15436970 TB Meningitis Draft Copy NCM102 Grand Case

7/31/2019 15436970 TB Meningitis Draft Copy NCM102 Grand Case

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University of Perpetual HelpDr. Jose G. Tamayo Medical University

Sto. Nio, ian !a"una

College of Nursing

#ase StudyT Menin"itis

Presented y$%&rea, Jemima' !.%"uilar, %drian %.

%lmenan(a, #at'erine !.%ma"o, Joanna Marie .

alana", )llen M.elencion, Ma. Melanie !.

#alumno, Ma. Jocine Mei %.#astro, Dar*in +.

#oronado, ainiair %.#orpu(, Janesan P.

#ui(on, Jo'n Ni--i D.Dayrit, Janine ristine P.

BSN3C Group9

Presented to$Mrs. Gina S. anieses

S!H / #linical 0nstructor

February 14, 2009


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CONTENTS

Introduction..

Patient Pro!i"e.

#nato$y and P%yio"o&y..

Pat%o'%yio"o&y..

(edica" (ana&e$ent..

)aboratory *eu"t.

+ru& Study

Nurin& Care P"an


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INTRODUCTION


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Tubercu"ou $enin&iti i a"o no-n a T $enin&iti or tubercu"ar $enin&iti. Tubercu"ou

$enin&iti i (ycobacteriu$ tubercu"oi in!ection o! t%e $enin&e/t%e yte$ o! $e$brane

-%ic% ene"o' t%e centra" nerou yte$. It i t%e $ot co$$on !or$ o! CNS tubercu"oi.Feer and %eadac%e are t%e cardina" !eature. Con!uion i a "ate !eature and co$a bear a 'oor

'ro&noi. (enin&i$ i abent in a !i!t% o! 'atient -it% T $enin&iti. Patient $ay a"o %ae

!oca" neuro"o&ica" de!icit.

Caue are Tenion %eadac%e are due to contraction ti&%tne o! t%e $uc"e in your %ou"der,

nec, ca"', and 3a-. T%ey are o!ten re"ated to tre, de'reion, or aniety. Oer-orin&, not&ettin& enou&% "ee', $iin& $ea", and uin& a"co%o" or treet dru& can $ae you $ore

uce'tib"e to %eadac%e. Food t%at can tri&&er a %eadac%e inc"ude c%oco"ate, c%eee, and

$onoodiu$ &"uta$ate (S5, a !"aor en%ancer. Peo'"e -%o drin ca!!eine can %ae

%eadac%e -%en t%ey don6t &et t%eir uua" dai"y a$ount.

(ycobacteriu$ tubercu"oi o! t%e $enin&e i t%e cardina" !eature and t%e in!"a$$ation i

concentrated to-ard t%e bae o! t%e brain. In!ection be&in in t%e "un& and $ay 'read to t%e

$enin&e by a ariety o! route.

T%e i&n and y$'to$ are7 !eer, ei8ure, ret"ene, "o o! a''etite, eere %eadac%e,nauea and o$itin&, ti!! nec, enitiity to "i&%t '%oto'%obia and "o o! concioune.

"oodborne 'read certain"y occur and 2:; o! 'atient -it% $i"iary T %ae T $enin&iti,

'reu$ab"y by croin& t%e b"oodbrain barrier< but a 'ro'ortion o! 'atient $ay &et T$enin&iti !ro$ ru'ture o! a cortica" !ocu in t%e brain< an een $a""er 'ro'ortion &et it !ro$

ru'ture o! a bony !ocu in t%e 'ine. It i rare and unuua" !or T o! t%e 'ine to caue T o! t%e

centra" nerou yte$, but io"ated cae %ae been decribed. +ia&noi o! T $enin&iti i

$ade by ana"y8in& CSF co""ected by "u$bar 'uncture. =%en co""ectin& CSF !or u'ected T$enin&iti, a $ini$u$ o! 1$" o! !"uid %ou"d be taen 're!erab"y : to 10$".T%e CSF uua""y

%a a %i&% 'rotein, "o- &"ucoe and a raied nu$ber o! "y$'%ocyte. #cid!at baci""i are

o$eti$e een on a CSF $ear, but $ore co$$on"y, (. tubercu"oi i &ro-n in cu"ture. #'ider -eb c"ot in t%e co""ected CSF i c%aracteritic o! T $enin&iti, but i a rare !indin&.

(ore t%an %a"! o! cae o! T $enin&iti cannot be con!ir$ed $icrobio"o&ica""y, and t%ee

'atient are treated on t%e bai o! c"inica" u'icion on"y. T%e cu"ture o! T !ro$ CSF tae a$ini$u$ o! t-o -ee, and t%ere!ore t%e $a3ority o! 'atient -it% T $enin&iti are tarted on

treat$ent be!ore t%e dia&noi i con!ir$ed.

I$a&in& tudie uc% a CT or (*I $ay %o- !eature tron&"y u&&etie o! T $enin&iti, butcannot dia&noe it.

T%e treat$ent o! T $enin&iti i ionia8id, ri!a$'icin, 'yra8ina$ide and et%a$buto" !or t-o$ont%, !o""o-ed by ionia8id and ri!a$'icin a"one !or a !urt%er ten $ont%. Steroid are a"-ay

ued in t%e !irt i -ee o! treat$ent and o$eti$e !or "on&er. # !e- 'atient $ay re>uire

i$$uno$odu"atory a&ent uc% a t%a"ido$ide. Treat$ent $ut be tarted a oon a t%ere i areaonab"e u'icion o! t%e dia&noi. Treat$ent $ut not be de"ayed -%i"e -aitin& !or

con!ir$ation o! t%e dia&noi. ?ydroce'%a"u occur a a co$'"ication in about a t%ird o!

'atient -it% T $enin&iti and -i"" re>uire a entricu"ar %unt.


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PATIENTS PROFILE


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IE7 Gnre$arab"e

Etre$itie7 no atro'%y noted

Neuro7

o H nec ri&idity

o H brud8ini i&n

o H erni& i&no babini re!"e

Mita" Si&n7

o P 90J0

o P*J

o **1B

o T@B OC

#d$ittin& I$'reion7 T (enin&iti tc ty'%oid !eerFina" +ia&noi7 T (enin&iti

F#(I) ?ISTO*

F#T?E* (OT?E* +I#ETES

?PE*TENSION

#ST?(# PT H

T%e 'atient %ad no !a$i"y %itory o! diabete, %y'ertenion, a -e"" a re'iratory dieaeuc% a at%$a but %ad !a$i"y %itory o! PT on $ot%er ide.


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ANATOMYAND

PHYSIOLOGY


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Central Nervous Syste

T%e centra" nerou yte$ CNS i t%e "ar&et 'art o! t%e nerou yte$, and inc"ude

t%e brain and 'ina" cord. T%e 'ina" caity %o"d and 'rotect t%e 'ina" cord, -%i"e t%e %eadcontain and 'rotect t%e brain. T%e CNS i coered by t%e $enin&e, a t%ree "ayered 'rotectie

coat. T%e brain i a"o 'rotected by t%e u"", and t%e 'ina" cord i a"o 'rotected by t%e

ertebrae.

T%e !entral nervous syste CNS i t%e 'art o! t%e nerou yte$ t%at !unction tocoordinate t%e actiity o! a"" 'art o! t%e bodie o! $u"tice""u"ar or&ani$. In ertebrate, t%e

centra" nerou yte$ i enc"oed in t%e $enin&e. T%e en"n#es in&u"ar en"n$ i t%e

yte$ o! $e$brane -%ic% ene"o' t%e centra" nerou yte$. T%e $enin&e conit o! t%ree"ayer7 t%e dura $ater, t%e arac%noid $ater, and t%e 'ia $ater. T%e 'ri$ary !unction o! t%e

$enin&e and o! t%e cerebro'ina" !"uid i to 'rotect t%e centra" nerou yte$. It contain t%e

$a3ority o! t%e nerou yte$ and conit o! t%e brain in ertebrate -%ic% %ae t%e$, andt%e 'ina" cord.


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T%e $enin&e in&u"ar $enin i t%e yte$ o! $e$brane -%ic% ene"o' t%e centra"

nerou yte$. T%e $enin&e conit o! t%ree "ayer7 t%e dura$ater, t%e arac%noid$ater, andt%e 'ia$ater. T%e 'ri$ary !unction o! t%e $enin&e and o! t%e cerebro'ina" !"uid i to 'rotect

t%e centra" nerou yte$. T%e 'ace bet-een t%ee $e$brane i bat%ed -it% a 'ina" !"uid$uc% "ie "y$'%, -%ic% ere a a 'rotectie cu%ion !or t%e de"icate nere tiue, and a""o-

o$e e'anion 'ace !or t%e brain -%en it b"ood u''"y i increaed.

@ "ayer o! $enin&e7

Dura ater a"o rare"y ca""ed $enin !ibroa, or 'ac%y$enin i a t%ic, durab"e

$e$brane, c"oet to t%e u"". It conit o! t-o "ayer, t%e 'eriotea" "ayer, c"oet to t%e

ca"aria and t%e inner $enin&ea" "ayer. It contain "ar&er b"ood ee" -%ic% '"it into t%e

ca'i""iarie in t%e 'ia $ater. It i co$'oed o! dene !ibrou tiue, and it inner ur!ace i


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coered by !"attened ce"" "ie t%oe 'reent on t%e ur!ace o! t%e 'ia $ater and arac%noid.

T%e dura $ater i a ac -%ic% ene"o' t%e arac%noid and %a been $odi!ied to ere

eera" !unction. T%e dura $ater urround and u''ort t%e "ar&e enou c%anne" dura"inue carryin& b"ood !ro$ t%e brain to-ard t%e %eart.

T%e %al$ !ere&r" e'arate t%e %e$i'%ere o! t%e cerebru$. T%e !a" cerebe""i e'arate t%e"obe o! t%e cerebe""u$.

T%e tentor"u !ere&ell"e'arate t%e cerebru$ !ro$ t%e cerebe""u$.

T%e e'"(ural s'a!e i a 'otentia" 'ace bet-een t%e dura $ater and t%e u"". I! t%ere i

%e$orr%a&in& in t%e brain, b"ood $ay co""ect %ere. #du"t are $ore "ie"y t%an c%i"dren to b"eed

%ere a a reu"t o! c"oed %ead in3ury.

T%e su&(ural s'a!ei anot%er 'otentia" 'ace)It i bet-een t%e dura $ater and t%e $idd"e "ayer

o! t%e $enin&e, t%e arac%noid $ater. =%en b"eedin& occur in t%e craniu$, b"ood $ay co""ect

%ere and 'u% do-n on t%e "o-er "ayer o! t%e $enin&e. I! b"eedin& continue, brain da$a&e-i"" reu"t !ro$ t%i 'reure. C%i"dren are e'ecia""y "ie"y to %ae b"eedin& in t%e ubdura"

'ace in cae o! %ead in3ury.

Ara!*no"( ater + T%e $idd"e e"e$ent o! t%e $enin&e i t%e arac%noid $e$brane, o

na$ed becaue o! it 'ider -eb"ie a''earance. It 'roide a cu%ionin& e!!ect !or t%ecentra" nerou yte$. T%e arac%noid $ater eit a a t%in, tran'arent $e$brane. It i

co$'oed o! !ibrou tiue and, "ie t%e 'ia $ater, i coered by !"at ce"" a"o t%ou&%t to

be i$'er$eab"e to !"uid. T%e arac%noid doe not !o""o- t%e cono"ution o! t%e ur!ace o!

t%e brain and o "oo "ie a "ooe"y !ittin& ac. In t%e re&ion o! t%e brain, 'articu"ar"y, a"ar&e nu$ber o! !ine !i"a$ent ca""ed arac%noid trabecu"ae 'a !ro$ t%e arac%noid t%rou&%

t%e ubarac%noid 'ace to b"end -it% t%e tiue o! t%e 'ia $ater.

T%e arac%noid and 'ia $ater are o$eti$e to&et%er ca""ed t%e leptomeninges.

T%e su&ara!*ano"( s'a!e "ie bet-een t%e arac%noid and 'ia $ater. It i !i""ed -it%cerebro'ina" !"uid. #"" b"ood ee" enterin& t%e brain, a -e"" a crania" nere 'a t%rou&%

t%i 'ace. T%e ter$ arac%noid re!er to t%e 'ider -eb "ie a''earance o! t%e b"ood ee"

-it%in t%e 'ace.

P"a ater + T%e 'ia or 'ia $ater i a ery de"icate $e$brane. It i t%e $enin&ea" ene"o'e

-%ic% !ir$"y ad%ere to t%e ur!ace o! t%e brain and 'ina" cord. # uc% it !o""o- a"" t%e

$inor contour o! t%e brain &yri and u"ci. It i a ery t%in $e$brane co$'oed o!!ibrou tiue coered on it outer ur!ace by a %eet o! !"at ce"" t%ou&%t to bei$'er$eab"e to !"uid. T%e 'ia $ater i 'ierced by b"ood ee" -%ic% trae" to t%e brain

and 'ina" cord, and it ca'i""arie are re'onib"e !or nouri%in& t%e brain.

Cere&ros'"nal %lu"( i a c"ear "i>uid 'roduced -it%in 'ace in t%e brain ca""ed entric"e.

)ie a"ia it i a !i"trate o! b"ood. It i a"o !ound inide t%e ubarac%noid 'ace o! t%e $enin&e

-%ic% urround bot% t%e brain and t%e 'ina" c%ord. In addition, a 'ace inide t%e 'ina" c%ord


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ca""ed t%e centra" cana" a"o contain cerebro'ina" !"uid. It act a a cu%ion !or t%e neurai,

a"o brin&in& nutrient to t%e brain and 'ina" cord and re$oin& -ate !ro$ t%e yte$.

Choroid Plexus

#"" o! t%e entric"e contain c%oroid '"eue -%ic% 'roduce cerebro'ina" !"uid by a""o-in&

certain co$'onent o! b"ood to enter t%e entric"e. T%e c%oroid '"eue are !or$ed by t%e!uion o! t%e 'ia $ater, t%e $ot interna" "ayer o! t%e $enin&e and t%e e'endy$a, t%e "inin& o!

t%e entric"e.

The Ventricles

T%ee !our 'ace are !i""ed -it% cerebro'ina" !"uid and 'rotect t%e brain by cu%ionin& it and

u''ortin& it -ei&%t.

T%e t,o lateral ventr"!lesetend acro a "ar&e area o! t%e brain. T%e anterior %orn o! t%ee

tructure are "ocated in t%e !ronta" "obe. T%ey etend 'oterior"y into t%e 'arieta" "obe and t%eir

in!erior %orn are !ound in t%e te$'ora" "obe.

T%e t*"r( ventr"!le"ie bet-een t%e t-o t%a"a$ic bodie. T%e $aa inter$edia 'ae t%rou&%

it and t%e %y'ot%a"a$u !or$ it !"oor and 'art o! it "atera" -a"".

T%e %ourt* ventr"!lei "ocated bet-een t%e cerebe""u$ and t%e 'on.

T%e !our entric"e are connected to one anot%er.

T%e t-o %ora"na o% Munro, -%ic% are a"o no- a t%e interentricu"ar !ora$ina, "in t%e

"atera" entric"e to t%e t%ird entric"e.

T%e A-ue(u!t o% Sylv"us-%ic% i a"o ca""ed t%e cerebra" a>ueduct connect t%e t%ird and

!ourt% entric"e.

T%e !ourt% entric"e i connected to t%e ubarac%noid 'ace ia t-o "atera" !ora$ina o! )uc%a

and by one $edia" !ora$en o! (a&endie.

ANATOMY OF THE CNS

.RAIN

T%e center o! t%e nerou yte$. T%e brain i "ocated in t%e %ead, 'rotected by t%e u""and c"oe to t%e 'ri$ary enory a''aratu o! iion, %earin&, ba"ance, tate, and $e"".


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The frontal lobe is concerned with higher intellectual functions, such as abstract

thought and reason, speech (Broca's areain the left hemisphere only), olfaction, and

emotion. Voluntary movement is controlled in the precentral gyrus(the primary motorarea).

The parietal lobe is dedicated to sensory awareness, particularly in the postcentral

gyrus (the primary sensory area). It is also concernes with abstract reasoning,

language interpretation and formation of a mental egocentric map of the surroundingarea.

Theoccipital lobeis responsible for interpretation and processing of visual stimuli from

the optic nerves, and association of these stimuli with other nervous imputs andmemories.

The temporal lobe is concerned with emotional development and formation, and also

contains the auitory area responsible for processing and discrimination of sound. It isalso the area thought to be responsible for the formation and processing of memories.

The brain can be subdivided into several distinct regions:

1. .ra"nste conit o! $edu""a ob"on&ata, 'on and $idbrain.

Me(ulla o&lon#ata i t%e "o-er 'ortion o! t%e brainte$. It dea" -it% autono$ic

!unction, uc% a breat%in& and b"ood 'reure. T%e !ar("a! !enteri t%e 'art o! t%e$edu""a ob"on&ata re'onib"e !or contro""in& t%e %eart rate.

Pons re"ay enory in!or$ation bet-een t%e cerebe""u$ and cerebru$< aid in

re"ayin& ot%er $ea&e in t%e brain< contro" aroua", and re&u"ate re'iration ee

re'iratory centre. In o$e t%eorie, t%e 'on %a a ro"e in drea$in&.

M"(&ra"n /esen!e'*alon0 + T%e $eence'%a"on i conidered 'art o! t%e brain te$.

It ubtantia ni&ra i c"oe"y aociated -it% $otor yte$ 'at%-ay o! t%e baa"

&an&"ia.

T%e %u$an $eence'%a"on i arc%i'a""ian in ori&in, $eanin& it &enera" arc%itecture i %ared

-it% t%e $ot ancient o! ertebrate. +o'a$ine 'roduced in t%e ubtantia ni&ra '"ay a ro"e in

$otiation and %abituation o! 'ecie !ro$ %u$an to t%e $ot e"e$entary ani$a" uc% ainect.

2. Cere&ellu i a re&ion o! t%e brain t%at '"ay an i$'ortant ro"e in t%e inte&ration o!

enory 'erce'tion, coordination and $otor contro". In order to coordinate $otor contro",t%ere are $any neura" 'at%-ay "inin& t%e cerebe""u$ -it% t%e cerebra" $otor corte -%ic%

end in!or$ation to t%e $uc"e cauin& t%e$ to $oe and t%e 'inocerebe""ar tract -%ic%

'roide 'ro'rioce'tie !eedbac on t%e 'oition o! t%e body in 'ace. T%e cerebe""u$inte&rate t%ee 'at%-ay, "ie a train conductor, uin& t%e contant !eedbac on body

'oition to !inetune $otor $oe$ent.

@. D"en!e'*alon or interbrain i t%e re&ion o! t%e brain t%at inc"ude t%e t%a"a$u,

%y'ot%a"a$u, e'it%a"a$u, 'ret%a"a$u or ubt%a"a$u and 'retectu$. T%e dience'%a"on i"ocated at t%e $id"ine o! t%e brain, aboe t%e $eence'%a"on o! t%e brain te$. T%e

dience'%a"on contain t%e 8ona "i$itan intrat%a"a$ica a $or'%o"o&ica" boundary andi&na""in& center bet-een t%e 'ret%a"a$u and t%e t%a"a$u.

T*alaus + '"ay an i$'ortant ro"e in re&u"atin& tate o! "ee' and -ae!u"ne.

T%a"a$ic nuc"ei %ae tron& reci'roca" connection -it% t%e cerebra" corte, !or$in&

t%a"a$ocorticot%a"a$ic circuit t%at are be"ieed to be ino"ed -it% concioune.


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T%e t%a"a$u '"ay a $a3or ro"e in re&u"atin& aroua", t%e "ee" o! a-arene, and

actiity. +a$a&e to t%e t%a"a$u can "ead to 'er$anent co$a.

E'"t*alaus 1 i a dora" 'oterior e&$ent o! t%e dience'%a"on a e&$ent in t%e

$idd"e o! t%e brain a"o containin& t%e %y'ot%a"a$u and t%e t%a"a$u -%ic%

inc"ude t%e %abenu"a, t%e tria $edu""ari and t%e 'inea" body. It !unction i t%e

connection bet-een t%e "i$bic yte$ to ot%er 'art o! t%e brain. Hy'ot*alaus + i a $a"" 'art o! t%e brain "ocated 3ut be"o- t%e t%a"a$u on bot%

ide o! t%e t%ird entric"e. )eion o! t%e %y'ot%a"a$u inter!ere -it% eera"

e&etatie !unction and o$e o ca""ed $otiated be%aior "ie eua"ity,

co$batiene, and %un&er. T%e %y'ot%a"a$u a"o '"ay a ro"e in e$otion.S'eci!ica""y, t%e "atera" 'art ee$ to be ino"ed -it% '"eaure and ra&e, -%i"e t%e

$edia" 'art i "ined to aerion, di'"eaure, and a tendency to uncontro""ab"e and

"oud "au&%in&. ?o-eer, in &enera" t%e %y'ot%a"a$u %a $ore to do -it% t%ee'reion o! e$otion

4. Cere&ru or to' 'ortion o! t%e brain, i diided by a dee' creice, ca""ed t%e "on&itudina"

u"cu. T%e "on&itudina" u"cu e'arate t%e cerebru$ in to t%e ri&%t and "e!t %e$i'%ere. Int%e %e$i'%ere you -i"" !ind t%e cerebra" corte, baa" &an&"ia and t%e "i$bic yte$. T%e

t-o %e$i'%ere are connected by a bund"e o! nere !iber ca""ed t%e cor'u ca""ou$. T%e

ri&%t %e$i'%ere i re'onib"e !or t%e "e!t ide o! t%e body -%i"e t%e o''oite i true o! t%e"e!t %e$i'%ere.

PHYSIOLOGY OF THE CNS

Me(ulla

T%e $edu""a i t%e contro" center !or re'iratory, cardioacu"ar and di&etie !unction.

PonsT%e 'on %oue t%e contro" center !or re'iration and in%ibitory !unction. ?ere it -i"" interact

-it% t%e cerebe""u$.

Cere&ru

T%e cerebru$, or to' 'ortion o! t%e brain, i diided by a dee' creice, ca""ed t%e "on&itudina"u"cu. T%e "on&itudina" u"cu e'arate t%e cerebru$ in to t%e ri&%t and "e!t %e$i'%ere. In t%e

%e$i'%ere you -i"" !ind t%e cerebra" corte, baa" &an&"ia and t%e "i$bic yte$. T%e t-o

%e$i'%ere are connected by a bund"e o! nere !iber ca""ed t%e cor'u ca""ou$. T%e ri&%t

%e$i'%ere i re'onib"e !or t%e "e!t ide o! t%e body -%i"e t%e o''oite i true o! t%e "e!t%e$i'%ere. Eac% o! t%e t-o %e$i'%ere are diided into !our e'arated "obe7 t%e !ronta" in

contro" o! 'ecia"i8ed $otor contro", "earnin&, '"annin& and 'eec%< 'arieta" in contro" o! o$aticenory !unction< occi'ita" in contro" o! iion< and te$'ora" "obe -%ic% conit o! %earin&center and o$e 'eec%. )ocated dee' to t%e te$'ora" "obe o! t%e cerebru$ i t%e inu"a.


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Cere&ellu

T%e cerebe""u$ i t%e 'art o! t%e brain t%at i "ocated 'oterior to t%e $edu""a ob"on&ata and

'on. It coordinate e"eta" $uc"e to 'roduce $oot%, &race!u" $otion. T%e cerebe""u$receie in!or$ation !ro$ our eye, ear, $uc"e, and 3oint about -%at 'oition our body i

current"y in 'ro'rioce'tion. It a"o receie out'ut !ro$ t%e cerebra" corte about -%ere t%ee

'art %ou"d be. #!ter 'rocein& t%i in!or$ation, t%e cerebe""u$ end $otor i$'u"e !ro$ t%ebrainte$ to t%e e"eta" $uc"e. T%e $ain !unction o! t%e cerebe""u$ i coordination. T%e

cerebe""u$ i a"o re'onib"e !or ba"ance and 'oture. It a"o ait u -%en -e are "earnin& a

ne- $otor i"", uc% a '"ayin& a 'ort or $uica" intru$ent.

T*e L"&"! Syste

T%e )i$bic Syte$ i a co$'"e et o! tructure !ound 3utbeneat% t%e cerebru$ and on bot% ide o! t%e t%a"a$u. It

co$bine %i&%er $enta" !unction, and 'ri$itie e$otion, into

one yte$. It i o!ten re!erred to a t%e e$otiona" nerou

yte$. It i not on"y re'onib"e !or our e$otiona" "ie, but a"oour %i&%er $enta" !unction, uc% a "earnin& and !or$ation o!

$e$orie. T%e )i$bic yte$ e'"ain -%y o$e t%in& ee$ o'"eaurab"e to u, uc% a eatin& and -%y o$e $edica"

condition are caued by $enta" tre, uc% a %i&% b"ood

'reure. T%ere are t-o i&ni!icant tructure -it%in t%e "i$bicyte$ and eera" $a""er tructure t%at are i$'ortant a -e"".

T%ey are7

1. T%e ?i''oca$'u2. T%e #$y&da"a

@. T%e T%a"a$u

4. T%e ?y'ot%a"a$u:. T%e Forni and Para%i''oca$'u

. T%e Cin&u"ate 5yru

Stru!tures o% t*e L"&"! Syste

H"''o!a'us

T%e ?i''oca$'u i !ound dee' in t%e te$'ora" "obe, %a'ed "ie a ea%ore. It conit o! t-o%orn t%at cure bac !ro$ t%e a$y&da"a. It i ituated in t%e brain o a to $ae t%e 're!ronta"

area a-are o! our 'at e'erience tored in t%at area. T%e 're!ronta" area o! t%e brain conu"t

t%i tructure to ue $e$orie to $odi!y our be%aior. T%e %i''oca$'u i re'onib"e !or$e$ory.

Ay#(ala

T%e #$y&da"a i a "itt"e a"$ond %a'ed tructure, dee' inide t%e anteroin!erior re&ion o! t%e

te$'ora" "obe, connect -it% t%e %i''oca$'u, t%e e'ti nuc"ei, t%e 're!ronta" area and t%e

$edia" dora" nuc"eu o! t%e t%a"a$u. T%ee connection $ae it 'oib"e !or t%e a$y&da"a to

'"ay it i$'ortant ro"e on t%e $ediation and contro" o! uc% actiitie and !ee"in& a "oe,


16/30

!riend%i', a!!ection, and e'reion o! $ood. T%e a$y&da"a i t%e center !or identi!ication o!

dan&er and i !unda$enta" !or e"! 'reeration. T%e a$y&da"a i t%e nuc"eu re'onib"e !or !ear.

T*alaus

)eion or ti$u"ation o! t%e $edia", dora", and anterior nuc"ei o! t%e t%a"a$u are aociated

-it% c%an&e in e$otiona" reactiity. ?o-eer, t%e i$'ortance o! t%ee nuc"ei on t%e re&u"ationo! e$otiona" be%aior i not due to t%e t%a"a$u ite"!, but to t%e connection o! t%ee nuc"ei -it%

ot%er "i$bic yte$ tructure. T%e $edia" dora" nuc"eu $ae connection -it% cortica" 8one

o! t%e 're!ronta" area and -it% t%e %y'ot%a"a$u. T%e anterior nuc"ei connect -it% t%e $a$i""arybodie and t%rou&% t%e$, ia !orni, -it% t%e %i''oca$'u and t%e cin&u"ated &yru, t%u tain&

'art in -%at i no-n a t%e Pa'e86 circuit.

Hy'ot*alaus

T%e ?y'ot%a"a$u i a $a"" 'art o! t%e brain "ocated 3ut be"o- t%e t%a"a$u on bot% ide o!

t%e t%ird entric"e. )eion o! t%e %y'ot%a"a$u inter!ere -it% eera" e&etatie !unction and

o$e o ca""ed $otiated be%aior "ie eua"ity, co$batiene, and %un&er. T%e

%y'ot%a"a$u a"o '"ay a ro"e in e$otion. S'eci!ica""y, t%e "atera" 'art ee$ to be ino"ed-it% '"eaure and ra&e, -%i"e t%e $edia" 'art i "ined to aerion, di'"eaure, and a tendency to

uncontro""ab"e and "oud "au&%in&. ?o-eer, in &enera" t%e %y'ot%a"a$u %a $ore to do -it% t%ee'reion o! e$otion. =%en t%e '%yica" y$'to$ o! e$otion a''ear, t%e t%reat t%ey 'oe

return, ia t%e %y'ot%a"a$u, to t%e "i$bic center and t%en t%e 're!ronta" nuc"ei, increain&

aniety.

T*e Forn"$ an( Para*"''o!a'al

T%ee $a"" tructure are i$'ortant connectin& 'at%-ay !or t%e "i$bic yte$.

T*e C"n#ulate Gyrus

T%e Cin&u"ate 5yru i "ocated in t%e $edia" ide o! t%e brain bet-een t%e cin&u"ated u"cu and

t%e cor'u ca""ou$. T%ere i ti"" $uc% to be "earned about t%i &yru, but it i a"ready no-nt%at it !ronta" 'art coordinate $e"" and i&%t, -it% '"eaant $e$orie o! 'reiou e$otion.

T%e re&ion 'artici'ate in t%e e$otiona" reaction to 'ain and in t%e re&u"ation o! a&&reie

be%aior.

Meory an( Learn"n#

(e$ory i de!ined a7 T%e $enta" !acu"ty o! retainin& and reca""in& 'at e'erience, t%e act or

intance o! re$e$berin& reco""ection. )earnin& tae '"ace -%en -e retain and uti"i8e 'at$e$orie.

Oera"", t%e $ec%ani$ o! $e$ory are not co$'"ete"y undertood. rain area uc% a t%e%i''oca$'u, t%e a$y&da"a, t%e triatu$, or t%e $a$$i""ary bodie are t%ou&%t to be ino"ed

in 'eci!ic ty'e o! $e$ory. For ea$'"e, t%e %i''oca$'u i be"ieed to be ino"ed in 'atia"

"earnin& and dec"aratie "earnin& "earnin& in!or$ation uc% a -%at you6re readin& no-, -%i"et%e a$y&da"a i t%ou&%t to be ino"ed in e$otiona" $e$ory. +a$a&e to certain area in 'atient

and ani$a" $ode" and ube>uent $e$ory de!icit i a 'ri$ary ource o! in!or$ation.

?o-eer, rat%er t%an i$'"icatin& a 'eci!ic area, it cou"d be t%at da$a&e to ad3acent area, or to a

'at%-ay trae"in& t%rou&% t%e area i actua""y re'onib"e !or t%e obered de!icit. Furt%er, it i


17/30

not u!!icient to decribe $e$ory, and it counter'art, "earnin&, a o"e"y de'endent on 'eci!ic

brain re&ion. )earnin& and $e$ory are attributed to c%an&e in neurona" yna'e, t%ou&%t to

be $ediated by "on&ter$ 'otentiation and "on&ter$ de'reion.

T%ere are t%ree baic ty'e o! $e$ory7

1. Senory (e$ory2. S%ort Ter$ (e$ory

@. )on& Ter$ (e$ory

Sensory Meory

T%e enory $e$orie act a a bu!!er !or ti$u"i t%rou&% ene. # enory $e$ory retain an

eact co'y o! -%at i een or %eard7 iconic $e$ory !or iua", ec%oic $e$ory !or aura" and

%a'tic $e$ory !or touc%. In!or$ation i 'aed !ro$ enory $e$ory into %ort ter$ $e$ory.So$e be"iee it "at on"y @00 $i""iecond, it %a un"i$ited ca'acity. Se"ectie attention

deter$ine -%at in!or$ation $oe !ro$ enory $e$ory to %ort ter$ $e$ory.

S*ort Ter MeoryS%ort Ter$ (e$ory act a a cratc% 'ad !or te$'orary reca"" o! t%e in!or$ation under 'roce.

For intance, in order to undertand t%i entence you need to %o"d in your $ind t%e be&innin& o!t%e entence a you read t%e ret. S%ort ter$ $e$ory decay ra'id"y and a"o %a a "i$ited

ca'acity. C%unin& o! in!or$ation can "ead to an increae in t%e %ort ter$ $e$ory ca'acity, t%i

i t%e reaon -%y a %y'%enated '%one nu$ber i eaier to re$e$ber t%an a in&"e "on& nu$ber.T%e ucce!u" !or$ation o! a c%un i no-n a c"oure. Inter!erence o!ten caue diturbance

in %ort ter$ $e$ory retention. T%i account !or t%e deire to co$'"ete a ta %e"d in %ort ter$

$e$ory a oon a 'oib"e.

=it%in %ort ter$ $e$ory t%ere are t%ree baic o'eration7

1. Iconic $e$ory t%e abi"ity to %o"d iua" i$a&e

2. #coutic $e$ory t%e abi"ity to %o"d ound. Can be %e"d "on&er t%an iconic.@. =orin& $e$ory an actie 'roce to ee' it unti" it i 'ut to ue. Note t%at t%e &oa" i

not rea""y to $oe t%e in!or$ation !ro$ %ort ter$ $e$ory to "on& ter$ $e$ory, but

$ere"y to 'ut it to i$$ediate ue.

T%e 'roce o! tran!errin& in!or$ation !ro$ %ort ter$ to "on& ter$ $e$ory ino"e t%e

encodin& or cono"idation o! in!or$ation. T%i i not a !unction o! ti$e, t%at i, t%e "on&er t%e

$e$ory tay in t%e %ort ter$ t%e $ore "ie"y it i to be '"aced in t%e "on& ter$ $e$ory. Onor&ani8in& co$'"e in!or$ation in %ort ter$ be!ore it can be encoded into t%e "on& ter$

$e$ory, in t%i 'roce t%e $eanin&!u"ne or e$otiona" content o! an ite$ $ay '"ay a &reater

ro"e in it retention in t%e "on& ter$ $e$ory. T%e "i$bic yte$ et u' "oca" reerberatin&circuit uc% a t%e Pa'a86 Circuit.

Lon# Ter Meory

)on& Ter$ (e$ory i ued !or tora&e o! in!or$ation oer a "on& ti$e. In!or$ation !ro$ %ort

to "on& ter$ $e$ory i tran!erred a!ter a %ort 'eriod. Gn"ie %ort ter$ $e$ory, "on& ter$

$e$ory %a "itt"e decay. )on& ter$ 'otentia" i an en%anced re'one at t%e yna'e -it%in t%e

%i''oca$'u. It i eentia" to $e$ory tora&e. T%e "i$bic yte$ in6t direct"y ino"ed in "on&


18/30

ter$ $e$ory neceari"y but it e"ect t%e$ !ro$ %ort ter$ $e$ory, cono"idate t%ee

$e$orie by '"ayin& t%e$ "ie a continuou ta'e, and ino"e t%e %i''oca$'u and a$y&da"a.

T%ere are t-o ty'e o! "on& ter$ $e$ory7

1. E'iodic (e$ory

2. Se$antic (e$ory

E'iodic $e$ory re'reent our $e$ory o! eent and e'erience in a eria" !or$. It i !ro$

t%i $e$ory t%at -e can recontruct t%e actua" eent t%at too '"ace at a &ien 'oint in our"ie. Se$antic $e$ory, on t%e ot%er %and, i a tructured record o! !act, conce't, and i""

t%at -e %ae ac>uired. T%e in!or$ation in t%e e$antic $e$ory i deried !ro$ our o-n e'iode

$e$ory, uc% a t%at -e can "earn ne- !act or conce't !ro$ e'erience.

T%ere are t%ree $ain actiitie t%at are re"ated to "on& ter$ $e$ory7

1. Stora&e

2. +e"etion

@. *etriea"

In!or$ation !or %ort ter$ $e$ory i tored in "on& ter$ $e$ory by re%eara". T%e re'eatede'oure to a ti$u"u or t%e re%eara" o! a 'iece o! in!or$ation tran!er it into "on& ter$

$e$ory. E'eri$ent a"o u&&et t%at "earnin& i $ot e!!ectie i! it i ditributed oer ti$e.

+e"etion i $ain"y caued by decay and inter!erence. E$otiona" !actor a"o a!!ect "on& ter$$e$ory. ?o-eer, it i debatab"e -%et%er -e actua""y eer !or&et anyt%in& or -%et%er it 3ut

o$eti$e beco$e increain&"y di!!icu"t to retriee it. In!or$ation $ay not be reca""ed

o$eti$e but $ay be reco&ni8ed, or $ay be reca""ed on"y -it% 'ro$'tin&. T%i "ead u to t%e

t%ird o'eration o! $e$ory, in!or$ation retriea".

T%ere are t-o ty'e o! in!or$ation retriea"7

1. *eca""2. *eco&nition

In reca"", t%e in!or$ation i re'roduced !ro$ $e$ory. In reco&nition t%e 'reentation o! t%ein!or$ation 'roide t%e no-"ed&e t%at t%e in!or$ation %a been een be!ore. *eco&nition i o!

"eer co$'"eity, a t%e in!or$ation i 'roided a a cue. ?o-eer, t%e reca"" $ay be aited by

t%e 'roiion o! retriea" cue -%ic% enab"e t%e ub3ect to >uic"y acce t%e in!or$ation in

$e$ory.


19/30

ANATOMY OF THE !NS

T%e 'eri'%era" nerou yte$ inc"ude 12 crania" nere @1 'air o! 'ina" nere. It can be

ubdiided into t%e o$atic and autono$ic yte$. It i a -ay o! co$$unication !ro$ t%e

centra" nerou yte$ to t%e ret o! t%e body by nere i$'u"e t%at re&u"ate t%e !unction o! t%e

%u$an body.

T%e t-e"e crania" nere are

IO"!actory Nere !or $e""

IIO'tic Nere !or iionIII Ocu"o$otor !or "ooin& around

I2Troc%"ear !or $oin& eye

2Tri&e$ina" !or !ee"in& touc% on !ace

2I#bducen to $oe eye $uc"e

2IIFacia" to $i"e, -in, and %e"' u tate

2III Metibu"ococ%"ear to %e"' -it% ba"ance, e>ui"ibriu$, and %earin&

I35"oo'%aren&ea" !or -a""o-in& and &a&&in&

3Ma&u !or -a""o-in&, ta"in&, and 'aray$'at%etic action o! di&etion

3I S'ina" acceory !or %ru&&in& %ou"der

3II?y'o&"oa" !or ton&ue $ore diided into di!!erent re&ion a $uc"e

T%e 10 out o! t%e 12 crania" nere ori&inate !ro$ t%e brainte$, and $ain"y contro" t%e!unction o! t%e anato$ic tructure o! t%e %ead -it% o$e ece'tion. CN receie icera"

enory in!or$ation !ro$ t%e t%ora and abdo$en, and CN I i re'onib"e !or inneratin& t%e

ternoc"eido$atoid and tra'e8iu $uc"e, neit%er o! -%ic% i ec"uie"y in t%e %ead.

S'ina" nere tae t%eir ori&in !ro$ t%e 'ina" cord. T%ey contro" t%e !unction o! t%e ret o! t%e

body. In %u$an, t%ere are @1 'air o! 'ina" nere7 B cerica", 12 t%oracic, : "u$bar, : acra"


20/30

and 1 coccy&ea". T%e na$in& conention !or 'ina" nere i to na$e it a!ter t%e ertebra

i$$ediate"y aboe it. T%u t%e !ourt% t%oracic nere ori&inate 3ut be"o- t%e !ourt% t%oracic

ertebra. T%i conention brea do-n in t%e cerica" 'ine. T%e !irt 'ina" nere ori&inateaboe t%e !irt cerica" ertebra and i ca""ed C1. T%i continue do-n to t%e "at cerica" 'ina"

nere, CB. T%ere are on"y J cerica" ertebrae and B cerica" 'ina" nere.

Per"'*eral nervous syste

T%e PNS i a re&iona" ter$ !or t%e co""ectie nerou tructure t%at do not "ie in t%e CNS. T%e

bodie o! t%e nere ce"" "ie in t%e CNS, eit%er in t%e brain or t%e 'ina" cord, and t%e "on&er o!t%e ce""u"ar 'rocee o! t%ee ce"", no-n a aon, etend t%rou&% t%e "i$b and t%e !"e% o!

t%e toro. T%e "ar&e $a3ority o! t%e aon -%ic% are co$$on"y ca""ed nere, are conidered to

be PNS.

T%e 'eri'%era" nerou yte$ PNS reide or etend outide t%e centra" nerou yte$CNS, -%ic% conit o! t%e brain and 'ina" cord. T%e $ain !unction o! t%e PNS i to connect

t%e CNS to t%e "i$b and or&an. Gn"ie t%e centra" nerou yte$, t%e PNS i not 'rotected by

bone or by t%e b"oodbrain barrier, "eain& it e'oed to toin and $ec%anica" in3urie. T%e

'eri'%era" nerou yte$ i diided into t%e o$atic nerou yte$ and t%e autono$ic nerouyte$.

P*ys"olo#"!al ("v"s"on

# "e anato$ica" but $uc% $ore !unctiona" -ay o! diidin& t%e %u$an nerou yte$ i

c"ai!ication accordin& to t%e ro"e t%at t%e di!!erent neura" 'at%-ay '"ay, re&ard"e o! -%et%eror not t%ey cro t%rou&% t%e CNSPNS7

T%e o$atic nerou yte$ i re'onib"e !or coordinatin& o"untary body $oe$ent

i.e. actiitie t%at are under conciou contro".

T%e autono$ic nerou yte$ i re'onib"e !or coordinatin& ino"untary !unction,

uc% a breat%in& and di&etion.

In turn, t%ee diiion o! t%e nerou yte$ can be !urt%er diided accordin& to t%e direction in-%ic% t%ey conduct nere i$'u"e7

#!!erent yte$ by enory neuron, -%ic% carrie i$'u"e !ro$ a o$atic rece'tor to

t%e CNS

E!!erent yte$ by $otor neuron, -%ic% carrie i$'u"e !ro$ t%e CNS to an e!!ector

*e"ay yte$ by interneuron a"o ca""ed Qre"ay neuronQ, -%ic% tran$it i$'u"e

bet-een t%e enory and $otor neuron bot% in t%e CNS and PNS.

T%e 3unction bet-een t-o neuron i ca""ed a yna'e. T%ere i a ery narro- &a' about

20n$ in -idt% bet-een t%e neuron ca""ed t%e yna'tic c"e!t. T%i i -%ere an action'otentia" t%e Q$ea&eQ bein& carried by t%e neuron, a"o no-n a t%e nere i$'u"e

i tran$itted !ro$ one neuron to t%e net. T%i i ac%ieed by re"ayin& t%e $ea&e

acro t%e yna'tic c"e!t uin& neurotran$itter, -%ic% di!!ue acro t%e &a'. T%eneurotran$itter t%en bind to rece'tor ite on t%e nei&%borin& 'otyna'tic neuron,

-%ic% in turn 'roduce it o-n e"ectrica"nere i$'u"e. T%i i$'u"e i ent to t%e net

yna'e, and t%e cyc"e re'eat ite"!.


21/30


22/30

nere I and II "ie in t%e !orebrain and t%a"a$u, re'ectie"y, and are t%u not conidered to be

true crania" nere. CN 10 receie icera" enory in!or$ation !ro$ t%e t%ora and

abdo$en, and CN I 11 i re'onib"e !or inneratin& t%e ternoc"eido$atoid and tra'e8iu$uc"e, neit%er o! -%ic% i ec"uie"y in t%e %ead.

S'ina" nere tae t%eir ori&in !ro$ t%e 'ina" cord. T%ey contro" t%e !unction o! t%e ret o! t%ebody. In %u$an, t%ere are @1 'air o! 'ina" nere7 J cerica", 12 t%oracic, : "u$bar, : acra"

and 1 coccy&ea". In t%e cerica" re&ion, t%e 'ina" nere root co$e out aboe t%e corre'ondin&

ertebrae i.e. nere root bet-een t%e u"" and 1t cerica" ertebrae i ca""ed 'ina" nere C1.Fro$ t%e t%oracic re&ion to t%e coccy&ea" re&ion, t%e 'ina" nere root co$e out be"o- t%e

corre'ondin& ertebrae. It i i$'ortant to note t%at t%i $et%od create a 'rob"e$ -%en na$in&

t%e 'ina" nere root bet-een CJ and T1 o it i ca""ed 'ina" nere root CB. In t%e "u$bar and

acra" re&ion, t%e 'ina" nere root trae" -it%in t%e dura" ac and t%ey trae" be"o- t%e "ee" o!)2 a t%e cauda e>uina.

Cerv"!al s'"nal nerves /C4+C50

T%e !irt 4 cerica" 'ina" nere, C1 t%rou&% C4, '"it and reco$bine to 'roduce a ariety o!nere t%at ubere t%e nec and bac o! %ead.

S'ina" nere C1 i ca""ed t%e ubocci'ita" nere -%ic% 'roide $otor inneration to $uc"e at

t%e bae o! t%e u"". C2 and C@ !or$ $any o! t%e nere o! t%e nec, 'roidin& bot% enory and

$otor contro". T%ee inc"ude t%e &reater occi'ita" nere -%ic% 'roide enation to t%e bac o!t%e %ead, t%e "eer occi'ita" nere -%ic% 'roide enation to t%e area be%ind t%e ear, t%e

&reater auricu"ar nere and t%e "eer auricu"ar nere. See occi'ita" neura"&ia. T%e '%renic nere

arie !ro$ nere root C@, C4 and C:. It innerate t%e dia'%ra&$, enab"in& breat%in&. I! t%e

'ina" cord i tranected aboe C@, t%en 'ontaneou breat%in& i not 'oib"e.

.ra!*"al 'le$us /C6+T40

T%e "at !our cerica" 'ina" nere, C: t%rou&% CB, and t%e !irt t%oracic 'ina" nere,T1,co$bine to !or$ t%e brac%ia" '"eu, or '"eu brac%ia"i, a tan&"ed array o! nere, '"ittin&,

co$binin& and reco$binin&, to !or$ t%e nere t%at ubere t%e ar$ and u''er bac. #"t%ou&%

t%e brac%ia" '"eu $ay a''ear tan&"ed, it i %i&%"y or&ani8ed and 'redictab"e, -it% "itt"eariation bet-een 'eo'"e.

Neurotrans"tters

T%e $ain neurotran$itter o! t%e 'eri'%era" nerou yte$ are acety"c%o"ine andnoradrena"ine. ?o-eer, t%ere are eera" ot%er neurotran$itter a -e"", 3oint"y "abe"ed Non

noradrener&ic, nonc%o"iner&ic N#NC tran$itter. Ea$'"e o! uc% tran$itter inc"ude non

'e'tide7 #TP, 5##, do'a$ine, NO, and 'e'tide7 neuro'e'tide , MIP, 5n*?, Subtance Pand C5*P.


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T*e Sy'at*et"! Syste

T*e Sy'at*et"! D"v"s"on

T%e y$'at%etic nerou yte$ actiate -%at i o!ten ter$ed t%e !i&%t or !"i&%t re'one, a it

i $ot actie under udden tre!u" circu$tance uc% a bein& attaced. T%i re'one i

a"o no-n a y$'at%eticoadrena" re'one o! t%e body, a t%e 're&an&"ionic y$'at%etic!iber t%at end in t%e adrena" $edu""a but a"o a"" ot%er y$'at%etic !iber ecrete acety"c%o"ine,

-%ic% actiate t%e ecretion o! adrena"ine e'ine'%rine and to a "eer etent noradrena"ine

nore'ine'%rine !ro$ it. T%ere!ore, t%i re'one t%at act 'ri$ari"y on t%e cardioacu"ar

yte$ i $ediated direct"y ia i$'u"e tran$itted t%rou&% t%e y$'at%etic nerou yte$ andindirect"y ia catec%o"a$ine ecreted !ro$ t%e adrena" $edu""a.

Neurons

Neuron are e"ectrica""y ecitab"e ce"" in t%e nerou yte$ t%at 'roce and tran$it

in!or$ation. Neuron are t%e core co$'onent o! t%e brain, t%e ertebrate 'ina" cord, t%e

inertebrate entra" nere cord, and t%e 'eri'%era" nere. # nu$ber o! di!!erent ty'e o! neuroneit7 enory neuron re'ond to touc%, ound, "i&%t and nu$erou ot%er ti$u"i e!!ectin&

enory or&an and end i&na" to t%e 'ina" cord and brain, $otor neuron receie i&na" !ro$

t%e brain and 'ina" cord and caue $uc"e contraction and a!!ect &"and, Interneuron connect

neuron to ot%er neuron -it%in t%e brain and 'ina" cord.


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T%ere are t%ree ty'e o! direction o! t%e neuron7

Senory yte$ by enory neuron, bet-een t%e enory and $otor neuron. ?o-eer,

t%ere are re"ay neuron in t%e CNS a -e"".

y !unction, t%e 'eri'%era" nerou yte$ i diided into t%e o$atic nerou yte$,

autono$ic nerou yte$ and t%e enteric nerou yte$. T%e o$atic nerou yte$ i

re'onib"e !or coordinatin& t%e body $oe$ent, and a"o !or receiin& eterna" ti$u"i.It i t%e yte$ t%at re&u"ate actiitie t%at are under conciou contro". T%e autono$icnerou yte$ i t%en '"it into t%e y$'at%etic diiion, 'aray$'at%etic diiion, and

enteric diiion. T%e y$'at%etic nerou yte$ re'ond to i$'endin& dan&er or tre,

and i re'onib"e !or t%e increae o! one6 %eartbeat and b"ood 'reure, a$on& ot%er'%yio"o&ica" c%an&e, a"on& -it% t%e ene o! ecite$ent one !ee" due to t%e increae o!

adrena"ine in t%e yte$. T%e 'aray$'at%etic nerou yte$, on t%e ot%er %and, i

eident -%en a 'eron i retin& and !ee" re"aed, and i re'onib"e !or uc% t%in& at%e contriction o! t%e 'u'i", t%e "o-in& o! t%e %eart, t%e di"ation o! t%e b"ood ee",

and t%e ti$u"ation o! t%e di&etie and &enitourinary yte$. T%e ro"e o! t%e enteric

nerou yte$ i to $ana&e eery a'ect o! di&etion, !ro$ t%e eo'%a&u to t%e

to$ac%, $a"" intetine and co"on.

Gl"al !ells

5"ia" ce"" are nonneurona" ce"" t%at 'roide u''ort and nutrition, $aintain %o$eotai, !or$$ye"in, and 'artici'ate in i&na" tran$iion in t%e nerou yte$. In t%e %u$an brain, &"ia are

eti$ated to outnu$ber neuron by about 10 to 1.

5"ia" ce"" 'roide u''ort and 'rotection !or neuron. T%ey are t%u no-n a t%e Q&"ueQ o! t%e

nerou yte$. T%e !our $ain !unction o! &"ia" ce"" are to urround neuron and %o"d t%e$ in

'"ace, to u''"y nutrient and oy&en to neuron, to inu"ate one neuron !ro$ anot%er, and to

detroy 'at%o&en and re$oe dead neuron.

Or#an"7at"on

Sy$'at%etic nere ori&inate inide t%e ertebra" co"u$n, to-ard t%e $idd"e o! t%e 'ina" cord int%e inter$edio"atera" ce"" co"u$n or "atera" %orn, be&innin& at t%e !irt t%oracic e&$ent o! t%e

'ina" cord and etendin& into t%e econd or t%ird "u$bar e&$ent. ecaue it ce"" be&in in t%e

t%oracic and "u$bar re&ion o! t%e 'ina" cord, t%e SNS i aid to %ae a t%oraco"u$bar out!"o-.#on o! t%ee nere "eae t%e 'ina" cord in t%e entra" branc%e ra$i o! t%e 'ina" nere,

and t%en e'arate out a 6-%ite ra$i6 o ca""ed !ro$ t%e %iny -%ite %eat% o! $ye"in around

eac% aon -%ic% connect to t-o c%ain &an&"ia etendin& a"on&ide t%e ertebra" co"u$n on t%e

"e!t and ri&%t. T%ee e"on&ated &an&"ia are a"o no-n a 'araertebra" &an&"ia or y$'at%etictrun. In t%ee %ub, connection yna'e are $ade -%ic% t%en ditribute t%e nere to $a3or

or&an, &"and, and ot%er 'art o! t%e body.

In order to reac% t%e tar&et or&an and &"and, t%e aon $ut trae" "on& ditance in t%e body,

and, to acco$'"i% t%i, $any aon "in u' -it% t%e aon o! a econd ce"". T%e end o! t%e

aon do not $ae direct contact, but rat%er "in acro a 'ace, t%e yna'e.

In t%e SNS and ot%er co$'onent o! t%e 'eri'%era" nerou yte$, t%ee yna'e are $ade at

ite ca""ed &an&"ia. T%e ce"" t%at end it !iber i ca""ed a 're&an&"ionic ce"", -%i"e t%e ce""


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-%oe !iber "eae t%e &an&"ion i ca""ed a 'ot&an&"ionic ce"". # $entioned 'reiou"y, t%e

're&an&"ionic ce"" o! t%e SNS are "ocated bet-een t%e !irt t%oracic e&$ent and t%e econd or

t%ird "u$bar e&$ent o! t%e 'ina" cord. Pot&an&"ionic ce"" %ae t%eir ce"" bodie in t%e&an&"ia and end t%eir aon to tar&et or&an or &"and.

T%e &an&"ia inc"ude not 3ut t%e y$'at%etic trun but a"o t%e u'erior cerica" &an&"ion-%ic% end y$'at%etic nere !iber to t%e %ead, and t%e ce"iac and $eenteric &an&"ia -%ic%

end y$'at%etic !iber to t%e &ut.

Relat"ons*"' to sy'at*et"!

=%i"e an oeri$'"i!ication, it i aid t%at t%e 'aray$'at%etic yte$ act in a reci'roca"

$anner to t%e e!!ect o! t%e y$'at%etic nerou yte$< in !act, in o$e tiue innerated by

bot% yte$, t%e e!!ect are yner&itic.

T*e Parasy'at*et"! D"v"s"on

T%e 'aray$'at%etic nerou yte$ i 'art o! t%e autono$ic nerou yte$. So$eti$e ca""edt%e ret and di&et yte$ or !eed and breed. T%e 'aray$'at%etic yte$ conere ener&y a it

"o- t%e %eart rate, increae intetina" and &"and actiity, and re"ae '%incter $uc"e in t%e&atrointetina" tract.

Re!e'tors

T%e 'aray$'at%etic nerou yte$ ue on"y acety"c%o"ine #C% a it neurotran$itter. T%e

#C% act on t-o ty'e o! rece'tor, t%e $ucarinic and nicotinic c%o"iner&ic rece'tor. (ot

tran$iion occur in t-o ta&e7 =%en ti$u"ated, t%e 're&an&"ionic nere re"eae #C% at t%e

&an&"ion, -%ic% act on nicotinic rece'tor o! t%e 'ot&an&"ionic nere. T%e 'ot&an&"ionic neret%en re"eae #C% to ti$u"ate t%e $ucarinic rece'tor o! t%e tar&et or&an.

T%e t%ree $ain ty'e o! $ucarinic rece'tor t%at are -e"" c%aracteried are7

T%e (1 $ucarinic rece'tor are "ocated in t%e neura" yte$.

T%e (2 $ucarinic rece'tor are "ocated in t%e %eart, and act to brin& t%e %eart bac to

nor$a" a!ter t%e action o! t%e y$'at%etic nerou yte$7 "o-in& do-n t%e %eart rate,

reducin& contracti"e !orce o! t%e atria" cardiac $uc"e, and reducin& conduction e"ocityo! t%e atrioentricu"ar node #M node. Note, t%ey %ae no e!!ect on t%e contracti"e !orce

o! t%e entricu"ar $uc"e.

T%e (@ $ucarinic rece'tor are "ocated at $any '"ace in t%e body, uc% a t%e $oot%

$uc"e o! t%e b"ood ee", a -e"" a t%e "un&, -%ic% $ean t%at t%ey caueaocontriction and bronc%ocontriction. T%ey are a"o in t%e $oot% $uc"e o! t%e

&atrointetina" tract 5IT, -%ic% %e"' in increain& intetina" $oti"ity and di"atin&'%incter. T%e (@ rece'tor are a"o "ocated in $any &"and t%at %e"' to ti$u"ateecretion in a"iary &"and and ot%er &"and o! t%e body.

Nervous T"ssue

T%e nerou yte$ coordinate t%e actiity o! t%e $uc"e, $onitor t%e or&an, contruct and

a"o to' in'ut !ro$ t%e ene, and initiate action. Pro$inent 'artici'ant in a nerou yte$

inc"ude neuron and nere, -%ic% '"ay ro"e in uc% coordination.Our nerou tiue on"y


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conit o! t-o ty'e o! ce"". T%ee ce"" are neuron and neuro&"ia ce"". T%e neuron are

re'onib"e !or tran$ittin& nere i$'u"e. Neuro&"ia ce"" are re'onib"e !or u''ortin& and

nouri%in& t%e neuron ce"".

Ty'es o% neurons

T%ere are t%ree ty'e o! neuron in t%e body. =e %ae enory neuron, interneuron, and $otorneuron. Neuron are a $a3or c"a o! ce"" in t%e nerou yte$. Neuron are o$eti$e ca""ed

nere ce"", t%ou&% t%i ter$ i tec%nica""y i$'recie, a $any neuron do not !or$ nere. In

ertebrate, neuron are !ound in t%e brain, t%e 'ina" cord and in t%e nere and &an&"ia o! t%e'eri'%era" nerou yte$. T%eir $ain ro"e i to 'roce and tran$it in!or$ation. Neuron %ae

ecitab"e $e$brane, -%ic% a""o- t%e$ to &enerate and 'ro'a&ate e"ectrica" i$'u"e. Senory

neuron tae nere i$'u"e or $ea&e ri&%t !ro$ t%e enory rece'tor and de"ier it to t%ecentra" nerou yte$. # enory rece'tor i a tructure t%at can !ind any ind o! c%an&e in it6

urroundin& or eniron$ent.

Stru!ture o% a neuron

Neuron %ae t%ree di!!erent 'art to t%e$. T%ey a"" %ae an aon, a ce"" body and dendrite. T%e

aon i t%e 'art o! t%e neuron t%at conduct nere i$'u"e. #on can &et to be >uite "on&.

=%en an aon i 'reent in nere, it i ca""ed a nere !iber. # ce"" body %a a nuc"eou and ita"o %a ot%er or&ane""e. T%e dendrite are t%e %ort 'iece t%at co$e o!! o! t%e ce"" body t%at

receie t%e i&na" !ro$ enory rece'tor and ot%er neuron.

Myel"n S*eat*

Sc%-ann ce"" contain a "i'id ubtance ca""ed $ye"in in t%eir '"a$a $e$brane. =%en

c%-ann ce"" -ra' around aon, a $ye"in %eat% !or$. T%ere are &a' t%at %ae no $ye"in

%eat% around t%e$< t%ee &a' are ca""ed node o! *anier. (ye"in %eat%e $ae ece""ent


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inu"ator. #on t%at are "on&er %ae a $ye"in %eat%, -%i"e %orter aon do not. T%e dieae

$u"ti'"e c"eroi i an autoi$$une dieae -%ere t%e body attac t%e $ye"in %eat% o! t%e

centra" nerou yte$.

In%orat"on trans"ss"on

(ea&e trae" t%rou&% t%e SNS in a bidirectiona" !"o-. E!!erent $ea&e can tri&&er c%an&ein di!!erent 'art o! t%e body i$u"taneou"y. For ea$'"e, t%e y$'at%etic nerou yte$ can

acce"erate %eart rate< -iden bronc%ia" 'aa&e< decreae $oti"ity $oe$ent o! t%e "ar&e

intetine< contrict b"ood ee"< increae 'erita"i in t%e eo'%a&u< caue 'u'i" di"ation,'i"oerection &ooe bu$' and 'er'iration -eatin&< and raie b"ood 'reure. #!!erent

$ea&e carry enation uc% a %eat, co"d, or 'ain.

T%e !irt yna'e in t%e y$'at%etic c%ain i $ediated by nicotinic rece'tor '%yio"o&ica""yactiated by acety"c%o"ine, and t%e tar&et yna'e i $ediated by adrener&ic rece'tor

'%yio"o&ica""y actiated by eit%er noradrena"ine or adrena"ine. #n ece'tion i -it% -eat

&"and -%ic% receie y$'at%etic inneration but %ae $ucarinic acety"c%o"ine rece'tor -%ic%

are nor$a""y c%aracteritic o! PNS. #not%er ece'tion i -it% certain dee' $uc"e b"ood ee",-%ic% %ae acety"c%o"ine rece'tor and -%ic% di"ate rat%er t%an contrict -it% an increae in

y$'at%etic tone. T%e y$'at%etic yte$ ce"" bodie are "ocated on t%e 'ina" cord ec"udin&t%e crania" and acra" re&ion. T%e 're&an&"onic neuron eit !ro$ t%e ertebra" co"u$n and

yna'e -it% t%e 'ot&an&"onic neroun in t%e y$'at%etic trun.

T%e 'aray$'at%etic nerou yte$ i one o! t%ree diiion o! t%e autono$ic nerou yte$.

So$eti$e ca""ed t%e ret and di&et yte$, t%e 'aray$'at%etic yte$ conere ener&y a it

"o- t%e %eart rate, increae intetina" and &"and actiity, and re"ae '%incter $uc"e in t%e

&atrointetina" tract.


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