13

The Brain, Cranial

Nerves, and Sensory
and Motor Pathways

Lecture Presentation by
Lori Garrett

© 2018 Pearson Education, Inc.

Key Concepts
1. Brain functions
• Special features (CSF, Blood brain barrier)
• Diseases (stroke)
2. Spinal cord functions
• Reflex
 Central Nervous System
• Composed of the brain and spinal cord
• Receives input from sensory neurons and directs
activity of motor neurons that innervate muscles and
glands
• ___________ neurons integrate sensory information
and help direct the
appropriate response to maintain
homeostasis and respond
to the environment.
 Brain statistics
• The adult brain has 100 billion neurons.
• It weighs about 1.5 kg (3−3.5 pounds).
• It receives ____% of the total blood flow to the body per
minute.
• Scientists have demonstrated limited neurogenesis (the
formation of new brain cells from neural stem cells) in
adult brains.
Developmental Sequence of the Brain
Cerebrum
• Derived from the telencephalon
• Largest portion of the brain - _____% of the mass
• Responsible for higher mental functions
• Consists of a right and left cerebral hemisphere
connected internally by the ______________________
 Cerebral Cortex
• The outer region of the cerebrum
composed of 2−4 mm gray matter
(________ or clusters of cell bodies)
with underlying white matter
(myelinated axons).
• Characterized by raised folds called gyri
separated by depressed grooves called
sulci; together called convolutions
• Each hemisphere is divided by deep
sulci or fissures into ___ lobes - Frontal
, Parietal, Temporal, Occipital, Insula
Language Centers
 Frontal & Parietal Lobes
• Frontal lobes are involved in _________ function,
problem solving, spontaneity, memory, language
(Broca’s area), initiation, judgement, impulse control,
and social and sexual behavior
• Parietal functions in processing __________
information regarding the location of parts of the
body as well as interpreting visual information and
mathematics.
Temporal, Occipital, and Insula Lobes
• Temporal lobe: ______________ centers and
processing language (Wernicke’s Area)
• Occipital lobe: _________ and coordination of eye
movements
• Insula: encoding of memory and integration of
sensory information with visceral responses;
receives olfactory, gustatory, auditory, and pain
information
Maps of the Precentral and Postcentral
Gyri
 Primary motor cortex
• Precentral gyrus in frontal lobe
• Controls ____________movement of opposite side of
the body
• Motor homunculus is similar to that of sensory
• more on tongue, lips, face, fingers
Somatosensory Cortex
• Postcentral gyrus in parietal lobe
• Receives input from somesthetic sensation &
proprioception from ____________ side of the body
(nerve fibers cross over in the pyramid of medulla)
• Sensory homunculus
• Distribution of sensory perception over different
parts of the body (more on tongue, lips, face, hands
& genitalia)
• Capable of spatial discrimination
• Localizes input of sensory stimuli & perceives level
of intensity of the stimulus
Techniques for Visualizing Brain
Function
 Visualizing the Brain (1)
• X-ray computed tomography (CT): looks at
soft tissue absorption of X-rays
• Positron emission tomography (PET):
• Used to monitor cancer
• Used to study brain ______________
• Magnetic resonance imaging (MRI):
• Shows clear definition between gray matter,
white matter, and cerebrospinal fluid
• Functional magnetic resonance imaging
(fMRI): visualizes increased neuronal activity
in different brain regions indirectly by looking
at blood flow
 Visualizing the Brain (2)
• Electroencephalogram (EEG): Electrodes on the scalp
detect synaptic potentials produced by cell bodies
and dendrites in the cerebral cortex.
• Measurement commonly used for
1. Distinguish various stages of ___________
2. Diagnosis of epilepsy (involuntary spasm due to
synchronous AP)
3. Legal determination of death (electrocerebral
silence)
 EEG Patterns
1. Alpha waves: active,________brain. Seen
most in frontal and parietal lobes
2. Beta waves: produced with visual
stimulation and _________activity. Seen
most in frontal lobe
3. Theta waves: seen during sleep; most from
occipital and temporal lobes. Common in
infants; adults in emotional distress or in
meditation
4. ________waves: also seen in sleep, from all
over the cerebrum, deep sleep waves
 Sleep: REM (rapid eye movement)
• State when __________ occur. Theta waves
are seen here
• Some brain regions are more active during
REM sleep than during the waking state.
• The limbic system (involved in emotion) is very
active during REM sleep.
• Breathing and heart rate may be very irregular.
• Benefits consolidation of nondeclarative
(unconscious) memories
 Sleep: Non-REM Sleep
• Delta waves are seen here.
• As you fall asleep, neurons decrease their firing
rates, decreasing blood flow and energy metabolism.
• Breathing and heart rate are very regular.
• Non-REM sleep may allow repair of metabolic
damage done to cells by free radicals and allows
time for the neuroplasticity mechanisms needed to
store memories.
• Benefits consolidation of spatial and declarative
(_____________) memories
 Sleep pattern
1)When people first fall asleep, they enter non-REM sleep
and progress through the four stages.
2)Next, a person ascends back up the stages of non-REM
sleep to REM sleep.
3)This cycle repeats every 90 minutes, and most people go
through five per night.
 Cerebral Lateralization
(Dominance)
• Each side of the precentral gyrus controls
movements on the contralateral (opposite)
side of the body due to decussation of
fibers.
• Somatoesthetic sensation from each side
of the body projects to contralateral sides
of the postcentral gyrus.
• Communication between the sides occurs
through the corpus callosum; this is
severed in severe forms of epilepsy.
 Cerebral
Lateralization
Some tasks seem to be
performed better by one side of
the brain than the other.
[Link] hemisphere:
visuospatial tasks,
recognizing faces, composing
music, arranging blocks,
reading maps
[Link] hemisphere:
______________, speech,
writing, calculations,
understand music
 Language
• Most of the knowledge of
how the brain controls
language has come from
studying people with speech
problems called __________
• Two areas are identified as
important :
[Link]’s area
[Link]’s area
Language pathway of signals from the eye
or the ear • To speak, word
comprehension originates in
Wernicke’s area and is sent to
Broca’s area, where
information is sent to the
motor cortex to direct
movement of appropriate
muscles.
• eye → visual cortex →
Wernicke's area → Broca's
area → motor cortex
• ear → auditory cortex →
Wernicke's area → Broca's
area → motor cortex
 Broca’s vs Wernicke’s Area
• Broca’s Area
• Located in the left inferior frontal gyrus
• Controls motor aspects of speech
• Damage leads to ________________ aphasia: slow, poorly
articulated speech. There is no impairment in
understanding.
• Possibly deficit in short term memory
• Wernicke’s Area
• Located in the left temporal lobe
• Controls ________________ of words.
• Damage leads to receptive aphasia: production of rapid
speech with no meaning, called “word salad.” Language
(spoken and written) comprehension is destroyed.
 Right cerebral Left cerebral
hemisphere hemisphere

Cerebral cortex
(gray matter)

White matter

Corpus callosum
Lateral ventricles Caudate nucleus
Basal
Thalamus Putamen nuclei
(gray
Third ventricle Globus pallidus
matter)
Claustrum

Mamillary bodies
(part of hypothalamus)

Fig. 5-12a, p. 124

 Basal Nuclei
• Basal nuclei refers to several masses of gray matter
deep within cerebral white matter
• Functions:
1. Monitor muscle tone by inhibition of input
2. Maintain purposeful motor activity
3. Coordinate slow, sustained contraction
• _____________ disease (PD)
• Lack of dopamine→ dysfunctional basal nuclei
• Increase muscle rigidity
• Resting tremor
• Slow in initiating & carrying out motor behaviors
 The Limbic System
• Group of brain regions responsible
for ______________ drives
(fear, anger, embarrassment)
• Areas of the cerebrum included: cingulate gyrus,
amygdala, hippocampus, septal nuclei, anterior insula
• The olfactory bulb, hypothalamus and thalamus (in the
diencephalon) are also part of this system
 Memory
• Studies of people with amnesia reveal that areas of
the temporal lobe, hippocampus, caudate nucleus,
and dorsomedial thalamus are involved in memory.
• The amygdala is important in learning fear responses.
• The prefrontal cortex may be involved in complex
problem solving and _____________ memory–very
short-term memory.
• Left inferior frontal lobe – mathematical calculations
• ________________ is the critical component
• Acquire new information (learning)
• Consolidation of short-term memory to long-term
memory
• Inferior temporal lobe – storage of long-term visual
memories
 Short-term memory
• Provide a temporary storage for information transferred
from sensory to long-term memory through process of
memory consolidation
• Memory consolidation occurs in the medial temporal
lobe, hippocampus, and amygdala.
• Sleep is needed for optimum memory consolidation.
• Working memory (WM)
• Refers to the ability to temporarily remember
information not to rehearse it but to immediately
process the information.
• Requires the ____________ lobe. People have
attention deficit has poor WM.
 Long-term memory
1)Requires actual structural change - Activation of genes,
synthesis of mRNA, production of proteins, and
formation of new synapses
2)Long-term memory can be classified into:
• Nondeclarative (implicit): memory of simple skills,
how to do things
• Declarative (explicit): memory of things that can be
verbalized. People with _____________ have
impaired declarative memory; further broken into:
1)Semantic: facts
2)Episodic: events
Categories of Memory
 Synaptic Changes in Memory
• Long-term memory requires a relatively ____________
change in neuron chemical structure and synapses.
• Long term potentiation (LTP) refers to a long-term
increase in the excitability of a neuron to a particular
synaptic input caused by repeated high frequency of that
particular input
 The role of hippocampus in learning
• Hippocampus is critical for learning. It progressively
transfer its short term memory during wakefulness to long
term memory in the cortex during ___________.
• Synaptic connection is constantly being changed with new
knowledge, and the greatest neuroplasticity takes place in
hippocampus
• Hippocampus has neurogenesis with most new stem cells
in adult brain. Neurogenesis increases the ability of the
hippocampus to process new information, and to process
it in new and more complex ways.
• Sleep deprivation, aging, stress reduce neurogenesis
 Alzheimer’s Disease
• Most common form of dementia
• Characteristics
1. Loss of brain weight and volume.
2. Loss of cholinergic fibers in hippocampus and
cerebral cortex
3. Accumulation of extracellular proteins called
senile plaques (beta amyloid).
4. Accumulation of intracellular proteins forming
neurofibrillary tangles (tau protein).
 Diencephalon
• Part of the forebrain that includes the epithalamus,
thalamus, hypothalamus, part of the pituitary gland,
and the third ventricle
• Surrounded by the cerebral hemispheres
 Thalamus and Epithalamus
• Thalamus
• Paired masses of gray matter
• _____________center through which all sensory
information, except smell, is passed to the
cerebrum
• Epithalamus
• Contains the choroid plexus over the third
ventricle where CSF is produced
• Also contains the pineal gland, which secretes the
hormone ________________that helps regulate
circadian rhythms
 Hypothalamus
• Is very important for maintaining homeostasis and
regulating the autonomic system. Contains centers for:
• Hunger/satiety and thirst
• Regulation of body temperature
• Regulation of sleep and wakefulness
• Sexual arousal and performance
• Emotions of fear, anger, pain, and pleasure
• Control of the endocrine system
• Controls hormone secretion from the pituitary
gland
• Regulation of ______________ (ADH)
 Midbrain or mesencephalon
• Corpora quadrigemina
• Superior colliculi: visual reflexes
• Inferior colliculi: auditory reflexes
• Cerebral peduncles: ascending and descending tracts
 Midbrain, cont
• Red nucleus: connects the cerebrum and cerebellum;
involved in motor coordination
• Substantia nigra: an important part of the motor
circuit; part of the dopaminergic nigrostriatal system
which is involved in the behavioral reward system and
has been implicated in addiction and psychiatric
disturbances
 Hindbrain (rhombencephalon)
• Composed of the metencephalon
(pons & cerebellum) and myelencephalon
(medulla oblongata)
• Produces automatic behaviors
necessary for survival (“_______________” functions→
movement, digestive, cardiovascular, respiratory)
• Passageway for all fiber tracts running between the
cerebrum and spinal cord
• Heavily involved with the innervation of the face and
head
• 10 of the 12 pairs of cranial nerves attach to it
 Pons
• The pons houses sensory and
motor tracts heading from/to the
spinal cord.
• Four cranial nerves (V, VI, VII )
arise from the pons
• Two ________________ control
centers are found here:
• Apneustic
• Pneumotaxic
• Surface fibers connect to the
cerebellum
 Cerebellum
• Second largest brain structure
gray matter outside, white matter inside
• Receives input from proprioceptors in joints, tendons,
and muscles
• Works with the basal nuclei and motor cortex to
coordinate movement
• Fibers from the cerebellum pass through the red
nucleus to the thalamus and then to the motor cortex
_____________ (on the same side of the brain)
• Reflexive (procedural/unconscious/emotional) memories
are stored here
 Medulla Oblongata
• All ascending and descending tracts (corticospinal tracts,
the pyramids) between the brain and spinal cord pass
through the medulla.
• Tracts cross sides in the pyramids.
• Cranial nerves (VIII-XII) arise here
• Control centers for regulating
• Breathing and heart rate.
• Blood vessel diameter, blood pressure
• _______________, vomiting, sneezing,
hiccupping, coughing
 Reticular Activating System
• Network to coordinate arousal and sleep, but also
involved in blood pressure regulation, muscle tone
and pain modulation
• General _____________
keep surgical patients
unconscious by
reducing activity in
this area
 Check your understanding
• Which of the following is involved in
performing preliminary processing of all
sensory input on its way to the cortex?
A. Pons
B. Medulla oblongata
C. Thalamus
D. Hypothalamus
E. Hippocampus
 Check your understanding
• Which brain area is involved in learning
and short-term memory?
A. Pons
B. Medulla oblongata
C. Hypothalamus
D. Hippocampus
The cerebrospinal fluid (CSF)
• Is produced by choroid plexus. It fills
the 4 ventricles of the brain and the
central canal of the spinal cord.
• It flows into the subarachnoid space to surround the brain
and spinal cord, and is absorbed back into the blood at
arachnoid villi
• Cerebrospinal fluid has three main functions:
1. CSF ___________ brain and spinal cord from trauma.
2. CSF supplies nutrients to nervous system tissue.
3. CSF removes waste products from cerebral metabolism.
• Spinal tap: CSF from the subarachnoid space at the lower
end of the spinal cord is taken to check on the chemical
environment of the brain and test for infection.
Endothelial
cells of
blood
capillaries
are joined
with tight
junctions
 The Blood-Brain Barrier (BBB)(1)
• The BBB is formed by endothelial cells of the capillary
wall, astrocyte end-feet and pericytes.
• The endothelial cells are joined together with
__________ junctions thus forming a special barrier
to seal the brain tissue from the surrounding blood.
• The brain tissue relies on CSF to bring in nutrients and
remove wastes.
 The Blood-Brain Barrier (2)
Advantages:
1. Protects brain from chemical fluctuations in blood
2. Minimizes the possibility that harmful blood-borne
substances might reach central nervous tissue
3. Prevents certain circulating hormones that could also
act as neurotransmitters from reaching brain
• Disadvantages: Limits the use of drugs for treatment of
brain and spinal cord disorders
• Many drugs cannot penetrate BBB
• Current methods for drug delivery: trojan horse
(tag drug to proteins which have gained entry),
osmotic _______________ of BBB (use
concentrated sugar solution to disrupt BBB)
 Energy demand of the brain
• The brain has a high demand for oxygen, and
receives about 15% of the total blood volume in
circulation
• Brain injury may start _____ min of reduced oxygen
or hypoxia
• The brain consumes about half of the __________
circulating in the body
• Brain death occurs 10-15 minutes without glucose
 Ischemic stroke
1. Ischemic strokes occur when
the arteries to your brain
become narrowed or blocked,
causing severely reduced ________ __flow (ischemia).
a. Most common is thrombotic stroke (when a
blood clot forms in one of the arteries that supply
blood to your brain)
b. Embolic stroke (blood clot comes from
somewhere else other than the brain)
2. ____________ stroke is due to either a brain aneurysm
burst or a weakened blood vessel leak leading blood spills
into or around the brain, creates swelling and pressure,
damaging cells and tissue in the brain.
 Stroke on L or R brain
Left Brain Right Brain
• Paralysis of R side of the • Paralysis of L side of the
body (L motor cortex) body(R motor cortex)
• Numbness of __ side of • Numbness of the L side
the body (L somatosensory of the body (R
cortex) somatosensory cortex)
• _____, cautious behavior • Quick, impulsive
• Speech difficulty behavior
• Inability to speak
(Broca’s area)
• Unable to comprehend
(Wernicke’s area)
• Short term memory loss (hippocampus, Broca’s area), visual
problem (optic nerve tract or occipital lobe)
 Check your understanding
• A patient who has stroke experienced the
following symptoms: lose ability to speak,
feel numbness on his right side of the
body? Which area of his brain is damaged?
A. Broca’s area and right postcentral cortex
B. Wernicke area and right postcentral
cortex
C. Broca’s area and left postcentral cortex
D. Wernicke’s area and right precentral
cortex
 Cell body of White matter Gray matter
efferent neuron
Interneuron

Cell body of
afferent neuron Dorsal root

Dorsal root
Efferent fiber ganglion

From receptors

To effectors

Ventral root

Spinal nerve

Fig. 5-20, p. 137

 Spinal Cord
• Protected by vertebral column, CSF (central canal) &
meninges
• Composed of white matter surrounding a gray matter
core
• The gray matter is arranged with a left and right
dorsal horn and a left and right ventral horn.
 Spinal Cord
• Dorsal root
• Afferent neurons (sensory neurons)
• Dorsal root ganglion (collection of sensory
neurons cell bodies)
• Ventral root
• Efferent neurons (motor neurons; cell body
inside gray matter)
• Function
1. Link between brain and
body
2. Integrating reflex
 Nerve tracts in Spinal Cord
• The white matter is composed of ascending and
descending fiber tracts.
• _______________ tracts carry sensory impulses and
are given the prefix spino- with a suffix that
indicates the brain region it synapses on; ex – lateral
spinothalamic tract
• Descending tracts carry motor impulses and are
given the suffix ____________and the prefix
indicates the brain region they come from; ex –
anterior corticospinal tract
 Ascending Tracts
• Convey sensory information
from receptors in the skin,
muscles, joints, and organs
• Crossover of tracts may
occur in the spinal cord or in
the medulla. This means
that the origin of the input
and the brain area are
contralateral.
 Descending Tracts
• Two major groups:
1. Corticospinal or pyramidal:
descend directly without
synaptic interruption from
the cerebral cortex to the
spinal cord
2. _____________ tracts:
originate in the brain stem
and are controlled by the
motor circuits of the corpus
striatum, substantia nigra,
and thalamus
 Reflex arc
• Unconscious motor response to a
sensory stimulus
• 5 components of an arc
1. Sensory ___________
2. →Sensory neuron
3. →Association neuron
(interneuron) in CNS
4. →Motor neuron
5. →____________ – muscle
or gland that responds
 Types of arcs
• Different effectors
1. ____________reflex – effectors are skeletal muscles
2. Autonomic reflex – effectors are smooth muscle,
cardiac muscle, or glands
• Simple or acquired:
1. Simple, or basic, reflexes
• Built-in, unlearned responses
2. Acquired, or conditioned, reflexes
• Result of practice and learning
 Monosynaptic Stretch Reflex
• Simplest reflex
• Only involves _________ synapse - monosynaptic
• Maintains optimal resting length of skeletal muscles
– is also known as a stretch reflex
• Can be stimulated by striking the patellar ligament
in the “knee-jerk reflex”
Reflexes used in diagnostic testing

Biceps
reflex Triceps reflex Ankle-jerk reflex

Babinski reflex

Plantar reflex Abdominal reflex

© 2018 Pearson Education, Inc.

Figure 12.15 1 – 4
© 2018 Pearson Education, Inc.
Figure 12.15
 Polysynaptic reflexes
• Automatic actions involved in complex movements
(examples—walking and running) or _____________
reflex (move away from stimulus)
• Involve pools of interneurons—may be excitatory or
inhibitory
• Involve reciprocal inhibition—
• Contraction of a muscle leads to relaxation of its
antagonist muscle in order to coordinate movement
and reduce resistance
Polysynaptic reflex :
flexor (withdrawal)
reflex
 Crossed __________ reflex
• Involve polysynaptic and withdrawal reflex
on the contralateral side of the body to
stabilize the posture.
• e.g. Painful stimulation of one foot causes
flexion (withdrawal) of the ipsilateral leg as
well as the extension of the contralateral leg,
to stabilize the posture; thus the ipsilateral
leg flexors are activated and the extensors
are inhibited and vice versa in the
contralateral leg.
Polysynaptic reflex involves flexor
reflex & crossed extensor reflex
Label the flexor reflex-crossed
extensor reflex diagram
5
4
6

8
7

9 11

3 12
2

1
 ipsilateral
Sensory interneuron Contralateral
neuron interneuron

E interneuron
I interneuron motor neuron
stimulates extensor
muscle→ crossed
E interneuron I interneuron extensor reflex
motor neuron motor neuron stimulates motor neuron
inhibits flexor muscle→ flexor or inhibits flexor
extensor withdrawal reflex muscle
muscle

Site of
stimulus