The brain

 

Nucleus                                              ganglion

 

A brain consists of 4 main areas;   Cerebrum       Cerebellum    Diencephalon            Brain stem

 

Cerebrum

In two hemispheres, right and left cerebral hemispheres, separated by the longitudinal fisure          

 

Gyrus                                      Sulcus             Grey matter                            White matter

 

Corpus callosum                   Lateral ventricles

 

Left hemisphere – mathematical, analytical, verbal functions

Right hemisphere – visual, special, musical functions

 

Outer area is the cerebral cortex which is 2 - 4 mm thick

 

Projection tracts connect the cortex with the brain stem via the internal capsules. The thalamus and cortex communicate via the projection tracts (corona radiate). These tracts are continuous with the internal capsule.

 

Basal nuclei (ganglia) are collections of nerve cell bodies low down in the cerebrum, caudate and lenticular nucleus

 

Frontal lobe - pre motor area, precentral gyrus (motor area), primary speech area (Broca`s area, on left side), reasoning, social functioning, abstract thinking, personality, character, moral sense, wisdom, your ambition

 

Frontal and parietal lobes separated by central sulcus

 

Parietal lobe - postcentral gyrus (sensory cortex), taste, positional sense, three-dimensional representation of the world, speech sensory area - understanding of language

 

Temporal lobe - auditory area, Wernicke`s area for language comprehension of language, olfaction, religious experience. The temporal lobe is partly limbic.

 

In 95% of people Broca`s and Wernicke`s area are in the left hemisphere

 

Temporal lobe separated by lateral fissure

 

Occipital lobe - vision

 

The cerebrum has localised and generalised areas of function

 

Generalised functions include reasoning, memory, association with other areas, experience of consciousness

 

Alcohol inhibits the cerebral cortex

 

Cerebellum

Automatic learned function              Balance, maintenance of posture, fine motor control

 

Diencephalon

Thalamus, hypothalamus, pineal gland

 

Thalamus

Relay station              Language       Recent memory         Emotion

 

Hypothalamus

Homeostasis             Body temperature     Hunger            Thirst               Endocrine homeostasis

 

Pineal gland

Produced melatonin in relation to a circadian cycle

The pineal gland is the only unpaired structure in the brain

 

Brain stem

Consists of the midbrain, pons and medulla oblongata

 

Midbrain        Nuclei for cranial nerves III  IV

 

Pons               Nuclei for nerves V  VI  VII  VIII

 

Medulla          Nuclei for VIII  IX  X  XI  XII    Vasomotor, respiratory and cardiac centres

 

Limbic system

An interconnected range of nuclei deep in the cerebrum surrounding the hypothalamus

Parts of the frontal, parietal and temporal lobes are limbic

Love, anger, aggression, compulsion, sexual behaviour, drives, sorrow, docility

Normally the limbic areas react to sensory input

Emotions may be completely shut down in emergencies, e.g. Dr. Livingston, soldiers, rape

Limbic system includes reward and punishment areas

Punishment areas generate displeasure, fear, terror, pain, punishment

Activation of punishment areas inhibit activity in reward centres

 

Hypothalamus

Has nuclei for hunger, thirst, satiety, rage, sexual drive, homeostasis of water and temperature

 

Hippocampus

Damage causes anterograde amnesia (loss of memory for recent events)

 

Amygdala

Stimulation produces similar effects as the hypothalamus

Seems to control a wide variety of behaviours

Decides how emotionally significant a stimulus is, eg. a chair or a tiger

 

Septum

Sexual pleasure, orgasm

 

Other limbic areas include the singulate gyrus and parts of the thalamus

 

 

Mental Illness

 

Capgras` delusion

After a head injury a mother was found to be an impostor

Eye to limbic disconnection

Ear to limbic is a separate connection

 

Cotard`s syndrome

A person thinking they are dead

A complete dissociation between sensory input and a limbic generated emotional response

 

Derealization

A relatively common symptom, "the world doesn't really exist"

 

Autism

Normally the limbic areas react to sensory input

In autism, emotional reactions may be generated to non-significant inputs eg. staring at a grain of dust

There may be no reaction to another input such as another person’s eyes

So in autism there is a breach between input and emotional reaction which appears arbitrary

 

Hysteria

Hysterical symptoms reflect an individuals understanding of a disorder

A paralysis may present in the presence of a nervous system

Prefrontal cortex prepares the motor function before activation of the motor cortex

 

In hysteria the prefrontal lights up but parts of the limbic system lobe also light up to inhibit the function of the motor cortex

 

Schizophrenia

 

Clinical features

Disorders of cognition and affect

Delusions, hallucinations

Lack of volition, poverty of thought and emotion, loss of insight

 

Dopamine hypothesis

Increased dopamine activity in limbic and other areas

Amphetamines work through dopaminergic mechanisms

Antipsychotic drugs block postsynaptic dopamine receptors

Increasing dopamine can aggravate schizophrenia

 

Genetics

Schizophrenia           Affective psychosis

General pop                           1%                              3%

Siblings                                  9%                              13%

One parent                             13%                            15%

Both parents                          40%               

MZ                                           40%                            70%

 

Environmental stress may trigger a genetic predisposition

 

New thinking

Confusion between internally generated thought and external reality

Thoughts are not corrected in the light of reality

 

Affective disorders

Unipolar and bipolar

Depression hypomania and mania

 

Depression

Lack of Noradrenaline and 5-HT

Reduced monoamine receptor sensitivity

Polygenetic interaction with environment

 

Bipolar

MZ concordance 70%

Affected parents gives a child risk of 10 – 15%

 

Treatments

Psychological

Selective serotonin reuptake inhibitors

Tricyclic antidepressants – prevent reuptake of nor adrenaline and serotonin

Monoamine oxidase inhibitors

Lithium – may work by inhibiting catecholamine breakdown

 

Anxiety states

GABA

Acute anxiety attacks

Cerebral circulation and breathing

Phobias

 

Organic brain syndromes

 

Dementia

 

Delirium

 

 

 

Spinal nerves

Spinal cord

Begins at the foramen magnum down to L2

 

31 pairs of large nerves

Cervical 1-8 (only 7 bones of course)

Thoracic 1 - 12

Lumbar 1 – 5

Sacral 1 – 5

Coccygear 1

 

Dermatomes

An area of skin supplied by the axons of a single spinal nerve, there is only a little overlap.

 

Cranial nerves

Start from the front and work back

 

I           Olfactory

 

II          Optic

 

III         Oculomotor              Pupils and some extrinsic eye muscles

 

IV        Trochlear                  Superior oblique eye muscles

 

V         Trigeminal                Mastication muscles and other facial muscles

 

VI        Abducens                 Lateral rectus of eyes

 

VII       Facial                         Taste receptors, glands of nasal and oral cavity, lacrimal glands,

facial muscles

 

VIII      Auditory (vestibulocochlear)      Hearing and balance

 

IX        Glossopharyngeal             Taste from back of tongue, mucous membranes back of mouth and pharynx, chemo and baroreceptors in carotid artery and body

 

X         Vagus                        External ear, muscles of palate, heart, lungs, abdominal viscera

 

XI        Spinal accessory   Trapezius  and sternomastoid

 

XII       Hypoglossal                        Extrinsic and intrinsic tongue muscles