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Chapter 13 Central Nervous System Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 1 Coverings of the Brain and Spinal Cord Two protective coverings (Figure 13-2): Outer covering is bone; cranial bones encase the brain, and vertebrae encase the spinal cord (Figure 13-1) Inner covering is the meninges; the meninges of the cord continue inside the spinal cavity beyond the end of the spinal cord Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 2 Coverings of the Brain and Spinal Cord Meninges—three membranous layers (Figure 13-3) Dura mater—strong, white fibrous tissue; outer layer of meninges and inner periosteum of the cranial bones; has three important extensions • Falx cerebri Projects downward into the longitudinal fissure between the two cerebral hemispheres Dural sinuses—function as veins, collecting blood from brain tissues for return to the heart Superior sagittal sinus—one of several dural sinuses • Falx cerebelli—separates the two hemispheres of the cerebellum • Tentorium cerebelli—separates the cerebellum from the cerebrum Arachnoid mater—delicate, cobwebby layer between the dura mater and pia mater Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 3 Coverings of the Brain and Spinal Cord Meninges—three membranous layers (cont.) Pia mater—innermost, transparent layer; adheres to the outer surface of the brain and spinal cord; contains blood vessels; beyond the spinal cord, forms a slender filament called filum terminale; at level of sacrum, blends with dura mater to form a fibrous cord that disappears into the periosteum of the coccyx Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 4 Coverings of the Brain and Spinal Cord Several spaces exist between and around the meninges • Epidural space—located between the dura mater and inside the bony covering of the spinal cord; contains a supporting cushion of fat and other connective tissues (virtually absent around brain because dura is continuous with periosteum of bone) • Subdural space—located between the dura mater and arachnoid mater; contains lubricating serous fluid • Subarachnoid space—located between the arachnoid and pia mater; contains a significant amount of cerebrospinal fluid Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 5 Cerebrospinal Fluid Functions Provides a supportive, protective cushion Reservoir of circulating fluid, which is monitored by the brain to detect changes in the internal environment Fluid spaces Cerebrospinal fluid—found within the subarachnoid space around the brain and spinal cord and within the cavities and canals of the brain and spinal cord Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 6 Cerebrospinal Fluid Fluid spaces (cont.) Ventricles—fluid-filled spaces within the brain; four ventricles within the brain (Figure 13-4) • First and second ventricles (lateral)—one located in each hemisphere of the cerebrum • Third ventricle—thin, vertical pocket of fluid below and medial to the lateral ventricles • Fourth ventricle—tiny, diamond-shaped space where the cerebellum attaches to the back of the brainstem Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 7 Cerebrospinal Fluid Formation and circulation of cerebrospinal fluid (Figure 13-5) Occurs by separation of fluid from blood in the choroid plexuses • Fluid from the lateral ventricles seeps through the interventricular foramen (of Monro) into the third ventricle • From the third ventricle, fluid goes through the cerebral aqueduct into the fourth ventricle Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 8 Cerebrospinal Fluid Formation and circulation of cerebrospinal fluid (cont.) • From the fourth ventricle, fluid goes to two different areas: Some fluid flows directly into the central canal of the spinal cord Some fluid leaves the fourth ventricle through openings in its roof into the cisterna magna, a space that is continuous with the subarachnoid space • Fluid circulates in the subarachnoid space and then is absorbed into venous blood through the arachnoid villi Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 9 Spinal Cord Structure of the spinal cord (Figure 13-6) Lies within the spinal cavity and extends from the foramen magnum to the lower border of the first lumbar vertebra Oval cylinder that tapers slightly from above downward Two bulges, one in the cervical region and one in the lumbar region Anterior median fissure and posterior median sulcus are two deep grooves; anterior fissure is deeper and wider Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 10 Spinal Cord Structure of the spinal cord (cont.) Nerve roots • Fibers of dorsal nerve root Carry sensory information into the spinal canal Dorsal root ganglion—cell bodies of unipolar, sensory neurons make up a small region of gray matter in the dorsal nerve root • Fibers of ventral nerve root Carry motor information out of the spinal cord Cell bodies of multipolar, motor neurons are in the gray matter of the spinal cord Interneurons are located in the spinal cord’s gray matter core Spinal nerve—a single mixed nerve on each side of the spinal cord where the dorsal and ventral nerve roots join together Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 11 Spinal Cord Structure of the spinal cord (cont.) Cauda equina—bundle of nerve roots extending (along with the filum terminale) from the conus medullaris (inferior end of spinal cord) (Figure 13-7) Gray matter • Columns of gray matter extend the length of the cord • Consists predominantly of cell bodies of interneurons and motor neurons • In transverse section, looks like an H with the limbs being called the anterior, posterior, and lateral horns of gray matter; cross-bar of H is the gray commissure White matter • Surrounds the gray matter and is subdivided in each half of the cord into three funiculi: anterior, posterior, and lateral white columns • Each funiculus consists of a large bundle of axons divided into tracts • Names of spinal tracts indicate the location of the tract, the structure in which the axons originate, and the structure in which they terminate Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 12 Spinal Cord Functions of the spinal cord Provides conduction routes to and from the brain • Ascending tracts—conduct impulses up the cord to the brain • Descending tracts—conduct impulses down the cord from the brain • Bundles of axons compose all tracts • Tracts are both structural and functional organizations of nerve fibers: Structural—all axons of any one tract originate in the same structure and terminate in the same structure Functional—all axons that compose one tract serve one general function Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 13 Spinal Cord Functions of the spinal cord (cont.) • Important ascending (sensory) tracts (Figure 13-8) Lateral spinothalamic tracts—crude touch, pain, and temperature Anterior spinothalamic tracts—crude touch, pressure Fasciculi gracilis and cuneatus—discriminating touch and conscious kinesthesia Spinocerebellar tracts—subconscious kinesthesia Spinotectal—touch related to visual reflexes Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 14 Spinal Cord Functions of the spinal cord (cont.) • Important descending (motor) tracts (Figure 13-8) Lateral corticospinal tracts—voluntary movements on opposite side of the body Anterior corticospinal tracts—voluntary movements on same side of body Reticulospinal tracts—maintain posture during movement Rubrospinal tracts—transmit impulses that coordinate body movements and maintenance of posture Tectospinal tracts—head and neck movements during visual reflexes Vestibulospinal tracts—coordination of posture and balance • Spinal cord—reflex center for all spinal reflexes; spinal reflex centers are located in the gray matter of the cord Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 15 The Brain Structures of the brainstem (Figures 13-9 and 13-10) Medulla oblongata • Lowest part of the brainstem • Part of the brain that attaches to spinal cord, located just above the foramen magnum • A few centimeters in length and separated from the pons above by a horizontal groove • Composed of white matter and a network of gray and white matter called the reticular formation network • Pyramids—two bulges of white matter located on the ventral side of the medulla; formed by fibers of the pyramidal tracts • Olive—oval projection located lateral to the pyramids • Nuclei—clusters of neuron cell bodies located in the reticular formation Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 16 The Brain Structures of the brainstem (cont.) Pons • Located above the medulla and below the midbrain • Composed of white matter and reticular formation Midbrain • Located above the pons and below the cerebrum; forms the midsection of the brain • Composed of white tracts and reticular formation • Extending divergently through the midbrain are cerebral peduncles; conduct impulses between the midbrain and cerebrum • Corpora quadrigemina—landmark in midbrain Made up of two inferior colliculi and two superior colliculi Forms the posterior, upper part of the midbrain that lies just above the cerebellum Inferior colliculus—contains auditory centers Superior colliculus—contains visual centers • Red nucleus and substantia nigra—clusters of cell bodies of neurons involved in muscular control Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 17 The Brain Functions of the brainstem Performs sensory, motor, and reflex functions Spinothalamic tracts—important sensory tracts that pass through the brainstem Fasciculi cuneatus and gracilis and spinoreticular tracts—sensory tracts whose axons terminate in the gray matter of the brainstem Corticospinal and reticulospinal tracts—two of the major tracts present in the white matter of the brainstem Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 18 The Brain Functions of the brainstem (cont.) Nuclei in medulla—contain reflex centers • Of primary importance—cardiac, vasomotor, and respiratory centers • Nonvital reflexes—vomiting, coughing, sneezing, etc. Pons—contains reflexes mediated by fifth, sixth, seventh, and eighth cranial nerves and pneumotaxic centers that help regulate respiration Midbrain—contains centers for certain cranial nerve reflexes Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 19 The Brain Structure of the cerebellum (Figure 13-11) Second largest part of the brain—contains more neurons than the rest of the nervous system Located just below the posterior portion of the cerebrum; transverse fissure separates these two parts of the brain Gray matter makes up the cortex, and white matter predominates in the interior Arbor vitae—internal white matter of the cerebellum; distinctive pattern similar to the veins of a leaf Cerebellum has numerous sulci and delicate, parallel gyri (folia) Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 20 The Brain Structure of the cerebellum (cont.) Consists of the cerebellar hemispheres and the vermis Internal white matter—composed of short and long tracts • Shorter tracts—conduct impulses from neuron cell bodies located in the cerebellar cortex to neurons whose dendrites and cell bodies compose nuclei located in the interior of the cerebellum • Longer tracts—conduct impulses to and from the cerebellum; fibers enter or leave by way of three pairs of peduncles Inferior cerebellar peduncles—composed chiefly of tracts entering the cerebellum from the medulla and cord Middle cerebellar peduncles—composed almost entirely of tracts entering the cerebellum from the pons Superior cerebellar peduncles—composed principally of tracts leading from dentate nuclei in the cerebellum through the red nucleus of the midbrain to the thalamus Dentate nuclei • Important pair of cerebellar nuclei, one of which is located in each hemisphere • Nuclei connected with thalamus and with motor areas of the cerebral cortex by tracts • By means of the tracts, cerebellar impulses influence the motor cortex, and the motor cortex influences the cerebellum Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 21 The Brain Functions of the cerebellum Cerebellum compares the motor commands of the cerebrum to the information coming from proprioceptors in the muscle; impulses travel from the cerebellum to both the cerebrum and muscles to coordinate movements to produce the intended action (Figure 13-12) General functions • Acts with cerebral cortex to produce skilled movements by coordinating the activities of groups of muscles • Controls skeletal muscles to maintain balance • Controls posture; operates at subconscious level to smooth movements and make movements efficient and coordinated • Processes sensory information; complements and assists various functions of the cerebrum Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 22 The Brain Diencephalon (Figure 13-13) Located between the cerebrum and the midbrain Consists of several structures located around the third ventricle: thalamus, hypothalamus, optic chiasma, pineal gland, and several others Thalamus • Dumbbell-shaped mass of gray matter made up of many nuclei • Each lateral mass forms one lateral wall of the third ventricle • Intermediate mass—extends through the third ventricle and joins the two lateral masses • Geniculate bodies—two of the most important groups of nuclei comprising the thalamus; located in posterior region of each lateral mass; play role in processing auditory and visual input Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 23 The Brain Thalamus (cont.) • Serves as a major relay station for sensory impulses on their way to the cerebral cortex • Performs the following primary functions: Plays two parts in mechanism responsible for sensations: – Impulses produce conscious recognition of the crude, less critical sensations of pain, temperature, and touch – Neurons relay all kinds of sensory impulses, except possibly olfactory, to the cerebrum Plays part in the mechanism responsible for emotions by associating sensory impulses with feeling of pleasantness and unpleasantness Plays part in arousal mechanism Plays part in mechanisms that produce complex reflex movements Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 24 The Brain Diencephalon (cont.) Hypothalamus • Consists of several structures that lie beneath the thalamus • Forms floor of the third ventricle and lower part of lateral walls • Prominent structures found in the hypothalamus Supraoptic nuclei—gray matter located just above and on either side of the optic chiasma Paraventricular nuclei—located close to the wall of the third ventricle Mamillary bodies—posterior part of hypothalamus, involved with olfactory sense Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 25 The Brain Hypothalamus (cont.) • Infundibulum—the stalk leading to the posterior lobe of the pituitary gland • Small but functionally important area of the brain, performs many functions of greatest importance for survival and enjoyment • Links mind and body • Links nervous system to endocrine system Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 26 The Brain Hypothalamus (cont.) • Summary of hypothalamic functions Regulator and coordinator of autonomic activities Major relay station between the cerebral cortex and lower autonomic centers; crucial part of the route by which emotions can express themselves in changed bodily functions Synthesizes hormones secreted by posterior pituitary and plays an essential role in maintaining water balance Some neurons function as endocrine glands Plays crucial role in arousal mechanism Crucial part of mechanism regulating appetite Crucial part of mechanism maintaining normal body temperature Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 27 The Brain Diencephalon (cont.) Pineal gland • Located just above the corpora quadrigemina of the midbrain • Involved in regulating the body’s biological clock (Figure 13-14) • Produces melatonin as a “timekeeping hormone” Melatonin is made from the neurotransmitter serotonin Melatonin levels increase when sunlight is absent and decreases when sunlight is present, thus regulating the circadian (daily) biological clock (Figure 13-15) Melatonin is the “sleep hormone” Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 28 The Brain Structure of the cerebrum Cerebral cortex • Largest and uppermost division of the brain; consists of right and left cerebral hemispheres; each hemisphere is divided into five lobes (Figure 13-16): Frontal lobe Parietal lobe Temporal lobe Occipital lobe Insula (island of Riel) Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 29 The Brain Cerebral cortex (cont.) • Cerebral cortex—outer surface made up of six layers of gray matter • Gyri—convolutions; some are named: precentral gyrus, postcentral gyrus, cingulate gyrus, and hippocampal gyrus • Sulci—shallow grooves Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 30 The Brain Cerebral cortex (cont.) • Fissures—deeper grooves, divide each cerebral hemisphere into lobes; four prominent cerebral fissures Longitudinal fissure—deepest fissure; divides cerebrum into two hemispheres Central sulcus (fissure of Rolando)—groove between frontal and parietal lobes Lateral fissure (fissure of Sylvius) —groove between temporal lobe below and parietal lobes above; island of Reil lies deep in lateral fissure Parietooccipital fissure—groove that separates occipital lobe from parietal lobes Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 31 The Brain Structure of the cerebrum (cont.) Cerebral tracts and basal nuclei • Basal nuclei—islands of gray matter located deep inside the white matter of each hemisphere (Figure 13-18); include the following: Caudate nucleus Lentiform nucleus—consists of putamen and pallidum Amygdaloid nucleus Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 32 The Brain Structure of the cerebrum (cont.) Cerebral tracts and basal nuclei (cont.) • Cerebral tracts make up cerebrum’s white matter; there are three types (Figure 13-17): Projection tracts—extensions of the sensory spinothalamic tracts and motor corticospinal tracts Association tracts—most numerous cerebral tracts; extend from one convolution to another in the same hemisphere Commissural tracts—extend from one convolution to a corresponding convolution in the other hemisphere; compose the corpus callosum and anterior and posterior commissures • Corpus striatum—composed of caudate nucleus, internal capsule, and lentiform nucleus Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 33 The Brain Functions of the cerebral cortex Functional areas of the cortex—certain areas of the cerebral cortex predominantly engage in one particular function (Figures 13-19 and 13-20) • Postcentral gyrus—mainly general somatic sensory area; receives impulses from receptors activated by heat, cold, and touch stimuli • Precentral gyrus—chiefly somatic motor area; impulses from neurons in this area descend over motor tracts and stimulate skeletal muscles • Transverse gyrus—primary auditory area • Occipital lobe—primary visual areas Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 34 The Brain Functions of the cerebral cortex (cont.) Sensory functions of the cortex • Somatic senses—sensations of touch, pressure, temperature, proprioception, and similar perceptions that require complex sensory organs • Cortex contains a “somatic sensory map” of the body • Information sent to primary sensory areas is relayed to sensory association areas, as well as to other parts of the brain • The sensory information is compared and evaluated, and the cortex integrates separate bits of information into whole perceptions Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 35 The Brain Motor functions of the cortex • For normal movements to occur, many parts of the nervous system must function • Precentral gyrus—primary somatic motor area; controls individual muscles • Secondary motor area—in the gyrus immediately anterior to the precentral gyrus; activates groups of muscles simultaneously Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 36 The Brain Integrative functions of the cortex • Consciousness (Figure 13-21) State of awareness of one’s self, one’s environment, and other beings Depends on excitation of cortical neurons by impulses conducted to them by the reticular activating system There are two current concepts about the reticular activating system: – Functions as the arousal system for the cerebral cortex – Its functioning is crucial for maintaining consciousness • Language Ability to speak and write words and ability to understand spoken and written words Speech centers—areas in the frontal, parietal, and temporal lobes Left cerebral hemisphere contains speech centers in approximately 90% of the population; in the remaining 10%, contained in either the right hemisphere or both Aphasias—caused by lesions in speech centers Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 37 The Brain Integrative functions of the cortex (cont.) • Emotions (Figure 13-22) Subjective experiencing and objective expressing of emotions involve functioning of the limbic system Limbic system—also known as the “emotional brain” – Most structures of limbic system lie on the medial surface of the cerebrum; they are the cingulate gyrus and the hippocampus – Have primary connections with other parts of the brain, such as thalamus, fornix, septal nuclei, amygdaloid nucleus, and hypothalamus • Memory One of the major human mental activities Cortex is capable of storing and retrieving both short- and long-term memory Temporal, parietal, and occipital lobes are among the areas responsible for short- and long-term memory Engrams—structural traces in the cerebral cortex that comprise long-term memories Cerebrum’s limbic system plays a key role in memory Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 38 The Brain Hemisphericity—specialization of cerebral hemispheres • Right and left hemispheres of the cerebrum specialize in different functions; however, both sides of a normal person’s brain communicate with each other to accomplish complex functions • Left hemisphere is responsible for the following: Language functions Dominating control of certain hand movements • Right hemisphere is responsible for the following: Perception of certain kinds of auditory material Tactual perception Perceiving and visualizing spatial relationships Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 39 Somatic Sensory Pathways in the Central Nervous System For the cerebral cortex to perform its sensory functions, impulses must first be conducted to the sensory areas by sensory pathways (Figure 13-24) Three main pools of sensory neurons: Primary sensory neurons—conduct impulses from the periphery to the central nervous system Secondary sensory neurons • Conduct impulses from cord or brainstem to thalamus • Dendrites and cell bodies are located in gray matter of cord and brainstem • Axons ascend in ascending tracts up cord and through the brainstem, and terminate in thalamus, where they synapse with dendrites or cell bodies of tertiary sensory neurons Tertiary sensory neurons • Conduct impulses from thalamus to the postcentral gyrus of parietal lobe • Bundle of axons of tertiary sensory neurons form thalamocortical tracts • Extend through internal capsule to cerebral cortex Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 40 Somatic Sensory Pathways in the Central Nervous System Sensory pathways to the cerebral cortex are crossed Two sensory pathways conduct impulses that produce sensations of touch and pressure: Medial lemniscal system • Consists of tracts that make up the fasciculi cuneatus and gracilis, and the medial lemniscus • Axons of secondary sensory neurons make up medial lemniscus • Functions—transmit impulses that produce discriminating touch and pressure sensations and kinesthesia Spinothalamic pathway—functions are crude touch and pressure sensations Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 41 Somatic Motor Pathways in the Central Nervous System For the cerebral cortex to perform its motor functions, impulses are conducted from its motor areas to skeletal muscles by somatic motor pathways Consist of motor neurons that conduct impulses from the central nervous system to skeletal muscles; some motor pathways are extremely complex, and others are very simple Principle of the final common path—cardinal principle about somatic motor pathways; only one final common path, the motor neuron from the anterior gray horn of the spinal cord, conducts impulses to skeletal muscles Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 42 Somatic Motor Pathways in the Central Nervous System Two methods used to classify somatic motor pathways: Divides pathways into pyramidal and extrapyramidal tracts (Figure 13-25) • Pyramidal tracts—also known as corticospinal tracts Approximately three quarters of the fibers decussate in the medulla and extend down the cord in the crossed corticospinal tract located on the opposite side of the spinal cord in the lateral white column Approximately one quarter of the fibers do not decussate but extend down the same side of the spinal cord as the cerebral area from which they came • Extrapyramidal tracts—much more complex than pyramidal tracts Consist of all motor tracts from the brain to the spinal cord anterior horn motor neurons except the corticospinal tracts Within the brain, consist of numerous relays of motor neurons between motor areas of cortex, basal nuclei, thalamus, cerebellum, and brainstem Within the spinal cord, some important tracts are the reticulospinal tracts Conduction by extrapyramidal tracts plays a crucial part in producing large, automatic movements Conduction by extrapyramidal tracts plays an important part in emotional expressions Motor program—set of coordinated commands that control the programmed motor activity mediated by extrapyramidal pathways (Figure 13-26) Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 43 Cycle of Life: Central Nervous System The development and degeneration of the central nervous system is the most obvious functional change over the life span Development of the brain and spinal cord begins in the womb Lack of development in the newborn is evidenced by lack of complex integrative functions Language Complex memory Comprehension of spatial relationships Complex motor skills Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 44 Cycle of Life: Central Nervous System Complex functions develop by adulthood Late adulthood—tissues degenerate Profound degeneration—unable to perform complex functions Milder degeneration—temporary memory lapse or difficulty with complex motor tasks Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 45 The Big Picture: The Central Nervous System and the Whole Body Central nervous system—ultimate regulator of the body; essential to survival Able to integrate bits of information from all over the body, make sense of them, and make decisions Mosby items and derived items © 2007, 2003 by Mosby, Inc. Slide 46