THE NERVOUS SYSTEM

The brain and spinal cord form the central nervous system (CNS), which consists of billions of interconnected
neurons (nerve cells). Input of information to the CNS comes from the sense organs. Motor instructions are sent
out to skeletal muscles, the muscles controlling speech, internal organs and glands, and the sweat glands in the
skin. This information is carried along nerves that fan out from the CNS to the entire body. Each nerve is a
bundle consisting of the axons (filamentous projections) of many individual neurons. In addition to the nervous
system’s anatomical divisions, there are various functional divisions. Two of the most important are the
autonomic nervous system, concerned with the automatic (unconscious) regulation of internal body functioning,
and the somatic nervous system, which controls the muscles responsible for voluntary movement. The overall
function of the nervous system is to gather and analyze information about the external environment and the
body’s internal state, and to initiate appropriate responses, such as avoiding physical danger. The nervous
system functions largely through automatic responses to stimuli (see reflex), although voluntary actions can also
be initiated through the activity of higher, conscious areas of the brain. Disorders of the nervous system may
result from damage to or dysfunction of its component parts (see brain; spinal cord; neuropathy; nerve injury).
They may also be due to impairment of sensory, analytical, or memory functions (see vision, disorders of;
deafness; numbness; anosmia; agnosia; amnesia), or of motor functions (see aphasia; dysarthria; ataxia)
The nervous system of the body is split into two parts: the central nervous system (CNS) and the peripheral
nervous system (PNS). The CNS is made up of the brain and the spinal cord components.
The PNS is all the nerves that branch out from the CNS components and extend to other parts of the body – to
the sense organs, muscles, and glands. The PNS connects the CNS to the rest of the body. The primary function
of the peripheral nervous system is to connect the brain and spinal cord to the rest of the body and the external
environment. The peripheral nervous system transmits information to and from the CNS. This is accomplished
through nerves that carry information from sensory receptors in the eyes, ears, skin, nose and tongue, as well as
stretch receptors and nociceptors in muscles, glands and other internal organs.

CRANIAL NERVES
Cranial nerves are the 12 nerves of the peripheral nervous system that emerge from the foramina and fissures of
the cranium. Their numerical order (1-12) is determined by their skull exit location (rostral to caudal). All
cranial nerves originate from nuclei in the brain. Two originate from the forebrain (Olfactory and Optic), one
has a nucleus in the spinal cord (Accessory) while the remainder originate from the brainstem. Cranial nerves
supply sensory and motor information to structures of the head and neck, controlling the activity of this region.
Only the vagus nerve extends beyond the neck, to innervate thoracic and abdominal viscera. The function of a
nerve is to carry sensory and/or motor information between the body and the brain. If the information goes from
the brain to the periphery, then it is an efferent (motor) nerve. If it travels from the periphery to the brain, then it
is an afferent (sensory) nerve. Nerves that do both are mixed nerves. Unlike spinal nerves which are always
mixed, cranial nerves can be purely motor, purely sensory or mixed.
Olfactory nerve (CN I)
Cranial nerve 1 is a special somatic afferent nerve which innervates the olfactory mucosa within the nasal
cavity. It carries information about smell to the brain. The many branches of the olfactory nerve, called
fila olfactoria, pass from the nasal cavity through the cribriform plate of the ethmoid bone. They
terminate in the olfactory bulb, which continues as the olfactory tract. Within the brain, the fibers of the
olfactory tract disperse and end within the olfactory cortex (piriform cortex, amygdala, entorhinal cortex).
The olfactory nerve doesn’t have a specific nucleus of its own. Instead its cell bodies are found in the
olfactory area-the nasal mucosa that covers the roof of the nasal cavity.
Optic nerve (CN II)
Cranial nerve 2 is a special somatic afferent nerve which innervates the retina of the eye and brings visual
information to the brain. Neural fibers originate from the photoreceptors of the retina. They converge at
the optic disc, forming the optic nerve. The optic nerve leaves the orbit through the optic canal.
On the floor of the middle cranial fossa, the nasal parts of each nerve cross to the opposite side forming
the optic chiasm. The nerve fibers then continue as the two optic pathways. CN II also doesn’t have its
own nuclei, but instead its cell bodies are found in the retina. The optic nerve synapses with the visual
relay centers of the brain.
Oculomotor nerve (CN III)
Cranial nerve 3 is both a somatic and visceral efferent motor nerve. This means it has two nuclei and
carries two types of efferent fibers. As the name suggests, the oculomotor nerve is the chief motor nerve
supplying the eye. It originates from the midbrain and leaves the skull through the superior orbital fissure
to enter the orbit where it enables eye movement, constriction of the pupil (miosis) and lens
accommodation.

Trochlear nerve (CN IV)

Cranial nerve 4 is a general somatic motor nerve. The trochlear nerve originates from the midbrain and
enters the orbit through the superior orbital fissure, supplying one extraocular muscle thus playing a role
in eye movement.

Trigeminal nerve (CN V)

Cranial nerve 5 is a mixed nerve, containing both special visceral and general somatic fibers. The fibers
originate from the brainstem, forming the trigeminal ganglion near the apex of the petrous part of the
temporal bone. The trigeminal nerve divides into three divisions; ophthalmic nerve (CN V1), maxillary
nerve (CN V2) and mandibular nerve (CN V3). Each of them leaves the skull through a different opening.
Ophthalmic leaves through the superior orbital fissure, maxillary through the foramen rotundum and the
mandibular nerve exits via the foramen ovale. All three branches of the trigeminal nerve supply sensation
to the facial skin. The areas of cutaneous innervation (dermatomes) are as follows; Ophthalmic nerve (CN
V1 dermatome) supplies the forehead, orbit and nose, maxillary nerve (CN V2 dermatome) the zygomatic
region and upper lip, while the mandibular nerve (CN V3 dermatome) innervates the buccal skin, lower
lip and skin of the mandibular region.
Abducens nerve (CN VI)
Cranial nerve 6 is a general somatic efferent nerve which innervates the lateral rectus muscle
(extraocular). The abducens nerve originates from the brainstem and exits the skull via the superior
orbital fissure.

Facial nerve (CN VII)

Cranial nerve 7 is a multimodal nerve, carrying both general and special fibers. It originates from the
brainstem as two separate divisions; a larger primary root carrying motor fibers and a smaller
intermediate nerve carrying sensory and parasympathetic fibers. The two divisions leave the cranial
cavity through the internal acoustic meatus and then travel through the facial canal. Here they join
forming the facial nerve proper and leave the cranium together through the stylomastoid foramen. Once
the facial nerve reaches the face it enables many functions, such as facial expression, secretion of glands
and taste sensation.
Vestibulocochlear nerve (CN VIII)
Cranial nerve 8 is a special somatic afferent nerve. It is comprised of two parts: the vestibular nerve and
the cochlear nerve. The cochlear component enables hearing, while the vestibular part mediates balance
and motion. At the fundus of internal acoustic meatus, both parts unite to form the vestibulocochlear
nerve and enter the cranium through the internal acoustic meatus. The two components synapse with their
respective nuclei in the brainstem. To save you from confusion, note that dorsal and ventral cochlear
nuclei terminology vary. Sometimes you’ll see them as anterior and posterior cochlear nuclei, and
elsewhere simply grouped as the auditory nuclei.

Glossopharyngeal nerve (CN IX)

Cranial nerve 9 is another multimodal nerve. It originates from the brainstem and leaves the skull through
the jugular foramen. It enables swallowing, salivation, and taste sensation, as well as visceral and general
sensation in the oral cavity.

Vagus nerve (CN X)

Cranial nerve 10 is also a multimodal nerve, It originates from multiple nuclei in the brainstem, and exits
the skull through the jugular foramen. It is the longest cranial nerve and the only one to leave the head
and neck region. The vagus nerve travels into the thoracic and abdominal cavities, providing
parasympathetic supply to visceral organs. CN 10 has two ganglia, called the superior ganglion of the
vagus nerve and the inferior ganglion of the vagus nerve (nodose ganglion). The former provides fibers
for general sensory function, while the latter gives special sensory and visceral output. The vagus nerve
controls a large number of functions, including gland secretion, peristalsis, phonation, taste, visceral and
general sensation of the head, thorax and abdomen.
Accessory nerve (CN XI)
Cranial nerve 11 is an efferent nerve originating from the brainstem and spinal cord. It exits the skull
through the jugular foramen, acting to enable phonation and movements of the head and shoulders.
Sensory fibers of the cervical plexus join the accessory nerve enabling general sensation for its target
muscles.

Hypoglossal nerve (CN XII)

Cranial nerve 12 is a general somatic efferent nerve originating from the brainstem. It leaves the skull
through the hypoglossal foramen. Its function is to enable tongue movements. The hypoglossal nerve is
extremely important for smooth daily functioning of every person, as it plays a significant role in
important mouth functions such as speech and swallowing. Similar to CN XI, the hypoglossal nerve also
interacts with the cervical plexus. It receives GSE fibers from C1 and C2 spinal nerves, and GSA fibers
from the spinal ganglion of C2 spinal nerve.

SPINAL NERVES
Spinal nerves are an integral part of the peripheral nervous system (PNS). They are the structures through
which the central nervous system (CNS) receives sensory information from the periphery, and through
which the activity of the trunk and the limbs is regulated. Also, they transmit the motor commands from
the CNS to the muscles of the periphery. They are composed of both motor and sensory fibers, as well as
autonomic fibers, and exist as 31 pairs of nerves emerging intermittently from the spinal cord to exit the
vertebral canal. There are 31 bilateral pairs of spinal nerves, named from the vertebra they correspond to.
For the most part, the spinal nerves exit the vertebral canal through the intervertebral foramen below their
corresponding vertebra. Therefore, there are 12 pairs of thoracic spinal nerves, 5 pairs of lumbar spinal
nerves, 5 pairs of sacral spinal nerves, and a coccygeal nerve.
The cervical spinal nerves differ from this pattern. C1-C7 spinal nerves emerge from the vertebral canal
above the corresponding vertebra, with an eighth pair of cervical spinal nerves emerging below the C7
vertebra, meaning there are a total of 8 pairs of cervical spinal nerves while there are only 7 cervical
vertebrae. The sacrum differs from the rest of the vertebral column in that its individual vertebrae are
fused together, thus there are no intervertebral foramina. The spinal nerves instead pass through the sacral
foramina. From the level of C1 down as far as the level of L1/L2, the spinal nerve roots have a short
distance to travel to their corresponding intervertebral foramen. Caudal to the level of L1/L2, the spinal
cord tapers into a structure called the conus medullaris where the remaining spinal nerve rootlets exit the
spinal cord at this level. These pairs of spinal nerves have to pass a longer distance to exit the vertebral
canal and form a structure within it that closely resembles a horse’s tail: the cauda equina. The dural and
subarachnoid layers of meninges surrounding the spinal cord in the vertebral canal cover the spinal nerve
roots as they pass towards the intervertebral foramen, effectively forming a meningeal sleeve. They fuse
with the nerve to become the outer coating of the spinal nerve, the epineurium
SPINAL NERVE NUMBER OF PAIRS
cervical 8
thoracic 12
lumbar 5
sacral 5
coccygeal 1
TOTAL 31
THE AUTONOMIC NERVOUS SYSTEM
The autonomic nervous system (ANS) is part of the peripheral nervous system, and is responsible for the
control of vital functions such as heart beat, breathing and digestion. It is also involved in the acute stress
response where it works with the endocrine system to prepare the body to fight or flight. It can be further
subdivided into the sympathetic and parasympathetic divisions. The ANS transmits information from and
to the internal body organs such as the liver and the lungs. It operates automatically, and is generally
considered to be outside the realm of voluntary control.
The ANS therefore differs from the somatic nervous system (another branch of the peripheral nervous
system) as this system is associated with controlling voluntary body movements. Although most of the
functions of the ANS are automatic, they can however work in conjunction with the somatic nervous
system.
The ANS works by receiving information from either external stimuli or the body. The hypothalamus,
which is right above the brain stem, receives autonomic regulatory input from the limbic system (a group
of structures deep in the brain which are associated with functions such as memory, emotion, and fear).
The hypothalamus uses this input to control much of the activity of the ANS.
There are also three key neurotransmitters involved for successful communication within the ANS:
Acetylcholine – primarily found within the parasympathetic nervous system, which has an inhibiting
effect.
Epinephrine – also known as adrenaline, primarily found within the sympathetic nervous system, which
has a stimulating effect.
Norepinephrine – also known as noradrenaline, primarily found within the sympathetic nervous system,
which has a stimulating effect.

SYMPATHETIC NERVOUS SYSTEM

The sympathetic nervous system that is involved in responses which help us deal with emergencies. It
slows bodily processes that are less important in emergencies such as digestion. For instance, if the
temperature of a room is hot, the sympathetic system will encourage the body to sweat in response to this
change.
The most noticeable function of the sympathetic branch is during the fight-or-flight response. During
conditions that are considered threatening or stressful, the sympathetic system activates, providing an
automatic response.
For example, when walking home alone down a dark street, this can be a scary situation for many people.
Whilst walking, your pupils may dilate, your heart rate may increase, and you may be sweating. This
response to a stressful situation is caused by the release of large quantities of the neurotransmitter
epinephrine from the adrenal gland. Once this stimulating neurotransmitter is released, this triggers the
body’s automatic responses. The purpose of stimulating these bodily responses is to prepare the
individual to either escape or fight in dangerous situations.
Although the sympathetic nervous system was evolutionarily used in life threatening situations, modern
day life and mental health can also trigger this response. Work-related stress, financial concerns, and
relationship problems are examples of when the sympathetic nervous system can produce this stress
response. Similarly, those with anxiety disorders and phobias experience high quantities of epinephrine,
resulting in them experiencing the same autonomic responses as if they are in life-threatening situations.
PARASYMPATHETIC NERVOUS SYSTEM
The parasympathetic nervous system that relaxes the individual once the emergency has passed (eg. slows
the heart rate down and reduces blood pressure) and conserves the body’s natural activity by decreasing
activity/maintaining it.
The parasympathetic nervous system is associated with returning the body to resting state functions such
as regulating heart rate, relaxing muscles, and controlling the bladder. This makes the parasympathetic
nervous system important in supporting homeostasis.
The parasympathetic nervous system can also come into action once a threatening situation is over. For
instance, thinking back to the scenario of walking home alone at night, once returned home and the
threatening situation is over, the body relaxes. The pupils will constrict, the heart rate returns to a resting
rhythm, and sweating is reduced or stopped.
The parasympathetic system is therefore important for ensuring we return to normal after a stressful
situation. Without this system, the body will be constantly alert, draining all energy, and can lead to
chronic stress.