Table Of Contents:
Atlas xxiv

Introduction to Neuroscience 1(26)

Animations

Brain anatomy

Ventricles

What is Neuroscience? 2(2)

Analysis of the Nervous System 2(2)

What Do We Learn From These Studies 4(1)

Organization of This Book 4(2)

Cellular Level 4(1)

Development of the Human Nervous System 5(1)

Somatic and Autonomic Systems 5(1)

Regions of the Nervous System 5(1)

Support Systems 6(1)

Appendices 6(1)

Introduction to Neuroanatomy 6(9)

Cellular Level Neuroanatomy 6(1)

Peripheral Nervous System 7(1)

Spinal Region 8(1)

Brainstem and Cerebellar Region 9(1)

Cerebrum 10(5)

Support Systems 15(1)

Vascular Anatomy 15(7)

Vascular Supply to the Brainstem and Cerebellum 15(2)

Vascular Supply to Cerebral Hemispheres 17(5)

Incidence and Prevalence of Disorders 22(1)

Clinical Application of Learning Neuroscience 22(4)

Neurologic Evaluation 23(2)

Diagnosis 25(1)

Summary 26(1)

Physical and Electrical Properties of Cells in the Nervous System 27(26)

Animations

Action potential

Action potential propagation

Na+/K+ pump

Guillain-Barre

Introduction 28(1)

Structure of Neurons 28(3)

Components of Neurons 28(2)

Types of Neurons 30(1)

Transmission of Information by Neurons 31(11)

Membrane Channels 32(1)

Electrical Potentials 32(10)

Direction of Information Flow in Neurons 42(1)

Interactions Between Neurons 43(1)

Glia: Supporting Cells 43(6)

Types of Glia 43(4)

Myelin: Clinical Application 47(2)

Neural Stem Cells 49(1)

Summary 50(3)

Synapses and Synaptic Transmission 53(18)

Animations

Synapse

Ligand-gated ion channel

Mechanically gated ion channel

Voltage-gated ion channel

Phosphorylation-gated ion channel

Second messenger system

Introduction 54(2)

Structure of the Synapse 54(1)

Events at the Synapse 54(2)

Electrical Potentials at Synapses 56(3)

Postsynaptic Potentials 56(2)

Presynaptic Facilitation and Inhibition 58(1)

Neurotransmitters and Neuromodulators 59(1)

Specific Neurotransmitters and Neuromodulators 60(1)

Acetylcholine 60(1)

Amino Acids 60(1)

Amines 60(1)

Peptides 61(1)

Nitric Oxide 61(1)

Synaptic Receptors 61(3)

Direct Activation of Ion Channels: Ligand-Gated Channels 62(1)

Indirect Activation of Ion Channels 62(1)

Cascade of Intracellular Events: Second-Messenger Systems 62(2)

The G-Protein Pathway Amplifies the Signal 64(1)

Specific Receptors 64(3)

Acetylcholine Receptors 64(2)

Glutamate Receptors 66(1)

GABA Receptors 66(1)

Amine Receptors 67(1)

Receptor Regulation 67(1)

Neurotransmitter Agonists and Antagonists 67(1)

Disorders of Synaptic Function 67(2)

Diseases Affecting the Neuromuscular Junction 67(1)

Channelopathy 68(1)

Summary 69(2)

Neuroplasticity 71(14)

Introduction 71(1)

Habituation 72(1)

Learning and Memory: Long-Term Potentiation 72(2)

Cellular Recovery From Injury 74(4)

Axonal Injury 74(2)

Synaptic Changes 76(1)

Functional Reorganization of the Cerebral Cortex 76(2)

Activity-Related Changes in Neurotransmitter Release 78(1)

Metabolic Effects of Brain Injury 78(2)

Effects of Rehabilitation on Plasticity 80(1)

Summary 81(4)

Development of the Nervous System 85(20)

Animations

Development of the neural tube

Development from day 20 to day 24

Fate of the somite

Development of the myotome

Introduction 86(1)

Developmental Stages In Utero 86(1)

Preembryonic Stage 86(1)

Embryonic Stage 86(1)

Fetal Stage 86(1)

Formation of the Nervous System 87(4)

Neural Tube Formation (Days 18 to 26) 88(1)

Relationship of Neural Tube to Other Developing Structures 88(2)

Brain Formation (Begins Day 28) 90(1)

Continued Development During Fetal Stage 91(1)

Cellular-Level Development 91(4)

Developmental Disorders: In Utero and Perinatal Damage of the Nervous System 95(6)

Neural Tube Defects 95(1)

Tethered Spinal Cord 96(1)

Forebrain Malformation 96(1)

Exposure to Alcohol or Cocaine In Utero 96(2)

Abnormal Location of Cells 98(1)

Mental Retardation 98(1)

Cerebral Palsy 99(1)

Developmental Coordination Disorder 100(1)

Autism 101(1)

Summary of Developmental Disorders 101(1)

Nervous System Changes During Infancy 101(1)

Summary 102(3)

Somatosensory System 105(24)

Animations

Upper limb dermatomes

Golgi tendon organ

Muscle spindle

Pathways

Touch

Fast pain

Introduction 105(1)

Peripheral Somatosensory Neurons 106(5)

Sensory Receptors 106(1)

Somatosensory Peripheral Neurons 106(1)

Cutaneous Innervation 107(1)

Musculoskeletal Innervation 108(3)

Summary: Function of Different-Diameter Axons 111(1)

Pathways to the Brain 111(3)

Conscious Relay Pathways to Cerebral Cortex 114(8)

Discriminative Touch and Conscious Proprioception 115(2)

Discriminative Pain and Temperature, Coarse Touch 117(5)

Divergent Pathways 122(3)

Medial Pain System 122(3)

Temperature Information 125(1)

Unconscious Relay Tracts to the Cerebellum 125(2)

High-Fidelity Pathways 125(1)

Internal Feedback Tracts 125(2)

Function of Spinocerebellar Tracts 127(1)

Summary 127(2)

Somatosensation: Clinical Application 129(40)

Introduction 130(1)

Contribution of Somatosensory Information to Movement 130(1)

Somatosensory Information Protects Against Injury 130(1)

Testing Somatosensation 130(4)

Quick Screening 131(1)

Complete Somatosensory Evaluation 131(1)

Interpreting Test Results 131(3)

Electrodiagnostic Studies 134(2)

Sensory Nerve Conduction Studies 136(1)

Somatosensory Evoked Potentials 136(1)

Sensory Abnormalities 136(5)

Proprioceptive Pathway Lesions: Sensory Ataxia 136(1)

Peripheral Nerve Lesions 136(2)

Spinal Region Lesions 138(1)

Brainstem Region Lesions 138(3)

Cerebral Region Lesions 141(1)

Clinical Perspectives on Pain 141(5)

Nociception From Muscles and Joints 141(1)

Referred Pain 141(1)

The Pain Matrix 142(2)

How Is Pain Controlled? 144(2)

Chronic Pain 146(15)

Nociceptive Chronic Pain 147(1)

Neuropathic Chronic Pain 147(4)

Sites That Generate Neuropathic Pain 151(6)

Chronic Pain Syndromes 157(4)

Surgical Treatment of Chronic Pain 161(1)

Red Flags for Headache 161(1)

Red Flags for Low Back Pain 162(1)

Summary 162(7)

Autonomic Nervous System 169(18)

Introduction 169(1)

Receptors 170(1)

Afferent Pathways 170(1)

Central Regulation of Visceral Function 170(3)

Control of Autonomic Functions by the Medulla and Pons 172(1)

Role of the Hypothalamus, Thalamus, and Limbic System in Autonomic Regulation 172(1)

Integration of Information 172(1)

Efferent Pathways 173(1)

Differences Between the Somatic Motor System and Autonomic Efferent System 173(1)

Neurotransmitters Used by the Autonomic Efferent System 173(1)

Sympathetic Nervous System 174(5)

Sympathetic Efferent Neurons 174(1)

Functions of the Sympathetic Nervous System 175(4)

Parasympathetic Nervous System 179(1)

Comparison of Sympathetic and Parasympathetic Functions 179(2)

Clinical Correlations 181(3)

Horner's Syndrome 181(1)

Peripheral Region 181(1)

Spinal Region 181(1)

Brainstem Region 182(1)

Cerebral Region 183(1)

Syncope 183(1)

Tests of Autonomic Function 183(1)

Summary 184(3)

The Motor System: Motor Neurons 187(56)

Animations

Weak actin-myosin bonds Titin

Postural control: Vestibulospinal tracts

Fine movement control and limb flexion: Lateral upper motor neurons

Cervical nerve root motor function

Lumbosacral nerve root motor function

Introduction 188(1)

Sensory Contribution to Movement Control 188(1)

Patient-Controlled Movements 188(1)

The Motor System 189(1)

Skeletal Muscle Structure and Function 190(7)

Contraction 192(1)

Force Production 192(1)

Number of Sarcomeres Adapts to Muscle Length 193(1)

Muscle Tone: Resistance to Passive Stretch 194(3)

Joint Stiffness 197(1)

Stretch Shortening Cycle 197(1)

Lower Motor Neurons 197(1)

Gamma Motor Neurons 197(1)

Alpha Motor Neurons 197(1)

Motor Units 197(1)

Peripheral Sensory Input to Motor Neurons 198(1)

Alpha-Gamma Coactivation 198(1)

Spinal Region 198(6)

Motor Neuron Pools in the Spinal Cord 198(1)

Spinal Region Coordination 199(2)

Spinal Control of Walking: Stepping Pattern Generators 201(1)

Reflexes 201(3)

Upper Motor Neurons 204(11)

Postural and Gross Movements: Medial Upper Motor Neurons 204(6)

Limb Flexion and Fine Movements of Limbs and Face: Lateral Upper Motor Neurons 210(4)

Nonspecific Upper Motor Neurons 214(1)

Signs of Motor Neuron Lesions 215(4)

Paresis and Paralysis 215(1)

Atrophy 215(3)

Involuntary Muscle Contractions 218(1)

Abnormal Muscle Tone 218(1)

Disorders of Lower Motor Neurons 219(2)

Upper Motor Neuron Syndrome 221(5)

Paresis 221(1)

Loss of Fractionation of Movement 221(1)

Abnormal Reflexes 221(1)

Muscle Hyperstiffness 222(4)

Evaluation of Movement Impairments in Chronic Upper Motor Neuron Lesions 226(4)

Types of Upper Motor Neuron Lesions 230(2)

Spinal Cord Injury 230(1)

Stroke 230(2)

Spastic Cerebral Palsy 232(1)

Common Characteristics of Upper Motor Neuron Lesions 232(1)

Interventions for Impairments Secondary to Upper Motor Neuron Lesions 232(3)

Improvement in Function Post Stroke 232(1)

Treatment of Hyperreflexia Post Spinal Cord Injury 233(2)

Amyotrophic Lateral Sclerosis 235(1)

Summary 236(7)

Basal Ganglia, Cerebellum, and Movement 243(36)

Introduction 243(1)

Basal Ganglia 244(13)

Neurotransmitters in the Basal Ganglia Circuit 246(1)

Function of the Basal Ganglia 246(1)

Basal Ganglia Pathology 246(11)

Cerebellum 257(7)

Anatomy of the Cerebellum 257(2)

Functional Regions of the Cerebellum 259(1)

Cerebellar Clinical Disorders 260(4)

Movement 264(11)

Summary of Normal Motor Control 264(1)

Three Fundamental Types of Movement 264(7)

Testing the Motor System 271(4)

Summary 275(4)

Peripheral Nervous System 279(22)

Introduction 280(1)

Peripheral Nerves 280(2)

Nerve Plexuses 281(1)

Movement Is Essential for Nerve Health 281(1)

Neuromuscular Junction 282(4)

Dysfunction of Peripheral Nerves 286(1)

Sensory Changes 286(1)

Autonomic Changes 286(1)

Motor Changes 286(1)

Denervation: Trophic Changes 286(1)

Classification of Neuropathies 286(7)

Traumatic Injury to a Peripheral Nerve: Mononeuropathy 286(4)

Multiple Mononeuropathy 290(1)

Polyneuropathy 290(3)

Dysfunctions of the Neuromuscular Junction 293(1)

Myopathy 293(1)

Electrodiagnostic Studies 293(2)

Clinical Testing 295(1)

Clinical Application 296(1)

Evaluation 296(1)

Treatment 296(1)

Summary 297(4)

Spinal Region 301(40)

Animations

Compression of nerve root

Compression of cauda equina

Anatomy of the Spinal Region 302(7)

Ventral and Dorsal Roots 303(1)

Segments of the Spinal Cord 304(1)

Spinal Nerves and Rami 304(1)

Internal Structure of the Spinal Cord 305(4)

Meninges 309(1)

Movements of the Central Nervous System Within the Vertebral Column 309(1)

Functions of the Spinal Cord 309(2)

Classifications of Spinal Interneurons 310(1)

Spinal Cord Motor Coordination 311(6)

Stepping Pattern Generators 312(2)

Reflexes 314(1)

Inhibitory Circuits 315(2)

Spinal Control of Pelvic Organ Function 317(1)

Effects of Segmental and Tract Lesions in the Spinal Region 317(5)

Segmental Function 318(1)

Vertical Tract Function 318(2)

Segmental and Vertical Tract Function 320(1)

Signs of Segmental Dysfunction 320(1)

Signs of Vertical Tract Dysfunction 320(2)

Differentiating Spinal Region From Peripheral Region Lesions 322(1)

Spinal Region Syndromes 322(2)

Effects of Spinal Region Dysfunction on Pelvic Organ Function 324(2)

Traumatic Spinal Cord Injury 326(5)

Abnormal Interneuron Activity in Chronic Spinal Cord Injury 327(1)

Classification of Spinal Cord Lesions 327(1)

Determination of Neurologic Levels 328(1)

Autonomic Dysfunction in Spinal Cord Injury 329(1)

Prognosis and Treatment in Spinal Cord Injury 329(2)

Specific Disorders Affecting Spinal Region Function 331(3)

Developmental Disorders 331(3)

Red Flags for the Spinal Region 334(1)

Summary 334(7)

Cranial Nerves 341(34)

Animations

Cranial nerves

Pupillary reflex

Introduction 342(1)

Cranial Nerve I: Olfactory 342(1)

Cranial Nerve II: Optic 343(1)

Cranial Nerves III, IV, and VI: Oculomotor, Trochlear, and Abducens 343(5)

Control of Eye Movement 343(3)

Coordination of Eye Movements 346(1)

Parasympathetic Fibers of Cranial Nerve III 347(1)

Pupillary, Consensual, and Accommodation Reflexes 347(1)

Cranial Nerve V: Trigeminal 348(4)

Cranial Nerve VII: Facial 352(1)

Cranial Nerve VIII: Vestibulocochlear 352(4)

Cochlea 352(4)

Auditory Function Within the Central Nervous System 356(1)

Cranial Nerve IX: Glossopharyngeal 357(1)

Cranial Nerve X: Vagus 357(1)

Cranial Nerve XI: Accessory 357(1)

Cranial Nerve XII: Hypoglossal 358(1)

Cranial Nerves Involved in Swallowing and Speaking 358(1)

Swallowing 358(1)

Speaking 359(1)

Systems Controlling Cranial Nerve Lower Motor Neurons 359(1)

Descending Control of Motor Cranial Nerves 359(1)

Disorders Affecting Cranial Nerve Function 360(5)

Olfactory Nerve 360(1)

Optic Nerve 360(1)

Oculomotor Nerve 360(1)

Trochlear Nerve 361(1)

Trigeminal Nerve 361(1)

Abducens Nerve 362(1)

Medial Longitudinal Fasciculus 362(1)

Facial Nerve 362(2)

Vestibulocochlear Nerve and Disorders of the Auditory System 364(1)

Glossopharyngeal Nerve 365(1)

Vagus Nerve 365(1)

Accessory Nerve 365(1)

Hypoglossal Nerve 365(1)

Dysphagia 365(1)

Dysarthria 365(1)

Testing Cranial Nerves 365(1)

Summary 365(10)

Brainstem Region 375(20)

Animation

Muscles of facial expression: UMN versus LMN lesion

Introduction 375(1)

Anatomy of the Brainstem 375(3)

Vertical Tracts in the Brainstem 375(1)

Longitudinal Sections of the Brainstem 376(2)

Reticular Formation 378(1)

Reticular Nuclei and Their Neurotransmitters 378(3)

Ventral Tegmental Area: Dopamine 379(1)

Pedunculopontine Nucleus: Acetylcholine 379(1)

Raphe Nuclei: Serotonin 379(2)

Locus Ceruleus and Medial Reticular Zone: Norepinephrine 381(1)

Regulation of Consciousness by the Ascending Reticular Activating System 381(1)

Medulla 381(3)

External Anatomy of the Medulla 381(1)

Inferior Medulla 382(1)

Upper Medulla 382(1)

Functions of the Medulla 382(2)

Pons 384(1)

Midbrain 385(1)

Basis Pedunculi 385(1)

Midbrain Tegmentum 385(1)

Midbrain Tectum 386(1)

Cerebellum 386(1)

Disorders in the Brainstem Region 386(6)

Vertical Tract Signs 386(2)

Disorders of Vital Functions 388(1)

Four Ds of Brainstem Region Dysfunction 388(3)

Disorders of Consciousness 391(1)

Tumors in the Brainstem Region 391(1)

Brainstem Region Ischemia 392(1)

Summary 392(3)

Vestibular and Visual Systems 395(36)

Introduction 395(1)

Vestibular System 395(7)

Vestibular Apparatus 396(3)

Central Vestibular System 399(1)

Vestibular Role in Motor Control 399(1)

Connection of the Vestibular Nuclei 399(3)

Visual System 402(7)

Sight: Information Conveyed From Retina to Cortex 402(1)

Processing of Visual Information 402(1)

Eye Movement System 403(1)

Types of Eye Movements 403(6)

Perception: Inhibitory Visual-Vestibular Interaction in the Cerebral Cortex 409(1)

Disorders of the Vestibular and Visual Systems 409(7)

Disorders of the Vestibular System 410(5)

Disorders of the Visual System 415(1)

Disorders of the Eye Movement System 416(1)

Motion Sickness 416(1)

Examining the Vestibular System 416(3)

Differentiation of Dizziness Complaints 416(1)

Tests of Vestibular Function 417(1)

Testing Postural Control, Transitional Movements, and Gait 417(1)

Coordination Tests 418(1)

Sensation Testing 418(1)

Head Position Test for Benign Paroxysmal Positional Vertigo 418(1)

Testing Vestibulo-ocular Reflexes 419(1)

Examining the Visual and Eye Movement Systems 419(7)

Rehabilitation in Vestibular Disorders 426(2)

Summary 428(3)

Cerebrum 431(26)

Introduction 431(1)

Diencephalon 432(2)

Thalamus 432(1)

Hypothalamus 432(1)

Epithalamus 433(1)

Subthalamus 434(1)

Subcortical Structures 434(3)

Subcortical White Matter 434(3)

Basal Ganglia 437(1)

Cerebral Cortex 437(7)

Mapping of the Cerebral Cortex 438(1)

Localized Functions of the Cerebral Cortex 438(6)

Limbic System 444(1)

Connections of the Limbic System 445(1)

Emotional and Memory Functions 445(1)

Emotions and Behavior 445(1)

Psychological and Somatic Interactions 446(2)

Memory 448(2)

Emotional Memory 448(1)

Declarative Memory 448(2)

Procedural Memory 450(1)

Communication 450(1)

Cerebral Dominance 451(1)

Perception 451(1)

Comprehension of Spatial Relationships 452(1)

Use of Visual Information 452(1)

Consciousness 452(2)

Summary 454(3)

Cerebrum: Clinical Applications 457(28)

Introduction 458(1)

Sites of Damage to Cerebral Systems 458(1)

Thalamic Injury 458(1)

Subcortical White Matter Lesions 458(1)

Basal Ganglia Disorders 459(1)

Disorders of Specific Areas of the Cerebral Cortex 459(3)

Primary Sensory Areas: Loss of Discriminative Sensory Information 459(1)

Sensory Association Areas: Agnosia 459(1)

Motor Planning Areas: Apraxia, Motor Perseveration, and Broca's Aphasia 460(1)

Primary Motor Cortex: Loss of Movement Fractionation and Dysarthria 460(1)

Dorsolateral Prefrontal Association Cortex: Loss of Executive Functions and Divergent Thinking 461(1)

Limbic Association Cortex: Personality and Emotional Changes 461(1)

Parietotemporal Association Areas: Problems With Communication, Understanding Space, and Directing Attention 462(1)

Disorders of Emotions 462(1)

Memory Disorders 463(1)

Language Disorders 464(1)

Disorders of Nonverbal Communication 464(1)

Neglect 464(2)

Inability to Use Visual Information 466(2)

Contraversive Pushing 468(1)

Diseases and Disorders Affecting Cerebral Function 468(5)

Loss of Consciousness 468(1)

Attention Deficit Hyperactivity Disorder 468(1)

Autism Spectrum Disorders 468(1)

Epilepsy 468(1)

Disorders of Intellect 469(1)

Traumatic Brain Injury 470(2)

Stroke 472(1)

Tumors 472(1)

Psychological Disorders 473(1)

Testing Cerebral Function 473(4)

Summary 477(8)

Support Systems: Blood Supply and Cerebrospinal Fluid System 485(18)

Animations:

Anterior circulation stroke

Posterior circulation stroke

Introduction 486(1)

Cerebrospinal Fluid System 486(4)

Ventricles 486(1)

Meninges 487(1)

Formation and Circulation of Cerebrospinal Fluid 488(1)

Clinical Disorders of the Cerebrospinal Fluid System 488(2)

Disorders of Vascular Supply 490(5)

Types of Stroke 490(2)

Stroke Signs and Symptoms by Arterial Location 492(2)

Disorders of Vascular Formation 494(1)

Fluid Dynamics 495(3)

Blood-Brain Barrier 495(2)

Cerebral Blood Flow 497(1)

Cerebral Edema 498(1)

Increases in Intracranial Pressure 498(1)

Uncal Herniation 498(1)

Central Herniation 498(1)

Tonsillar Herniation 499(1)

Laboratory Evaluation of Cerebral Blood Flow 499(1)

Venous System 499(1)

Summary 500(3)
Appendix A Intracellular Messengers 503(2)
Appendix B Neurotransmitters and Neuromodulators 505(4)
Answers 509(22)
Glossary 531(24)
Index 555