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South Ar ansas Community College

BIOL 2064: Anatomy & Physiology 1 Chapter 11

Edited by Brenda Holmes MSN/Ed, RN Associate Professor

!ole"s !uman Anatomy an# Physiology


$%el&th '#ition

Shier Butler Le%is


Chapter 11 (er)ous System II: *i)isions o& the (er)ous System

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11+1: Intro#u,tion
!e central ner"o#s system $%NS& consists of t!e brain and s'inal cord( !e brainstem connects t!e brain to t!e s'inal cord( %omm#nication to t!e 'eri'!eral ner"o#s system $PNS& is by )ay of t!e s'inal cord(

11+2: -eninges
!e menin+es Membranes of %NS Protect t!e %NS !ree $3& layers, -#ra mater . o#+! mot!er/ 0eno#s sin#ses 1al2 Arac!noid mater .S'ider)eb3li4e/ S'ace contains cerebros'inal fl#id $%S1& Pia mater .1ait!f#l mot!er/ Enca's#lates blood "essels
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Scalp Cranium Cerebrum "entorium cerebelli Cerebellum #ertebra Spinal cord Meninges

S!in Subcutaneous tissue Bone o s!ull Dural sinus (superior sagittal sinus) $rachnoid granulation Dura mater $rachnoid mater Pia mater Meninges

Subarachnoid space Falx cerebri Gray matter White matter (b) Cerebrum

(a)

-eninges o& the Spinal Cor#


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Spinal cord

#entral root Dorsal root Spinal ner%e Dorsal root ganglion Pia mater $rachnoid mater Dura mater

Subarachnoid space

&pidural space Dorsal root

Spinal ner%e Dorsal root ganglion

Dorsal branch (dorsal ramus) #entral branch (%entral ramus) Spinal cord #entral root &pidural space Body o %ertebra

"horacic %ertebra (a) (b)

11+.: /entri,les an# Cere0rospinal 1lui#


!ere are fo#r $*& "entricles !e "entricles are interconnected ca"ities )it!in cerebral !emis'!eres and brain stem !e "entricles are contin#o#s )it! t!e central canal of t!e s'inal cord !ey are filled )it! cerebros'inal fl#id $%S1& !e fo#r $*& "entricles are, 7ateral "entricles $2& 8no)n as t!e first and second "entricles !ird "entricle 1o#rt! "entricle 9nter"entric#lar foramen %erebral a:#ed#ct
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'ateral %entricle (nter%entricular oramen "hird %entricle Cerebral a)ueduct Fourth %entricle

"o central canal o spinal cord (a) (nter%entricular oramen 'ateral %entricle

"hird %entricle

Cerebral a)ueduct Fourth %entricle

(b)

"o central canal o spinal cord

Cere0rospinal 1lui#
Secreted by t!e c!oroid 'le2#s $%an yo# recall t!e s'ecific cells<& %irc#lates in "entricles, central canal of s'inal cord, and t!e s#barac!noid s'ace %om'letely s#rro#nds t!e brain and s'inal cord E2cess or )asted %S1 is absorbed by t!e arac!noid "illi $And )!ere are t!ese located<& %lear fl#id similar to blood 'lasma 0ol#me is only abo#t 12= ml( N#triti"e and 'rotecti"e Hel's maintain stable ion concentrations in t!e %NS
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$rachnoid granulations Blood* illed dural sinus Choroid plexuses o third %entricle Pia mater "hird %entricle Cerebral a)ueduct Fourth %entricle Subarachnoid space $rachnoid mater Dura mater Choroid plexus o ourth %entricle

Central canal o spinal cord Pia mater Subarachnoid space Filum terminale $rachnoid mater Dura mater

11+1 Clini,al Appli,ation


Cere0rospinal 1lui# Pressure

>

11+4: Spinal Cor#


Slender col#mn of ner"o#s tiss#e contin#o#s )it! brain and brainstem E2tends do)n)ard t!ro#+! "ertebral canal Be+ins at t!e foramen ma+n#m and terminates at t!e first and second l#mbar "ertebrae $71/72& inters'ace
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Foramen magnum Cer%ical enlargement Spinal cord

Brainstem

Cer%ical enlargement

#ertebral canal 'umbar enlargement Conus medullaris

'umbar enlargement Conus medullaris Cauda e)uina

Filum terminale

?
(a) (b)

Stru,ture o& the Spinal Cor#


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Posterior horn Posterior uniculus White matter Gray matter 'ateral uniculus Dorsal root o spinal ner%e Dorsal root ganglion #entral root $nterior o spinal ner%e horn $nterior median issure Central canal $nterior uniculus Posterior median sulcus Gray commissure

Portion o spinal ner%e


1=

(a)

1un,tions o& Spinal Cor#


%ond#it for ner"e im'#lses to and from t!e brain and brainstem %enter for s'inal refle2es

11

2e&le3 Ar,s
Refle2es are a#tomatic, s#bconscio#s res'onses to stim#li )it!in or o#tside t!e body Sim'le refle2 arc $sensory @ motor& Most common refle2 arc $sensory @ association @ motor&
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Sensory or a erent neuron

Central ,er%ous System

Motor or e erent neuron

+eceptor (a)

& ector (muscle or gland)


12 13

2e&le3 Ar,s

13

4eneral Components o& a Spinal 2e&le3


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Spinal cord (nterneuron 1 +eceptor Cell body o sensory neuron / White matter Gray matter Dorsal

0 Sensory neuron

Motor neuron . & ector (muscle or gland) (b)

#entral

Central canal

1*

2e&le3 Beha)ior
E2am'le is t!e knee-jerk reflex Sim'le monosyna'tic refle2 Hel's maintain an #'ri+!t 'ost#re
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$xon o sensory neuron Cell body o sensory neuron

Spinal cord & ector ()uadriceps emoris muscle group) +eceptor associated 2ith dendrites o sensory neuron Patella

Cell body o motor neuron $xon o motor neuron

Direction o impulse

Patellar ligament

15

2e&le3 Beha)ior
E2am'le is a withdrawal reflex Pre"ents or limits tiss#e dama+e
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Cell body o sensory neuron Direction o impulse $xon o sensory neuron (nterneuron

Dendrite o sensory neuron Pain receptor in s!in "ac!

& ector ( lexor muscle contracts and 2ithdra2s part being stimulated)

$xon o motor neuron

Spinal cord Cell body o motor neuron

16

2e&le3 Ar,
E2am'le crossed extensor reflex %rossin+ of sensory im'#lses )it!in t!e refle2 center to 'rod#ce an o''osite effect
(nterneuron 4 5 3 Stimulation 3 (nhibition 4 5 4 5
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Sensory neuron

&xtensor relaxes

&xtensor contracts Flexor relaxes

Motor neurons Flexor contracts

Motor neurons

1;

1>

11+2 Clini,al Appli,ation


5ses o& 2e&le3es

1>

$ra,ts o& the Spinal Cor#


Ascendin+ tracts cond#ct sensory im'#lses to t!e brain -escendin+ tracts cond#ct motor im'#lses from t!e brain to motor ne#rons reac!in+ m#scles and +lands
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Dorsal column

Fasciculus gracilis Fasciculus cuneatus

Posterior spinocerebellar tract 'ateral corticospinal tract 'ateral reticulospinal tract +ubrospinal tract $nterior spinocerebellar tract $nterolateral system 'ateral spinothalamic tract $nterior spinothalamic tract $nterior reticulospinal tract Medial reticulospinal tract $nterior corticospinal tract

1?

As,en#ing $ra,ts
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MaAor ascendin+ $sensory& s'inal cord tracts, 1ascic#l#s +racilis and fascic#l#s c#neat#s S'inot!alamic tracts 7ateral and anterior S'inocerebellar tracts Posterior and anterior

Sensory cortex o cerebrum Cerebrum ( rontal section)

"halamus

Midbrain

Spinothalamic tract

Brainstem (trans%erse sections) Pons Fasciculus cuneatus tract Sensory impulse rom s!in temperature or pain receptors

Medulla

Spinal cord (trans%erse section) Sensory ibers cross o%er

2=

*es,en#ing $ra,ts
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MaAor descendin+ $motor& s'inal cord tracts, %orticos'inal tracts 7ateral and anterior Retic#los'inal tracts 7ateral, anterior and medial R#bros'inal tract

Motor cortex o cerebrum

Cerebrum ( rontal section) Corticospinal tract

Midbrain

Brainstem (trans%erse sections) Pons Motor ibers cross o%er Medulla oblongata

Spinal cord (trans%erse section) Motor impulse to s!eletal muscle

21

(er)e $ra,ts o& the Spinal Cor#

22

11+. Clini,al Appli,ation


Spinal Cor# In6uries

23

11+7: Brain
1#nctions of t!e brain, MaAor 'arts of t!e brain, 9nter'rets sensations %erebr#m -etermines 'erce'tion 1rontal lobes Stores memory Parietal lobes Reasonin+ Bcci'ital lobes Ma4es decisions em'oral lobes %oordinates m#sc#lar mo"ements 9ns#la Re+#lates "isceral acti"ities -ience'!alon -etermines 'ersonality %erebell#m Brainstem Midbrain Pons 2* Med#lla oblon+ata

$he Brain
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Gyrus S!ull Meninges Cerebrum Diencephalon Midbrain Brainstem Pons Medulla oblongata Cerebellum Corpus callosum Fornix Sulcus

Spinal cord (a)

Fornix Cerebrum Corpus callosum Diencephalon

Midbrain Pons "rans%erse issure Cerebellum Medulla oblongata

Spinal cord

25
(b)
!" Martin M. #ot$er%Photo #esearchers, Inc.

Brain *e)elopment
Ne#ral t#be !ree 'rimary "esicles, 1orebrain $Prosence'!alon& Midbrain $Mesence'!alon& (a) Hindbrain $R!ombence'!alon& 1i"e secondary "esicles, elence'!alon -ience'!alon Mesence'!alon Metence'!alon (b) Myelence'!alon
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Prosencephalon ( orebrain) Mesencephalon (midbrain)

+hombencephalon (hindbrain)

,eural tube

"elencephalon Diencephalon Mesencephalon Metencephalon Myelencephalon ,eural tube

Cerebral hemispheres Diencephalon Midbrain Pons and Cerebellum Medulla oblongata Spinal cord (c)

26

Brain *e)elopment

2;

Stru,ture o& the Cere0rum


%or'#s callos#m %onnects cerebral !emis'!eres $a commiss#re& Cyri B#m's or con"ol#tions S#lci Croo"es in +ray matter %entral s#lc#s of Rolando 1iss#res 7on+it#dinal, se'arates t!e cerebral !emis'!eres rans"erse, se'arates cerebr#m from cerebell#m 7ateral fiss#re of Syl"i#s
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Central sulcus Gyrus Sulcus Frontal lobe 'ateral sulcus "emporal lobe

Parietal lobe

6ccipital lobe "rans%erse issure Cerebellar hemisphere Central sulcus Parietal lobe

(a)

Central sulcus 'ongitudinal issure Parietal lobe 6ccipital lobe (b) 6ccipital lobe Frontal lobe (nsula +etracted temporal lobe (c)

2>

Lo0es o& the Cere0rum


1i"e $5& lobes bilaterally, 1rontal lobe Parietal lobe em'oral lobe Bcci'ital lobe 9ns#la a4a D9sland of ReilE
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Central sulcus Parietal lobe

6ccipital lobe Frontal lobe (nsula +etracted temporal lobe (c)

2?

1un,tions o& the Cere0rum


9nter'retin+ im'#lses 9nitiatin+ "ol#ntary mo"ements Storin+ information as memory Retrie"in+ stored information Reasonin+ Seat of intelli+ence and 'ersonality

3=

1un,tional 2egions o& the Cere0ral Corte3


%erebral corte2 !in layer of +ray matter t!at constit#tes t!e o#termost 'ortion of cerebr#m %ontains ;5F of all ne#rons in t!e ner"o#s system
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Central sulcus Motor areas in%ol%ed 2ith the control o %oluntary muscles Concentration8 planning8 problem sol%ing Frontal eye ield $uditory area Front lobe Parietal lobe Sensory speech area ( Wernic!e7s area) 6ccipital lobe Motor speech area (Broca7s area) 'ateral sulcus (nterpretation o auditory patterns Combining %isual images8 %isual recognition o ob9ects #isual area Cerebellum Sensory areas in%ol%ed 2ith cutaneous and other senses

31

"emporal lobe

Brainstem

1un,tions o& the Cere0ral Lo0es

32

Sensory Areas 8post9,entral sul,us:


%#taneo#s sensory area
Parietal lobe 9nter'rets sensations on s4in

Sensory area for taste Near base of t!e central s#lc#s Sensory area for smell
Arises from centers dee' )it!in t!e cerebr#m
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0is#al area
Bcci'ital lobe 9nter'rets "ision
Concentration8 planning8 problem sol%ing Frontal eye ield $uditory area

Central sulcus Motor areas in%ol%ed 2ith the control o %oluntary muscles Sensory areas in%ol%ed 2ith cutaneous and other senses

Parietal lobe Sensory speech area ( Wernic!e7s area) 6ccipital lobe

A#ditory area
em'oral lobe 9nter'rets !earin+

Front lobe

Motor speech area (Broca7s area) 'ateral sulcus (nterpretation o auditory patterns

Combining %isual images8 %isual recognition o ob9ects #isual area Cerebellum

"emporal lobe

Brainstem

33

Sensory Areas
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$rm Forearm "humb8 ingers8 and hand Facial expression Sali%ation #ocali:ation Mastication S2allo2ing

"run!

Pel%is

"high

"run! Pel%is ,ec! Forearm $rm "high <and8 ingers8 and thumb ;pper ace 'ips "eeth and gums "ongue and pharynx

'eg

'eg Foot and toes Genitals

Foot and toes

'ongitudinal issure (a) Motor area (b) Sensory area

'ongitudinal issure

Frontal lobe Motor area Sensory area Central sulcus Parietal lobe

3*

Asso,iation Areas
Re+ions t!at are not 'rimary motor or 'rimary sensory areas Gides'read t!ro#+!o#t t!e cerebral corte2 AnalyHe and inter'ret sensory e2'eriences Pro"ide memory, reasonin+, "erbaliHation, A#d+ment, emotions
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Central sulcus Motor areas in%ol%ed 2ith the control o %oluntary muscles Concentration8 planning8 problem sol%ing Frontal eye ield $uditory area Front lobe Parietal lobe Sensory speech area ( Wernic!e7s area) 6ccipital lobe Motor speech area (Broca7s area) 'ateral sulcus (nterpretation o auditory patterns Combining %isual images8 %isual recognition o ob9ects #isual area Cerebellum Sensory areas in%ol%ed 2ith cutaneous and other senses

"emporal lobe

Brainstem

35

Asso,iation Areas
1rontal lobe association areas %oncentratin+ Plannin+ %om'le2 'roblem sol"in+ Parietal lobe association areas Inderstandin+ s'eec! %!oosin+ )ords to e2'ress t!o#+!t em'oral lobe association areas 9nter'ret com'le2 sensory e2'eriences Store memories of "is#al scenes, m#sic, and com'le2 'atterns Bcci'ital lobe association areas AnalyHe and combine "is#al ima+es )it! ot!er sensory e2'eriences

36

-otor Areas 8pre9,entral sul,us:


Primary motor areas
1rontal lobes %ontrol "ol#ntary m#scles
Concentration8 planning8 problem sol%ing Frontal eye ield $uditory area Front lobe Parietal lobe Sensory speech area ( Wernic!e7s area) 6ccipital lobe Combining %isual images8 %isual recognition o ob9ects #isual area Cerebellum "emporal lobe
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Central sulcus Motor areas in%ol%ed 2ith the control o %oluntary muscles Sensory areas in%ol%ed 2ith cutaneous and other senses

BrocaEs area

Anterior to 'rimary motor corte2 Is#ally in left !emis'!ere %ontrols m#scles needed for s'eec!

Motor speech area (Broca7s area)

'ateral sulcus

(nterpretation o auditory patterns

Brainstem

1rontal eye field


Abo"e BrocaEs area %ontrols "ol#ntary mo"ements of eyes and eyelids
3;

-otor Areas
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$rm Forearm "humb8 ingers8 and hand Facial expression Sali%ation #ocali:ation Mastication S2allo2ing

"run!

Pel%is

"high

"run! Pel%is ,ec! Forearm $rm "high <and8 ingers8 and thumb ;pper ace 'ips "eeth and gums "ongue and pharynx

'eg

'eg Foot and toes Genitals

Foot and toes

'ongitudinal issure (a) Motor area (b) Sensory area

'ongitudinal issure

Frontal lobe Motor area Sensory area Central sulcus Parietal lobe

3>

!emisphere *ominan,e
!e left !emis'!ere is dominant in most indi"id#als
-ominant !emis'!ere controls, S'eec! Gritin+ Readin+ 0erbal s4ills Analytical s4ills %om'#tational s4ills Nondominant !emis'!ere controls, Non"erbal tas4s Motor tas4s Inderstandin+ and inter'retin+ m#sical and "is#al 'atterns Pro"ides emotional and int#iti"e t!o#+!t 'rocesses

3?

-emory
S!ort term memory 7on+ term memory Gor4in+ memory %!an+es str#ct#re or %losed ne#ronal circ#it f#nction of ne#rons %irc#it is stim#lated o"er and En!ances syna'tic o"er transmission G!en im'#lse flo) ceases, memory does also #nless it enters lon+3term memory "ia memory consolidation

*=

11+4 Clini,al Appli,ation


$raumati, Brain In6ury

*1

Basal (u,lei
Masses of +ray matter -ee' )it!in cerebral !emis'!eres %a#date n#cle#s, '#tamen, and +lob#s 'allid#s Prod#ce do'amine %ontrol certain m#sc#lar acti"ities Primarily by in!ibitin+ motor f#nctions
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'ongitudinal issure +ight cerebral hemisphere

Caudate nucleus Putamen Globus pallidus

Basal nuclei

"halamus <ypothalamus Brainstem

Cerebellum

Spinal cord

*2

*ien,ephalon
Bet)een cerebral !emis'!eres and abo"e t!e brainstem S#rro#nds t!e t!ird "entricle
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!alam#s E'it!alam#s Hy'ot!alam#s B'tic tracts B'tic c!iasm 9nf#ndib#l#m Posterior 'it#itary Mammillary bodies Pineal +land

Superior colliculus Corpora )uadrigemina 6ptic ner%e Pituitary gland Mammillary body 6ptic tract 6ptic chiasma (n erior colliculus

"halamus "hird %entricle Cerebral peduncles

Pons

Pineal gland Fourth %entricle

Pyramidal tract 6li%e

Cerebellar peduncles Medulla oblongata

Spinal cord

(a)

(b)

*3

*ien,ephalon
!alam#s Cate)ay for sensory im'#lses !eadin+ to cerebral corte2 Recei"es all sensory im'#lses $e2ce't smell& %!annels im'#lses to a''ro'riate 'art of cerebral corte2 for inter'retation Hy'ot!alam#s Maintains !omeostasis by re+#latin+ "isceral acti"ities 7in4s ner"o#s and endocrine systems $!ence some say t!e ne#roendocrine system
**

*ien,ephalon
$he Lim0i, System
%onsists of, Portions of frontal lobe Portions of tem'oral lobe Hy'ot!alam#s !alam#s Basal n#clei Bt!er dee' n#clei 1#nctions, %ontrols emotions Prod#ces feelin+s 9nter'rets sensory im'#lses

*5

11+7 Clini,al Appli,ation


Par inson *isease

*6

Brainstem
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<ypothalamus

!ree 'arts, 1( Midbrain 2( Pons 3( Med#lla Bblon+ata

Diencephalon "halamus

Corpus callosum

Corpora )uadrigemina Midbrain Pons

Cerebral a)ueduct

+eticular ormation Medulla oblongata Spinal cord

*;

-i#0rain
Bet)een dience'!alon and 'ons %ontains b#ndles of fibers t!at Aoin lo)er 'arts of brainstem and s'inal cord )it! !i+!er 'art of brain %erebral a:#ed#ct %erebral 'ed#ncles $b#ndles of ner"e fibers& %or'ora :#adri+emina $centers for "is#al and a#ditory refle2es&
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Superior colliculus Corpora )uadrigemina 6ptic ner%e Pituitary gland Mammillary body 6ptic tract 6ptic chiasma (n erior colliculus

"halamus "hird %entricle Cerebral peduncles

Pons

Pineal gland Fourth %entricle

Pyramidal tract 6li%e

Cerebellar peduncles Medulla oblongata

Spinal cord

(a)

(b)

*>

Pons
Ro#nded b#l+e on #nderside of brainstem Bet)een med#lla oblon+ata and midbrain Hel's re+#late rate and de't! of breat!in+ Relays ner"e im'#lses to and from med#lla oblon+ata and cerebell#m
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Superior colliculus Corpora )uadrigemina 6ptic ner%e Pituitary gland Mammillary body 6ptic tract 6ptic chiasma (n erior colliculus

"halamus "hird %entricle Cerebral peduncles

Pons

Pineal gland Fourth %entricle

Pyramidal tract 6li%e

Cerebellar peduncles Medulla oblongata

Spinal cord

(a)

(b)

*?

-e#ulla O0longata
Enlar+ed contin#ation of s'inal cord %ond#cts ascendin+ and descendin+ im'#lses bet)een brain and s'inal cord %ontains cardiac, "asomotor, and res'iratory control centers %ontains "ario#s non"ital refle2 control centers $co#+!in+, sneeHin+, s)allo)in+, and "omitin+&
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Superior colliculus Corpora )uadrigemina 6ptic ner%e Pituitary gland Mammillary body 6ptic tract 6ptic chiasma (n erior colliculus

"halamus "hird %entricle Cerebral peduncles

Pons

Pineal gland Fourth %entricle

Pyramidal tract 6li%e

Cerebellar peduncles Medulla oblongata

Spinal cord

(a)

(b)

5=

2eti,ular 1ormation
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%om'le2 net)or4 of ner"e fibers scattered t!ro#+!o#t t!e brain stem E2tends into t!e dience'!alon %onnects to centers of !y'ot!alam#s, basal n#clei, cerebell#m, and cerebr#m 1ilters incomin+ sensory information Aro#ses cerebral corte2 into Midbrain state of )a4ef#lness Pons

<ypothalamus Diencephalon "halamus

Corpus callosum

Corpora )uadrigemina

Cerebral a)ueduct

+eticular ormation Medulla oblongata Spinal cord

51

$ypes o& Sleep


Slo) )a"e Ra'id Eye Mo"ement $REM& Non3REM slee' Parado2ical slee' Person is tired Some areas of brain acti"e -ecreasin+ acti"ity of Heart and res'iratory rates retic#lar system irre+#lar Restf#l -reamin+ occ#rs -reamless Red#ced blood 'ress#re and res'iratory rate Ran+es from li+!t to !ea"y Alternates )it! REM slee'
52

Cere0ellum
9nferior to occi'ital lobes Posterior to 'ons and med#lla oblon+ata )o !emis'!eres 0ermis connects !emis'!eres %erebellar corte2 $+ray matter& Arbor "itae $)!ite matter& %erebellar 'ed#ncles $ner"e fiber tracts& -entate n#cle#s $lar+est n#cle#s in cerebell#m& 9nte+rates sensory information concernin+ 'osition of body 'arts %oordinates s4eletal m#scle acti"ity Maintains 'ost#re
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'ongitudinal issure

"halamus

Corpus callosum

Superior peduncle Pons Middle peduncle (n erior peduncle Medulla oblongata Cerebellum

53

-a6or Parts o& the Brain

5*

11+6 Clini,al Appli,ation


Brain ;a)es

55

11+6: Peripheral (er)ous System


%ranial ner"es arisin+ from t!e brain Somatic fibers connectin+ to t!e s4in and s4eletal m#scles A#tonomic fibers connectin+ to "iscera S'inal ner"es arisin+ from t!e s'inal cord Somatic fibers connectin+ to t!e s4in and s4eletal m#scles A#tonomic fibers connectin+ to "iscera

56

(er)ous System Su0#i)isions

5;

Stru,ture o& a Peripheral (er)e


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Fascicle

Peripheral ner%e

&pineurium Motor neuron ending $xon

Perineurium &ndoneurium ,ode o +an%ier Sch2ann cell Sensory receptor Myelin sheath ,eurilemma

5>

(er)e an# (er)e 1i0er Classi&i,ation


Sensory ner"es %ond#ct im'#lses into brain or s'inal cord Motor ner"es %ond#ct im'#lses to m#scles or +lands Mi2ed $bot! sensory and motor& ner"es %ontain bot! sensory ner"e fibers and motor ner"e fibers Most ner"es are mi2ed ner"es A77 s'inal ner"es are mi2ed ner"es $e2ce't t!e first 'air&

5?

(er)e 1i0er Classi&i,ation


Ceneral somatic efferent $CSE& fibers %arry motor im'#lses from %NS to s4eletal m#scles Ceneral "isceral efferent $C0E& fibers %arry motor im'#lses a)ay from %NS to smoot! m#scles and +lands Ceneral somatic afferent $CSA& fibers %arry sensory im'#lses to %NS from s4in and s4eletal m#scles Ceneral "isceral afferent $C0A& fibers %arry sensory im'#lses to %NS from blood "essels and internal or+ans

6=

(er)e 1i0er Classi&i,ation


S'ecial somatic efferent $SSE& fibers %arry motor im'#lses from brain to m#scles #sed in c!e)in+, s)allo)in+, s'ea4in+ and formin+ facial e2'ressions S'ecial "isceral afferent $S0A& fibers %arry sensory im'#lses to brain from olfactory and taste rece'tors S'ecial somatic afferent $SSA& fibers %arry sensory im'#lses to brain from rece'tors of si+!t, !earin+ and e:#ilibri#m
61

Cranial (er)es
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

6l actory bulb 6l actory tract

6l actory (()

6ptic ((() 6ptic tract 6culomotor (((() "rochlear ((#) "rigeminal (#) #estibulocochlear (#((() <ypoglossal (=(() #agus (=) $bducens (#() Facial (#(() Glossopharyngeal ((=) $ccessory (=()

62

Cranial (er)es
Remember, %ranial ner"es are desi+nated D% NE %ranial ner"es are desi+nated )it! Roman n#merals $9 @ J99&

63

Cranial (er)es I an# II


Blfactory ner"e $%N 9& Sensory ner"e 1ibers transmit im'#lses associated )it! smell B'tic ner"e $%N 99& Sensory ner"e 1ibers transmit im'#lses associated )it! "ision

6*

Cranial (er)es III an# I/


Bc#lomotor ner"e $%N 999& Primarily motor ner"e Motor im'#lses to m#scles t!at,
Raise eyelids Mo"e t!e eyes 1oc#s lens AdA#st li+!t enterin+ eye

roc!lear ner"e $%N 90& Primarily motor ner"e Motor im'#lses to m#scles t!at mo"e t!e eyes Some sensory Pro'rioce'tors

Some sensory Pro'rioce'tors

65

Cranial (er)e /
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

ri+eminal ner"e $%N 0& Mi2ed ner"e . !ree $3& sisters/ $1& B'!t!almic di"ision
Sensory from s#rface of eyes, tear +lands, scal', fore!ead, and #''er eyelids

'acrimal ner%e 6phthalmic di%ision 'acrimal gland &ye Maxillary di%ision Mandibular di%ision Maxilla 'ingual ner%e (n erior al%eolar ner%e "ongue (n raorbital ner%e

$2& Ma2illary di"ision


Sensory from #''er teet!, #''er +#m, #''er li', 'alate, and s4in of face

$3& Mandib#lar di"ision


Sensory from scal', s4in of Aa), lo)er teet!, lo)er +#m, and lo)er li' Motor to m#scles of mastication and m#scles in floor of mo#t!

Mental ner%e 66 Mandible

Cranial (er)es /I an# /II


Abd#cens ner"e $%N 09& Primarily motor ner"e Motor im'#lses to m#scles t!at mo"e t!e eyes Some sensory Pro'rioce'tors 1acial ner"e $%N 099& Mi2ed ner"e Sensory from taste rece'tors Motor to m#scles of facial e2'ression, tear +lands, and sali"ary +lands
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

"emporal ner%e >ygomatic ner%e Buccal ner%e Facial ner%e Posterior auricular ner%e Parotid sali%ary gland Mandibular ner%e Cer%ical ner%e

6; 6>

Cranial (er)es /III an# I<


0estib#lococ!lear ner"e $%N 0999& A4a aco#stic or a#ditory ner"e Sensory ner"e )o $2& branc!es, 0estib#lar branc! Sensory from e:#ilibri#m rece'tors of ear %oc!lear branc! Sensory from !earin+ rece'tors Closso'!aryn+eal ner"e $%N 9J& Mi2ed ner"e Sensory from '!aryn2, tonsils, ton+#e and carotid arteries Motor to sali"ary +lands and m#scles of '!aryn2

6>

Cranial (er)e <


Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

0a+#s ner"e $%N J& Mi2ed ner"e Somatic motor to m#scles of s'eec! and s)allo)in+ A#tonomic motor to "iscera of t!ora2 and abdomen Sensory from '!aryn2, laryn2, eso'!a+#s, and "iscera of t!ora2 and abdomen

Meningeal branch $uricular branch Pharyngeal branch Palate Superior laryngeal ner%e

Superior ganglion o %agus ner%e (n erior ganglion o %agus ner%e ,er%e =( ,er%e =((

Carotid body

+ecurrent laryngeal ner%e

'e t %agus ner%e

Cardiac ner%es 'ung

<eart

Stomach 'i%er Spleen

Pancreas ?idney

Small intestine

6?
'arge intestine

Cranial (er)es <I an# <II


Accessory ner"e $%N J9& Primarily motor ner"e Ge called t!is .S'inal/ Accessory beca#se, %ranial branc! Motor to m#scles of soft 'alate, '!aryn2 and laryn2 S'inal branc! Motor to m#scles of nec4 and bac4 Some sensory Pro'rioce'tor Hy'o+lossal ner"e $%N J99& Primarily motor Motor to m#scles of t!e ton+#e Some sensory Pro'rioce'tor

;=

1un,tions o& Cranial (er)es

;1

Spinal (er)es
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

A77 are mi2ed ner"es $e2ce't t!e first 'air& 31 'airs of s'inal ner"es, > cer"ical ner"es $%1 to %>& 12 t!oracic ner"es $ 1 to 12& 5 l#mbar ner"es $71 to 75& 5 sacral ner"es $S1 to S5& 1 coccy+eal ner"e $%o or %c&

C1 C0 C/ CC. C@ CA CB "1 "0 "/ "". "@ "A "B "C "1D "11 "10 '1 Cauda e)uina '0 '/ ''. S1 S0 S/ SS. Co

Posterior %ie2

Cer%ical ner%es

"horacic ner%es

'umbar ner%es

Sacral ner%es Coccygeal ner%e

;2

Spinal (er)es
-orsal root $a4a 'osterior root& Sensory root A2ons of sensory ne#rons are in t!e dorsal root +an+lion -orsal root +an+lion A4a -RC %ell bodies of sensory ne#rons )!ose a2ons cond#ct im'#lses in)ard from 'eri'!eral body 'arts
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

Dorsal root

Dorsal root ganglion Dorsal root Posterior median sulcus Posterior horn

Dorsal branch o spinal ner%e #entral branch o spinal ner%e

#entral root Para%ertebral ganglion

#isceral branch o spinal ner%e (b) 'ateral horn $nterior horn Central canal $nterior median issure (a) #entral root #entral branch o spinal ner%e (%entral ramus) Dorsal branch o spinal ner%e (dorsal ramus) Spinal ner%e Para%ertebral ganglion #isceral branch o spinal ner%e

;3

*ermatome
An area of s4in t!at t!e sensory ner"e fibers of a 'artic#lar s'inal ner"e inner"ate
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display. C0 C0 C/ CC. "1 C@ "1 C/ CC. C@ CA

CB

"1

"10

'1 '.

"10 '1 C@ CA S0 S/ '0 '/

S1 S0 S/ SS. CD '1 '0

'CB '/ '.

S1 ''.

;*

(a)

(b)

Spinal (er)es
0entral root $a4a anterior root& Motor root A2ons of motor ne#rons )!ose cell bodies are in t!e s'inal cord S'inal ner"e Inion of "entral root and dorsal roots Hence )e no) !a"e a .mi2ed/ ner"e
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

Dorsal root

Dorsal root ganglion Dorsal root Posterior median sulcus Posterior horn

Dorsal branch o spinal ner%e #entral branch o spinal ner%e

#entral root Para%ertebral ganglion

#isceral branch o spinal ner%e (b) 'ateral horn $nterior horn Central canal $nterior median issure (a) #entral root #entral branch o spinal ner%e (%entral ramus) Dorsal branch o spinal ner%e (dorsal ramus) Spinal ner%e Para%ertebral ganglion #isceral branch o spinal ner%e

;5

(er)e Ple3uses
Ner"e 'le2#s %om'le2 net)or4s formed by anterior branc!es of s'inal ner"es !e fibers of "ario#s s'inal ner"es are sorted and recombined !ere are t!ree $3& ner"e 'le2#ses, $1& %er"ical 'le2#s 1ormed by anterior branc!es of %13%* s'inal ner"es 7ies dee' in t!e nec4 S#''ly to m#scles and s4in of t!e nec4 %33%*3%5 ner"e roots contrib#te to '!renic ner"es bilaterally

;6

Bra,hial Ple3us
$2& Brac!ial 'le2#s 1ormed by anterior branc!es %53 1 7ies dee' )it!in s!o#lders !ere are fi"e $5& branc!es, 1( M#sc#loc#taneo#s ner"e
S#''ly m#scles of anterior arms and s4in of forearms
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

#entral ramiF C.8 C@8 CA8 CB8 "1 "run!sF upper8 middle8 lo2er $nterior di%isions Posterior di%isions
Dorsal scapular nE

C. C@ CA C. CB "1 C@

CA Suprascapular nE 'ateral pectoral nE Medial pectoral nE 'o2er subscapular nE "horacodorsal nE Musculocutaneous nE Median nE ;lnar nE $xillary nE +adial nE (a) Median nE "1 $xillary nE CB <umerus

2( Ilnar and 3( Median ner"es


S#''ly m#scles of forearms and !ands S#''ly s4in of !ands

Musculocutaneous nE

;lnar nE +adial nE

;lna

*( Radial ner"e
S#''ly 'osterior m#scles of arms and s4in of forearms and !ands

+adius

5( A2illary ner"e
S#''ly m#scles and s4in of anterior, lateral, and 'osterior arms
;; ;>
(b)

Lum0osa,ral Ple3us
$3& 7#mbosacral 'le2#s 1ormed by t!e anterior branc!es of 713S5 roots %an be a l#mbar $71375& 'le2#s and a sacral $S13S5& 'le2#s E2tends from l#mbar re+ion into 'el"ic ca"ity Bbt#rator ner"e
S#''ly motor im'#lses to add#ctors of t!i+!s
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display. #entral rami $nterior di%isions Posterior di%isions '1

Superior gluteal nE (n erior gluteal nE 6bturator nE Sacral plexus Pudendal nE

'0

'/

Femoral nE

'ateral emoral cutaneous nE Femoral nE 6bturator nE

'Saphenous nE

Sciatic nE

Posterior cutaneous nE

'.

S1 S0 Superior gluteal nE (n erior gluteal nE Common ibular (peroneal) nE "ibial nE S/ SS.

"ibial nE Common ibular (peroneal) nE

1emoral ner"e
S#''ly motor im'#lses to m#scles of anterior t!i+! and sensory im'#lses from s4in of t!i+!s and le+s

Sciatic nE

Pudendal nE

(a)

(b)

(c)

Sciatic ner"e
S#''ly m#scles and s4in of t!i+!s, le+s and feet
;>

Ple3uses
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

Posterior %ie2 C1 C0 C/ CC. C@ CA CB "1 "0 "/ "". "@ "A "B "C "1D "11 "10 Cauda e)uina '1 '0 '/ 'Femoral ner%e 6bturator ner%e Sciatic ner%e Co '. S1 S0 S/ SS. 'umbosacral plexus ("105S.) (ntercostal ner%es

Cer%ical plexus (C15C-) Brachial plexus (C.5"1)

Musculocutaneous ner%e $xillary ner%e +adial ner%e Median ner%e ;lnar ner%e Phrenic ner%e

;?

11+= Clini,al Appli,ation


Spinal (er)e In6uries

>=

11+=: Autonomi, (er)ous System


1#nctions )it!o#t conscio#s effort %ontrols "isceral acti"ities Re+#lates smoot! m#scle, cardiac m#scle, and +lands Efferent fibers ty'ically lead to +an+lia o#tside of t!e %NS )o a#tonomic di"isions re+#late, Sym'at!etic di"ision $s'eeds #'& Pre'ares body for Dfi+!t or fli+!tE sit#ations Parasym'at!etic di"ision $slo)s do)n& Pre'ares body for Drestin+ and di+estin+E acti"ities
>1

Autonomi, (er)e 1i0ers


Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

All of t!e ne#rons are motor $efferent& Pre+an+lionic fibers


A2ons of 're+an+lionic ne#rons Ne#ron cell bodies in %NS

(nterneurons

Dorsal root ganglion Sensory neuron Spinal cord Preganglionic iber Postganglionic iber #iscera Somatic motor neuron

Dorsal root ganglion

Sensory neuron

$utonomic ganglion

S!in

Post+an+lionic fibers
A2ons of 'ost+an+lionic ne#rons Ne#ron cell bodies in +an+lia
(a) $utonomic path2ay

S!eletal muscle (b) Somatic path2ay

>2

Sympatheti, *i)ision
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

!oracol#mbar di"ision @ location of 're+an+lionic ne#rons Pre+an+lionic fibers lea"e s'inal ner"es t!ro#+! )!ite rami and enter 'ara"ertebral +an+lia Para"erterbral +an+lia and fibers t!at connect t!em ma4e #' t!e sym'at!etic tr#n4

Spinal cord #entral root Dorsal root Dorsal root ganglion Pia mater $rachnoid mater

Sympathetic trun! Para%ertebral sympathetic ganglion Spinal ner%es

Dura mater "rans%erse process

#ertebral notch ( orms part o inter%ertebral oramen)

Body o %ertebra

>3

Sympatheti, *i)ision
Post+an+lionic fibers e2tend from sym'at!etic +an+lia to "isceral or+ans Post+an+lionic fibers #s#ally 'ass t!ro#+! +ray rami and ret#rn to a s'inal ner"e before 'roceedin+ to an effector E2ce'tion, 're+an+lionic fibers to adrenal med#lla do not syna'se )it! 'ost+an+lionic ne#rons
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

Preganglionic Postganglionic neuron neuron Spinal cord Posterior horn

Dorsal root ganglion Dorsal root

Gray ramus White ramus Sympathetic trun!

'ateral horn $nterior horn Spinal ner%e

Dorsal branch o spinal ner%e

#entral root

#entral branch o spinal ner%e Para%ertebral sympathetic ganglion

#isceral e ector (intestine)

Collateral ganglion

"o %isceral e ectors (smooth muscle o blood %essels8 arrector pili muscles8 and s2eat glands)

>*

Sympatheti, *i)ision
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

'acrimal gland &ye

Parotid gland8 submandibular and sublingual glands Blood %essels <eart

Celiac and pulmonary plexuses

"rachea

'ungs S!in

Celiac ganglion

Fibers to s!in8 blood %essels8 and adipose tissue

Superior mesenteric ganglion

'i%er Gallbladder Stomach Pancreas

Small intestine 'arge intestine Spinal cord (n erior mesenteric ganglion $drenal gland Sympathetic chain ganglia ?idney

Preganglionic Postganglionic neuron neuron

;rinary bladder

6%ary Penis Scrotum ;terus

>5

Parasympatheti, *i)ision
%raniosacral di"ision @ location of 're+an+lionic ne#rons Can+lia are near or )it!in "ario#s or+ans erminal +an+lia S!ort 'ost+an+lionic fibers %ontin#e to s'ecific m#scles or +lands Pre+an+lionic fibers of t!e !ead are incl#ded in ner"es 999, 099, and 9J Pre+an+lionic fibers of t!ora2 and abdomen are 'arts of ner"e J

>6

Parasympatheti, *i)ision
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

Sphenopalatine ganglion Cranial ner%e ((( Ciliary ganglion

'acrimal gland &ye Submandibular and sublingual glands Parotid gland

Cranial ner%e #(( Cranial ner%e (=

Submandibular ganglion 6tic ganglion

Cranial ner%e = (#agus)

<eart

"rachea

'ung Cardiac and pulmonary plexuses

Celiac plexus

'i%er Gallbladder Stomach Spleen Pancreas

Superior hypogastric plexus

Small intestine

Spinal cord

(n erior hypogastric plexus

'arge intestine

?idney

Pel%ic ner%es ;rinary bladder Preganglionic Postganglionic neuron neuron

Scrotum Penis

;terus 6%ary

>;

Autonomi, (eurotransmitters
%!oliner+ic fibers Release acetylc!oline Pre+an+lionic Cranial sym'at!etic and parasympathetic 'arasym'at!etic fibers neurons Post+an+lionic 'arasym'at!etic fibers Adrener+ic fibers Release nore'ine'!rine Most 'ost+an+lionic sym'at!etic fibers
Copyright The McGraw-Hill Companies, Inc. Permission required or reproduction or display.

Brain

$Ch 3 acetylcholine (cholinergic) ,& 3 norepinephrine (adrenergic) #isceral e ectors Preganglionic iber (axon) Ganglion $Ch $Ch

$Ch

Postganglionic iber (axon) Para%ertebral ganglion $Ch

,&

Sympathetic neurons

,& Collateral ganglion Sacral parasympathetic neurons

$Ch $Ch

>>

A,tions o& Autonomi, (eurotransmitters


Res#lt from bindin+ to 'rotein rece'tors in t!e membrane of effector cells, %!oliner+ic rece'tors Bind to acetylc!oline $Ac!& M#scarinic
E2citatory

Adrener+ic rece'tors Bind to e'ine'!rine and nore'ine'!rine Al'!a and beta


Bot! elicit different res'onses on "ario#s effectors

Slo) Nicotinic
E2citatory Ra'id

>?

$erminating Autonomi, (eurotransmitter A,tions


!e enHyme acetylc!olinesterase ra'idly decom'oses t!e acetylc!oline t!at c!oliner+ic fibers release( Nore'ine'!rine from adrener+ic fibers is remo"ed by acti"e trans'ort(

?=

Control o& Autonomi, A,ti)ity


%ontrolled lar+ely by %NS Med#lla oblon+ata re+#lates cardiac, "asomotor and res'iratory acti"ities Hy'ot!alam#s re+#lates "isceral f#nctions, s#c! as body tem'erat#re, !#n+er, t!irst, and )ater and electrolyte balance 7imbic system and cerebral corte2 control emotional res'onses
?1

11+>: Li&espan Changes


Brain cells be+in to die before birt! B"er a"era+e lifetime, brain s!rin4s 1=F Most cell deat! occ#rs in tem'oral lobes By a+e ?=, frontal corte2 !as lost !alf its ne#rons N#mber of dendritic branc!es decreases -ecreased le"els of ne#rotransmitters 1adin+ memory Slo)ed res'onses and refle2es 9ncreased ris4 of fallin+ %!an+es in slee' 'atterns t!at res#lt in fe)er slee'in+ !o#rs
?2

Important Points in Chapter 11: Out,omes to 0e Assesse#


11+1: Intro#u,tion -escribe t!e +eneral str#ct#re of t!e brain( -escribe t!e relations!i' amon+ t!e brain, brainstem, and s'inal cord( 11+2: -eninges -escribe t!e co"erin+s of t!e brain and s'inal cord( 11+.: /entri,les an# Cere0rospinal 1lui# -escribe t!e formation and f#nction of cerebros'inal fl#id( 11+4: Spinal Cor# -escribe t!e str#ct#re of t!e s'inal cord and its maAor f#nctions( -escribe a refle2 arc( -escribe refle2 be!a"ior( 11+7: Brain Name t!e maAor 'arts of t!e brain and describe t!e f#nctions of eac!( -istin+#is! amon+ motor, sensory, association areas of t!e cerebral ?3 corte2(

Important Points in Chapter 11: Out,omes to 0e Assesse#


E2'lain !emis'!ere dominance( E2'lain sta+es in memory stora+e( E2'lain t!e f#nctions of t!e limbic system and retic#lar formation( 11+6: Peripheral (er)ous System 7ist t!e maAor 'arts of t!e 'eri'!eral ner"o#s system( -escribe t!e str#ct#re of a 'eri'!eral ner"e and !o) its fibers are classified( Name t!e cranial ner"es and list t!eir maAor f#nctions( E2'lain !o) s'inal ner"es are named and t!eir f#nctions 11+=: Autonomi, (er)ous System -escribe t!e +eneral c!aracteristics of t!e a#tonomic ner"o#s system( -istin+#is! bet)een t!e sym'at!etic and t!e 'arasym'at!etic di"isions of t!e a#tonomic ner"o#s system( -escribe a sym'at!etic and a 'arasym'at!etic ner"e 'at!)ay( E2'lain !o) t!e a#tonomic ne#rotransmitters differently affect ?* "isceral effectors

K#iH 11
%om'lete K#iH 11 no)L Read %!a'ter 12(
?5

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