Comprehensive Lectures on the Central Nervous System for Medical Students Kumudini Mohan Ram
INDEX
A
Alzheimer’s disease 236
Antidiuretic hormone 202
Aphasias 241
Ascending or afferent pathways 49
Ascending reticular activating system 79
Autonomic nervous system 184
chemical transmission at autonomic junctions 192
effects of parasympathetic stimulation 189
features of autonomic function 190
sympathetic nervous system 186
visceral afferents 191
B
Basal ganglia 121
diseases 124
neurotransmitters 123
Bell Magendie law 21
Blood-brain barrier 39
Braking effect 118
Brown-Séquard’s syndrome 33, 64 (also see Sensory system)
C
Central nervous system 1
cerebral hemisphere 6
development 3
evolution 2
medulla 5
spinal cord 5, 19
thalamus 6, 54
Cerebellum 107
cerebellar cortex 111
classification 109
connections 114
features of cerebellar lesions 118
functional division 109
input 113
organization 110
pontocerebellar 117
spinocerebellum 117
structure and divisions 107
Cerebrospinal fluid 36
absorption 37
blood-brain barrier 39
circulation 36
composition 39
Queckenstedt test 38
site of formation 36
Cerveau isole preparation 81
Control of motor activity 137
Cortical association areas 230
Cutaneous sensations 44
D
Damping effect 118
Dominant hemisphere 239
E
Electrical activity of the brain 170
clinical uses of the EEG 174
electroencephalogram 171
F
Frontal lobe lesions 238
G
Grand mal epilepsy 175
H
Higher functions of the brain
learning 231
memory 233
Hypothalamic obesity syndrome 205
Hypothalamic releasing and inhibiting hormones 204
Hypothalamus
anatomy 199
and behaviour 207
feeding and satiety 204
funcions 200
relation to autonomic function 206
relation to sleep 206
sympathetic responses 206
temperature regulation 204
thirst and water intake 205
I
Inverse stretch reflex 94
Irradiation 103
J
Jendrassik’s maneuver 94
L
Lateral medullary syndrome 141
Limbic system
components 212
connections 213
fear and rage 216
functions 214
Kluver-Bucy syndrome 217
motivation 217
Lower motor neuron lesions 142
M
Maintenance of posture and postural reflexes 147
Medial medullary syndrome 140
Memory 235
lesions 236
Microglia 7
Motor cortex 130
connections 133
lesions 139
Muscle spindle 91
N
Neurotransmitters
acetyl choline 221
acetyl choline receptors 222
alpha and beta receptors 224
amino acids 225
norepinephrine and epinephrine 223
purinergic transmitters 227
Noradrenergic neurons 193
O
Oxytocin 203
P
Pain 68
brain opiate system 73
facilitation theory 71
gate-control theory 72
mechanism 71
pathway 69
receptors 69
types 70
Papez circuit 213
Parkinson’s disease 126
Petit mal epilepsy 175
Placing and hopping reactions 154
Primary afferent depolarization 15
Q
Queckenstedt test 38
R
Reciprocal innervation 102
Recruitment of motor units 103
Reflex activity 86
classification 87
decerebrate preparation 98
muscle tone 96
polysynaptic reflex 100
reaction time 101
Reticular formation 76
ascending reticular activating system 79
functions-ARAS 80
modulation of pain 83
motor and visceral functions 81
reciprocal connections 78
S
Senile dementia 236
Sensory system 41, 64
anterolateral pathways 51
brainstem lesions 66
classification 43
coding of sensory information 41
cortical lesions 66
lesion of a peripheral nerve 64
lesion of the dorsal root 64
lesions of the spinal cord 64
somatosensory tracts 49
spinocerebellar tracts 51
thalamic lesions 66
transmission in peripheral nerves 48
Sham rage 149
Simiusculus 131
Sleep 175
disorders 179
distribution of sleep stages 177
mechanism of sleeping and working 177
REM sleep 177
slow wave NREM sleep 176
Speech 240
Spinal cord 19
ascending tracts 23
descending tracts 25
functional anatomy 19
hemisection 33
lesions 29
medial longitudinal fasciculus 29
spinal gray-laminar organization 22
Spinothalamic pathways 51
Stages of spinal transection 30
degeneration 32
recovery 32
reflex activity 31
spinal shock 30
Stretch reflex 90
Synapse 8
convergence and divergence 16
electrical transmission 12
excitatory post-synaptic potential 11
ionic basis 11
properties 15
synaptic activity and learning 16
types 9
Synaptic inhibition 12
indirect inhibition 14
inhibitory post-synaptic potential 12
pre-synaptic inhibition 13
Renshaw cell inhibition 13
T
Thalamic syndrome 66
Thalamus 54
classification 56
functions 55
somatosensory cortexÿ 58
thalamic syndromes 58
Tonic neck reflexes 151
Toniclabyrinthine reflexes 152
U
Upper motor neuron lesions 142
V
Vestibular function
anatomy 159
neural pathways 163
otolith organs 163
vestibular connections 164
W
Weber’s syndrome 140
Wilson’s disease 127
Withdrawn reflex 103
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1Comprehensive Lectures on the Central Nervous System for Medical Students2
3Comprehensive Lectures on the Central Nervous System for Medical Students
Kumudini Mohan Ram MD Former Professor and Head Department of Physiology Osmania Medical College Hyderabad, India
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
EMCA House, 23/23B Ansari Road, Daryaganj
New Delhi 110 002, India
Phones: 23272143, 23272703, 23282021, 23245672, 23245683
Fax: 011-23276490
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Comprehensive Lectures on the Central Nervous System for Medical Students
© 2003, Kumudini Mohan Ram
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition : 2003
9788180611896
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd, A-14, Sector 60, Noida
5Preface
Teaching neurophysiology to the medical student, over the years, has been both a challenging as well as a very satisfying experience.
Neurophysiology is a vast subject and the student, especially the undergraduate, often finds it difficult to refer to a number of textbooks since all aspects of the central nervous system are not covered in any one textbook. While some textbooks give too many details dealing with a few topics, quite a few fundamental aspects are not presented. There has been a felt need for a comprehensive presentation of the fundamentals of the central nervous system which would help the student.
After years of procrastination, I have ultimately settled down to making my humble contribution through these lectures intended to benefit the medical student. My lectures over the years have been based mainly on material and extracts drawn from a number of reviews and textbooks and the same has been presented here with a mention of the sources at the end of each chapter/topic. This overview is meant to be a guide to enable the student to have a grasp of the subject of neurophysiology.
I express my thanks to Mr J P Vij, Chairman and Managing Director and Mr P S Ghuman, Sr. Production Manager of M/s Jaypee Brothers Medical Publishers (Pvt) Ltd, for their meticulous efforts in bringing out this publication.
Kumudini Mohan Ram