09級(jí)部分標(biāo)注版課件學(xué)術(shù)couples10.神經(jīng)生理nervous system

1、PUMC & CAMS Xue Gao Autonomic Nervous System (ANS) Instinctual Behavior & EmotionElectric Activity of Brain 重點(diǎn)：腦電波Activity of ANSANS also operates by means of visceral reflexes.Subconscious sensory signals from visceral organ can enter the nervous center, then return subconscious reflex response dir

2、ectly back to the visceral organ to control its activities.The efferent autonomic signals are transmitted through two subdivisions: parasympathetic nervous system & sympathetic nervous system.主要功能：調(diào)節(jié)內(nèi)臟活動(dòng)Metasympathetic nervous systemAn relative independent nervous system responsible for regulation o

3、f visceral organ functions.Controlled by sympathetic nerve or parasympathetic nerve, enable organs adapt to the changes from internal & external of body better.后交感Somatic Movement& Visceral ActivitySomatic: Skeletal muscle Conscious & Unconscious AcetylcholineVisceral: Smooth & cardiac muscle & glan

4、ds Unconscious activity Acetycholine by preganglionic or postganglionic neurons Norepinephrine by postganglionic neuronsSomatic & Autonomic Nervous System區(qū)別：有一個(gè)換元過程節(jié)前神經(jīng)元節(jié)后神經(jīng)元AChAch Sweat Glands, Sympathetic Vasodilator NerveSkeletalMuscle (SM)AchSomatic Nervous SystemAChAChParasympatheticAChAdrenal

5、MedullaE, NEAdrenal Medulla Cardiac muscle Smooth muscle GlandsAChNEAutonomic Nervous SystemSympathetic Cardiac muscle Smooth muscle Glands區(qū)別：交感神經(jīng)節(jié)前纖維短，節(jié)后纖維長副交感相反特殊，注意，只受交感神經(jīng)支配，Ach主要作為激素Function of Sympathetic and Parasympathetic Nerve Sympathetic nervous system “fight” or “flight” Increase energy e

6、xpenditure Increase cardiac activity Increase blood flow into skeletal muscle Decrease blood flow to visceral smooth muscles Digestion is deceased Dilatation of the pupils Decrease salivary production Increases sweat Function of Sympathetic and Parasympathetic Nerve Parasympathetic nervous system “r

7、est” or “digest”. Decrease cardiac activity Enhancement in digestion constriction of the pupilsFunctional Characters of Automatic Nervous System Sympathetic tone or Parasympathetic tone Organs double innervated, except vessel in skin 2 對(duì)同一效應(yīng)器的雙重支配 & visceral organs only sympathetic nerve innervated

8、Organic effects depend on the state of organs1 緊張性支配：交感和副交感平時(shí)都是有緊張活動(dòng)的：eg：心血管的自主神經(jīng)調(diào)節(jié)：心交感緊張，心迷走緊張3 受效應(yīng)器所處功能狀態(tài)的影響Eg：有孕和無孕的子宮孕婦子宮是收縮性的無孕子宮是舒張性的1. Spinal cord Micturition reflex & defecation reflex Baroreceptor reflex壓力感受反射 sweating reflex Central Regulation of Visceral Function排尿排便2. 延髓：心血管，呼吸中樞是最基本的生命中

9、樞脊休克過后可恢復(fù)2. Hypothalamus 高級(jí)中樞 Vital (respiratory, cardiovascular, digestion & kidney) centerCentral Regulation of Visceral FunctionFunction of HypothalamusAutonomic Nervous System Body Temperature Biorhythm: 生物節(jié)律中樞：視上核，視旁核 Circannual rhythm年節(jié)律：鳥類遷徙 Circalunar rhythm月節(jié)律：月經(jīng) Circadian rhythm (Suprachia

10、smatic Nucleus)日節(jié)律：血壓，激素，褪黑素Function of Hypothalamus Endocrine functionSuprachiasmatic NucleusGnRH視交叉上核促。激素釋放激素垂體門脈系統(tǒng)腺垂體視上核，視旁核ADH神經(jīng)垂體束神經(jīng)垂體（中樞：滲透壓感受器，在下丘腦前部）（血管升壓素，縮宮素） Instinctual Behavior Function of HypothalamusBasic Instinctual Behavior Survive Ethnic Multiply Food intake Water intake Sexual Beh

11、avior Hypothalamus本能行為種系繁衍 Food Intake: Feeding Center: Lateral, Increasing food intake Satiety Center: Ventromedial, Decreasing food intake Food Intake: Feeding & Satiety center have neurons sensitive to Glucose Glucose may decrease feeding center discharge & increase satiety center discharge, caus

12、e Food Intake Decrease However, in diabetes, even though the high level of glucose, lower utilization rate of glucose duo to the insufficiency of insulin, feed intake increase糖尿病人：雖然葡萄糖的濃度高，但是葡萄糖利用率下降，所以多食 Water intake Water Balance (Water Intake & water effluence) Osmoreceptor in hypothalamus下丘腦的滲透

13、壓感受器 Body lack of water: Be thirsty to drink Increasing ADH (vasopressin) secret, cause decreasing water effluence from kidney動(dòng)脈血壓降低，血管血量降低，也引起渴感低血量腎素增加血管緊張素II室周器渴覺渴覺的產(chǎn)生：1 血漿晶體滲透壓：下丘腦的滲透壓感受器2 細(xì)胞外液量明顯減少：腎素-血管緊張素系統(tǒng) EmotionFunction of HypothalamusEmotion Emotion is a mental and physiological state asso

14、ciated with a wide variety of feelings, thoughts, and behavior. Emotions are subjective experiences, often associated with mood, temperament, personality, and disposition Fear & Rage related to the limbic systemDefense reaction (Fight-Flight reaction)Fear & RageFlight & FightLateral part Dorsal part

15、 Fight FlightDefense center in hypothalamus下丘腦屬于邊緣系統(tǒng)防御反應(yīng)Sham Rage保留下丘腦，出現(xiàn)假怒下丘腦失去了高位中樞的抑制作用，表現(xiàn)出過度的防御反應(yīng)Pleasure & Agony Self Stimulation to localize the center Reward system or Approach system (Pleasure): Located in external & ventral medial of hypothalamus Relate to the dopaminergic多巴胺 pathway Punish

16、ment system or Avoidance system (Agony)： Located from midbrain to hypothalamusPleasure & Agony Electric Activity of Brain Electric Activity of Brain Brain function involves continuous electrical activity Patterns of brain (neuronal) electrical activity recorded are called Brain Wave腦電波 Brain waves c

17、hange with body state, e.g. Sleep, Wakefulness, disease such as Epilepsy, PsychosesOrigin of Brain Waves Discharge of a single neuron or single nerve fiber in the brain can never be recorded from the surface of the brain Many thousands or even millions of neurons or fibers must fire synchronously, t

18、hen the potential from the individual neurons or fibers summate enough to be recorded all the way through the skull記錄的不是神經(jīng)元的動(dòng)作電位，而是突觸后電位（可以是興奮性的或者抑制性的，可以加和） Spontaneous Electric Activity of Brain自發(fā)腦電活動(dòng) Evoked Cortical Potential皮層誘發(fā)電位 Electric Activity of Brain Electroencephalogram (EEG): Record of S

19、pontaneous Electric Activity of Brain腦電圖：記錄自發(fā)腦電活動(dòng) Some pathologic state, e.g. Epilepsy can be discerned distinct pattern EEG in Normal Healthy people Voltage Frequency 50mV 813 Hz520mV 1430Hz100150mV 47Hz20200mV 3.5 Hz從上到下，頻率逐漸變慢，振幅依次增加waves: Occur when a person is awake, relaxed with eyes closed安靜清

20、醒閉目不思考Alpha Waves(Alpha rhythm) Definition: Replacement of the alpha rhythm by an asynchronous, low-voltage beta rhythm whenopening the eyesAlpha Block 波阻斷(Arousal response)waves (Fast waves): Higher-frequency but lower-voltage waves produced by visual stimuli & mental activity & in “fast wave sleep

21、” Indicating the excited state of cerebral cortex Beta Waves有思維活動(dòng)，清醒，睜眼，快波睡眠waves: More regular with higher-voltage but lower-frequency Normally occurred in children & some adult with emotional stress, disappointment or frustratedTheta Waves多見于兒童成年人精神緊張，失望，受到打擊時(shí)，亞健康狀態(tài)也有，困倦狀態(tài)。waves (Slow waves): High

22、-amplitude but low-frequency waves Occur during very deep sleep in adult & awake infant If occurred in awake adults, indicating a very serious organic brain disease Delta Waves深睡眠，覺醒的嬰兒 Synchronous: The neurons activity of cerebral cortex is in step, represent a kind of low frequency but high voltag

23、e waves（波） Indicating the further suppression體現(xiàn)大腦皮層的抑制， Asynchronous: The neurons activity of cerebral cortex is out of step, represent a kind of high frequency but low voltage waves（波） Indicating the further excitation Synchronous & Asynchronous同步化，去同步化皮層誘發(fā)電位：感覺傳入系統(tǒng)或者腦的某一部位受刺激時(shí)，在皮層某一局限區(qū)域引起的電位變化體感誘發(fā)

24、電位自主誘發(fā)電位內(nèi)臟誘發(fā)電位記錄比較復(fù)雜主反應(yīng)，次反應(yīng)，后發(fā)放。Clinical Correlate EpilepsyEpilepsy Definition: Epilepsy also called seizures, is characterized by uncontrolled excess activity of either part or all of the central nervous system Classified into three types: Grand mal epilepsy大發(fā)作 Petit mal epilepsy小發(fā)作 Focal epilepsy局

25、部發(fā)作 Grand mal epilepsy: Characterized by extreme neuronal discharges in all areas of the brain, last from a few seconds to 3 to 4 minutes Neuronal discharge transmitted all the way into the spinal cord cause tonic seizures of the entire body Then followed by spasmodic muscle contraction“Tonic-Clonic

26、 Seizures”1全身性的僵直反應(yīng)2 肌肉不規(guī)則的痙攣：陣攣會(huì)出現(xiàn)紫紺一定注意保持呼吸道的通暢和避免把舌頭咬傷Grand mal epilepsy“Tonic-Clonic Seizures”EEG: High Frequency High Voltage What initiated a grand mal attack ? Strong emotional stimuli Overbreathing 過度通氣：堿中毒，神經(jīng)元活動(dòng)性增加 (Alkalosis Neuronal Overactivity) Drug Fever Loud noise or flashing lightsWh

27、at stop the grand mal attack ? Neuronal fatigue 突觸疲勞：遞質(zhì)耗竭，受體脫敏 (Fatigue of synaptic transmit) Active inhibitory neurons激活抑制性神經(jīng)元自行緩解“Absence Epilepsy” “Absence Seizures” Petit mal epilepsy: Characterized by 3 to 30 seconds of unconsciousness or diminished consciousness during which the person has several twitch-like contractions of the muscle, usually in the head region, especially blinking the eyes First appear during late childhood & may disappear by the age of 30無意識(shí)或意識(shí)減弱肌肉抽搐，眨眼EGG: spike-and-dome pattern Petit mal epilepsy腦電圖特點(diǎn)：頻率突然增快，振幅突然增大Focal Epi