses

Information is transmitted through the body from one neuron to another. Some messages may be
processed through only a few neurons, while others may require thousands of neuronal connections.
The neurons that transmit the impulses do not actually touch each other. The junction between two
neurons is called a synapse. The small space between the axon terminals of one neuron and the cell
body or dendrites of another is called the synaptic cleft. Neurons conducting impulses toward the
synapse are called presynaptic neurons and those conducting impulses away are called postsynaptic
neurons.
A chemical, called a neurotransmitter, is stored in the axon terminals of the presynaptic neuron. An
electrical impulse through the neuron causes the release of this neurotransmitter into the synaptic
cleft.

The neurotransmitter then diffuses across the synaptic cleft and combines with receptor sites that are
situated on the cell membrane of the postsynaptic neuron.

The result of the combination of neurotransmitter-receptor site is the determination of whether or not
another electrical impulse is generated. If one is generated, the result is called an excitatory response
and the electrical impulse moves on to the next synapse, where the same process recurs. If another
electrical impulse is not generated by the neurotransmitter-receptor site combination, the result is
called an inhibitory response, and synaptic transmission is terminated.

The cell body or dendrite of the postsynaptic neuron also contains a chemical inactivator that is
specific to the neurotransmitter that has been released by the presynaptic neuron. When the synaptic
transmission has been completed, the chemical inactivator quickly inactivates the neurotransmitter to
prevent unwanted, continuous impulses, until a new impulse from the presynaptic neuron releases
more neurotransmitter.

Autonomic Nervous System

The autonomic nervous system (ANS) is actually considered part of the peripheral nervous system.
Its regulation is integrated by the hypothalamus, however, and therefore the emotions exert a great
deal of influence over its functioning. For this reason, the ANS has been implicated in the etiology of
a number of psychophysiological disorders.

The ANS has two divisions:

 The sympathetic
 The parasympathetic.

The sympathetic division is dominant in stressful situations and prepares the body for the “fight or
flight” response. The neuronal cell bodies of the sympathetic division originate in the thoracolumbar
region of the spinal cord. Their axons extend to the chains of sympathetic ganglia where they
synapse with other neurons that subsequently innervate the visceral effectors. This results in an
increase in heart rate and respirations and a decrease in digestive secretions and peristalsis. Blood is
shunted to the vital organs and to skeletal muscles to ensure adequate oxygenation.
The neuronal cell bodies of the parasympathetic division originate in the brainstem and the sacral
segments of the spinal cord, and extend to the parasympathetic ganglia where the synapse takes place
either very close to or actually in the visceral organ being innervated. In this way, a very localized
response is possible. The parasympathetic division dominates when an individual is in a relaxed,
nonstressful condition. The heart and respirations are maintained at a normal rate and secretions and
peristalsis increase for normal digestion. Elimination functions are promoted.

Neurotransmitters

Neurotransmitters were described during the explanation of synaptic activity.

They are being discussed separately and in detail because of the essential function they play in the
role of human emotion and behavior and because they are the target for mechanism of action of
many of the psychotropic medications.

Neurotransmitters are chemicals that convey information across synaptic clefts to neighboring target
cells. They are stored in small vesicles in the axon terminals of neurons.

When the action potential, or electrical impulse, reaches this point, the neurotransmitters are released
from the vesicles. They cross the synaptic cleft and bind with receptor sites on the cell body or
dendrites of the adjacent neuron to allow the impulse to continue its course or to prevent the impulse
from continuing.

After the neurotransmitter has performed its function in the synapse, it either returns to the vesicles
to be stored and used again, or it is inactivated and dissolved by enzymes.

The process of being stored for reuse is called reuptake, a function that holds significance for
understanding the mechanism of action of certain psychotropic medications.

Many neurotransmitters exist in the central and peripheral nervous systems, but only a limited
number have implications for psychiatry.

Major categories include

 Cholinergics
 Monoamines
 Amino acids
 Neuropeptides

Neurotransmitters in the Central Nervous System

Implications for Mental


Neurotransmitter Possible Location/Function
Illness
I. Cholinergics
ANS: Sympathetic and Increased levels: Depression
parasympathetic presynaptic
nerve terminals; Decreased levels: Alzheimer’s
parasympathetic postsynaptic disease nerve terminals
A. Acetylcholine Huntington’s disease,
CNS: Cerebral cortex, Parkinson’s disease
hippocampus, limbic structures,
and basal ganglia
Functions: Sleep, arousal, pain
perception, movement, memory
II. Monoamines
ANS: Sympathetic Decreased levels: Depression
postsynaptic nerve terminals

CNS: Thalamus, hypothalamus, Increased levels: Mania,


limbic system, hippocampus, anxiety states, schizophrenia
A. Norepinephrine cerebellum, cerebral cortex

Functions: Mood, cognition,


perception, locomotion,
cardiovascular functioning, and
sleep and arousal
Frontal cortex, limbic system, Decreased levels: Parkinson’s
basal and ganglia, thalamus, disease, depression
posterior pituitary and spinal
cord Increased levels: Mania and
B. Dopamine
Functions: Movement and schizophrenia
coordination, emotions,
voluntary judgment, release of
prolactin
Hypothalamus, thalamus, Decreased levels: Depression
limbic system, cerebral cortex,
cerebellum, spinal cord Increased levels: Anxiety
states
C. Serotonin
Functions: Sleep and arousal,
libido, appetite, mood,
aggression, pain perception,
coordination, judgment
Hypothalamus Decreased levels: Depression

D. Histamine Functions: Wakefulness; pain


sensation and inflammatory
response
III. Amino Acids
Hypothalamus, hippocampus, Decreased levels:
cortex, cerebellum, basal Huntington’s disease anxiety
A. Gamma-amino-, butyric ganglia, spinal cord,, and retina disorders, schizophrenia,
acid (GABA) various forms of epilepsy
Functions: Slowdown of body
activity
Spinal cord and brain stem Toxic levels: “glycine
encephalopathy”
B. Glycine Functions: Recurrent inhibition
of motor neurons decreased levels are correlated
with spastic motor movements
Pyramidal cells of the cortex, Increased levels: Huntington’s
cerebellum and the primary disease, temporal lobe epilepsy
sensory afferent systems;, spinal cerebellar degeneration
C. Glutamate and, Aspartate
hippocampus, thalamus,
hypothalamus, spinal cord
Functions: Relay of sensory
information and in the
regulation of various motor and
spinal reflexes
IV. Neuropeptides

A. Endorphins and enkephalins Hypothalamus, thalamus, Modulation of dopamine


limbic Enkephalins structures, activity by opioid peptides may
midbrain, and brain stem; are indicate link to some symptoms
also found in the of schizophrenia
gastrointestinal tract
Functions: Modulation of pain
and reduced peristalsis
(enkephalins)
Hypothalamus, limbic Decreased levels: Huntington’s
structures, and midbrain, brain disease Alzheimer’s disease
stem, thalamus, basal ganglia,
and spinal cord; also found in Increased levels: Depression
B. Substance P
gastrointestinal tract and
salivary glands

Function: Regulation of pain


Cerebral cortex, hippocampus, Decreased levels: Alzheimer’s
thalamus, basal ganglia, brain disease
stem, and spinal cord
Increased levels: Huntington’s
Function: Depending on part disease
of the brain being affected,
C. Somatostatin stimulates release of dopamine,
serotonin, norepinephrine, and
acetylcholine, and inhibits
release of norepinephrine,
histamine, and glutamate. Also
acts as a neuromodulator for
serotonin in the hypothalamus
BIBLIOGRAPHY

1. Townsend C. Mary. Psychiatric mental health nursing- concepts of care in evidence based
practice (6th ed.); Published by jaypee brothers medical publishers (P) Ltd,( New Delhi,
India)
Pg no. 49-60
2. Dr. Lalitha K. mental health and psychiatric nursing: an Indian perspective. (1st ed)
published by: V.M.G. Book House (Bangalore, India) Pg no. 82-90
3. https://www.news-medical.net/health/What-is-the-Nervous-System.aspx
4. https://www.britannica.com/science/nervous-system
5. https://www.livescience.com/22665-nervous-system.html

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