The Nervous System with Mental Health

The Nervous System with Mental Health
Chapter 6 The Nervous System with Mental Health

Chapter 6 The Nervous System with Mental Health
Multimedia Asset Directory Slide 26 Brain and Brainstem Animation Slide 51 Alzheimer's Movie Slide 57 Epilepsy Movie Slide 67 Multiple Sclerosis Animation Slide 71 Parkinson's Disease Movie

The Nervous System Composed of the brain, spinal cord, and nerves
These organs enable you to sense the world around you, to form thoughts and memories, and to control your body movements and many internal functions

Prefixes a- = without mono- = single di- = two pan- = all, entire
dys- = bad, abnormal para- = near, alongside hemi- = one-half poly- = many hydro- = water pre- = before hyper- = excessive tetra- = four

Word Roots astheni = weakness cephal = head
cerebell = little brain, or cerebellum cerebr = brain, or cerebrum cran, crani, = cranium dur = hard encephal = brain esthesi = sensation, perception

Word Roots (cont.) gangli, ganglion = knot or swelling gli = glue
lys = break apart, or dissolution mening = membrane ment = the mind myel = spinal cord, or bone marrow, or medulla, or myelin sheath neur = sinew or cord; nerve

Word Roots (cont.) phas = speech plegi = paralysis psych = the mind
quad, quadri = four radic, radicul = nerve root somat = the body thalam = inner chamber

Suffixes -algia, algesia = pain -asthenia = weakness
-cele = a swelling or hernia -gram = recording -iatry = treatment, specialty -itis = inflammation of -lepsy = seizure

Suffixes (cont.) -oid = resemblance to -paresis = slight paralysis
-phagia = eating or swallowing -phasia = speaking -plegia = paralysis

Anatomy and Physiology
The nervous system provides a system of communication between the brain and distant parts of the body It monitors changes in the environment inside and outside of the body It conducts all of this by electrochemical messages called nerve impulses Nerve impulses race through your body every moment, traveling along special routes, or nerves, at high speeds

Divisions of the Nervous System
The nervous system is divided into two main groups Central nervous system (CNS) Includes the brain and spinal cord Peripheral nervous system (PNS) Includes the nerves and sensory receptors

Figure 6.1: Organization of the nervous system

Nervous Tissue The nervous system contains specialized tissue that conducts nerve impulses The functional cells of nervous tissue are called neurons; they receive support from nearby neuroglial cells Each neuron consists of a cell body and numerous branches The cell body contains the nucleus and most of the cytoplasm The branches include many dendrites, which carry impulses toward the cell body, and a single axon, which carries impulses away

Figure 6.2: Neurons and nervous tissue organization
The neuron is shown in yellow, and three types of neuroglial cells are shown in various colors. Source: Icon Learning Systems.

Nervous Tissue In many neurons, the axon is covered with numerous neuroglial cells known as Schwann cells Schwann cells provide a white-colored protective sheath, known as the myelin sheath, that is mostly fat, and enable an axon to extend great distances through the body by offering it protection and insulation Neurons have the ability to conduct nerve impulses very quickly, providing an excellent method of communication

Nervous Tissue (cont.) Neurons communicate by releasing chemicals across tiny gaps, called synapses, that separate them These chemicals, known as neurotransmitters, are released by a neuron when a nerve impulse reaches its distal end. The neurotransmitters then diffuse across the synapse to contact the adjacent cell. Contact with the next neuron may stimulate it to trigger a nerve impulse, or may inhibit it.

Central Nervous System
Is the central station for incoming and outgoing nerve impulses Includes the brain and spinal cord which are protected by membranes called the meninges The meninges form a protective cover that is several layers thick Outer tough layer is the dura mater Middle layer is the arachnoid Inner thin layer is the pia mater

Figure 6.3: The meninges surround the brain and spinal cord
(a) Section through the head with the cranium partially removed. The thick, parchment-like dura mater is shown pulled upward to reveal the subarachnoid space and the pia mater attached to the brain surface. (b) A sectional view through the top of the brain, frontal view. The large blue space is the superior sagittal sinus, an enlarged vein where CSF is reabsorbed upon its return after circulating around the brain and spinal cord within the subarachnoid space. Source: Icon Learning Systems. (a) (b)

The Brain Receives sensory information, interprets and integrates this information, and controls muscle and glandular responses Its nerve impulse activity also provides memory, thoughts, dreams, and personality It receives a large blood supply to fuel its activity If blood flow is restricted for more than a few minutes, neurons begin to expire Extending from the brain are 12 pairs of nerves

The Brain (cont.) The brain is composed of nervous tissue that includes both gray and white matter Gray matter consists mainly of neuron cell bodies and dendrites Gray matter serves as integrative centers White matter consists of axons that are covered with an insulative myelin sheath White matter carries nerve impulses

The Brain’s Four Main Parts
Cerebrum The largest part of the brain, it is the center of thought, personality, emotions, memory and sensory perception, and it initiates muscle contractions It is divided into the right and left hemispheres A large fissure separates the two hemispheres, and is bridged by a band of nervous tissue called the corpus callosum The most important functional part of the cerebrum is the cerebral cortex The cortex is divided into functional zones known as lobes Each lobe houses a cluster of neurons that perform a particular function in common

The Brain’s Four Main Parts (cont.)
Cerebellum Means little brain Coordinates muscle responses and manages equilibrium Diencephalon Means double brain Contains the thalamus and hypothalamus Thalamus is a relay station, redirecting nerve impulses to and from the cerebrum Hypothalamus is the center for involuntary activities

The Brain’s Four Main Parts (cont.)
Brain stem Includes the medulla and pons The medulla transmits nerve impulses between the spinal cord and brain, and regulates breathing The pons provides a connection between the medulla and cerebellum

Ventricles of the Brain
Within the brain’s center are several small spaces known as ventricles Each ventricle is filled with a slightly yellowish fluid known as cerebrospinal fluid (CSF) CSF is continuously produced from the blood supply and circulates through the ventricles and around the brain and spinal cord by way of interconnecting channels

Figure 6.4: The Brain The brain is shown sectioned down its midline, separating it into right and left portions, with the diencephalon, cerebellum, and brain stem separated. The colored areas of the cerebrum illustrate the cerebral lobes. Source: Pearson Education.

Brain and Brainstem Animation
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The Spinal Cord Extends from its union with the medulla of the brain down the back It passes through the spinal canal to terminate between L1 and L2 The spinal cord is divided into 31 segments Each segment includes a pair of spinal roots, which form spinal nerves as they leave the spinal cord

The Spinal Cord Contains both gray and white matter
The gray matter is in the center of the cord The white matter is in the outer portions of the cord, and consists of long nerves that carry impulses up and down the spinal cord

Figure 6.5: The spinal cord and its nerve roots
(a) Posterior view of the body with the vertebral column removed, revealing the spinal cord and nerve roots. (b) The spinal cord is shown dissected in this illustration to reveal the meninges and nerve roots. Note the cross section at the top of the figure, where the gray matter in the center of the cord is distinct from the white matter surrounding it. Source: Icon Learning Systems. (b)

The Peripheral Nervous System
Consists of nerves that course throughout the body carrying nerve impulses to and from the CNS and also contains the ganglia and sensory receptors

The Nerves The nerves of the body are branches from the 12 cranial nerves that communicate with the brain, and branches from the 31 pairs of spinal nerves that communicate with the spinal cord Each nerve is composed of a combination of nervous tissue, blood vessels, and supportive connective tissue

Figure 6.6: Photograph of a cut nerve
Scanning electron photograph of a single, cut nerve reveals its composition of many individual nerve fibers, each supported by sheaths of connective tissue. Source: Icon Learning Systems.

The Nerves (cont.) The body’s nerves transmit sensory or motor impulses; some can transmit both Sensory nerves are also called afferent nerves Carry nerve impulses from the sensory receptors to the brain or spinal cord Motor nerves are also known as efferent nerves Carry impulses from the brain or spinal cord to muscles and glands

Ganglia Are clusters of neuron cell bodies that lie outside the brain and spinal cord Appear as a swelling along the path of a spinal nerve route Are centers where nerve impulses are passed from one neuron to another across synapses

Sensory Receptors Are nervous structures that respond to changes in the environment Once the change occurs, it stimulates a sensory neuron to initiate a nerve impulse The nerve impulse then travels along the sensory nerve to the spinal cord or brain

Word Root and Terms Formed from the Word Root
arachn = spider Arachnoid Subarachnoid space cerebell = little brain Cerebellum cerebr = cerebrum or brain Cerebrospinal fluid Cerebrum Cerebral hemispheres Cerebral cortex Cerebral lobes

Word Root and Terms Formed from the Word Root (cont.)
crani = cranium Cranium, skull Cranial nerves encephal = brain Diencephalon gangli, ganglion = swelling, knot Ganglia mening = membrane Meninges

myel, spinal cord, bone = marrow, medulla, myelin sheath A white, fatty membrane that partially wraps the axons of certain neurons neur = sinew, cord Neuroglia Neuron Neurotransmitter spin = spine Spinal cord Spinal nerves

thalam = inner chamber Thalamus Hypothalamus

Other Important Terms Afferent nerves Brain Brain stem
Central nervous system Corpus callosum Dura mater Efferent nerves Medulla

Other Important Terms (cont.)
Peripheral nervous system Pia mater Pons Synapse Ventricles

Medical Terms of the Nervous System
Neuroscience The study of the nervous system Neuroscientist One who focuses their study on the nervous system Neurology The medical application within the nervous system field of medicine Neurosurgeon A physician whose medical practice focuses on brain or spinal cord surgery

Medical Terms of the Nervous System (cont.)
Psychiatrists Physicians whose focus is mental illness Psychologists Practitioners whose focus is on behavioral disorders

The Health of the Nervous System
Can experience many types of challenges and is delicate and easily damaged Protection is provided by bones, meninges, CSF, and a blood-brain barrier

CVA The most common affliction of the nervous system is a stroke, also known as cerebrovascular accident (CVA) It is a disruption of the normal flow of blood to the brain, causing brain damage It is the third most common cause of death in the United States

Source: Icon Learning Systems.
Figure 6.7: CVA Cerebrovascular accident (CVA) or stroke. A stroke may result from two primary causes: a reduced blood flow to the brain (ischemic) or a sudden release of blood into brain tissue (hemorrhagic). Reduced blood flow can be caused by a thrombosis (top left), an embolism (middle left), or the result of a heart attack (lower left). A sudden release of blood can be caused by a ruptured aneurysm (upper right) or the breakage of blood vessels due to high blood pressure (lower right). Source: Icon Learning Systems.

Symptoms Aphasia Cephalalgia Dysphasia Hyperesthesia
Inability to speak Cephalalgia A headache Dysphasia Difficulty speaking Hyperesthesia Increased sensitivity to stimulation such as touch or pain

Symptoms (cont.) Neuralgia Neurasthenia Paresthesia Pain in a nerve
A vague condition of body fatigue often associated with depression Paresthesia Abnormal sensation of numbness and tingling without an objective cause

Diseases and Disorders
Agnosia A loss of the ability to interpret sensory information Alzheimer’s disease Deterioration of brain function characterized by confusion, short term memory loss, and restlessness; abbreviated AD

Figure 6.8: Alzheimer’s disease
(b) (a) PET scan of a normal brain. The red and yellow areas represent normal metabolic activity of healthy neurons, and the blue and black areas represent low activity due to the presence of ventricles with CSF. Source: Pearson Education. (b) PET scan of an Alzhemier patient’s brain. Notice the reduction of activity in this scan relative to the normal brain scan. Source: Pearson Education.

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Alzheimer’s Movie Click here or on the screenshot to view the movie. Return to Directory

Diseases and Disorders (cont.)
Amyotrophic lateral sclerosis Progressive atrophy of muscle caused by hardening of nervous tissue on the lateral columns of the spinal cord. It is also known as Lou Gehrig disease; abbreviated ALS Cerebellitis Inflammation of the cerebellum Cerebral aneurysm A type of cerebral vascular disease where a blood vessel supplying the brain becomes dilated

Cerebral arteriosclerosis A type of cerebral vascular disease characterized by hardening of the arteries of the brain Cerebral atherosclerosis A type of cerebral vascular disease where a build up of fatty plaque on the inside wall of a vessel supplying the brain results in reduced blood flow Cerebral embolism Presence of an embolism (mobile blood cot) in a vessel supplying the brain

Cerebral palsy A condition revealed by partial muscle paralysis that is caused by a brain defect or lesion present at birth or shortly after; abbreviated CP Cerebral thrombosis A thrombosis (blood clot) within vessels supplying the brain Cerebrovascular accident Caused by a thrombosis, embolism, or hemorrhage this disruption of the blood supply to the brain results in functional losses or death; also called stroke and abbreviated CVA

Cerebrovascular disease A general disorder resulting from a change within one or more blood vessels supplying the brain Coma A general term describing several levels of decreased consciousness; also know as deep sleep Dementia Literally not in the mind; impairment of mental function that is characterized by memory loss, disorientation, and confusion

Duritis Inflammation of the dura mater Encephalitis Inflammation of the brain, usually caused by bacterial or viral infection Encephalomalacia Softening of the brain tissue, usually caused by deficient blood flow Epilepsy A brain disorder characterized by recurrent seizures

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Epilepsy Movie Click here or on the screenshot to view the movie. Return to Directory

Figure 6.9: Encephalitis (a) (b)
(a) Illustration of the ventral side of a brain with encephalitis. Notice the inflammation of the right and left temporal lobes and frontal lobes, shown in pink. It is usually caused by a release of bacterial toxins that penetrate the bood-brain barrier. (b) CAT scan of a brain with encephalitis, which is represented by the abnormal presence of fluids along the edges of the brain (fluid appears white). Source: Icon Learning Systems.

Gangliitis Inflammation of a ganglion Glioma A tumor of neuroglial cells Hemiplegia Paralysis on one side of the body Hydrocephalus Increased volume of CSF in the brain ventricles of a child before the cranial sutures have sealed, causing enlargement of the cranium

Figure 6.10: Glioma (a) Illustration of a large glioma (colored area) within the left cerebral hemisphere in a sectioned brain. Notice how the tumor crowds out normal brain tissue. Source: Icon Learning Systems. (b) A glioma may also press against the cerebellum and brain stem, causing a loss of motor function and reflexes. (c) PET scan of a glioma within the frontal lobe. The red and yellow colors indicate that metabolic activity is very high, compared to normal nervous tissue in green and purple. This type of glioma is called a glioblastoma multiforme, which is a fast-growing tumor. Courtesy of Dr. Giovanni DiChiro and Dr. Ramesh Raman of the Neuroimaging Branch, National Institute of Neurological Disorders and Stroke, National Institute of Health. (a) (b) (c)

Meningioma Benign tumor of the meninges Meningitis Inflammation of the meninges, usually caused by bacterial or viral infection Meningocele Protrusion of the meninges through an opening caused by a defect in the skull or spinal column

Figure 6.11: Meningioma (a) A meningioma may arise from the meninges of the brain. In this illustration, the tumor is pressing against the right cerebral hemisphere; its surgical removal is also illustrated. The photograph is an MRI of the top of the brain, showing the tumor as the oval, solid mass. (b) A meningioma may also develop from the meninges of the spinal cord. Here, the tumor is shown pushing against the cord and enveloping the spinal root and nerve. The likely symptom of this tumor is paralysis. Source: Icon Learning Systems. (a) (b)

Figure 6.12: Meningitis Caused by either bacterial or viral infection, it usually strikes the meninges of the spinal cord. If the infection spreads to the meninges of the brain, it may develop into encephalitis, a condition with more life-threatening consequences. The illustrations show a lateral view of the spinal cord and brain meningitis, and a cross section of brain meningitis. There is also involvement within the ventricles of the brain in this example. Source: Icon Learning Systems.

Figure 6.13: Meningocele (a) (b)
(a) A meningocele is a herniation of the meninges, usually associated with the spinal cord. It is illustrated in this cross-sectional view of a portion of the vertebral column as the large swelling, and in the view of a child’s back. When it occurs in a newborn, it is a congenital defect known as spina bifida. Source: Icon Learning Systems. (b) Photograph of a child born with spina bifida, with a large meningocele. (b)

Meningomyelocele Protrusion of the meninges and spinal cord through the spinal column Monoplegia Paralysis of one limb Multiple sclerosis The deterioration of the myelin sheath covering the axons within the brain, exhibited by episodes of localized functional losses; abbreviated MS

Figure 6.14: Multiple Sclerosis
(a) (b) (a) A disease characterized by the gradual development of small areas of hardened (sclerotic) tissue in the cerebrum, it results in a gradual loss of brain function. The illustration shows a single sclerotic lesion within the right cerebral hemisphere. Source: Icon Learning Systems. (b) MRI of sclerotic lesions within the brain, which are characteristic of MS.

Multiple Sclerosis Animation
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Myelitis Inflammation of the spinal cord Narcolepsy A sleep disorder characterized by sudden uncontrollable attacks of sleep, attacks of paralysis, and hypnagogic hallucinations Neuritis Inflammation of a nerve

Neuroarthropathy A disease of the nervous system resulting in pain within one or more joints Neuroma A general term for any tumor originating from nervous tissue Neurosis An emotional disorder involving a counterproductive way of dealing with stress

Palsy Paralysis of localized areas; the most common is Bell’s palsy, in which facial muscles are paralyzed on one side of the head Paraplegia Paralysis from the waist down Parkinson’s disease Chronic degenerative disease of the brain indicated by hand tremors, rigidity, expressionless face, and shuffling gait; also called Parkinsonism and abbreviated PD

Parkinson’s Disease Movie
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Poliomyelitis Inflammation of gray matter of the spinal cord caused by one of several polioviruses that often leads to paralysis; also called polio Polyneuritis Inflammation of many nerves at one time Psychopathy A disease of the mind

Psychosis An incapacitating mental disorder indicated by a gross distortion of emotions, incapacity to recognize reality and relate to others, and to cope with ordinary demands of daily life Psychosomatic Pertaining to both the mind and body Quadriplegia Paralysis of all four limbs, also known as tetraplegia

Radiculitis Inflammation of the spinal nerve roots Radiculopathy A disease of spinal nerve roots Sciatica Inflammation of the sciatic nerve, producing pain that extends from the thigh to the toes

Seizure A sudden attack of spasms or convulsions; seizures are classified as grand mal which involves all muscle groups, petit mal which involves brief losses of consciousness without motor involvement, or partial which involves only limited areas of the brain with local symptoms Shingles Viral infection of the peripheral nerves that erupts as painful skin blisters along nerve tracts; also called herpes zoster

Syncope Fainting, usually caused by a sudden loss of blood flow to the brain Transient ischemic attack A brief episode of loss of blood flow to the brain that results in a temporary neurologic impairment, and often precedes a CVA; abbreviated TIA

Accumulation of Fluids in the Brain
Two types of fluids circulate throughout the cranial cavity Blood in blood vessels Cerebrospinal fluid (CSF) in ventricles If either of these fluids escapes the boundaries of their containment, the intracranial pressure rises and causes severe health problems

Aneurysm Blood may escape from blood vessels coursing through the brain as a result of a severe head injury, or congenital weakness in the wall of an artery; this is known as an aneurysm In both cases, blood vessels rupture and blood accumulates in brain tissue, increasing the intracranial pressure If immediate medical intervention is not received, severe neural damage occurs that may lead to death Medical intervention includes surgical insertion of a draining tube to remove the excess blood and surgical repair of the damaged vessels, if possible

Cerebrospinal Fluid Any disturbance of production, circulation, or reabsorption of CSF may cause an increase in intracranial pressure A disturbance can be caused by head injuries, a tumor, or congenital defect During a disturbance, CSF increases in volume and fills the ventricles beyond capacity In infants born with this defect, the brain tissue is pushed against the cranium and expands the cranium to form an enlarged head: this is called hydrocephalus Treatment for these conditions involves the surgical installation of a shunt, which serves as a bypass to drain the excess CSF and reduce intracranial pressure

Treatments, Procedures, and Devices
Analgesic An agent that relieves pain Anesthesia Without feeling or sensation Cerebral angiography X-ray photograph of the blood vessels in the brain following injection of a contrast medium

Figure 6.15: Cerebral Angiography

Treatments, Procedures, and Devices
Computed tomography Also called CT scan, this procedure involves the use of a computer to interpret a series of images and construct from them a 3-dimensional view of the brain; this is particularly useful in diagnosing tumors Craniectomy Excision of part of the skull to approach the brain Craniotomy Incision into the skull to approach the brain

Figure 6.16: Cerebral aneurysm and craniectomy
As the lower illustration reveals, cerebral aneurysm is the abnormal dilation of arteries, which is caused by a weakening of the arterial walls. The upper illustration demonstrates a treatment for this condition, which includes a craniectomy followed by excision of the dilations. Source: Icon Learning Systems.

Treatments, Procedures, and Devices (cont.)
Echoencephalography Use of ultrasonography to record brain structures; abbreviated EchoEG Electroencephalography A procedure recording the electrical impulses of the brain; abbreviated EEG Evoked potential studies Also called EP studies, this group of diagnostic tests measures changes in brain waves during particular stimuli to determine brain function, providing a test for sight, hearing, and other senses

Figure 6.17: Electroencephalogram
To obtain the EEG, electrodes attached to the patient’s head pick up electrical signals and convey them to a computer for analysis and printing.

Ganglionectomy Excision of a ganglion; also called gangliectomy Lumbar puncture Aspiration of CSF from the subarachnoid space in the lumbar region of the spinal cord; abbreviated LP Magnetic resonance imaging Use of magnets to identify structural details of soft tissues within the body, coupled with computer imaging, to produce 3-dimensional images that are useful in targeting brain tumors, brain trauma, MS and other conditions; abbreviated MRI

Figure 6.18: Lumbar puncture
(a) Diagram of the vertebral column to illustrate the location where the lumbar puncture needle is inserted. Between vertebrae L4 and L5, the needle is pushed through the dura mater to enter the subarachnoid space and CSF circulation. (b) Supporting the patient for a lumbar puncture.

Figure 6.19: Magnetic resonance imaging
(b) (a) The MRI lab includes the scanning instrument and a computer station. (b) An open chamber MRI, into which the patient is transported. The “cave” is surrounded by a series of magnets and detectors that rotate around the immobilized patient. (c) Enhanced color MRI of the head at a lateral view. (c)

Myelogram X-ray photograph of the spinal cord following injection of a contrast dye Neurectomy Excision of a nerve Neurology The study and medical practice of the nervous system Neurolysis Separating a nerve by removing adhesions

Neuroplasty Surgical repair of a nerve Neurorrhaphy Suture of a nerve Neuroscientist One who studies in the field of neuroscience Neurotomy Incision into a nerve

Positron emission tomography Brain scan providing a map of blood flow within the brain that can be correlated to brain activity; also called PET scan Psychiatry The branch of medicine that addresses disorders of the brain Psychology The field of study of human behavior Radicotomy Incision into a nerve root; also called rhizotomy

PET Brain Scan The two images of the brain highlight areas of metabolic activity.

Reflex testing Diagnostic tests performed to observe the body’s response to a touch stimulus, which are useful when assessing stroke, head trauma, and other neurological challenges; this includes deep tendon reflexes (DTR) involving percussion at the patellar tendon or elsewhere, and Babinski reflex involving stimulation of the plantar surface of the foot Sedative An agent that quiets tension and anxiety Subdural Pertaining to below the dura mater

Abbreviatons AD ALS CT (CAT) scan CP CVA DTR EchoEG
Alzheimer’s disease ALS Amyotrophic lateral sclerosis CT (CAT) scan Computed (axial) tomography scan CP Cerebral palsy CVA Cerebrovascular accident (stroke) DTR Deep tendon reflexes EchoEG Echoencephalography

Abbreviations (cont.) EEG EP MRI MS PD PET TIA Electroencephalography
Evoked potential MRI Magnetic resonance imaging MS Multiple sclerosis PD Parkinson’s disease PET Positron emission tomography TIA Transient ischemic attack

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