Sensory Receptors

London School of Massage

“Massage to a Higher Level” 

Neurological System

At the end of this section you will understand and appreciate:

 Structure and function of the nervous system  Classification of nervous tissue  Classification of the nervous system  Coverings of the brain and spinal cord  The Reflex Arc  Conditions affecting the nervous system  How massage affects the nervous system

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The Neurological or Nervous System transmits and receive messages to and from the brain and all parts of the body. It can be thought of as the electrical wiring of the body.

THE NERVE CELL

The basic cell of the nervous system is called the neurone

Dendrites Transmit nerve impulses to the Direction Cell Body of Impulse

Nucleus CELL BODY

Axon Long single nerve fibre which transmits impulses away from the cell body

Myelin Sheath Made up of a white fatty substance. It INSULATES the axon and SPEEDS up nerve transmission Neurilemma

Fine delicate membrane Nodes of Ranvier which surrounds the axon and helps REGENERATE Compressed points along the the nerve cell. myelin sheath. It helps SPEED up It is only found in nerve transmission by making the PERIPHERAL NERVES impulse JUMP

Axon terminals

Diagram of Neuron and Nerve Sheath

London School of Massage  2015 All Rights Reserved: Anatomy, Physiology Pathology & Massage 172 The synapse is a small gap between neurones. The impulse is transmitted via a neurotransmitter – a chemical substance which moves from the axon terminal to the next dendrite Diagram of a Synapse

NERVE TRANSMISSION

Nerve cells transmit and receive impulses throughout the body. Impulses do not continually run along each nerve but are created in response to internal or external stimuli.

The transmission of a nerve impulse along a neuron from one end to the other occurs as a result of chemical changes across the membrane of the neuron. The membrane of an unstimulated neuron is polarized—that is, there is a difference in electrical charge between the outside and inside of the membrane. The inside is negative with respect to the outside. This is maintained by differences in the permeability to these ions and by the sodium potassium pump.

Na + = Sodium Ions

K+ = Potassium Ions

When a stimuli is detected, the axon membrane become temporarily permeable to sodium ions, which rush in, making the inside of the cell more positive (depolarisation). The electrochemical charge continues in waves along the length of the nerve cell as a nerve impulse.

Individual neurones have the same function throughout the body (to transmit information), but collectively they make up 5 different types of nerves and nervous tissue, which have specific function: Type Function 1 Motor Nerve . Carry impulses from brain or spinal cord to muscular and (Efferent) glandular tissue. . Provide instruction to muscle on movement and contraction

2 Sensory Nerve . Carry impulse from all parts of the body to the brain (Afferent) 3 Mixed . Carry both sensory and motor nerves Motor & Sensory) . Are only present in the PERIPHERAL NERVES

4 White Matter . Found: a. Inner part of BRAIN b. Outer part of the SPINAL CORD . Made up of bundles of myelinated nerve fibres

5 Grey Matter . Found: a. Outer part of BRAIN b. Inner part of the SPINAL CORD

. Made up of bundles of unmyelinated nerve fibres

THE TWO DIVISIONS OF THE NERVOUS SYSTEM

There are two divisions to the nervous system. These are:

1. Central Nervous System (CNS) - Brain + Spinal Cord

2. Peripheral Nervous System i. Cranial Nerves ii. Spinal Nerves

Sympathetic Nervous System iii. Autonomic Nervous System

Parasympathe tic Nervous System

THE BRAIN

For descriptive purposes, the brain can be divided into three separate structures:

1. Cerebrum

2. Cerebellum

3. Brain Stem – (Hypothalamus, Midbrain, Pons Varolii, Medulla Oblongata)

Brain Stem

Cerebrum Intelligence & reasoning

Hypothalamus Mid Brain

Pons Varolii Cerebellum Posture & balance Medulla Oblongata

Spinal Cord

Diagram of the Brain

1. Cerebrum

 Is divided into a right and left hemisphere (half)  Has many folds on its which consist of white and grey matter

The functions of the cerebrum are:

 Controls voluntary movements  Controls mental activity like intelligence and reasoning  Interprets and perceives conscious sensation like temperature and pain.

This is similar in make up to the cerebrum (white and grey matter).

The functions of the Cerebellum are:

 Coordinate muscular activity and makes actions smooth  Maintains posture and balance

3. Brain Stem

This is divided into: The Mid Brain, Medulla Oblongata and Pons Varolii

Mid Brain This lies between the cerebrum and cerebellum and above the pons varolii and medulla oblongata. The Functions are:  Is a relay station of the brain transmitting messages from the spinal cord, cerebellum and cerebrum.

Medulla Oblongata

This joins the spinal cord and brain – lowest part of the brain stem. It is interspersed with white and grey matter. It is known as the vital centre as it controls the actions of the heart and the lungs.

The medulla has 4 centres. These are:

 Cardiac Centre : controls rate and force of heart contraction  Respiratory Centre : controls rate and depth of breathing  Vasomotor Centre : controls vasoconstriction and vasodilation  Reflex Centre : controls vital reflexes like vomiting & coughing

Pons Varolii

The pons acts as a bridge, which unites the left and right hemispheres of the cerebellum and transmits messages to and from the spinal cord and cerebellum.

Hypothalamus

This is situated at the top of the brain stem and with the pituitary gland attached to its base. It contains the heat regulating centre as well as controlling bodily drives (appetite, thirst, sex etc.).

It also regulates the pituitary gland thus forming the main link between the nervous and endocrine systems – NEUROENDOCRINE LINK

The Brain and the spinal cord are surrounded by 3 membranes. These are called the Meninges and lie between the skull and brain and spinal cord and vertebra (see diagram below).

1. Dura Mater: Tough fibrous double layered membrane. Travels from the skull to the sacrum

2. Arachnoid mater: A delicate membrane positioned under the dura. It connects with the Subarachnoid space which is filled with C.S.F

3. Pia Mater: A thin vascular membrane, which closely covers the brain. It supplies blood to the brain and Spinal cord.

Cerebrospinal Fluid (CSF)

Is a colourless fluid similar to plasma and produced by the CHOROID PLEXUS in the brain and reabsorbed by the arachnoid mater.

Pia Mater Functions:

1. Protects brain & spinal cord forming a Arachnoid Mater cushion and acting as a shock absorber.

2. Keeps the pressure around the brain Dura Mater constant.

3. Provides nutrients and removes waste from the brain

Meninges covering the Spinal Cord

This continues from the Medulla, lying in the vertebral canal. It gives out nerve roots (31 pairs in total) at various levels that then go onto form the CAUDA EQUINA

Nerve fibres travelling up the spinal cord pass through the Medulla where they cross to the opposite side. Therefore, the right half of the body is controlled by the left side of the brain and left half of the body is controlled by the right side of the brain.

The PNS concerns all the nervous system outside the CNS and contains Sensory and Motor nerves that transmit information to and from the body and the brain. It consists of: 1. CRAINIAL NERVES

2. SPINAL NERVES

3. AUTONOMIC NERVES

(i) Sympathetic Nerves (ii) Parasympathetic Nerves

Cranial Nerves

These nerves originate in the brain. There are 12 pairs altogether. They consist of sensory, motor and mixed nerves. No Cranial Nerve Type Function I Olfactory SENSORY Sense of smell II Optic SENSORY Sense of vision III Oculomotor Motor Supplies muscles moving the eye IV Trochlear Motor Supplies muscles moving the eye V Mixed Sensation from face (heat, pain, pressure) as well as supplying muscles of mastication

Nerve has 3 division: 1. Ophthalmic – Forehead, eyes, nose 2. Maxillary – lower eye lids, upper gums/teeth and cheeks 3. Mandibular – sensory around lower jaw and motor supply to muscles of mastication VI Abducent Motor Supplies muscles moving the eye VII Facial Mixed Supplies muscles of facial expression as well as sense of taste from tongue. VIII Vestibulocochlear SENSORY Supplies sense of hearing as well as balance IX Glossopharyngeal Mixed Sense of taste from tongue, sensation from throat as well as muscles connecting to the pharynx X Vagus Mixed Sensory and motor to digestive and respiratory organs XI Accessory Motor Supplies sternocleidomastoid and upper trapezius XII Hypoglossal Motor Supplies muscle of tongue

Diagram of the Cranial Nerves

There are 31 pairs of spinal nerves. These are:

 Cervical region - Eight pairs

 Thoracic region - Twelve pairs

 Lumbar region - Five pairs

 Sacral region - Five pairs

 Coccygeal region - One pair

Spinal nerves exit the foramina combine in different ways to form nerves.

The spinal nerves at each level (cervical, thoracic and lumbar) combine together to form a network called a Plexus Name of Plexus Supplies

Cervical Plexus Muscles and skin to neck & upper shoulder C1 – C4 Gives off the PHRENIC nerve which supplies the Diaphragm

Muscles and skin from base of neck to the whole of the upper Brachial Plexus extremity. C5 – T1

Thoracic (Nerves) This is not a plexus but the nerves supply muscles of the chest and T2 – T12 main part of the abdomen as well as sensation to this area.

Lumbar Plexus Supplies skin and muscles of the lower abdomen, groin & anterior L1 – L3 (L4) thigh. Sacral Plexus Supplies skin and muscles to the lower pelvic floor. L4 – S4 Gives rise to the Sciatic Nerve. Including the whole leg and posterior thigh. Coccygeal Plexus This group forms a second small plexus on the back of the pelvic cavity. It supplies the anal sphincter muscles and external genitalia.

Plexuses Brain A: Cervical Plexus B: Brachial Plexus Cerebellum T: Thoracic Plexus Spinal Cord L: Lumbar Plexus A S: Sacral Plexus B Brachial Nerve

Musculocutaneous Nerve T Radial Nerve

Median Nerve Subcostal Nerve L Iliohypogastric Nerve

Genitofemoral Nerve S Femoral Nerve Gluteal Nerves Ulnar Nerve

Digital Nerve

Sciatic Nerve Sciatic Nerve

Saphenous Nerve

Common Peroneal Nerve

Tibial Nerve

Deep Peroneal Nerve

Superficial Peroneal Nerve

Sural Nerve

Plantar Nerves

In massage therapy, the tendency is to focus on the role of muscles in pain or injury, sometimes excluding other soft tissues. Nerves are one of these often forgotten tissues, yet they play a critical role in many pain complaints.

The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system consists of cranial nerves, which branch out of the brain, and spinal nerves, which branch out of the spinal cord. A total of 31 sets of nerves branch out of the spinal cord. The point at which the nerve branches out from the cord is known as the nerve root. Each nerve travels a short distance (about ½ inch) from the cord and then divides into small posterior divisions (dorsal rami) and larger anterior divisions (ventral rami).

Spinal nerves have motor and sensory fibres. The motor fibres stimulate certain muscles, while the sensory fibres innervate (means to ‘stimulate via nerves’) certain areas of skin. A skin area stimulated by the sensory fibres of a single nerve root is known as a dermatome.

A plexus is any complex structure containing an intricate network of parts, in this case ‘nerves’.

Following are the four main nerve plexuses.

Plexus Locations Innervates the … Cervical plexus C1 – C4 diaphragm, shoulder and neck Brachial plexus C5 – T1 upper limbs Lumbar plexus T12/L1 – L4 thigh Sacral plexus L4 – S4 leg and foot

The ANS controls the functions of the body, which happen “automatically”. That is, it is concerned with all that which we cannot control consciously. It is controlled by the HYPOTHALAMUS. All internal organs are supplied by both the Sympathetic Nervous System and Parasympathetic Nervous System and the way the organ functions is dependent on which one of the systems is more active. The Autonomic Nervous System is divided into two parts:

1. The Sympathetic Nervous System (SNS)

Structure Function

Consists of Ganglia (collection of nerve  Prepares the body for stressful situations / physical cells), which are situated in front of Activity – “Flight or Fight Syndrome”. vertebral column and travel length of  Neurones release the neurotransmitters body from the Thoracic to the Lumbar ACETYLCHOLINE and NORADRENALIN at the region. synapse.

 Accelerates action of heart, increasing rate and force of contraction.

 Causes dilation of arteries increasing blood supply to the Heart.

 Causes dilation of arteries increasing blood supply to Skeletal muscle, increasing nourishing and waste removal process thus enabling muscle to work better.

 Raises blood pressure by constricting small arteries and arterioles that supply the skin therefore making it look pale / white.

 Causes sustained contraction of spleen, thus increasing volume of blood circulating.

 Constricts blood vessels in secretory glands of Digestive system, restricting flow of digestive juices. This slows down the system.

2. Parasympathetic Nervous System (PNS) Structure Function

Consists of the:  Stimulates opposite action in organs to that 1. Vagus produced by SNS

2. Glossopharangeal  When active, it slows down the action of an organ (except digestive system). 3. Occulomoter  Neurones release ACETYLCHOLINE as the 4. Facial neurotransmitter at the synapse.

5. Sacral Outflow  Slows action of heart, reducing rate and force of contraction. These branch to the organs of the:  Constricts flow of blood to heart muscle.  Head (salivary glands)  Stimulates the digestive system & urinary system.  Chest  Has a relaxing effect on the body – “chills you out”  Abdomen

 Genitalia

A reflex is an involuntary (not controlled by the brain) movement as a result of a sensory stimulus, e.g. letting go of a hot object instinctively.

The action is instant and involuntary.

Several structures are involved in the production of a reflex and together they form a Reflex arc.

Diagram of the Reflex Arc

Note that it consists of:

1. Sense Organ e.g. temperature receptors

2. Sensory nerve travelling TO the spinal cord.

3. Spinal Cord

4. Motor nerve travelling to the motor organ

The five sensory organs of the body are:

Organ Structure Sense Function Sensory Receptor Eyes Contain light receptors, Sight Photoreceptor structures called rods and cones Ears Contains receptors which detect Hearing Mechanoreceptor sound Proprioceptor Nose Contains smell and taste Smell and Taste Chemoreceptors receptors Skin Contain pressure, taste and Touch Mechanoreceptor temperature receptors Thermoreceptor Nociceptor Tongue Contain taste receptors which Taste Chemoreceptor can detect, salty, sweet, sour or bitter taste

Sensation is the awareness of changing conditions in the environment. It depends on the following components, is this order:

1. Stimulus - a change in one or more conditions, e.g., light, sound, temperature. The stimulus can arise from a change in the external (outside the body) or internal environment (inside the body).

2. Receptor - a cell, tissue or organ designed to respond to one type of environmental change.

When the stimulus is received by the receptor cell, a generator potential (sensory message) is produced. The strength of the generator potential is directly proportional to the strength or significance of the stimulus.

Example of a receptor potential is in a taste bud, where taste is converted into an electrical signal then sent to the brain for processing or interpretation.

3. Conduction – sensory messages must be conducted from the receptor to the CNS (Central Nervous System). These sensory impulses are carried by nerves of the Peripheral Nervous System.

The frequency of nerve impulses in the sensory neuron is determined by the strength of the generator potential produced in the receptor cell.

4. Interpretation - the sensory messages are interpreted in various regions of the cerebral cortex.

Example, nerve messages from the retina of the eye are ‘made sense of’ (interpreted) in the visual cortex of the occipital lobe of the cerebrum.

For touch, pressure and pain the interpretive centre is in the parietal lobe.

Auditory (sound) signals are interpreted in the temporal lobe.

Category Description Receptor Stimulus Chemoreceptors A sensory nerve cell activated  Taste buds  Chemicals in saliva - Chemoreception by chemical stimuli.  Olfactory tract  Chemicals in the air  Carotid body  Oxygen in blood  Nociceptors  Pain due to trauma

Mechanoreceptors A sense organ or cell that  Pacinian corpuscle  Pressure - Mechanoreception responds to mechanical  Meissner’s corpuscle  Touch stimuli such as touch or  Merkel cell  Light Touch sound.  Cochlea  Soundwaves  Semi-circular canals  Position/Balance  Muscle spindles  Proprioception  Golgi tendon organ  Proprioception Photoreceptors The Retina has 2 types of  Retina  This is the only - Photoreception photoreceptor: Rods & Cones receptor stimulated by Light Rods are most sensitive to light & dark changes, shape and movement. They are must less sensitive to colour.

Cones are most sensitive to colour and less sensitive to light and dark, shapes etc. Thermoreceptors These are non-specialised  Cold receptors in  Cool temp (10-30 C) - Thermoreception sensory receptors that epidermis  Warm temp (32-48 C) respond to relative changes in  Warm receptors in  Very cold or very hot temperature. dermis  Nociceptors Nociceptors These respond to potentially - Nociception damaging stimuli by sending (No-see-ceptor) signals to the spinal cord and brain. Proprioceptors These are sensors that - Proprioception provide information about joint (pro-pry-o-ceptor) angle, muscle length, and muscle tension, which is integrated to give information about the position of the limb in space.

The nose is the organ of olfaction (smell).

At the top of the nose are two areas of pigmented tissue known as olfactory membranes, they contain the smell-sensing cells that contain cilia (small hairs).

Olfactory Nerve

Olfactory Bulb

Nasal cavity

Diagram showing cross section of the nose and olfactory system

Lacrimal Eye Lid Gland

Lacrimal Sac Lacrimal Gland Ducts

Pupil

Sclera

Iris Lacrimal Duct

Lacrimal Puncta Lacrimal Canal

Aqueous/Vitreous Humour A transparent, gelatinous fluid that fills the eye ball

Diagram showing cross section of an eye

Condition Description Image Conjunctivitis Conjunctivitis is a common condition that causes redness and inflammation of the thin layer of tissue that covers the front of the eye (the conjunctiva). It can often be referred to conjunctivitis as red eye.

Blepharitis Blepharitis is a condition where the edges of the eyelids become inflamed (red and swollen). The condition can develop at any age, but is more common in people over 40. Signs of blepharitis can include, itchy and sore eyelids and eyelids that stick together.

Cataracts Cataracts are cloudy patches that develop in the lens of your eye and can cause blurred or misty vision. They are very common. Over time, the cataracts become worse and start affecting vision. Many people with cataracts will eventually need surgery to remove and replace the affected lens.

Corneal Ulcer A corneal ulcer is an open sore in the outer layer of the cornea. Corneal ulcers are most commonly caused by an infection with bacteria, viruses, fungi, or a parasite.

Glaucoma Glaucoma is a condition which can affect sight due to build-up of pressure within the eye. It often both eyes, but one eye may develop glaucoma quicker than the other. Glaucoma develops when the aqueous humour cannot drain properly and pressure builds up.

Diagram showing cross section of an ear

Condition Description Vertigo Vertigo is a symptom, rather than a condition itself. It's the sensation that you, or the environment around you, is moving or spinning. Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making normal life very difficult. Tinnitus Tinnitus is the term for hearing sounds that come from inside your body, rather than from an outside source. It's often described as "ringing in the ears", although several sounds can be heard (buzzing, humming, grinding) Labyrinthitis Labyrinthitis is an inner ear infection. It causes a delicate structure deep inside your ear called the labyrinth to become inflamed, affecting your hearing and balance. Ménière's disease A disease affecting the membranous labyrinth of the ear, causing progressive deafness and attacks of tinnitus and vertigo. Motion Sickness Motion sickness is a term that describes an unpleasant combination of symptoms, such as dizziness, nausea and vomiting, that can occur when you're travelling. Middle Ear Infection Most middle ear infections occur when a viral or bacterial infection such as a cold (Otitis Media) causes mucus to build up in the middle ear, which then becomes infected. The infection can be classed as: Acute - the middle ear becomes inflamed and infected Serous - a collection of fluid in the middle ear, which can be acute or chronic Chronic - long term damage to the middle ear through previous acute infection

The tongue is a muscular organ in the mouth. The tongue is covered with moist, pink tissue called mucosa. Tiny bumps called papillae give the tongue its rough texture.

Lingual Tonsil

Palatine Tonsil

Root

Circumvallate Papillae

Foliate Papillae Filiform Papillae Body

Fungiform Papillae

Apex

Taste buds are collections of nerve-like cells that connect to nerves running into the brain. There are thousands of taste buds covering the surfaces of the papillae.

Smell and taste are part of the same interconnected sensory system, and believe it or not, but flavour is almost entirely sensed in the nose.

Smell (olfactory sense) and taste (gustatory sense) fall broadly in the category of "chemical senses" and work in similar ways. Not only that, the flavour of food is almost entirely detected in the nose and not the tongue. The taste receptors on the tongue and the "odorant" receptors in the nose work together to tell us about the air we breathe and the food we eat.

Smell is the easiest to understand: The nasal cavity contains 12 million (!) different odorant receptors, each sensitive to slightly different chemical structures. When molecules in the air enter the nose and contact the various odorant receptors, a "picture" of the chemical composition of the air is generated and sent to the brain, which we experience as smell.

The taste buds are distributed throughout the mouth and upper throat, but are mainly on the tongue. All taste buds detect all tastes, unlike what used to be taught in schools that different parts of the tongue sense different tastes.

Sweet Detects the hydrocarbon structure of most (but not all) sugars

Sour Measures acidity

Salty Measures dissolved positive electrolyte ions, mainly sodium and potassium

Bitter Detects numerous things with high sensitivity, many of which are toxic. It should be noted that bitter is not well understood.

Savoury/ Senses chemical compounds in meat and also …. MSG! Umami

Most food flavours are sensed via a combination of taste receptor activation and vapour molecules in the mouth that are exhaled into the nasal cavity for detection by odorant receptors. The result is that chemicals that are inhaled are sensed as smell, and chemicals that are exhaled are sensed as taste. The involvement of the olfactory receptors in taste is why food lacks flavour when the nose is stuffed up from a cold.

 Fruit flavours are detected by the nose but are only registered if there is acidity in the mouth activating the sour taste receptors. White Wine with low acidity may smell fruity but will taste flat.  Meat activates the savoury (umami) taste receptor, giving meat and meat broth their meaty flavour. MSG activates this receptor directly, making meat dishes taste even meatier… tricky huh!  Hot peppers contain capsaicin, which activates the thermoreceptors in the mouth, making peppers taste hot.  Mint contains menthol, which activates cold thermoreceptors in the mouth, making mint taste cool.  Hard alcohol indirectly activates heat thermoreceptors by lowering the activation threshold to below body temperature, causing body temperature to activate them. In summary, "smell" is a chemical composition measurement of the air we breathe in, and "taste" is a chemical composition measurement of the food in our mouth.

However the perception of food flavour is actually constructed from a broad array of sensations which include the odorant receptors in the nasal cavity.

Some people are born with taste disorders, but most develop them after an injury or illness. Among the common causes of taste problems are:

1. Upper respiratory and middle ear infections

2. Radiation therapy for cancers of the head and neck

3. Exposure to certain chemicals, such as insecticides

4. Some medications, including some common antibiotics and antihistamines

5. Head injury

6. Some surgeries to the ear, nose, and throat (such as middle ear surgery) or extraction of the third molar (wisdom tooth)

7. Poor oral hygiene and dental problems.

Condition Description Ageusia Is an inability to taste sweet, sour, bitter, or salty substances. Hypogeusia Is a reduced ability to taste sweet, sour, bitter, or salty substances.

Dysgeusia Is an abnormal taste or change in taste that won't go away. It can be described as bad, metallic, salty, foul or rancid.

Xerostomia Is a condition that usually results from decreased production of saliva. At times, can (Dry Mouth) make it difficult to speak and may lead to malnutrition. Extreme dry mouth and salivary gland dysfunction can produce significant and permanent mouth and throat disorders and can impair a person's quality of life.

Vitamin D Deficiency A common effect of vitamin B deficiency is a burning sensation in the mouth, especially on the tongue. People with this deficiency can also have trouble swallowing. The tongue may feel swollen and the tissue of the inner cheeks can be pale and may break apart easily

Glossitis Is an inflammation of the tongue

Atrophic Glossitis A pathological condition in which the various papillae are lost from the surface of the tongue, resulting in a very sore and highly sensitive surface that makes eating difficult.

Disorder Description Picture

Alzheimer’s disease The most common form of dementia in order people that affects many areas of cognitive function.

Bell’s Palsy Injury or infection of the facial nerve that subsequently becomes inflamed Effect: facial paralysis.

Cerebral Palsy Damage to the brain, caused during birth or resulting from a pre-natal defect. Effect: affects motor system control.

Concussion An injury to the brain caused by a blow; usually resulting in loss of consciousness.

Depression Is a bipolar affective disorder – also known as manic depression, seasonal affective disorder (SAD - seasonal (SAD) – also known as winter depression or affective disorder) winter blues, post-natal is a form of clinical depression that can affect women, and less frequently men, after childbirth. Epilepsy A disorder of the central nervous system characterised by loss of consciousness and convulsions (fits).

Headache Headache or cephalalgia is a symptom of a number of different conditions of the head. Some of the causes are benign while others are medical emergencies.

Migraine A severe, disabling headache, usually affecting the one side of the head, and often accompanied by nausea, vomiting, photophobia (dislike for light) and visual disturbances.

Motor Neurone A rare progressive disorder, in which the Disease motor neurons in the body gradually deteriorate Effect: weakness and wasting of muscles

London School of Massage  2015 All Rights Reserved: Anatomy, Physiology Pathology & Massage 197 Multiple Sclerosis (also known as disseminated sclerosis) Loss of the protective myelin sheath from nerve fibres in the central nervous system. Effect: causes muscular weakness, loss of muscular coordination, problems with skin sensation, speech and vision. Myalgic Also known as post-viral fatigue or chronic Encephalomyelitis fatigue syndrome. (ME) Effect: exhaustion, general aches and pains, headaches and dizziness, inflammation of the brain and spinal cord. Myasthenia Gravis The Chronic progressive disorder characterized by fatigue and a muscular weakness especially in the face and neck.

Neuralgia Various causes.

Effect: bouts of burning or stabbing pain along the course of one or more nerves. Neuritis Inflammation of a nerve, caused by infection, injury, poison, etc.

Effect: pain along the nerve's length and/ or loss of use of the structures supplied by the nerve. Parkinsons Progressive disease caused by damage to Disease basal ganglia of the brain and resulting in loss of dopamine (neuro-transmitter).

Effect: causes tremor and rigidity in muscles, as well as difficulty and slowness

with voluntary movement. Poliomyelitis An acute viral disease marked by inflammation of the nerve cells of the brainstem and spinal cord.

Sciatica Pressure on the roots of the sciatic nerve often caused by degeneration of an intervertebral disc

Effect: pain down the back and outside of the thigh, leg and foot

London School of Massage  2015 All Rights Reserved: Anatomy, Physiology Pathology & Massage 198 Spina Bifida A developmental birth defect involving the neural tube; a not uncommon congenital defect in which a vertebra is malformed and therefore does not form properly.

Stress Stress is any factor that affects mental or physical well-being. Emotions such as anxiety, fear and other negative feelings can affect the nervous system causing increased heart rate, breathing difficulties, sleep disturbances and stomach problems. All of these physical effects are caused by the nervous system over-working in response to stress. Stroke A sudden loss of consciousness resulting when the rupture or occlusion of a blood vessel leads to lack of oxygen in the brain. “F A S T” Transient Sometimes called a mini-stroke: a temporary Ischaemic Attack restriction in the blood supply to the brain, (TIA) which causes short –term symptoms such as temporary vision loss or impairment.

Should not last for more than 24 hours.

INTERRELATIONSHIP OF NERVOUS SYSTEM WITH OTHER BODY SYSTEMS

All the systems Provides nutrition to the whole body.

Circulatory Nerves control the heart rate.

Respiratory Nerves control the process of respiration.

Endocrine Works closely with endocrine system to maintain homoeostasis – balance in the body.

Muscular Muscles require a nerve supply to contract.

Skeletal Muscle contraction (caused by nerve impulses) produces movement in the skeleton.

Skin Skin contains a variety of nerve endings, at different levels in the layers.

1. Has a “calming and soothing” effect on nerve pathways leading to the higher centres 2. Some movements have a stimulatory effect on nerve endings –(tapotement movements) 3. Encourages the release of endorphins - substances that reduce pain and promote sense of well-being.

SYMPTOMS OF THE NERVOUS SYSYEM

Symptoms can vary greatly as the system is vast. Some common symptoms are listed below:  Pins and needles feeling / tingling sensation radiating into the extremities  Loss of control of part of limb or body.  Loss of sensation  Loss of balance  Pain / Radiating pain  Loss of memory and higher function