Nervous System

HSC 1531 Medical Terminology for Healthcare Professionals professor: michael l. whitchurch, mhs

“If I only had a brain”
The Nervous System
Medical Terminology
HSC 1531


http://www.scienceline.org/2007/10/ask-hsu-spinning-girl-right-left-brain-hemispheres/

do you see the dancer turning clockwise or counter-clockwise?
http://www.youtube.com/watch?v=HVGlfcP3ATI&feature=related


Look at the chart above and say the color of the word - not the word itself.
The right side of the brain tries to say the color while the left side tries to say the word.


Right and Left Brain Conflict
What you just experienced was left-brain / right-brain conflict. Your
right brain saw the color but your left brain insisted that you say the
word.

The conflict made this activity cumbersome, slow and often
frustrating. You have been forced to be this way because it is how you
learned how to read. You have read this way for many years and it is
ingrained in you.

Your left brain first wanted to say the word, but then it analyzed the
color. Meanwhile, your right brain knew all along the color, but was
dominated the whole time by the left brain trying to do a simple right
brain job.

http://www.beabetterhitter.com/text/mental/Right%20Brain%20Left%20Brain/RightBrain-LeftBrain.htm

Medical Terminology

for Healthcare Professionals

The Nervous System
Florida State College of Jacksonville
Instructor: Michael L. Whitchurch, MHS


Nervous System at a Glance
Functions of Nervous System
 Coordinates and controls body function
 Receives sensory input
 Makes decisions
 Orders body responses

integumentary musculoskeletal cardiovascular

blood and lymphatic immune respiratory

digestive urinary reproductive

endocrine eyes and ears


Nervous System at a Glance
Central Nervous System CNS
 Brain
 Spinal cord

Peripheral Nervous System PNS
 Nerves

http://www.youtube.com/watch?v=XKb20ri05pQ


What are you Right or Left brain dominant ?


Nervous System Combining Forms

 cephal/o
 head
 cerebell/o
 cerebellum
 cerebr/o
 cerebrum
 encephal/o
 brain
 gli/o
 glue
 medull/o
 medulla



 mening/o
 meninges
 meningi/o
 meninges
 myel/o
 spinal cord
 neur/o
 nerve
 phas/o
 speech
 poli/o
 gray matter



 pont/o
 pons
 radicul/o
 nerve root
 thalam/o
 thalamus
 thec/o
 sheath (meninges)
 ventricul/o
 ventricle


Nervous System Suffixes
 –algesia
 pain, sensitivity
 –esthesia
 feeling, sensation
 –paresis
 weakness
 –phasia
 speech
 –plegia
 paralysis
 –taxia
 muscle coordination


Anatomy and Physiology
 Coordinates all activity of body
 Receives information from both external and internal
sensory receptors
 Uses that information to adjust activity of muscles and
glands to match needs of body
 Nervous system is divided into:
 Central nervous system (CNS)
 Peripheral nervous system (PNS)


Anatomy and Physiology
 Central nervous system consists of:
 Brain
 Spinal cord
 Peripheral nervous system consists of:
 Cranial nerves
 Spinal nerves

http://frontalcortex.com/video/pns_and_neuro_exam


Nervous Tissue
 Nervous system composed of two types of cells
 Neurons
 Neuroglial cells
 Neurons
 Individual nerve cells
 Capable of conducting electrical impulses


Nervous Tissue
 Neurons have three basic parts:
 Dendrites – highly branched projections
that receive impulses
 Nerve cell body – contains nucleus & organelles
 Axon – conducts electrical impulse to destination


The structure of a neuron.

Copyright ©2009 by Pearson Education, Inc.
Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458
Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.


Photomicrograph of typical neuron showing the
nerve cell body, nucleus, and dendrites.



Nervous Tissue
 Synapse
 Point where axon of one neuron
meets dendrite of second neuron
 Synaptic cleft
 Gap between two neurons in a
synapse
 Electrical impulse cannot cross
 Neurotransmitter
 Chemical released by axon
 Crosses gap to stimulate
dendrite of second neuron


Neuroglia Cells

ependymocytes
The term neuroglia literally means nerve glue
because these cells were originally believed to serve
only one function: to bind neurons to each other
and to other structures.

http://www.fadavis.com/related_resources/1_2625_1737.pdf


Nervous Tissue
 Neuroglial cells
 Variety of cells found in nervous
tissue
 Each has different support
function for neurons
 Some Neuroglial cells produce
myelin, a fatty substance that acts
as insulation for many axons
 Neuroglial cells do not conduct
electrical impulses


Electronmicrograph illustrating an axon (red) wrapped
in its myelin sheath (blue).



Central Nervous System
 Combination of the brain and
spinal cord
 Function
 Receives impulses from all over
body
 Processes this information
 Responds with action
 Bundles of nerve fibers
interconnecting different parts of
CNS are called tracts


Central Nervous System
 Consists of both gray and
white matter
 Gray matter
 Comprised of unsheathed
or uncovered cell bodies
and dendrites
 White matter
 Myelinated nerve fibers


The Brain
 One of the largest organs in body
 Coordinates most body activities
 It is center for:
 Thoughts
 Memory
 Judgment
 Emotion



The Brain
 Four sections:
 Cerebrum
 Cerebellum
 Diencephalon
 Brain stem


The regions of the brain



Cerebrum
 Largest section
 Upper portion
 Processes:
 Thoughts
 Judgment
 Memory
 Association skills
 Ability to discriminate
between items


The regions of the brain.



Cerebrum
 Cerebral cortex
 Outer layer of cerebrum
 Composed of folds of gray
matter
 Gyri
 Elevated portions of the
cerebrum, or convolutions
 Sulci
 Fissures, or
valleys, between gyri


Lobes of Cerebrum
 Subdivided into left and
right halves called cerebral
hemispheres
 Each hemisphere has four
lobes:
 Frontal lobe
 Parietal lobe
 Occipital lobe
 Temporal lobe


Lobes of Cerebrum
 Frontal lobe
 Most anterior lobe
 Controls motor
function, personality, and
speech
 Parietal lobe
 Most superior portion
 Receives & interprets nerve
impulses
 Interprets language


Lobes of Cerebrum
 Occipital lobe
 Most posterior
 Controls vision
 Temporal lobe
 Left and right lateral
portion
 Controls hearing and
smell


FRONTAL
Controls motor function, PARIETAL
personality, and speech Receives and interprets
Nerve impulses
and Language

TEMPORAL OCCIPITAL
Controls hearing and Controls visual function
sense of smell

The functional regions of the cerebrum.



Diencephalon
 Located below
cerebrum
 Contains two of most
critical areas of brain:
 Thalamus
 Hypothalamus


Diencephalon
 Thalamus
 Center for relaying impulses from
eyes, ears, and skin to cerebrum
 Controls perception of pain
 Hypothalamus
 Controls body temperature,
appetite, sleep, sexual desire, and
emotions
 Controls autonomic nervous
system, cardiovascular system,
gastrointestinal system, and
release of hormones from pituitary
gland


Cerebellum
 Second largest portion of brain
 Located beneath posterior part of
cerebrum
 Aids in:
 Coordinating voluntary body
movements
 Maintaining balance and
equilibrium
 Refines muscular movements
initiated in cerebrum


Brain Stem
 Has three components:
 Midbrain
 Pons
 Medulla oblongata


Brain Stem
 Midbrain
 Acts as pathway for impulses
between brain and spinal
cord
 Pons
 Means bridge
 Connects cerebellum to rest
of brain
 Medulla oblongata
 Most inferior portion of brain
 Connects brain to spinal cord


Brain Ventricles
 Cavities containing
cerebrospinal fluid (CSF)
 Watery, clear fluid
 Provides shock protection for
CNS
 Locations:
 One in each cerebral
hemisphere
 One in thalamus
 One in front of cerebellum


Spinal Cord
 Extends from medulla oblongata to second lumbar vertebra
 Within vertebral column
 33 vertebrae of back bone
 Line up to form continuous canal
 Called spinal cavity or vertebral canal


The levels of the spinal cord and spinal nerves.



Spinal Cord
 Protected by cerebrospinal fluid
 Flows through central canal down
through spinal cord
 Outer portion of spinal cord is
myelinated white matter
 Ascending tracts carry
sensory information up to brain
 Descending tracts carry
motor commands down from brain
to peripheral nerve


Photograph of the spinal cord as it descends from the brain with spinal nerve
roots visible. (Video Surgery/Photo Researchers, Inc.)



Meninges
 Protective membrane sac
 Encases entire CNS
 Consists of three layers:
 Dura mater
 Arachnoid layer
 Pia mater


The meninges.



Meninges
 Dura mater
 Means tough mother
 Outermost, tough, fibro
us sac around CNS
 Subdural space
 Empty space between
dura mater and
arachnoid layer


Meninges
 Arachnoid layer
 Means spider-like
 Thin, delicate layer
attached to pia mater by
web-like filaments
 Subarachnoid space
 Between arachnoid layer
and pia mater
 Contains cerebrospinal
fluid


Meninges
 Pia mater
 Means soft mother
 Innermost membrane layer
 Applied directly to surface of brain


Peripheral Nervous System (PNS)
 Consists of:
 12 pairs of cranial nerves
 31 pairs of spinal nerves
 Cranial nerves
 Arise from brain
 Spinal nerves
 Split off from spinal cord
 One pair (left and right) exit between each pair of vertebrae


Nerves
 A nerve:
 Is a bundle of axon fibers
located outside CNS
 Carries messages between
CNS and various parts of
body
 Nerve root
 Point where nerve is
attached to CNS
 Names of most nerves reflect:
 Organ the nerve serves
 Portion of body the nerve is
traveling through


The major spinal nerves.



Spinal cord injuries showing the
extent of paralysis

C4 ; C6 = Quadriplegia

T6 ; L1 = Paraplegia


Cranial Nerves


Cranial Nerves
I Olfactory sense of smell

II Optic sense of sight

II Oculomotor controls eye muscles and pupil of eye

IV Trochlear controls oblique muscles of eye

facial sensation and controls muscles for
V Trigeminal
chewing

VI Abducens controls eyeball muscles to turn eye to side


Cranial Nerves
controls facial muscles for expression,
VII Facial salivation, and taste on two-thirds of
tongue (anterior)
VIII Vestibulocochlear sense of equilibrium and hearing

sensation from pharynx and taste on
IX Glossopharyngeal
one-third of tongue

supplies most organs in abdominal and
X Vagus
thoracic cavities

XI Accessory controls neck and shoulder muscles

XII Hypoglossal controls tongue muscles


Neurons
 Each nerve can carry information
both to and from CNS
 But any individual neuron can
carry information in only one
direction
 Either an:
 Afferent neuron
 Efferent neuron


Neurons
 Afferent neurons
 Also called sensory neurons
 Carry sensory information from sensory receptor to CNS
 Efferent neurons
 Also called motor neurons
 Carry activity instructions from CNS to muscles or glands


A reflex arc showing afferent and efferent neurons.



Divisions of PNS
 Nerves of PNS are subdivided into two divisions
 Autonomic nervous system (ANS)
 Somatic nerves
 Each division serves different area of body


Autonomic Nervous System (ANS)
 Control of involuntary or unconscious
bodily functions
 It may increase or decrease the
activity of:
 Smooth muscle found in viscera and
blood vessels
 Cardiac muscle of heart
 Glands
 ANS divided into 2 branches:
 Sympathetic branch
 Parasympathetic branch


Autonomic Nervous System (ANS)
 Sympathetic branch
 Stimulates body in times of stress and crisis
 Increases heart rate, dilates airways, increases blood pressure,
inhibits digestion, and stimulates production of adrenaline
 Parasympathetic branch
 Serves as counterbalance for sympathetic nerves
 Causes heart rate to slow down, lowers blood pressure, and
stimulates digestion


Somatic Nerves
 Mainly involved with conscious
and voluntary activities of body
 Serve skin and skeletal muscles
 Carry information from sensory
receptors of skin
 Such as touch, temperature,
pressure, and pain
 Carry motor commands to
skeletal muscles


Right Brain

Left Brain

http://frank.mtsu.edu/~studskl/hd/hemis.html


Word Building with
cephal/o, cerebell/o and cerebr/o
–algia cephalalgia head pain

–ar cerebellar pertaining to cerebellum

–itis cerebellitis inflammation of cerebellum

–al cerebral pertaining to cerebrum

spin/o
cerebrospinal pertaining to cerebrum and spine
–al


Word Building with encephal/o,
meningi/o and mening/o
electr/o
electroencephalogram record of brain electricity
–gram

–itis encephalitis brain inflammation

–oma meningioma meninges tumor

–eal meningeal pertaining to meninges

–itis meningitis meninges inflammation


Word Building with neur/o
–al neural pertaining to nerve

–algia neuralgia nerve pain

–ectomy neurectomy removal of nerve

–ologist neurologist nerve specialist

–oma neuroma nerve tumor


Word Building with neur/o
–pathy neuropathy nerve disease

–plasty neuroplasty surgical repair of nerve

poly–
polyneuritis inflammation of many nerves
–itis

–rrhaphy neurorrhaphy suture a nerve


Word Building with myel/o and pont/o
–gram myelogram spinal cord record

–itis myelitis inflammation of spinal cord

–ine pontine pertaining to pons


Word Building with
radicul/o, thalam/o and thec/o
–itis radiculitis nerve root inflammation

–pathy radiculopathy nerve root disease

–ic thalamic pertaining to thalamus

intra– –al intrathecal pertaining to inside meninges


Nervous System Vocabulary
the use of anesthesia for surgical procedures, resuscitation,
anesthesiology
and pain management

neurology diagnosis and treatment of diseases of nervous system

neurosurgery treating nervous system disease by surgical means


sensations occurring prior to epileptic seizure or migraine; such as
aura
seeing colors

alternating between strong involuntary muscle contractions and
convulsion
relaxations

sudden, uncontrollable onset of symptoms; such as in epileptic
seizure
seizure

focal seizure seizure in only one limb or body part

syncope fainting


conscious awake and aware of surroundings

unconscious unaware of surroundings; unable to respond to stimuli

coma state of profound unconsciousness

paresthesia abnormal sensations such as burning or tingling

tremor involuntary repetitive alternating movements


delirium confusion, disorientation, and agitation

dementia impaired intellectual function

hemiparesis weakness on one side of body

paralysis temporary or permanent loss of voluntary movement

hemiplegia paralysis on one side of body

paraplegia paralysis of lower portion of body

palsy loss of ability to control movements


Brain Pathology
disorder characterized by progressive dementia, disorientation,
Alzheimer’s disease
apathy, and loss of memory

astrocytoma malignant tumor originating in astrocytes, a neuroglial cell

intracranial mass; may be malignant or benign; dangerous
brain tumor
because occupies space

cerebral aneurysm ballooning of cerebral artery; may cause stroke


Color enhanced CT-scan showing two malignant tumors in the brain. (Scott
Camazine/Photo Researchers, Inc.)



Common locations for cerebral artery aneurysms
in the Circle of Willis.



Brain Pathology

bruising of brain from impact; symptoms last longer than 24 hrs;
cerebral contusion
include unconsciousness, dizziness, vomiting, unequal pupils

concussion brain injury from impact; symptoms last less than 24 hrs

brain damage results from defect, trauma, or oxygen
cerebral palsy (CP)
deprivation at time of birth


Brain Pathology

infarct due to loss of blood supply to brain; may be due
cerebrovascular accident
to hemorrhage, thrombus, embolus, or compression;
(CVA)
commonly called a stroke

transient ischemic attack temporary interference with blood supply to brain; may
(TIA) lead to a CVA

specific type of headache with severe pain, light
migraine
sensitivity, dizziness, and nausea


The four common causes for cerebrovascular accidents.



Brain Pathology
seizures and loss of consciousness caused by uncontrolled
epilepsy
electrical activity of brain

epileptic seizure with strong muscle spasms; formerly called
tonic-clonic seizure
grand mal

epileptic seizure characterized by loss of awareness and
absence seizure
absence of activity; formerly called petit mal


Brain Pathology
hydrocephalus accumulation of cerebrospinal fluid within brain ventricles

chronic disorder of brain with tremors, weakness, muscle
Parkinson’s disease
rigidity, and shuffling gait

acute encephalopathy and organ damage; follows viral
Reye syndrome
infection and associated with taking aspirin


Hydrocephalus.



Spinal Cord Pathology
amyotrophic lateral degeneration of motor neurons of spinal cord; also called
sclerosis (ALS) Lou Gehrig’s disease

viral infection affecting spinal cord; paralysis may be mild
poliomyelitis
and temporary or severe and permanent

damage to spinal cord due to trauma; may be bruised and
spinal cord injury (SCI)
recover or severed and permanent


Spinal Cord Pathology
congenital defect where lamina of vertebra do not meet
spina bifida
or close to form spinal canal

protrusion of meninges sac through opening left by
meningocele
spina bifida defect

protrusion of meninges and spinal cord through
myelomeningocele
opening left by spina bifida defect


Spina bifida.



Nerve Pathology
one-sided facial paralysis due to inflammation of facial nerve
Bell’s palsy
caused by virus

Guillain-Barré temporary loss of myelin sheath; may be autoimmune; starts in
syndrome legs and progresses up nervous system

multiple sclerosis
loss of myelin sheath; results in weakness and numbness
(MS)


Multiple Sclerosis Animation

Click here to view an animation on the development of multiple sclerosis.


Nerve Pathology
muscular weakness and fatigue due to insufficient
myasthenia gravis
neurotransmitter at synapses

eruption of painful blisters on body along a nerve path;
shingles
caused by Herpes zoster virus


Photograph of the skin eruptions associated with shingles.



Meninges Pathology
epidural hematoma mass of blood in space outside dura mater

mass of blood forming inside subdural space; due to torn
subdural hematoma
meningeal blood vessel; space occupying lesion


A subdural hematoma.



Clinical Laboratory Tests
cerebrospinal fluid examination of CSF; may detect infections and blood in the
analysis fluid


Diagnostic Imaging
image of brain after injection of radioactive
brain scan
isotopes into bloodstream

X-ray of cerebral blood vessels after injection of
cerebral angiography
radiopaque dye

echoencephalography ultrasound image of brain


Diagnostic Imaging
X-ray of spinal cord after injection of radiopaque dye into spinal
myelography
canal

positron emission use of positive radionuclides to construct an image of the brain;
tomography (PET) image reveals metabolic activity of brain areas


Additional Diagnostic Tests
reflex test that reveals nervous system lesions;
Babinski’s reflex
performed by stroking sole of foot

electroencephalography (EEG) records the electrical activity of brain

lumbar puncture puncture to remove CSF for examination

measures speed at which an impulse travels
nerve conduction velocity
along a nerve; reveals nerve damage


Electroneurodiagnostic Technician
Video

Click here to view a video on electroneurodiagnostic technicians.


A lumbar puncture.



Medical Treatment

anesthetic injection into nerve area to block nerve impulses on
nerve block
that nerve; used to treat chronic pain


Surgical Treatments
removes blockage of major artery in neck that carries blood
carotid endarterectomy
to brain by removing inner lining of the artery
cerebrospinal fluid shunt carries CSF from ventricle to abdominal cavity; treats
shunt hydrocephalus

laminectomy removes part of vertebra; relieves pressure on spinal nerve

tractotomy surgical cut of nerve tract; treats severe chronic pain


Nervous System Pharmacology
treats minor to moderate pain, non-
analgesic Tylenol, Aleve
narcotic

produces loss of sensation or Xylocaine,
anesthetic
consciousness Novocain

reduces nerve excitability to prevent Tegretol,
anticonvulsant
seizures Nembutal

dopaminergic drugs treats Parkinson’s disease L-dopa, Sinemet


Nervous System Pharmacology
hypnotic promotes sleep Seconal, Restoril

narcotic analgesic treats severe pain OxyContin, Demerol

sedative calming or relaxing effect Amytal, Butisol


Nervous System Abbreviations
ALS amyotrophic lateral sclerosis

ANS autonomic nervous system

CNS central nervous system

CP cerebral palsy

CSF cerebrospinal fluid

CVA cerebrovascular accident

CVD cerebrovascular disease

EEG electroencephalography


Nervous System Abbreviations
HA headache

ICP intracranial pressure

LP lumbar puncture

MS multiple sclerosis

PET positron emission tomography

PNS peripheral nervous system

SCI spinal cord injury

TIA transient ischemic attack

Nervous System

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