Contents

• Chapter 1. OVERVIEW OF THE NERVOUS SYSTEM (L. Pinar)
•        Organization of the Central Nervous System....................................................... 4
•        General Functions of the Main Parts of the Brain................................................ 4
•        Cerebrum............................................................................................................... 4
•        Brainstem............................................................................................................... 5
•        Cerebellum............................................................................................................ 6
•        Meninges (Meninx).............................................................................................. 6
•        Cerebrospinal fluid (CSF) .................................................................................... 6
•        Blood Brain Barrier (BBB)..................................................................................... 6
•        Cranial Nerves....................................................................................................... 7
•        REFERENCES............................................................................................................... 9
• Chapter 2. BIOELECTRIC POTENTIALS OF THE EXCITABLE CELL (L. Pinar)
•        Resting Membrane Potential................................................................................. 13
•        Generation of the resting membrane potential............................................ 14
•        Individual Ions Involved in the Resting Membrane Potential..................... 15
•        Nernst Potentials: Equilibrium Potentials of Ions.......................................... 15
•        The Equilibrium (Nernst) Potential of Potassium.......................................... 16
•        The Equilibrium (Nernst) Potential of Sodium............................................... 17
•        Calculation of the Sum Effects of Several Permeable Ions on the
•        Resting Membrane Potential: Goldman-Hodgkin-Katz Equation............... 18
•        Gibbs Donnan Effect ......................................................................................... 18
•        The Effects of Na-K ATPase on Membrane Potential................................... 20
•        The Membrane of Excitable Cell...................................................................... 20
•        Action Potential.................................................................................................. 22
•        Investigation of Ion Channels: Voltage Clamp and Patch Clamp Techniques 26
•        REFERENCES............................................................................................................ 27
• Chapter 3. NERVE PHYSIOLOGY (L. Pinar)
•        Glial Cells ................................................................................................................. 31
•        Astrocytes............................................................................................................ 31
•        Functions of Astrocytes..................................................................................... 32
•        Oligodendrocytes............................................................................................... 32
•        Schwann cells..................................................................................................... 33
•        Microglia.............................................................................................................. 33
•        Ependymal Cells................................................................................................. 33
•        Neurons..................................................................................................................... 33
•        The Functional and Structural Parts of a Typical Neuron............................. 33
•        Myelinated and Unmyelinated Neurons........................................................ 35
•        Distribution of Ion Channels in Neurons........................................................ 36
•        Conduction of the Action Potential Along the Axons.................................. 37
•        Orthodromic and Antidromic Impulse Conduction...................................... 39
•        Mixed Nerves...................................................................................................... 39
•        Nerve Fiber Types.............................................................................................. 40
•        Transport of Proteins in the Axons ................................................................ 41
•        Neurotrophic Factors......................................................................................... 41
•        Degeneration and Regeneration of Nerve Fibers........................................ 42
•        Demyelinating Diseases................................................................................... 43
•        Effects of Changing Concentrations of Plasma Ions on the
•        Excitability of Nerves......................................................................................... 43
•        Rhythmicity of Some Excitable Tissues........................................................... 45
•        Electrotonic Potentials, Local Response ........................................................ 45
•        Clinical Aspects........................................................................................................ 46
•        Channelopathies (Ion Channel Myopathies)................................................. 46
•        REFERENCES............................................................................................................ 47
• Chapter 4. MUSCLE PHYSIOLOGY (L. Pinar)
•        Skeletal Muscle........................................................................................................ 51
•        Morphology of Skeletal Muscle ....................................................................... 51
•        Cross Striation..................................................................................................... 52
•        Sarcolemma........................................................................................................ 54
•        Sarcotubular System.......................................................................................... 54
•        Contractile Proteins of Skeletal Muscle.......................................................... 55
•        Thin filaments..................................................................................................... 55
•        Thick Filaments .................................................................................................. 56
•        Dystrophin-Glycoprotein Complex................................................................. 56
•        Electrical Characteristics of Skeletal Muscles................................................. 57
•        The Flux of Ions .................................................................................................. 57
•        Contraction................................................................................................................ 58
•        Muscle Twitch..................................................................................................... 58
•        Molecular Basis of Contraction......................................................................... 58
•        Excitation-Contraction Coupling...................................................................... 59
•        Transmission of the Excitation to Contraction............................................... 60
•        Sliding Mechanism............................................................................................. 60
•        Relaxation............................................................................................................ 60
•        Fatigue................................................................................................................. 61
•        Rigor Complex ................................................................................................... 61
•        Rigor Mortis......................................................................................................... 61
•        The Length and Tension Relationship of Contraction.................................. 61
•        Types of Excitation............................................................................................. 62
•        Types of Contraction.......................................................................................... 62
•        Energy Mechanism of Muscle Contraction........................................................ 63
•        Muscle Fiber Types............................................................................................. 64
•        Properties of Entire Muscles................................................................................. 65
•        Motor Unit............................................................................................................ 65
•        Grading of Muscular Activity............................................................................. 66
•        Summation of the Contractions: Strengthening of the Muscle Twitches...... 67
•        Temporal (Time-Related) Summation............................................................ 67
•        Spatial Summation............................................................................................. 68
•        Denervation Sensitivity of Skeletal Muscle, Denervation Potentials......... 68
•        Diseases of Muscle ................................................................................................. 70
•        Muscular Dystrophy........................................................................................... 70
•        Channelopathies................................................................................................ 70
•        Smooth Muscle......................................................................................................... 71
•        REFERENCES............................................................................................................ 73
• Chapter 5. EXERCISE PHYSIOLOGY ( L. Pinar)
•        Benefits of Regular (long-term) Aerobic Exercise............................................ 77
•        Quantitative Values for Physical Capacities...................................................... 78
•        Strength, Power and Endurance of the Muscles........................................... 78
•        Energy Systems of Exercises............................................................................. 79
•        Recovery of the Muscle Metabolic System after Exercise........................... 79
•        Oxygen Debt....................................................................................................... 80
•        Maximal Resistance Training............................................................................ 80
•        Muscle Training for Hypertrophy and Strengthening .................................. 81
•        Effects of the Exercise on the Respiratory System .......................................... 81
•        Oxygen Consumption (VO2) ............................................................................ 82
•        Effects of the Exercise on the Cardiovascular System .................................... 82
•        Summary.............................................................................................................. 83
•        Maximal Oxygen Consumption....................................................................... 84
•        VO2 max Levels................................................................................................... 84
•        Measurement of VO2 max....................................................................................... 84
•        Submaximal Level of Exercises........................................................................ 85
•        Uth-Sorenson-Overgaard-Pederson Estimation ........................................... 85
•        Cooper Test......................................................................................................... 85
•        6-Minute Walk Test ........................................................................................... 86
•        Body Heat in Exercise............................................................................................. 86
•        Heatstroke........................................................................................................... 86
•        Doping Drugs...................................................................................................... 87
•        REFERENCES............................................................................................................ 87
• Chapter 6. SYNAPTIC TRANSMISSION (L. Pinar)
•        Types of Synapses................................................................................................... 91
•        Morphology of Chemical Synapses................................................................. 92
•        Presynaptic and Postsynaptic Structures........................................................ 93
•        Fusion................................................................................................................... 94
•        Divergence and Convergence......................................................................... 94
•        Excitatory and Inhibitory Postsynaptic Potentials........................................... 94
•        Excitatory Post Synaptic Potential ................................................................... 95
•        Inhibitory Post Synaptic Potential.................................................................... 96
•        Temporal and Spatial Summation.................................................................... 97
•        Slow Post Synaptic Potentials........................................................................... 98
•        Function of Dendrites........................................................................................ 98
•        Inhibition and Facilitation at Synapses............................................................... 98
•        Direct and Indirect Inhibitions.......................................................................... 98
•        Presynaptic Inhibition and Facilitation.......................................................... 100
•        Organization of Inhibitory Systems............................................................... 101
•        Neuromuscular Transmission .......................................................................... 101
•        Neuromuscular (or Myoneural) Junction..................................................... 101
•        Drugs That Affect the Transition of Action Potential from Nerve to Muscle 104
•        Blockers............................................................................................................. 104
•        Drugs That Block Acetylcholinesterase........................................................ 104
•        Clinical Aspects .................................................................................................... 105
•        Myasthenia Gravis ........................................................................................... 105
•        Lambert-Eaton Syndrome .............................................................................. 105
•        Neurotransmitters................................................................................................. 106
•        Neuromodulators............................................................................................. 106
•        Receptors.......................................................................................................... 107
•        Mechanism of Reuptake................................................................................. 108
•        Monoamine Transmitters.................................................................................... 108
•        Acetylcholine ................................................................................................... 108
•        ACh Receptors.................................................................................................. 108
•        Serotonin........................................................................................................... 109
•        Serotonin Receptors........................................................................................ 109
•        Histamine ......................................................................................................... 109
•        Catecholamines .............................................................................................. 109
•        Dopamine ........................................................................................................ 110
•        Excitatory Amino Acids....................................................................................... 110
•        Glutamate.......................................................................................................... 110
•        Glutamate Receptors....................................................................................... 110
•        Inhibitory Amino Acids....................................................................................... 111
•        Glycine .............................................................................................................. 111
•        GABA (Gamma Amino Butyric Acid)............................................................. 111
•        GABA Receptors............................................................................................... 111
•        Large Molecule Transmitters ............................................................................. 112
•        Substance P....................................................................................................... 112
•        Opioid Peptides................................................................................................ 112
•        Clinical Aspects .................................................................................................... 112
•        Excitotoxins....................................................................................................... 112
•        Role of Serotonin in Mood and Behavior..................................................... 113
•        Phenylketonuria............................................................................................... 113
•        Schizophrenia .................................................................................................. 113
•        REFERENCES.......................................................................................................... 113
• Chapter 7. CUTANEOUS SENSES and PAIN (T. Yörükan)
•        Introduction to the Special Senses..................................................................... 117
•        Types of Sensation................................................................................................ 117
•        Touch and Pressure......................................................................................... 117
•        Vibration............................................................................................................ 119
•        Proprioception.................................................................................................. 119
•        Tickle and Itch................................................................................................... 119
•        Thermal Senses................................................................................................ 119
•        Two-Point Discrimination............................................................................... 120
•        Epicritic sensibility or localisation.................................................................. 120
•        Topognosis (localisation of stimuli)............................................................... 121
•        Pain or Nociception.............................................................................................. 121
•        The Gating Theory............................................................................................ 124
•        Somatic Pain............................................................................................................... 124
•        Visceral Pain........................................................................................................... 124
•        Referred Pain.................................................................................................... 124
•        Transmission..................................................................................................... 126
•        Lateral Inhibition.............................................................................................. 128
•        Analgesia........................................................................................................... 128
•        Analgesic Substances............................................................................................ 128
•        Opiate Peptides ............................................................................................... 128
•        Effect of Acetylcholine on Pain .................................................................... 129
•        Cannabinoids in Pain Relief............................................................................ 129
•        Pain Suppression in the Brain and Spinal Cord ........................................... 129
•        Clinical Aspects ............................................................................................... 130
•        Neuropathic Pain................................................................................................... 131
•        Sensory Symptoms of Spinal Cord Diseases................................................ 132
•        Cortical Representation.................................................................................. 132
•        Clinical Aspects................................................................................................ 133
•        REFERENCES.......................................................................................................... 134
• Chapter 8. PHYSIOLOGY OF VISION (T. Yörükan)
•        Structure of the Eye............................................................................................... 137
•        The Sclera.......................................................................................................... 138
•        The Choroid...................................................................................................... 140
•        The Retina......................................................................................................... 142
•        The Optical System of the Eye- the first function of the eye........................ 146
•        Lens strength and normal vision................................................................... 148
•        Near Point Convergence Reflex.................................................................... 150
•        Visual Fixation Reflex....................................................................................... 150
•        Binocular Vision ............................................................................................... 150
•        Visual Acuity...................................................................................................... 151
•        Physiologic Mechanisms in Vision - the second step in vision.................. 151
•        Scotopic Vision...................................................................................................... 152
•        Photopic Vision..................................................................................................... 152
•        Photochemical and Bioelectric Processes in Scotopic vision................... 152
•        Mechanism of Excitation................................................................................. 153
•        Physiologic Nystagmus................................................................................... 156
•        Colour Vision......................................................................................................... 156
•        Transmission of signals from the retina to the Visual centres ................. 158
•        Lesions at different levels of the Optic tract .............................................. 161
•        Eye movements .............................................................................................. 162
•        Visual Field and Perimeter.............................................................................. 162
•        Scotoma............................................................................................................. 162
•        REFERENCES.......................................................................................................... 163
• Chapter 9. AUDITORY PHYSIOLOGY (T. Yörükan)
•        Perilymph and Endolymph............................................................................. 171
•        Sound - Physical characteristics........................................................................ 171
•        The Decibel ...................................................................................................... 172
•        Summary of the Auditory process..................................................................... 172
•        Cochlear Sound Transmission........................................................................ 172
•        Place Theory of Cochlear Function............................................................... 175
•        Transmission to the Auditory Cortex................................................................ 176
•        The Types of Hearing Loss.................................................................................. 177
•        Equilibrium............................................................................................................ 177
•        Disturbances of Balance................................................................................. 181
•        REFERENCES.......................................................................................................... 181
• Chapter 10. CHEMICAL SENSES OF TASTE AND SMELL OR GUSTATION AND OLFACTION (T. Yörükan)
•        Taste or Gustation................................................................................................. 185
•        General mechanism of stimulation............................................................... 186
•        Localisation....................................................................................................... 188
•        Transmission......................................................................................................... 189
•        Smell or Olfaction................................................................................................. 190
•        Vomeronasal Organ......................................................................................... 191
•        Mechanism of Excitation................................................................................. 192
•        Sensation modalities....................................................................................... 192
•        Transmission......................................................................................................... 193
•        Disturbances of Olfaction............................................................................... 195
•        REFERENCES.......................................................................................................... 195
• Chapter 11. AUTONOMIC NERVOUS SYSTEM (T. Yörükan)
•        Sympathetic Division........................................................................................... 200
•        Parasympathetic Division................................................................................... 201
•        Synapses.................................................................................................................. 202
•        Autonomic Transmitters................................................................................. 202
•        Sympathetic postganglionic fibre Effector Organ Synapse....................... 204
•        Regulation of Norepinephrine Release and Synthesis.............................. 204
•        Adrenergic Receptors..................................................................................... 204
•        Alpha Receptors............................................................................................... 205
•        Beta Receptors................................................................................................. 205
•        Acetylcholine Receptors................................................................................. 206
•        Denervation Hypersensitivity............................................................................ 207
•        Responses in Effector Organs............................................................................. 207
•        The actions of sympathetic nerves on effector organs............................. 207
•        Actions of Parasympathetic Nerves on Effector Organs............................ 209
•        Cranial Division..................................................................................................... 209
•        Responses of Effectors to Autonomic Nerve Impulses................................. 210
•        Autonomic reflexes......................................................................................... 212
•        Central Control of Autonomic functions........................................................... 213
•        REFERENCES.......................................................................................................... 214
• Chapter 12. MOTOR FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM (L. Pinar)
•        Three Main Levels of the Central Nervous System Involved in Motor Functions 217
•        Spinal cord (Medulla Spinalis) Level.............................................................. 217
•        Lower Brain Level............................................................................................ 217
•        Upper Brain Level, Cortical Level.................................................................. 218
•        The Simplest Motor Activities Of the Spinal Cord.......................................... 219
•        Stretch Reflex................................................................................................... 219
•        The Effect of the Gamma Motor Neurons.................................................... 222
•        Reciprocal Innervation and Inhibition........................................................... 223
•        Golgi Tendon Reflex........................................................................................ 223
•        Pathological Reflexes...................................................................................... 225
•        Withdrawal Reflex (Flexion Reflex)............................................................... 225
•        Spinal Shock...................................................................................................... 226
•        Brown Sequard Syndrome ............................................................................. 227
•        Mass Reflex....................................................................................................... 227
•        Clinical Aspects..................................................................................................... 229
•        Amyotrophic Lateral Sclerosis (Motor Neuron Disease)............................ 229
•        Brainstem and Reticular Formation.................................................................. 230
•        Reticular Facilitatory (Excitatory) Area.......................................................... 230
•        Reticular Inhibitory Area................................................................................. 231
•        Functions of the Neocortex................................................................................. 232
•        Cerebral Dominance ...................................................................................... 232
•        Control of Motor Functions................................................................................. 234
•        Motor Areas in the Cerebral Cortex ............................................................. 235
•        Primary Motor Cortex ..................................................................................... 235
•        Premotor Cortex.............................................................................................. 236
•        Supplementary Motor Cortex........................................................................ 236
•        Somatic Sensory Area in Motor activity........................................................ 237
•        Initiation of the Motor Commands by the Cerebral Cortex...................... 237
•        Control of the Axial and Distal Muscles of the Body..................................... 238
•        Corticospinal Tracts............................................................................................. 240
•        Lateral Corticospinal Tract (Pyramidal tract)................................................ 240
•        Anterior (Ventral) Corticospinal Tract .......................................................... 241
•        Corticobulbar Tract.......................................................................................... 242
•        Rubrospinal Tract.............................................................................................. 242
•        Extrapyramidal System (Ventromedial System Tracts) .............................. 243
•        Pontine Reticulospinal Tract (tr. Reticulospinalis medialis)....................... 243
•        Medullary Reticulospinal Tract (tr. Reticulospinalis lateralis).................... 243
•        Medial and Lateral Vestibulospinal Tracts.................................................... 243
•        Tectospinal Tract.............................................................................................. 244
•        The Inhibitory Areas of Central Nervous System ....................................... 244
•        Decerebrate Rigidity....................................................................................... 245
•        Decorticate Rigidity (Spasticity)..................................................................... 246
•        Lower and Upper Motor Neurons and Their Lesions ................................ 246
•        Lesions of Cortical Areas................................................................................. 247
•        Cerebral Palsy (CP).......................................................................................... 249
•        Impairment of the Sensorimotor Integration ............................................. 249
•        Basal Ganglia.......................................................................................................... 250
•        Direct Tract ....................................................................................................... 252
•        Indirect Tract..................................................................................................... 252
•        Neuronal Circuits of the Basal Ganglia............................................................. 253
•        Putamen Circuit............................................................................................... 253
•        Caudate Circuit................................................................................................. 254
•        Metabolic Properties of the Basal Ganglia................................................... 255
•        Clinical Aspects..................................................................................................... 255
•        Huntington’s disease....................................................................................... 255
•        Parkinson’s Disease (Paralysis Agitans)........................................................ 256
•        Cerebellum.............................................................................................................. 257
•        Function............................................................................................................. 257
•        Afferent Tracts to the Cerebellum from the Brain .................................... 259
•        Afferent Tracts to the Cerebellum from the Periphery............................. 259
•        Efferent Tracts from the Cerebellum............................................................ 260
•        Functional Unit of the Cerebellum............................................................... 260
•        Function of the Lateral Hemispheres........................................................... 262
•        Romberg Test................................................................................................... 262