THE CENTRAL NERVOUS

SYSTEM.
Boaz kemboi
Introduction.
• The central nervous system (CNS), consisting of the brain and spinal
cord.
• It receives input from sensory neurons and directs the activity of
motor neurons that innervate muscles and glands.
• The association neurons associate appropriate motor responses with
sensory stimuli, and thus to maintain homeostasis in the internal
environment.
• The CNS is also involved in learning and memory.
Embryology.
• The early embryo contains on its surface an embryonic tissue layer
known as ectoderm.
• As development progresses, a groove appears in this ectoderm along the
dorsal midline of the embryo’s body. This groove deepens, and by the
twentieth day after conception it has fused to form a neural tube.
• The part of the ectoderm where the fusion occurs becomes a separate
structure called the neural crest, which is located between the neural
tube and the surface ectoderm.
• Eventually the neural tube will become the central nervous system, and
the neural crest will become the ganglia of the peripheral nervous
system.
Embryology.
• By the middle of the fourth week after conception, three distinct
swellings are evident on the anterior end of the neural tube, which is
going to form the brain:
• Forebrain (prosencephalon)
• Midbrain (mesencephalon)
• Hindbrain (rhombencephalon)
• During the fifth week, these areas become modified to form five
regions:
• The forebrain divides into the telencephalon and diencephalon
• The mesencephalon remains unchanged
• The hindbrain divides into the metencephalon and myelencephalon
Embryology.
• The telencephalon grows disproportionately, forming the two
enormous cerebral hemispheres (of the cerebrum) that cover the
diencephalon, the midbrain, and a portion of the hindbrain.
• The CNS begins as a hollow tube, and remains hollow as the brain
regions are formed.
• The cavities of the brain are known as ventricles and become filled
with cerebrospinal fluid (CSF).
• The cavity of the spinal cord is called the central canal, and is also
filled with CSF.
Cerebrospinal fluid.
• CSF is formed by the choroid plexuses, which are thin structures protruding into the
ventricles. They consist of a simple epithelium associated with blood capillaries containing a
fenestrated endothelium.
• These form CSF by diffusion and active transport, rather than by the simple filtration of blood
plasma. As a result, the CSF has a constant
• Composition: slightly hypertonic, and differs from plasma in its concentration of various ions.
• CSF in the ventricles is moved by pulsations of the choroid plexuses and by cilia on the
ependymal cells that line the ventricles.
• CSF exits through openings in the brain stem to fill the subarachnoid space between the pia
and the arachnoid membrane.
• The CSF is reabsorbed into venous blood across arachnoid villi that project through the dura.
• The average CSF volume of 140 to 200 mL is turned over 3–5 times per day, producing a
normal intracranial pressure of 5–15 mmHg.
Composition of the CNS.
• The CNS is composed of gray and white matter.
• The gray matter, containing neuron cell bodies and dendrites, is found in
the cortex of the brain and deeper within the brain in aggregations known
as nuclei.
• White matter consists of axon tracts that underlie the cortex and surround
the nuclei.
• The adult brain contains an estimated 100 billion neurons, weighs
approximately 1.5 kg, and receives about 15% of the total blood flow to the
body per minute.
• This high rate of blood flow is a consequence of the high metabolic
requirements of the brain.
THE CEREBRUM.
• It is the only structure of the telencephalon.
• It is the largest portion of the brain (accounting for about 80% of its
mass) and is the brain region primarily responsible for higher mental
functions.
• The cerebrum consists of right and left hemispheres, which are
connected internally by a large fiber tract called the corpus callosum.
• The corpus callosum is the major tract of axons that functionally
interconnects the right and left cerebral hemispheres.
Cerebral cortex.
• The cerebrum consists of an outer cerebral cortex, composed of 2 to 4 mm
of gray matter and underlying white matter.
• The cerebral cortex is characterized by numerous folds and grooves called
convolutions.
• The elevated folds of the convolutions are called gyri, and the depressed
grooves are sulci.
• Each cerebral hemisphere is subdivided by deep sulci, or fissures, into five
lobes, four of which are visible from the surface.
• These lobes are the frontal, parietal, temporal, and occipital, which are
visible from the surface, and the deep insula, which is covered by portions
of the frontal, parietal, and temporal lobes
Cerebral lobes.
• The frontal lobe is the anterior portion of each cerebral hemisphere. A
deep fissure, called the central sulcus, separates the frontal lobe from
the parietal lobe.
• The precentral gyrus involved in motor control, is located in the frontal
lobe just in front of the central sulcus. The cell bodies of the interneurons
located here are called upper motor neurons because of their role in
muscle regulation.
• The postcentral gyrus, which is located behind the central sulcus in the
parietal lobe of each hemisphere, contains the somatosensory cortex.
This is the primary area responsible for the perception of somatesthetic
sensations arising from cutaneous, muscle, tendon, and joint receptors.
Cerebral lobes.
• The temporal lobe contains auditory centers that receive sensory fibers from
the cochlea of each ear. This lobe is also involved in the interpretation and
association of auditory and visual information.
• The occipital lobe is the primary area responsible for vision and for the
coordination of eye movements.
• The insula is implicated in the encoding of memory and in the integration of
sensory information with visceral responses. It receives olfactory, gustatory
(taste), auditory, and somatosensory (principally pain) information, and helps
control autonomic responses to the viscera and cardiovascular system.
Because it receives sensory information from the viscera, it is believed to be
important in assessing the bodily states that accompany emotions.
DIENCEPHALON.
• The diencephalon is the part of the forebrain that contains the
epithalamus, thalamus, hypothalamus, and part of the pituitary gland.
• The diencephalon, together with the telencephalon constitutes the
forebrain and is almost completely surrounded by the cerebral
hemispheres.
• The third ventricle is a narrow midline cavity within the
diencephalon.
Thalamus and Epithalamus.
• The thalamus composes about four-fifths of the diencephalon and
forms most of the walls of the third ventricle.
• It consists of paired masses of gray matter, each positioned immediately
below the lateral ventricle of its respective cerebral hemisphere.
• The thalamus acts primarily as a relay center through which all sensory
information (except smell) passes on the way to the cerebrum.
• The epithalamus is the dorsal segment of the diencephalon, containing
a choroid plexus over the third ventricle where CSF is formed.
• The epithalamus also contains the pineal gland (epiphysis), which
secretes the hormone melatonin that helps regulate circadian rhythms.
Hypothalamus and Pituitary gland.
• The hypothalamus is the most inferior portion of the diencephalon.
• Located below the thalamus, it forms the floor and part of the lateral walls of the
third ventricle.
• This small but extremely important brain region contains neural centers for
hunger and thirst; the regulation of body temperature; and hormone secretion
from the pituitary gland.
• Centers in the hypothalamus contribute to the regulation of sleep, wakefulness,
sexual arousal and performance, and such emotions as anger, fear, pain, and
pleasure.
• Acting through its connections with the medulla oblongata of the brain stem, the
hypothalamus helps to evoke visceral responses to various emotional states.
• In its regulation of emotion, the hypothalamus works together with the limbic
system.
Hypothalamus and Pituitary gland.
• The pituitary gland is located immediately inferior to the
hypothalamus.
• The posterior pituitary derives embryonically from a down growth of
the diencephalon, and the entire pituitary remains connected to the
diencephalon by means of a stalk.
• The pituitary gland is divided into two:
• Anterior pituitary (adenohypophyis)
• Posterior pituitary (neurohypophysis)
MIDBRAIN AND HINDBRAIN.
• The midbrain and hindbrain contain many relay centers for sensory
and motor pathways, and are particularly important in the brain’s
control of skeletal movements.
• The medulla oblongata contains centers for the control of breathing
and cardiovascular function.
The midbrain.
• The mesencephalon, or midbrain, is located between the diencephalon and the pons.
• The corpora quadrigemina are four rounded elevations on the dorsal surface of the
midbrain.
• The two upper mounds, the superior colliculi, are involved in visual reflexes; the inferior
colliculi, immediately below, are relay centers for auditory information.
• The midbrain also contains the cerebral peduncles, red nucleus, substantia nigra, and
other nuclei.
• The cerebral peduncles are a pair of structures composed of ascending and descending
fiber tracts.
• The red nucleus, an area of gray matter deep in the midbrain, maintains connections
with the cerebrum and cerebellum and is involved in motor coordination.
The midbrain.
• The midbrain has two systems of dopaminergic neurons that project to
other areas of the brain.
• The nigrostriatal system projects from the substantia nigra to the corpus
striatum of the basal nuclei. This system is required for motor
coordination, and it is the degeneration of these fibers that produces
Parkinson’s disease.
• Other dopaminergic neurons in the ventral tegmental area (VTA) of the
midbrain, adjacent to the substantia nigra, are part of the mesolimbic
system that projects dopaminergic input to the limbic system of the
forebrain. This system is involved in behavioral reward and has been
implicated in drug addiction and psychiatric disturbances.
The Hindbrain.
• The rhombencephalon, or hindbrain, is composed of two regions:
• metencephalon
• myelencephalon
The metencephalon.
• The metencephalon is composed of the pons and the cerebellum.
• The pons can be seen as a rounded bulge on the under side of the
brain, between the midbrain and the medulla oblongata.
• Surface fibers in the pons connect to the cerebellum, and deeper
fibers are part of motor and sensory tracts that pass from the medulla
oblongata, through the pons, and on to the midbrain.
• Within the pons are several nuclei associated with specific cranial
nerves—the (V), (VI), (VII), and (VIII).
The metencephalon.
• Other nuclei of the pons cooperate with nuclei in the medulla
oblongata to regulate breathing.
• The two respiratory control centers in the pons are known as the
apneustic and the pneumotaxic centers.
• Damage to the ventral pons can produce a rare condition called
locked-in syndrome, characterized by paralysis of almost all voluntary
muscles so that communication by the aware, awake person is
possible only by eye blinks.
The metencephalon.
• The cerebellum, containing about 50 billion neurons, is the second largest
structure of the brain.
• Like the cerebrum, it contains outer gray and inner white matter.
• Fibers from the cerebellum pass through the red nucleus to the thalamus,
and then to the motor areas of the cerebral cortex.
• Other fiber tracts connect the cerebellum with the pons, medulla
oblongata, and spinal cord.
• The cerebellum receives input from proprioceptors (joint, tendon, and
muscle receptors) and, working together with the basal nuclei and motor
areas of the cerebral cortex, participates in the coordination of movement.
The metencephalon.
• The cerebellum is needed for motor learning and for coordinating the movement
of different joints during a movement.
• It is also required for the proper timing and force required for limb movements.
• The cerebellum, for example, is needed to touch your nose with your finger, bring
a fork of food to your mouth, or find keys by touch in your pocket or purse.
• These functions must operate through specific cerebellar neurons known as
Purkinje cells, which provide the only output from the cerebellum to other brain
regions.
• Purkinje cells produce only inhibitory effects on the motor areas of the cerebral
cortex. Acting through this inhibition, the cerebellum aids in the coordination of
complex motor skills and participates in motor learning.
The myelencephalon.
• The myelencephalon is composed of only one structure, the medulla
oblongata (medulla).
• About 3 cm long, the medulla is continuous with the pons superiorly and the
spinal cord inferiorly.
• All of the descending and ascending fiber tracts that provide communication
between the spinal cord and the brain must pass through the medulla.
• Many of these fiber tracts cross to the contralateral side in elevated triangular
structures in the medulla called the pyramids. Thus, the left side of the brain
receives sensory information from the right side of the body and vice versa.
• Similarly, because of the decussation of fibers, the right side of the brain
controls motor activity in the left side of the body and vice versa.
Summary.
Embryology
• During embryonic development, five regions of the brain are formed:
the telencephalon, diencephalon, mesencephalon, metencephalon,
and myelencephalon.
1. The telencephalon and diencephalon constitute the forebrain; the
mesencephalon is the midbrain, and the hindbrain is composed of
the metencephalon and the myelencephalon.
2. The CNS begins as a hollow tube, and thus the brain and spinal cord
are hollow. The cavities of the brain are known as ventricles.
Summary.
The cerebrum
• The cerebrum consists of two hemispheres connected by a large fiber tract called the
corpus callosum.
1. The outer part of the cerebrum, the cerebral cortex, consists of gray matter.
2. Under the gray matter is white matter, but nuclei of gray matter, known as the basal
nuclei, lie deep within the white matter of the cerebrum.
3. The two cerebral hemispheres exhibit some specialization of function, a phenomenon
called cerebral lateralization.
4. In most people, the left hemisphere is dominant in language and analytical ability,
whereas the right hemisphere is more important in pattern recognition, musical
composition, singing, and the recognition of faces.
5. The two hemispheres cooperate in their functions; this cooperation is aided by
communication between the two via the corpus callosum.
Summary.
The diencephalon
• The diencephalon is the region of the forebrain that includes the thalamus, epithalamus,
hypothalamus, and pituitary gland.
1. The thalamus serves as an important relay center for sensory information, among its
other functions.
2. The epithalamus contains a choroid plexus, where cerebrospinal fluid is formed. The
pineal gland, which secretes the hormone melatonin, is also part of the epithalamus.
3. The hypothalamus forms the floor of the third ventricle, and the pituitary gland is
located immediately inferior to the hypothalamus.
4. The hypothalamus is the main control center for visceral activities.
5. The hypothalamus contains centers for the control of thirst, hunger, body temperature,
and (together with the limbic system) various emotions.
6. The hypothalamus regulates the secretions of the pituitary gland. It controls the
posterior pituitary by means of a fiber tract, and it controls the anterior pituitary by
Summary.
Midbrain and Hindbrain
• The midbrain contains the superior and inferior colliculi, which are involved
in visual and auditory reflexes, respectively, and nuclei that contain
dopaminergic neurons that project to the corpus striatum and limbic system
of the forebrain.
• The hindbrain consists of two regions: the metencephalon and the
myelencephalon.
• The metencephalon contains the pons and cerebellum. The pons contains
nuclei for four pairs of cranial nerves, and the cerebellum plays an important
role in the control of skeletal movements.
• The myelencephalon consists of only one region, the medulla oblongata.
• The medulla contains centers for the regulation of such vital functions as