Introduction to the central nervous system (CNS)

The nervous system is a complex network of nerves and cells that carry messages
to and from the brain and spinal cord to various parts of the body. The proper
functioning of these nerves ensures that each organ system, such as the
cardiovascular, gastrointestinal, and immune systems, can adequately communicate
with one another.

The nervous system includes the central nervous system (CNS) and peripheral
nervous system (PNS). The CNS is made up of the brain and spinal cord, whereas
the PNS is made up of the somatic and autonomic nervous systems.

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The brain
On average, the brain weighs between 1.3 to 1.4 kg, with about 60% of the brain
consisting of fat. The remaining 40% of the brain consists of protein, water,
carbohydrates, and salts.

The brain can be divided into four distinct regions: the brainstem, cerebrum,
cerebellum, and diencephalon. Taken together, these different areas of the brain
control thought, memory, emotion, touch, motor skills, vision, breathing, hunger,
temperature, and all other processes that occur within the body.

The brain consists of both gray and white matter. Gray matter, which is darker in
color and surrounds white matter, consists of neuron somas, and round central cell
bodies. Conversely, white matter, which is lighter in color and comprises the inner
portion of the brain, is primarily made up of axons, the long stems that connect
neurons.

Gray matter typically processes and interprets information, whereas white matter
transmits information to other areas of the nervous system.
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The brainstem
The brainstem, located in the middle of the brain, is the stalk-like part of the brain
that connects the brain to the spinal cord and is only about one inch long. This region
regulates essential functions such as blood pressure, breathing, heart rhythms, and
swallowing.

The brainstem can be further subdivided into the midbrain, pons, and medulla.

The midbrain, otherwise known as the mesencephalon, is crucial for regulating eye
movements, emotions, hearing, and long-term memory. Notably, the substantia
nigra, rich in dopamine neurons, is located within the midbrain and is often affected
by Parkinson's disease.

The pons is the starting location for four of the 12 cranial nerves. Some of the
different functions regulated by the pons include facial movements, hearing,
breathing, and balance.

The medulla is located at the bottom of the brainstem where the brain and spinal
cord meet. This region of the brainstem regulates breathing, heart rate, and blood
pressure. Additionally, the medulla maintains reflective activities such as sneezing,
vomiting, coughing, and swallowing.

The cerebrum
The cerebrum is the most significant part of the brain and is lined by a deeply folded
layer of nerve tissue called the cerebral cortex. Located at the front of the brain, the
cerebrum is divided into the right and left cerebral hemispheres, both connected by
the corpus callosum.

The right hemisphere is responsible for creating awareness, emotions, facial

expression perception, posture, and prosody, whereas the left hemisphere is
dominant in language and pre-processing social emotions. The right hemisphere
controls the left side of the body, whereas the left hemisphere controls the right side.

The hemispheres are divided into four lobes, which include the frontal, temporal,
parietal, and occipital lobes.

The frontal lobe is anterior to the central sulcus and regulates voluntary movements,
speech, memory, emotions, personality, judgment, motor function, planning,
organizing, and short-term memory.

The parietal lobe is posterior to the central sulcus and above the occipital lobe. This
lobe controls spatial relationships, allowing individuals to understand where their
body is compared to surrounding objects. Furthermore, the parietal lobe allows for
perceiving sensations like pain and touch.
Broca's and Wernicke's areas are essential for speech production and
understanding. Broca's area, which controls the ability to produce speech, is located
in the frontal lobe. Conversely, Wernicke's area, which allows individuals to
understand spoken language, is located in the parietal lobe.

The temporal lobes are located at the sides of the brain and are inferior to the lateral
fissure. These lobes are essential for visual, smell, and taste processing, sound and
language interpretation, memory, and hearing.

The occipital lobe is located in the posterior portion of the brain behind the parietal
and temporal lobes and is responsible for processing visual data, including colors
and shapes.

The cerebellum
The cerebellum is located beneath the temporal and occipital lobes and above the
brainstem. The cerebrum is responsible for regulating voluntary motor function,
coordination, and balance. Recent studies have indicated that the cerebellum may
also be involved in thought, emotions, and social behaviors, as well as the
pathophysiology of addiction, autism, and schizophrenia.

The diencephalon
The diencephalon includes the thalamus and hypothalamus. The thalamus is a relay
center for sensory data, whereas the hypothalamus transmits hormonal signals to
the body through the pituitary gland.

The thalamus and hypothalamus, together with the amygdala and hippocampus,
comprise the limbic system. The amygdala regulates emotion, memory, as well as
the brain's reward system, stress, and the 'fight or flight' response to threats.

The hippocampus, located underneath each temporal lobe, is vital for long-term
memory. This structure also has a role in learning, navigation, and spatial
perception.

The spinal cord

The spinal cord is a long tube-like structure that extends from the brain. The spinal
cord can be classified into cervical, thoracic, and lumbar areas located in the neck,
chest, and lower back.

A total of 31 pairs of nerves and nerve roots comprise the spinal cord. The spinal
cord region from which a pair of spinal nerves originates is called the spinal
segment.

The cervical spinal cord consists of eight nerves that originate from the neck and run
mainly to the face and head.

A total of twelve pairs of nerves can be found within the thoracic region of the spinal
cord. These nerves allow for movements in the upper body, including extension of
the chest, upper back, and abdomen.

An additional ten pairs of nerves originate from the lower back, with five nerve pairs
in the lumbar and sacral regions. The lumbar nerve pairs proceed to the legs and
feet, whereas the sacral nerve pairs extend from the low back into the pelvis.

The meninges
The meninges are three membranous layers that cover and protect both the brain
and spinal cord. The meninges layers include the dura mater, arachnoid, and pia
mater.

The dura mater is the outermost meninges layer and can be further subdivided into
the periosteal and meningeal layers. The middle meninges layer is the arachnoid, a
web-like layer of connective tissue that does not contain any nerves or blood
vessels. Finally, the pia mater is the thinnest meninges layer.

Neurons
The neuron, the basic unit of the nervous system, is a specialized conductor cell that
receives and transmits electrochemical nerve impulses between the brain and the
rest of the nervous system.
A neuron consists of a cell body, dendrite, and axon. The cell body contains the
nucleus, which controls cellular activities and contains genetic material.

Dendrites are branched projections that extend from the cell body and receive
signals from other neurons.

Electrical signals travel down a long and thin process known as an axon, which
extends from the cell body. These chemical signals, more commonly referred to as
neurotransmitters, travel between neurons through a space known as the synapse.

Sensory neurons carry signals from sensory receptors to the brain, whereas motor
neurons carry signals from the brain to other nerves, muscles, and glands. The third
class of neurons includes interneurons.

The myelin sheath insulates neurons and is continuous along the axons or dendrites,
except at the nodes of Ranvier. Myelin, which consists of fat and proteins, provides
protection to the neuron, propagates electrical impulses between neurons, and
maintains the strength of the signal as it travels down the axon.

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The PNS
The PNS consists of both the somatic and autonomic nervous systems. Taken
together, these systems transmit information from different areas of the body to the
brain and ensure that signals sent from the brain are transmitted to other areas of
the body.

The somatic nervous system

The somatic nervous system (SNS) consists of peripheral nerve fibers that carry
sensory information or sensations from peripheral organs to the CNS. The SNS also
includes motor nerve fibers that exit the brain to carry commands for movement to
the skeletal muscles.

For example, upon touching a hot object, sensory nerves carry information about the
heat to the brain. Subsequently, the brain, through motor nerves, commands the
hand muscles to withdraw it immediately. This process takes less than one second
to complete. The neural cell body that carries this information often lies within the
brain or spinal cord and projects directly to a skeletal muscle.

The autonomic nervous system

The autonomic nervous system (ANS) controls the nerves of the body's inner organs
that cannot be controlled consciously. The ANS can be further subdivided into the
sympathetic, parasympathetic, and enteric nervous systems. Some of the different
activities controlled by the ANS include the heartbeat, digestion, subconscious
breathing, blood pressure, and sexual arousal.