Introduction to

Neurophysiology
Qushay Umar Malinta
 “How does the body work?”
PHYSIOLOGY
“What are the normal processes?

”What went
WRONG?” PATHOPHYSIOLOGY
Where do PHYSIOLOGY play its role?

Medical
Normal phenomenon Pathologic

I-nfection
Studies Macro Micro
Co-ngenital
Structure Anatomy Histology
S Ne-oplasm
Function PHYSIOLOGY Biochemistry t
Her-editary
u
d Immu-ne (autoimmune)
Clinical Medicine i Met-abolic
e
Tra-uma
s
Diagnosis Therapy D-egenerative
PATHOPHYSIOLOGY
 Pathophysiology of Diseases
-No structural disruption  functional disorder
-With structural disruption  organic disorder
PATHOLOGIC
CONDITION
“ICONEHER IMMUMETRAD”
I-nfection
Co-ngenital
disruption Ne-oplasm
Her-editary
Immu-nologic/ autoimmune
Met-abolic
NORMAL Tra-uma
PHYSIOLOGY D-egenerative
 SKDI Levels  Indonesian
Doctors must be able to perform…
 Level 4 : diagnosis  comprehensive treatment
 Priority : mandatory
 Level 3B : diagnosis  primary treatment (emergency)
 Priority : mandatory
 Level 3A : diagnosis  primary treatment (non-emergency)
 Priority : mandatory
 Level 2 : diagnosis
 Priority : secondary
 Level 1 : literature research
 Priority : complimentary
Steps of learning in med school:
1. Open the SKDI 2012
2. Find the pathophysiological concepts of
diseases
 Start from level 4’s, then proceed to level 3’s
 If you have more time, continue to level 2’s & 1’s
3. Something you don’t understand?
 Open the anatomy/ histology/ physiology/
biochemistry books
 Physiology of Nervous System
 Function:
 Coordination & control

 Main processes:
 Input (sensory)  sensory/ afferent neurons
 Processing (integration)  interneurons
 Output (response)  motor/ efferent neurons
Neuron: “The Messenger”
Glia: “The Nurturer”
Electricity in cells =
changes of membrane potential
Examples of gated ion channels

The key to open this gate: The key to open this gate:
binding of CHEMICAL VOLTAGE change
Two types of membrane potentials
Graded potential: Action potential (AP):
 spread both ways  propagate one way only
ACTION POTENTIAL (AP)
 All-or-none law
 more stimuli = more rapid AP
frequency
Refractory period
to ensure forward AP conduction (no backflow of AP)
 Two types of refractory period:
 Absolute
 Relative
ACTION POTENTIAL
Two factors affecting conduction speed:
myelin & nerve fiber diameter
 SYNAPSE &
NEUROTRANSMITTER
 Synapse: intercellular
connection
 Direct contact =
electrical = gap junction
 No direct contact =
chemical  cleft
 Neurotransmitter: the
chemical in the cleft
 Excitatory:
to excite target cell
 Inhibitory:
to inhibit target cell
Examples of neurotransmitters
Examples of neurotransmitters (cont’d)
 The Brain
 Nourishment:  Protection:
 Cerebral blood flow
○ Almost all of brain
energy = exclusive from
glucose + O2 -->
maintenance of CBF is
absolutely important
○ 4 minutes no O2 = death
of neuron
 Blood-brain barrier
○ Role of BBB
 Skin + hard skull
 Cerebrospinal fluid
○ Support & cushion
○ Flow of CSF: from ventricles
to spinal
 3 layers of meninges:
○ Dura-
○ Arachnoid-
○ Pia-
Overview of Brain Function
Functions of cerebral cortex
Hemispheres of the brain
Higher function of brain:
CONSCIOUSNESS
Brain waves
 Alpha
 awake, calm & relaxed
 Beta
 awake, concentrating
 Theta
 in child & concentrating
adult
 Delta
 Deep sleep, anesthesia
 Brain damage if happen
in awake person
 RAS:
center of
alertness
Sleep
 Types of sleep:
 REM & Non-REM (NREM)

 Why sleeping?
 REM: reverse learning
(“forgetting”)
 NREM 3 & 4: restoring
Higher function of brain:
LANGUAGE
Limbic system: emotion & behavior
 Memories…
Declarative (facts) >< procedural (skills)
Short term >< long term
How do we
memorize?

How to
enhance
memorization?

Memory strength ~
synaptic strength
Habituasi & sensitisasi

• Habituasi: kalo sungut disentuh pelan,

awalnya sungut ditarik pelan lama2
sungut tidak ditarik lagi.
• Sensitisasi: kalo sungut dipukul,
sungut ditarik dgn cepat  lama2, meski
cuma disentuh pelan, sungutnya ditarik
dgn cepat
CRANIAL
NERVES:
 Sensory:
 I
 II
 VIII
 Motor:
 III, IV, VI
 XI
 XII
 Both:
 V
 VII
 IX
 X
Fisiologi nervus spinalis
REFLEX
Reflex
 5 components of
reflex arc
 Dual innervation
 Muscle tone
 Ipsilateral reflex ><
contralteral reflex
Autonomic nervous system (ANS)
 Sympathetic:  Parasympathetic
 Fight-or-flight response  Rest-and-digest response
 Dual innervation of
the ANS
Homunculus cerebri: conscious sensory & motor center
Sensory input: ascending pathway to
CNS (posterior & anterolateral)

 Tactile receptors:  Nocireceptor:

○ Touch ○ Pain
○ Pressure  Fast >< slow
○ Vibration  Superficial >< deep
 Visceral & referred
○ Stretch
 Nociceptive >< neuropathic
○ Tickle
○ Itch
 Proprioreceptor:
○ Muscle length
 Thermoreceptor:
○ Muscle tension
○ Warm
○ Joint position & movement
○ Cold
Abilities of sensory perception
 Detection
 what sensation?
 Magnitude
 how intense?
 Spatial discrimination
 where? One or two point?
 Character of sensation
 warm? hard?
 Quality of sensation
 sweet and/ or sour?
 Pattern recognition
 song or speech?
Motor response:
descending
pathway from CNS
 Upper motor neuron
 Lower motor neuron/
final common
pathway to skeletal
Cerebrum: monitoring & correction of movement
 Danke Schoen

 Reference:
 Sherwood
 Fox
 Marieb
 Tortora
 SKDI 2012