The central nervous system (CNS) consists of the brain
and the spinal cord
, immersed in the cerebrospinal fluid (CSF).
Weighing about 3 pounds (1.4 kilograms), the brain consists of three main structures: the cerebrum
, the cerebellum
and the brainstem
.
Cerebrum - divided into two hemispheres (left and
right), each consists of four lobes
(frontal, parietal
, occipital
and temporal). The outer layer of the brain is known
as the cerebral cortex
or the ‘grey matter’. It covers the nuclei deep within the cerebral hemisphere known as the ‘white
matter’.
- Grey matter – closely packed neuron
cell bodies form the grey matter
of the brain. The grey matter includes regions of the brain involved in muscle control, sensory perceptions, such
as seeing and hearing, memory, emotions and speech.
- White matter – neuronal tissue containing mainly long, myelinated axons
, is known as white matter
or the diencephalon. Situated between the brainstem and cerebellum, the white matter consists of structures at the
core of the brain such as the thalamus
and hypothalamus
. The nuclei of the white matter are involved in the relay of sensory information from the rest of the body to the
cerebral cortex, as well as in the regulation of autonomic (unconscious) functions such as body temperature, heart rate and
blood pressure. Certain nuclei within the white matter are involved in the expression of emotions, the release of hormones from the pituitary gland,
and in the regulation of food and water intake. These nuclei are generally considered part of the limbic
system
.
Cerebellum – responsible for psychomotor function, the cerebellum co-ordinates sensory input from the inner
ear and the muscles to provide accurate control of position and movement.
Brainstem – found at the base of the brain, it forms the link between the cerebral cortex, white matter and
the spinal cord. The brainstem contributes to the control of breathing, sleep and circulation.
Other important areas in the brain include the basal ganglia, thalamus, hypothalamus, ventricles
, limbic system, and the reticular activating system.
Basal Ganglia
Collectively the caudate nucleus, putamen
and globus pallidus form the basal ganglia, and are involved
in movement control. These highly specialised clusters of cells/nuclei are found within the white matter, beneath the cerebral
cortex.
Thalamus and Hypothalamus
The thalamus and hypothalamus are prominent internal structures. The thalamus has wide-ranging connections with
the cortex and many other parts of the brain, such as the basal ganglia, hypothalmus and brainstem. It is capable of perceiving
pain but not at accurately locating it. The hypothalamus has several important functions, including control of the body’s
appetite, sleep patterns, sexual drive and response to anxiety.
Ventricles
Within the brain there are a number of cavities called ventricles. Ventricles are filled with CSF, which is produced
within the ventricle wall. The CSF also surrounds the outer surfaces of the brain and ‘cushions’ the brain against
trauma, maintains and control the extracellular environment, and circulates endocrine hormones. It is the CSF that is removed
from the spine when a lumbar puncture (LP) is performed on a patient. Results of an LP can show whether the CSF has normal
glucose and electrolyte concentrations and whether there is an infection in or around the brain.
Limbic System
The limbic system is not a structure, but a series of nerve pathways incorporating structures deep within the temporal
lobes, such as the hippocampus
and the amygdale. Forming connections with the cerebral cortex, white matter and brainstem, the limbic system is
involved in the control and expression of mood and emotion, in the processing and storage of recent memory, and in the control
of appetite and emotional responses to food. All these functions are frequently affected in depression
and the limbic system has been implicated in the pathogenesis of depression. The limbic system is also linked with parts of
the neuroendocrine and autonomic nervous systems, and some neurological disorders, such as anxiety, are associated with both
hormonal and autonomic changes.
Reticular Activating System
At the core of the brainstem is a collection of nuclei called the reticular formation.These nuclei receive input
from most of the body’s sensory systems (eg sight, smell, taste, etc) and other parts of the brain, such as the cerebellum
and cerebral hemispheres.
Some neurons from the reticular formation project to meet motor neurons of the spinal cord and influence functions
such as cardiovascular and respiratory control. In addition, there are also neurons projecting into most of the rest of the
brain. The ascending fibres of the reticular formation form a network called the reticular activating system, which influence
wakefulness, overall degree of arousal and consciousness – all factors which may be disturbed in depressed patients.
The brain and the different areas of the brain can be illustrated using images of the brain in different orientations
or ‘sections’. The most commonly used sections are the mid-sagittal (simply, from front to back) and coronal sections.
Although extremely complex, the brain is largely made up of only two principal cell types: neurons and glial cells.
There are over 100 000 million neurons in the brain and an even greater number of glial
cells
. It is estimated that there are more than 10 000 million cells in the cerebral cortex alone.
Neurons
Neurons are involved in information transmission – receiving, processing and transmitting information through
their highly specialised structure. Neurons consist of a cell body and two types of projections – the dendrites
and an axon. Most neurons have many dendrites, but only one axon.
The majority of neurons are unable to undergo cell division or repair. This limitation results in irreversible
damage to the nervous system after trauma, intoxication, oxygen deficiency or stroke.
Neurons use their highly specialised structure to both send and receive signals. Individual neurons receive information
from thousands of other neurons, and in turn send information to thousands more. Information is passed from one neuron to
another via neurotransmission. This is an indirect process that
takes place in the area between the nerve ending (nerve terminal) and the next cell body. This area is called the synaptic cleft
or synapse.
Glia
Glial cells are major constituents of the central nervous system, and while they do not have a direct role in neurotransmission,
glial cells play a supporting role that helps define synaptic contacts and maintain the signalling abilities of neurons. Various
types of glial cells can be found in the brain (or CNS); including astrocytes, oligodendroglia and microglia. The total number
of glial cells exceeds that of neurons by approximately three-fold.
Glial cells are smaller than neurons and lack axons and dendrites. The well-defined roles of the glia include:
modulating the rate of nerve impulse propagation; controlling the uptake of neurotransmitters; and playing a pivotal role
during development and adulthood. Some evidence also suggests that glial cells aid (or, in some cases, prevent) recovery from
neuronal injury and that they are involved in a number of diseases, such as Alzheimer’s disease, multiple
sclerosis
and other central and peripheral neuropathies.