Nervous System 1 (Viva)
Nervous System 1 (Viva)
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Central nervous system (CNS) includes the brain and spinal cord.
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Mesencephalon (midbrain)
Midbrain
Pons
Medulla oblongata
Neuron or nerve cell is defined as the structural and functional unit of the nervous system.
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Q.7 What are the important structures present in the nerve cell body of the neuron?
Nissl bodies are the small granules present throughout the soma of neuron and dendrites but
not in axon hillock and axon. These bodies are responsible for the tigroid or spotted
appearance of soma. Nissl bodies contain ribosomes and are concerned with the synthesis of
proteins in the neuron.
Dendrite – the short process that carries the impulses towards the cell body.
Axon – the long process that carries the impulses away from the cell body.
Each neuron has only one axon. The dendrite may be absent or present. If present, it may be
one or many in number.
The axoplasm and the axolemma that covers the axon are together called the axis cylinder.
Myelin sheath is not continuous around the axon and it is absent at regular intervals. The area
where the myelin sheath is absent is known as a node of Ranvier. The segment of axon
between the two nodes is called the internode.
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It is responsible for the faster rate of conduction of impulses through nerve fiber.
In myelinated nerve fiber, the impulses are conducted by means of saltatory
conduction
It has a high insulating capacity. Because of this it restricts the nerve impulse
within the single nerve fiber and prevents stimulation of neighboring nerve
fibers.
Schwann cells are a type of cells present in neurilemma close to axolemma. These cells are
responsible for the development of the myelin sheath.
Neurilemma (neurilemmal sheath or Schwann sheath) is the thin membrane that forms the
outermost covering of the nerve fibers. It contains Schwann cells and so it is essential for
myelinogenesis.
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Type A fibers are again divided into A alpha, A-beta, A gamma, and A-delta nerve
fibers.
Q.19 Name the nerve fibers conducting the impulse with maximum and minimum
velocity.
Type A alpha nerve fibers conduct the impulse with maximum velocity (70 to 120
meters/second).
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Type C fibers conduct the impulse with minimum velocity (0.5 to 2 meters/second).
Aδ Fiber C fibers
Excitability
Conductivity
Refractory period
Summation
Adaptation
Infatigability
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Q.22 What are the two types of potentials noticed in nerve fibers?
Action potential (nerve impulse) – produced when the nerve is stimulated with adequate
strength of stimulus (threshold or minimal stimulus). It is propagated and nongraded.
Electrotonic potential or local response – is produced when the strength of the stimulus is not
adequate (subthreshold or sub minimal stimulus). It is non-propagated and graded.
About – 70 mV
EPSP AP
Does not obey all or none law Obeys all or none law
Non-propagatory Propagatory
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It is non-propagatory in nature
It is monophasic
It does not obey all or none law.
Whereas if sub-minimal stimuli are repeated at short intervals in a single nerve, reflex action
can also be evoked which is known as temporal summation.
Direct stimulation of motor nerve results in more response than reflex response or in other
words the tension developed reflexly is always a fraction of the response that is produced by
direct motor nerve stimulation. This is known as fractionation phenomenon.
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Synapse permits the conduction of impulse from presynaptic to postsynaptic neurons only, i.e.
unidirectionally. This property is known as the law of forward conduction.
Q.30 Name the receptors responsible for following sensations—touch, pressure, hot,
cold, and pain.
Propagative
Biphasic
All or none law
No summation
Refractory period.
In a myelinated nerve fiber, the action potential (nerve impulse) jumps from one node of
Ranvier to another node of Ranvier, making the velocity of conduction faster. This type of
conduction in a myelinated nerve fiber is called saltatory conduction.
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Myelin sheath is not permeable to ions. So during the conduction of action potential, the entry
of sodium ions from extracellular fluid into nerve fiber occurs only at the node of Ranvier,
where the myelin sheath is absent. This causes depolarization only in successive node and not
in the internode. So, the action potential jumps from one node to another. Hence, it is called
saltatory conduction (saltare = jumping).
Nerve fiber is not fatigued because it can conduct only one action potential at a time. At that
time it is completely refractory and cannot conduct another action potential.
Q.35 What are the changes, which take place in the nerve cell body during the
degeneration of nerve fiber?
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Degenerative change in the distal cut end of the nerve fiber is called Wallerian degeneration.
Axis cylinder swells and breaks up into small pieces. After a few days, the debris is
seen in the space that was occupied by the axis cylinder
Myelin sheath disintegrates into fat droplets
Neurilemmal sheath is not affected but the cells of Schwann multiply rapidly. The
macrophages invade from outside and remove the debris of the axis cylinder and
fat droplets. So neurilemmal tube becomes empty and it is filled with cytoplasm
of Schwann cell.
The degenerative change that occurs at the proximal cut end of the nerve fiber is called
retrograde degeneration.
If an afferent nerve fiber is cut, the degeneration occurs in the neuron with which the afferent
nerve fiber synapses. This is called transneuronal degeneration.
Q.40 What are the criteria for the regeneration of nerve fiber?
The gap between the cut ends of the nerve fiber should not exceed 3 mm
Neurilemma should be present
Nucleus must be intact
The two cut ends should remain in the same line.
Q.41 Why regeneration does not occur in the central nervous system?
Neurilemma is necessary for regeneration. But neurilemma is absent in the central nervous
system, so regeneration can not take place.
Neuroglial cell, neuroglia or glia is the supporting cell of the nervous system.
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Astrocytes:
Microglia:
Oligodendrocytes:
Schwann cells:
Satellite cells:
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The receptor is an afferent nerve terminal, which receives the stimulus. It is defined as the
biological transducer that converts various forms of energy, i.e. stimulus into action potential
in nerve fiber.
Exteroceptors:
– Cutaneous receptors
– Chemoreceptors
– Telereceptors.
Interoceptors:
– Visceroreceptors
– Proprioceptors.
Receptors situated in the skin are called cutaneous receptors. The different cutaneous
receptors
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The receptors, which give response to stimuli arising away from the body are called
telereceptors.
Telereceptors are:
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Receptors situated in the viscera are called visceroreceptors. Stretch receptors, baroreceptors,
chemoreceptors, and osmoreceptors are the visceroreceptors. Visceroreceptors are situated in
the heart, blood vessels, lungs, gastrointestinal tract, urinary bladder, and brain.
Proprioceptors are the receptors, which give response to change in the position of different
parts of the body.
Specificity of response
Adaptation
Response to increase in strength of stimulus
Electrical property — receptor potential.
Each receptor gives a response to a particular type of stimulus. For example, the pain receptors
are stimulated by pain stimuli. This property of the receptor is called the Doctrine of specific
nerve energies or specificity of response.
When a receptor is continuously stimulated with the same strength of stimulus, after some
time receptor stops sending impulses through afferent nerve. This property is called
adaptation.
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Phasic receptors which get adapted rapidly. Touch and pressure receptors are
the phasic receptors
Tonic receptors, which adapt slowly. Pain receptors and muscle spindle are tonic
receptors.
Non-propagated
Monophasic
Does not obey all or none law.
The junction between two neurons is called a synapse. It is only a physiological continuity
between two nerve cells and not the anatomical continuation.
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Anatomical classification:
Synapse is divided into three types depending upon the axon ending:
– Axosomatic synapse
– Axodendritic synapse
– Axoaxonic synapse.
Functional classification:
Synapse is divided into two types depending upon the transmission of impulses:
– Electrical synapse
– Chemical synapse.
Axon of presynaptic neuron divides into many presynaptic terminals. This has a covering
membrane called the presynaptic membrane. The presynaptic terminal contains mitochondria
and the synaptic vesicles. Synaptic vesicles contain neurotransmitter substances. The
membrane of the postsynaptic neuron is called the postsynaptic membrane. It contains
receptor proteins. The space between the presynaptic and postsynaptic membrane is called the
synaptic cleft. The basal lamina of the synaptic cleft contains cholinesterase.
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The main function of the synapse is to transmit the impulses, i.e. action potential from one
neuron to another. However, some of the synapses inhibit the transmission of impulses. Thus,
synapses are of two types:
Chemical Electrical
When an action potential reaches the presynaptic axon terminal, voltage-gated calcium
channels at the presynaptic membrane open, and calcium ions enter the terminal. This causes
the release of acetylcholine from synaptic vesicles. Acetylcholine passes through the
presynaptic membrane and synaptic cleft and binds with receptor protein present on the
postsynaptic membrane. The acetylcholine receptor complex opens ligand-gated sodium
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channels so that, sodium ions enter the synapse, i.e. soma. This produces excitatory
postsynaptic potential (EPSP), which in turn causes the development of action potential in the
initial segment of the axon of postsynaptic neurons.
When an action potential reaches the presynaptic axon terminal, it causes the development of
a non-propagated electrical potential in the soma of postsynaptic neurons through
acetylcholine. This potential in the postsynaptic neuron is known as excitatory postsynaptic
potential (EPSP).
Nonpropagated
Monophasic
Does not obey all or none law.
EPSP causes the development of action potential in the initial segment of the axon of the
postsynaptic neurons. Actually, EPSP opens sodium channels in the initial segment of axon so
that sodium ions enter the axon from ECF resulting in the development of action potential.
The failure of the production of the action potential in the postsynaptic membrane because of
the release of an inhibitory neurotransmitter from the presynaptic terminal is called
postsynaptic inhibition.
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The inhibitory neurotransmitter released from the presynaptic axon terminal causes the
opening of potassium channels. This results in the efflux of potassium ions from the soma of
postsynaptic neurons and the development of hyperpolarization. This type of
hyperpolarization is called postsynaptic inhibitory potential (IPSP).
In some synapses, the action potential reaching the presynaptic axon terminal fails to release
neurotransmitters from the synaptic vesicles. So, the transmission of impulse is inhibited. This
is called presynaptic or direct inhibition.
This occurs in the spinal cord. Renshaw cell is a type of motor neuron situated near the alpha
motor neurons in the anterior gray horn. When alpha motor neuron of the spinal cord sends
motor impulses via anterior nerve root fibers, some of the impulses reach the Renshaw cell by
passing through collateral fibers. Renshaw cell in turn sends inhibitory impulses to alpha
motor neurons so that, the discharge from motor neurons is reduced.
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Synaptic inhibition offers restriction over the neurons and muscles so that the excess stimuli
are inhibited and the various movements are performed properly and accurately.
The impulses are transmitted only in one direction in the synapse, i.e. from presynaptic
neurons to postsynaptic neurons. This is called Bell-Magendie law.
The delay in the transmission of impulses through synapse is known as the synaptic delay.
Release of neurotransmitter
Movement of neurotransmitter from axon terminal to postsynaptic membrane
Opening of ionic channels in the postsynaptic membrane by the
neurotransmitter.
The frequency of action potential in a sensory nerve is directly proportional to the magnitude
of generator potential which in turn is directly proportional to the intensity of stimulus. This
relationship between the intensity of stimulus, the magnitude of GP, and the frequency of AP in
the afferent nerve is known as Weber Fechner law.
Sensation produced by impulses generated in a receptor depends on the specific part of the
brain, i.e. the specific pathways for specific sensation are separated from the nerve organs to
the cerebral cortex. This is known as Muller’s law.
No matter where a particular sensory pathways are stimulated along its course to the cortex,
the conscious sensation produced is referred to as the location of the receptor. This principle is
called as law of projection. A limb that has been lost by accident or amputation, the patient
usually experiences intolerable pain and proprioceptive sensations in the absent limb and is
called a phantom limb. Chemical and electrical synapses Chemical Electrical
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The anatomical neural pathway for a reflex action is called reflex arc.
Receptor
Afferent or sensory nerve
Center
Efferent or motor nerve
Effector organ.
Unconditioned reflexes which are present at the time of birth. These reflexes do not require
previous learning or training or conditioning but contact of a substance with the receptor is
essential. The best example is the secretion of saliva when an object is kept in the mouth
Conditioned reflexes which are acquired after birth. These reflexes require previous learning or
training or conditioning and contact of a substance with receptor is not necessary. The example
is the secretion of saliva by the sight, smell, thought, or hearing of a known edible substance.
Q.88 Classify the reflexes depending upon the situation of the center.
Cerebellar reflexes
Cortical reflexes
Midbrain reflexes
Bulbar or medullary reflexes
Spinal reflexes
Q.89 Classify the reflexes depending upon the purpose or functional significance.
Superficial reflexes, which are elicited from the surface of the body, i.e. from skin
(superficial cutaneous reflexes) and mucus membrane (superficial mucus
membrane reflexes)
Deep reflexes which arise from structure beneath the skin
Visceral reflexes which are elicited from organs in the viscera
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Pathological reflexes which are abnormal reflexes and can be elicited only in
diseased conditions.
Spatial summation: When two afferent nerve fibers supplying a skeletal muscle are stimulated
separately with subliminal stimulus, there is no response. But, if both nerve fibers are
stimulated together with the same strength of stimulus, the muscle contracts. This is called
spatial summation.
Temporal summation: When one nerve is stimulated repeatedly with subliminal stimuli, these
stimuli are summed up and cause contraction of the muscle. This is called temporal
summation.
94.What is occlusion?
In a muscle which is innervated by two motor nerves called A and B, when both nerves are
stimulated simultaneously, the tension developed by the muscle is less than the sum of the
tension developed when each nerve is stimulated separately. This type of response is called
occlusion.
For example, if nerve A is stimulated alone, the arbitrary unit of tension developed is 9. If nerve
B is stimulated the tension developed is 9 units. So, the sum of tension developed when nerves
A and B are separately stimulated = 9 + 9 = 18 units. But when, both A and B are stimulated
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together, the tension produced is (A+B) = 12 units only. This phenomenon is called occlusion
and it is due to the overlapping of the nerve fibers during the distribution.
In some reflexes which involve the muscle with two nerve fibers called A and B, the tension
developed by simultaneous stimulation of two nerve is greater than the sum of tension
produced by the stimulation of these nerves separately. For example, if nerve A or B is
stimulated alone, the arbitrary unit of tension developed by muscle = 3 units. So, the sum of
tension developed if nerves A and B are stimulated separately is 3+3 = 6 units. But, when both
the nerves are stimulated together, the tension developed = (A +B) = 12 units. So, the tension
here is greater than the sum of tension produced if A and B are separately stimulated. This
phenomenon is called subliminal fringe and it is due to the effect of spatial summation.
When an excitatory nerve is stimulated with stimuli of constant strength for a long time, there
is a progressive increase in the number of motor neurons activated. This phenomenon is called
recruitment. It is similar to the effect of temporal summation.
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If a reflex action is elicited continuously for some time, and then the stimulation is stopped, the
reflex activity i.e., contraction may continue for some time even after the stoppage of stimulus.
This is called after discharge. The center discharges impulses even after stoppage of stimulus.
This is because of internuncial neurons, which continue to transmit afferent impulses even
after the stoppage of stimulus.
The center or the synapse of the reflex arc is the first seat of fatigue.
When a flexor reflex is elicited in one limb, the flexor muscles of that limb are stimulated and
the extensor muscles are inhibited. But on the opposite limb, the flexors are inhibited and
extensors are excited. This is called crossed extensor reflex. It is due to reciprocal innervation.
Babinski’s sign is the abnormal plantar reflex. In normal plantar reflex, a gentle scratch over
the outer edge of the sole of the foot causes plantar flexion and adduction of all toes and
dorsiflexion and inversion of the foot. But in Babinski’s sign, there is dorsiflexion of the big toe
and fanning of other toes. It is common in infants due to the non-myelination of pyramidal
tracts. In normal persons, it can be elicited during deep sleep. The pathological condition when
it appears is upper motor lesion.
Clonus is a series of rapid and repeated jerky movements, which occur while eliciting a deep
reflex. In a normal deep reflex, the contractions of a muscle or group of muscles are smooth
and continuous. Clonus occurs when deep reflexes are exaggerated due to the hypertonicity of
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muscles in pyramidal tract lesions. Clonus is well seen in calf muscles producing ankle clonus
and quadriceps producing patella clonus.
While eliciting a tendon jerk, some slow oscillatory movements are developed instead of brisk
movements. These movements are called pendular movements and are common in the
cerebellar lesion.
Q.103 What are the eff ects of upper and lower motor neuron lesions on reflexes?
During the upper motor neuron lesion, all the superficial reflexes are lost. The deep reflexes
are exaggerated and the Babinski’s sign is positive. During lower motor neuron lesion, all the
superficial and deep reflexes are lost.
Cervical segments = 8
Thoracic segments = 12
Lumbar segments = 5
Sacral segments = 5
Coccygeal segment = 1
Q.105 What are the neurons present in the gray horn of the spinal cord?
Anterior gray horn consists of motor neurons. The posterior gray horn consists of sensory
neurons. The lateral gray horn contains intermediolateral horn cells, which give rise to
sympathetic preganglionic fibers.
Q.106 Name the types of neurons present in the anterior gray horn.
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Q.107 Name the types of neurons present in the posterior gray horn.
Anterior white column – between the anterior median fissure on one side and anterior nerve
root and anterior gray horn on the other side
Lateral white column – between the anterior nerve root and anterior gray horn on one side and
posterior nerve root and posterior gray horn on the other side
Posterior gray column – in between the posterior nerve root and posterior gray horn on one
side and posterior median septum on the other side.
– Association or intrinsic tracts which connect the adjacent segments of the spinal cord on the
same side
– Commissural tracts, which connect the opposite halves in the same segment of the spinal
cord.
Long tracts or projection tracts connecting the spinal cord with other parts of the central
nervous system:
– Ascending tracts which carry sensory impulses from the spinal cord to the brain
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– Descending tracts, which carry motor impulses from the brain to the spinal cord.
Q.111 Name the type of fibers forming ascending tracts of the spinal cord.
All ascending tracts of the spinal cord are formed by the fibers of second-order neurons
(crossed fibers) except posterior column tracts. The posterior column tracts are formed by the
fibers of first-order neurons (uncrossed fibers)
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Anterior spinothalamic tract carries crude touch (protopathic) sensation and the lateral
spinothalamic tract carries pain and temperature sensations.
Ventral and dorsal spinocerebellar tracts carry subconscious kinesthetic sensation to the
cerebellum.
Pyramidal tracts which give the appearance of a pyramid on the upper part of the
anterior surface of medulla oblongata while running from the cerebral cortex
towards the spinal cord
Extrapyramidal tracts, which are the descending tracts other than pyramidal
tracts.
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Primary motor areas and supplementary motor areas in the frontal lobe of the
cerebral cortex (30%)
Premotor area in frontal lobe (30%)
Parietal lobe particularly from somatosensory areas (40%).
After taking origin from the cerebral cortex, the fibers of pyramidal tracts descend down
through corona radiata, internal capsule, midbrain, and pons and enter the medulla. While
running down through the upper part of the anterior surface of the medulla, these fibers give
the appearance of a pyramid.
At the lower border of the medulla, 80% of fibers from each side cross to the opposite side
forming pyramidal decussation or motor decussation. After crossing, these fibers descend
through the lateral white column of the spinal cord as the lateral corticospinal tract. The
remaining 20% of the fibers descend down on the same side through the anterior white
column as the anterior corticospinal tract.
Pyramidal tracts are concerned with voluntary movements of the body and are responsible for
fine and skilled movements.
It causes:
Babinski’s sign.
Medial longitudinal fasciculus helps in the coordination of reflex ocular movements and the
integration of ocular and neck movements.
Vestibulospinal tracts are concerned with the adjustment of the position of head and body
during angular and linear acceleration.
The reticulospinal tract is concerned with the control of movements, maintenance of muscle
tone, respiration, and control of the diameter of blood vessels.
Q.127 What are the eff ects of the complete transection of the spinal cord?
Complete transection of the spinal cord causes immediate loss of sensation and voluntary
movements below the level of lesion.
During the stage of reflex activity after complete transection of the spinal cord, the tone returns
to flexor muscles first. And the limbs in this condition tend to adopt a position of
slight flexion. This type of paralysis is known as paraplegia in flexion.
Q.129 What are the eff ects of incomplete transection of the spinal cord?
The effects of incomplete transection of the spinal cord are similar to the effects of complete
transection except that, during the stage of reflex activity, the tone returns to extensor muscles
first.
During the stage of reflex activity after incomplete transection of the spinal cord, the tone
returns to extensor muscles first. The limbs in this condition tend to adopt a position of slight
extension. This is called paraplegia in extension.
The sensations carried by crossed spinothalamic tracts such as crude touch, pain, and
temperature sensations are not affected. The motor changes resemble the effects of upper
motor lesions.
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Q.134 What are the eff ects of hemisection of the spinal cord on the opposite side of
the body below the lesion?
The sensations carried by crossed spinothalamic tracts such as crude touch, pain, and
temperature sensations are lost. The sensations carried by uncrossed fibers of posterior
column tracts namely, fine touch sensation, tactile localization, tactile discrimination, sensation
of vibration, conscious kinesthetic sensation, and stereognosis are not affected. The motor
functions are not affected. If affected, it would be mild and the effects resemble the effects of
upper motor lesion.
Q.135 What are the eff ects of hemisection of the spinal cord on the same side of the
body at the level of the lesion?
There is complete anesthesia, i.e. all the sensations are lost. The motor changes resemble the
effects of lower motor lesions.
Q.136 What are the eff ects of hemisection of the spinal cord on the opposite side of
the body at the level of the lesion?
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The sensations carried by crossed spinothalamic tracts such as crude touch, pain, and
temperature sensations are lost. The sensations carried by uncrossed fibers of posterior
column tracts namely, fine touch sensation, tactile localization, tactile discrimination, sensation
of vibration, conscious kinesthetic sensation, and stereognosis are not affected. The motor
functions are not affected. If affected, it would be mild and the effects resemble the effects of
lower motor lesion.
In the case of syringomyelia, there is loss of pain and temperature sensation whereas the sense
of touch is unaffected. This condition is known as dissociated anesthesia.
Tabes dorsalis is a disease of the spinal cord. It occurs due to the degeneration of dorsal nerve
roots. Degeneration of dorsal nerve roots is common in syphilis.
The characteristic feature of tabes dorsalis is the slow progressive nervous disorder affecting
the motor and sensory functions of the spinal cord.
• Somatic sensations:
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– Deep sensations.
• Special sensations:
– Visual sensation
– Auditory sensation
Pressure sensation
Pain sensation
Temperature sensation with a wider range.
Q.145 How are the sensations from the face transmitted to the brain?
Through the ophthalmic, maxillary, and mandibular divisions of the trigeminal nerve.
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The somatosensory system is the sensory system involving the pathways, which convey the
information from the sensory receptors present in the skin, skeletal muscles, and joints.
Receptor
First-order neurons
Second-order neurons
Third-order neurons in some cases
Center in the brain.
General anesthesia: Loss of all sensations with loss of consciousness produced by anesthetic
agents.
The prominent bundles of sensory nerve fibers in the brain are called lemnisci.
Different lemnisci:
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Lateral lemniscus formed by fibers carrying the sensation of hearing from cochlear
nuclei to the inferior colliculus and medial geniculate body
The lateral motor system is the part of the motor system formed by the motor nerve fibers,
which terminate on motor neurons situated in the lateral part of the ventral gray horn in the
spinal cord and also on the corresponding motor neurons of cranial nerve nuclei in the
brainstem.
It includes:
Lateral corticospinal tract activates the muscles in the distal portions of the limbs
and skilled voluntary movements
Rubrospinal tract facilitates the tone of flexor muscles
Corticobulbar tracts are concerned with the movements of expression in the
lower part of the face and movements of the tongue.
The medial motor system is the part of the motor system formed by the motor nerve fibers
which terminate on the motor neurons situated in the medial part of the ventral gray horn of
the spinal cord and on the corresponding motor neurons of cranial nerve nuclei in the
brainstem.
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It includes:
The neurons in the higher center of the brain, which control the lower motor neurons are
called upper motor neurons.
Lower neurons are the anterior horns cells in the spinal cord and motor neurons of the cranial
nerve nuclei situated in the brainstem, which innervate the skeletal muscles directly. These
neurons constitute the ‘Final common pathway” of the motor system. The lower motor
neurons are the alpha motor neurons in the anterior horns of the spinal cord and the cells of
nuclei of III, IV, V, VI, VII, IX, X, XI, and XII cranial nerve.
Q.156 What are the eff ects of upper motor neuron lesions?
Hypertonia
Spastic paralysis of muscles without wastage
Loss of superficial reflex
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Q.157 What are the eff ects of lower motor neuron lesion?
Hypotonia
Flaccid paralysis with wastage of muscles
Loss of all reflexes
Q.158 What are the main diff erences between upper and lower motor neuron lesions?
LMNL UMNL
All reflexes are absent as Deep reflexes are hyperactive due increased g motor
the motor pathway is activity and some superficial reflexes like abdominal,
damaged cremasteric reflexes are lost.
Fast pain: Whenever pain stimulus is applied, a fast, bright, sharp, and localized
pain sensation is produced. This is called fast pain
The fast pain sensation is followed by a dull, diffused, and unpleasant pain called
slow pain.
Fast pain is transmitted by type A delta afferent fibers and slow pain is transmitted by type C
fibers.
Ischemia
Chemical stimuli
Spasm of hollow organs
Over distension of hollow organs.
The pain sensation, produced in some parts of the body is felt in other structures away from
the place of development. This is called referred pain.
Cardiac pain referred to the inner part of the left arm and shoulder
Pain in the ovary referred to umbilicus
Pain in testis referred to abdomen
Pain in the diaphragm referred to right shoulder
Pain in gallbladder referred to epigastric region
Renal pain referred to loin.
Substance P
The pain control system of the central nervous system is called the analgesia system. It inhibits
the impulses of pain sensation.
Q.166 What are the pain control systems in the brain and spinal cord?
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The pain control system in the brain is present in gray matter surrounding the aqueduct of
Sylvius and raphe Magnus nuclei in the pons. In the spinal cord, the pain control system is in
the posterior gray horn which is considered as a gateway for pain impulses.
When pain sensation is produced in any part of the body, along with pain fibers, some of the
other afferent fibers particularly the touch fibers reaching the posterior column of the spinal
cord are also activated. The posterior column of the spinal cord sends collaterals to cells of
substantia gelatinosa in the posterior gray horn. Thus, some of the impulses ascending via
posterior column fibers pass through the collaterals and reach substantia gelatinosa. Here, the
impulses inhibit the release of substance P by pain fibers, and pain sensation is suppressed.
Thus, there is a gating of pain in the posterior gray horn level.
Respiratory centers
Vasomotor center
Deglutition center
Vomiting center
Superior and inferior salivatory nuclei
Nuclei of 12th, 11th, 8th, and 5th cranial nerves
Vestibular nuclei.
The red nucleus is a large oval or round mass of gray matter between the superior colliculus
and the hypothalamus.
It controls:
Muscle tone
Complex muscular movements
Righting reflexes
Eyeball movements
Skilled movements.
Midline nuclei
Infralaminar nuclei
Medial mass nuclei
Lateral mass nuclei
Posterior group nuclei.
Thalamus form:
The signs and symptoms that occur during thalamic lesion are together called thalamic
syndrome. The features are:
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Thalamic lesion occurs mostly because of the blockage of thalamogeniculate branch of the
posterior cerebral artery by thrombosis.
Rapid alternate rhythmic and involuntary movement of flexion and extension in the joints of
fingers and wrist or elbow is called tremor. In thalamic syndrome, intension tremor (tremor
while attempting to do any voluntary act) occurs.
The internal capsule is the compact band of afferent and efferent fibers connecting the cerebral
cortex with the brainstem and spinal cord. It is situated in between the thalamus and caudate
nucleus on the medial side and lenticular nucleus on the lateral side.
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Q.180 What is the role of hypothalamic centers for regulation of body temperature?
Q.181 What is the role of the hypothalamus in the regulation of food intake?
Hypothalamus has two centers to regulate the food intake, the feeding center, and satiety
center. Normally, the feeding center is active and it is controlled by the satiety center.
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Q.182 Name the mechanisms involved in the regulation of appetite and food intake.
Glucostatic mechanism
Lypostatic mechanism
Peptide mechanism
Hormonal mechanism
Thermostatic mechanism.
Q.183 What is the role of the hypothalamus in the regulation of water balance?
By thirst mechanism - when body water reduces the thirst center in the
hypothalamus is stimulated leading to water intake
When body water reduces, the osmolarity of body fluids increases. This, in turn,
stimulates ADH secretion from the hypothalamus. ADH increases the
reabsorption of water from renal tubules.
Q.184 Name the hypothalamic centers concerned with behavior and emotional
changes.
Reward center
Punishment center.
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Diabetes insipidus.
Dystrophia adiposogenitalis.
Laurence-Biedl-Moon syndrome
Narcolepsy
Cataplexy.
Diabetes insipidus is the disease characterized by excretion of large quantity of dilute urine. It
is due to the failure of water reabsorption from renal tubules. It occurs due to deficiency or
absence of ADH because of tumor of the hypothalamus.
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