PHYSIOLOGY (Part 1)

EAR, EYE, SKIN, BRAIN

MD. ISHAK MIA, DEPERTMENT OF
PSYCHOLOGY
Chapter 6: Auditory sense organs

The Ear: Anatomy and Functions

The ear is a remarkable organ responsible for two essential functions: hearing and equilibrium.
It is anatomically divided into three main sections: the external ear, middle ear, and internal
ear.

1. External Ear

The external ear plays a critical role in capturing sound waves and directing them toward the
tympanic membrane (eardrum). It consists of two major components:

• Auricle (Pinna):
o The auricle is the visible part of the ear, shaped like a funnel to effectively collect
sound waves. Its ridges and depressions help to capture sound from different
directions.
o The pinna is primarily composed of elastic cartilage covered by skin, making it
flexible yet supportive.
• External Acoustic Meatus:
o This is a short, curved tube about 2.5 cm long that extends from the auricle to the
tympanic membrane.
o The skin lining the meatus contains ceruminous glands, which produce
cerumen (earwax), a protective substance that traps dust, debris, and
microorganisms. The hairs present in this canal enhance this protective function
by acting as a barrier.

2. Middle Ear

The middle ear, also known as the tympanic cavity, is an air-filled space that contains several
important structures, each contributing to the process of hearing:

• Tympanic Membrane (Eardrum):

o The tympanic membrane is a thin, cone-shaped barrier that separates the external
ear from the middle ear. It is made up of three layers: an outer layer of skin, a
middle layer of fibrous tissue, and an inner layer of mucous membrane.
o It vibrates in response to sound waves, converting the energy of sound into
mechanical vibrations.
• Auditory (Eustachian) Tube:
o This tube connects the tympanic cavity to the nasopharynx (the upper part of the
throat behind the nose). Its main function is to equalize pressure on both sides of
the tympanic membrane, which is essential for its proper function.
o The tube is usually closed but opens during swallowing or yawning, allowing air
to flow in or out, which is why you may feel your ears "pop" during changes in
altitude.

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 • Auditory Ossicles:
o The middle ear contains three tiny bones known as the ossicles:
§ Malleus (Hammer): The malleus is attached to the tympanic membrane
and transfers vibrations to the incus.
§ Incus (Anvil): The incus acts as a bridge between the malleus and the
stapes.
§ Stapes (Stirrup): The stapes is the smallest bone in the human body and
connects to the oval window of the inner ear. It transmits vibrations to the
fluid in the cochlea.
o These bones form a lever system that amplifies sound waves by focusing the
vibrations from the larger surface area of the tympanic membrane to the smaller
area of the oval window.

3. Internal Ear

The internal ear is a complex structure responsible for converting sound vibrations into neural
signals and maintaining balance. It consists of the bony labyrinth and the membranous
labyrinth, housing different fluids that are crucial for function:

• Cochlea:
o The cochlea is a spiral-shaped, fluid-filled structure that plays a key role in
hearing.
o It is divided into three chambers:
§ Scala Vestibuli: Filled with perilymph, it receives vibrations from the
stapes at the oval window.
§ Scala Tympani: Also filled with perilymph, it leads to the round window.
§ Cochlear Duct (Scala Media): Filled with endolymph, it houses the
organ of Corti, which contains the sensory hair cells for hearing.
o The basilar membrane within the cochlea vibrates in response to sound waves,
and the tectorial membrane above it moves, causing the stereocilia of hair cells
to bend and create electrical impulses.
• Spiral Organ (Organ of Corti):
o Located on the basilar membrane, this structure contains the sensory receptors
for sound: the hair cells. Each hair cell has hair-like projections (stereocilia) that
detect mechanical vibrations and convert them into electrical signals.
o When sound waves cause the basilar membrane to vibrate, the movement of the
stereocilia opens ion channels, leading to depolarization and the generation of
nerve impulses.
o These impulses are transmitted to the brain via the cochlear branch of the
vestibulocochlear nerve (CN VIII), where they are interpreted as sound.
• Vestibule and Semicircular Canals:
o The vestibule is involved in detecting changes in linear acceleration and static
positions, helping maintain balance. It contains structures called otolith organs
(utricle and saccule) that detect gravity and linear movements.
o The semicircular canals (three in total) are arranged in three planes and are
responsible for detecting rotational movements of the head. Each canal contains
a structure called the ampulla, which houses hair cells that respond to fluid
movement caused by head rotation.
o Together, these structures send information about balance and spatial orientation
to the brain, allowing for coordination and stability during movement.
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Summary

The ear is a highly sophisticated organ that integrates the functions of hearing and balance. The
external ear captures sound waves, the middle ear amplifies and transmits these vibrations, and
the internal ear converts them into neural signals while also providing sensory information for
balance. Each component of the ear plays a vital role in ensuring that we can hear and maintain
equilibrium, showcasing the intricate design and functionality of this sensory system.

Summary of Ear Function

Ear Part Structures Functions
External Auricle (Pinna) Collects and directs sound waves towards the tympanic
Ear membrane.
External Acoustic Channels sound waves to the tympanic membrane; protects
Meatus with cerumen and hairs.
Middle Ear Tympanic Vibrates in response to sound waves; separates external and
Membrane middle ear.
(Eardrum)
Auditory Equalizes air pressure on both sides of the tympanic
(Eustachian) Tube membrane.
Auditory Ossicles Malleus, Incus, and Stapes amplify and transmit sound
vibrations from the tympanic membrane to the oval window.
Internal Ear Cochlea Converts mechanical vibrations into neural signals; involved
in hearing.
Vestibule Detects changes in linear acceleration and static position;
aids in balance.
Semicircular Canals Detects rotational movements of the head; contributes to
balance.
Spiral Organ (Organ Contains hair cells that convert vibrations into electrical
of Corti) impulses.
Nerve Cochlear Branch of Transmits auditory signals from the cochlea to the brain.
Pathways CN VIII
Vestibular Branch of Transmits balance information from the vestibular apparatus
CN VIII to the brain.

Key Functions of Ear

1. Hearing: Capturing sound waves, amplifying them, and converting them into neural
signals.
2. Balance: Sensing changes in head position and movement to maintain equilibrium.

This chart summarizes the main structures of the ear and their specific functions, providing a
clear overview of how the ear contributes to hearing and balance.

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Physiology of Hearing
1. Sound Wave Detection:
o The human ear is capable of detecting sound waves with frequencies ranging
from approximately 20 Hz to 20,000 Hz (20 kHz). The sensitivity of human
hearing is highest between 2,000 and 3,000 Hz, a range important for
understanding speech and environmental sounds.
2. Transmission of Sound Waves:
o Sound waves enter through the external acoustic meatus (ear canal) and strike
the tympanic membrane (eardrum). The impact of these sound waves causes the
tympanic membrane to vibrate in and out.
o The intensity of the sound affects how much the tympanic membrane vibrates:
loud sounds create greater displacement, while soft sounds cause less
movement.
3. Movement of Auditory Ossicles:
o The tympanic membrane is connected to three small bones known as the auditory
ossicles: the malleus, incus, and stapes.
o When the tympanic membrane vibrates, it moves the malleus, which is attached
to it. The malleus then moves the incus, and finally, the stapes vibrates in and out
at the oval window, a membrane-covered opening to the inner ear.
4. Perilymph Movement:
o The vibration of the stapes at the oval window generates waves in the perilymph,
the fluid within the scala vestibuli and scala tympani of the cochlea.
o This movement creates oscillations that also cause the membrane covering the
round window to bulge outward, allowing for pressure relief and continued wave
propagation through the cochlea.
5. Cochlear Hair Cell Stimulation:
o As the perilymph moves, it causes the basilar membrane to vibrate. The basilar
membrane is crucial because it varies in stiffness and width along its length.
o High-frequency sounds (higher pitch) vibrate the base of the cochlea, while low-
frequency sounds vibrate the apex. When the basilar membrane vibrates, it causes
the stereocilia (hair-like projections) of the cochlear hair cells to bend against
the tectorial membrane located above them.
o This mechanical bending of stereocilia opens ion channels, leading to the
depolarization of hair cells and the generation of nerve impulses.
6. Transmission to the Brain:
o The nerve impulses generated by cochlear hair cells are transmitted via the
cochlear branch of the vestibulocochlear nerve (Cranial Nerve VIII) to the
auditory pathways in the brain.
o The auditory information is relayed to the cochlear nuclei in the brainstem,
where the signals are processed. Some nerve fibers cross over to the opposite side
of the brain, which allows both hemispheres to integrate auditory information
from both ears.
o Finally, the impulses travel to the temporal lobes of the cerebrum, specifically
to the auditory cortex, where they are interpreted as specific sound sensations.

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Pitch and Loudness
• Pitch:
oThe pitch of a sound refers to its perceived frequency. It is determined by the
specific area of the basilar membrane that is stimulated.
o Different segments of the basilar membrane respond to different frequencies:
§ Low-pitched sounds (e.g., a bass drum) cause longer fibers near the apex
of the cochlea to vibrate.
§ High-pitched sounds (e.g., a whistle) activate shorter fibers near the base
of the cochlea.
o The activation of different areas of the cochlea sends nerve impulses to distinct
regions of the auditory cortex, allowing the brain to interpret the pitch of the
sound.
• Loudness:
o Loudness is related to the amplitude of the sound waves, which correlates with
the intensity of the vibrations in the cochlear structures.
o A more intense sound wave causes a greater displacement of the tympanic
membrane, leading to a stronger vibration of the basilar membrane.
o The louder the sound, the higher the frequency of nerve impulses generated by
the cochlear hair cells and sent to the auditory cortex. This relationship allows the
brain to perceive not just the presence of sound, but also its volume.

Summary

The process of hearing involves a sophisticated interaction between the outer, middle, and inner
ear structures. Sound waves are transformed into mechanical vibrations, which are then
converted into electrical signals that the brain can interpret. This intricate system allows us to
perceive a wide range of sounds, including speech, music, and environmental noises, enhancing
our ability to communicate and interact with the world around us. Understanding this physiology
is crucial not only in fields like audiology and psychology but also in medicine and neuroscience,
where auditory processing plays a significant role in human experience and behavior.

Equilibrium
Equilibrium is essential for maintaining balance and coordinating movements. The body relies
on several sensory receptors, particularly in the inner ear, to provide information about position
and movement. The main types of equilibrium are:

1. Static Equilibrium: Sensing the head's position relative to gravity.

2. Dynamic Equilibrium: Sensing linear acceleration and rotational movements of the
head.

Static Equilibrium

The macula, located in the utricle and saccule of the vestibule, is responsible for static
equilibrium.

• Structure: Each macula contains vestibular hair cells with hair-like stereocilia
embedded in a gelatinous mass that contains otoliths (calcium carbonate crystals). These
otoliths increase the mass of the gelatinous layer, enhancing sensitivity to gravity.

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 Mechanism:

1. Head Position Changes: When the head tilts, gravity pulls on the gelatinous mass,
bending the stereocilia and generating nerve impulses.
2. Impulse Transmission: These impulses travel via the vestibular branch of the
vestibulocochlear nerve to the brain.
3. Processing: The cerebellum uses this information to maintain static equilibrium, while
the cerebrum interprets the signals, leading to conscious awareness of head position.

Dynamic Equilibrium

The maculae also detect linear acceleration in both horizontal and vertical directions, similar
to static equilibrium.

• When the head accelerates, inertia causes the gelatinous mass to bend the stereocilia,
creating nerve impulses. This provides the brain with information about changes in
velocity.

Rotational Motion Detection: The semicircular canals detect rotational movements.

• Ampulla and Crista Ampullaris: Each semicircular canal has an ampulla containing
the crista ampullaris with hair cells extending into a gelatinous mass called the
ampullary cupula.

Mechanism:

1. Head Rotation: Turning the head causes the endolymph fluid to push against the
ampullary cupula, bending the stereocilia and generating impulses.
2. Unique Responses: Each canal is oriented differently, so the brain receives distinct
patterns of impulses for various movements.
3. Cerebellum and Cerebrum: The cerebellum adjusts balance subconsciously, while the
cerebrum provides conscious awareness of rotational movement.

Summary

Equilibrium involves complex interactions between sensory systems in the inner ear, particularly
through the maculae and semicircular canals. These structures provide crucial information about
body position and motion, enabling us to maintain balance and coordinate movements
effectively. Understanding these mechanisms is important for fields like neuroscience and
rehabilitation.

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Disorders of the Ear
1. Deafness

• Definition: Deafness refers to a partial or total loss of hearing.

• Types:
o Nerve Deafness: Caused by damage to the cochlear hair cells in the spiral organ,
often due to high-intensity sounds (e.g., loud music, jet noise). This form is
usually permanent.
o Conduction Deafness: Results from issues with sound transmission through the
tympanic membrane or auditory ossicles. This type may be repairable through
surgery or the use of hearing aids.

2. Labyrinthine Disease

• Description: Refers to disorders of the internal ear that result in symptoms such as
dizziness, nausea, tinnitus (ringing in the ears), and hearing loss.
• Causes: It can be caused by:
o An excess of endolymph (fluid in the inner ear)
o Infections
o Allergies
o Trauma
o Circulation disorders
o Aging

3. Motion Sickness

• Description: A functional disorder characterized by nausea resulting from repetitive

stimulation of the equilibrium receptors in the inner ear. It often occurs during travel or
other activities that involve motion.

4. Otitis Media

• Definition: An acute infection of the tympanic cavity (middle ear).

• Symptoms: May include severe pain and bulging of the tympanic membrane due to fluid
accumulation.
• Causes: Pathogens typically enter the middle ear from the pharynx via the auditory tube
or through a perforated tympanic membrane. Young children are particularly susceptible
due to the horizontal orientation and shorter length of their auditory tubes, which
facilitates bacterial spread from the pharynx to the tympanic cavity.

Summary

Disorders of the ear can significantly impact hearing and balance, with conditions ranging from
deafness and labyrinthine diseases to motion sickness and otitis media. Understanding these
disorders and their causes is important for diagnosis, treatment, and prevention, especially in
vulnerable populations like young children.

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Chapter 5: Visual sense organ

Vision
Vision is a critical sense that provides essential information to the brain. The sensory receptors
for light stimuli are located within the eyes, which are protected by the orbits, formed by seven
skull bones. These structures are cushioned and supported by connective tissues.

Eyelids, Eyelashes, and Eyebrows

• Eyelids: The anterior surface of the eye is shielded by eyelids, which not only protect
but also keep the eye moist through the process of blinking. Blinking spreads tears and
mucus across the eye surface. The internal surface of each eyelid is lined with the
conjunctiva, a mucous membrane that extends over the anterior eye, except for the
cornea. This membrane produces mucus that lubricates the eye and contains blood
vessels and nociceptors (pain receptors).
• Eyelashes: These small hairs help prevent airborne particles from reaching the eye,
providing a barrier against dust and debris. They also contribute to reducing the amount
of excess light that enters the eye.
• Eyebrows: Situated on the brow ridges, eyebrows play a role in shielding the eyes from
overhead light and diverting sweat away from the eyes, which can help maintain clear
vision.

Lacrimal Apparatus

The lacrimal apparatus is vital for tear production and drainage.

• Tear Production: The lacrimal gland, located in the superior, lateral part of each orbit,
continuously produces tears. These tears contain lysozyme, an antibacterial enzyme that
helps reduce the risk of infections.
• Tear Flow: Tears are distributed over the eye surface during blinking, flowing
downwards and medially. They are collected at the medial corner of the eye by small
channels called lacrimal canaliculi, which direct the tears into the lacrimal sac. From
there, tears travel through the nasolacrimal duct into the nasal cavity. This drainage
system not only keeps the eye moist but also helps clear away foreign particles.

Extrinsic Muscles

The movement of the eyes is essential for good vision and is achieved through six extrinsic
muscles:

• These muscles originate from the back of the orbit and attach to the outer surface of the
eyeball. They are responsible for the precise and coordinated movement of the eyes in
various directions.
• Four of the muscles exert a direct pull on the eye, while two muscles pass through
cartilaginous loops, allowing them to exert an oblique pull on the eyeball. This
coordinated action enables a wide range of eye movements, essential for tracking objects
and maintaining visual stability. Each muscle has specific functions, working together to
achieve smooth and accurate movements of both eyes.

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Structure of the Eye
The eye is a hollow, spherical organ approximately 2.5 cm (1 inch) in diameter, comprising three
layers and filled with fluids that support its shape.

External Layer

• Sclera: The sclera is the opaque, white part of the eye that forms the majority of the
external layer. It is a tough, fibrous structure that protects the internal components of the
eye and the optic nerve (CN II), which extends from the back of the eye. The anterior
part of the sclera is covered by the conjunctiva.
• Cornea: The cornea is the clear, dome-shaped front of the eye. It has a more pronounced
curvature than the rest of the eye, allowing it to bend light rays effectively. The cornea
is avascular, meaning it lacks blood vessels, and contains no nerves that would obstruct
light entry.

Middle Layer

• Choroid: This layer contains blood vessels that nourish the eye and a high concentration
of melanin, which absorbs light to prevent back-scattering and enhance vision clarity.
• Ciliary Body: This structure encircles the lens and contains ciliary muscles that help
adjust the shape of the lens through a process known as accommodation. The ciliary
zonule consists of fibrous strands connecting the ciliary body to the lens, holding it in
place.
• Lens: A transparent, elastic structure composed of protein fibers, the lens focuses light
rays precisely onto the retina. The ciliary muscles' contraction and relaxation alter the
lens's shape for distant or near vision.
• Iris: The iris is a colored, thin disc of connective tissue and smooth muscle that regulates
the amount of light entering the eye by controlling the size of the pupil. The pupil's size
adjusts based on lighting conditions, constricting in bright light and dilating in dim light.

Internal Layer

• Retina: This film-like layer lines the internal surface of the eye behind the ciliary body.
It contains two types of photoreceptor cells:
o Rods: Long, thin cells sensitive to low light levels, enabling black-and-white
vision.
o Cones: Shorter, thicker cells responsible for color vision, which function best in
bright light.
• Macula: A yellowish area on the retina directly behind the lens, the macula contains the
fovea centralis, a small depression densely packed with cones for the sharpest color
vision. The density of cones decreases away from the fovea, while rods become more
prevalent.
• Optic Disc: Located medial to the fovea, the optic disc is where nerve impulses from
rods and cones converge into the optic nerve. This area lacks photoreceptors, creating a
"blind spot," which is usually compensated by the overlapping visual fields of both eyes.
• Blood Vessels: An artery enters and a vein exits the eye via the optic disc, supplying
nourishment to the internal structures. These vessels are the only blood vessels in the
body visible directly through an ophthalmoscope.

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Internal Cavities

• Anterior Chamber: This space between the cornea and iris is filled with aqueous
humor, a watery fluid that maintains intraocular pressure and nourishes the cornea and
lens.
• Posterior Chamber: Located between the iris and lens, this chamber also contains
aqueous humor. The fluid is produced in the ciliary body, flows through the posterior
chamber, into the anterior chamber, and is absorbed at the sclera-corneal junction.
• Vitreous Chamber: Positioned behind the lens, this large chamber is filled with the
vitreous body, a clear, gel-like substance formed during embryonic development. It
maintains the eye's shape and presses the retina against the eye wall, ensuring proper
alignment and function.

These structures work together to facilitate vision by focusing light onto the retina, where visual
information is processed before being sent to the brain for interpretation.

Functions of Eye Structures

Eye Structure Function
Sclera Provides protection and structure; serves as the attachment point for eye muscles.
Cornea Allows light to enter the eye; bends light rays for focusing; provides protection
against dust and debris.
Conjunctiva Lubricates the eye and keeps it moist; protects the anterior surface of the eye;
contains blood vessels and nerve endings.
Choroid Supplies blood and nutrients to the retina; absorbs excess light to prevent
scattering.
Ciliary Body Contains ciliary muscles that change the shape of the lens for focusing
(accommodation).
Ciliary Zonule Holds the lens in place; connects the ciliary body to the lens.
Lens Focuses light rays onto the retina; changes shape for near and distant vision.
Iris Controls the size of the pupil to regulate the amount of light entering the eye.
Pupil The opening that allows light to pass through to the lens; adjusts size in response
to light conditions.
Retina Contains photoreceptors (rods and cones) that convert light into neural signals;
processes visual information.
Rods Enable vision in low light; responsible for black-and-white vision.
Cones Enable color vision; function best in bright light; concentrated in the fovea
centralis for sharp vision.
Macula Area of the retina for sharp central vision; contains the fovea centralis.
Fovea Contains the highest concentration of cones; responsible for the sharpest color
Centralis vision.
Optic Disc The point where the optic nerve leaves the eye; lacks photoreceptors (blind spot).
Aqueous Maintains intraocular pressure; nourishes the cornea and lens; allows light to pass
Humor through.
Vitreous Body Maintains the shape of the eye; supports the retina against the choroid; helps keep
the retina in place.

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Physiology of Vision

1. Refraction of Light:
o Light rays entering the eye are bent (refracted) to focus on the retina.
o Cornea: The convex shape of the cornea produces the greatest degree of
refraction.
o Lens: The lens further fine-tunes the focus through a process called
accommodation, adjusting its shape based on the distance of the object being
viewed.
2. Inversion of Image:
o The optics of the eye cause images to be inverted on the retina.
o The visual cortex of the brain corrects this inversion, allowing us to perceive
objects in their correct orientation.
3. Conversion of Light to Nerve Impulses:
o When light hits the retina, photoreceptors (rods and cones) convert light stimuli
into nerve impulses.
o Rods:
§ Contain rhodopsin, a light-sensitive pigment that breaks down into opsin
(a protein) and retinal (derived from vitamin A).
§ The breakdown of rhodopsin generates nerve impulses sent via the optic
nerve to the brain.
§ A deficiency in vitamin A can lead to insufficient rhodopsin, causing
night blindness.
o Cones:
§ There are three types of cones, each sensitive to different wavelengths of
light (red, green, and blue).
§ The perceived color of objects results from the combination of stimulated
cones and the interpretation of their nerve impulses by the brain.
4. Nerve Pathway:
o The nerve impulses travel from the photoreceptors via the optic nerve.
o The optic nerves merge at the optic chiasma, where axons from the medial half
of the retina cross over to the opposite side.
o The left optic tract consists of the medial axons from the left eye and lateral axons
from the right eye, while the right optic tract consists of the medial axons from
the right eye and lateral axons from the left eye.
o These tracts carry impulses to the thalamus, where they synapse with neurons that
transmit signals to the visual areas of the occipital lobes.
5. Stereoscopic Vision:
o The crossing of medial axons allows each visual area to receive images from
slightly different perspectives, contributing to stereoscopic (3D) vision and depth
perception.

Summary of Vision Mechanism:

1. Light rays are bent by the cornea.

2. The iris regulates light passing through the pupil.
3. The ciliary body alters the lens shape for focusing.
4. Rods and cones absorb light and generate nerve impulses.
5. Nerve impulses travel to neurons that converge at the optic disc, forming the optic nerve.
6. Medial axons cross at the optic chiasma, forming optic tracts that lead to the thalamus.
7. Nerve impulses reach the occipital lobes for visual interpretation.

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Disorders of the Eye
Disorder Description Causes
Astigmatism Unequal focusing of light Unequal curvature of the cornea or lens.
rays on the retina, causing
part of an image to appear
blurred.
Blindness Partial loss or lack of vision Cataract, glaucoma, retinal detachment, damage
caused by various disorders. to optic nerves or visual centers in the brain.
Cataract Cloudiness or opacity of the Common in older adults; age-related changes.
lens, impairing or preventing Surgical removal of the clouded lens and
vision. implantation of a plastic lens usually restores
good vision.
Color Blindness Inability to perceive certain Inherited condition, often sex-linked, more
colors, particularly reds and common in males due to the absence of red or
greens. green cones.
Conjunctivitis Inflammation of the Allergic reactions, infections (viral or bacterial),
conjunctiva, commonly physical or chemical irritants. Highly contagious
known as pink eye. if bacterial.
Farsightedness Blurred vision caused by light Lens abnormalities or a shorter-than-normal eye.
(Hyperopia) rays being incorrectly
focused behind the retina.
Nearsightedness Blurred vision caused by light Lens abnormalities or a longer-than-normal eye.
(Myopia) rays being incorrectly
focused in front of the retina.
Presbyopia Diminished ability of the lens Natural aging process; requires objects to be
to accommodate for near farther away to see clearly.
vision due to decreased
elasticity.
Retinoblastoma Cancer of immature retinal Genetic mutations affecting retinal development.
cells, accounting for about
2% of cancers in children.
Strabismus Disorder of the extrinsic eye Muscle imbalance, neurological issues.
muscles causing the eyes to Treatment may involve eye exercises, corrective
not align toward the same lenses, or surgery.
object.

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Chapter 7: Cutaneous Sensation

Functions of the Skin

The skin performs six important functions:

1. Protection. The skin provides a physical barrier between internal tissues and the external
environment. It provides protection from abrasion, dehydration, ultraviolet (UV) radiation,
chemical exposure, and pathogens.

2. Excretion. Perspiration, produced by sweat glands, removes small amounts of organic wastes,
salts, and water.

3. Temperature regulation. During periods of excessive heat production by the body, blood
vessels near the body surface dilate to increase heat loss and cool the body. Sweat production
and evaporation also aid in heat loss. During periods of excessive heat loss, blood vessels near
the body surface constrict to conserve body heat.

4. Sensory perception.The skin contains nerve endings and sensory receptors that detect stimuli
associated with touch, pressure, temperature, and pain.

5. Synthesis of vitamin D. Exposure to UV radiation stimulates the production of precursor

molecules that are needed for the body to form active vitamin D.

6. Absorption. The skin is capable of absorbing lipid-soluble vitamins (A, D, E, and K), in
addition to lipid-soluble drugs (e.g., topical steroids, nicotine patches) and toxins (e.g., acetone,
lead, mercury).

Structure of the Skin

Skin is the largest organ of the human body. The surface area of the skin on an average adult
male is approximately 19 to 21 square feet.

• Average thickness: Skin thickness varies across the body, averaging around 2-3 mm.

The skin is thickest in areas subjected to wear and tear (abrasion), such as the soles of the feet,
where it may be 6 mm in thickness. It is thinnest on the eyelids, eardrums, and external genitalia,
where it averages about 0.5 mm in thickness.

The skin consists of two major layers: the epidermis and the dermis. The epidermis, the thinner
superficial layer, is composed of an epithelium. The dermis, the thicker deep layer, is composed
of connective tissue. The subcutaneous tissue, located deep to the dermis, is not part of the skin
but is considered here because of its close association with the skin.

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The Skin and Subcutaneous Tissue

Layer Structure Function

Epidermis Keratinized stratified squamous Protects against abrasion,
epithelium; forms hair and hair evaporative water loss, pathogen
follicles, sebaceous glands, and sweat invasion, chemical exposure, and
glands that penetrate into the dermis or UV radiation
subcutaneous tissue
Dermis Areolar and dense irregular connective Provides strength and elasticity;
tissues containing blood vessels, sensory receptors enable detection
nerves, and sensory receptors of touch, pressure, pain, cold, and
heat; blood vessels supply nutrients
to the epidermis
Subcutaneous tissue Areolar connective tissue and adipose Provides insulation, protection
tissue; contains abundant blood vessels from impact, and fat storage;
and nerves attaches skin to deeper organs

Epidermis Overview:
The epidermis is a keratinized stratified squamous epithelium, which lacks blood vessels,
making it avascular. This characteristic prevents unnecessary bleeding from minor injuries.
Since it has no direct blood supply, the epidermis depends on diffusion from blood vessels in the
dermis to receive nutrients and remove waste. It contains numerous nerve endings, allowing it
to detect changes on the body’s surface.

As the body’s outermost boundary with the environment, the epidermis provides critical
protection against:

1. Pathogen entry, blocking harmful microorganisms.

2. Harmful UV radiation.
3. Excessive water loss, helping maintain hydration.
4. Environmental chemicals.
5. Physical abrasion, which could damage underlying tissues.

Additionally, the epidermis is involved in synthesizing precursor molecules necessary for

vitamin D production, an essential nutrient for bone health and immune function.

Structure and Layers of the Epidermis:

The epidermis primarily consists of keratinocytes, cells that produce keratin, a durable and
fibrous protein that waterproofs and strengthens the skin. These keratinocytes are organized into
distinct layers based on their location and stage in the keratinization process.

• Thin Skin: Found on most of the body, the epidermis is organized into four layers.
• Thick Skin: Located in high-abrasion areas such as the palms and soles, thick skin has
an additional fifth layer for extra protection.

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The layers of the epidermis include:

1. Stratum Basale: This is the deepest layer of the epidermis, where new keratinocytes are
produced continuously through mitosis. As new cells form, older cells are pushed
upwards toward the surface. This ongoing cell division enables the epidermis to repair
itself after damage. Melanocytes (pigment-producing cells) are also found here,
contributing to skin color.
2. Stratum Spinosum: As keratinocytes leave the stratum basale, they enter the stratum
spinosum, where keratin production begins within their cytoplasm. Neighboring cells
become connected by desmosomes, which give the layer a “spiny” appearance under a
microscope. Dendritic (Langerhans) cells are present in this layer, providing immune
defense by capturing pathogens.
3. Stratum Granulosum: Here, keratinocytes contain numerous granules that stain darkly,
which are essential for keratin formation. As cells progress through this layer, they
undergo apoptosis—programmed cell death—which involves the breakdown of the
nucleus and organelles. This process prepares the cells to become fully keratinized.
4. Stratum Lucidum (only in thick skin): This transparent layer is found only in thick skin,
such as on the palms and soles. Cells here have lost their nuclei and organelles, giving
the layer a “lucid” appearance under the microscope. The stratum lucidum provides an
additional layer of protection.
5. Stratum Corneum: The outermost layer, consisting of 20–40 layers of dead, squamous,
keratinized cells. These cells, also called “cornified” cells, are constantly being shed and
replaced by new cells moving up from lower layers. The journey from the stratum basale
to the stratum corneum usually takes 7–10 days, and cells remain in the stratum corneum
for an additional two weeks before being sloughed off. This layer provides the primary
waterproof and abrasion-resistant barrier.

Specialized Cells in the Epidermis:

• Melanocytes: Located in the stratum basale, melanocytes produce melanin, the brown-
black pigment that contributes to skin color and provides some UV protection.
• Dendritic (Langerhans) Cells: These immune cells, derived from white blood cells, are
found in the stratum spinosum and stratum granulosum. They use phagocytosis to capture
and break down pathogens attempting to enter the body and alert the immune system to
mount a response.
• Tactile (Merkel) Cells: These sensory cells are also located in the stratum basale, where
they work with sensory nerve endings in the dermis (forming tactile discs) to detect
touch.

15
Dermis Overview:
The dermis is the deeper layer of the skin and can be divided into two main regions: the papillary
layer and the reticular layer.

1. Papillary Layer:
o Located adjacent to the epidermis and composed of areolar connective tissue.
o Contains dermal papillae—nipple-like projections that extend into the epidermis.
o Dermal papillae:
§ Contain blood vessels that supply nutrients to and remove wastes from
the epidermis through diffusion.
§ House tactile (Meissner) corpuscles, which detect touch.
§ Form epidermal ridges and grooves, which create unique fingerprints and
toe prints.
§ Increase traction on gripping surfaces and help interlock the epidermis
and dermis to ensure they move as a unit.
2. Reticular Layer:
o Deeper and thicker than the papillary layer, making up 70–80% of the dermis's
thickness.
o Composed of dense irregular connective tissue with abundant collagen and elastic
fibers:
§ Collagen fibers provide strength and toughness.
§ Elastic fibers offer extensibility (stretch) and elasticity (return to original
shape).
o Contains various sensory receptors:
§ Lamellated (Pacinian) corpuscles detect pressure.
§ Free nerve endings throughout the dermis and epidermis detect touch,
pain, and temperature.
o Blood vessels in this layer play a critical role in temperature regulation.

Subcutaneous Tissue (Hypodermis)

The subcutaneous tissue, also known as the hypodermis, is the layer beneath the skin that
connects it to deeper tissues and organs. It consists mainly of two types of tissue:

1. Areolar Connective Tissue

2. Adipose Tissue (fat tissue)

Functions and Characteristics:

• Attachment: Connects the skin to underlying tissues and organs.

• Injection Site: Common site for subcutaneous injections due to its accessibility.
• Immune Defense: Contains white blood cells that combat pathogens that have
penetrated the skin.
• Impact Absorption: The adipose tissue cushions and absorbs impact forces, protecting
underlying structures.
• Fat Storage: Acts as a storage site for fat, which can be used as an energy reserve.
• Insulation: Helps conserve body heat and limits external heat from penetrating into the
body.
• Blood Supply: Contains blood vessels and nerves that extend branches to supply the
dermis above.
16
Key receptors, their alternative names, and the types of stimuli they respond to

Receptor Type Eponymous/Historical Stimuli

Name
Free Nerve Endings None Pain, temperature, and
mechanical deformation
Mechanoreceptors Merkel’s Discs Low frequency vibration (5-
15 Hz)
Bulbous Receptors Ruffini Endings Skin stretch and pressure
Tactile Receptors Meissner's Corpuscles Light touch and vibration
below 50 Hz
Lamellated Receptors Pacinian Corpuscles Deep pressure and high
frequency vibration
(around 250 Hz)
Hair Follicle Plexus None Movement of hair (light
touch detection)
Muscle Spindle None Muscle contraction and
stretch (proprioception)
Tendon Stretch Organ Golgi Tendon Organ Tension in tendons
(proprioception)

Determination of Skin Color

Skin color is determined by the interaction of three main pigments: hemoglobin, carotene, and
melanin.

1. Hemoglobin
o Description: A red pigmented protein in red blood cells that carries oxygen and
carbon dioxide.
o Effect on Skin Color: Hemoglobin contributes a pinkish hue to the skin,
particularly noticeable in lighter-skinned individuals where melanin
concentrations are lower.
2. Carotene
o Description: A group of lipid-soluble plant pigments that vary in color from
violet to red-yellow to orange-yellow.
o Sources: The most abundant carotene, beta-carotene, is found in yellow-orange
and green leafy fruits and vegetables.
o Effect on Skin Color: Excess carotene is stored in the body’s fatty areas, such
as subcutaneous tissue and the stratum corneum, contributing to skin color.
3. Melanin
o Description: A brown-black pigment produced by melanocytes, which are
distributed throughout the epidermis.
o Function: Melanin protects the skin from ultraviolet (UV) radiation by forming
a protective shield over the nuclei of keratinocytes.
o Distribution:
§ Areas exposed to more sunlight, like the face, neck, and limbs, have
higher concentrations of melanocytes for increased UV protection.
§ Melanocytes also cluster in areas like the areola and external genitalia,
resulting in darker pigmentation associated with reproductive readiness.
§ Freckles are caused by localized concentrations of melanin due to the
random clumping of melanocytes.
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 4. Genetic Influence on Melanin Production
o Variation: The amount of melanin produced is genetically determined.
§ Individuals predisposed to higher melanin production have darker skin.
§ Those with a predisposition for lower melanin production have lighter
skin.
o Response to UV Exposure: Exposure to UV radiation stimulates melanin
production, leading to a tanned appearance in lighter-skinned individuals as a
protective mechanism. When UV exposure decreases, melanin production
reduces, and the tan fades as tanned cells are shed.
5. Racial Differences in Skin Color
o Skin colors among different races result from varying amounts of carotene and
melanin, which are inherited traits.
o Dark-skinned individuals produce more melanin, providing greater protection
against UV radiation.
o Light-skinned individuals (e.g., Caucasians) have lower melanin levels, making
them more susceptible to UV damage. Their skin may exhibit a pinkish hue due
to visible hemoglobin.
o Some individuals of Asian descent may have a yellowish tint to their skin,
resulting from a different form of melanin.

Protection from Ultraviolet Radiation

The skin provides critical protection against harmful ultraviolet (UV) radiation through the
following mechanisms:

1. Melanin Production
o Role of Melanin: Melanin acts as a natural sunscreen by absorbing and
dissipating UV radiation, preventing damage to DNA in skin cells.
o Increased Production: Upon UV exposure, melanocytes increase melanin
production, darkening the skin and enhancing its protective capacity.
2. Physical Barrier
o Epidermis: The outermost layer of skin (epidermis) provides a physical barrier
to UV radiation. The thickness of the skin can also contribute to its protective
ability.
3. Cellular Response to Damage
o Repair Mechanisms: When skin cells experience UV-induced damage, the body
activates repair mechanisms to fix DNA damage, reducing the risk of mutations
that can lead to skin cancer.
4. Inflammatory Response
o Sunburn: Intense UV exposure can cause an inflammatory response (sunburn),
which serves as a warning system for the body to minimize further exposure to
UV radiation.

Conclusion

Skin color results from the complex interaction of various pigments, particularly hemoglobin,
carotene, and melanin, which are influenced by genetic and environmental factors. The skin's
ability to protect against UV radiation is crucial for preventing skin damage and maintaining
overall health. Understanding these mechanisms highlights the importance of protecting the skin
from excessive sun exposure to reduce the risk of skin-related health issues.

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Common Infectious and Noninfectious Disorders of the Skin
The skin is highly exposed to environmental factors, making it prone to various injuries and
disorders. These can be broadly categorized into infectious and noninfectious disorders, with
some inflammatory conditions falling into either category based on their specific causes.

Infectious Disorders of the Skin

Infectious skin disorders are caused by various pathogens, including bacteria, viruses, and fungi.
Here’s a detailed overview of some common infectious skin disorders:

1. Acne
o Description: A chronic skin disorder characterized by plugged hair follicles,
often leading to the formation of pimples (pustules).
o Causes: Triggered by increased sebum secretion during puberty due to elevated
sex hormones, along with bacterial infection.
2. Athlete’s Foot (Tinea Pedis)
o Description: A slightly contagious fungal infection affecting the skin, primarily
between and under the toes.
o Symptoms: Reddish, flaky, and itchy patches of skin, often exacerbated by
moisture.
3. Boils
o Description: Acute, painful infections caused by Staphylococcus bacteria,
affecting hair follicles and sebaceous glands.
o Note: Multiple boils can coalesce to form a carbuncle.
4. Fever Blisters (Cold Sores)
o Description: Clusters of fluid-filled vesicles typically located on the lips or oral
membranes.
o Causes: Result from the Herpes simplex virus type 1, transmitted through oral or
respiratory exposure.
5. Genital Herpes
o Description: Characterized by painful blisters in the genital area.
o Causes: Can be caused by either Herpes simplex virus type 1 or type 2, primarily
transmitted through sexual activity.
6. Impetigo
o Description: A highly contagious bacterial skin infection, often seen in children.
o Symptoms: Fluid-filled pustules that rupture, leaving a yellow crust over the
infected area.

Noninfectious Disorders of the Skin

Noninfectious skin disorders encompass a range of conditions that can affect the skin's
appearance and function without being caused by pathogens. Below are some common
noninfectious skin disorders:

1. Alopecia
o Description: Loss of hair, commonly associated with inherited male pattern
baldness.
o Causes: May also result from noninherited factors such as poor nutrition,
sensitivity to medications, and conditions like eczema.
2. Bed Bugs (Cimex lectularius)
o Description: Microscopic parasitic insects that primarily feed on human blood.

19
 o Habitat: Found in sleeping areas of homes, hotels, and public transport, with
peak feeding activity at night, causing itchy welts on exposed skin.
o Treatment: Washing infested clothing and bedding in hot water (115°F or 46°C),
using insecticides, and deep cleaning infested areas.
3. Bedsores (Decubitus Ulcers)
o Description: Sores resulting from chronic blood circulation deficiency in the
dermis and subcutaneous tissue.
o Cause: Form over bony areas subjected to prolonged pressure, commonly in
bedridden patients.
o Prevention: Frequent repositioning of patients to reduce pressure on vulnerable
areas.
4. Blisters
o Description: Fluid-filled pockets that form when the epidermis separates from
the dermis due to abrasion, burn, or injury.
5. Burns
o Classification:
§ First-Degree Burns: Affect only the epidermis; heal rapidly.
§ Second-Degree Burns: Damage the epidermis and superficial dermis;
painful blisters form and healing takes 2 to several weeks, with possible
scarring.
§ Third-Degree Burns: Full-thickness burns destroying all skin layers and
nerve endings; often painless but require significant medical intervention
like skin grafting, with scarring common.
6. Calluses and Corns
o Description: Thickened skin areas due to chronic pressure.
o Calluses: Larger, typically on palms and balls of the feet.
o Corns: Smaller, usually on the tops of toes; often caused by poorly fitting shoes.
7. Common Mole (Nevus)
o Description: Pink, tan, or brown growths that usually appear in childhood and
continue to develop into adulthood.
o Characteristics: Result from clustered melanocytes; rarely develop into
melanoma.
8. Dandruff (Seborrheic Dermatitis)
o Description: Excessive shedding of dead epidermal cells from the scalp.
o Causes: Often linked to seborrheic eczema, a noninfectious dermatitis affecting
the scalp.
9. Eczema (Atopic Dermatitis)
o Description: Inflammation leading to redness, itching, scaling, and sometimes
cracking of the skin.
o Causes: Noninfectious, can be triggered by irritants or allergic reactions.
Seborrheic eczema involves overactivity of sebaceous glands, causing red,
scaling patches.
10. Hives
o Description: Red, itchy bumps or wheals caused by allergic reactions to foods,
drugs, or pollens.
11. Psoriasis
o Description: Chronic, noncontagious dermatitis characterized by raised, reddish
patches covered with whitish scales.
o Triggers: Excessive skin cell production can be triggered by emotional stress or
poor health, typically affecting the scalp, elbows, knees, buttocks, and lower
back.

20
Chapter 4: Brain and Spinal cord
Protection for the Central Nervous System

Overview:
The brain and spinal cord are soft, delicate organs that require protection from injury. They are
encased in bones and supported by fibrous membranes.

• The brain and spinal cord are delicate organs requiring protection to prevent damage.
• Surrounding structures:
o The brain is housed within the cranial cavity formed by cranial bones.
o The spinal cord is protected by the vertebral canal formed by vertebrae.

Meninges

• The meninges are three protective membranes surrounding the Central Nervous
System (CNS):
1. Pia Mater ("tender mother")
§ The innermost layer; thin and delicate.
§ Closely envelopes the brain and spinal cord, penetrating grooves and
depressions.
§ Contains numerous blood vessels that nourish the CNS.
2. Arachnoid Mater ("spider mother")
§ The middle layer; thin and web-like, without blood vessels.
§ Does not penetrate small depressions; lies between the pia mater and the
dura mater.
§ Contains the subarachnoid space, filled with cerebrospinal fluid
(CSF), which acts as a shock absorber.
3. Dura Mater ("tough mother")
§ The outermost layer; tough and fibrous.
§ Attached to the internal surfaces of the cranial bones; extends into brain
fissures.
§ Forms a protective tube in the vertebral canal, extending to the sacrum.
§ Separated from the vertebral bone by the epidural space, filled with
adipose tissue for cushioning.

• Subdural Hematoma: A condition resulting from physical trauma, where blood pools
between the dura and arachnoid mater, creating an artificial subdural space.

Brain Structure
Overview

• The brain is a complex organ with approximately 100 billion neurons and numerous
processes.
• It consists of four major components: cerebrum, cerebellum, diencephalon, and
brainstem.

The biological name for the brain is encephalon. Average brain size:

• Male: ~1,380g, 1,300-1,400 cm³

• Female: ~1,250g, 1,100-1,250 cm³

21
Cerebrum

• Largest portion of the brain, responsible for higher functions: sensations, voluntary
actions, reasoning, planning, and problem-solving.
• Structure:
o Comprised of left and right cerebral hemispheres, connected by the corpus
callosum.
o Separated by the longitudinal cerebral fissure.
o Surface features:
§ Gyri: Folds/ridges on the brain's surface.
§ Sulci: Shallow grooves between gyri.
o Gray matter: Superficial layer (cerebral cortex).
o White matter: Deeper layer, composed of myelinated and unmyelinated axons,
responsible for transmitting nerve impulses.

Lobes of the Cerebrum

1. Frontal Lobe: Anterior to the central sulcus; involved in reasoning and voluntary
actions.
2. Parietal Lobe: Posterior to the central sulcus; processes sensory information.
3. Temporal Lobe: Inferior to frontal and parietal lobes; involved in hearing and memory.
4. Occipital Lobe: Posterior to parietal and temporal lobes; processes visual information.
5. Insula: Deep to the lateral sulcus; not visible superficially.

Functions of the Cerebrum

• Sensory Areas: Interpret sensory impulses; located in specific lobes:

o Vision: Occipital lobes
o Hearing: Temporal lobes
o Skin sensations: Postcentral gyri of parietal lobes
o Taste: Inferior end of postcentral gyri
o Smell: Inferior part of frontal lobe and medial aspect of temporal lobe
• Motor Areas: Control voluntary muscle movement; located in the frontal lobe:
o Primary Motor Area: Precentral gyri, controlling skeletal muscles.
o Premotor Area: Anterior to primary motor area, involved in complex activities.
o Motor Speech Area (Broca's Area): Controls speech, usually located in the left
hemisphere.
• Association Areas: Interrelate sensory inputs and motor outputs, critical for sensations,
memory, and motor coordination.
o Common Integrative Area: Located at the junction of temporal, parietal, and
occipital lobes.
o Posterior Language Area (Wernicke Area): Interprets language; typically
found in the left hemisphere.
o Prefrontal Area: Involved in planning, conscience, personality, and executive
functions; not fully developed until the 20s.

Hemisphere Specialization

• The left hemisphere: Controls analytical and verbal skills (math, reading, writing,
speech).
• The right hemisphere: Controls musical, artistic, spatial awareness, imagination, and
insight.
• Men generally exhibit greater lateralization than women, leading to more pronounced
effects from hemisphere damage.
22
Limbic System

• The limbic system is a complex structure formed by the thalamus, hypothalamus, and
associated parts of the cerebral cortex and deep nuclei within the cerebrum.
• Functions:
o Involved in memory and emotions such as sadness, happiness, anger, and fear.
o Regulates emotional behavior, particularly those enhancing survival.
o Associated with mood disorders, like depression, due to malfunctions.
o Referred to as the “motivational system” because it drives actions based on
commands from the cerebrum.

Diencephalon
• The diencephalon is a small yet crucial part of the brain located between the brainstem
and cerebrum. It consists of three major components: thalamus, hypothalamus, and
epithalamus.

Components of the Diencephalon

1. Thalamus
o Composed of two lateral masses of nervous tissue joined by the interthalamic
adhesion.
o Functions:
§ Receives sensory nerve impulses (except smell) from lower brain regions
and the spinal cord.
§ Relays these impulses to the cerebral cortex.
§ Provides general awareness of sensations (pain, pressure, touch,
temperature).
§ Associates sensations with emotions but does not interpret them; this
function is performed by the cerebral cortex.
§ Acts as a relay station for communication between motor areas of the
brain.
2. Hypothalamus
o Located inferior to the thalamus and anterior to the midbrain.
o Communicates with the thalamus, cerebrum, and other brain parts.
o Functions:
§ Controls the autonomic nervous system, regulating most internal organs.
§ Links the brain and the endocrine system via control of the pituitary
gland (hypophysis).
§ Plays a vital role in maintaining homeostasis by regulating:
§ Body temperature
§ Mineral and water balance
§ Appetite and digestive processes
§ Heart rate and blood pressure
§ Sleep and wakefulness
§ Emotions
§ Hormonal secretion by the pituitary gland
o Despite its small size, it has a significant impact on body functions.
o

23
 3. Epithalamus
o A small mass of tissue located superior and posterior to the thalamus, forming
part of the roof of the third ventricle.
o Major structure:
§ Pineal gland: Produces the hormone melatonin in response to low
sunlight levels during the evening.
§ Induces sleepiness and initiates the night component of the day-
night cycle.
§ May assist in regulating the onset of puberty.

Brainstem

• The brainstem is a stalklike structure that connects higher brain centers to the spinal
cord. It consists of several nuclei surrounded by white matter, facilitating the passage of
ascending (sensory) and descending (motor) axons.

Components of the Brainstem:

1. Midbrain
o The most superior part of the brainstem, located posterior to the hypothalamus
and superior to the pons.
o Contains reflex centers for head, eye, and body movements in response to visual
and auditory stimuli.
2. Pons
o Positioned between the midbrain and medulla oblongata, recognizable by its
bulblike anterior portion.
o Composed mainly of axons; connects lower and higher brain centers
longitudinally and the cerebellum transversely.
o Collaborates with the medulla oblongata to control the rate and depth of
breathing.
3. Medulla Oblongata
o The most inferior part of the brain, acting as the connecting link to the spinal
cord.
o Contains vital integration centers for homeostasis:
1. Respiratory rhythmicity center: Controls the basic rhythm of breathing
and associated reflexes (e.g., coughing, sneezing).
2. Cardiac control center: Regulates the rate and force of heart
contractions.
3. Vasomotor center: Regulates blood pressure and flow by controlling
blood vessel diameter.

Reticular Formation

• The reticular formation is a network of axons and small nuclei of gray matter extending
from the superior spinal cord through the brainstem into the diencephalon.
• Functions:
o Generates and transmits nerve impulses that maintain wakefulness.
o Decreased activity results in sleep.
o Damage may lead to unconsciousness or coma.

Cerebellum
24
 • The cerebellum is the second largest brain portion, separated from the cerebrum by the
transverse cerebral fissure.
• Divided into two lateral hemispheres by the vermis.
• Composed of a thin layer of gray matter over deep white matter.
• Functions:
o Acts as a reflex center to control and coordinate skeletal muscle interaction.
o Regulates posture, balance, and muscle coordination during movement.
o Damage can lead to loss of equilibrium, coordination, and muscle tone.

Summary of Brain Functions

Part Function
Cerebrum Sensory areas interpret nerve impulses as sensations. Motor areas control
voluntary skeletal muscle actions. Association areas interrelate various
sensory and motor areas and are involved in intellectual processes, will,
memory, emotions, and personality traits. The limbic system is involved
with motivation and with emotions as they relate to survival behavior.
Thalamus Receives and relays sensory nerve impulses (except smell) to the
cerebrum and motor nerve impulses to lower brain centers. Provides a
general awareness of pain, touch, pressure, and temperature.
Hypothalamus Serves as the major integration center the autonomic nervous system.
Controls water and mineral balance, heart rate and blood pressure,
appetite and digestive activity, body temperature, and sexual response. Is
involved in sleep and wakefulness and in emotions of anger and fear.
Regulates functions of the pituitary gland.
Epithalamus Production of the hormone melatonin
Midbrain Relays sensory nerve impulses from the spinal cord to the thalamus and
motor nerve impulses from the cerebrum to the spinal cord. Contains
reflex centers that move the eyeballs, head, and neck in response to visual
and auditory stimuli.
Pons Relays nerve impulses between the midbrain and the medulla oblongata
and between the cerebellar hemispheres. Helps medulla oblongata control
breathing.
Medulla oblongata Relays nerve impulses between the brain and spinal cord. Reflex centers
control heart rate and contraction force, blood vessel diameter, breathing,
swallowing, vomiting, coughing, sneezing, and hiccupping. Motor axons
cross over to the opposite side.
Cerebellum Controls posture, balance, and the coordination of skeletal muscle
contractions.

25
Ventricles and Cerebrospinal Fluid (CSF)
Overview of Ventricles

The brain contains four interconnecting ventricles filled with cerebrospinal fluid (CSF), lined
by ependymal cells. These ventricles include:

1. Lateral Ventricles (First and Second)

o The largest ventricles located within the cerebral hemispheres.
2. Third Ventricle
o A narrow space located on the midline between the lateral masses of the thalamus
and superior to the hypothalamus.
3. Fourth Ventricle
o Situated on the midline in the posterior portion of the brainstem, just anterior to
the cerebellum. It is continuous with the central canal of the spinal cord.

Choroid Plexus

• Each ventricle contains a choroid plexus, composed of specialized capillaries and

ependymal cells that produce CSF.
• The majority of CSF is generated in the lateral ventricles.

Flow of Cerebrospinal Fluid

• CSF Circulation Pathway:

1. From the lateral ventricles, CSF flows through the interventricular foramina
into the third ventricle.
2. It then moves through the cerebral aqueduct into the fourth ventricle.
3. From the fourth ventricle, some fluid flows down the central canal of the spinal
cord.
4. Most of the CSF enters the subarachnoid space surrounding the brain and spinal
cord.
• Within the subarachnoid space, CSF flows:
o Superiorly around the brain.
o Inferiorly along the posterior of the spinal cord, returning superiorly along the
anterior surface, and continuing around the brain.
• CSF is reabsorbed into the dural venous sinus, which is filled with blood and located
along the superior midline of the dura mater.

Functions of Cerebrospinal Fluid

• Protection: CSF acts as a shock absorber, surrounding the brain and spinal cord.
• Transport: It facilitates the movement of ions, nutrients, and waste products
throughout the central nervous system (CNS).
• Buoyancy: CSF provides buoyancy to the brain, helping it “float” within the skull and
preventing damage from contact with the cranial floor.
• Hydrostatic Pressure Maintenance: The secretion and absorption of CSF typically
occur at equal rates, resulting in a stable hydrostatic pressure within the ventricles and
subarachnoid space.

26
Spinal Cord
The spinal cord is an extension of the brain, descending from the medulla oblongata through
the foramen magnum into the vertebral canal and continuing to the second lumbar vertebra.
Beyond this level, the vertebral canal is occupied solely by the roots of the inferior spinal
nerves.

Structure of the Spinal Cord

• Shape: The spinal cord is cylindrical with two grooves—the anterior median fissure
(wider) and the posterior median sulcus (narrower)—extending its length, dividing it
into left and right halves.
• Spinal Nerves: There are 31 pairs of spinal nerves branching from the spinal cord,
which is divided into four segments based on where spinal nerves exit the vertebral
column:
o Cervical
o Thoracic
o Lumbar
o Sacral
• Gray and White Matter:
o Gray Matter: Centrally located, shaped like a butterfly with pointed
projections called horns.
§ Anterior Horns: Contain cell bodies of somatic motor neurons. Their
axons enter spinal nerves and carry impulses to skeletal muscles.
§ Posterior Horns: Contain interneurons receiving impulses from sensory
axons in the spinal nerves, carrying them to sites within the CNS.
§ Lateral Horns: Present only in the thoracic and lumbar segments, these
contain cell bodies of autonomic motor neurons, which carry impulses to
cardiac and smooth muscle, glands, and adipose tissue.
o White Matter: Surrounds the gray matter and is divided by the horns into three
regions:
§ Anterior Funiculi
§ Posterior Funiculi
§ Lateral Funiculi
o Funiculi: Contain nerve tracts made of bundles of myelinated and unmyelinated
axons of interneurons extending up and down the spinal cord.

Functions of the Spinal Cord

1. Transmission of Nerve Impulses: The spinal cord transmits impulses to and from the
brain via axons in nerve tracts.
o Ascending Tracts (Sensory): Carry sensory impulses to the brain.
o Descending Tracts (Motor): Carry motor impulses from the brain.
2. Reflex Center: The spinal cord acts as a reflex center for spinal reflexes, processing
reflex actions directly within the spinal cord.

This structure-function organization allows the spinal cord to serve both as a conduit for
information and as an independent center for reflexive actions.

27