Kin 312 Introduction to

Neurological Disorders

Winter 2023 (Tu/Thurs 1-2:20)

Optometry 347
Sherri Thomson
[email protected]
KIN 312 Introduction to
Neurological Disorders
Week 1
Thursday
Nervous System Review
This week:
We will continue the overview of background information needed
to understand how neurological disorders impact function.

Today
1. Relevant review the nervous system
2. Review of signal transmission
Today’s Learning Objectives
By the end of today, students will be able to:
• Recall and describe the parts of the nervous system and their
functions
• Describe to process of cellular transmission (within and
between)
• Describe the contributions of the nervous system to movement
control
Nervous System:
• A network of billions of nerve cells
linked together in a highly
organized manor to form the rapid
control system

• Essential for sensation, movement,

cognition, regulating body systems
(in conjunction with the endocrine
system)

He et al., 2017
https://www.youtube.com/watch?time_continue=27&v=j7aOwjGLOq0&feature=emb_logo
The Building Blocks of the Nervous
System
• Not just neurons!
• Neurons and glial cells are the main building blocks of the
nervous system
• Both required for healthy functioning of the central/peripheral
nervous systems
• Disease or injury to the neurons or glial cells can result in
disordered function sensation/movement
• Approximately 100 billion neurons and 100 billion glial cells in
the brain
Parts of a Neuron
Neurons
• structural/functional units
Axon hillock
• Specialized for rapid communication
• Composed of
• Cell body with dendrites
• Axon and axon terminals

Dendrites = input from other cells

Axon hillock = controls firing of neuron

Myelin Sheath
• Concentric layers of lipid and protein that insulates axons
• Increase & improve velocity of impulse conduction
• Schwann cells = peripheral nervous system
• Oligodendrocytes = central nervous system
https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics-life-and-death-neuron
Functional Classification of Neurons
Motor (efferent) neuron
• Input from neuron
• Output to muscle

Sensory (afferent) neurons

• Input from special ending that
senses stimuli
• Output to neuron

Interneuron
• Input from neuron
• Output to neuron

http://humanphysiology.academy/Neurosciences%202015/Chapter%202/P.2.2p%20Spinal%20Reflex%20Pathways.html
Neuroglia
‘Glia’ from the Greek for ‘glue’ -- but they do much more than just hold things together

~ previously believed about 10:1 ratio of glial cells for every neuron (now believed 1:1)

Functions:
• Physical support
• Regulation
• Insulation (myelination)
• Homeostasis (nutrients, oxygen, chemical gradients)
• Pathogen removal
• Synaptogenesis and plasticity
Types of Neuroglia (CNS)
Astrocytes
• Regulate neuronal excitability (Ca2+)
• Homeostasis (ion concentrations, vascular connection, blood flow)
• Repair and plasticity

Oligodendrocytes
• Myelination
• Insulates axon & increases communication speed

Microglia (immune system)

• Prune neural connections, remove damaged cells, removal of debris
Types of Neuroglia (PNS)
• Schwann cells
• Myelinating glial cells
• Associate with a single neuron

• Satellite cells
• Non-myelinating glial cell
• for supportive capsule around nerve cell bodies located in the ganglia
(outside the CNS)

https://brainstuff.org/blog/what-are-satellite-glial-cells
 Neurons and Neuroglia
1. Oligodendrocyte
2. Neuronal axon
3. Neuron (cell body)
4. Myelin
5. Microglia
6. Astrocyte
7. Synapse
8. Blood Vessel

http://med.stanford.edu/news/all-news/2009/09/unsung-brain-cells-play-key-role-in-neurons-development.html
Signal Transmission
Signal Transmission
Action potential
• Within a neuron

Synaptic transmission
• Between neurons
Conduction of Information: Within
Neurons
Action Potentials
• Changes in the electrochemical
gradient across the membrane of a
neuron
• Due to influx /outflux of ions
• Na+
• K+
• Ca2+
 Action Potential Process:
Resting cell ~ -70mV due to ATP fueled Na+/K+pump

1. Stimulus at dendrites travel to axon hillock

2. Threshold reached (-55mV)

• voltage gated Na+ channels open = depolarization
• Inside of neuron becomes positive

3. Na+ channels close but K+ channels open (K+ moves

out of cell) (at +40mV) and cell repolarizes

4. Too much K+ moves out (hyperpolarization) before K+

channels close (refractory period)

5. K+ channels close and polarization is restored

Refractory period = no action potential can occur

https://www.moleculardevices.com/applications/patch-clamp-electrophysiology/what-action-potential
Saltatory conduction
Myelin sheath
• No Na+/K+ pump or ion channels

Node of Ranvier
• Concentration of Na+/K+ pump and ion
channels

Saltatory conduction
• Action potential “hops” between nodes
• Faster than in non-myelinated nerves
Conduction of Information: Between Neurons

Synaptic Transmission
Neurotransmitters stored in synaptic vesicles in pre-
synaptic cell

1. Action-potential arrives at synapse

2. Ca2+ channels open, Ca2+ enters cell
3. Docked vesicles release neurotransmitter into
synapse (exocytosis)
4. Neurotransmitter docks with receptor on post-
synaptic cell
• May depolarize (excitatory) or hyperpolarize (inhibitory)
post-synaptic cell

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249630/#:~:text=Ca2%2B%20triggers%20synaptic
%20vesicle,vesicles%20and%20initiating%20synaptic%20transmission.
Quick Poll
Which glia cell provides myelin sheath in the peripheral nervous
system?

A) Astrocyte
B) Schwann Cell
C) Oligodendrocyte
D) Microglia
Quick Poll
By which process do neurons “talk” to other neurons?

A) Signal Transduction
B) Signal Transmission
C) Saltatory Conduction
D) Action Potential
Organization of the Nervous System
Components of the Nervous system: Structural Division

Central Nervous System (CNS)

• Brain
• Brainstem
• Spinal cord

Peripheral Nervous System (PNS)

• Cranial nerves
• Spinal nerves
• Peripheral nerves
• sensory, motor, autonomic

Moore and Dalley, 2006 Fig 1.28 pg 49

Components of the Nervous system: Structural Division

Central Nervous System (CNS)

• Brain
• Brainstem
• Spinal cord

Peripheral Nervous System (PNS)

• Cranial nerves
• Spinal nerves
• Peripheral nerves
• sensory, motor, autonomic

Moore and Dalley, 2006 Fig 1.28 pg 49

 Role of the Central Nervous System
Principal Role
• Integrate and co-ordinate incoming (afferent) and
outgoing (efferent) neural signals
• Carry out higher mental functions (thinking,
learning)

Terminology
• A bundle of nerve cell bodies in the CNS =
nucleus
• A bundle of axons connecting neighbour or
distant nuclei in CNS = tract
• Cell bodies = “grey matter”
• Axons(fiber tracts)= “white matter

https://www.hopkinsmedicine.org/health/conditions-and-diseases/anatomy-of-the-brain
Selected CNS components
Cerebral cortex
Diencephalon
Corpus callosum
1. Spinal cord
2. Brain stem Pituitary gland Cerebellum
medulla
Pons Brain stem
pons
midbrain
3. Cerebellum
4. Diencephalon
thalamus Vertebrae
hypothalamus Spinal cord
(& epithalamus)
5. Basal ganglia
6. Cerebral cortex Cauda equina
Conus medularis
Spinal Cord
Entry & exit to the peripheral nervous system

Fibre tracts
• Ascending: sensory info from body towards brain
• Descending: information from brain to body to initiate actions
(movement, organ functions)

Interneurons (relay neurons)

• Found in both spinal cord and brain
• Relay signals between sensory and motor nerves
Cervical spinal cord
• 7 cervical vertebrae
• 8 cervical spinal nerves

Thoracic spinal cord

• 12 thoracic vertebrae
• 12 thoracic spinal nerves

Lumbar spine
• 5 lumbar vertebrae
• 5 lumbar spinal nerves
• Conus medularis (end of spinal
cord at L1/2)

Sacral Spine
• 5 fused vertebral segments
• 5 spinal nerve roots

https://www.nature.com/articles/nrdp201718 Ahuja et al., 2017

 Cross sectional spinal cord
White matter (yellow)
• tracts/ axons
• white d/t myelination

Grey matter (orange)

• Unmyelinated
• contains cell bodies
• axon terminals and dendrites
• H or butterfly shape
• ventral horn
• efferent (motor) fibers
• dorsal horn
• afferent (sensory)fibers

Dorsal root ganglion

• sensory neuron cell bodies
Brain stem
Brain stem
Structurally continuous with spinal cord
• fibre tracts (ascending/descending)

Cranial nerves (entry/exit)

• Sensory function
• smell
• sight
• Hearing
• Taste
• Vestibular (dizziness/vertigo)
• facial sensation
• Motor function
• mastication, facial expression, swallowing,
trapezius, SCM)

Important role in sensory integration

Brain stem
Medulla:
• Control centers for involuntary functions
• Blood pressure, breathing, vomiting,
swallowing, sneezing
• Pyramids
• Cross over point for many
corticospinal tracts
Brain stem
Pons
• Bulbous protrusion on ventral brain stem
• Relay station for info transfer between
the cerebellum and cerebrum
• Coordinates control of breathing with the
medulla
• Important in sleep-wake cycle (arousal
system)
• Contains junctions for several cranial
nerves

https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics-understanding-sleep
Brain stem
Midbrain
• Smallest brainstem region
• Functions include control of eye
movement and relay signals for
auditory visual reflexes
Cerebellum
 Cerebellum (Little brain)
Communicates with cortex via brainstem
• Inputs / outputs through the brain stem.

Involved in:
• Maintenance of balance and posture
• Control of voluntary movement
• Coordination, precision, timing
• Motor learning
• Non-motor activities
• Language, spatial processing, working memory,
emotional processing

https://www.pharmacy180.com/article/the-brain-3551/
Cerebellar exam on real patient
Diencephalon (Between brain)
 Diencephalon
Thalamus
• Relay station:
• Sensory & motor signals to and from
cerebral cortex
• From spinal cord/brain stem,
cerebellum, basal ganglia
• Regulation of consciousness, sleep

Hypothalamus
• Regulates homeostasis
• Behavioural drive (hunger, thirst)
• Links (primarily autonomic) nervous system to
endocrine system

Biella, 2009
 Basal ganglia
• Group of subcortical nuclei Thalamus
Putamen
• Connected to cortex, thalamus and
Tail of
brain stem Caudate
Head of
Caudate
Include:
• Putamen Globus Amygdala
Pallidus
• Caudate
• Globus pallidus
• Subthalamic nucleus
• Substantia nigra
Sejnowski et al., 2014
 Basal ganglia
Control of movement
• Action selection
• Inhibition of movement
• Release of inhibition enables
movement
• Procedural learning (patterns of
inhibition, enabling)

Role in eye movement cognition and

emotions
Cerebral cortex
 Cerebral cortex
Frontal lobe
• Decision-making, planning
• Attention/ impulse control
• Action selection
Parietal lobe
• Somatosensory processing;
(tactile/sensory)
• Visuospatial map/navigation
Temporal lobe
• Memory
• Auditory, language, emotional
processing
Occipital lobe
• Visual processing
https://bio.libretexts.org/Bookshelves/Introductory_and_General_Biology
 homunculus

Sensory processing
Parietal
• Primary somatosensory cortex

Temporal
• Primary auditory cortex

Occipital
• Primary visual cortex
Primary Somatosensory Cortex
homunculus
• Parietal lobe
• Post central gyrus
• Skin, musculoskeletal
system, organs taste buds
• Arranged topographically
• Homunculus

Busti et al., 2015

Primary Auditory Cortex

• Located in temporal lobe

• Superior temporal gyrus
• Information from ears
• Tonotopic map

Neuroscience. 2nd edition.Purves D, Augustine GJ, Fitzpatrick D, et al., editors.

Sunderland (MA):; 2001.
Primary Visual Cortex

• V1: located in the occipital

lobe
• Receives retinal
information
• Multiple visual areas in the
visual cortex (V1-5)

Dubuc, 2002
https://thebrain.mcgill.ca
 Motor control Posterior Parietal
Primary Motor Cortex Cortex
Supplementary
Frontal Motor Area
• Primary motor cortex Premotor Cortex
• Executes voluntary Dorsolateral
movements Prefrontal
Associative
• Supplementary motor areas, Cortex
premotor cortex
• Selects voluntary movements
(with basal ganglia)

Somatosensory
Cortex
 Motor control Posterior Parietal
Primary Motor Cortex Cortex
Supplementary
Frontal Motor Area
• Dorsolateral Prefrontal Premotor Cortex
cortex Dorsolateral
• Higher-order instructions, Prefrontal
Associative
planning Cortex

Parietal
• Posterior parietal cortex
• Guides movements in space
• Integration of somatosensory Somatosensory
and visual input Cortex
Peripheral nervous
system
Components of the Nervous system: Structural Division

Central Nervous System (CNS)

• Brain
• Brainstem
• Spinal cord

Peripheral Nervous System (PNS)

• Cranial nerves
• Spinal nerves
• Peripheral nerves
• sensory, motor, autonomic

Moore and Dalley, 2006 Fig 1.28 pg 49

Cranial Nerves
Set of 12 paired nerves
I: Olfactory = Sense of Smell
II: Optic = Sense of Sight (only cranial nerve part of CNS)
III: Occulomotor = movement of the eye (extraocular, pupillary muscle)
IV: Trochlear = extraocular eye movement
V: Trigeminal = sensory function of the face, muscles of mastication
VI: Abducens = extraocular eye movement
VII: Facial = motor function of the face (facial expression)
Cranial Nerves
• VIII: Vestibulocochlear = Hearing and vestibular function
• IX: Glossopharyngeal = Muscles involved in swallowing
• X : Vagus = complex functions : motor, sensory, autonomic nervous
system function to internal organs (digestion, heart rate, breathing,
cardiovascular activity etc)
• XI: Accessory = sternocleidomastoid muscles and trapezius muscles
• XII: Hypoglossal = muscles of the tongue
Components of the Nervous system: Functional Division

Somatic Nervous System

• All functions we are consciously control
• Sensation and voluntary movement and somatic
reflex arcs (withdrawal reflex)
• Afferent (sensory) nerves
• Travel towards CNS
• Efferent (motor) nerves
• Travel from CNS

Autonomic Nervous System

• Involuntary/ Messages btw CNS and internal
organs
• Sympathetic
• parasympathetic

Moore and Dalley, 2006 Fig 1.28 pg 49

Components of the Nervous system: Structural Division

Somatic Nervous System

• All functions we are consciously aware of
• Sensation and voluntary movement and reflex
arcs
• Afferent (sensory) nerves
• Travel towards CNS
• Efferent (motor) nerves
• Travel from CNS

Autonomic Nervous System

• Involuntary/ Messages btw CNS and internal
organs
• Sympathetic (fight or flight)
• Parasympathetic (rest and digest)
Moore and Dalley, 2006 Fig 1.28 pg 49
Motor unit
 Motor unit
Motor neuron
• Nerve that activates muscle fibers

Motor unit
• Motor neuron and
• ALL the muscle fibers it connects to
• Muscle fibers of motor units
contract fully or not at all
• All or None Law
• More motor units recruited result in
greater muscular contraction
 Upper motor neuron

Lower motor neurons

– cell body located in the spinal cord
or brainstem
– sends out axon that directly
innervates skeletal muscle fibers CST

Upper motor neurons

– cell body of neuron located in the Motor unit
cortex (M1, premotor, S1)
Lower motor
– axon travels via the CST neuron
(corticospinal tract) and synapses
on the lower motor neuron
https://anatomyqa.com/uuper-lower-motor-neurons-lesions/
Movement disorders
Damage to neurons in most regions of the central & peripheral
nervous system can disrupt control of movement

Disruption to movement is determined by the specific region that

is damaged or injured
Quick Poll
Which structure is NOT part of the central nervous system?
A) Brain stem
B) Cerebellum
C) Spinal nerve
D) Basal ganglia
Quick Poll
Which brain lobe is most associated with visual processing?
A) Frontal lobe
B) Occipital lobe
C) Temporal lobe
D) Parietal lobe
Quick Poll
Which structure is part of the diencephalon?
A) Hypothalamus
B) Putamen
C) Caudate nucleus
D) Substantia nigra
• Selma blair describes the moment she received her multiple sclerosis
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Questions?