Demyelinating disease

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The central nervous system (CNS) represents the largest part of the nervous system, including the brain and the spinal cord. Together with the peripheral nervous system, it has a fundamental role in the control of behavior. The CNS is contained within the dorsal cavity, with the brain within the cranial subcavity, and the spinal cord in the spinal cavity. The CNS is covered by the meninges. The brain is also protected by the skull, and the spinal cord is also protected by the vertebrae.

Since the strong theoretical influence of cybernetics in the fifties, the CNS is conceived as a system devoted to information processing, where an appropriate motor output is computed as a response to a sensory input. Yet, many threads of research suggest that motor activity exists well before the maturation of the sensory systems and then, that the senses only influence behavior without dictating it. This has brought the conception of the CNS as an autonomous system.

In the developing fetus, the CNS originates from the neural plate, a specialised region of the ectoderm, the most external of the three embryonic layers. During embryonic development, the neural plate folds and forms the neural tube. The internal cavity of the neural tube will give rise to the ventricular system. The regions of the neural tube will differentiate progressively into transversal systems. First, the whole neural tube will differentiate into its two major subdivisions: brain (rostral/cephalic) and spinal cord (caudal). Consecutively, the brain will differentiate into prosencephalon and brainstem. Later, the prosencephalon will subdivide into telencephalon and diencephalon, and the brainstem into mesencephalon and rhombencephalon.

The telencephalon gives rise to the striatum (caudate nucleus and putamen), the hippocampus and the neocortex, its cavity becomes the lateral (first and second) ventricles. The diencephalon give rise to the subthalamus, hypothalamus, thalamus and epithalamus, its cavity to the third ventricle. The mesencephalon gives rise to the tectum, pretectum, cerebral peduncle and its cavity develops into the mesencephalic duct or cerebral aqueduct. Finally, the rhombencephalon gives rise to the pons, the cerebellum and the medulla oblongata, its cavity becomes the fourth ventricle.

The basic pattern of the CNS is highly conserved throughout the different species of vertebrates and during evolution. The major trend that can be observed is towards a progressive telencephalisation: while in the reptilian brain that region is only an appendix to the large olfactory bulb, it represent most of the volume of the mammalian CNS. In the human brain, the telencephalon covers most of the diencephalon and the mesencephalon. Indeed, the allometric study of brain size among different species shows a striking continuity from rats to whales, and allows us to complete the knowledge about the evolution of the CNS obtained through cranial endocasts.

• Glossary of anatomical terminology, definitions and abbreviations
• List of regions in the human brain
• Central nervous system infection
• Neuroradiology
• Encephalization
• Neocortex
• Archicortex

• Sylvius: 400+ structure neuroanatomical visual glossary
• High-Resolution Cytoarchitectural Primate Brain Atlases
• Human Brains: A Learning Tool.
• Explaining the human nervous system.
• Nervous System – Back Pain – Anatomy (info on nerve pairs).
• Textbook in Medical Physiology And Pathophysiology, many links
• Brain and Cranial Nerves, Anatomy and Physiology Lecture, Northland Community College
• Latest Research on the Brain and Central Nervous System From ScienceDaily

Template:Nervous system

ar:جهاز عصبي مركزي ast:Sistema nerviosu central ca:Sistema nerviós central cs:Centrální nervová soustava da:Centralnervesystemet de:Zentralnervensystem io:Centrala nervaro is:Miðtaugakerfið it:Sistema nervoso centrale he:מערכת העצבים המרכזית lt:Centrinė nervų sistema mk:Централен нервен систем nl:Centraal zenuwstelsel no:Sentralnervesystemet simple:Central nervous system sk:Centrálna nervová sústava sl:Osrednje živčevje sr:Централни нервни систем fi:Keskushermosto sv:Centrala nervsystemet uk:Центральна нервова система

Template:WikiDoc Sources

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The peripheral nervous system (PNS) can be divided into the somatic nervous system and the autonomic nervous system (ANS). The PNS is not protected by bone, leaving it exposed to injury, unlike the central nervous system, which is made of the brain and spinal cord, to serve the limbs and organs. ^[1]

The peripheral nervous system can be classified either by direction of neurons or by function.

There are three types of directions of the neurons:

• Sensory system by sensory neurons,between the sensory and motor neurones. However, there are relay neurons in the CNS as well.

By function, the peripheral nervous system is divided into the somatic nervous system , autonomic nervous system and the enteric nervous system. The somatic nervous system is responsible for coordinating the body movements, and also for receiving external stimuli. It is the system that regulates activities that are under conscious control. The autonomic nervous system is then split into the sympathetic division, parasympathetic division, and enteric division. The sympathetic nervous system responds to impending danger or stress, and is responsible for the increase of one’s heartbeat and blood pressure, among other physiological changes, along with the sense of excitement one feels due to the increase of adrenaline in the system. The parasympathetic nervous system, on the other hand, is evident when a person is resting and feels relaxed, and is responsible for such things as the constriction of the pupil, the slowing of the heart, the dilation of the blood vessels, and the stimulation of the digestive and genitourinary systems. The role of the enteric nervous system is to manage every aspect of digestion, from the esophagus to the stomach, small intestine and colon.

Ten out of the twelve cranial nerves originate from the brainstem, and mainly control the functions of the anatomic structures of the head with some exceptions. The nuclei of cranial nerves I and II lie in the forebrain and thalamus, respectively, and are thus not considered to be true cranial nerves. CN X (10) receives visceral sensory information from the thorax and abdomen, and CN XI (11) is responsible for innervating the sternocleidomastoid and trapezius muscles, neither of which is exclusively in the head.

Spinal nerves take their origins from the spinal cord. They control the functions of the rest of the body. In humans, there are 31 pairs of spinal nerves: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal. The naming convention for spinal nerves is to name it after the vertebra immediately above it. Thus the fourth thoracic nerve originates just below the fourth thoracic vertebra. This convention breaks down in the cervical spine. The first spinal nerve originates above the first cervical vertebra and is called C1. This continues down to the last cervical spinal nerve, C8. There are only 7 cervical vertebrae and 8 cervical spinal nerves.

The first 4 cervical spinal nerves, C1 through C4, split and recombine to produce a variety of nerves that subserve the neck and back of head.

Spinal nerve C1 is called the suboccipital nerve which provides motor innervation to muscles at the base of the skull. C2 and C3 form many of the nerves of the neck, providing both sensory and motor control. These include the greater occipital nerve which provides sensation to the back of the head, the lesser occipital nerve which provides sensation to the area behind the ears, the greater auricular nerve and the lesser auricular nerve. See occipital neuralgia. The phrenic nerve arises from nerve roots C3, C4 and C5. It innervates the diaphragm, enabling breathing. If the spinal cord is transected above C3, then spontaneous breathing is not possible. See myelopathy

The last four cervical spinal nerves, C5 through C8, and the first thoracic spinal nerve, T1,combine to form the brachial plexus, or plexus brachialis, a tangled array of nerves, splitting, combining and recombining, to form the nerves that subserve the arm and upper back. Although the brachial plexus may appear tangled, it is highly organized and predictable, with little variation between people. See brachial plexus injuries

The first nerve off the brachial plexus, or plexus brachialis, is the dorsal scapular nerve, arising from C5 nerve root, and innervating the rhomboids and the levator scapulae muscles. The long thoracic nerve arises from C5, C6 and C7 to innervate the serratus anterior. The brachial plexus first forms three trunks, the superior trunk, composed of the C5 and C6 nerve roots, the middle trunk, made of the C7 nerve root, and the inferior trunk, made of the C8 and T1 nerve roots. The suprascapular nerve is an early branch of the superior trunk. It innervates the suprascapular and infrascapular muscles, part of the rotator cuff. The trunks reshuffle as they traverse towards the arm into cords. There are three of them. The lateral cord is made up of fibers from the superior and middle trunk. The posterior cord is made up of fibers from all three trunks. The medial cord is composed of fibers solely from the medial trunk.

The lateral cord gives rise to the following nerves:

• The lateral pectoral nerve, C5, C6 and C7 to the pectoralis major muscle, or musculus pectoralis major.
• The musculocutaneous nerve which innervates the biceps muscle
• The median nerve, partly. The other part comes from the medial cord. See below for details.

The posterior cord gives rise to the following nerves:

• The upper subscapular nerve, C7 and C8, to the subscapularis muscle, or musculus supca of the rotator cuff.
• The lower subscapular nerve, C5 and C6, to the teres major muscle, or the musculus teres major.
• The thoracodorsal nerve, C6, C7 and C8, to the latissimus dorsi muscle, or musculus latissimus dorsi.
• The axillary nerve, which supplies sensation to the shoulder and motor to the deltoid muscle or musculus deltoideus, and the teres minor muscle, or musculus teres minor, also of the rotator cuff.
• The radial nerve, or nervus radialis, which innervates the triceps brachii muscle, the brachioradialis muscle, or musculus brachioradialis,, the extensor muscles of the fingers and wrist (extensor carpi radialis muscle), and the extensor and abductor muscles of the thumb. See radial nerve injuries.

The medial cord gives rise to the following nerves:

• The median pectoral nerve, C8 and T1, to the pectoralis muscle
• The medial brachial cutaneous nerve, T1
• The medial antebrachial cutaneous nerve, C8 and T1
• The median nerve, partly. The other part comes from the lateral cord. C7, C8 and T1 nerve roots. The first branch of the median nerve is to the pronator teres muscle, then the flexor carpi radialis, the palmaris longus and the flexor digitorum superficialis. The median nerve provides sensation to the anterior palm, the anterior thumb, index finger and middle finger. It is the nerve compressed in carpal tunnel syndrome.
• The ulnar nerve originates in nerve roots C7, C8 and T1. It provides sensation to the ring and pinky fingers. It innervates the flexor carpi ulnaris muscle, the flexor digitorum profundus muscle to the ring and pinky fingers, and the intrinsic muscles of the hand (the interosseous muscle, the lumbrical muscles and the flexor pollicus brevis muscle). This nerve traverses a groove on the elbow called the cubital tunnel, also known as the funny bone. Striking the nerve at this point produces an unpleasant sensation in the ring and little finger.

The main neurotransmitters of the peripheral nervous system are acetylcholine and noradrenaline. However, there are several other neurotransmitters as well, jointly labeled Non-noradrenergic, non-cholinergic (NANC) transmitters. Examples of such transmitters include non-peptides: ATP, GABA, dopamine, NO, and peptides: neuropeptide Y, VIP, GnRH, Substance P and CGRP. ^[2]

Template:Nervous system

bs:Periferni nervni sistem ca:Sistema nerviós perifèric de:Peripheres Nervensystem dv:ޕެރިފެރަލް ނާރވަސް ސިސްޓަމް id:Sistem saraf tepi is:Úttaugakerfið it:Sistema nervoso periferico he:מערכת העצבים ההיקפית lt:Periferinė nervų sistema mk:Периферен нервен систем nl:Perifeer zenuwstelsel no:Det perifere nervesystemet simple:Peripheral nervous system sl:Obkrajno živčevje sr:Периферни нервни систем fi:Ääreishermosto sv:Perifera nervsystemet ur:ملحقہ عصبی نظام

Template:WH Template:WS