LECTURE SEQUENCE: NERVOUS SYSTEM PHYSIOLOGY

Lecture
Topic Key Concepts Covered
No.
Introduction to Nervous Divisions (CNS, PNS), functions, types of neurons,
1
System basic anatomy
2 Neuron Structure & Function Neuronal types, parts of neuron, synapse, glial cells
Resting membrane potential, depolarization,
3 Generation of Action Potential
repolarization, ion channels
Neurotransmitter release, receptor types, excitatory vs.
4 Synaptic Transmission
inhibitory signals
Neurotransmitters and Acetylcholine, dopamine, serotonin, GABA,
5
Neuromodulators glutamate, etc.
Reflex arc, types of reflexes (monosynaptic,
6 Reflex Physiology
polysynaptic), spinal reflexes
Central Nervous System
7 Brain and spinal cord overview, protective structures
(CNS)
Cerebrum, thalamus, hypothalamus – functions and
8 Forebrain Physiology
integration
Brainstem parts, functions in motor control,
9 Midbrain and Hindbrain
autonomic processes
10 Cerebellum & Basal Ganglia Coordination, movement, posture, Parkinson’s disease
Somatosensory system, pain, temperature,
11 Sensory Pathways
proprioception pathways
Upper/lower motor neurons, corticospinal tract,
12 Motor Pathways
voluntary/involuntary control
Sympathetic vs. parasympathetic functions,
13 Autonomic Nervous System
neurotransmitters, receptors
Vision, hearing, taste, smell, balance – introduction to
14 Special Senses (Overview)
neural control
Sleep cycle, REM/NREM physiology, circadian
15 Sleep and Wakefulness
rhythm, brain regulation
16 Higher Brain Functions Learning, memory, emotion, language, limbic system
Disorders of the Nervous Epilepsy, stroke, Alzheimer’s, Parkinson’s,
17
System demyelinating diseases
Introduction to the Nervous System: Anatomy & Physiology

Category Details
The nervous system is a complex network of neurons that coordinates
Definition
body activities by transmitting signals between different parts of the body.
1. Central Nervous System (CNS) – Brain and spinal cord
Main Divisions
2. Peripheral Nervous System (PNS) – Cranial and spinal nerves
1. Somatic Nervous System – Voluntary control of skeletal muscles
2. Autonomic Nervous System – Involuntary control (e.g., heart, glands)
Sub-Divisions of PNS
- Sympathetic (fight or flight)
- Parasympathetic (rest and digest)
- Sensory input (detect stimuli)
Main Functions - Integration (process and interpret)
- Motor output (respond to stimuli)
1. Sensory (Afferent) – Carry signals to CNS
Types of Neurons 2. Motor (Efferent) – Carry signals from CNS to effectors
3. Interneurons – Connect neurons within the CNS
- Neurons – Transmit impulses
Major Cell Types
- Neuroglia (glial cells) – Support, protect, and nourish neurons
- Neurons: Cell body, axon, dendrites
Basic Anatomy - Synapse: Junction between neurons
- Myelin Sheath: Insulates axons to speed conduction
Physiological - Excitability – Respond to stimuli
 Category Details
- Conductivity – Transmit impulses
Properties
- Secretion – Neurotransmitter release at synapse
- Electrical (within neurons)
Signal Transmission
- Chemical (between neurons at synapses)
Acetylcholine, Dopamine, Serotonin, GABA, Glutamate,
Neurotransmitters
Norepinephrine, etc.
Neuron Structure & Function Overview

Category Details
A specialized excitable cell that transmits electrical impulses in the
Definition of Neuron
nervous system.
1. Sensory (Afferent) – Carry information to CNS
Types of Neurons 2. Motor (Efferent) – Carry signals from CNS to muscles/glands
3. Interneurons – Located in CNS, connect sensory & motor neurons
- Cell Body (Soma): Contains nucleus & organelles
- Dendrites: Receive impulses
- Axon: Conducts impulses away from soma
Parts of Neuron
- Axon Terminals: Release neurotransmitters
- Myelin Sheath: Insulates axon for faster conduction
- Nodes of Ranvier: Gaps in myelin, aid in saltatory conduction
- Junction between two neurons or neuron and effector
- Presynaptic neuron: Sends signal
Synapse
- Postsynaptic neuron: Receives signal
- Signal type: Chemical (neurotransmitter) or Electrical
- Action potential travels down axon
Signal Transmission - Triggers neurotransmitter release
- NT binds to receptor on postsynaptic cell, initiating a new signal
Neurotransmitters Acetylcholine, Dopamine, Serotonin, GABA, Glutamate,
 Category Details
Norepinephrine, etc.
In CNS:
- Astrocytes: Maintain blood-brain barrier
- Oligodendrocytes: Form myelin in CNS
Glial Cells - Microglia: Immune defense
(Neuroglia) - Ependymal cells: Line ventricles & produce CSF
In PNS:
- Schwann cells: Myelinate PNS axons
- Satellite cells: Support PNS neurons
Neuroglia and The different types of neuroglia, their structure, location, physiological role
and pathology
CLINICAL APPLICATION

Demyelinating diseases are those in which the myelin sheaths are specifically attacked. Because
Schwann cells form the myelin in the PNS, whereas oligodendrocytes form the myelin of the
CNS, the immune system attacks one or the other type of myelin. In Guillain Barre syndrome,
the T cells of the immune system (chapter 15) attack myelin sheaths of the PNS. This produces
rapid onset of symptoms that include muscle weakness (which can dangerously affect the
muscles of breathing) due to dysfunction of somatic motor axons, and cardiac and blood pressure
problems due to dysfunction of autonomic axons. Multiple sclerosis (MS) is produced by an
autoimmune attack by T lymphocytes (chapter 15, section 15.6), causing lymphocytes and
monocyte-derived macrophages (chapter 15) to enter the brain and target the myelin sheaths. The
inflammation this produces causes demyelination, partial restoration of the destroyed myelin
with neuroglia scarring, and axon degeneration. MS is usually diagnosed in people between the
ages of 20 and 40, and is twice as common among women as men. It is a chronic remitting and
relapsing disease with highly variable symptoms, including sensory impairments, motor
dysfunction and spasticity, bladder and intestinal problems, fatigue, and others. Treatment for
MS includes drugs that reduce autoimmune activity and inflammation, and drugs that interfere
with the entry of autoreactive T cells into the CNS. These drugs help in treating the symptoms of
MS, but do not restore myelin sheaths or cure the disease
Generation of Action Potential – Step-by-Step Physiology

Key Ions
Stage Description Ion Channels
Involved
- Neuron at rest, inside more
K⁺ (efflux),
1. Resting Membrane negative (~–70 mV) - Na⁺/K⁺ ATPase
Na⁺ (low
Potential - Maintained by Na⁺/K⁺ pump - Leaky K⁺ channels
influx)
and leaky K⁺ channels
- Stimulus causes slight
- Voltage-gated Na⁺
depolarization
2. Threshold Potential Na⁺ channels begin to
- If reaches ~–55 mV, action
open
potential is triggered
- Na⁺ channels open rapidly
- Na⁺ rushes into cell - Voltage-gated Na⁺
3. Depolarization Na⁺ (influx)
- Membrane becomes positive channels
(~+30 mV)
- Na⁺ channels inactivate
- K⁺ channels open, K⁺ rushes - Voltage-gated K⁺
4. Repolarization K⁺ (efflux)
out of cell channels
- Membrane returns to negative
- K⁺ channels close slowly
- Membrane potential becomes - Delayed closure of
5. Hyperpolarization K⁺
more negative than resting (~– K⁺ channels
80 mV)
- Na⁺/K⁺ pump restores ionic
6. Return to Resting gradients
Na⁺, K⁺ - Na⁺/K⁺ ATPase
Potential - Resting potential (~–70 mV) is
re-established

🔁 Summary Flow:

Stimulus → Threshold → Na⁺ influx (Depolarization) → K⁺ efflux (Repolarization) →

Hyperpolarization → Resting State

Would you like a labeled diagram of this action potential curve or a flowchart for better
visualization?
Neurotransmitters and Neuromodulators
Neurotransmitter / Main Brain Associated
Type Major Functions
Neuromodulator Regions Disorders
Muscle activation, Neuromuscular Alzheimer’s
Acetylcholine
Neurotransmitter learning, memory, junction, disease (↓ ACh),
(ACh)
attention hippocampus Myasthenia Gravis
Parkinson’s
Reward, motivation, Substantia nigra,
disease (↓ DA),
Dopamine (DA) Neurotransmitter mood, attention, ventral tegmental
Schizophrenia (↑/↓
motor control area
DA), Addiction
Mood regulation, Depression (↓ 5-
Raphe nuclei
Serotonin (5-HT) Neurotransmitter appetite, sleep, HT), Anxiety,
(brainstem)
learning, cognition OCD
Primary inhibitory
GABA (γ- Epilepsy (↓
neurotransmitter, Widespread in
Aminobutyric Inhibitory NT GABA), Anxiety
reduces neuronal CNS
Acid) disorders
excitability
Primary excitatory
Widespread in Excitotoxicity
Glutamate Excitatory NT neurotransmitter,
CNS (Stroke), Epilepsy
learning, memory
Alertness, attention,
Norepinephrine Depression (↓
Neuromodulator arousal, fight-or- Locus coeruleus
(NE) NE), PTSD
flight response
Reduced
Hypothalamus,
Endorphins Neuromodulator Pain relief, euphoria sensitivity to pain,
pituitary
stress modulation
Sleep-wake cycle, Sleep disorders,
Histamine Neuromodulator Hypothalamus
alertness, appetite allergic reactions
Chronic pain,
Spinal cord,
Substance P Neuromodulator Pain perception Inflammatory
brainstem
conditions
Autism spectrum,
Social bonding, Hypothalamus,
Oxytocin Neuromodulator emotional
emotional regulation pituitary
dysregulation

Reflex Physiology: Summary Table

 Aspect Details
A reflex is an automatic, rapid, and involuntary response to a stimulus,
Definition
typically mediated by the spinal cord or brainstem.
1. Receptor (senses stimulus)
2. Sensory neuron (transmits impulse to CNS)
Reflex Arc
3. Integration center (spinal cord or brain)
Components
4. Motor neuron (sends signal to effector)
5. Effector (muscle/gland responding)
- Monosynaptic Reflex: Involves one synapse (e.g., Knee-jerk reflex)
Types of Reflexes - Polysynaptic Reflex: Involves multiple synapses (e.g., Withdrawal
reflex)
Reflexes processed at the level of the spinal cord without direct
Spinal Reflexes involvement of the brain. Examples: Patellar reflex, Flexor (withdrawal)
reflex
- Protection from harmful stimuli
- Maintenance of posture
Functions
- Coordination of movement
- Autonomic regulation (e.g., baroreceptor reflex)
- Glutamate (excitatory in reflex arcs)
Neurotransmitters
- GABA/Glycine (inhibitory interneurons in polysynaptic reflexes)
- Hyperreflexia (seen in upper motor neuron lesions)
Associated Disorders
- Hyporeflexia/Areflexia (in lower motor neuron damage, neuropathies)
Spinal Reflexes
Aspect Details

Spinal reflexes are automatic, involuntary motor responses to specific

Definition sensory stimuli that occur via circuits located in the spinal cord,
without involving the brain initially.

Reflex arc components:

1. Sensory receptor → detects stimulus
2. Sensory neuron → transmits afferent impulse to spinal cord
Basic Structure 3. Integration center → interneurons (in spinal cord gray matter)
process information
4. Motor neuron → sends efferent impulse to effector organ
5. Effector (muscle/gland) → responds

- Monosynaptic Reflex: Direct synapse between sensory and motor

neuron (e.g., knee-jerk)
Types of Spinal Reflexes
- Polysynaptic Reflex: Involves one or more interneurons (e.g.,
withdrawal reflex)

- Stretch Reflex (Patellar Reflex): Monosynaptic; maintains muscle

tone
Examples - Withdrawal Reflex (Flexor Reflex): Polysynaptic; withdrawal from
painful stimuli
- Crossed-Extensor Reflex: Supports body when one limb withdraws

- Receptor Activation: Stimulus activates sensory receptors (e.g.,

muscle spindle for stretch reflex)
- Signal Transmission: Sensory neuron carries signal into spinal cord
Physiology - Integration: Either direct synapse or interneurons process
information
- Motor Response: Motor neuron stimulates effector muscle or gland
for immediate action

- Glutamate: Major excitatory neurotransmitter at sensory neuron

synapse
Neurotransmitters
- Glycine: Major inhibitory neurotransmitter (especially in inhibitory
Involved
interneurons)
- GABA: Contributes to inhibition to prevent excessive reflexes

- Protect body from injury (withdrawal reflex)

- Maintain muscle tone and posture (stretch reflex)
Functions - Coordinate body movements automatically (crossed-extensor reflex)
- Enable quick, survival-driven responses without conscious brain
processing
 Aspect Details

- Hyporeflexia: Reduced reflexes; seen in peripheral neuropathy,

spinal cord injury
- Hyperreflexia: Exaggerated reflexes; seen in upper motor neuron
Diseases and Disorders
lesions (e.g., stroke, spinal cord trauma)
Associated
- Spinal shock: Temporary loss of reflexes after spinal injury
- Amyotrophic Lateral Sclerosis (ALS): Motor neuron disease
affecting reflex arcs
Central Nervous System (CNS): Tabular Overview

Protective
Component Subparts / Structure Functions
Structures
- Cerebrum - Skull
- Diencephalon (thalamus, - Conscious thought, voluntary - Meninges
Brain hypothalamus) movement, sensory integration, - CSF
- Brainstem coordination, and vital regulation - Blood-brain
- Cerebellum barrier (BBB)
- Relays signals between brain and - Vertebral
- Cervical, thoracic,
body column
Spinal Cord lumbar, sacral, coccygeal
- Reflex actions - Meninges
segments
- Autonomic control - CSF
Forebrain Physiology: Cerebrum, Thalamus, Hypothalamus

Structure Location Functions Integration Role

- Sensory perception
Integrates sensory input with
Largest part of the - Voluntary motor control
memory, emotion, and
Cerebrum brain; divided into two
decision-making for
hemispheres - Language, memory,
coordinated responses
emotion, reasoning
- Relay station for
Diencephalon, Filters and directs sensory
sensory impulses
Thalamus superior to the signals to appropriate cortical
- Motor signals
brainstem areas
- Consciousness, alertness
- Regulates autonomic
nervous system Connects nervous system with
Below thalamus, part - Endocrine functions endocrine system via the
Hypothalamus
of diencephalon - Thermoregulation, pituitary; maintains
hunger, thirst, circadian homeostasis and emotion
rhythms

These components coordinate higher cognitive, sensory, emotional, autonomic, and

endocrine functions, making the forebrain central to both survival and conscious experience.
Midbrain and Hindbrain Physiology

Region Key Parts Major Functions Motor Control Autonomic Role

- Tectum
(superior &
- Controls voluntary
inferior
- Visual & auditory motor signals via - Regulates alertness
colliculi)
reflexes corticospinal tracts and reflexive actions
Midbrain - Tegmentum
- Eye movement - Dopaminergic (pupillary, auditory
- Substantia
- Sleep-wake cycle control via substantia startle)
nigra
nigra
- Cerebral
peduncles

- Part of
- Relay signals
brainstem - Modulates motor - Helps regulate
between forebrain
- Bridge control and posture breathing rhythm via
Pons and cerebellum
between indirectly via pontine respiratory
- Sleep, respiration
cerebrum and cerebellar circuits group
control
cerebellum

- Cardiovascular
- Coordinates
regulation
- Lower part of involuntary motor - Critical for heart
- Respiratory
Medulla brainstem responses rate, blood pressure,
rhythm
oblongata - Continuous - Pathway for digestion, and
- Reflex centers
with spinal cord descending motor respiration control
(coughing,
tracts
vomiting)

Cerebellum - Posterior to - Balance - Fine-tunes motor - Minimal direct

pons and - Coordination activity autonomic control, but
medulla - Muscle tone - Corrects movement supports motor-
- Learning motor errors autonomic
skills - Maintains coordination
 Region Key Parts Major Functions Motor Control Autonomic Role

equilibrium

🔁 Integration Summary

 Midbrain integrates sensory-motor information and modulates movement via dopamine.

 Pons acts as a relay for signals between cerebrum and cerebellum and influences
respiration.
 Medulla is a life-support center regulating involuntary autonomic functions.
 Cerebellum is crucial for balance and fine motor coordination but works in close
cooperation with brainstem and cerebrum.
Cerebellum & Basal Ganglia – Physiology and Functions

Primary Diseases
Structure Location Role in Movement
Functions Associated

- Coordinates
voluntary
movements - Compares intended vs
- Ataxia
Posterior to brainstem, - Maintains actual movement
Cerebellum - Dysmetria
beneath occipital lobes posture and - Smoothens and
- Hypotonia
balance corrects motor output
- Motor
learning

Basal Deep within cerebral - Regulates - Facilitates purposeful - Parkinson’s

Ganglia hemispheres (includes initiation of movements disease (↓
caudate, putamen, globus movement - Dopamine modulates dopamine)
pallidus, substantia nigra, - Inhibits excitatory/inhibitory - Huntington’s
subthalamic nucleus) unwanted pathways disease
movements - Dystonia
- Motor
planning and
 Primary Diseases
Structure Location Role in Movement
Functions Associated

habit formation

⚙️Mechanism of Parkinson’s Disease (Related to Basal Ganglia)

Aspect Details

Degeneration of dopaminergic neurons in substantia nigra pars

Cause
compacta

↓ Dopamine → disrupted balance between direct and indirect pathways

Effect on Basal Ganglia
→ bradykinesia, rigidity

Symptoms Resting tremor, slowed movement, muscle stiffness, postural instability

Neurotransmitter
Dopamine (deficiency is central to Parkinson's pathophysiology)
Involved

Spinal Cord Structure and Function –

Aspect Details

Extends from the foramen magnum (base of the skull) to the first
Spinal Cord Extent
lumbar vertebra (L1)

Gray Matter Location Located centrally in the spinal cord, shaped like an “H”

- Dorsal (posterior) horns → Receive sensory input

Gray Matter Parts
- Ventral (anterior) horns → Send motor output

White Matter
Surrounds the gray matter
Location

White Matter Division Divided into six columns called funiculi

Function of White
Contains ascending (sensory) and descending (motor) tracts
Matter

Functional Organization:
 Component Function Examples

Ascending Carry sensory information from the - Anterior spinothalamic tract: Touch,
Tracts body to the brain. pressure → thalamus

Descending Carry motor commands from the - Lateral corticospinal (pyramidal) tract:
Tracts brain to spinal cord and muscles. Motor control from cerebral cortex

Ascending tracts carrying sensory information. This information is delivered by third-order

neurons to the cerebral cortex. (a) Dorsal column-medial lemniscus tract; (b) lateral
spinothalamic tract
Naming Convention of Tracts:

Tract Type Naming Pattern Example

Ascending (Sensory) Spino- + brain target area Spinothalamic (spinal cord to thalamus)

Descending (Motor) Brain origin + -spinal Corticospinal (cortex to spinal cord)

Tract Classification and Naming

Tract Type Function Naming Convention Example

Carry sensory Start with "spino-" + Anterior spinothalamic tract

Ascending
information from body brain region of (touch & pressure → thalamus →
Tracts
to brain synapse cortex)

Descending Carry motor signals Start with brain origin Lateral corticospinal tract
Tracts from brain to body + "-spinal" (motor control from cortex)

Clinical Significance:

 Damage to ascending tracts = Sensory deficits , Loss of sensory perception (e.g., touch,
pressure, pain, temperature) (e.g., numbness, loss of pain/temp).
 Damage to descending tracts = Motor dysfunction (e.g., weakness, paralysis).
 Understanding the anatomy and tract orientation is vital for neurological localization
during spinal cord injuries, strokes, or diseases like multiple sclerosis.
Descending Motor Tracts: Pyramidal vs. Extrapyramidal

Pyramidal Tracts
Feature Extrapyramidal Tracts
(Corticospinal)
→ Reticulospinal tract
→ Lateral corticospinal tract
Main Pathways → Rubrospinal, Tectospinal,
→ Anterior corticospinal tract
Vestibulospinal
→ Cerebral cortex (Precentral → Brainstem (Reticular formation,
Origin
gyrus = Primary Motor Cortex) red nucleus, etc.)
→ Supplementary motor area → Basal ganglia, cerebellum,
Additional Input
(Superior frontal gyrus) thalamus
→ 80–90% cross in medullary
pyramids (form lateral tract) → May cross or remain uncrossed
Decussation (Crossing)
→ Remaining 10–20% cross in depending on specific tract
spinal cord (form anterior tract)
→ Monosynaptic: Direct from → Polysynaptic: Indirect, through
Synaptic Nature
cortex to spinal cord multiple nuclei
→ Fine voluntary movement → Posture, muscle tone, gross
Primary Function
(especially distal limbs) movements, facial expression
→ Skilled, conscious voluntary → Unconscious or automatic motor
Control Type
control control
Neurotransmitters → Dopamine (nigrostriatal
→ Glutamate (excitatory)
Involved pathway), GABA, others
Major Tract Example → Lateral corticospinal tract → Reticulospinal tract
→ Basal ganglia (caudate, putamen,
Key Nuclei Involved → Motor cortex only globus pallidus)
→ Substantia nigra, thalamus
→ Indirect via modulation of
Cerebellum’s Role → Minimal (indirect)
vestibular, red, and basal nuclei
Example of Lesion → Hemiparesis, muscle weakness → Parkinsonian symptoms: tremors,
Effect (opposite side) rigidity, bradykinesia
→ Parkinson’s disease,
→ Stroke affecting internal
Disorders extrapyramidal side effects of
capsule
antipsychotics
Laterality (Body Side → Right hemisphere controls left → Bilateral and complex control
 Pyramidal Tracts
Feature Extrapyramidal Tracts
(Corticospinal)
Controlled) body side (and vice versa) (via various interconnections)
→ Left hemisphere sends info to → Right hemisphere cross-talks
Corpus Callosum Role
right for bilateral hand control with left for motor behavior

🧩 Key Takeaways:

 Pyramidal tracts are direct, responsible for skilled movement and originate mainly
from the motor cortex.
 Extrapyramidal tracts are indirect, involved in posture and involuntary movement,
and modulated by basal ganglia & brainstem.
 Dopamine deficiency (e.g., in Parkinson’s) mainly affects extrapyramidal pathways,
causing motor symptoms.

FIG (below) descending pyramidal (corticospinal) motor tracts. These tracts contain axons that
pass from the precentral gyrus of the cerebral cortex down the spinal cord to make synapses with
spinal interneurons and lower motor neurons.
The higher motor neuron control of skeletal muscles. The pyramidal (corticospinal) tracts are
shown in pink and the descending motor pathways from the brain stem that are controlled by the
extrapyramidal system are shown in black
Sensory Pathways Overview

Sensory Receptors Primary Decussation Destination in

Pathway
Modalities Involved Tracts Site Brain

Fasciculus
Medulla
Dorsal Column- Fine touch, Meissner’s gracilis & Primary
(internal
Medial Lemniscus vibration, corpuscles, cuneatus → somatosensory
arcuate
(DCML) proprioception muscle spindles Medial cortex (S1)
fibers)
lemniscus

Free nerve Lateral (pain Spinal cord

Spinothalamic Pain, crude Primary
endings, & temp) (entry level,
Tract (Anterior & touch, somatosensory
thermoreceptor Anterior within 1-2
Lateral) temperature cortex (S1)
s (crude touch) segments)

Dorsal & Mostly

Muscle
Spinocerebellar Unconscious ventral ipsilateral
spindles, Golgi Cerebellum
Tract proprioception spinocerebella (partial
tendon organs
r tracts decussation)

Brainstem
Facial touch, Trigeminal Somatosensory
Trigeminothalamic Trigeminal (pons/medulla
pain, nerve (CN V) cortex (face
Pathway lemniscus depending on
temperature receptors region)
modality)

⚙️Functional Summary

Component Function

Somatosensory Cortex Receives and interprets sensory information from the body

Thalamus Relay center; filters and directs sensory signals to appropriate areas

Cerebellum Integrates proprioceptive input for coordination and balance

Spinal Cord Initial relay for pain, temperature, and some proprioceptive signals

Motor Pathways Overview

 Component Description

Upper Motor Neurons

Originate in the cerebral cortex or brainstem and synapse on LMNs
(UMNs)

Lower Motor Neurons Originate in the brainstem or spinal cord and directly innervate
(LMNs) skeletal muscles

Corticospinal Tract Main pathway for voluntary motor control

Involved in involuntary/reflex motor control (e.g., posture,

Extrapyramidal Tracts
coordination)

🚦 Types of Motor Pathways

Pathway Function Origin Termination Decussation

Lateral Fine voluntary Primary motor Spinal cord Pyramids of

Corticospinal movement (limbs) cortex (anterior horn) medulla (85%)

Anterior Voluntary movement Cervical and Partial or no

Motor cortex
Corticospinal (trunk muscles) thoracic spinal cord decussation

Upper limb flexor Red nucleus Immediately after

Rubrospinal Spinal cord
control (midbrain) red nucleus

Posture and Reticular

Reticulospinal Spinal cord Mostly uncrossed
locomotion formation

Balance and head Vestibular Uncrossed

Vestibulospinal Spinal cord
coordination nuclei (pons) (ipsilateral)

Reflex turning of Superior Crosses in

Tectospinal Cervical spinal cord
head toward stimulus colliculus midbrain

⚙️Voluntary vs Involuntary Motor Control

Aspect Voluntary Control Involuntary Control

Pathway Corticospinal tracts Extrapyramidal tracts

Initiation Conscious brain commands Reflex centers (brainstem, spinal cord)

Examples Writing, walking intentionally Postural adjustment, reflex withdrawal from heat
🧪 UMN vs LMN Lesions

Feature UMN Lesion LMN Lesion

Muscle Weakness Yes Yes

Muscle Atrophy No (mild disuse) Yes (severe)

Reflexes Hyperreflexia Hyporeflexia or areflexia

Muscle Tone Increased (spasticity) Decreased (flaccid)

Fasciculations Absent Present

Babinski Sign Positive (toe extension) Negative

🩺 Clinical Conditions Associated

Disease Area Affected Symptoms

Amyotrophic Lateral Sclerosis Muscle weakness, atrophy,

Both UMN and LMN
(ALS) fasciculations

Stroke (e.g., MCA infarct) UMN (cortex) Contralateral spastic hemiparesis

Poliomyelitis LMN (anterior horn) Flaccid paralysis

UMN or LMN (depends on

Spinal cord injury Paralysis, sensory loss
level)

The autonomic nervous system helps regulate the activities of cardiac muscle, smooth muscles,
and glands. In this regulation, impulses are conducted from the CNS by an axon that synapses
with a second autonomic neuron. It is the axon of this second neuron in the pathway that
innervates the involuntary effectors

🧠 Autonomic Nervous System (ANS) Overview

 Parasympathetic Nervous
Aspect Sympathetic Nervous System (SNS)
System (PNS)

Craniosacral (CN III, VII, IX, X,

Origin Thoracolumbar (T1–L2)
S2–S4)

Function "Fight or Flight" "Rest and Digest"

Preganglionic Neuron Short Long

Postganglionic
Long Short
Neuron

Ganglia Location Near spinal cord (paravertebral chain) Near or in target organs

Neurotransmitter
Acetylcholine (ACh) Acetylcholine (ACh)
(Pre)

Neurotransmitter Norepinephrine (NE) except sweat

Acetylcholine (ACh)
(Post) glands (ACh)

Receptors (Target) Adrenergic (α, β) Muscarinic (M1–M5)

Effect on Heart Rate Increases Decreases

Effect on Pupil Dilates (mydriasis) Constricts (miosis)

Effect on GIT Decreases motility and secretion Increases motility and secretion

Effect on Bronchi Dilates Constricts

Contracts detrusor, relaxes

Effect on Bladder Relaxes detrusor, contracts sphincter
sphincter

Effect on Blood
Constricts (↑ BP) No major direct effect
Vessels

🧪 Neurotransmitters and Receptors Summary

Region Neurotransmitter Receptor Type Effect

Preganglionic Excitatory to postganglionic

ACh Nicotinic (Nn)
(both) neuron

Postganglionic SNS NE α1, α2, β1, β2 Variable (e.g., ↑ HR,

 Region Neurotransmitter Receptor Type Effect

vasoconstriction)

Muscarinic (M1– Variable (e.g., ↓ HR, ↑ GIT

Postganglionic PNS ACh
M5) activity)

ACh → E/NE
Adrenal medulla Nicotinic (Nn) Systemic fight-or-flight response
release

🩺 Clinical Relevance

Disorder Affected Division Symptoms

Autonomic SNS (common in spinal

Hypertension, bradycardia, sweating
Dysreflexia injury)

Horner’s Syndrome Sympathetic lesion Ptosis, miosis, anhidrosis

Sudden fainting due to bradycardia,

Vasovagal Syncope Parasympathetic overactivity
hypotension

Adrenal medulla (SNS

Pheochromocytoma Hypertension, tachycardia, sweating
tumor)
Special Senses Overview Table

Function / Primary
Sense Sensory Organ Receptors Primary Nerve(s)
Perception Brain Area

Detection of Occipital lobe

Photoreceptors
Vision Eye (retina) Optic nerve (CN II) light, color, (visual
(rods & cones)
shape, motion cortex)

Detection of
Temporal
Cochlea (inner Hair cells in Organ Vestibulocochlear sound waves,
Hearing lobe (auditory
ear) of Corti nerve (CN VIII) pitch &
cortex)
intensity

Facial (CN VII), Perception of Insula &

Taste buds
Chemoreceptors Glossopharyngeal sweet, salty, parietal
Taste (tongue,
(gustatory cells) (CN IX), Vagus (CN sour, bitter, cortex
pharynx)
X) umami (gustatory)

Detection of Olfactory
Olfactory
Olfactory receptors Olfactory nerve (CN volatile bulb →
Smell epithelium
(bipolar neurons) I) chemical Temporal
(nasal cavity)
substances lobe

Vestibular
apparatus (inner Detection of Cerebellum
ear: Mechanoreceptors Vestibulocochlear head position, & brainstem
Balance
semicircular (hair cells) nerve (CN VIII) acceleration, vestibular
canals, utricle, equilibrium nuclei
saccule)

🎯 Key Points in Neural Control

  Vision: Light passes through cornea → lens → retina → phototransduction by rods/cones
→ optic nerve → visual cortex.
 Hearing: Sound waves vibrate tympanic membrane → ossicles → cochlea → hair cell
stimulation → CN VIII → auditory cortex.
 Taste: Tastants bind to receptors → CN VII/IX/X transmit → medulla → thalamus →
gustatory cortex.
 Smell: Odorants bind to olfactory receptors → CN I → olfactory bulb → olfactory tract
→ limbic system & cortex.
 Balance: Head movement → endolymph shifts → hair cells bend → CN VIII →
brainstem & cerebellum for motor response.

Sleep & Wakefulness Physiology Table

Aspect Details

- NREM Sleep (Non-Rapid Eye Movement)

Sleep Types
- REM Sleep (Rapid Eye Movement)

- Stage 1: Light sleep, alpha to theta wave shift

NREM Stages - Stage 2: Sleep spindles, K-complexes
- Stage 3: Deep sleep (slow-wave), delta waves

- High brain activity, dreaming, muscle atonia

REM Sleep
- EEG resembles wakefulness

Repeats every 90–110 minutes, cycling through NREM → REM; ~4–6

Sleep Cycle
cycles per night

24-hour internal biological clock regulated by suprachiasmatic nucleus

Circadian Rhythm
(SCN) of hypothalamus

- Melatonin: Released by pineal gland (↑ at night)

Hormonal Control
- Cortisol: Peaks in morning

- Hypothalamus (SCN, VLPO)

Brain Areas
- Thalamus
Involved
- Brainstem (reticular formation, pons)

- Promote wakefulness: Acetylcholine, norepinephrine, dopamine,

Neurotransmitters histamine, orexin
- Promote sleep: GABA, adenosine, melatonin

Functions of Sleep - Brain restoration and memory consolidation

 Aspect Details

- Synaptic plasticity
- Hormonal regulation, immune support

- Insomnia
- Narcolepsy (orexin deficiency)
Disorders
- Sleep apnea
- Parasomnias

Higher Brain Functions – Overview Table

Brain Regions Associated

Function Physiology/Mechanism Neurotransmitters
Involved Disorders
Hippocampus, Encoding, consolidation Glutamate, Learning
Learning prefrontal cortex, (especially during sleep), dopamine, disabilities,
cerebellum and retrieval of information acetylcholine dementia
Hippocampus - Short-term: prefrontal
Alzheimer's
(short-term to long- cortex Acetylcholine,
Memory disease,
term), amygdala, - Long-term: hippocampus glutamate, serotonin
amnesia
temporal lobe to neocortex
Amygdala, Depression,
Emotional responses, fear Serotonin, dopamine,
hypothalamus, anxiety
Emotion processing, mood norepinephrine,
cingulate gyrus, disorders,
regulation GABA
frontal cortex PTSD
Broca's area
(speech), Production and
Aphasia,
Language Wernicke's area understanding of speech Glutamate, dopamine
dyslexia
(comprehension), and written language
angular gyrus
Hippocampus,
Regulation of emotion, Serotonin, dopamine, Mood
Limbic amygdala,
memory, motivation, and acetylcholine, disorders,
System hypothalamus,
olfaction GABA schizophrenia
cingulate cortex

🌟 Key Points:

 Hippocampus is vital for forming new memories.

  Amygdala regulates emotional responses and fear.
 Broca’s area (left frontal lobe) is involved in speech production.
 Wernicke’s area (left temporal lobe) manages language comprehension.
 The limbic system integrates memory and emotional processing.

Disorders of the Nervous System – Summary Table

Affected Key Neurotransmitte Common

Disorder Physiological Basis
Area Symptoms rs Involved Treatments
Seizures,
Abnormal, excessive loss of Antiepileptics
Cerebral GABA (↓),
Epilepsy neuronal firing consciousnes (e.g., valproate,
cortex Glutamate (↑)
causing seizures s, muscle carbamazepine)
spasms
Interrupted blood Sudden
supply paralysis, Thrombolytics
Brain tissue Glutamate (↑
Stroke (ischemic/hemorrhag speech (ischemic),
(localized) excitotoxicity)
ic) leads to neuronal difficulty, physiotherapy
death vision loss
Memory
β-amyloid plaques &
Hippocampu loss, Cholinesterase
Alzheimer tau tangles impair Acetylcholine
s, cerebral confusion, inhibitors, NMDA
’s synaptic (↓), Glutamate
cortex disorientatio antagonists
communication
n
Parkinson’ Substantia Degeneration of Tremors, Dopamine (↓) Levodopa,
 Affected Key Neurotransmitte Common
Disorder Physiological Basis
Area Symptoms rs Involved Treatments
nigra dopaminergic rigidity, dopamine
s
(midbrain) neurons bradykinesia agonists
Muscle
CNS white Varies;
Autoimmune weakness,
Multiple matter (brain demyelination Immunomodulato
demyelination of visual issues,
Sclerosis & spinal affects rs, corticosteroids
neurons coordination
cord) transmission
problems

🔍 Key Insights:

 Epilepsy results from hyperexcitability of neurons.

 Stroke damage is rapid and irreversible if not treated urgently.
 Alzheimer’s is progressive and starts with short-term memory loss.
 Parkinson’s motor symptoms worsen due to dopamine depletion.
 Multiple Sclerosis (MS) causes relapsing and remitting neurological deficits.