Part I:Development, Structure, and Function 1
Preface 3
1.Overview of the Nervous System 3
Introduction 3
Overall development of the nervous system 3
Acknowledgements 4
Dedication 7
2.Cellular Physiology of the Nervous System 11
Neuronal structure and variation 11
The central nervous system environment 13
Synaptic transmission 17
Excitation and inhibition 21
Damage and repair in the nervous system 28
3.The Somatosensory System 31
The spinal cord and spinal tracts 31
Somatosensation and the sensory cortex 35
Nociception and the perception of pain 39
4.Motor Control 47
Movement control 47
Motor units and recruitment of muscle fibres 49
Reflex action and muscle tone 50
The motor cortex and pyramidal tracts 54
Basal ganglia and thalamus 57
The cerebellum 61
The vestibular system, posture, and locomotion 64
5.The Brainstem 69
The brainstem nuclei 69
The reticular formation 73
Brainstem-acting drugs and general anaesthetics 75
6.The Autonomic Nervous System 79
Introduction 79
Structure and function of the sympathetic nervous system 79
Structure and function of the parasympathetic nervous system 82
The enteric nervous system 83
7.Vision 85
The eye 85
Retinal function and image processing 87
Central visual pathways and the visual cortex 91
Attention and perception 94
8.Hearing 97
The ear and conduction of sound 97
The central auditory pathways and the auditory cortex 100
9.Olfaction and Taste 103
Receptions for taste and smell 103
Central pathways of taste and smell 104
10.Higher Centres of the Central Nervous System 107
Localization of brain function and behaviour 107
Learning and memory 109
The limbic system 110
Cognitive development and degeneration 113
Pharmacology of higher central nervous system function 115
Part II:Clinical Assessment 123
11.Taking a History 125
Things to remember when taking a history 125
The structure of the history 125
Common presenting complaints 127
12.The Neurological Examination 137
Speech 137
Mental state and higher function 138
Gait 142
The cranial nerves 145
The motor system 157
Sensation 164
The autonomic nervous system 166
Examination of the unconscious patien 167
13.Further Investigations 169
Neurophysiological investigations 169
Routine investigations 171
Imaging of the nervous system 175
Part III:Basic Pathology 181
14.The Central Nervous System 183
Common pathological features of the central nervous system 183
Malformations, developmental disease, and perinatal injury 186
Trauma of the central nervous system 188
Cerebrovascular disease 191
Infections of the central nervous system 194
Demyelination and degeneration 197
Metabolic disorders and toxins 200
Neoplasms ofthe central nervous system 202
Epilepsy 204
Diseases of the autonomic nervous system 207
15.Pathology of the Peripheral Nerves and Muscle 209
Hereditary neuropathies 209
Traumatic neuropathies 210
Inflammatory neuropathies 212
Infectious neuropathies 214
Neurocutaneous syndromes 216
Metobolic and toxic neuropathies 216
Diseases of the muscle and neuromuscular junction 217
Part IV:Self-assessment 219
Multiple-choice Questions 221
Short-answer Questions 226
Essay Questions 227
MCQ Answers 228
SAQ Answers 229
Appendices 231
Appendix 1:gross anatomy 231
Appendix 2:vascular supply to the central nervous system 232
Index 235