OLEHProf.Dr. H.GUSBAKTI

The PNS consists of sensory neurons running from stimulus receptors that inform the CNS of the stimuli motor neurons running from the CNS to the muscles and glands - called effectors - that take action.The CNS consists of the spinal cord and the brain The peripheral nervous system is subdivided into the sensory-somatic nervous system and the autonomic nervous system

The Sensory-Somatic Nervous SystemThe sensory-somatic system consists of 12 pairs of cranial nerves and 31 pairs of spinal nerves.

The peripheral nervous system (PNS) is the system of nerves outside of the central nervous system (CNS or brain and spinal cord).

The central nervous system (CNS) is responsible for all involuntary nerve action, meaning you DO NOT have to initiate it or think about it in order for it to work.

The peripheral nervous system (PNS) runs from your spinal cord to your appendages (arms, legs, hands and feet) and you DO HAVE TO consciously and voluntarily make this nervous system move or work.

"Included" in the peripheral nervous system (PNS) are the 12 pairs of cranial nerves, 31 pairs of spinal nerves and their branches to the entire body. Also included in this system are all sensory nerves and the sympathetic and parasympathetic nerves. The parasympathetic and sympathetic nervous system are part of the autonomic nervous system (ANS).

SISTEM SARAF PERIFER SS SOMATIK & OTONOM MEMBAWA INPUT INFORMASI KE (AFF) KE CNS MENGHANTAR INPUT KE PERIFER (EFF)

PERANAN CNS:MENELITI DN MENGEVALUASI (MIS: MEMBANDINGKAN INFEORMASI YG DISIMPAN)MENGOLAH INFORMASI YG DITERIMA RESPON THDP INPULS EFEREN

CNS BERFUNGSI MELAKUKAN INTEGRASI DAN KOORDINASITDD : OTAK DAN MEDULLA SPINALISOTAK :, MED OBLONGATA, PONS, MESENSEFALON (BTG OTAK), SEREBELUM, DIENSEFALON DAN TELESEFALONBTG OTAK KONTRUKSINYA = MED SPINALISMGDG BDN SEL (NUCLEUS) SARAF SEREBRI

BTG OTAK KONTRUKSINYA = MED SPINALISMGDG BDN SEL (NUCLEUS) SARAF SEREBRI DAN BGN LAINNYAPUSAT PENGATUR RESPIRASI & SIRKULASIJUGA SEP SEREBELUM PENTING PENGATURAN MOTORIK

DIESEFALON MELIPUTI ;TALAMUS PENGHUBUNG SEMUA INPUT SENSORIK AFEREN (KULIT,MATA,TELINGA DAN BGN OTAK LAINNYA)HIPOTALAMUS ; PUSAT FUNGSI OTONOMIKINTEGRASI SISTEM SARAF DG SISTEM ENDOKRIN MELALUI HIPOFISE

TELENSEFALON TDD NUKLEUS DAN DAERAH KORTIKALMELIPUTI BASAL GANGLIA UTK MENGATUR MOTORIKBASAL GANGLIA TDDNUKLEUS KAUDATUSPUTAMENGLOBUS PALLIDUSNUKLEUS SUBTALAMIKUSSUBSTANSIA NIGRANUKLEUS KAUDATUS, PUTAMEN KORPUS STRIATUMPUTAMEN & GLOBUS PALIDUS NUKLEUS LENTIKULARIS

TELENSEFALON PERMUKAAN EKSTERNALNYA KORTEKS SEREBRI TDD SULKUS (LEKUKAN) SENTRALIS DAN LATERALISMENJADI 5 LOBUS ;LOBUS FRONTALISLOBUS PARIETALISLOBUS OKIPITALISLOBUS TEMPORALISLOBUS LIMBIKKEDUA HEMISFER DIHU ERAT SATU DG LAINNYA OLEH KORPUS KOLOSUM

KORTEKS SEREBRI TEMPAT ASAL SEMUA KESADARAN DAN KERJA BAWAH SADARSTASIUN PENGUMPUL & PEMEROSES KESAN SENSORI, SENSASI DAN PERSEPSI, SERTA PUSAT MEMORI

BASAL GAGLIA DISCHARGE BEGINS BEFORE MOVEMENTINVOLVED IN PLANNING AND PROGRAMMING OF VOLUNTARY MOVEMENTINHIBITS THE MUSCLE TONEREGULATES THE SUBCONSCIOUS GROSS MOVEMENTS IN MUSCLEROLE IN COGNITIVE PROCESSES CAUDATE NUCLEUSSUBSTANSIA NIGRA INVOLVED IN COORDINATION OF IMPULSES ESSENTIAL FOR SKILLED MOVEMENTSCENTER FOR CONTROL NORMAL AUTOMATIC MOVEMENTS LIKE SWINGING OF ARMS DURING WALKING

APPLIED PARKINSOS DISEASE CASE DEGENERATION OF SUBSTANSIA NIGRA & GLOBUS PALIDUSCHARACTERISTIC: RIGIDITY, POSTURE IN FLEXED ATTITUDE, DUE TO LACK OF DOPAMINERGIC ACTIVITY AND DEGENERATION OF SUBSTANTIA NIGRA

RESTING TREMORHIPOKINESIA DIFICULTY IN INITIATING VOLUNTARY MOVEMENTSLOW SPEECH, MASK LIFE FACE, SHUFFLING GAIT, LOSS OF MOVEMENT DURING WALKING SUCH AS SWINGING OF ARMS

CHOREA SPONTANEOUS INVOLUNATRY MOVEMENTS DUE TO DAMAGE TO THE CAUDATE NUCLEUSFEATURES : MUSCLE WEAKNESS, RAPID, IRREGULAR, INVOLUNTARY MOVEMENTS

ATHETOSIS DUE TO LESION OF LENTICULAR NUCLEUSFEATURES : CONTINOUS SLOW, TWISTING MOVEMENTS

WILSONS DISEASE COPPER CONTENT OF SUBSTANTIA NIGRA INCREASEDFEATURES : CIRRHOIS OF LIVER, MUSCULAR RIGIDITY, TREMOR, EMOTIONAL PROBLEMS

*Note: These do contain a few sensory neurons that bring back signals from the muscle spindles in the muscles they control.

The Cranial Nerves

NervesTypeFunctionI Olfactorysensoryolfaction (smell)II Opticsensoryvision (Contain 38% of all the axons connecting to the brain.)III Oculomotormotor* eyelid and eyeball musclesIV Trochlearmotor*eyeball musclesV TrigeminalmixedSensory: facial and mouth sensation Motor: chewingVI Abducensmotor*eyeball movementVII FacialmixedSensory: taste Motor: facial muscles and salivary glandsVIII Auditorysensoryhearing and balanceIX GlossopharyngealmixedSensory: taste Motor: swallowingX Vagusmixedmain nerve of the parasympathetic nervous system (PNS)XI Accessorymotorswallowing; moving head and shoulderXII Hypoglossalmotor*tongue muscles

Central nervous systemBrainProsencephalonTelencephalonRhinencephalon, Amygdala, Hippocampus, Neocortex, Basal ganglia, Lateral ventriclesDiencephalonEpithalamus, Thalamus, Hypothalamus, Subthalamus, Pituitary gland, Pineal gland, Third ventricleBrain stemMesencephalonTectum, Cerebral peduncle, Pretectum, Mesencephalic ductRhombencephalonMetencephalonPons, CerebellumMyelencephalonMedulla oblongataSpinal cord

OLEHProf.H.Dr. GUSBAKTI

rhombencephalonprosencephalon

Two hemispheresSeparated by falx cerebriInterconnected by corpus callosumThree polesThree surfacesFive lobesOuter gray matter & inner white matter

It has 25 billion neurons, 62,000 miles of axons and 300,000,000,000,000 synapses2-4mm thick2200 sq cmGyri and sulciImportant sulci- Central (Rolandic) sulcus, Lateral (Sylvian) sulcus, Parieto-occipital sulcus, Calcarine sulcus

Brodmann- 47 Brodmann areasArea 4- Primary motor area- Precentral gyrusArea 3,1,2- Primary sensory area- Postcentral gyrusArea 6, 8-13, 24, 32, 44-47 Frontal association areaArea 41- Primary auditory areaArea 20, 21, 22- Auditory association areasArea 5, 7- Sensory association areasArea 40- Stereognosis areaArea 17- Primary visual areaArea 18, 19- Visual association areas

Lies between central, parieto-occipital & lateral sulci.

Major areas- (1) Somatosensory area I(2) Somatosensory area II(3) Area 5 & 7(4) Area 40

Somatosensory Area IPostcentral gyrusAreas 3,1,2Afferents from opposite side of body and both sides of faceSensory homunculus (little man)Removal- causes loss of fine touch & position sense and deficits in discrimination of size and shape.

(2) Somatosensory Area II:Mostly buried in superior wall of Sylvian fissureAfferents from both sides of bodyRemoval cause deficits of discrimination power

(3) Sensory Association Area ( Areas 5 & 7)Located behind S IInputs from S I, ventrobasal nucleus of thalamus, visual and auditory cortex.Removal causes amorphosynthesisBilateral removal causes constructional apraxia and loss of spatial orientation

(4) Area 40- Stereognosis Area Located in supramarginal gyrus

Appreciation of primary sensesDiscrimination of stimuliStereognosis Recognition of spatial relationshipIntegration of general, auditory and visual sensory signals

Lies in front of central sulcus

Major areas- Motor cortex and prefrontal areas

Primary Motor Area: Area 4Precentral gyrusMotor homunculusFace, pharynx, vocal cords and respiratory muscles have bilateral representation

Supplementary motor area medially beyond the margin of central sulcus over medial surfaceIt is concerned with complex movements involving planning

Premotor Area: Area 6Located anterior to motor cortexTopography is same as motor cortexPostural movements to assist specific tasksAnterior part develops motor image and send signals to posterior part or primary motor cortex.

Frontal eye field: Area 8Lies anterior to premotor areaStimulation causes conjugate deviation of eyes to opposite sideSuppressor Areas: Areas 4s, 2s, 8s, 19s & 24sInhibition of stretch reflexProjects to basal ganglia also

Lies anterior to motor areas 4, 6 & 8.Major areas are 9-13, 24, 32 and 44-47.Silent area/organ of mindConnections:Afferents- Fibers from dorsomedial nucleus of thalamus project to areas 9-12 and 44-47. Dorsomedial nucleus receives afferents from hypothalamusFibers from anterior nucleus of thalamus projects to area 24. It forms a part of Papez circuit

Efferents-Areas 24s and 8s project to caudateFrontopontine tract from area10Coritcotegmental tract from area 8Projections from areas 9 & 10 to tegmental reticular formation and anterior & ventral thalamic nucleiIntercortical connections-Fronto-occipital projection (visual agnosia)Fibers form areas 44-47 and area 18 pass to temporal lobe

Functions of Prefrontal lobe:Connections with thalamus, hypothalamus & other areas of cortexControl of ANSControl of personalityControl of emotional affectsControl of behaviour & social consciousnessResponsible for resting EEG

3. Alterations in social behaviourRemoval of anterior cingulate gyrus abolished moral sense of right or wrong Loss of shyness and fear4. Impairment of memory5. Impairment of learning and intellectual functionsElectrical stimulation-Changes in autonomic activity

Lies below lateral sulcusPrimary auditory area- Area 41Auditory association area- Areas 20,21,22Wernickes area- Area 22

Functions:Perception and processing auditory signalsSense of equilibrium in posterior part of superior temporal gyrusLanguage and memoryWernickes area is associated in interpretation and understanding of auditory & visual signals

Klver-Bucy syndrome (bilateral temporal lobectomy):Obedient, hyperphagic (omniphagia) & hypersexualLoss of fearVisual agnosiaOral explorationHyper-metamorphosis

Lies posterior to parieto occipital sulcusAreas 17, 18, 19Primary visual and visual association areas

Works in close association with hypothalamusConcerned with emotions and memory

OLEHProf.H.Dr. GUSBAKTI

SYMPHATETICPARASYMPHATETICfight or flight activated during emergenciesexercise or vigorous physical activityrev up the body to respond to situations, such as anger or fear that upset homeostasis

opposite effects on its target organsrest or digestreduce energy usepromotes the digestion of food,the storage of energy,the elimination of wastesgeneral homeostasis

The autonomic nervous system consists of sensory neurons and motor neurons that run between the central nervous system (especially the hypothalamus and medulla oblongata) and various internal organs such as the:

It is responsible for monitoring conditions in the internal environment and bringing about appropriate changes in them. The contraction of both smooth muscle and cardiac muscle is controlled by motor neurons of the autonomic system. The actions of the autonomic nervous system are largely involuntary (in contrast to those of the sensory-somatic system). It also differs from the sensory-somatic system is using two groups of motor neurons to stimulate the effectors instead of one. The first, the preganglionic neurons, arise in the CNS and run to a ganglion in the body. Here they synapse with postganglionic neurons, which run to the effector organ (cardiac muscle, smooth muscle, or a gland).The autonomic nervous system has two subdivisions, the sympathetic nervous system and the parasympathetic nervous system.

ThoracolumbarNerve fibers originate between T1 & L2

CraniosacralNerve fibers emerge from brain & sacrum

Ganglia close to spinal cord Short, lightly myelinated preganglionic neurons Long, unmyelinated postganglionic neurons

Preganglionic neurons - Cholinergic = ( release acetylcholine )

Adrenal medulla: releases epinepherine & norepinepherine into bloodie. Adrenergic Postganglionic neurons: release norepinepherine at target organs ie. Adrenergic

Located only on sympathetic target organs Respond only to norepinepherine released by postganglionic neurons (precise effects) orEpinepherine & norepinepherine released by adrenal medulla into blood (general effects)

Alpha 1:In walls of blood vessels leading to places other than skeletal muscles, brain & lungs.Not on heart (cardiac muscle)Alpha 2:On membranes of platelets.

Beta 1:On heart (cardiac muscle) & kidneys Beta 2:On coronary arteries, bronchioles & on smooth muscle walls of digestive & urinary systems

Alpha 1:Excites (constricts) smooth muscles in certain blood vessels & in spincters directing blood to skeletal musclesDilates pupils.Alpha 2:Promotes blood clottingBeta 1:Cardiac Muscle Increases heart rate & strengthBeta 2:Depresses (dilates) smooth muscle in bronchioles & coronary arteries increasing blood flow to heart and air flow to lungs.

Ganglia close to or on target organs

Preganglionic neurons - long

Post ganglionic neurons - short

Preganglionic neurons release acetylcholine = Cholinergic

Postganglionic neurons release acetylcholine = Cholinergic

Found on skeletal muscle cells regulated by motor neurons.Motor Neuron

Found on dendrites & cell bodies of postganglionic neurons of both sympathetic and parasympathetic divisions of ANS.

Found on parasympathetic target organs.

Nicotinic:On skeletal muscle cellsOn postganglionic dendrites & cell bodies in both sympathetic & parasympatheticAlmost always exciteMuscarinic:On all target organs of parasympatheticMay excite or decrease activity depending on target

Cardiac Muscle - Slows heart rate and strength of contractionDigestive System - Increases digestive activity including secretions & peristalsis. Increases flow of blood to liver, pancreas & digestive organs by vasodilation of appropriate vessels.Eye - Causes constriction of Iris

Interfere with stimulatory or depressing effects of neurotransmitters by blocking the receptors on target organs.Normal neurotransmitter cant bind with receptor because blocker covers the binding site.

Block receptor binding sites preventing the binding of epinepherine or norepinepherineBeta 1 blockers on heartprevent heart rate increase & arrhythmias in cardiac patients without interfering with other sympathetic effects.Examples: Acebutolol (Sectral), Metoprolol (Lopressor)or Inderal.

Alpha 1 blockersDecrease blood pressure in patients with hypertension without interfering with other sympathetic effects.Example:Phentolamine

Muscarinic blockersBlock parasympathetic effects on target organsExample:Atropine Used topically during eye exams to dilate pupilsSometimes used prior to surgery to reduce salivation & respiratory secretions

THANKS FOR LISTENING

THANKS FOR LISTENING

*The Sympathetic division of the ANS is sometimes referred to as the thoracolumbar branch * because its nerve fibers * arise from the central nervous system (spinal chord) between the first thoracic and the second lumbar vertebrae. * **The Parasympathetic division of the ANS is sometimes referred to as the craniosacral division because its nerve fibers arise from the Central Nervous System directly from the brain in the cranium * and from spinal chord between the sacral vertebrae. **The target organs whose activities are regulated by the ANS are innervated by two neurons in tandem which synapse in ganglia * between the Central Nervous system and the target organ. The first ( preganglionic neuron) arises from the CNS * and carries information to the ganglion, * while the second carries information from the ganglion to the target organ (postganglionic neuron). *The particular arrangement of these neurons that is characteristic of the Sympathetic division, includes a short, lightly myelinated preganglionic neuron and a much longer, unmyelinated postganglionic neuron which reaches from the ganglion to the target organ. Since the preganglionic neurons are short, the ganglia in which the sympathetic neurons synapse are located very close to the spinal cord itself. * Thus the innervation of visceral targets in the sympathetic division include a short preganglionic neuron, a ganglion that is close to the spinal cord and a much longer postganglionic neuron that reaches out to the target organ. **As far as neurotransmitters are concerned, the preganglionic neurons of the Sympathetic division of the ANS release the neurotransmitter, acetylcholine (ACH). * Thus the preganglionic neurons are said to be cholinergic. * An exception to the general rule that two neurons are necessary to innervate target organs is the adrenal gland. When stimulated, the preganglionic neuron carries information directly to the adrenal gland, and releases acetylcholine. * The ACH causes the adrenal gland to release its neurotransmitters epinepherine (adrenaline) & norepinepherine (noradrenaline) directly into the blood. When blood carrying these neurotransmitters reaches target organs with receptors for epinepherine & norepinepherine, the target organ responds to the stimulus. **Sympathetic postganglionic neurons * which release norepinephrine to stimulate target organs * are referred to as adrenergic neurons. *The term comes from the words noradrenaline & adrenaline which were previously used in place of the currently used names norepinephrine and epinephrine. * As the medulla of stimulated adrenal glands * release both epinephrine and norepinephrine * into the blood, they are considered to be adrenergic as well. * Thus we see that a unique characteristic of the Sympathetic division of the ANS is that its preganglionic neurons are always cholinergic while its postganglionic neurons are adrenergic.**Adrenergic receptors which bind with and respond to norepinephrine or epinephrine * are found exclusively on sympathetic target organs. * While adrenergic receptors which react to norepinephrine * delivered via postganglionic neurons stimulate very precise responses by target organs, * receptors which are stimulated by epinephrine and norepinephrine * delivered via the blood from the adrenal medulla stimulate more generalized effects. * **While adrenergic receptors all react to norepinephrine and epinephrine, they react differently, based on the specific receptor class they belong to. Alpha receptors are generally excited when bound with either epinepherine or norepinepherine. Alpha 1 type receptors * are located primarily in the walls of blood vessels leading to places other than to the skeletal muscles, the brain or to the lungs and on spincters in visceral organs. * * Alpha 1 receptors are not found on cardiac muscle of the heart. * Alpha 2 receptors are located on the membranes of platelets which have to do with blood clotting. *Beta receptors may be either be excited or depressed when they bind with epinephrine or norepinephrine depending on the specific type of Beta receptor. Beta 1 receptors, * are found on the cardiac muscle of the heart and on the kidneys. Beta 2 receptors * are located in the walls of bronchioles leading to the lungs, on the coronary arteries and on smooth muscles in the walls of the digestive and urinary organs. * *When bound to epinephrine or norepinephrine, Alpha 1 receptors become excited and cause constriction of the blood vessels and spincters they are located on. * This causes vasoconstriction of blood vessels directing the majority of blood flow to the skeletal muscles to support increased activity. Alpha 1 receptors in the kidneys stimulate the release of renin when stimulated. In the eyes, excited Alpha 1 receptors causes dilation of the pupil for better close vision. Excited Alpha 2 receptors promote blood clotting in case of injury.Beta 1 receptors * on the cardiac muscle of the heart * increase heart rate and strength when stimulated. This increases cardiac output to support increased physical activity during an emergency (fight or flight). Beta 2 receptors * are depressed when they bind with epinephrine or norepinephrine. * Since they are located on smooth muscle cells lining the bronchioles and coronary arteries, their effect is to cause dilation which increases the flow of O2 to the lungs and increases the flow of blood to the myocardium of the heart. **The Parasympathetic division of the ANS is characterized having the ganglia * very close to or on the target organs. * As a result, the preganglionic neurons * must be long to reach from the spinal cord to the ganglia. The postganglionic neurons * are relatively short, since they only must reach from the ganglia to the target organ the ganglia are already near or on. **The only neurotransmitter that the receptors of the Parasympathetic division respond to is acetylcholine. * Because all preganglionic neurons in the Parasympathetic and the Sympathetic branches of the ANS release acetylcholine, * they are all considered to be cholinergic neurons. **Postganglionic neurons * associated with the Parasympathetic division of the ANS also release the neurotransmitter acetylcholine. * Thus they are also considered to be cholinergic. One of the unique characteristics of the Parasympathetic division of the ANS is that both the preganglionic and the postganglionic neurons are cholinergic. **If you will recall, * skeletal muscles are stimulated to contract by motor neurons * * which release the neurotransmitter acetylcholine. * Thus the motor neurons are cholinergic. Thus the receptors * on skeletal muscle cells which bind with acetylcholine are considered to be cholinergic receptors. *** Since the preganglionic neurons of both the Sympathetic and the Parasympathetic divisions are cholinergic, * the receptors located on the dendrites and cell bodies of postganglionic neurons must be cholinergic receptors as well. * Recall that the receptors located on the target organs * which are regulated by the Parasympathetic division also are cholinergic. **Just as there were Alpha and Beta types of adrenergic receptors, there are two types of cholinergic receptor types as well. * Nicotinic receptors are found on skeletal muscle cells * as well as on the dendrites and cell bodies * of postganglionic neurons in both the Sympathetic and Parasympathetic divisions of the ANS. * When bound with acetylcholine, these almost always excite. * Muscarinic receptors * are only found on the target organs affected by the Parasympathetic division of the ANS. * Muscarinic receptors which bind to acetylcholine * may either stimulate activity or decrease activity depending on the target organ. **To give you specific examples of the varying effects of acetylcholine on muscarinic receptors, consider the following.* Acetylcholine binding to muscarinic receptors on cardiac muscle cells of the heart slow down the heart rate and decrease the strength of contractions. * This has the effect of reducing cardiac output to restore the bodies normal resting rate of activity. * When acetylcholine binds to muscarinic receptors on glands and smooth muscles associated with the digestive system, the effect is to excite or increase the secretion of glands and the contractions of the smooth muscle cells in the walls of the digestive organs to promote peristalsis.* Stimulated muscarinic receptors on arterioles leading to the liver, pancreas and other digestive organs dilate to increase the flow of blood to those organs during times when digestive activities are needed to digest and store materials for future use.* Stimulated muscarinic receptors on the smooth muscles of the iris cause the iris to constrict, thus reducing the size of the pupil and allowing less light into the eye. **Blocking agents are chemicals which bind to the receptors on target organs and prevent the normal neurotransmitter from binding. * Here you can see an illustration of a receptor on the membrane of a cell. * When a neurotransmitter molecule binds with the receptor, the cell will react. * Blocking agents bind with and cover up the binding site on the receptor * * so that the neurotransmitter cannot bind. * Thus the neurotransmitter molecule will not have its normal effect on the blocked cell. **Adrenergic blocking agents * block the receptor binding sites to prevent epinephrine and norepinephrine from binding. * Beta 1 blockers on the cardiac muscles of the heart * prevent the increase in heart rate and accompanying arrhythmias that could be compromising to cardiac patients. * Examples of Beta 1 blockers * include acebutolol (Sectral) * and Metoprolol (Lopressor).**Adrenergic blockers dont allow epinephrine or norepinephrine to bind with adrenergic receptors by binding with their binding sites. * Alpha 1 blockers * are used to decrease blood pressure in patients with chronic hypertension without interfering with other sympathetic effects by binding only Alpha 1 receptors. * An example of a common Alpha 1 blocker is Phentolamine. * **Cholinergic blocking agents interfere with the binding of acetylcholine with cholinergic receptors. * Since muscarinic receptors are exclusively located on the target organs effected by the Parasympathetic division of the ANS, they effect only Parasympathetic responses. * An example of a muscarinic blocking agent is Atropine, * which is used topically during eye exams to dilate the pupil of the eye. * Atropine us sometimes also used prior to surgery to reduce salivation and respiratory secretions.*