CNS – 3

~ Hypothalamus: (LAQ) {connections, functions, and

disorders}

Introduction:
Hypothalamus controls the vegetative/visceral
functions of the body. It is an integrating center where
several neural and endocrine influences originating
throughout the brain converge. After due processing, the
neural and endocrine outputs of the hypothalamus
diverge to all parts of the body.
Hypothalamus consists of a large number of nuclei
and also fiber tracts.
~ Connections and functions:
- The main afferent connections of the
hypothalamus are with the limbic system and the
midbrain tegmentum.
- The main efferents from the hypothalamus are
projected to the limbic system, midbrain, thalamus,
pituitary, and the medulla.

(1) Regulation of activity of the anterior pituitary

gland –
  The hypothalamus regulates the activity of the
anterior pituitary; it releases the “releasing
factors” and “inhibiting factors” for the
hormones of the anterior pituitary gland. {For
example: the growth hormone (GH) of the
anterior pituitary is controlled by GH.RH and
GH.IH secreted by the hypothalamus.}
(2) Regulation of the posterior pituitary hormone
secretion –

 Hormones of the posterior pituitary gland (ADH

& oxytocin) are synthesized in the hypothalamic
nuclei: the supra-optic and paraventricular nuclei
of the hypothalamus.

 Then, via the axons of those nerve cells (of

nuclei), the hormones are transported into the
posterior pituitary. The hormones are then
released by the posterior pituitary into the
circulation.
(3) Control of the circadian rhythm –
- The body has internal “biological clock”; it
follows the 24-hour cycle. This cycle is circadian
rhythm.
- Variations in the body functions during daytime
and nighttime are called diurnal variations.
- For example: cortisol levels are highest at 6 A.M.
(morning), and lowest at 6 P.M. (evening).
  Hypothalamus is the link between external
environmental changes and the body’s internal
biological rhythm.
 Visual impulses (about day and night) are
transmitted from the retina into the optic tract (II
cranial nerve). The optic nerve gives out
collateral fibers that reach the hypothalamus.
These fibers synapse in the suprachiasmatic
nucleus (SCN) of hypothalamus.
 From the SCN, the signals about light and
darkness are forwarded to the pineal gland.
Pineal gland secretes the hormone
melatonin. This secretion increases in the
darkness (or nighttime). Thus, it forms a signal
mechanism for body functions to be altered as
the darkness sets in.
(4) Regulation of body temperature –
 In the anterior hypothalamus, there is “preoptic
area”. Neurons in this area are ‘temperature-
sensitive’; that is, they can sense the
temperature of the blood.
when the body temperature increases;
blood temperature is increased

as the blood circulates and reaches the brain

 neurons in the preoptic area of hypothalamus
sense this increased blood temperature

they increase the signals to the cardiovascular

center in medulla

blood flow to skin will increase; heat will be lost

from skin;
body temperature returns to normal
(5) Regulationof body water and osmolality of
body fluids -
Osmolality of the plasma (and body fluids) is linked
to its water content.
Neurons in the hypothalamus can act as
“osmoreceptors”; they can detect the
osmolality of plasma.
If the plasma water is decreased, the plasma will
become hyperosmolar. Hypothalamus then regulates
it in two ways:
 - When the plasma water is decreased, plasma
becomes hypertonic. Blood circulates, and
reaches the brain.
- Hypothalamic neurons sense this increased
osmolality of the plasma. Now, (1) the thirst
center in the hypothalamus gets activated; and
(2) neurons in the supraoptic nucleus of
hypothalamus, projecting onto posterior
pituitary, release ADH hormone from the
posterior pituitary.

thirst center in hypothalamus release of

ADH from
activated posterior
pituitary

person drinks water/fluids; ADH acts on

kidney tubules ;
water absorbed from G.I.T. water retention from
kidneys

Water absorbed into the blood

Water is absorbed into the blood (from GIT and from
kidneys); thus water content and osmolality of the body
fluids/plasma returns to normal.
(6) Regulation of hunger and feeding –

 There are two hypothalamic centers concerned

with hunger and feeding:
a. Ventromedial nucleus of hypothalamus: It
acts as satiety center. When the neurons of
this center fire, it limits the food intake (it
gives the feeling of “satiety” at the end of
food intake).
b. Lateral hypothalamic area: It acts as
hunger center.
Mechanism:
The neurons in the “satiety center” are said to
be “glucostats” or “glucoreceptors”; they can sense
the blood glucose level.
When the blood glucose level falls, satiety center lifts
the inhibition of the hunger center. The person will
feel the hunger. When food intake occurs, and
glucose level in blood rises, the satiety center
becomes active and it inhibits the hunger center.
(7) Cardiovascular regulation –
The hypothalamus acts as the relay station; there are
corticohypothalamic descending pathways which
 discharge by emotions. Emotional effects on the CVS
are executed by these fibers.
(8) Control of the ANS –
The hypothalamus is called the “head ganglion of the
autonomic nervous system (ANS)”. Areas in
hypothalamus are said to control sympathetic and
parasympathetic nerve responses.
(9) Control of emotional responses –
Stimulation of the periventricular nuclei in
hypothalamus leads to fear and punishment
reactions.
(10) Sexual drive -
Most anterior and most posterior portions of the
hypothalamus control the sexual drive.

~ Effects of hypothalamic lesions:

- Lesion of the lateral hypothalamus (which
controls hunger): It leads to decreased drinking
and eating. There may be lethal starvation. Also,
the animal becomes extremely passive.
- Lesion of the ventromedial areas of
hypothalamus (which control satiety): It will
produce opposite effects. There will be excessive
drinking and eating. And, there will be
hyperactivity.
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The cerebral cortex (LAQ)

~ Physiologic anatomy:

 There are two cerebral hemispheres; they are

connected with each other by a bundle of nerve
fibers called the corpus callosum.
 The most superficial part of each cerebral
hemisphere is the “cerebral cortex” (or
cerebral grey matter). It is 2 to 4 mm thick. Its
total surface area is about 2200 cm2.

 Beneath the cerebral cortex lies the subcortical

white matter in which embedded are masses of
the grey matter. These subcortical masses of
grey matter or masses of nuclei mainly include
the thalamus, hypothalamus, and the basal
ganglia.

 The entire cerebral hemisphere is marked by

ridges called gyri, and the fissures called sulci.
  Because of the major sulci, the entire cerebral
hemisphere is divided into 4 lobes:
1. Frontal lobe – It lies in front of the central
sulcus. Motor cortex is located here. It is
concerned with initiation and control of the
voluntary movements of the body.
2. Parietal lobe – It lies between the central
sulcus and parieto-occipital sulcus.
Somatosensory cortex is located here. It is
concerned with perception of general
sensations (such as touch, pressure, etc) from
all over the body.
3. Temporal lobe – It lies below the lateral
sulcus. Auditory cortex is located here.
Sound perception occurs here.
4. Occipital lobe - It lies behind the parieto-
occipital sulcus. Visual cortex is located
here. Visual sense starting from the eyes is
perceived here.
~ The typical cortex has 6 layers, numbered I to VI from
outside to inside.
In the so-called neocortex (or isocortex), all 6 layers
are present. 90% of the cerebral cortex has all 6 layers of
cells.
10% of the cortex is “allocortex”. It includes parts of the
limbic system. (It does not have all 6 layers.)
In all the lobes, the cortex has two functional divisions:
(a) primary cortex, and (b) secondary cortex or
association areas.
{Primary cortex in each lobe performs the primary
function of that particular cortex; secondary or
association areas perform the “analytical” function. For
instance, primary sensory areas detect specific
sensations – visual, auditory, or somatic – transmitted
from periphery. Secondary sensory areas analyze the
meanings of the specific sensory signals. Primary motor
cortex has direct connections with muscles so as to cause
specific muscle contractions. Association or
supplementary motor areas provide “patterns” of motor
activity.}
(1) Frontal lobe: (mainly the motor areas)
- Located in front of the central sulcus; it is mainly
concerned with the motor functions.
- It is subdivided into two main areas: (a)
precentral cortex, and (b) prefrontal cortex.
(a) Precentral cortex: (immediately in front of
the central sulcus)

 Area 4: Primary motor cortex. It is the

area for initiation of the voluntary motor
activity.

 Area 6: Premotor areas. In front of the

primary motor cortex; thought/idea of the
 voluntary movement begins here. It
provides the “pattern” for the motor
activity.

 Area 8: frontal eye field. Situated in front

of the area 6. It controls the conjugate
movements of the eyeballs to the
opposite side.

 Area 44: Broca’s area for speech. Situated

in the dominant hemisphere; it is the
motor area for speech.
(b) Prefrontal cortex/prefrontal lobe:
(remainder of the frontal lobe, situated most
anteriorly, in front of areas 4,6, & 8)

 It is also called orbito-frontal cortex.

 It has to and fro connections with the

thalamus, hypothalamus, and many other
regions of the cerebral cortex.

 Area 24: of the cingulate gyrus; is

connected with hippocampus. It forms a
part of “Papez circuit”; involved in genesis
of emotions
 Areas 9, 10, 11, & 12: “Seat of
intelligence”.
 Functions of the prefrontal cortex:
  Control of some of the higher
intellectual activities

 Control of personality

 Control of behavior and social

consciousness
(2) Parietal lobe: (somatosensory cortex)
- Areas 3, 1, & 2: primary sensory area [S1].
Situated just behind the central sulcus (in the
post central gyrus).

 It is concerned with appreciation of general

sensations such as touch, pain,
temperature, etc.

 Body representation is upside down. That is,

sensations from the face reach the lower
aspect.
- Areas 5 & 7: sensory association areas [S2].

 It analyzes the sensations perceived by

primary sensory areas.
 Recognition of the objects placed in the
hand, without looking at them –
“stereognosis”. This is by analyzing the
touch, pressure, texture of the object.

 Tactile localization, two-point discrimination,

and recognition of spatial relationship are
the functions assigned to this cortex.
 - Posterior parietal cortex: This area provides
continuous analysis of the spatial
coordinates of all parts of the body as well as
of the surroundings of the body.
(3) Temporal lobe: (auditory cortex)
- Areas 41 & 42: in the Heschl’s gyrus.
Auditosensory area I & II. These areas are
concerned with perception of sound.
- Areas 20, 21, & 22: auditopsychic areas. They
are auditory association areas.
- Area planum temporale: large in musicians;
recognition of pitch of the sound
- Wernicke’s area: area for language
comprehension; behind the primary auditory
cortex.

 It is the area where somatic, visual, and

auditory association areas meet.

 It is also called general interpretive area.

(4) Occipital lobe: (visual cortex)
- Area 17: the primary visual cortex; areas 18 &
19: secondary or visual association areas.
- Primary visual cortex perceives an image; visual
association areas (visuopsychic areas) interpret
the exact meaning of a visual image.
 - Area for recognition of faces; area for naming
objects. These areas are located in the occipital
lobe.
~ Angular gyrus:
Lies in the posterior parietal lobe; it fuses with the
visual areas in the occipital lobe.
It is concerned with interpretation of visual information.
Lesion of this area: “dyslexia” or word blindness – The
person may be able to see words and even know that
they are words, but not be able to interpret their
meanings.

~ Limbic lobe: The limbic system –

{Limbus means a ring; the term limbic system is applied
to the parts of the cortical and subcortical structures that
form a ring around the brain stem.}
- The limbic system consists of the limbic lobe or
limbic cortex and the related subcortical nuclei.
- The limbic cortex includes: cingulated gyrus,
isthmus, hippocampal gyrus, and uncus.
- The related subcortical nuclei include: (i)
amygdala (the group of nuclei on the tip of the
temporal lobe), (ii) septal nuclei, (iii)
hypothalamus, and (iv) anterior thalamic nuclei.
~ This area was formerly called as ‘rhinencephalon’
because of its relation to olfaction (smell); however, only
a small part of it is actually concerned with smell.
~ The limbic cortex is phylogenetically the oldest part of
the cerebral cortex. Histologically, it is made up of a
primitive type of cortical tissue, called “allocortex”.
~ Functions:
(1) Thelimbic system represents the primary area for
the control of autonomic functions (heart rate, BP,
G.I. movements, etc).
(2) It is known to regulate the emotional behavior of
an individual; the emotions of rage and fear are
elicited on stimulation of the limbic system.
(3) It plays an important role in the motivational
drive of the individual.
(4) It is also concerned with olfaction.
(5) It plays a role in memory, particularly the long-
term memory.

~ Role of the hypothalamus:

- The non-hypothalamic parts of the limbic system
receive information from cortical association
areas, particularly those in the frontal lobe. This
information is sent directly to the hypothalamus.
The emotional meaning of the external stimuli,
 information gathered from memory and
understanding, is thus passed on to the
hypothalamus.
- The hypothalamus then integrates the
endocrine, autonomic, and some other motor
activities that form appropriate emotional
behavior.
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Higher functions of the cerebrum
~ The concept of the dominant hemisphere:
As known already, there are two cerebral
hemispheres: the left and the right.
In general, higher functions of the nervous
system are developed on one side of the brain or
one cerebral hemisphere than the other.
Dominant hemisphere or categorical hemisphere:
Higher functions, such as language (speech), are
developed in one hemisphere. This hemisphere is called
the dominant or categorical hemisphere.
Non-dominant hemisphere or representational
hemisphere:
This hemisphere is specialized in “spatio-temporal
coordinates”; that is, orientation/relation of body parts
with each other, and orientation of the body with respect
to the surrounding.
~ About 90% or more of the human population is
right-handed. For them, the left cerebral
hemisphere is the dominant hemisphere.
The individuals who are left-handed: in about 30%
left handed individuals – right hemisphere is dominant; in
the remaining 70% - left hemisphere is dominant.
~ Speech: (The language function)
Definition:
Speech is the production of articulate sounds which
bear a definite meaning.
The speech requires formation of the proper words and
expression of those words verbally.
Speech: It has two components –
1. Proper word formation in the brain. The centers in
the brain that cause this are collectively called
“central speech apparatus”.
2. Production of the words verbally. This would require
respiratory system, vocal cords, and organs of the
oral cavity. This is called “peripheral speech
apparatus”.

Brain mechanism for speech:

For the proper speech to be executed, following neural
mechanisms/centers will be necessary:
a. We must be able to hear sounds. This requires an
intact auditory pathway, from the ears to the
auditory cortex (area 41).
b. We must be able to understand the sounds/spoken
words. This requires the audio-psychic area (or
auditory association area; areas 20, 21).
c. We must be able to express the thoughts in spoken
words. This process involves the activity of the
Wernicke’s area.

 Wernicke’s area is located in the superior temporal

gyrus; in the dominant (categorical) hemisphere. It is
concerned with interpretation and understanding of
auditory and visual informations. It is called the
“sensory area of speech”.
Wernicke’s area integrates the auditory, visual, and
other sensory information necessary to form the
speech.
It then sends the information to another area, the
“Broca’s area”.
 Broca’s area: It is located in the inferior frontal
gyrus, in the dominant (categorical) hemisphere. It
processes the information received from Wernick’e
area, to form a detailed and coordinated pattern for
 vocalization (speech). This pattern is then projected
to the motor cortex which initiates the appropriate
movements of the lips, tongue, and larynx to
produce.
Thus, Broca’s area is the “motor area of speech”.
~ Peripheral speech apparatus:
The signals initiated by the Broca’s area are sent to
the peripheral speech apparatus for execution (that is,
production of spoken words).
It involves two processes: (a) phonation – means
production of sound, and (b) articulation – means
conversion of that sound into the specific words.
Phonation: As the expired air is coming out of lungs, it
causes vibrations of the vocal cords. This will produce a
sound.
Articulation: The organs of the mouth (lips, tongue,
palate) articulate in a specific manner while the sound is
coming out; so that the sound is converted into a specific
word.
~ Applied physiology:
• Aphasia:
Defect of speech that results from lesions of the
central speech apparatus (speech centers of the
brain).
Types of aphasias –
 a. Wernicke’s aphasia:
Spoken or written word can be understood, but
inability to interpret the thought that is expressed.
It results from a lesion of the Wernicke’s area
(superior temporal gyrus).
b. Motor aphasia:
The person may be capable of deciding what he or
she wants to say but cannot make the vocal
system emit the decided words.

~ Neurophysiology of learning & memory: (short

note)
Definition:
“Learning” is acquisition of new information.
“Memory” is the retention and storage of that
information.

• Learning:
Learning is due to “synaptic plasiticty”. That is,
there are changes in the synaptic function; the
modification of the synaptic transmission is the basis
for learning.
Learning is mainly of two types – (1) non-
associative learning: in this form of learning, the
animal learns about a single stimulus, and (2)
associative learning: in this form of learning, the
animal learns about the relation of one stimulus to
another.
(1) Non-associative learning:
In this form of learning, the animal learns about a
single stimulus. Examples of this type of learning
are habituation & sensitization.
a. Habituation:
 It is a simple form of learning in which a
neural stimulus is repeated many times.
Initially, it evokes a reaction. However, as
the stimulus is repeated, it evokes less and
less response.

 Eventually, the subject becomes habituated

to the stimulus, and learns to ignore it. E.g.
ticking of a clock may not allow a person to
fall asleep initially. But, later on, the
person’s nervous system learns to ignore it
so that he/she can sleep.
 Mechanism: With repeated stimulation,
there will be decreased release of
neurotransmitter from the presynaptic
terminal.
b. Sensitization: (opposite of habituation)
  A repeated stimulus produces a greater
response if it is coupled with an unpleasant
or a pleasant stimulus.

 E.g. the mother who sleeps through many

kinds of noise but wakes promptly when her
baby cries.
 Mechanism: augmented postsynaptic
responses.
(2) Associative learning:
This type of learning is based on observing
repeatedly the association between two events.
For example, observing repeatedly that dark
clouds are followed by rain makes us learn that
dark clouds lead to rain (a ‘cause-effect’
relationship). As a result, the next time we observe
dark clouds while leaving home, we carry an
umbrella (change in behavior).
This type of learning occurs by the “conditioning” of the
animal to paired stimuli.
a. Classical conditioning: (a reflex or passive
process)
- This type of learning was studied by Pavlov in
dogs. {It is also called Pavlov’s conditioned
reflex.}
 - If a dog is presented with food, there is reflex
salivation in the dog. This is innate reflex, and
food is the “unconditioned stimulus” (US).
- Ringing of a bell does not produce salivary
secretion normally. In the experiment, a bell is
rung and then immediately food is presented to
the dog. This is done repeatedly. The dog
‘learns’ to expect food after the ringing of bell.
Then, only ringing of bell will cause reflex
salivation in the dog. Sound of the bell is called
the “conditioned stimulus” (CS). The reflex
response to the CS is called “conditioned reflex”.
- Thus, pairing of two stimuli (CS & US) will cause
the animal to learn. CS should be immediately
followed by the US. If the CS is presented
repeatedly without the US, the conditioned
reflex eventually dies out. This is called
“extinction” or “internal inhibition”. If there
is external stimulus causing disturbance,
between CS and US, the conditioned response
may not occur. This is called “external
inhibition”.
b. Operant conditioning: (animal operates “actively”
on the environment)
- It is a form of conditioning in which the animal is
taught to perform some task (“operate on the
environment”), in order to obtain a reward or
avoid punishment.
 - The US is the pleasant or unpleasant event. For
example, an animal is taught that by pressing a
bar it can prevent an electric shock to the feet.
- This type of learning is an “active” form.
(compare with classical conditioning which is a
reflex or passive process)

• Memory:
- Memory is retention and storage of the learned
information.
- It is the ability to recall past events at the
conscious or unconscious level.
It is also due to the synaptic plasiticity or modulation
of the synaptic transmission.
Declarative or explicit memory –
It involves conscious recall of events.
Non-declarative or implicit memory – (reflexive
memory)
It includes classical conditioning, skills, habits; it is
generally unconscious.
Types of declarative memory:
Depending on how long a conscious memory lasts, it
is divided into following types – (1) short-term memory,
(2) intermediate-term memory, and (3) long-term
memory.
(1) Short-term or recent memory:
- It involves mechanisms that can cause
immediate recall of events that occurred some
time ago (seconds/minutes/hours).
- E.g. remembering and recalling a phone number
for some time by repeatedly going through the
digits.
- Mechanism: POST TETANIC POTENTIATION
If a particular synapse in the brain is stimulated
tetanically (repeated quick successive stimuli for
short duration), the transmission at that synapse
is enhanced for some time thereafter. This is
“post tetanic potentiation”.
Repeated quick successive stimuli will cause Ca+
+
to accumulate in the presynaptic neuron.
Neurotransmitter release by this neuron will be
greater as long as the Ca++ content in it is high.
Hence, the response at this synapse is also
potentiated.
(2) Intermediate-term memory:
- It may last for several minutes or even upto
weeks.
- Eventually it will be lost unless converted into
long-term memory.
 - Mechanism: (cAMP mediated activation of
protein kinase in the neurons)

 There is facilitation at the synapses of brain.

The postulated neurotransmitter at these
synapses is serotonin.
 Serotonin acts on its receptors on the
presynaptic terminal. This leads to
activation of adenylyl cyclase enzyme, and
formation of cAMP in the neuron. cAMP
activates protein kinase enzyme. This leads
to prolonged facilitation of synaptic
transmission.
(3) Long-term memory:
In this type, the events and information can be
recalled even after years.
- Long-term memory is believed to result from
actual structural changes at the synapses.
Structural and functional changes lead to
facilitation of synaptic transmission on a long-
term basis.
- Structural changes:

 Increase in the number of presynaptic

terminals

 Changes in the dendritic geometry

  Increase in the number of transmitter
vesicles
- There is evidence which suggests that activation
of genes and new protein synthesis is involved in
the processes responsible for memory.
- Molecular or biochemical basis of long-term
memory: (long-term potentiation)
 The synaptic facilitation that occurs on a
long-term basis is postulated to be due to
the phenomenon called “long-term
potentiation” (LTP) at the synapses.

 Role of hippocampus in long-term memory:

LTP is known to occur at the synapses in the
hippocampus.
The neurons projecting from other parts of
the brain to the hippocampus release
glutamate as the transmitter.
Glutamate acts on its receptors, the NMDA
receptors. This leads to increased entry of
Ca++ in the post- synaptic neurons. There is
long-term potentiation of the hippocampal
neurons.
- Consolidation and storage of memory:
Hippocampus promotes storage of memories.
~ Applied physiology: (AMNESIA)
- Loss of memory is called amnesia.
- Bilateral lesion of hippocampus leads to
anterograde amnesia. That is, person is not
able to establish new long-term memories after
hippocampal lesion because hippocampus is the
storage site for memory.
- Retrograde amnesia: Inability to recall
memories from the past.
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Electroencephalogram (EEG) and sleep

~ Electroencephalogram (EEG):
The background electrical activity of the brain can be
recorded from the scalp. Record of these brain potentials
is called electroencephalogram (EEG).
- These potentials are recorded by placing
electrodes on the scalp.
- These potentials are NOT ACTION POTENTIALS of
the neurons; they are post-synaptic
 potentials (EPSPs & IPSPs) of the synapses in
the brain.
- German psychiatrist Hans Berger introduced the
term EEG; hence the waves of the EEG are also
called “Berger rhythm”.
• Waves of EEG –
(1) Alpha
waves: (waves of quiet
wakefulness)
 When an adult human is awake but mind
is at rest eyes closed and mind is
wandering, his EEG record will mainly
show these (α ) waves.
 Frequency of these waves: 8 – 12 Hz.

 These waves are recorded mainly from

the parieto-occipital area.
(2) Beta waves: (waves of alert wakefulness)
 When the person is awake and mentally
alert, with eyes open, his EEG record will
mainly show these (β ) waves.

 Frequency: 18 – 30 Hz; low amplitude

 These waves are generally recorded over

the frontal region of the brain.

 Paradoxically, these waves are also seen

in REM type of sleep.
 (3) Theta
waves: (large amplitude, slower
frequency)

 These waves are generally recorded in

children.

 Frequency: 4 – 7 Hz; large amplitude

 They are also known to be generated in

the hippocampus.
 These waves are seen in the EEG when
the person falls asleep; in stage 2 & 3 of
the sleep.
(4) Delta
waves: (large amplitude, slowest
frequency)

 These waves have the slowest frequency:

less than 4 Hz.

 They are recorded in very deep sleep, and

in organic brain disease.

 These waves do not require activity of the

lower brain regions.
~ Gamma oscillations:
- Very high frequency: 30 – 80 Hz
- These rapid oscillations in EEG are seen when
the individual is aroused and focuses attention
on something.
 • Changes in EEG pattern at different states of
wakefulness and sleep: (note that: when the person
is awake, the waves are high frequency and low
amplitude. As the person falls asleep, and goes into
deeper sleep, progressively the waves become low
frequency and high amplitude.)

Alert wakefulness (beta waves)

Quiet wakefulness (alpha waves)

Stage 1 sleep (low voltage waves)

Stage 2 & 3 sleep (theta waves)

Stage 4 slow wave sleep (delta waves)

REM sleep (beta waves)

~ Sleep:
Definition:
 It is the unconsciousness from which the person can
be aroused by sensory or other stimuli.
(Compare with coma; the unconsciousness from which
the person cannot be aroused.)

• Two types of sleep:

During each night, a person goes through stages of
two types of sleep: (1) slow-wave sleep (the brain
waves are very large but very slow), and (2) rapid
eye movement sleep (“REM sleep”) (there are rapid
eye movements during this type of sleep)
o When a person falls asleep, about 90 minutes of
slow-wave sleep (non-REM sleep) and then a
bout of REM sleep for 5 to 30 minutes. This
pattern will occur throughout the sleep duration.

(1) Slow-wave sleep: (or nREM sleep)

- As the person falls asleep, it begins with the
nREM sleep. And, except for the bouts of REM
sleep intermittently, the major proportion of the
sleep is slow-wave sleep.
- The person goes through 4 stages of slow-wave
sleep, which becomes deeper and deeper with
these stages.

 Stage 1: low voltage waves in the EEG

  Stage 2: sleep spindles and large “K-
complexes” are seen in the EEG

 Stage 3: theta waves

 Stage 4: delta waves (slowest waves,

deepest sleep)
- Sleepwalking (“somnambulism”), bed-wetting,
and nightmares occur during slow-wave sleep.
- Although dreams may occur during slow-wave
sleep, there is no consolidation of those dreams
in the memory. Hence, those dreams are not
likely to be remembered when the person wakes
up.
(2) REM sleep: (or paradoxical sleep)
- In a night, bouts of REM sleep (5 to 30 minutes
each) occur every 90 minutes. There may be 5
to 6 episodes of REM sleep every night.
- In young adults, it may occupy 25% of the total
sleep duration.
- There are ‘Rapid Eye Movements’ during this
type of sleep, hence it is called REM sleep.
- During the episode of REM sleep, the brain is
highly active. EEG record of this sleep shows
predominance of beta (β ) waves which are the
waves of alert wakefulness. Hence, it is called
“paradoxical sleep”.
 - This type of sleep is associated with active
dreaming. There may also be consolidation of
dreams into the memory, so that the person can
remember the dreams (which occurred during
REM sleep). Along with this, there may be tooth-
grinding (“bruxism”) in some individuals.
- The muscle tone is throughout the body is
depressed.
- Heart rate and respiratory rate become
irregular.
• Probable cause: (genesis of REM sleep)
There are cholinergic neurons in the reticular
formation of the pons. Discharge of these neurons is
thought to initiate the REM sleep.

~ Applied physiology:
- Insomnia:
It generally means inability to fall asleep
normally. (Sleep latency will be more; there may
be intermittent awakening during sleep, and
total duration of sleep reduced.)

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Cerebrospinal fluid [CSF] (short note)
Introduction:
It is the fluid circulating around the brain and the
spinal cord. It is found the ventricles of the brain, in the
cisterns around the outside of the brain, and in the
subarachnoid space around the brain and the spinal cord.
Composition of the CSF:

 It is a clear, colorless alkaline fluid; specific gravity:

1005 – 1008

 Volume: about 150 ml

 Daily secretion: about 500 ml

 It is almost cell-free and protein-free

 It contains less glucose than plasma; (glucose: about
50 mg% in CSF)
~ Formation, flow, and absorption of CSF:
- About 2/3rd of CSF is formed as a secretion from
the choroid plexuses in the ventricles, mainly
the two lateral ventricles.
- Additional amounts are secreted by the
ependymal surfaces of the ventricles. Some
amount is also secreted by blood vessels of the
brain and the spinal cord.
- After its formation, it passes from the lateral
ventricle into the 3rd ventricle. Some fluid gets
added here. Then, along the aqueduct of Sylvius
 it comes into the 4th ventricle. from here, it
passes out via foramina of Luschka and foramen
of Magendie, and via cisterna magna it comes
into the subarachnoid space. CSF then circulates
in the subarachnoid space around the brain and
the spinal cord.
- It is mainly absorbed by the subarachnoid villi
into the venous (dural) sinuses.
~ CSF pressure:
About 130 mm of water; in lateral lying position
130 mm of water = 13 cm of water
13 cm of water = 10 mm of Hg {1 mm Hg = 1.3 cm
of water}
• Functions of CSF:
1. CSF serves as a fluid buffer that provides optimum
environment to neurons of the CNS.
2. Protective function: CSF provides the cushioning
effect to the delicate structures of the cranial
vault.
3. Regulates contents of the cranium: CSF acts as a
reservoir and regulates contents of the cranium.
For example, if the blood volume of brain
increases, then CSF drains away the excess
amount of fluid.
 4. It helps in transfer of metabolic waste products of
brain into the blood.
5. It may serve as a medium for nutrient supply to
the CNS.
~ Applied physiology:
- Lumbar puncture:
It is the procedure by which CSF can be
accessed through the lumbar segments of the
spinal cord. A needle is inserted between the
two lumbar vertebrae (L2-3), to reach the
subarachnoid space.
For diagnosis:
CSF is collected by lumbar puncture; it is then
analyzed for infections of the CNS, or
malignancies.
For therapeutic purpose:
Drugs can be instilled into the CSF; for the
purpose of anesthesia or antibiotics against CNS
infections