Module 14.

0 - Nervous Tissue
The nervous system, in conjunction with the endocrine system, is responsible for
maintaining homeostasis throughout the body. The nervous system is able to perform
its diverse tasks as a result of the conductive properties of nervous tissue, which
permit the propagation of electrical signals to and from the brain through a complex
network of wiring. In order to understand the nature of this electrical network, we
must first explore the conductive properties of neurons, which are some of its most
basic functional units.

Module 14.1 - Organization of the Nervous

System
The Nervous System
 The body’s primary communication and control system.
 Can be divided according to:

o Structural categories

o Functional categories
Structural subdivisions of the nervous system

The central nervous system (CNS) consists of the brain and spinal cord and
functions as the body's nervous integration and command center.

The peripheral nervous system (PNS) is composed of peripheral nerves that

connect all body regions to the CNS and consists of two groups of nerves
extending to and from the brain and spinal cord.

 The cranial nerves are 12 pairs of nerves that originate from within the skull.
 The spinal nerves are 31 pairs of nerves that are attached to the spinal cord
and supply most of the body inferior to the head.

Module 14.2 - Sensory and Motor Divisions of

the Nervous System
In addition to the division of the nervous system into the CNS and PNS, the
nervous system can be functionally divided three components somatic nervous
system, autonomic nervous system and enteric nervous system.
The somatic sensory division of the nervous system detects general somatic
senses such as touch, pain, vibration, pressure, temperature, and
proprioception, which sense joint position and movement. Special somatic
 senses are detected by receptors located in the head for hearing, balance,
vision, and smell.
The somatic motor component is the voluntary nervous system. It is the branch
of the nervous system that initiates contraction of skeletal muscles under our
own voluntary control.
The autonomic nervous system and is also called the involuntary nervous
system, as it controls the contraction of smooth and cardiac muscle, secretion
from the body's glands, and the function of visceral organs without voluntary
input.
The enteric nervous system consists of neurons that occur throughout the gut.

Module 14.3 - Cytology of Nervous Tissue

Nervous tissue consists of two basic types of cell: neurons and glial cells.

Neurons
 excitable cells
 initiate and transmit nerve impulses

Glial cells
• nonexcitable cells
• support and protect the neurons

Neurons are specialized cells that conduct electrical impulses called action potentials
along the plasma membrane. The neuron is the basic functional unit of the nervous
system, and the human body contains billions of neurons.

Neuron Structure
The cell body, sometimes called the soma or perikaryon, is an enlarged portion of the
neuron which contains a nucleus surrounded by cytoplasm and cellular organelles. It
also contains the following special structures:

• chromatophilic (Nissl) bodies which are clusters of rough ER and free ribosomes
that continually produce proteins for the active cell.

• neurofibrils which are bundles of intermediate filaments that create a network

between chromatophilic bodies to prevent physical stretching of the cell.

Two types of processes extend from the cell body: Dendrites (tree-like) and axons.

Dendrites
  Dendrites are the numerous extensively branching processes which arise from
the cell body and function as receptive sites for incoming signals from other
neurons.
 They transmit electrical signals (graded potentials) towards the cell body.

Axons

 Each neuron has only one axon, which transmits impulses away from the
cell body.
 An axon forms a cone-shaped axon hillock where it exits the cell body.
 Some axons contain branches called axon collaterals, but branches at
the end of an axon are known as axon terminals (telodendria).
 Axons and their branches end in knobs called synaptic bulbs or knobs,
which release chemicals called neurotransmitters.

Module 14.4 - Neuron Classification

Neurons can be classified according to their structure.

• Unipolar (pseudounipolar) neurons start as bipolar neurons during development and

their processes fuse to form a short, single process that emerges from the cell body.

 Bipolar neurons are composed of a cell body with only two processes, an axon
and a dendrite. These are rare neurons and are only found in some special
sensory organs such as the olfactory mucosa of the nose and the retina of the
eye.
 Multipolar neurons have more than two processes emerging from the cell body.
They have numerous dendrites and one axon, and examples include motor
neurons, and the interneurons of the CNS.

Neurons can also be classified according to their function and direction of

travel of the nerve impulse.

Sensory (afferent) neurons transmit impulses toward the CNS. Virtually all
afferent neurons are unipolar neurons. The cell bodies are found in ganglia
outside the CNS and their single short processes can be divided into a central
process which runs centrally into the CNS and a peripheral process which
extends peripherally to the receptors.

Motor (efferent) neurons carry impulses from the CNS to effector organs. They
are mostly multipolar: their cell bodies are found within the CNS, and their
axons form junctions with effector cells.

Interneurons (association neurons) are usually multipolar and lie among the
motor and sensory neurons of the CNS.
Module 14.5 - Glial Cells
Glial cells are supporting cells and are sometimes referred to as neuroglia.

 Glial cells have branching processes and a central cell body.

 They outnumber neurons ten to one and compose half the mass of the brain.
 Unlike neurons, they can reproduce throughout life.

Glial Cells in the CNS

There are four types of glial cells in the CNS.

Astrocytes are the most abundant type of glial cell.

 They have numerous radiating processes with bulbous ends, which give them a
star- like shape.
 Functions include controlling the local environment around neurons, producing
molecules necessary for neuronal growth, replacing damaged neurons and
forming the blood-brain barrier (BBB).

Ependymal cells are cuboidal in shape and line the central cavity of the spinal
cord and the ventricles of the brain. They possess cilia which help circulate the
cerebrospinal fluid through these compartments.

Microglia are the smallest and least abundant glial cell and consist of elongated cell
bodies with numerous processes.

 These cells are phagocytic and behave like the macrophages of the CNS,
engulfing invading microorganisms and dead cells.
 They are derived from blood cells called monocytes.

Oligodendrocytes are large cells whose few branches wrap around axons in the CNS
and produce myelin sheaths.

Glial Cells in the PNS

The two types of PNS supporting cells are very similar and differ primarily in location.
Satellite cells surround neuron cell bodies within peripheral ganglia.
Neurolemmocytes (Schwann cells) surround axons in the PNS and form their myelin
sheaths.

Module 14.6 - Myelination of Axons

Axons of some neurons are covered in segmented structures composed of the
lipoprotein myelin, which forms an insulating layer around the axons.

Myelination increases the speed of impulse conduction along an axon.

Myelin Sheaths in the PNS

 Myelin is formed by Schwann cells, which wrap in concentric layers around the
axon.
 The neurilemma is a Schwann cell-based membrane external to the myelin
layers.
 Neurofibril nodes (nodes of Ranvier) are gaps along the axon between
Schwann cells.

Myelin Sheaths in the CNS

Oligodendrocytes form the myelin sheaths around axons in the CNS.

Unlike Schwann cells, they have multiple processes, so each process can coil around
multiple axons.

Unmyelinated Axons
Not all axons in the PNS and CNS are myelinated.

In the PNS, unmyelinated axons remain associated with a Schwann cell. However,
oligodendrocytes are not associated with unmyelinated axons in the CNS.

Module 14.7 - Synaptic Communication

A synapse is composed of these structures:

 The presynaptic neuron conducts an electrical signal toward a synapse and

releases the neurotransmitter (chemical message) stored in synaptic vesicles
from its synaptic knob.
 The synaptic cleft is the space between neurons in which neurotransmitters
must travel across.
 The postsynaptic neuron receives the neurotransmitter and transmits
electrical activity away from a synapse.

Module 14.8 - White and Gray Matter

Dissected sections of brain and spinal cord show variations described as white and
gray matter .
The white matter is aggregations of myelinated and unmyelinated axons of many
neurons. The concentration of myelin (which is white) lends this area its’ color. The
gray matter areas contain neuronal cell bodies, dendrites, unmyelinated axons, axon
terminals and neuroglia. The concentration of Nissl bodies impart a gray color to this
area.

The cerebral nuclei, often wrongly called the basal ganglia, have an important role in
motor control. These are Islands of gray matter containing neuron cell bodies found in
cerebrum, diencephalon and midbrain.

The cerebral nuclei consist of the following:

 The caudate nucleus, putamen and globus pallidus are associated with motor
control.
 The amygdala, although located in the cerebrum, is actually considered part of
the limbic system.
 The claustrum functions in the processing of visual information.

Module 15.0: The Spinal Cord and Spinal Nerves

The central nervous system comprises: the spinal cord and brain. The brain is far
more complex than the spinal cord and is often likened to a supercomputer, but that
analogy doesn't even begin to really do it justice. Although both are capable of
receiving tremendous amounts of input, processing it and sending the appropriate
output, the brain is infinitely more dynamic. Not only is it responsible for learning
and adapting, but it is also the source of all of our dreams, memories and behaviors.

Module 15.1 Spinal cord and nerves

The spinal cord is located within the vertebral canal of the vertebral column. The
vertebral foramina of all the vertebra stacked one on top of the other form the
vertebral canal.

Spinal Cord Meninges

The vertebral column is lined by dura mater known as the spinal dural sheath, which
is

composed of only a single meningeal layer.

Anesthetics are administered in the epidural space, located between the dural
sheath and the vertebral canal.

Internal to the dura mater, the arachnoid and pia mater are continuous with their
counterparts in the brain.
Denticulate ligaments are derived from pia mater, and they anchor the spinal cord to
the vertebrae.

The filum terminale is a thin strand of pia mater that attachs the conus medullaris to
the coccyx.

Structure of a single Nerve.

 Nerves are long, string-like organs in the PNS, composed of numerous parallel
axons of neurons wrapped in connective tissue.
 They are composed of myelinated and unmyelinated sensory and motor nerve
fibers.
 Each axon is first surrounded by myelin, then wrapped in a delicate layer of
connective tissue called the endoneurium.
 Groups of axons are bound into bundles called nerve fascicles and are
surrounded by a connective tissue wrapping called the perineurium.
 The exterior of the whole nerve is covered by a tough fibrous sheath called the
epineurium.

Spinal nerves are nerves associated with the spinal cord and like all nerves of the
peripheral nervous system are parallel bundles of axons and their associated
neuroglial cells wrapped in layers of connective tissue. Spinal nerves connect the CNS
to sensory receptors, muscles and glands in all parts of the body.

Module 15.2 - Gross Anatomy of the Spinal Cord

Link between the brain and the body. Exhibits some functional independence from
the brain. • The spinal cord and spinal nerves serve two functions:

o pathway for sensory and motor impulses

o responsible for reflexes

The spinal cord lies within the vertebral canal from the foramen magnum to
approximately the L2 vertebra.

Two deep grooves run the length of the cord, creating left and right halves and are
known as the posterior median sulcus and anterior median fissure.
The spinal cord is divided into cervical, thoracic, lumbar, sacral and coccygeal
regions.

 Each region contains the motor neurons to the corresponding spinal nerves.
 There are eight cervical nerves (C1-C8), twelve thoracic nerves (T1-T12), five
lumbar
 nerves (L1-L5), five sacral nerves (S1-S5) and one coccygeal nerve (Co).

 However, the regions of the spinal cord do not overlap with the corresponding
vertebrae.

Cervical and lumbar enlargements contain the neurons that innervate the upper and
lower limbs, respectively.

The inferior end of the spinal cord becomes the conus medullaris, which breaks up
into a collection of nerve fibers called the cauda equina.

The spinal cord is protected by bone, meninges, and CSF.

Module 15.3 - Spinal Nerves

Each spinal nerve is comprised of an anterior (ventral) and posterior (dorsal) root.

 The anterior root contains motor axons.

 The posterior root contains sensory axons.
 Attached to the posterior root, the cell bodies of the sensory neurons form the
posterior root ganglion.

Anterior and posterior roots join to form a spinal nerve in the intervertebral
foramen.

Upon exiting the intervertebral foramen, the spinal nerve branches into rami.
Posterior rami serve the skin and deep muscles of the back.

Anterior rami branch and join with one another to form nerve plexuses that primarily
serve the limbs.

 A nerve plexus is a complex network of nerves.

 These rami branch in cervical, brachial, lumbar, and sacral regions, but not in
the region of T2 - T12.

The Cervical Plexus

 Formed by the anterior rami of first four cervical nerves (C1-C4), it is buried
deep in the neck under the sternocleidomastoid muscle.
 Most are cutaneous nerves that supply the skin, but some innervate muscles of
the anterior neck.
 The phrenic nerve, the most important nerve of the cervical plexus, innervates
the diaphragm.

The Brachial Plexus

The brachial plexus is formed by anterior rami of C5 - T1 and is distributed through
the neck and axilla.

Its five roots are deep to the sternocleidomastoid and form three trunks: the upper,
middle and lower trunks.

Each trunk can be divided into anterior and posterior divisions.

 The anterior division innervates the flexors of the upper limb.

 The posterior division innervates the extensors of the upper limb.

The three trunks give rise to three cords: the lateral, medial and posterior cords.

These three cords give rise to five important nerves of the upper limb: the radial,
axillary, median, musculocutaneous and ulnar nerves.

 The radial nerve is a continuation of the posterior cord and is the largest
branch of the brachial plexus. It innervates muscles of the posterior upper
limb.
 The axillary nerve innervates the deltoid and teres minor.
 The median nerve innervates anterior forearm and thenar muscles and the
lateral two lumbricals
 The musculocutaneous nerve innervates the anterior arm muscles.
 The ulnar nerve innervates anterior forearm muscles and muscles of the hand.

The Lumbar Plexus

It arises from spinal nerves L1-L4.
Smaller branches innervate the posterior abdominal wall and psoas muscle. The main
branches innervate the anterior thigh.

The femoral nerve is the largest terminal branch, and it innervates anterior thigh
muscles.

The obturator nerve passes through the pelvis and innervates adductor muscles.

The Sacral Plexus

It arises from spinal nerves L4 - S4 and is located immediately caudal to the lumbar
plexus. Sometimes it is considered in conjunction with the lumbar plexus and called
the lumbosacral plexus.

The sciatic nerve is the thickest and longest nerve in the body and is actually two
nerves in a single sheath:
  The tibial nerve innervates most of the posterior lower limb muscles. It
becomes medial and lateral plantar nerves in the foot. I t also contributes to
the sural nerve, which supplies skin on the posterior leg.
 The common fibular (peroneal) nerve innervates muscles of the anterolateral
leg and gives rise to the superficial and deep fibular nerves.

Superior and inferior gluteal nerves innervate the gluteal muscles.

The posterior femoral cutaneous nerve innervates the cutaneous region of the
posterior thigh.
Pudendal nerve innervates muscles of the perineum.

Module 15.4 - Reflexes

Reflex arcs are simple chains of neurons that explain involuntary behaviors and
account for reflexes.

Reflexes are rapid, automatic motor responses that occur in response to a stimulus
and can be either visceral or somatic.

Components of a Reflex Arc

 Receptors are the sites where the stimulus is received.

 Sensory neurons transmit afferent impulses to the CNS.
 Integration center consists of one or more synapses in the CNS.
 Motor neurons conduct efferent impulses from integration center to an
effector.
 Effectors can represent muscles that contract or gland cells and respond to
efferent impulses by either contracting or secreting a hormone.

Module 19.0 - The Respiratory System

Typically, humans can survive for days without water and weeks without food, but
can only live for minutes without oxygen. This continuous requirement for oxygen is
necessary to enable the trillions of cells throughout the body to generate the energy
(in the form of ATP) that they need to sustain life. In addition to requiring oxygen,
the body must also eliminate carbon dioxide which is a byproduct of aerobic
metabolism. Both of these gases are exchanged through the respiratory system which
operates conjunction with the circulatory system that transports them.

Module 19.1 - The Respiratory System Functions

The respiratory system has many functions.

 It supplies body with oxygen and eliminates carbon dioxide.

  It enables vocalization (speaking).
 It allows olfaction (sense of smell).
 Respiratory structures defend against airborne pathogens.

Functional Anatomy of the Respiratory System

The respiratory organs are these:

 nose, nasal cavity, and paranasal sinuses.

 pharynx, larynx, and trachea.
 bronchi and their smaller branches of the lungs.
 lungs and their alveoli.

Module 19.2 - Upper Respiratory Tract

The upper respiratory tract includes the nose, nasal cavity, pharynx, and
their associated structures.

Nose and Nasal Cavity

The nose provides an airway for respiration.

- It moistens and warms air upon entry, filters particles from inhaled air, provides a
resonating chamber for speech, and contains the olfactory (smell) receptors.

The nose is divided into two main parts

 External nose, which is composed of the following:

o The bridge which consists of the nasal bones.

o The dorsum nasi and supporting lateral and alar cartilages.

 Nasal cavity

The external nares are commonly called the nostrils.

The nasal septum, which divides the nasal cavity into left and right halves, has
two parts:

 The anterior portion is composed of septal cartilage (hyaline cartilage).

 The posterior portion is formed by the ethmoid bone and vomer.

The cavity is continuous with the nasopharynx through posterior nasal

apertures known as internal nares (choanae).
The nasal cavity is separated from the oral cavity by the palate, which is made up of
two parts:

 The hard palate is anterior and is composed of maxillae and palatine bones.
 The soft palate with uvula is posterior, and is composed of muscle.
The anterior portion of the nasal cavity, which contains hair follicles, is called
the

vestibule.
Two types of pseudostratified ciliated columnar epithelium line the nasal
cavity:

 Olfactory epithelium which also contains the olfactory receptors.

 Respiratory epithelium which lines most of the nasal cavity.

The nasal conchae are three medially projecting mucus-covered bony structures in
the nasal cavity .

 They include the superior, middle and inferior conchae.

 They direct particulate matter onto mucus-coated surfaces.
 The groove inferior to each of the conchae is called a nasal meatus.

Paranasal Sinuses
The paranasal sinuses are air-filled cavities inside the bones surrounding the nasal
cavity. They are located in the frontal, sphenoid, ethmoid, and maxillary bones and
are named accordingly. They serve to reduce the weight of the head.

Pharynx

This funnel-shaped passageway connects the nasal cavity and mouth to both the
respiratory and digestive systems. It runs from the base of the skull to the sixth
cervical vertebra, and its type of mucosal lining varies along its length. The pharynx is
subdivided based on location and function into three parts:

Nasopharynx

 Lies superior to the point where food enters, and serves only as an airway. It is
closed off by the soft palate during swallowing.
 It contains the openings of the auditory tubes and is lined with ciliated
pseudostratified epithelium.
 The nasopharynx contains the pharyngeal tonsil (or adendoids), which is
located higher the posterior wall and which destroys pathogens that enter via
inspired air.
 Oropharynx

This lies posterior to the oral cavity and extends from the soft palate to the
epiglottis. It contains arch-like structures called fauces and is lined with a
stratified squamous epithelium.

Two types of tonsils are associated with the oropharynx:

 Palatine tonsils are found in the lateral walls of the fauces.

 Lingual tonsils cover the posterior surface of the tongue.

Laryngopharynx

This part of the pharynx is directly posterior to the larynx and is a passageway
for both food and air.

It is lined with stratified squamous epithelium and it is continuous with the

esophagus and larynx.

Module 19.3 - Lower Respiratory Tract

The lower respiratory tract is composed of the conducting airways and gas exchange
regions of the respiratory system.

Larynx
The larynx, often called the voice box, is located between the fourth and sixth
cervical vertebrae. The larynx is attached to the hyoid bone and is continuous with
the trachea (windpipe).

Its epithelium consists of stratified squamous (superiorly) and ciliated

pseudostratified columnar (inferiorly) epithelium.

The cartilages that make up this structure are interconnected by membranes and
ligaments:

 Thyroid cartilage contains the laryngeal prominence (Adam’s apple).

 Cricoid cartilage forms a complete ring on the inferior base of the larynx.
 Arytenoid cartilages anchor the vocal chords.
 Corniculate cartilages attach to the arytenoid cartilages.
 Cuneiform cartilages are located within the aryepiglottic fold.
 Epiglottis seals the laryngeal inlet during swallowing.

Within the larynx, there are two groups of muscles:

  intrinsic muscles attach to the arytenoid and corniculate cartilages.

 extrinsic (infrahyoid) muscles attach the thyroid cartilage to the hyoid bone.


Paired vocal folds (true vocal cords), composed of vocal ligaments and attached mucosa, are
found in the larynx.
 The opening between these vocal folds is called the rima glottidis.
 The vocal folds and rima glottidis make up the glottis.
 Vestibular ligaments and surrounding mucosa comprise the vestibular folds and form
the false vocal cords.
 Voice is produced by the intermittent release of air over the vocal cords, which causes
them to vibrate.
 Pitch is determined by the tension of the vocal cords and loudness depends on the force
of air passing across them.