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NERVOUS SYSTEM
CONTENTS
DEVELOPMENT OF NERVOUS SYSTEM .......................................................................................................................... 8
ANATOMY OF NERVOUS SYSTEM ................................................................................................................................. 8
GENERAL FEATURES OF ANATOMY OF NERVOUS SYSTEM ....................................................................................... 8
ANATOMY OF BRAIN ................................................................................................................................................. 9
SULCUS OF BRAIN ................................................................................................................................................... 10
BLOOD SUPPLY OF BRAIN AND SPINAL CORD ......................................................................................................... 10
VENOUS SYSTEM OF BRAIN .................................................................................................................................... 11
LOBES OF BRAIN ...................................................................................................................................................... 11
AREAS OF BRAIN ..................................................................................................................................................... 11
THALAMUS .............................................................................................................................................................. 12
LIMBIC SYSTEM ....................................................................................................................................................... 13
HYPOTHALAMUS ..................................................................................................................................................... 13
VENTRICLES OF BRAIN ............................................................................................................................................ 14
CEREBELLUM ........................................................................................................................................................... 14
AFFERENT AND EFFERENT ....................................................................................................................................... 15
CRANIAL NERVE ...................................................................................................................................................... 16
SPINAL CORD ........................................................................................................................................................... 17
PHYSIOLOGY OF NERVOUS SYSTEM ............................................................................................................................ 18
GENERAL FEATURES OF PHYSIOLOGY OF NERVOUS SYSTEM ................................................................................. 18
NERVE FIBRES .......................................................................................................................................................... 19
CEREBROSPINAL FLUID ........................................................................................................................................... 21
MUSCLES ................................................................................................................................................................. 22
MUSCLE CONTRACTION .......................................................................................................................................... 23
NERVE AND ACTION POTENTIAL ............................................................................................................................. 25
NERVE CONDUCTION AND INHIBITION ................................................................................................................... 27
SYNAPTIC POTENTIALS ............................................................................................................................................ 28
BLOOD BRAIN BARRIER ........................................................................................................................................... 28
MEMORY ................................................................................................................................................................. 28
THERMAL REGULATION .......................................................................................................................................... 29
TEMPERATURE REGULATION IN NEONATES ........................................................................................................... 30
NEUROTRANSMITTERS............................................................................................................................................ 30
PAIN ........................................................................................................................................................................ 31
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NERVOUS SYSTEM
APPETITE ................................................................................................................................................................. 31
TRACTS IN NERVOUS SYSTEM ................................................................................................................................. 31
PYRAMIDAL TRACT .................................................................................................................................................. 32
REFLEX ..................................................................................................................................................................... 32
PHYSIOLOGY OF AUTONOMIC NERVOUS SYSTEM .................................................................................................. 33
BRAIN DEATH .......................................................................................................................................................... 33
HEADACHE .................................................................................................................................................................. 33
CLUSTER HEADACHE ............................................................................................................................................... 33
TENSION HEADACHE ............................................................................................................................................... 34
MIGRAINE ............................................................................................................................................................... 34
BASILAR MIGRAINE ................................................................................................................................................. 35
OPHTHALMOPLEGIC MIGRAINE .............................................................................................................................. 35
SYNCOPE ..................................................................................................................................................................... 35
APHASIA ...................................................................................................................................................................... 35
GENERAL FEATURES OF APHASIA ........................................................................................................................... 35
BROCAS APHASIA ................................................................................................................................................... 35
WERNICKES APHASIA ............................................................................................................................................. 36
SEIZURE ....................................................................................................................................................................... 36
GENERAL FEATURES OF SEIZURE ............................................................................................................................ 36
ABSENCE SEIZURE ................................................................................................................................................... 37
MYOCLONIC SEIZURES ............................................................................................................................................ 37
POST TRAUMATIC SEIZURES ................................................................................................................................... 38
FEBRILE SEIZURES .................................................................................................................................................... 38
STATUS EPILEPTICUS ............................................................................................................................................... 39
INFANTILE SPASM ................................................................................................................................................... 39
GENERAL TONIC CLONIC SEIZURES ......................................................................................................................... 39
PARTIAL SEIZURES ................................................................................................................................................... 39
NEONATAL SEIZURES .............................................................................................................................................. 40
INFANTILE TREMOR SYNDROME ............................................................................................................................. 40
ANTIEPILEPTIC DRUGS ............................................................................................................................................ 40
MOTOR NEURON DISEASES ........................................................................................................................................ 42
UPPER MOTOR NEURON DISEASE .......................................................................................................................... 42
LOWER MOTOR NEURON DISEASE ......................................................................................................................... 42
MOTOR NEURON DISEASE ...................................................................................................................................... 43
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NERVOUS SYSTEM
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NERVOUS SYSTEM
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NERVOUS SYSTEM
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NERVOUS SYSTEM
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NERVOUS SYSTEM
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NERVOUS SYSTEM
Infancy
Hippocampus & Olfactory bulb
Length of Axon
6 months (sensory nerves earlier)
Sensory area
Motor area
Medulla oblongata
Pons and cerebellum
Spongioblast of mantle zone
32 weeks
Astrocytes
Layer 5
Layer 1
Layer 6
Grey matter
White matter
Peripheral nerves, Anterior horn cells, Anterior nerve
root
Superior sagittal sinus
Nucleus acumbans
Substantia gelatinosa, Dorsal root ganglion
Purkinje cells
Inferior medullary velum
Anterior choroidal artery
Maxillary nerve, Mandibular nerve
Ant and post ethmoidal, Mandibular
5,10,12 nerve
4 nerve
Auriculotemporal nerve
Protoplasmic astrocytes are found in grey matter,
Oligodendrocytes are derived from ectoderm, Microglia
are mesodermal in origin
Microglial cell
Phagocytosis
Hortega carbonate
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NERVOUS SYSTEM
Damage to nerve tissue is repaired by
Brain lipid binding proteins is expressed by
Myelin sheath in CNS is synthesized by
Gitter cells/hortega cells
NOT a neural cells
NOT true about neuropeptide
Citelli angle
Facial index is a rough index of development of
Transaction through lower end of medulla through
pyramids
Astrocyte
Mature astrocytes
Oligodendroglia
Microglia, Lipid laded microglial cell, Modified CNS
macrophages
Ependymal phagocytes
Its level decreases during starvation
Sinodural angle
Brain
Incoordination, Spasticity, Increased tendon reflex
ANATOMY OF BRAIN
Fibres passing through crus cerbri
Cells NOT present in cerebral cortex
Genu of internal capsule carries
Fibres passing through genu of internal capsule
Corticospinal fibers pass through which
part of internal capsule
Association fibres
NOT an association fibre
Splenial fibres connecting two occipital
lobes
Tapetum
Cistern ambiens
Ventral striatum contains
Corpus callosum
Induseum Griseum is
Sommer sector area
Areas of hippocampus
Hippocampal formation include
NOT a part of hippocampal complex
Area immediately lateral to anterior perforating
substance
Trapezoid body is present in
Interpeduncular fossa contains
Cortical representation of body in cerebrum is
Substances promoting growth and survival of neurons
Serotonin in brain mainly seen in
Biondi ring tangles are found in
Cranial structure insensitive to pain
Healthy female, got pregnant for first time. LSCS done
for fetal distress. Mild hypertension during pregnancy. 2
days after delivery she had headache and seizures. CT
Corticonuclear , Corticospinal
Bipolar
Sensory fibres to thalamus and brain
Corticonuclear
Anterior two third of posterior limb
Uncinate, Cingulum, Longitudinal fasciculus
Forceps major
Forceps major
Connects both parietal lobe
Between splenium of corpus callsoum and
tectum of midbrain
Nucleus acumbens, olfactory tubercle
Unite far area of two sides of brain, Connect two frontal
lobe, Unites two hemisphere, Superiorly related to
indusium griseum
Dorsal to Corpus callosum
CA1 area of hippocampus
Cornu ammonis, dentate gyrus
Dentate gyrus, Subicular complex, Entorhinal complex
Amygdaloid nucleus
Limen insulae
Pons
Mamillary body, Posterior perforated substance,
OCCULOMOTOR nerve, Trochlear nerve, Tuber cinerum
Vertical
Neurotrophins
Raphae nucleus
Choroid plexus cells
Choroid plexus
Sagittal sinus thrombosis
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NERVOUS SYSTEM
shows 2*3 cm parasagittal hematoma. No proteinuria
NOT true about dural sinus
SULCUS OF BRAIN
Limiting Sulcus of Cerebrum
Rolando fissure
Central Sulcus is a
Complete Sulcus
Complete sulcus
Sylvius
Structure lying in lateral sulcus
Central Sulcus
Central sulcus
Operculated sulcus
Calcarine sulcus
Collateral sulcus, calcarine sulcus
Lateral sulcus
Superficial middle cerebral vein
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NERVOUS SYSTEM
LOBES OF BRAIN
Neurophysiological defects present in right lobe
involvement are
NOT a Neurophysiological defects present in right lobe
involvement
Left lobe is responsible for
Left paracental lobule injured. Paresis of
Lobe of brain associated with psychiatric
illness
Witzelsucht syndrome (pathological joking)
Euphoria, uncontrolled laugh, joking,
making pun
MRI feature of Mesial temporal sclerosis
PET feature of mesial temporal lobe
epilepsy
Lesion of medial temporal lobe is associated with
Lesion for Prosopagnosia
Prosopagnosia is characterized by
Occipital lobe is a part of
Stria of Gennari in
AREAS OF BRAIN
Brocas area
Brocas area
Motor area of brodmans area
Frontal eye motor area
NOT frontal eye motor area
Area of brain responsible for self stimulation reward on
induction
Primary motor area of cerebral cortex
First centre activated by voluntary skillful movements
Most important area in organising and planning
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NERVOUS SYSTEM
complex sequential skilled movements
Sensory impairment in extensive damage to primary
somatosensory area
Pain sensation
Increased baroreceptor discharge
Skilled voluntary movement is initiated at
Swallowing centre is located in
Sudden onset of dysphagia ,vomiting, vertigo, horners
syndrome
Presence of ataxic nystagmus indicates a lesion in
Gustatory cortex is situated in
Field of Forel H2
Copper is present in
Iron in
Zinc in
Calamus scriptoris
Red nucleus is situated at
THALAMUS
Basal ganglia nucleus
Nucleus of basal ganglia
NOT a basal ganglia nucleus
NOT a part of basal ganglia
Major afferent to Basal Ganglia to
Highest density of glutamate receptors in basal ganglia
Functions of basal ganglia
Role of basal ganglia in motor function
Primarily glutaminergic
Efferent bundle of substantia nigra transmits dopamine
to
Major neurotransmitter in substantia nigra
Selective lesion of globus pallidus causes
Thalamic nuclei are
Solitario thalamic
Sensory nucleus of thalamus
Motor nucleus of thalamus
Region for memory in thalamus
Region for emotion in thalamus
Region for visual memory in thalamus
Epithalamus
NOT a part of epithalamus
Ventral posterior nucleus of thalamus
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NERVOUS SYSTEM
Thalamic nuclei projecting to neocortex
Thalamic nuclei NOT projecting into neocortex
B/L Babinsky is associated with
Injury to thalamus does NOT cause
LIMBIC SYSTEM
Window of limbic system
Nucleus that lies immediately medial and
deep to uncus
Main output of amygdala is conveyed
through
Function of limbic system
Reward centre
Involved in emotion
Hippocampus lesion affect
Amygdala
Amygdala
Stria terminalis
Emotion, Memory, Higher function
Medial forebrain bundle
Limbic system, Hippocampus
Explicit memory/declarative memory, Transformation
of short term to long term memory
HYPOTHALAMUS
Site of synthesis of vasopressin
Key regulators of sleep are located in
Special sense NOT having relay in hypothalamus
NOT a function of hypothalamus
Osmoreceptors are located in
OVLT
First response of osmoreceptors to
hyperosmality
Osmometer is based on
Area posterema is associated with
Subfornical organ is associated with
Substance having effect on thirst
mechanism
Thirst centre is stimulated by
Cell bodies of orexinergic neurons present in
Feeding centre
Feeding centre is stimulated by
Satiety centre
Satiety centre is stimulated by
Lesion affecting ventromedial hypothalamus manifest
with
Part of hypothalamus most closely related to sexual
activity in males
Drinking can be induced by
Sham range
Hypothalamus
Hypothalamus
Smell
Increase in heart rate with exercise
Anterior Hypothalamus
Osmoreceptor
Vasopressin secretion
Freezing point depression
Vascular tonicity
Thirst
Angiotensin
OVLT, subfornical organ
Lateral hypothalamic area
Lateral hypothalamus
Neuropeptide Y, orexin A and B, ghrelin
Ventromedial nucleus
Leptin, peptide XY, POMC
Hyperphagia
Preoptic nucleus
Osmotic stimulation of supraoptic nucleus
Caused by hypothalamic stimulation, NOT abolished by
decortications, Pathological rage reaction, Association
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NERVOUS SYSTEM
VENTRICLES OF BRAIN
Cavity of telencephalon
Cavity of diencephalon
Cavities of diencephalon
Cavity of mesencephalon
Cavity of rhombencephalon
CSF from lateral to third ventricle
Lateral Ventricle is connected to third ventricle by
Floor of third ventricle formed by
NOT seen in floor of third ventricle
Cerebral aqueduct of sylvius
Obstruction to flow of CSF at aqueduct of sylvius will
lead to enlargement of
Fourth ventricle
th
Nucleus found in floor of 4 ventricle
Floor of fourth ventricle is formed by
Lateral ventricle
Third ventricle
Interthalamic adhesions join lateral walls, Lamina
terminalis contain anterior communicating artery
Aqueduct
Fourth ventricle
Foramen of munro
Interventricular Formen of Monro
Infundibulum, Mamillary body, Optic chiasma
Occulomotor nerve
rd
th
Connects 3 to 4 ventricle
Both lateral and third ventricle
Rhomboid fossa forms floor
Abduscens, Dorsal vagal nuclei, Facial , Hypoglossal
Post surface of pons, Sulcus limitans, Post surface of
medulla
CEREBELLUM
Cerebellum
Phylogenetically older cerebellum
Phylogenetically newer cerebellum
NOT true about cerebellum
Glomeruli are present in
Somata of golgi cells of cerebellum are located in
Flocconodular lobe is a component of
Flocconodular lobe has direct connections with
Flocculonodular lobe has direct connection with
Vetibuloocular reflex concerned with
Efferent tracts from cerebellum arise from
Most lateral and deep cerebellar nucleus
Dentate nucleus is a part of
Neocerebellum to Ventral lateral nucleus of thalamus
through
Two main afferent to cerebellar cortex
Cerebellar component that would be
abnormal in a degenerative disease that
affects spinal sensory neuron
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NERVOUS SYSTEM
Cerebellar rosette
Only output from cerebellar cortex
Cells particularly sensitive to ischemic damage in brain
Cerebellar connection to other parts of brain
All cerebral cells are inhibitory except
Purkinje cells from cerebellum end in
Axons of Purkinje cells and efferents from Cerebrum
NOT a cell in cerebellum
Cerebellar peduncle connects cerebellum to
Largest & most lateral cerebellar peduncle
Afferent tract to middle cerebellar peduncle
Middle cerebellar peduncle transmits
Efferents in superior cerebellar peduncle
arise mainly from
Inferior cerebellar peducle
NOT passing through inferior cerebellar peduncle
Vestibulocerebellar tract terminates at
Function of Spinocerebellar tract
Cerebellum
Role of cerebellum in motor function
Lesion of Cerebellum is associated with
Lesions of lateral cerebellum
Focal cerebellar lesion is associated with
NOT a feature of cerebellar disease
NOT a cerebellar sign
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NERVOUS SYSTEM
CRANIAL NERVE
Cranial nerves in posterior fossa
Cranial nerves in pontomedullary
junction
Cranial nerves present in apex of petrous temporal
bone
Site of lesion affecting 5,6,7 cranial nerves
Nerve arising from medulla
th
th
th
7 , 9 and 10 cranial nerves end in
Nucleus common to 9,10,11 cranial nerve
Fibres from nucleus ambiguous joins with
Brain stem nuclei derived from alar plate
Brain stem nuclei NOT derived from alar plate
Cranial nerve carrying parasympathetic fibres
MC nerve involved in intracranial aneurysm
Neuroepithelium type of sensory receptors
Neuroepithelim type of sensory receptors NOT seen in
Neuroepithelium is a type of receptor in
Olfactory epithelium is
Olfactory nerve first relays in
Nerve having receptors as dendrite
Information from olfactory bulb travels
via the lateral olfactory stria to
Lesion developed from Olfactoty Mucosa
Optic tract related to
Largest intracranial course
Smallest cranial nerve
Cranial nerve decussating with brain
Only cranial nerve to emerge from dorsal aspect of
brain stem
Does NOT carry parasympathetic outflow
Trochlear nerve supplies
Number of trigeminal nucleus
Ends in Posteromedial ventral nucleus of Thalamus
Trigeminal nerve extends lower down up to Level of
Trigeminal nerve
Branches of fifth nerve supplying duramater
Recurrent Tentorial nerve is a branch of
Recurrent branch of ophthalmic nerve
Nucleus of masseteric reflex
Afferent component of corneal reflex by
Passes through meckel cave
Unilateral trigeminal nerve palsy
Unilateral trigeminal nerve injury tested by
Not supplied by trigeminal nerve
Between labyrinthine artery and anterior
inferior cerebellar artery
3 to 12
6, 7 and 8
5,6
CP angle, Pons
Glossopharyngeal, Vagus, Dorsal horn of grey matter
Nucleus tractus solitaries
Nucleus ambiguous
IX, X, XI cranial nerves
Inferior olivary, Substantia nigra, Dentate
Hypoglossal
3,7,9,10
Occulomotor, Abduscent
Visual, olfactory, gustatory
Auditory
Olfactory
Pseudostratified
Temporal Cortex
Olfactory nerve
Piriform cortex, amygdala, entorhinal
complex
Esthesioneuroepithelioma
Lateral geniculate body
Trochlear
Trochlear nerve
Trochlear
Trochlear nerve
Trochlear
Contralateral superior oblique
4
Trigeminal nucleus
C2
Four nuclei, Carries sensation from face and scalp,
Composed of spinal nerve root, Has motor branch
Anterior ethmoidal, posterior ethmoidal, mandibular
Ophthalmic branch of Trigeminal nerve
Tentorium cerebelli
Mesencephalic nucleus of trigeminal nerve
Trigeminal nerve
Trigeminal nerve
Mandible deviates to same side
Elevation and lowering of jaw
Stylohyoid
Abduscent artery
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NERVOUS SYSTEM
Cranial nerve passing through petrous
apex
Cranial nerve NOT containing parasympathetic fibres
Vestibular nerve
Efferents from cochlear nucleus arise for
Concerned with auditory pathway
Facial colliculus seen in
Vestibular Evoked Myogenic Potential (VEMP) detects
Glossopharyngeal Nerve supplies
Glossophayngeal nerve gives
Glossopharyngeal nerve does NOT supply
Vagus nerve carry
Vagus nerve innervates
VI
VI
Nucleus supplied by PICA, anastomotic connection with
facial nerve, Vestibular ganglion aka scarpa ganglion
Superior olivary nucleus
Trapezoid body
Lower pons
Inferior vestibular nerve
Posterior one-third of tongue
Tympanic Nerve, Pharyngeal plexus, Tonsillar branches
Constrictors of Pharynx
Preganglionic parasympathetic fibres
Right two thirds of transverse colon,
stimulates peristalsis and relaxes
sphincter
Heart rate
Bronchodilatation
Carries postganglionic parasympathetic fibres
Stylopharyngeus
Atrophy on affected side, Deviation of tongue towards
the site of lesion, Deviation of Larynx to the
contralateral side during swallowing
SPINAL CORD
Nucleus pulposus is a remnant of
Length of human adult spinal cord
Spinal cord
Spinal cord
Notochord
46 cm
In adults spinal cord ends at lower of L1 vertebra. In
newborn may extend up to L3. Cauda equina extends
from lumbar vertebra to coccyx
Central canal lies in grey matter, Efferents leave from
anterior horn, Denticulate ligaments suspend medulla
in subarachnoid space
Lower border of L1
L1, L2
L3
S2
31
C5
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