Chapter 1: Fundamentals of the Nervous System

INTRODUCTION

A good working knowledge of neuroanatomy is essential to every clinician in every specialty. More than any other organ, the nervous system makes human beings special. The human central nervous system (CNS) is the most complex and elegant computing device that exists. It receives and interprets an immense array of sensory information, controls a variety of simple and complex motor behaviors, and engages in deductive and inductive logic. The brain can imagine, plan ahead, make complex decisions, think creatively, and feel emotions. It can generalize and possesses an elegant ability to recognize that cannot be reproduced by even advanced computers. The human nervous system, for example, can immediately identify a familiar face regardless of the angle at which it is presented. It can carry out many of these demanding tasks in a nearly simultaneous manner.

The complexity of the nervous system’s actions is reflected by a rich and intricate structure—in a sense, the nervous system can be viewed as a complex and dynamic network of interlinked computers. Nevertheless, the anatomy of the nervous system can be readily learned and understood. Since different parts of the brain and spinal cord subserve different functions, the astute clinician can often make relatively accurate predictions about the site(s) of dysfunction on the basis of the clinical history and careful neurological examination. Clinical neuroanatomy (ie, the structure of the nervous system, considered in the context of disorders of the nervous system) is essential for an understanding of disorders of the nervous system.

OVER-ALL PLAN OF THE NERVOUS SYSTEM

Main Divisions

A. Anatomy

The human nervous system consists of two subdivisions.

1. CNS

The CNS, comprising the brain and spinal cord, is enclosed in bone and wrapped in protective coverings (meninges) and fluid-filled spaces.

2. Peripheral nervous system (PNS)

The PNS is formed by the cranial and spinal nerves (Fig 1–1).

B. Function

Functionally, the nervous system is divided into two systems.

1. Somatic nervous system

This innervates the structures of the body wall (muscles, skin, and mucous membranes).

2. Autonomic (visceral) nervous system (ANS)

The ANS contains portions of the central and peripheral systems. It controls the activities of the smooth muscles and glands of the internal organs (viscera) and the blood vessels and returns sensory information from these organs to the brain.

Structural Units and Overall Organization