11/4/13 Ch.

12 continued Multiple sclerosis Autoimmune disease Progressive destruction of myelin sheath in neurons in the CNS Myelin sheaths deteriorate to scleroses hardened scars

Epilepsy 1% of the population Short recurrent, periodic attacks, of motor, sensory, or psychological malfunction called epileptic seizures Initiated by abnormal synchronous electrical discharges from millions of neurons in the brain Most epileptic seizures are idiopathic no cause

Chapter 14 Brain The brain is the center for registering sensations, correlating sensations with one another, and with stored information Making decisions and taking action Center for intellect, emotions, behavior, and memory Directs our behavior Protective Coverings The cranial meninges are continuous with the spinal meninges and function The also bear the same names: o A tough outer dura mater o A spidery arachnoid mater o And a thin, delicate pia mater

Figure 14.2 Protective Coverings contd The falx cerebri longitudinal sagittal fissure that separates the two cerebral hemispheres The falx cerebelli separates the two cerebellar hemispheres

Protective coverings Clinical application Tentorum Cerebelli Tentorium cerebelli is important because brain tumors are often characterized as supratentorial and infratentorial Most childhood tumors are infratentorial Most adult tumors are supratentorial

Tentorium is a hard structure any brain swelling that brain can get partly pushed down and herniate through the tentorium which becomes a life threatening event

Brain Blood Flow The brain represents only 2 percent of total body weight, but receives about 20% of the bodys blood supply and consumes about20% of the oxygen and glucose (even when resting)

Maintaining CSF and blood/brain barrier 1. Ependymal cells a. Epithelial cells arranged in a single layer b. Ciliated cuboidal or columnar epithelium c. Line ventricles in the brain and central canal d. Form CSF and assist in its circulation (due to cilia) 2. Tight junctions between ependymal cells a. Prevent some substances from entering b. Protect brain and spinal cord from harmful blood borne substances The CSF contributes to homeostasis in three ways 1. Mechanical protection shock absorbing, keeps brain and cord from hitting bony walls of the skull and vertebrae 2. Chemical protection Provides optimal chemical environment for neuronal signaling 3. Circulation the medium for exchange of nutrients and waste products between blood and nervous tissue Other Facts About CSF 1. CSF is formed at equal rate to its absorption 2. Pressures in brain and spinal cord remain constant Meningitis clinical app. Occurs by violation of the blood brain barrier or CSF blood barrier Bacterial and viral causes Smears of fluid will contain agent White cells prevalent Swelling reaction in meninges Raises in pressures in spinal cord and cranium

Hydrocephalus Blockage of drainage of CSF (tumor inflammation, developmental malformation, meningitis, hemorrhage, or injury) Continued production causes an increase in pressure hydrocephalus Neurosurgeon implants a drain shunting the CSF to the veins of the neck or the abdomen

Brain Organization

Medulla Oblongata Continuation of spinal cord Cardiovascular center is housed in the medulla oblongata o Force and rate of heart beat, diameter of blood vessels Respiratory center is also housed here o Medullary rhythmicity area sets basic rhythm of breathing o Able to override voluntary control Information in and out of cerebellum

Reflex centers for coughing , sneezing, swallowing etc. Injury to the Medulla Pons Midbrain One inch in length Extends from pons to diencephalon Cerebral aqueduct connects 3rd ventricle about to 4th ventricle below Ventricles open cavities that make CSF The pons is located superior to the medulla means bridge Connects the spinal cord with the brain Relays nerve impulses related to voluntary skeletal movements from the cerebral cortex to the cerebellum Helps control respiration Hard blow to back of the head may be fatal Cranial nerve malfunctions on same side as injury; loss of sensation or paralysis of the throat or tongue; irregularities in breathing and heart rhytm

Midbrain in Section Cerebral peduncles clusters of motor and sensory fibers Helps control subconscious muscle activity Helps cerebral cortex and cerebellum coordinate muscular movements by sending information here from the cortex and cerebellum Coordinates eye movements with visual stimuli and coordinate head movements with auditory stimuli

Reticular formation Scattered nuclei in medulla, pons, and midbrain Reticular activating system Alerts cerebral cortex to sensory signals (sound of alarm, flash light, smoke or intruder) to awaken from sleep

Maintains consciousness and helps keep you awake with stimuli from ears, eyes, skin and muscles Motor function is involvement with maintaining muscle tone Figure 16-13 Cerebellum 2 cerebellar hemispheres and vermis (central area) Funtion o Correct voluntary muscle contraction and posture based on sensory data from body about actual movements sense of equilibrium

The Diencephalon Thalamus Hypothalamus Eipthalamus The pineal gland secretes melatonin to influence diurnal cycles in conjunction with the hypothalamus Subthalamus Lies immediately inferior to the thalamus Connect to motor areas of the cerebrum Controls the ANS (autonomic nervous system) Produce hormones Relay stations for all sensory impulses except smell to the cerebral cortex Registers recognition of pain and temperature (intense feelings) Awareness of light touch and pressure Essential role in awareness and the acquisition of knowledge

Circumventricular Organs The Cerebrum The cerebrum is nearly separated into right and left halves, called hemispheres, by the longitudinal fissure. Lie in 3rd ventricle Monitor chemical changes in the blood because they lack a blood brain barrier Coordinate homeostatic activities of the endocrine and nervous systems They are also thought to be the site of entry into the brain of HIV

Table 14.3 Hemispheric lateralization Clinical Application Brain injuries

Caused by Head trauma Displacement or distortion of neuronal tissue Secondary effects most important Blood pressure changes Intercranial pressure increase Infection Respiratory complications

Concussion Contusion Laceration Tear in the brain skull fracture. Ex. Gun shot wound Rupture of large blood vessels Bleeding into brain or subarachnoid space Cerebral hemotoma, swelling, increased intracranial pressure Bruising of the brain Leakage of blood from small blood vessels Pia matter may be be torn blood leaks into subarachnoid space Loss of reflexes Cessation of respiration, decreased blood pressure Abrupt but temporary loss of consciousness No bruising of brain occurs not obviously Headache, drowsiness, confusion, amnesia

Brain Waves EEG 14.17 Brain Waves Electrical potentials generated Recorded as an electroencephalogram (EEG) Four Wave Types 1. Alpha waves awake vs. asleep (disappear) 2. Beta periods of sensory input (visual, audio etc.) 3. Theta periods of emotional stress 4. Delta - Produced in an asleep adult, when produced by an awake adult indicates brain damage

Diagnostic Value of Brain Waves Epilepsy/seizure disorders Infection Tumors Trauma/ blood clots

Metabolic abnormalities Degenerative diseases Periods of unconsciousness and confusion Sleep and wakefulness

11/11/13 Chapter 15 Autonomic Nervous System (ANS) Regulates activity of smooth muscle, cardiac muscle, and certain glands Helps maintain homeostasis Depends on continuous sensory input and motor output Operates without conscious control

ANS is regulated by.. Hypothalamus Medulla Oblongata Receives input from cerebrum and limbic system (emotional part of our brain)

The autonomic nervous system consists of Autonomic sensory neurons Integrating centers in the central nervous system Autonomic motor neurons Autonomic Sensory Neurons Associated with sensory receptors that monitor internal conditions Interoreceptors o Located in blood vessels and viscera o Provide info about the internal environment Examples of interoreceptors o Chemoreceptors blood CO2 levels o Mechanoreceptors stretch and pressure o May send signals of to somatic sensory area

Autonomic Motor Neurons Regulate visceral activities by either increasing (exciting) or decreasing (inhibiting) activities at the effect tissues Examples o Diameter of the pupils o Dilation and constriction of blood vessels o Rate and force of heart beat

The ANS motor neurons uses two neurotransmitters

Acetylcholine used in parasympathetic and sympathetic Norepinephrine used in the sympathetic division of ANS

The ANS has two principle branches Sympathetic division o Stimulates effectors/ increase activity Parasympathetic division o Inhibits effectors/ decrease activity Most organs have dual innervation

Figure 15-2 (dont memorize) The Layout Of The ANS motor portion Figure 15.1 Two motor neurons preganglionic and postganglionic The axons of preganglionic neurons extend from the CNS and synapses in a ganglion with the postganglionic neuron The postganglionic neuron synapses on an effect

Using the autonomic nervous system for drug design ANS neurotransmitters and receptors Autonomic neurons based on neurotransmitter are classified o Adrenergic o Cholinergic

Cholinergic Neurons and Receptors Release acetylcholine All sympathetic and parasympathetic preganglionic neurons All parasympathetic postganglionic neurons Cholinergic receptors exist in the postsynaptic cell membrane

Two types Nicotinic receptor cause excitation of the postsynaptic cell ionotropic Muscarinic cause excitation or inhibition depending on the cell that is being stimulated metabotropic

Adrenergic Neurons and Receptors Adrenergic neurons release norepinephrine or epinephrine Include most sympathetic post ganglionic neurons Main types of receptors alpha and beta with many subtypes Activation can result in either excitation or inhibition Receptor Agonist and Antagonists Drugs and Natural products

Agonist- substance that can bind to and activates the receptor Mimics the effect of the neurotransmitter or hormone Example phenylephrine cold rememdy acts on alpha 1 adrenergic transmitters to constricts blood vessels in the nasal passages slows mucous production

Receptor Agonists and Antagonists Drugs and Natural Products Antagonist o Substance that binds to blocks the receptor prevents natural neurotransmitter from having effect Example propranolol blood pressure medication blocks beta adrenergic receptors, decreases heart rate and force of contraction

Physiological effects of the ANS Most body structures have dual innervation both sympathetic and parasympathetic Parasympathetic housekeeping (rest and digest) Sympathetic emergency

Sympathetic Responses (emergency) Fight or flight response Vigorous activity Rapid ATP production Sympathetic responses E responses Exercise Emergency Excitement Embarrassment

The fight or flight response Dilated pupils Airways dilate fast movement of air in lungs Heart rate, force of contraction, blood pressure all increase Blood vessels that supply nonessential organs constrict kidneys, digestive Blood vessels that involve exercise or fighting off danger dilate heart, skeletal muscle greater blood flow Liver performs glucose production and other energy molecule production Processes not essential for meeting the stress are turned off

Parasympathetic response Energy conservation Rest and digest Support body functions that conserve and restore body energy i.e. digestion of food

5 Parasympathetic Responses SLUDD S salivation L Lacrimation tear production U urination D - digestion D defacation

Control of the ANS Hypothalamus controls and integrates the autonomic nervous system. Connected to both the sympathetic and parasympathetic. Cerebral cortext controls ANS primarily In times of emotional stress