Neuroscience and Mental Health - Imperial College Union | · Laminae- Layers of functional similar...

Collection of definitions

Afferent neurone- Neurones which carry sensory information from periphery to the CNS

Anterograde transport- Movement of molecules outwards from the soma towards the synapse or plasma membrane

Autonomic Nervous System Controls visceral (organ) function

Central Nervous System Section of the nervous system containing the brain and the spinal cord

Efferent neurones- Motor information from CNS to periphery

Fibre Tract- Groups of bundles of axons in the CNS that may or may not be myelinated Examples included corpus callosum and internal capsule

Ganglion- Group of encapsulated cell bodies within the PNS Examples include dorsal root ganglia and sympathetic ganglia

Laminae- Layers of functional similar cells such as the cerebral cortex grey matter and the cerebellar grey matter

Nerve- Discrete bundles of axons that are usually part of PNS

Nucleus- Group of unencapsulated neuronal cell bodies within the CNS often of functionally similar cells

Peripheral Nervous System Contains the nerves and ganglia outside of the CNS

Retrograde transport- Movement of molecules inwards from synapse to soma It returns used synaptic vesicles and informs the soma of the conditions at the axon terminal

Somatic Nervous System Controls motor and sensory function for body wall

Accommodation Act of refocusing the visual imageAction potential Brief reversal of the neuronal membrane potential resulting from altered membrane permeabilityAffective disorder Psychiatric disorder of moodAfferent Conveying impulses towards a structureAgnosia Inability to recognise or attach meaning to objectsAgraphia Inability to writeAkinesia Loss or slowness of movementAmnesia Loss of memoryAnaesthesia Loss of sensationAnalgesia Loss of pain sensationAnterior Towards the frontAphasia Loss of ability to use language in the absence of motor and sensory loss Apraxia Inability to carry out a voluntary movement in the absence of paralysis sensory loss and ataxiaAreflexia Loss of reflexesAtaxia Loss of motor co-ordinationAthetosis Involuntary movement continuous slow writhingAtonia The absence of muscle tone Atrophy Reduction in sizeAxon Neuronal process carrying impulses away from the cell bodyBallismus Involuntary violent movements of the extremitiesBradykinesia Slowness of movementBulbar Relating to the brainstemCaudal Towards the tailCerebral Relating to the cerebrum (=hemispheres + diencephalon)Chiasma (chiasm) Crossing over of fibres from optic nerveColumn Bundle of axons within the CNSComa State of unconsciousness from which the patient cannot be aroused by sensory stimulationCommissure Bundle of axons linking two sides of CNSContralateral Situated in or projecting to the opposite side of the bodyCoronal plane Plane running vertically from side to sideCortex Outer layer of grey matter of the brainDecussation Crossing over of bundles of axons in the midlineDementia Loss of cognitive capabilities without objective loss of sensory or motor functionsDendrite Neuronal process that receives input from other neuronesDenervation Lack of nervous control of part of the bodyDiplopia Double visionDorsal Towards the backDysarthria Difficulty with pronouncing wordsDyskinesia Difficulty with movementDysphagia Difficulty with swallowingEfferent Conveying impulses away from a structureEPSP Excitatory postsynaptic potential - local depolarisation of neuronal membrane brought about by synaptic activityFasciculus Bundle of axons within the CNSFibres Either bundles of axons in the CNS or whole nerves in the peripheryForamen OpeningFuniculus Bundle of axons within the CNSGanglion A collection of neurone cell bodies outside the CNSGrey matter Nervous tissue where neurone cell bodies are localisedGyrus A convolution of the cerebral cortexHemiplegia Paralysis of one side of the bodyHemianopia Loss of vision in half of the visual fieldHeteronymous Relating to different parts of the visual field in each eyeHomonymous Relating to the same part of the visual field in each eyeHyperalgesia A reduced threshold or increased response to painful stimuliHyperopia Condition in which only objects far from the eye are in focusHypertonia Abnormal increase in muscle toneIdiopathic Without known causeInfarct(ion) Area of necrotic tissue resulting from vascular occlusion

Guide for use of these notes

First of all thank you for choosing to download these notes to study from I hope you find them useful please feel free to email me if you have any problems with the notes or if you notice any errors I dont promise to respond to all emails but Ill do my best

For the Neuroscience notes I used Vanders physiology but mostly from the lecture notes and course guide

I organise my notes so that you should read the learning objectives on the left then proceed down the right hand side for a few learning objectives and then cross back over to the left and continue like that

Anything in this highlighted green is a definition or explains basically somethings functionText highlighted in yellow or with a star is what I would deem important and key to your informationItalics and bold just help to make certain terms stand out

The notes are a bit quirky but I hope you like them and find some of the memory aides strange enough so that they stick in your head

I provide them to you in OneNote format as that is how I created them they can be saved as PDF but the formatting is not as nice The one caveat with this is that these notes are freely copy able and editable I would prefer if you didnt copy and paste my notes into your own but used them as a reference or preferably instead embellished these already existing notes by adding to them

Good luck with first yearAnd I love Light Opera Soc

Stuart Taylor

Innervation Nerve supply Interneuron(e) Interconnects other neurones usually locallyIpsilateral Situated in or projecting to the same side of the body IPSP Inhibitory postsynaptic potential ndash local hyperpolarisation of neuronal membrane brought about by synaptic activityIschaemia Lack of sufficient blood supply resulting in permanent damage if not restored rapidlyKinaesthesia Perception of movementLateral Away from the midline Lemniscus Ribbon-like bundle of axons in CNSLesion A circumscribed area of injury or disease

Papilloedema Swelling of the head of the optic nerve due to raised intracranial pressure Pathway A chain of functionally connected neuronesPlexus Interwoven nerves or blood vesselsPosterior Towards the backProprioception Conscious or unconscious reception by the brain of information from muscles tendons and jointsPsychosis Abnormal mental state including altered precepts (hallucinations) and false ideas (delusions)Ptosis Abnormal drooping of the upper eyelid

Neuroscience and Mental Health10 January 20121358

Stuarts Neuroscience and Mental Health

restored rapidlyKinaesthesia Perception of movementLateral Away from the midline Lemniscus Ribbon-like bundle of axons in CNSLesion A circumscribed area of injury or diseaseMania An abnormally elevated expansive or irritable moodMedial Towards the midlineMembrane potential Potential difference across the neuronal membrane maintained by differential permeabilityMemory The retention of learned informationMiosis Pupillary constrictionMydriasis Extreme dilation of the pupilMyopia Condition in which only objects close to the eye are in focusMotor Involved in movement or responseNeoplasia Cancerous overgrowth of tissueNeurite Process of a neurone dendrite or axonNeuroglia (glia) Cells which support the function of neurones in the CNSNeuron(e) Complete nerve cell comprising cell body dendrites and axonNeuropil Complex meshwork of dendrites axon terminals and neuroglial processesNeurotransmitter Specific chemical agent released by a presynaptic neurone on excitation which crosses the synaptic cleft to stimulate or inhibit the postsynaptic cellNociception Response to noxious stimulationNucleus A collection of neurone cell bodies within the CNSNystagmus Involuntary rapid movements of the eyeballsOedema Swelling of tissue due to accumulation of fluidOphthalmoplegia Paralysis of the extrinsic eye musclesPalsy Weakness or paralysis of musclesParaesthesia Distorted sensationParalysis Loss of voluntary movement following neural injuryParaplegia Paralysis of lower limbsParesis Weakness partial paralysis

Proprioception Conscious or unconscious reception by the brain of information from muscles tendons and jointsPsychosis Abnormal mental state including altered precepts (hallucinations) and false ideas (delusions)Ptosis Abnormal drooping of the upper eyelidRamus Branch (particularly of spinal nerve)Root Interconnects spinal cord and spinal nerveRostral Towards the headQuadriplegia Paralysis of all four limbs (tetraplegia)Saccade Small quick eye movements on changing point of fixationSagittal plane Plane running vertically from front to back Seizure Sudden disturbance of consciousness or sensorimotor functionSensory Involved in receiving information from the environment (internal or external)Sign In medicine an abnormality observed by the physician and independent of the observation of the patientSomatic Relating to the body framework as distinct from the internal organsSomatotopic The orderly representation of body parts in the CNSSpasticity Condition of increased muscle tone and exaggerated tendon reflexesStria Narrow band of axons in the CNSSulcus Groove between adjacent gyriSymptom In medicine an abnormality observed by the patient and reported to the physician - symptoms are necessarily subjectiveSynapse Site of functional contact between neuronsSyndrome Group of signs and symptoms which characterise a diseaseTetraplegia See quadriplegiaTract Bundle of axons within the CNSVentral Towards the frontVisceral Relating to the internal organsVisual field The total region of space that is viewed by both eyes when fixated on a pointWhite matter Nervous tissue made up mainly of axons

Stuarts Neuroscience and Mental Health Page 2

Learning Objectives

Define the following terms and explain how they interact with each other Central nervous system peripheral nervous system autonomic nervous system and somatic nervous system

Outline diagnostic methods and how to perform a neurological examination

Outline the major causes of neurological disorders

Refer to other important information






Regulatory functions of ANS

Genitalia1Structures in the eye2Internal organs3Blood vessels4Glands5


Diagnostic methods

Taking a detailed history if possiblebullNeurological ExaminationbullImaging bullNeurophysiologybull

Neurological examination

Level of consciousnessbullSpeechbullMental state and cognitive abilitybullMotor functionbullSensory functionbullCranial nerve functionbull

ElectroencephalogrambullElectromyogrambullNerve conduction testbull

Neurophysiology

Imaging

CT scanbullMRIbull


Memorisation tool MICE n TING

Metabolic disorders- Diabetic induced neuropathy Hypoglycaemia can cause coma likewise hyperglycaemia can result in ketoacidosis which likewise can result in coma

Immunological defects- Multiple sclerosis is a condition whereby there is an autoimmune response to the axon myelin sheath which causes demyelination Signal transduction is thus weaker which neurological effects can then occur from

Cerebrovascular incidents- Stroke or cerebrovascular infarct can occur reducing vital glucose and oxygen supply to brain and quickly causing necrosis Little or no storage of glucose in brain so a constant supply is vital If swelling occurs it can raise ICP which is similarly serious

Environmental factors- Examples being toxins and forms of recreational drugs Lead is one such example hence why there is such strict regulation on lead paint Alcohol with foetal alcohol syndrome being a case in point See mobile phones and recreational drugs for other areas Heavy metal encephalopathies

Trauma- Fracture of the skull or severing of the spinal cord can cause paralysis or the likelihood of developing potentially fatal haematomas Refer to PBL if interested

Infection- Meningitis which is inflammation of meninge membranes Two types viral and bacterial Viral causes serious illness whereas bacterial is often fatal Brain is relatively well protected against infection as a result of the blood brain barrier

Neoplasia- Abnormal proliferation which can cause cancers such as meningiomas Neurones are unlikely to be affected due to their cessation of mitosis after development Instead cancers can occur in supporting cells (glial- glioma) or the connective tissue cells Most cancers that are present are metastases from other locations in the body

Genetic defects- Extensive list of genetic conditions that can affect the brain One example is Huntingdons disorder whereby there is destruction of the caudate and putamen nuclei

Other important information

AXONS DO NOT I REPEAT DO NOT REGENERATE IN THE CNS They do however to a degree in the PNS Furthermore neurones as entire entities are also not replacedHigh energy requirement of brain means that there is little storage

Epilepsy- Neurological condition that can be caused by infection trauma or genetic factors Abnormal firing of neurones occurs within a epileptic focus which can spread to a large proportion of neurones in the brain causing the symptoms of the disorder such as fitting

Organisation and disorders10 January 20121408


Learning Objectives

Draw and label of a typical neuron identifying soma dendrites axon and terminals

Define the role of each cellular component in the specialised function of the neuron

Outline the organisation and functions of intracellular transport in the neuron

Define the functional subtypes of neurons and list the ways in which they are organised collectively in the nervous system

Describe the organisation of synapses

Name the main classes of neuroglia and explain their functions in the nervous system


Basic Information of the Neuron

Basic unit of the nervous system Each one can be thought of as a processing unit Responsible for the generation and transmission of electrical impulses Synapses are junctions between neurones Supported by glial cells of which there are many types Glial cells outnumber neurons 91

Nucleus

Schwann Cell

Axon TerminalsDendrites

Soma

Nodes of Ranvier

Myelin SheathDefine the role of each cellular component in the specialised function of the neuron

Soma is the metabolic centre of activity for the whole neuron

Large nucleusbullProminent NucleolusbullAbundant Rough ERbullWell developed Golgi- Required for the large amount of neurosecretionsbullAbundant mitochondriabullOrganised cytoskeletonbullMost metabolically active cell in bodybull

A highly branched structure originating from the cell body bullHas a large surface area which is improved further by the presence of protrusions called dendritic spines These structures receive the majority of synapses

bull

Large pyramidal neurons may have as many as 30-40000 spinesbull

Dendrites receives all the inputs into the cell

Axons the cellular component of the neuron concerned with the output mechanism

Impulses are generated at the axon hillock and progress away from the cell body Initiator of impulse- Axon hillock

bull

Usually only one per cell In picture above axon would be at the base of the pyramidal cell (cannot see due to focusing)

bull

Branching can occur after leaving the cell body or upon reaching the targetbullProminent microtubules and neurofilaments that contributes to cable like transporting system of the axon

bull

Can be myelinated or unmyelinated if so nodes of Ranvier are unmyelinated junctions where the action potential is propagated from

bull

As stated axons branch extensively close to a target- process known as terminal arbor

bull

Axon terminals form synapses with their targetsbullCan end with varicosities or boutons (think synaptic knob)bull

Axon terminals-

Highly organised cytoskeleton is required with microfilaments intermediate filaments and microtubules which are particularly abundant

bull

Neurofilaments play a critical role in determining axon calibrebull

Neuronal cytoskeleton-


Transport of membrane associated materialsbullVesicles with associated motors are moved down the axon at 100-400mm per daybullDifferent membrane structures targeted to different componentsbullRetrograde moving organelles are morphologically and biochemically very different from anterograde vesicle

bull

Fast axonal transport


Fast- Transports synaptic vesicles transmitters and mitochondriabullSlow - Anterograde transport results in the delivery of cytoskeletal and cytoplasmic constituents

bull


Prevalent Golgi apparatus packages neurotransmitter into vesicles which is the transported by fast anterograde transport

bull

Mechanisms are in place for the successful completion of exocytosis and in particular the fusion of the vesicles to the plasma membrane

bull

Abundant mitochondria consume about 45 of cells energy expenditure This is required for the pumping of ions and synaptic transmission

bull

Neuronal integration occurs when multiple competing synaptic inputs are integrated in post synaptic neurone

bull

Three main types of synapse

Axo-dendritic- Often excitatory- Also Grays Type 1Axo- somatic- Often inhibitory- Also Grays Type 2Axo-axonic- Often modulatory-


Cells of the Nervous System20 January 20121315



bull

Transports substances from an extracellular spacebullUses microtubule-associated ATPase to drive particles along microtubulesbullTransports soluble cytoplasmic constituentsbullIs the process by which material returns from the terminals to the cell body either for degradation or recycling

bull



Pseudounipolar

Cell has two fused process which are axonal in structure This is a sensory neuronbullExample- Dorsal root ganglion cellsbull

Bipolar

Cells in retina in addition to white matter of cortexbullBIPOLAR THINK OPPOSITES BLACK RETINA ANDbullWHITE CORTEX

Golgi Type I multipolar

Highly branched dendritic treesbullPyramidal cells of cerebral cortexbullAnterior horn cells of the spinal cordbullPurkinje cells of cerebellum (15 million)bullExtremely long extending axonsbullRetinal ganglion cellsbullPAPERbull

Golgi Type II multipolar

Highly branched dendritic treesbullShort axons that terminate near to cell bodiesbullStellate cells of cerebral cortexbull


Types of neurons

Sensory1Motor2Interneurons (responsible for modification integration coordination facilitation and inhibition of sensory input)

3

Organisational structure of Neurons


Examples include brain stem (Raphe) and deep cerebral cortex (Dentate)bullNNNucleus NNNoo capsule (unencapsulated)bull

Laminae rhymes with greybull

Laminae- Layers of functionally similar cells such as the cerebral cortex grey matter and the cerebellar grey matter



Bring information to the CNS from sensory receptors and bring axons to effector organs

bull

Often a combination of both motor and sensory neuronsbullExceptions to PNS are optic and olfactory nervesbull



These are the support cells of the nervous systembullEssential for correct functioning of neurones and have many and varied functionsbull

Astroglia

Oligodendroglia

Microglia

Immature progenitors

Ependymal cells- Epithelial lining of the ventricles

Schwann cells

Satellite glia

Examples includebull

Neuroglia

Star shaped cell (think astrology)bullMost abundant cell in CNSbullEach cell forms a specific territory that interfaces with microvasculaturebull

Fibrous astroglia (White Matter)i)Protoplasmic astroglia (Grey Matter)ii)Radial astrogliaiii)

Several different typesbull

Numerous IF bundles in cytoplasm of fibrous astrogliabullGap junctions suggest astroglia-astroglia signallingbullHas intimate associations with other cell typesbullInteracts with blood vessels in an ordered arrangement with little overlapbull

Astroglia

Scaffold for neuronal migration and axon growth during development1Formation of blood brain barrier2Transport of substances from blood to neurons3Segregation of neuronal processes (synapses)4Removal of neurotransmitters5Synthesis of neurotropic factors6Neuronal-glial and glial neuronal signalling7Potassium ion buffering8Glial scar formation9

SSS FTR NPGbull

Functions of astroglia

Myelin

Myelin is an insulating membrane found around nerve cells that is made up of lipid

bull

Up to 50 lamellae- thin plate like structurebullDark and light bands seen at EM levelbullHighly susceptible to damage and loss of either oligodendroglia or myelin is disastrous

bull

- AdrenoleucodystrophyMyelin disease states- Multiple Sclerosisbull


Potassium ion buffering8Glial scar formation9

SSS FTR NPGbull

Myelin producing cells of the CNSbullSmall spherical nucleibullFew thin processesbullProminent ER and GolgibullMetabolically highly activebull

Interfasicular oligodendroglia

Perineuronal oligodendroglia

Types includebull

Oligodendroglia

Functions of oligodendroglia

Production and maintenance of myelin sheath1Each cell can produce numerous sheaths (1-40)2

Derived from bone marrow during early developmentbullResident macrophage population of CNSbullInvolved in immune surveillancebullTypical macrophage functions- ie APCbullRole in tissue modellingbullSynaptic strippingbull

Microglia

These are the myelin producing cells of the PNSbullOnly produce one sheath per cellbullPromote axon regenerationbullSurround unmyelinated axonsbull

Peripheral Glial- Schwann Cells


Learning Objectives

Diffusion of an iono

Permeability of a cell membraneo

Electrochemical gradient of an iono

Define the following

Describe how a resting membrane potential can arise from a difference in concentration of an ion across a selectively permeable membrane (use diagrams)

Define electrochemical equilibrium for an ion

What is the equilibrium potential for an ion

The Nernst equation is Ex+ = (RTZF) ln (CoCi) You should know that Ex+ is the equilibrium potential of ion X+ R is the gas constant T is absolute temperature Z is the charge on the ion and F is Faradayrsquos number coulombs of charge per mol of ion

Substituting the values of the constants and T= 37oC gives 27

What are typical values for the concentration of K+ and for Na+ inside and outside a normal neuron

What is a typical value for the resting potential of a neuron

K+ concentration has a much stronger effect on the resting potential than Na+ concentration does Explain the basis of this difference

Diffusion of an ion- The passive movement of an ion down its concentration

gradient

Permeability of a cell membrane- The selectivity of a membrane to ions is its

permeability

Electrochemical gradient of an ion- The movement of ions from an area of

high concentration and relative charge to an area of low concentration and opposite charge



Zero-reference is outside of the cellbullThe inside of the cell is negative compared to the outsidebullAll cells have a membrane potentialbullResting potential is -70mvbull

Concentration of at least one permanent ion is different on one side of the membranebull

Permeable pores that open and close that are selective for different types of ion eg (K+ Na+ Cl- Ca2+)

bull

Open by change in membrane potential

Voltage dependent-1)

Open all the time- these are the ones that produce the resting potential

Voltage independent2)

2 major typesbull

Permeability of membrane to potassium allows it to leave generating a negative charge within the cell- Resting potential Equilibrium of electrochemical gradient is produced resulting in small flux between compartments

bull

Permeability of membrane to sodium allows it to enter generating a negative charge outside and a positive charge inside- Action Potential

bull

Ion Channels


Electrochemical equilibrium- Reached when the concentration gradient is balanced by the electrical gradient across the membrane


Equilibrium potential- Potential that prevents diffusion down the ions concentration gradient


Nernst equation

bull EX = (RTZF) ln (Co Ci)

ndash C is concentration of the ion [X+]

bull o = outside cell

bull i = inside cell

ndash Co = [X+] outside cell

ndash Ci = [X+] inside cell

bull R = gas constant

bull T = Temp o Kelvin

bull Z = charge on ion

bull -1 for Cl- +2 for Ca2+

bull F = Faradayrsquos number

bull charge per mol of ion

bull ln means log to base e

Ex- is the equilibrium potential of the ion X


EX = (27Z) ln (Co Ci)

Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92

bull What sign for the equilibrium potential

bull The sign the inside needs to maintain the concentration

gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)

bull ENa = +27 ln(15)

bull ENa = +27 +27

bull ENa = +73 mV


Sodium Potassium

Inside (mM) 10 150

Outside (mM) 150 5


-70mVbull

K+ concentration has a much stronger effect on the resting potential than Na+

concentration does Explain the basis of this difference

Potassium sodium and chlorine concentrations all contribute to the real membrane potential

bull

The size of each ions contribution is proportional to how permeable the membrane is to the ion

bull

Goldman-Hodgkin-Katz voltage equation

This is an equation used to describe the resting membrane potentialbullTHINK- youd need a rest after saying that namebull

0 means the channel is completely close

05 means the channel is open half of the time

1 means the channel is fully open

Within the equation the letter P denotes permeability or channel open probabilitybull

GHK equation worked examples

bull 1) All channels are open all the time (PK PNa PCl = 1)

bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV

bull 3) Now increase Na+ permeability by 5 (PK = 1 PNa = 005 PCl = 0)

bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV

bull Increasing permeability for Na+ makes the cell more positive

RTF at 37 oC = 27

Concentration [ ] is in Moles

bull 2) Only K+ channels are open and Cl- and Na+ channels are closed (PK = 1 PNa = 0 PCl = 0)

bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV

bull Ion concentration has not changed BUT Vm moved to EK

Graded Potentials

Resting Potential14 May 20121248



Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27

bull ENa = +73 mV GHK equation worked examples


bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV


Through these series of equations we can clearly see that potassium contributes most to the resting potential as increasing the permeability of sodium by only 5 means that the resting potential is now slightly too positive

bull

Concentration is in moles not millimoles bull

Changes in membrane potential

Graded Potentials

Graded potentials occur at synapses and sensory receptor and their function is to contribute to initiating or preventing action potentials

bull

Change in membrane potential caused by alteration in permeability of ion channels Not of a fixed time and length like action potentials

bull

Graded potentials change in membrane potential in response to stimulation bull

Can be depolarizing or hyperpolarizing

A stronger stimulus produces a larger graded potential

Graded potentials get smaller the farther they travel (Decremental spread)

Properties of graded potentialsbull


Learning Objections

You should be able to explain in general terms what the function of the action potential is

Give some examples of other types of excitable cells (in addition to neurons) in which action potentials occur

ThresholdRefractory periodldquoAll or nothingrdquo behaviourDepolarizationRepolarizationHyperpolarizationSaltatory conduction

Define the following terms as they apply to action potentials

Voltage-gated channelChannel inactivationPositive feedback

Define the following terms as they apply to the membrane channels involved in producing the action potential

Outline the sequence of events during a typical action potential in the neuron Include changes in membrane potential changes in membrane permeability and fluxes of ions across the membrane (a diagram will help)

State the size and duration (including units) of a typical action potential in a neuron

Define the term ldquoregenerativerdquo as applied to action potentials and its significance for spread of the action potential along an axon

Explain how conduction of the action potential occurs (conduction here means spread along the axon alternatively this process may be called transmission or propagation)

List two structural features that affect the conduction velocity along normal axons Briefly explain why they affect velocity as they do

Be able to list at least one pathological condition that affects conduction velocity

You should be able to explain in general terms what the function of the action potential isGive some examples of other types of excitable cells (in addition to neurons) in which action potentials occur

The function of the action potential is to transport messages through the nervous system very rapidly

bull

Action potentials also exist in muscle cellsbull


Threshold- The level of depolarisation needed to cause the triggering of an

action potential

Refractory period- Unresponsive to threshold depolarization

Absolute refractory period- New action potential cannot be triggered even with very strong stimulus because inactivation gate is closed

Relative refractory period- Inactivation gate is open but sodium channel activation gate is closed meaning a stronger than normal stimulus is required to trigger an action potential

ldquoAll or nothingrdquo behaviour- Once triggered a full sized action potential

occurs

Depolarization- When the membrane becomes more positive towards

sodiums ion equilibrium potential

Repolarization- Efflux of potassium ions to restore membrane to negative

state

Hyperpolarization- Over efflux of potassium results in membrane potential

dropping below resting potential

Saltatory conduction- From the latin (hop or to leap) is the propagation of

action potentials along myelinated axons from one node of Ranvier to the next

Voltage-gated channel- Ion channels that only open when there is a

change in voltage

Channel inactivation- Closing of the inactivation gate in response often

to an extracellular positive charge

Positive feedback- A mechanism that means that action potentials

constantly regenerate



At the resting potential voltage-gated ion channels (Na+ and K+) are closed

Note these are different to non-voltage gated channels that generate the resting potential

Resting potential PKgtgtPNa Where P is the permeability of the membrane1

Stimulus- depolarises the membrane potential and causes it to become more positive

2

PNa rapidly increases because the voltage gated Na+ channels open quicker than potassium channels

Potassium permeability increase as the voltage gated K+ channels start to slowly open and as the upstroke progresses more and more voltage gated K channels open

Potassium leaves the cell down the electrochemical gradient but is less than Na entering

Membrane potential moves toward the Na+ equilibrium potential

Depolarisation- Starts at the threshold potential3

Big decrease in PNa because the voltage-gated Na channels inactivation gate is closed and sodium entry stops generating the absolute refractory period

Moderate PK increase as there are more voltage gated K+ channels and they remain open for longer which means that K leaves by its electrochemical gradient

Membrane potential moves toward the K+ equilibrium potential

Repolarisation-4


1-2ms for an action potentialbullSize= -70 to + 40 therefore 110mVbull


If less than threshold then graded potentialbullOnce threshold is reached the cycle continues in a positive feedback mannerbullCycle continues until the voltage-gated sodium channels inactivate (closed and voltage insensitive)

bull

Membrane remains in a refractory state until the voltage gated sodium channels recover from inactivation

bull

Ions may move in and out but only a very small number of ions actually cross the membrane to change the potential ie the change in concentration is extremely small (less than 01)

bullIon Movements during action potential

Explain how conduction of the action potential occurs (conduction here means spread along the axon alternatively this process may be called

Action Potential14 May 20122245


periodModerate PK increase as there are more voltage gated K+ channels and they remain open for longer which means that K leaves by its electrochemical gradient


At rest voltage gated K channels are still open therefore K continues to leave down gradient

Membrane potential moves closer to the K+ equilibrium

Voltage gated K+ channels then close but can still possibly generate an AP if the stimulus is very strong- Relative Refractory period

Membrane potential returns to the resting potential

After hyperpolarization5

Time Course of changes in permeability

small (less than 01)


Active Propagation

Passive propagation

Only resting K+ channels

openInternal (or axial) amp Membrane

Resistance alters propagation

distance and velocity


Large diameter myelinated axons= 120msbullSmall diameter non myelinated = 1msbullSpeed of sound= 331msbull

Less resistance to current flow inside large diameter axons

Increases with axon diameter1

Action potentials only occur at nodes of Ranvier

Higher in myelinated than non-myelinated axons of the same diameter2

Reduced axon diameter (ie regrowth after injury)

Reduced myelination (MS and diphtheria)

Cold anoxia compression and drugs (some anaesthetics)

Conduction velocity is slowed by


Multiple sclerosis and diphtheria causes demyelination of axonsbull


Learning Objectives

Define the essential components required for neurotransmitter release

Understand the differences between excitatory and inhibitory transmission

Define at least two mechanisms for the termination of neurotransmitter action at the synapse

Describe how modulation of the synaptic properties of GABA can be modulated pharmacologically to treat epilepsy

Features of neurotransmission

Transfer across a synapse requires the release of neurotransmitters and their interaction with postsynaptic receptors

bull

Transmitter released from 1st cell synaptic activation of 2nd cell signal integration and signal conduction by 2nd cell

bull

Rapid timescale1)Adaptability2)Plasticity 3)Diversity4)Learning and memory5)

Features

RAPDL- sounds like rapidbullDendrites receive inputs where it is integrated in the somabull

SynapseGap is about 20-100 nmbull5000 molecules of neurotransmitter per synaptic vesiclebullHigh energy dependency is satiated by high levels of mitochondriabullPost synaptic knob is electron densebull

Features of neurotransmitters

Provide enormous diversity in variety of transmitters and their receptorsbullAmino acids (eg glutamate gamma amino butyric acid [GABA] amines (eg noradrenaline [NA] and dopamine [DA] and neuropeptides (eg opioid peptides)

bull

May mediate rapid (micro to milli second responses) or slower effects (ms)bullVary in abundance from mM to nM CNS tissue concentrationbullNeurones receive multiple transmitter influence which are integrated to produce diverse functional responses

bull


Essential componentsAn action potential is necessary to initiate neurotransmitter releasebullIt has to be very fast within ms (200 micro seconds)bullCalcium is essential- transmitter release requires an increase in intracellular Ca2+ to about 200microM

bull

A protein complex formation between vesicle membrane and cytoplasmic proteins to enable both vesicle docking and a rapid response to Ca entry leading to membrane fusion and exocytosis

bull

ATP and vesicle recyclingbull

Extra information on neurotransmittersSynaptic transmission is restricted to specialised structures ie the synapsebullSynaptic vesicles (SVs) provide the source of neurotransmitter (4000-10000 molecules per SV)

bull

Vary from mM to nM in CNS tissue concentrationsbull5-10 mM amino acids in brainbull

Activation of transmitter release is calcium dependent and requires rapid transduction

bull

Series of events= Membrane depolarisation-gt Calcium influx -gt Vesicle fusion -gt Vesicle exocytosis-gt Transmitter release

bull

From calcium influx to transmitter release has to be within this 200 microsecondsbullSuch rapid release rates can be achieved due to the vesicles being primed at the active zone close to Ca entry

bull

Localisation of vesicle at pre synaptic area Also alignment with calcium channel must occur so the response is rapid this is also helped by proteins associating between presynaptic membrane and vesicle to enable docking

bull

Vesicular proteins are targets for neurotoxinsbull

Types of neurotoxins

Botulinum toxin and tetanus destroys membrane association proteins and vesicles1Black widow spider- alpha latrotoxin that interferes with resealing of membrane so neurotransmitter is released to depletion

2

Vesicular proteins aretargets for neurotoxins

TETANUS toxinCtetani causes paralysis

BOTULINUM toxinCbotulinum causes flacid paralysis

alpha LATROTOXINblack widow spiderstimulates transmitterrelease to depletion

Zn2+-dependent endopeptidasesinhibit transmitter release

Steps of synaptic transmission

Biosynthesis packaging and release of neurotransmitter1

Membrane depolarisationaCalcium channels openbCalcium influxcVesicle fusiondVesicle exocytosis- fusion of vesicle to membrane and release of transmittereTransmitter releasef

Release

Receptor action2

Ion channel receptor- Extremely fast (msecs) mediate all fast excitatory and inhibitory transmission

bull

Glutamate can be synthesized from glucose via the TCA cycle

GABA is synthesised from Glutamate by removing a carboxyl group form N terminal Glutamate decarboxylase

CNS- Glutamate GABA

NMJ- Acetylcholine at nicotinic receptors

Examples bull

G- protein coupled receptor- Slow secs mins- Effectors may be enzymes (adenyl cyclase phospholipase C cGMP-PDE) or channels (eg Ca or K) Abundant in CNS

bull

CNS and PNS ACh at muscarinic receptors dopamine noradrenaline 5hydroxytryptamine (5ht) and neuropeptides eg enkaphalin

Examplesbull


Glutamates effects propagated by sodiumbullimport in the post synaptic membraneExcitatory postsynaptic EPSPbull(membrane is becoming depolarised)

Excitatory-


Excitatory CNS synapse mediated by Glutamate

G G

G G G

G

Excitatory amino acid

Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate

Neurotransmission10 January 20121408


import in the post synaptic membraneExcitatory postsynaptic EPSPbull(membrane is becoming depolarised)

Excitatory postsynpatic potential (EPSP)

GABA- which results from Chlorine bullentering the post synaptic neuroneInhibitory postsynaptic EPSP (membrane bullis hyperpolarized which makes it veryhard to generate an action potential

Inhibitory-

Glutamate receptors

Alpha amino-3-hydroxy-5methyl-4-isoxazole propionic acid (AMPA)bullMajority of fast excitatory synapses with rapid onset offset and desensitisationbullInitiated by just Na entrybull

AMPA receptors

N-methyl-aspartatebullSlow component of excitatory transmissionbullServe as coincidence detectors which underlie learning mechanismsbullInitiate by Na and Ca entrybull

NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate

GLUR receptor takes up Na and Ca in PosSM (Post synaptic Membrane)bullGlutamate is the transported by Excitatory amino acid Transporter (EAAT) to glial cells

bull

Here it is converted to glutamine by glutamine synthasebullHence the glial cell has removed the neurotransmitter link to Cells of the Nervous System

bull

Inhibitory CNS synapse mediated by GABA

GABA GABA

GABA GABA GABA

GABA

GABA transporter GAT

GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA

Glutamate is converted to GABA by Glutamic acid decarboxylase (GAD)bullGABA has effects on PSM receptor which causes chloride influxbullGABA is then relocated to Glial cell by GABA Transport (GAT)bullGABA trans aminase GABA-T converted GABA to Succinate semialdehydebull


In epilepsy there is an excess of glutamate which causes abnormal neuronal firingbullThe concept of GABA drugs is that they will be used to inhibit the effects of glutamatebull

Frequency of opening of channel is increased when binding to benzodiazepinesbullBarbiturates- Open channel for longerbull

alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol

Pentameric organisation of the GABA receptorand pharmacologically important binding domains

Drugs facilitating GABA transmission areantiepilepticanxiolyticsedativemuscle relaxant

Qu 1 Which of the following is NOT a normal route for neurotransmitter inactivation

Addition of a methyl group in the synaptic cleft

X Diffusion out of the cleft

Enzymatic destruction in the synaptic cleft-

Re-uptake by the pre-synaptic terminal- NE

Uptake by glial cells- GABA glutamate

X Mark = -2 (conf=2 )

Best Option Addition of a methyl group in the synaptic cleftSuch a method of inactivation does not existLecture Neurotransmitters

Pasted from lthttpswwwuclacuklaptlaptlitesysrunhtmicl08_neurof=cleari=icl1k=1u=_st1511i=Imperialgt


Session 4 Tutorial ndash Neurotransmitters and epilepsy

Tutorial notes

1 Epilepsy terminology

The term epilepsy refers to a disorder of brain function characterized by the periodic and unpredictable occurrence of seizures

bull

The term seizure refers to a transient alteration of behaviour due to the disordered synchronous and rhythmic firing of populations of brain neurones

bull

The pharmacological agents in current clinical use for inhibition of seizures are referred to as anticonvulsant or antiepileptic drugs

bull

Seizures are thought to arise from the cerebral cortex and they can be classified into bull

Partial seizures those beginning focally at a cortical site

Generalized seizures those that involve both hemispheres widely from the outset

The behavioural manifestations of a seizure are determined by the functions normally served by the cortical site at which the seizure arises

bull

LEFT HEMISPHERE WOULD CAUSE RIGHT SIDED JERKING

Thus for example a seizure involving the motor cortex is associated with clonic jerking of the body part controlled by this region of the cortex

bull

A simple partial seizure is associated with preservation of consciousness whilst acomplex partial seizure is associated with impairment of consciousness

bull

Examples of generalized seizures include absence myoclonic and tonic-clonic seizures You will be shown examples of the principal seizure types by video presentation during this teaching session

bull

2 Neurotransmitters in epilepsy

Epilepsy is a neurological disorder associated with abnormal neurotransmitter functionin the brain

bull

A decrease in GABA-mediated inhibition or an increase in glutamate-mediated excitation in the brain may result in seizure activity Indeed both glutamate and GABA are thought to play key roles in the brain mechanisms causing epilepsy in man

bull

Pharmacological evidence for a role of neurotransmitters in epilepsy

Dr Martin Croucher

Impairment of GABA-mediated inhibition causes seizures in animals eg impairment of synthesis release (tetanus toxin) or postsynaptic action (bicuculline picrotoxin)

bull

Enhancement of GABA-mediated inhibition leads to seizure suppression eg central (icv) administration of GABA or inhibition of the GABA metabolizing enzyme GABA-T (vigabatrin)

bull

Many clinically useful anticonvulsant drugs are known to act at least in part by potentiating central GABA-mediated inhibition eg benzodiazepines phenobarbital (see Section 3)

bull

Central (icv focal) administration of glutamate or glutamate receptor agonists causes seizure-like activity in animals

bull

Glutamate receptor antagonists are anticonvulsant in experimental models of epilepsy

bull

Some therapeutically effective anticonvulsant drugs act partly by blocking glutamate-mediated excitation in the brain eg phenobarbital

bull

Biochemical evidence for a role of neurotransmitters in epilepsy

Cobalt-induced seizures in rodents are associated with increased glutamate release

and with decreased GABA concentration GAD activity and GABA uptake (probably reflecting GABA neurone loss) at the seizure focus

bull

Audiogenic seizures in mice (DBA2 mice) are associated with glutamate receptor

binding in the brain and with GABA release from depolarized brain slices

bull

The baboon Papio papio which is highly sensitive to photically-induced seizures has a lower than normal CSF GABA concentration

bull

3 Some examples of antiepileptic drugs

Notes

Many neurological conditions are from malfunction in brainbullGABA malfunctions in epilepsy with propensity to repeated seizuresbull~1 in 100200bull

50 have well controlled epilepsy

25 have good control but side effects

25 have complex partial epilepsy which is poorly controlled

In epilepsy 502525 is an important ratiobull

Depression is associated with excessive noradrenalinebull

5 of people can have a seizure and 1 have epilepsybull

Epileptic focus- Excessively synchronous or sustained discharge of a group of neurones in the brain

Intracerebroventricular into lateral ventricles

ValiumLibrium are benzodiazepines

Whole list Important for exams possibly

Epilepsy can be causes by infection head trauma tumoursMeningitis-encephalitis Gliomas Stroke- ischaemic damage May occur in ~10 strokesGABA-interneurones small in CNS

Place in skull of rats and causes epileptic focus

Loud sounds causes seizures

Strobe of certain light frequency gives epilepsy Assumed that CSF is typical of brain

Generalized Seizures

Tonic- Clonic- Grand mal Tonic extension is continuous extensions which may cause the person to fall over Clonic rhythmical jerking 23 minutes

Absence- Petit mal Bit of eye fluttering 1015 secs phase out Occur very often

Myoclonic- Brief involuntary twitching of a muscle

Atonic- Lose muscle tone and posture fall forward onto face Epic face plant

Partial seizures-

Focal seizures can attribute to one direct point

Simple- Right motor cortex- left side activity Twitch tremor and face Can develop into secondary generalised seizure

Complex-Impairment of consciousness Lip smacking Temporal lobe epilepsy

Secondary generalised- Partial expands to general seizures

Parkinsons disease is caused by a lack of dopaminebullAkenisa- awkward gait Pill rolling tremorbullAlzheimers is caused by a lack of acetylcholinebull

4 Questions to be addressed

Review the process of neurotransmission occurring at central synapses utilising the inhibitory neurotransmitter GABA

bull

Present a convincing case for a role of neurotransmitter (glutamate or GABA) malfunction in the aetiology of epilepsy

bull

Draw a diagram to illustrate the principal steps in GABAergic neurotransmission (synthesis storage release etc) Indicate on your diagram i) established and ii) potential new target

bull

Epilepsy20 January 20120954


________________________________________________________________

Potential for drugs to solely target specific GABAA receptors to ensure only anti-convulsant and stop side effect of drowsiness

bull

Long acting- suicide anti convulsant

GABASynapse


bull

Draw a diagram to illustrate the principal steps in GABAergic neurotransmission (synthesis storage release etc) Indicate on your diagram i) established and ii) potential new target sites for drugs acting to enhance GABA-mediated neurotransmission in the brain

bull


Learning Objectives

Draw a diagram to explain the relationship between the following major divisions of the CNS spinal cord brainstem cerebellum diencephalon cerebral hemispheres

Define the 3 components of the brainstem and state the main functions of the brainstem

Describe the functions of the 2 main structures in the diencephalon

State the functions of the basal ganglia and the cerebellum

Draw on a diagram of the cerebral hemisphere the cortical lobes and primary cortical areas

Recognise the main structures of the brain in a diagram or MRI

Describe the 3 layers of the meninges and explain their role in protecting the brain

Explain how the major divisions of the brain relate to the cranial fossae in the base of the skull

Explain the relationship between the spinal segments spinal nerves and vertebrae and state at what level a lumbar puncture can be performed safely

Define the functions of the dorsal and ventral horns of the spinal cord and explain how the dorsal and ventral roots and spinal nerves relate to them

Identify the components of the ventricular system and relate them to the divisions of the CNS

Explain the composition circulation and functions of CSF

State the average total volume and flow rate of CSF

Define hydrocephalus and outline how it may be treated

Distinguish between an epidural (extradural) and subdural haemorrhage


pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem


Midbrain1Pons-usually very tubular and has a bulge on the anterior surface2Medulla- With pons and cerebellum lies in hindbrain3

Midbrain pons and medulla share a lot of their functions These include controlling vital functions such as breathing consciousness and also innervating cranial nerve function

bull

Cranial Nerves

All are part of the PNS apart from the optic nervebullFunctional components less regularly organised than for spinal nervesbullSupply motor and sensory innervation to the headbullAutonomic (parasympathetic) innervation to head thoracic and abdominal organsbullSpecial senses eg vision hearing balancebull

Cerebral Hemispheres

Cortex of grey matter superficially that is responsible for most brain functions

1

Basal ganglia deep within brain that are involved with movement2

The cerebral hemisphere can be divided into two main partsbull

There is also the Corpus callosum which is a tract of fibres that connect the two hemispheres

bull

Central sulcus separates off the frontal lobe from the parietal lobebullSulcus are grooves and gyri are foldsbull

Cerebellum

Co-ordinates movement in terms of timing accuracy and precision (TAP) It may also have some involvement in cognitive function and in the fear and pleasure response

bull

TAP that cerebellumbullThe hindbrain contains the pons medulla and cerebellum



Primary motor cortex is a strip Imagine that there is a man lying upside in the strip so damage to bottom of strip would affect his head or upper body

bull

Primary visual cortex- This area receives information from the retinas if there is a malfunction here it is likely you would become blind

bull

Auditory cortex receives information from inner earbullOther associated cortex areas seem to be related to higher functionbullWernickes area is involved with understanding language apparently according to recent literature the area should be moved and will then have more in common with experimental data and the area in primates

bull

Brocas area- Making speech case study evolved from a patient who had neurosyphillis destroying just that particular area and couldnt talk This area is more prominent in the left hemisphere

bullIdentify the components of the ventricular system and relate them to the divisions of the CNS

lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal


The diencephalon is a structure above the brain stembullIt is composed of the thalamus which relays information from lower structures to the cerebral cortex and the hypothalamus which is essential in coordinating homeostatic mechanisms and is the interface between CNS ANS and endocrine system

bull

Central sulcus

Lateral sulcus

CNS Lectures + Practicals31 January 20120900


lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal

Region of brain Region of ventricular system

Cerebral hemisphere Lateral ventricle

Diencephalon 3rd Ventricle

Midbrain Aqueduct

Pons and Medulla Fourth Ventricle

Lateral ventricle is C-shaped and there is one present in each hemispherebullFourth ventricle lies in front of the cerebellum and behind the pons and the medullabullHalfway down medulla it becomes the central canal and goes down into spinal cordbullEpendymal cells line the ventricular systembullChoroid plexus secretes CSFbull

Explain the composition circulation and functions of CSFState the average total volume and flow rate of CSF

The CSF is secreted by choroid plexus a structure within the lateral 3rd and 4th ventricles of the brain

bull

Most of the CSF leaves the 4th ventricle via holes and circulates via outside of the brain between the meninge membranes

bull

Lower number of cellsi)Decreased amount of proteinii)Lower Potassium and sodiumiii)Increased Magnesium and chlorine concentrationiv)

Differences between CSF and blood includebull

Circulates through ventricular system and subarachnoid space formed by the meninge membranes

bull

The CSF is reabsorbed into the venous sinuses via arachnoid villi which stops the accumulation of fluid possible oedema and a raised ICP

bull

Functions of CSF

Helps protective the brain against damage by suspending it in liquid 1Also has a few metabolic functions and waste products and helps distribute certain hormones

2

500ml per day is the flow rateTotal volume at any one time is 150ml


3 layers of the meninges

Dura mater- Tough outer layer1Arachnoid mater - Delicate middle layer2Pia mater- Layer firmly attached to the surface of the brain3

Arachnoid villus drains CSF fluid into the venous sinusbull

Meningitis

Meningitis is most likely to infect Pia Mater and subarachnoid space but in the worst cases it can also spread to the upper layers of the cortex

bull

In order to determine between viral and bacterial and meningitis one can look at the CSFbull

BacterialThere should be a high white cell count in particular neutrophilsbullProtein concentration would be increased whereas there would be a decrease in glucose concentration- dangerous for brain metabolism

bull

Bacteria may actually be themselves identifiablebull

ViralLymphocytes account for the predominant change in leukocytes countbullProtein and glucose are normalbullViral identification is unlikelybull


Brain cut in mid-sagittal plane


Inside of base of skull

Explain the relationship between the spinal segments spinal


Protein and glucose are normalbullViral identification is unlikelybull

Inferior aspect of brain

Cranial Fossae Part of brain

Anterior Cranial Frontal Lobe

Middle Cranial Temporal Lobe

Posterior Cranial Cerebellum

Lies above sphenoid bone Hypothalamus

Passes through the Foramen Magnum Medulla


Terminal end of spinal cord is called Conus MedullarisbullThere are 5 spinal segments cervical thoracic lumbar sacral and coccyx 7 12 5 5 4

bull

Spinal nerves are associated with each specific segment ie cervical etc but they do not necessarily have the same number of nerves to vertebrae and they terminate in different areas

bull

Type of vertebrae

Number of Vertebrae

Number of spinal nerves

Relationship of nerve to vertebrae

Cervical 7 8 Above

Thoracic 12 12 Below

Lumbar 5 5 Below

Sacrum 5 5 Below

Coccyx 4 (1 fused) 1 Below

The safe area to perform a lumber puncture is between L3 and L4- this is because the spinal cord has finished before this are and the nerves can be pushed aside by the needle without damage

bull

Spinal cord is much shorter than the vertebral column because the spinal cord develops mostly in the embryo whereas bones take much longer to develop

bull


VRRMM VRRMM- sound like an engine VM= Ventral + Motor neurone cell bodies The more ridiculous the better right

Ventral Horn- Contains motor neurone cell bodiesbull

DI- Dorsal + interneurones Investigate what the bloody hell goes on in the spine (Detective Inspector- DI)

Dorsal Horn- Contains interneurones which receive sensory information from the body

bull

Afferent pathway is receives of sensory information via dorsal horn efferent pathway is motor information leaving the spinal cord Spinal nerve is collection on both and thus has bidirectional information transfer

bull

Grey matter contains the neuronal cell bodies and it is the white matter that contains the bundles of axons

bull


Hydrocephalus- Water on the brain caused by CSF flow abnormalities

Communicating- All 4 ventricles affecteda)Non- communicating- Not all 4 enlargedb)

2 predominant types

Block in CSF absorption or CSF over brain surface caused bybullMeningitisbullHead injurybullCongenitalbull

MHCH

Haemorrhage (sub-arachnoid)bull

Communicating-

Block in ventricular system caused bybullAqueduct stenosisbullVentricular tumoursbull

AVPParaventricular tumoursbull

Non- Communicating-


EMA- Extradural= meningeal artery

Extradural haemorrhage is usually due to a damaged meningeal artery between the skull and the dura after head trauma

bull

Subdural haemorrhage- Usually due to a damaged vein between the dura and arachnoid membrane

bull

Both of these pathologies can cause a space-occupying lesion in the confined space bounded by the membranes and hence cause neurological pathologies

bull

Symptoms such as headache drowsiness vomiting or seizure are more likely to present quickly from an arterial (extradural) than a subdural haemorrhage

bull

Can also be confirmed by imagingbull

Subdural are more common than epiduralbullSubdural haemorrhages are more frequently seen in alcoholics the elderly patients on anticoagulants whereas epiduralextradural haemorrhages more commonly arise from blows to the side of the head



AVP

HeadachebullDrowsinessbullBlackoutsbullRaised intracranial pressurebullIncreased head circumference (in child)bull

Symptoms

Remove causes eg papillomabullPut in a shunt to divert CSFbullOpen alternate pathway- ventriculostomybull

Treatment


Brachial plexus forms at level C5-T1bull

Macrophage clears up debris along proximal end of axoniAxon sends at pseudopodia (projections of membrane) to make contact with Schwann cell which it grows through and coats it in myelin

ii

Axon reaches distal end of axon as a complete entityiiiNodes of Ranvier are reinserted however there are usually more than there was before which slows nerve conduction down slightly

iv

Axon sustains damage eg in example by forceps crushing it

Growth of axon is about 2-5mm per day

Soma undergoes chromatolysis

Failure to re-join proximal to distal end can result in Neuroma

Nerve degenerationbull

Qu 2 Which of the following statements about peripheral nerves is INCORRECT

Axons form bundles called fascicles

They may contain axons from difference spinal nerves

radic They contain only myelinated nerve fibres

They contain a mixture of fibres of different diameter

They contain a mixture of fibres of different conduction velocities


Definitions

Dorsal ramus- Posterior branches of the spinal nerves that are smaller than anteriorventral divisions Carry visceral motor somatic motor and sensory information to and from the skin and deep muscles of the backVentral ramus- Supply the antero-lateral parts of the trunk and limbs they are for the most part larger than the posterior divisionsDorsal root ganglion- Nodule on dorsal root that contains cell bodies of neurons in afferent spinal nervesDorsal root- Afferent sensory root of a spinal nerveVentral root- Efferent motor root of a spinal nerveGray ramus communicans- Contain unmyelinated postganglionic sympathetic fibres that are from ganglion of sympathetic trunkWhite ramus communicans- Preganglionic sympathetic outflow from the spinal cord

Additional info on white ramus communicans

The thoracic and the first and second lumbar nerves each contribute a branch white ramus communicans to the adjoining sympathetic ganglion Unlike the gray rami white rami communicants do not extend below L2 or above T1

bull

PNS18 May 20122302


Learning Objectives

Describe the basic anatomy of ANS innervation in terms of pre-ganglionic neurons ganglia and post-ganglionic fibres Contrast the anatomical location of sympathetic and parasympathetic ganglia

Describe the sympathetic and parasympathetic pathways and their centralspinal connections

Describe the thoracolumbar (sympathetic) and craniosacral (parasympathetic) central origins of the ANS

Describe the influence of the sympathetic and parasympathetic nervous system on the principal systemsorgans of the body (eg cardiovascular system lung gut exocrine glands) and understand the concept of dual innervation and autonomic tone (giving examples)

Understand the importance of the sacral parasympathetic outflow for innervation of structures within the pelvis eg the bladder

Classify the cholinoceptors found within the autonomic nervous system and identify the principal loci of (a) the nicotinic cholinoceptors and (b) the muscarinic cholinoceptors Note that the nicotinic receptors are ion-gated and the muscarinic receptors are G-protein coupled

Identify the neurotransmitter substances released at different levels within the autonomic nervous system and describe the principal steps involved in their biosynthesis and metabolism

CNS- ANS or SMS or NES

Principal ANS components

Exocrine glandsbullSmooth musclebullCardiac musclebullMetabolismbullHost defencebull

General information on ANS

Sympathetic- Fight and flightParasympathetic- Rest and digest

Often sympathetic and parasympathetic in many tissues are antagonists with often inhibitory functions

bull

An interesting point of note is that there are only parasympathetic nerves innervating the lungs which results in bronchoconstriction

bull

Furthermore although sympathetic is usually associated with dilation of blood vessels- maximum oxygen to muscles the sympathetic nervous system can cause vasoconstriction depending on the particular vessel receptor

bull

At rest there is usually a balance between parasympathetic and sympathetic nervous system

bull

SALIVARY GLANDS

Thick viscious secretion

Copious watery secretionSKIN

Piloerection

Increased sweating (C)HEART

rate and contractility


GASTROINTESTINAL

motility and tone

Sphincter contraction

motility and tone

secretions

BLOOD VESSELS

Constriction

(skin mucous membranes and splanchnic area)

EYE

Dilatation (Pupil)

Constriction (Pupil)

Contraction (Ciliary Muscle)

TRACHEA AND BRONCHEOLES

Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY

Increased renin secretion

URETERS AND BLADDER

Relaxes detrusor constriction of

trigone and sphincter

Contraction of detrusor relaxation

of trigone and sphincter

BLOOD VESSELS

(skeletal muscle) Dilatation

Yellow = sympathetic

Pink = parasympathetic

C = sympathetic cholinergic


Parasympathetic efferent output

Known as craniosacral- although it may affect head there are no cervical nerves

bull

4 cranial nerves are in red Vagus is most interesting as it descends into thorax and has effect on the lungs and heart etc

bull

Sacral nerves are located inferiorly to cranial nerves and innervate lower internal viscera

bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum

Reproductive organsSplachnic

nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye

Lacrimal and salivary glands

Oculomotor nerve

Vagus

Glossopharyngeal nerve

Facial nerve


Ganglia are a collection of neuronal cell bodies within the Peripheral Nervous System This is also where the neurons synapse

bull

The parasympathetic system has very long pre-ganglionic fibres cell bodies originate in CNS and move towards effector organs

bull

Ganglion are very close to effector organ- therefore short post-ganglionicbull

Parasympathetic- craniosacral

Sympathetic- thoracolumbar

Ganglion are grouped in structures just outside of spinal cord called the sympathetic trunk- this allows a very coordinated response

bull

Allows mass discharge of sympathetic nervesbullCan pass up and down sympathetic trunkbullOpposite set up very short pre-ganglionic fibres and very long post ganglionic fibres

bull

Innervation to adrenal medulla is atypical No official ganglion but adrenal medulla does almost act like one Short neurone from spinal cord and no post ganglionic neurone- neurotransmitters are released from medulla into blood stream instead

bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular

Cardiac output= SV x HR

Sympathetic activity increases the force of contraction of cardiac muscle (inotropic effect) therefore increases SV

bull

Increases HR (chronotropic effect)bullResult is a large increase in Cardiac Outputbull

Total peripheral resistance- Dual innervation

Sympathetic tone particularly affects arteriolesbullIncrease in sympathetic= vasoconstriction- increase TPRbullDecreased in sympathetic= vasodilation- decrease TPRbull

The combination of increased TPR and CO should result in increased arterial blood pressure

Vasodilation

Exceptions

Increased sympathetic activity to some blood vessels in skeletal muscle either cholinergic fibres or have adrenergic beta-receptors

bull

Local vasodilators (eg CO2 increased H+ nitric oxide and histamine etcbull

Sympathetic efferent output

Known as thoracolumbar refer to anatomy section for more detailbull

Autonomic Nervous System07 February 20120859


Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull

Local vasodilators (eg CO2 increased H+ nitric oxide and histamine etcbullAlthough parasympathetic doesnt usually have an effect it can have an effect in certain organs such as the penis clitoris GI and salivary glands

bull

Gastrointestinal tract

Sympathetic Activity Parasympathetic Activity

Generally decreases motility and tone Increases motility and tone

Usually stimulates contraction of sphincters

Usually causes relaxation of sphincters

Generally inhibits secretory activity Generally stimulates secretory activity

Think rest and digest Plus is digesting of food really an important focus if there was a lion in the lecture theatre

How can sympathetic affect lungs if there are no nerve fibres going there

Sympathetic effects via the adrenal glands and the secretion of adrenalineAdrenaline induces bronchodilation which increases oxygen delivery to the lungs

ANS innervation of the eye

Sympathetic activity Parasympathetic activity

Contracts radial muscle (pupil dilation)

Contracts pupillary sphincter (pupil contracts)

Contracts ciliary muscle lens bulges for near vision


Outline

Within the bladder there is both voluntary and ANS controlbullMain influences are parasympathetic coming from sacral region of the spinal cord

bull

Ganglion is located virtually within the tissuebullParasympathetic nerves fibres causes Detrussor muscle to contract and thus urination occurs

bull

Sympathetic nerves from the sympathetic trunk controls the internal sphincter whereby innervation closes it

bull

Voluntary control over sphincter carried by motor nervesbull

Detailed

Baroreceptors in the bladder sends information up the afferent pelvic nerveto sacral spinal cord this is known as the Micturition Reflex This reflex innervates the parasympathetic system and makes you more likely to urinateneed to urinate

bull

Afferent and efferent neurons are usually found together within the same larger nerve

bull

Decreased sympathetic outflow via hypogastric nervebullPudendal nerve is a somatic nerve that controls the ability to consciously urinate

bull

If pressure gets too great than voluntary control is overcomebull


The general synthesis of a neurotransmitter is as follows

Enzymatic conversion of precursor to active form1


Acetylcholine

ACh binds to Nicotinic or Muscarinic receptors Nicotinic is an ion channel linked receptor that is present in the ganglion This ensures that pre-post ganglionic transmission is extremely quick In effector organs we have Muscarinic which is a G-Protein Coupled Receptor This is slower but still quick

bull

Adrenergic receptors are bound by noradrenaline which is a G-Protein coupled receptor

bull

Not actually activepresent until enzyme converts from dopaminebullDoes not get broken down in the synapse It has transportreuptake proteins that transports it back to the cell

bull

Degraded in neuronebullUptake 1- back to neuronebullUptake 2- extracellular tissuebull

Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased

sympathetic activity)

Sympathetic

control

Hypogastric nerve

parasympathetic

control Detrussor muscle

(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter

(relaxes following central inhibition)

Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve

(micturition reflex)




Noradrenaline adrenaline and also dopamine belong to a group of chemicals called catecholamines because they have a catel ring

bull

All parasympathetic neurones release acetylcholine and it is ACh that also effects target organs

bull

Most sympathetic- Pre= Acetylcholine Post= Noradrenalinebull

Adrenal glands- ACh causes production of predominantly A (but also NA) by medulla

Some have ACh as pre and post ganglionic This is where sympathetic nervous are influencing secretion- sweat

Noradrenaline is main in sympathetic

Other variations exceptionsbull

Principal metabolites of noradrenaline and adrenaline

Noradrenaline Adrenaline

3-methoxy-4 hydroxy-

phenylethelene glycol

(MOPEG)Conjugation (glucuronide or sulphate)

Urine

Catechol -O-methyl transferase (COMT)

Monoamine oxidase A (MOA-A)


involved in their biosynthesis and metabolism


Enzymatic conversion of precursor to active form1Transmitter packaged into vesicles close to the surface of the neurone2Stimulation of nerve causes calcium entry into the neurone3Promotes exocytosis of neurotransmitter into synapse4Moves into synapse5Binds to receptor- random bouncing around by diffusion6Degradation of neurotransmitter by enzyme at some stage7Reuptake of certain molecules for resynthesis8

Acetylcholine

Same steps as above but the precursors are the chemicals acetyl Co-A and choline

bull

The enzyme that catalyses the formation of acetylcholine is Choline Acetyl Transferase

bull

Finally the enzyme that degrades ACh is Acetylcholin-esterasebull

Noradrenaline

The synthesis of Noradrenaline has a few more unique reactions that that of ACh

bull

Tyrosine enters the pre-synaptic neurone and is converted by Tyrosine Hydroxylase to form DOPA (dihydroxyphenylalanine) This reaction is the rate limiting step

bull

DOPA is converted by the enzyme DOPA carboxylase to dopaminebullDopamine is then packaged into a vesicle within the enzyme Dopamine βhydroxylase which converts it to Noradrenaline

bull

Unlike with ACh there is no further metabolism of the neurotransmitter after it has been bound to its receptor Instead a set of uptake proteins either take it back to the pre-synaptic neurone (Uptake Protein 1) or to the post-synaptic neurone (Uptake Protein 2)

bull

PreMOdona- Presynaptic= Mono-amine oxidase

In the PreSN an enzyme called Mono-amine oxidase A breaks down the noradrenaline back down to its metabolites inside the mitochondria

Way of remembering- Youll catch a cold if you are broken down

In the PostSN an enzyme called COMT (Catechol-O-Methyl Transferase) degrades the noradrenaline

Degredation of the noradrenaline is different depending upon its locationbull

Acetyl Co A

+

CholineCholine acetyl

transferaseACh + Co A

ACh

ACh

ACh

ACh

ReceptorEffector cell

Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase Monoamine oxidase

A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine

hydroxylaseMetabolites

DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine



Sympathetic Parasympathetic

Is a diffuse system which allows it to stimulated multiple parts of the body at once (Mass discharge)

Relatively discrete system innervating individual target tissues via specific nerves

Can also have more discrete effects

The sympathetic nervous system

The acute stress response

BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia

pre-ganglionic fibres post-ganglionic fibres

CATECHOLAMINES

Fight or flight response

First described by Cannon in 1915 as a mass sympathetic discharge in response to distress or alarm

bull

Results inIncreased arterial blood pressure1Increased blow flow to muscles and decreased levels to other areas such as splanchnic bed

2

Increased blood glucose concentration3Increased respiration4Increased awareness5

Adrenaline

Looks similar to noradrenaline in terms of synthesis but you must note that Adrenaline is NOT a neurotransmitter it is a hormone This is why there is no PostSN but a capillary instead

bull

Furthermore note that it is synthesised in Adrenal Chromaffin Cells which are specialised sympathetic post-ganglionic fibres

bull

Same initial steps as noradrenaline but Noradrenaline leaves vesicle and is changed by enzyme Phenylethanolamine Methyl Transferase (PNMT) to give Adrenaline

bull


Learning Objectives



Understand the terms sympathetic trunk plexus and subsidiary ganglia

Identify the rich sympathetic plexuses that surround the major organs and blood vessels

Understand the pre-ganglionic nature of the thoracic and lumbar splanchnic nerves and their synapses in subsidiary ganglia eg coeliac ganglion


Identify which of the cranial nerves contain parasympathetic pre-ganglionic fibres

Describe the basic anatomy of ANS innervation in terms of pre-ganglionic neurons ganglia and post-ganglionic fibres Contrast the anatomical location of sympathetic and parasympathetic gangliaDescribe the thoracolumbar (sympathetic) and craniosacral (parasympathetic) central origins of the ANS

Sympathetic

Sympathetic trunks (x2)aNerve plexusesbSubsidiary gangliac

Largest division of the ANS which consists ofbull

To cause vasoconstriction in blood vessels

Secretomotor function in sweat glands and motor function in the erector pilli muscles of hair

To accompany motor nerves to voluntary muscles but only distributed to blood vessels supplying the muscles

Viscera- dilation of pupils dilation of arterioles movement of alimentary tract and urinary bladder (ie relaxes wall constricts sphincters)

Functionsbull

Thoracic spinal nerves

Upper lumbar spinal nerves (L1-3)

Preganglionic efferent fibres arise frombull

Pre ganglionic neurons are very short and are situated in the lateral column grey matter of spinal cord T1 to L3

bull

They emerge from the spinal cord via the ventral root of the spinal nervebullThey pass through ventral ramus to white rami communicans to ganglionbullSynapse within ganglion or send fibres up and down to other ganglionbull

Postganglionic fibres are distributed to effector organ via grey rami communicansbullTravel in dorsal or ventral ramibull


Parasympathetic

Cranial nerves

Sacral (spinal) nerves


Anterior rami of S2-4

Visceral branches passing directly to pelvic viscera ie pelvic splanchnic nerves

Minute ganglia in wall of viscera giving rise to post ganglionic fibres

Sacral outflowbull

Motor fibres to rectum and bladder wall

Inhibitory fibres to bladder sphincter

Erection of penisclitoris via vasodilator fibres

Fibres also pass superiorly to supply large part of the gut with visceromotor innervation

Pelvic splanchnic nerves


The sympathetic trunks are located on either side of the spinal cord and go from the base of the skull to the coccyx and are divided as so

bull

Cervical- 3 ganglia- Superior cervical ganglion follows internal carotid arteryThoracic- 11 or 12 gangliaLumbar- 4 or 5 gangliaSacral- 4 or 5 ganglia

Sympathetic Trunks


Anatomy of the ANS19 May 20122057


Horners syndrome- Loss of sympathetic supply around the eye Ptosis- drooping upper eye lid Pinpoint pupil- unopposed parasympathetic activity Anhydrosis- loss of sweating around the eye

bull

Caused by tumour in the thorax- apex of lungbull

All parasympathetic ganglions are subsidiary ganglionsbullTherefore I would attempt to define a subsidiary ganglion as sobullSubsidiary ganglion- Any ganglions that are not part of the sympathetic system and are located next to the organ they innervate

bull


Plexus around pharynx

Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull

Plexus around thoracic aorta

Thoracic aorta supply

Pierces diaphragm and enters abdominal plexus through the great vessels

Greater

Pierces diaphragm and enter abdominal plexus through the aorta

Lesser

Pierces diaphragm and enters abdominal plexus through gut

Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia

Lumbar splanchnic nerves take part in all plexi of sympathetic nerves in abdominal and pelvic regions

Lumbarbull

Sympathetic Plexuses


Ciliary ganglionbullPost ganglionic fibres to sphincter pupillae and ciliary muscle inside the eyebull

Oculomotor Nerve (CN III)

Submandibular ganglionbullPost ganglionic fibres to submandibular and sublingual salivary glandsbullPterygopalatine ganglionbullPost ganglionic fibres to paranasal sinuses and lacrimal glandsbull

Facial nerve (CN VII)

Otic ganglionbullPostganglionic fibres to parotid glandbull

Glossopharyngeal nerve (CN IX)

Enters neck and thorax via carotid sheathbullBranches to lungs heart esophagus stomach and intestinesbull

3 7 9 10bull

Vagus nerve (CN X)

Enteric System

Myenteric (Auerbachs) plexus

Submucous (Meissners) plexus

In walls of alimentary tractbull

Sensory- monitoring mechanical chemical and hormonal activity of gutbullMotor- gut motility secretion vessel tonebullCan be overridden by sympathetic and parasympathetic systemsbull

Qu 5 Provides cannular access to the sacral epidural space for the administration of anaesthetics

Best Option Sacral hiatusThis is a naturally occurring gap at the lower end of the sacrum Because there is a failure of the laminae of the last sacral segments to coalesce this space is available for cannular use



restored rapidlyKinaesthesia Perception of movementLateral Away from the midline Lemniscus Ribbon-like bundle of axons in CNSLesion A circumscribed area of injury or diseaseMania An abnormally elevated expansive or irritable moodMedial Towards the midlineMembrane potential Potential difference across the neuronal membrane maintained by differential permeabilityMemory The retention of learned informationMiosis Pupillary constrictionMydriasis Extreme dilation of the pupilMyopia Condition in which only objects close to the eye are in focusMotor Involved in movement or responseNeoplasia Cancerous overgrowth of tissueNeurite Process of a neurone dendrite or axonNeuroglia (glia) Cells which support the function of neurones in the CNSNeuron(e) Complete nerve cell comprising cell body dendrites and axonNeuropil Complex meshwork of dendrites axon terminals and neuroglial processesNeurotransmitter Specific chemical agent released by a presynaptic neurone on excitation which crosses the synaptic cleft to stimulate or inhibit the postsynaptic cellNociception Response to noxious stimulationNucleus A collection of neurone cell bodies within the CNSNystagmus Involuntary rapid movements of the eyeballsOedema Swelling of tissue due to accumulation of fluidOphthalmoplegia Paralysis of the extrinsic eye musclesPalsy Weakness or paralysis of musclesParaesthesia Distorted sensationParalysis Loss of voluntary movement following neural injuryParaplegia Paralysis of lower limbsParesis Weakness partial paralysis

Proprioception Conscious or unconscious reception by the brain of information from muscles tendons and jointsPsychosis Abnormal mental state including altered precepts (hallucinations) and false ideas (delusions)Ptosis Abnormal drooping of the upper eyelidRamus Branch (particularly of spinal nerve)Root Interconnects spinal cord and spinal nerveRostral Towards the headQuadriplegia Paralysis of all four limbs (tetraplegia)Saccade Small quick eye movements on changing point of fixationSagittal plane Plane running vertically from front to back Seizure Sudden disturbance of consciousness or sensorimotor functionSensory Involved in receiving information from the environment (internal or external)Sign In medicine an abnormality observed by the physician and independent of the observation of the patientSomatic Relating to the body framework as distinct from the internal organsSomatotopic The orderly representation of body parts in the CNSSpasticity Condition of increased muscle tone and exaggerated tendon reflexesStria Narrow band of axons in the CNSSulcus Groove between adjacent gyriSymptom In medicine an abnormality observed by the patient and reported to the physician - symptoms are necessarily subjectiveSynapse Site of functional contact between neuronsSyndrome Group of signs and symptoms which characterise a diseaseTetraplegia See quadriplegiaTract Bundle of axons within the CNSVentral Towards the frontVisceral Relating to the internal organsVisual field The total region of space that is viewed by both eyes when fixated on a pointWhite matter Nervous tissue made up mainly of axons


Learning Objectives













Diagnostic methods





Neurophysiology

Imaging

CT scanbullMRIbull
















Learning Objectives










Nucleus

Schwann Cell


Soma

Nodes of Ranvier





bull





bull


bull


bull


bull


bull


Axon terminals-


bull





bull




bull



bull


bull


bull


bull







bull


bull



Pseudounipolar


Bipolar







Types of neurons


3









bull





Astroglia

Oligodendroglia

Microglia



Schwann cells

Satellite glia


Neuroglia





Astroglia


SSS FTR NPGbull


Myelin


bull


bull




SSS FTR NPGbull




Types includebull

Oligodendroglia




Microglia




Learning Objectives














gradient


permeability








bull





2 major typesbull


bull


bull

Ion Channels






Nernst equation

















Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27

bull ENa = +73 mV


Sodium Potassium

Inside (mM) 10 150

Outside (mM) 150 5


-70mVbull




bull


bull









bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV


Graded Potentials




Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27



bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV



bull



Graded Potentials


bull


bull







Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objectives













Diagnostic methods





Neurophysiology

Imaging

CT scanbullMRIbull
















Learning Objectives










Nucleus

Schwann Cell


Soma

Nodes of Ranvier





bull





bull


bull


bull


bull


bull


Axon terminals-


bull





bull




bull



bull


bull


bull


bull







bull


bull



Pseudounipolar


Bipolar







Types of neurons


3









bull





Astroglia

Oligodendroglia

Microglia



Schwann cells

Satellite glia


Neuroglia





Astroglia


SSS FTR NPGbull


Myelin


bull


bull




SSS FTR NPGbull




Types includebull

Oligodendroglia




Microglia




Learning Objectives














gradient


permeability








bull





2 major typesbull


bull


bull

Ion Channels






Nernst equation

















Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27

bull ENa = +73 mV


Sodium Potassium

Inside (mM) 10 150

Outside (mM) 150 5


-70mVbull




bull


bull









bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV


Graded Potentials




Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27



bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV



bull



Graded Potentials


bull


bull







Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objectives










Nucleus

Schwann Cell


Soma

Nodes of Ranvier





bull





bull


bull


bull


bull


bull


Axon terminals-


bull





bull




bull



bull


bull


bull


bull







bull


bull



Pseudounipolar


Bipolar







Types of neurons


3









bull





Astroglia

Oligodendroglia

Microglia



Schwann cells

Satellite glia


Neuroglia





Astroglia


SSS FTR NPGbull


Myelin


bull


bull




SSS FTR NPGbull




Types includebull

Oligodendroglia




Microglia




Learning Objectives














gradient


permeability








bull





2 major typesbull


bull


bull

Ion Channels






Nernst equation

















Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27

bull ENa = +73 mV


Sodium Potassium

Inside (mM) 10 150

Outside (mM) 150 5


-70mVbull




bull


bull









bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV


Graded Potentials




Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27



bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV



bull



Graded Potentials


bull


bull







Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System










bull


bull



Pseudounipolar


Bipolar







Types of neurons


3









bull





Astroglia

Oligodendroglia

Microglia



Schwann cells

Satellite glia


Neuroglia





Astroglia


SSS FTR NPGbull


Myelin


bull


bull




SSS FTR NPGbull




Types includebull

Oligodendroglia




Microglia




Learning Objectives














gradient


permeability








bull





2 major typesbull


bull


bull

Ion Channels






Nernst equation

















Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27

bull ENa = +73 mV


Sodium Potassium

Inside (mM) 10 150

Outside (mM) 150 5


-70mVbull




bull


bull









bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV


Graded Potentials




Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27



bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV



bull



Graded Potentials


bull


bull







Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System










SSS FTR NPGbull




Types includebull

Oligodendroglia




Microglia




Learning Objectives














gradient


permeability








bull





2 major typesbull


bull


bull

Ion Channels






Nernst equation

















Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27

bull ENa = +73 mV


Sodium Potassium

Inside (mM) 10 150

Outside (mM) 150 5


-70mVbull




bull


bull









bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV


Graded Potentials




Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27



bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV



bull



Graded Potentials


bull


bull







Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objectives














gradient


permeability








bull





2 major typesbull


bull


bull

Ion Channels






Nernst equation

















Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27

bull ENa = +73 mV


Sodium Potassium

Inside (mM) 10 150

Outside (mM) 150 5


-70mVbull




bull


bull









bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV


Graded Potentials




Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27



bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV



bull



Graded Potentials


bull


bull







Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System










Co

(mM)

Ci

(mM)

ENa

(mV)

Na+ 150 10 +73

Co

(mM)

Ci

(mM)

ENa

(mV)

K+ 5 150 -92



gradient

bull RTF 37 oC = 27

bull EK = (27 +1) ln(0005 M 015 M)

bull EK = +27 ln(003)

bull EK = +27 -34

bull EK = -92 mV

bull RTF 37 oC = 27

bull ENa = (27 +1) ln(015 M 001 M)


bull ENa = +27 +27



bull Vm = 27 ln(1[0005] + 1[015] + 1[0005] 1[015] + 1[001] + 1[011])

bull Vm = 27 ln(016 027)

bull Vm = 27 -05

bull Vm = -14 mV


bull Vm = 27 ln(1[0005] + 005[015] + 0[0005] 1[015] + 005[001] + 0[011])

bull Vm = 27 ln(00125 01505)

bull Vm = 27 -249

bull Vm = -67 mV


RTF at 37 oC = 27



bull Vm = 27 ln(1[0005] + 0[015] + 0[0005] 1[015] + 0[001] + 0[011])

bull Vm = 27 ln(0005 015)

bull Vm = 27 -34

bull Vm = -92 mV



bull



Graded Potentials


bull


bull







Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objections















bull




action potential





occurs




state






change in voltage











2









Repolarisation-4





bull


bull
















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System



















Active Propagation

Passive propagation


















Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objectives







bull


bull


Features





bull


bull



bull


bull



bull



bull


bull


bull


bull




2









Release

Receptor action2


bull



CNS- Glutamate GABA


Examples bull


bull


Examplesbull



Excitatory-



G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate






Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System












Inhibitory-

Glutamate receptors


AMPA receptors


NMDA receptors

G G

G G G

G


Transporter EAAT

GLIAL

CELL

Na+ Na+ and Ca2+

glucose

TCAcycleaKG

Glutamate

receptor

GLUR

GLUTAMINE

SYNTHETASE

Glutamine

Glutamate


bull


bull


GABA GABA

GABA GABA GABA

GABA


GLIAL

CELL

Cl- Cl-

glucose

TCAcycle

aKG

GABA receptor

GABAAR

Cl-

GLUTAMATE

Glutamic acid

decarboxylase

GAD (B6)

GABA trans

-aminase

GABA-T

Succinate

semialdehyde

GABA





alpha

szlig

GABA

barbiturates

steroids

benzodiazepines

Zn

convulsantsethanol














Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System










Tutorial notes



bull


bull


bull





bull



bull


bull


bull



bull


bull


Dr Martin Croucher


bull


bull


bull


bull


bull


bull




bull



bull


bull


Notes





















Partial seizures-








bull


bull


bull



________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









________________________________________________________________


bull


GABASynapse


bull


bull


Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objectives

















pons

midbrain

medulla spinal cord

cerebellum

cerebral

hemisphere

diencephalon

brainstem




bull

Cranial Nerves




1




bull


Cerebellum


bull





bull


bull


bull



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal



bull

Central sulcus

Lateral sulcus



lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









lateral ventricle

aqueduct

third ventricle

fourth ventricle

central canal




Midbrain Aqueduct





bull


bull




bull


bull

Functions of CSF


2






Meningitis


bull



bull



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System



















bull


bull

Type of vertebrae

Number of Vertebrae



Cervical 7 8 Above


Lumbar 5 5 Below

Sacrum 5 5 Below



bull


bull






bull


bull


bull




2 predominant types


MHCH


Communicating-



Non- Communicating-




bull


bull


bull


bull





AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









AVP


Symptoms


Treatment




ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System











ii


iv













Definitions




bull

PNS18 May 20122302


Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objectives














bull


bull


bull


bull

SALIVARY GLANDS



Piloerection




GASTROINTESTINAL

motility and tone


motility and tone

secretions

BLOOD VESSELS

Constriction


EYE

Dilatation (Pupil)




Dilates (Ad)

Constriction

LIVER

Glycogenolysis

Gluconeogenesis

ADIPOSE

Lipolysis

KIDNEY


URETERS AND BLADDER





BLOOD VESSELS








bull


bull


bull

Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve



bull


bull





bull


bull


bull

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels


Cardiovascular



bull





Vasodilation

Exceptions


bull






Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Cervical

Thoracic

Lumbar

Sacral

Lungs intestine

rectum


nerve

Heart

Stomach

Pancreas

Small intestine

Lung

Eye


Oculomotor nerve

Vagus


Facial nerve

Eye


Lung

Heart

Foregut

Adrenal medulla

Midgut

Hindgut

Pelvic organs

All chain ganglia

supply the skin and

blood vessels

Exceptions


bull


bull
















Outline


bull


bull


bull


Detailed


bull


bull


bull






Acetylcholine


bull


bull


bull


Noradrenaline

PRESSURE

BUILDS UP

IN BLADDER

Internal sphincter

(relaxes with

decreased


Sympathetic

control

Hypogastric nerve

parasympathetic


(contracts)

Parasympathetic

ganglion

Main Influence

Motor nerves

(voluntary control)

External sphincter


Pudendal nerve

Sacral

segments of

spinal cord

Pelvic nerve






bull


bull











Urine







Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System












Acetylcholine


bull


bull


Noradrenaline


bull


bull


bull


bull






Acetyl Co A

+



ACh

ACh

ACh

ACh


Choline +

AcetateCa++

ACh = acetylcholine

6

3

7

8

1

2

4

5

NA

Ca++

Tyrosine

DOPA

DopamineDopamine


Tyrosine

hydroxylase


A (MAO-A)

Noradrenaline

NA

Metabolites

Tyrosine

NA

Adrenoceptor

Uptake 1

Uptake 2

Degradation

(COMT)

Tyrosine


DOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

37

8

1

2

4

5

1

1

8

A

Ca++

Tyrosine

DOPA

DopamineDopamine

Dopamine

hydroxylase

Tyrosine

hydroxylase

DOPA decarboxylase

NoradrenalineNA

Metabolites

Tyrosine

A

Tyrosine

hydroxylaseDOPA

Dopamine

Tyrosine

hydroxylaseDOPA

Dopamine

6

3

1

2

4

5

1

1A

Phenylethanolamine

Methyl transferase

CapillaryA






Urine









BRAIN

(hypothalamus

and brain stem)

STRESS

ACTIONS

Spinal cord

ADRENAL

MEDULLA

sympathetic

ganglia


CATECHOLAMINES



bull


2


Adrenaline


bull


bull


bull


Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Learning Objectives









Sympathetic







Functionsbull





bull




Parasympathetic

Cranial nerves






Sacral outflowbull








bull


Sympathetic Trunks





bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System










bull



bull



Cardiac plexus

Thyroid plexus

PCTP

Pulmonary plexus

Cervicalbull




Greater


Lesser


Least

Splanchnic nerves

Thoracicbull

4 lumbar ganglia


Lumbarbull










3 7 9 10bull

Vagus nerve (CN X)

Enteric System









Neuroscience and Mental Health - Imperial College Union | · Laminae- Layers of functional similar...

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Transcript of Neuroscience and Mental Health - Imperial College Union | · Laminae- Layers of functional similar...