Complete set of notes for this element in the Bristol A100 Pre-clinical course. This is everything you need to know to achieve 90% marks. It is presented in a simple question, simple answer layout. If you have any questions or if anything doesn’t make sense, email me at mh14782@my.bristol.ac.uk....
NERVOUS SYSTEM
Table of Contents Systems 3
Nervous System ................................................................................................................ 2
Lecture 1: Introduction to the Nervous System .............................................................................................................................. 2
Lecture 2: Development and Organisation of the Nervous System ................................................................................................ 4
Lecture 3: Structure and Function of the Meninges and CSF .......................................................................................................... 8
Lecture 4: Functional Organisation of the Brain ............................................................................................................................ 10
Lecture 5: Space Occupying Lesions & Raised Intracranial Pressure ............................................................................................. 12
Lecture 6: Neural Tissues ............................................................................................................................................................... 14
Lecture 7: Neuronal Populations ................................................................................................................................................... 16
Lecture 8: Somatosensory Neurones and Receptors..................................................................................................................... 19
Lecture 9: Somatosensory Physiology ........................................................................................................................................... 20
Lecture 10: Pain and Nociception .................................................................................................................................................. 24
Lecture 11: Physiology of Pain 2 .................................................................................................................................................... 28
Lecture 12: Local Anaesthetics ...................................................................................................................................................... 29
Lecture 13: Opiate Analgesia and Neuropathic Pain ..................................................................................................................... 32
Lecture 14: Pain Mechanisms & Treatment .................................................................................................................................. 34
Lecture 15: General Anaesthetics .................................................................................................................................................. 34
Lecture 16: Cranial Nerves ............................................................................................................................................................. 36
Lecture 17: Motor Control 1 - Spinal Reflexes ............................................................................................................................... 39
Lecture 18: Motor Control 2 – Supraspinal Mechanisms .............................................................................................................. 42
Lecture 19: Motor Control 3 .......................................................................................................................................................... 44
Lecture 20: Functional Anatomy of the Basal Ganglia ................................................................................................................... 46
Lecture 21: Clinical Aspects of Parkinson’s .................................................................................................................................... 49
Lecture 22: Treatment of Movement Disorders (Parkinson’s and Huntington’s) ......................................................................... 50
Lecture 23: Demyelinating Diseases .............................................................................................................................................. 52
Lecture 24: Introduction to Multiple Sclerosis .............................................................................................................................. 53
Lecture 25: Stroke 1 (Cerebral Blood Flow) ................................................................................................................................... 55
Lecture 26: Clinical Aspects of Stroke ............................................................................................................................................ 56
Lecture 27: Stroke and Rehabilitation ........................................................................................................................................... 58
Lecture 28: Hearing & Balance 1 (Sound and Structure of Auditory System)................................................................................ 58
Lecture 29: Hearing & Balance 2 ................................................................................................................................................... 63
Lecture 30: Hearing and Balance 3 (Hearing Loss) ........................................................................................................................ 67
Lecture 31: Vision 1 ....................................................................................................................................................................... 69
Lecture 32: Vision 2 ....................................................................................................................................................................... 72
Lecture 33: Vision 3 ....................................................................................................................................................................... 76
Lecture 34: Computed Tomography (CT) of the Brain ................................................................................................................... 80
Lectures 35 & 36: Substance Abuse............................................................................................................................................... 81
Lecture 37: Antidepressant Drugs ................................................................................................................................................. 83
Lecture 38: Epilepsy ....................................................................................................................................................................... 85
Lecture 39: Anti-convulsants ......................................................................................................................................................... 87
Lecture 40: Anxiolytics ................................................................................................................................................................... 90
Histopathology of Dementia .......................................................................................................................................................... 91
Lecture 41: Plasticity ...................................................................................................................................................................... 92
Lecture 42: Bacterial Meningitis .................................................................................................................................................... 94
Lecture 43: The Limbic System ...................................................................................................................................................... 96
Lecture 44: Memory & Amnesia .................................................................................................................................................... 97
Lecture 45: Viral Infection………………………….………………………….………………………….……………………………………..……………………………… 99
Lecture 46: Anti-psychotic Drugs….………………………….………………………….……………………………………………….……………………………..….101
Lecture 47: Cognitive Enhancement Drugs.................................................................................................................................. 101
Lecture 48: Molecular & Cellular Aspects of Dementia ............................................................................................................... 102
Lecture 49: Dementia – Current and Future of Dementia Treatment ......................................................................................... 104
Lecture 50: Clinical Aspects of Dementia .................................................................................................................................... 104
Lecture 51: Reticular Formation .................................................................................................................................................. 105
Marc Huttman
, Nervous System
Lecture 1: Introduction to the Nervous System
• What does afferent mean? Towards the CNS, carrying sensory information
• What does efferent mean? Away from CNS, carrying motor information
• What are the special senses? Hearing, taste, vision, smell and balance
• Understand the following divisions of the nervous system
• What information would general somatic afferent fibres carry? Things like touch, pain, vibration,
temperature, pressure and proprioception
• What information would special somatic afferent fibres carry? Hearing, vision and balance.
Remember that the ears and eyes are outside the body so its somatic not visceral.
• What information would special visceral afferent fibres carry? Smell and taste. Remember the
tongue is inside the body therefore its visceral. Smell goes with taste.
• What information would general visceral afferent fibres carry? Stretch, pain, temperature,
chemical changes, visceral irritation, nausea and hunger.
• What information would general somatic efferent fibres carry? Motor innervation to all skeletal
muscles
• What information would general visceral motor fibres carry? Motor innervation to smooth muscle,
cardiac muscle and glands. Also known as the Autonomic nervous system!!!
• How many neurones are there in the brain? 100 billion
• How many genes are expressed in the nervous system? 25000 genes
• What is ‘plasticity’? It describes how experiences reorganises neural pathways within the brain. The
more plastic a neurone is the more it will change in its
environment. It is therefore linked to learning.
• What is a dendritic spine? A site of a single synapse on a
dendrite. A single dendrite will have many dendritic spines.
Each green bobble on the dendrite in the picture is a dendritic
spine where there is a synapse.
• What is diffuse tensor imaging? Functional mapping of the
brains white matter
• What are the basic functions of the following cells?
Marc Huttman 2
, Cell Diagram Function
Astrocytes 1) Provides blood brain barrier
2) Regulates blood flow and match it to the level
of activity of local neurones
3) Astrocytes cover synapses and regulate
transmission by removing neurotransmitters and
releasing neuromodulators
Oligodendrocytes Myelinates the axons of nerves in the CNS. It can
myelinate up to 50 axons at the same time.
Microglia The phagocytes of the CNS that clear up debris.
They also remove bits of neurone that aren’t
working properly or aren’t needed anymore –
‘housekeeping’
Ependymal cells These are ciliated and help to waft around CSF to
make sure it flows around. Ependymal cells in the
choroid plexus produce CSF.
Schwann cells Myelinates the axons of nerves in the PNS. It only
myelinates a single axon.
Satellite cells These sit on the cell bodies of peripheral neurone
cell bodies to provide them with nutrients and
protect them
• Describe the sequence of events of synaptic transmission.
1. Action potential occurs at axon terminal
2. Ca2+ channels open
3. Raised intracellular Ca2+ causes exocytosis of
neurotransmitter
4. Diffusion of neurotransmitter across synaptic cleft
which binds to receptor
5. Specific ion channels open due to binding
6. Postsynaptic potential generated:
i. If Na+ floods in you get depolarisation and an
excitatory post-synaptic potential
ii. If Cl- floods in you get hyperpolarisation and an
inhibitory post-synaptic potential
7. Local currents spread along cell membrane
• What is GABA? An inhibitory neurotransmitter that causes the
post-synaptic neurone to be inhibited. Hence, it causes influx
of Cl- at the post-synaptic membrane.
• What is glutamate? An excitatory neurotransmitter that
causes the post-synaptic neurone to be activated.
• What is Broca’s area? The region in the frontal lobe where you
generate speech
• What is Wernicke’s area? The region in the temporal lobe
where you interpret spoken language
Marc Huttman 3
, • What is Broca’s aphasia? Can’t speak. Damage to Broca’s area leads to an expressive aphasia where
you can’t speak because you physically can’t generate speech. You can still understand what is being
said to you though because Wernicke’s area is still intact.
• What is Wernicke’s aphasia? Can’t understand speech. Damage to Wernicke’s area leads to a
receptive aphasia where you cannot speak because you cannot understand what is being said to
you. You could still technically generate nonsensical speech because Broca’s area is still intact.
• What do we mean when we say language is lateralized? Language is controlled mainly in one
hemisphere of the brain. Most right handed people have their language centres in their left
hemispheres.
• What is a lesion? An abnormality in a tissue (extremely broad term)
• What’s the difference between a destructive or irritative lesion?
o Irritative lesion = A lesion that stimulates or excites activity in the part of the body where it is
situated. It causes seizures when they occur in the brain.
o Destructive lesion = a lesion that causes tissue damage and so destroys the functioning of that
tissue
• What is papilloedema? A non-inflammatory optic disc swelling due to
increased intracranial pressure. This can be visualised using fundoscopy.
• What fatal event might occur due to raised ICP? Herniation of the brainstem
through the foramen magnum
Lecture 2: Development and Organisation of the Nervous System
• How many cranial nerves are there? 12 pairs
• How many spinal nerves are there? 31 pairs (8C, 12T, 5L, 5S, 1C)
• What is the microstructure of a nerve? Epineurium à Perineurium à Endoneurium
• Where from the spinal cord do efferent motor fibres arise? Ventral (remember DAVE = dorsal
afferent ventral efferent)
Marc Huttman 4
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