Anatomy of the Nervous system

Anatomy of the Nervous system

A nervous system can be defined as an organized group of cells called neurons which is
specialized for the conduction of an impulse – an excited state from a sensory receptor through
a nerve network to an effector, the site at which the response occur.
Functions of the nervous system
1) Sensory function – gathers information from both inside and outside of the body.
2) Transmit information to the processing areas of the brain and spine .
3) Process the information in the brain and the spine – integration function
4) Motor function – sends information to the muscles, glands, and organs so they can respond
The Nervous system is divided in to two divisions
1) Central nervous system
2) peripheral nervous system .
Peripheral nervous system is divided in to #somatic nervous system and autonomic nervous system.

A nervous system can be defined as an organized group of cells called neurons which is
specialized for the conduction of an impulse – an excited state from a sensory receptor through
a nerve network to an effector, the site at which the response occur.
Functions of the nervous system
1) Sensory function – gathers information from both inside and outside of the body.
2) Transmit information to the processing areas of the brain and spine .
3) Process the information in the brain and the spine – integration function
4) Motor function – sends information to the muscles, glands, and organs so they can respond
The Nervous system is divided in to two divisions
1) Central nervous system
2) peripheral nervous system .
Peripheral nervous system is divided in to #somatic nervous system and autonomic nervous system.

Autonomic nervous system has further sub divisions in to sympathetic nervous system and =parasympathetic nervous system.

Neuron – unit of nervous system
Transmit impulses up to 250 mph.
1) Dendrite – receive stimulus and carry impulse toward the cell body.
2) Cell body – with nucleus and most of the cytoplasm.
3) Axon – fibres which carry impulses away from the cell body.
4) schwann cells- cells which produce myelin or fat layer in the peripheral nervous system
5) myelin sheath- dense lipid layer which insulates the axon.
6) Nodes of Ranvier – These are gaps in myelin sheath.
1) Sensory neurons – beings information to CNS
2) Motor neurons – carry messages from CNS
3) Interneuron – between sensory and motor neurons in the CNS
1) a stimulus is a change in the environment with sufficient strength to initiate a response.
2) Excitability is the ability of a neuron to respond to the stimulus and convert it into a nerve
impulse .
3) All of nothing rule – the stimulus is either strong enough to start and impulse or nothing
4) Impulses are always the same length along a given neuron and they are self propagation .
Once it starts it continues to the end of the neuron in only one direction from Dendrite to cell
body to axon.
5) The nerve impulse causes a movement of ions across the cell membrane of the nerve cell.

● SYNAPSE – small gap or space between the axon of one neuron and the dendrite of another .
It is junction between neurons which uses neurotransmitter to start the impulse in the second
neuron or an effector. The synapse insures one way transmission of IMPULSES.
●Neurotransmitters – Chemicals in the junction which allow IMPULSES to be started in the
second neuron.
Components of REFLEX ARC
A) Receptor – reacts to stimulus
B) Afferent pathway – conducts impulses to CNS
C) Interneuron – consist of one or more synapses in the CNS
D) Efferent pathway – Conducts impulses from CNS to effector .
E) Effector – muscles fibers or glands responds by contracting or secreting a product.
Spinal reflexes – initiated and completed at the spinal cord level. Occur without the involvement
of higher brain centers.
Brain stem –
•medulla ,
•pons, midbrain
•Diencephalon – thalamus and hypothalamus
•Cerebellum , cerebrum
2) spine
•Spinal cord

Meninges are the three coverings around the brain and spine and help cushion, protect and
nourish the brain and spinal cord.
1) Duramater is the most outer layer
2) Archanoid mater is the middle layer and adheres to the duramater and has web like
attachments to the innermost layer, the pia mater.
3) pia mater is very thin , transparent but tough and covers the entire brain .
4) Cerebrospinal fluid which buffers, nourishes and detoxifies the brain and spinal cord , flows
through the subarachnoid space , between the arschanoid mater and the pia mater.

• Regions of the brain
1) Cerebellum – coordination of movement and aspects of motor learning
2) Cerebrum – conscious activity including perception, emotions,thought and planning
3) Thalamus – filters and then relay information to various brain regions
4) Medulla – vital reflexes as heartbeat and respiration
5) Brainstem – medulla, pons, midbrain and relays information from spine to upper brain.
6) Hypothalamus – involved in regulating activities of internal organs,monitoring information
from the autonomic nervous system, controlling the pituitary gland and its hormone , regulate
sleep and appetite.

• CEREBRUM – Its the largest portion of the brain encompasses about two third of the brain
mass. It consist of two hemispheres divided by a fissure called corpus callosum.
It includes
• the cerebral cortex ,
• the medullary body,and
• basal ganglia.
• cerebral cortex – it’s the layer of the brain called gray matter as it has cell bodies and
synapses but no myelin.
• Medullary body – is the white matter of the cerebrum and consist of mayelinated axons
• Basal ganglia- they are the gray matter in each hemisphere which are involved in the control of
voluntary muscle movement.

1) frontal – motor area involved in movement and in coordinating behaviour.
2)parietal- sensory processing , attention, and language
3) temporal – Auditory perception, speech and complex visual perception .
4) Occipital – visual center – plays a role in processing visual information.
Special regions
1) BROCA’S Area – located in the frontal lobe, aids in speech
2) WERNICKE’S area – Comprehension of language
3) LIMBIC system – help regulates the expression of emotions and emotional memory.
BRAIN WAVES – are rhythmic fluctuation of electric potential between parts of the brain as seen
on EEG .
Electrodes are placed on to the scalp using the EEG .
There are 4 types of brain WAVES
• Beta
• Alpha
• Theta
• Delta
• Cranial 12
• Spinal 31
• Somatic nervous system ( voluntary)
1) relays information from skin, sense organs and muscles to CNS
2) Brings responses back to skeletal muscles for responses.

• Autonomic nervous system ( involuntary)
1) regulates bodies involuntary responses
2) relays information to internal organs.
3) Two divisions
A) sympathetic nervous system in times of
Emergency response , fight or flight.
B) Parasympathetic nervous system – when body is at rest or with normal functions. Normal
everyday conditions.
Major sense organs.
Sensation and perception.
Vision – eye
Hearing – ear
Taste – taste receptors
Smell – olfactory system
Skin – hot, cold, pressure, pain
Sense organs
Eye- the organ used to sense light

Three layers –
Outer layer consists of sclera and cornea
Middle layer consist of choroid, ciliary body and iris
Inner layer consist of retina
Sclera – A tough protective layer of connective tissue that helps maintain the shape of the eye
and provides an attachment for the muscles that move the eye.
Cornea – the clear, dome shaped part of the sclera covering the front of the eye through which
light enters the eyes.
Anterior chamber – is a small chamber between the cornea and the pupil.
Choroid layer – middle layer of the eye containing many blood vessels
Optic nerve – the nerve that transmits electrical impulses from the retina to the brain.
Retina – sensory tissue that lines the back of the eye. It contains millions of photoreceptors that
convert light rays in to electrical impulses that are relayed to the brain via optic nerve.
Lens – a crystalline structure located just behind the iris . It focuses light on to the retina.
OUTER EAR & EAR CANAL – brings sounds into eardrum.
Eardrum – vibrates to amplify sound and separates inner and middle ear
Middle ear has 3 small bones anvil, stirrup, stapes ( amplify sounds ) which vibrates sound.
Eustachian tube – connects middle ear to throat and equalizes pressure on eardrum
Cochlea – has receptors for sound and send signal to brain via auditory nerve.

Taste and smell
Taste buds – the mouth contains around 10,000 taste buds, most of which are located on and
around the tiny bumps on your tongue . Every taste buds detect five primary tastes.
1) sour
2) sweet
3) bitter
4) Salty
5) umami – salts of certain acids
Each of your tastebud contain 50 -100 specialized receptors cells.
Sticking out of every single one of these receptors cells is a tiny taste hair that checks out the
food chemicals in your saliva. Each taste hair responds best to one of the basic tastes.

Smell receptors or olfactory receptors
1) humans are able to detect thousands of different smells
2) olfactory receptors occupy a stamp sized area in the roof of the nasal cavity, the hollow space
inside the nose.
3) tiny hairs are covered with mucus
4) olfactory hairs easily fatigued so you do not notice smell.
5) if a smell , formed by chemicals in the air , dissolves in the mucus , the hair absorbs it and
excite your olfactory receptors .
6) smell leave long lasting impressions and our strongly linked to your memories.

Skin receptors
Most of your touch receptors sit close to your skin’s surface.
Light touch – Meissner s corrupslces are enclosed in a capsule of connective tissue.
They react to light touch and are located in the skin of your palms, soles, lips, eyelids ,external
genitals and nipples. These areas are particularly sensitive.
Heavy pressure – paccinian corrupslces sense pressure and vibration changes deep in your skin .
Pain – skin receptors register pain, pain receptor are the most numerous
Temperature – skin receptors registers warmth and cold. Each square centimetre of your skin
contains 6 receptors for cold and one receptor for warmth. Thermoreceptors are found all over
the body , but cold receptors are found in greater density than heat receptors – most of the
the time of our environment is colder than our body temperatures. The highest concentration
of thermoreceptors can be found in the face and ears so your nose and ears always gets cold
faster than the rest of your body on a chilly winter day


It is an autoimmune disease which causes cells to develop rapidly on the skin. The overgrowth
an lead to thick, scaly plaques which causes itch and discomfort.
Parts of the body which are affected by psoriasis are
1) elbows and knees
2) face, scalp
3) genitals
4) low back
5) arms, palms and feet
Types of psoriasis
80 to 90% of the psoriasis type is plaque psoriasis. Other types are
1) inverse psoriasis- this appears in skin fold. It looks like thin pink plaques without scales.
2) guttate psoriasis – it may appears after sore throat as it is caused by streptococcal infection.
It looks like small, red drop shaped scaly spots.
3)pustular psoriasis- has small, pus filled bumps on top of the red patches.
4) sebopsoriasis- appears on the face and scalp as red bumps and plaques with greasy yellow
Note- psoriasis is most common in winter , when people gets less sunlight. And male gender are
most prone. The rash is not contagious . You can’t get it from affected ones. Psoriasis has no
Risk factors1) family history- psoriasis can run in genes. If one of the parent is carrier then 50% of the
chances are there that one of the child will have psoriatic symptoms .
2) stress- excessive stress can hamper your immune system, increased level of stress can
become the cause of this disease
3) smoking- smoking will play a vital role in the initial development and will deteriorate the
Complications of psoriasis
1) eye conditions such as blepharitis, conjunctivitis.
2) hypertension
3) depression
4) cardiovascular disease
5) type 2 diabetes
6) psoriatic arthritis
7) chron’s disease, celiac disease, scelerosis, inflammatory bowel disease
Main aim of the treatment is to reduce the growth of the cells and releive symptoms like itching,
dry skin. Common treatment includes
1) steroid creams
2) moisturizer for dry skin, aloevera gel.
3) retinoid creams, vit d based creams, coal tar.
For severe psoriasis treatment includes
Light therapy which includes ultraviolet light on the skin. PUVA is a treatment includes psoralens
tablet with ultraviolet rays.
Psoralen tablets should be taken 2 hours before sunlight exposure. Psoralen Mgs will be
dependable on patient’s weight and age.
10mg for less than 30 kg
20mg for 30 to 50 kg
30mg for 51 to 65kg
40mg for 66 to 80kg
50mg for 81 to 90kg
60mg for 91 to 115kg
70mg for more than 115kg


Shin pain is common exercise related injury refers pain along the inner edge of shin bone (tibia) or sometimes on front of lower leg. Physical activity such as running, jumping or any vigorous sports activity can bring on shin pain, in case if you are starting at fresh or after a long time gap.

There can be some of the factors which can correlate as shin pain such as Stress fracture of tibia, Periostitis, Contusion injury, Compartment syndrome and MTSS (Medial Tibial Stress Syndrome). What is more common in athletes or exercise beginners is MTSS, known as shin splints where due to stress loading on tissues develop inflammation of muscles, tendons and bone tissue along the medial border of tibia (inner edge of shin bone).


Generally, shin splints develop by overworking of muscles and periosteum (outer most layer of bone) by repetitive activities or bio-mechanical faults or environmental factors (exercise surface). Sudden changes in duration, intensity, and frequency of physical exercise can lead to shin splints.

Other factors which can contribute to shin splints are:-

             Flat feet or abnormal rigid arches can create abnormal stress on medial border of tibia (inner edge).

             Pain can be sharp, throbbing or dull.

             Pain occurs during and after exercise.

             Pain aggravates by touching on sore area or tender area.

If you ask, Should I take any medicine or go for radiological tests?

Oh No! Taking medicines such as anti-inflammatory and pain killers will not sort out your injury. Pills only kill the pain for some time, it’s momentarily relief and will not resolve your injury.

Secondly if you choose to do X-Ray, MRI etc., you will be wasting your time and money. Instead if you won’t find anything in radiological findings you can increase your anxiety level (beware of that).

Seek expert advice for the best treatment and go ahead as per their advice.

What will Sports physio do?

Assessment is a vital part for any injury or condition to be diagnosed. Sports physio will discuss about your pain, history and symptoms.

Shall do keen observation on your pain area

Shall palpate the tissues

Shall examine your movements

Do physical skill tests to evaluate and making correct diagnosis

Most importantly explaining to you the whole condition in the easiest ways that what it is.

How it occurred?

Why it happened?

What is the cure?

We the “Pain free zone” is a hub of specialized sports physio or expert in sports injuries. We will assess, diagnose and will treat you.

We have

-dynamic approach and multidimensional knowledge base which is patient centered

-clinical reasoning process that is embedded in problem solving approach

-central focus on movement assessment

-consistent virtues in caring and commitments towards patient.

“To have the effective treatment there is a need of correct assessment and diagnosis”

Coming to the topic again stress fracture, tendinitis, chronic exertional compartment syndrome can be detected by physical tests, movements and palpatory skills.

And we “PFZ” are highly expert in these.

Can I do something at home to relieve my pain before coming to you?

 Yeah why not?

             Do ice- use cold packs for 15-20 mins several times a day , but be careful about time duration

             Compression – wear elastic compressive bandage over pain area

             Proper shoes – wear good cushioning shoes to reduce stress on shin bone while walking.

             Avoid running on hard surface or either stop vigorous activity for some days.

If these can relieve my pain what all different you will do?

 You can have relief in pain by these but in future this pain can come again and can be more severe.

Why you wear sweaters and blazers in winters! Well you are feeling cold or last time you suffered from chills and fever.

Above mentioned are just home advices, treatment and solving your problem is way far.

 *If your pain is due to bio-mechanical fault such as over pronation, flat feet so ice and home remedies won’t work for you at all. That needs to be corrected

Pain free zone apply most advanced techniques in physiotherapy management

             Modalities

             Dry needling

             IASTM- Instrument Assisted Soft Tissue Mobilization

             Therapeutic Taping

             Manual Therapy

             Specific Exercise Program

             Return to Activities


Whatsapp..hottest craze and necessity in today’s scenario. If we talk about youngsters their friends and group chatting and if we talk work then discussions on projects makes you involve in typing on mobile through your thumb resulting in pain in and around thumb.

The causative factor for Whatsapp syndrome is repetitive use of thumb musculature leading overuse strain. The muscles of thumb like flexor pollicis, Opponens pollicis and abductor pollicis gets repeated action leading to formation of trigger points.

Consequences –

Overuse syndrome can give rise to degeneration in the bones and joints.

Osteoarthritis in chronic cases can be caused.

How to avoid –

Pain in the thumb can be avoided by intermittent rest period.

Stretching the thumb musculature.

How Physiotherapy can help –

Muscle strain caused by repeated action of typing can be resolved by many advanced therapeutic techniques in physiotherapy like Dry needling, myofascial release and laser therapy.

Stretching of the musculature and taping the structures helps to resolve the problem sooner.

DRY NEEDLING, What’s that?


Dry needling is an invasive procedure where a filamentous needle is inserted into the skin and muscle. It is aimed at myofascial trigger points which are hyperirritable spots in skeletal muscles that are associated with a hypersensitive palpable nodule in a taut band. It can be done on superficial fascia which is the topmost layer under skin, muscles, tendons and in the articular region to resolve pain and dysfunction. Dry needling is a new upcoming technique in the medical field and spreading at very fast pace because of its effectiveness. It is not at all same or similar as acupuncture. Acupuncture is part of traditional chinese medicine whereas dry needling is a western medicine technique. Dry needling works by changing the way your body senses pain(neurological effects) and by helping the body heal stubborn muscle spasm associated with trigger points (myofascial effects). Dry needling is a part of physiotherapy and it is very significant that the patient does his exercises for faster recovery.

The therapist will choose a length and thickness of needle appropriate for your condition and body size. The needle is inserted through the skin at appropriate place. A small pinprick is felt and depending on the type of technique chosen by the therapist, you may also feel a muscle ache and a muscle twitch. These are all normal and good sensations, and mean that you will experience good relief from your symptoms.

Generally there is no/very less risk involved with this technique if performed by a properly trained physiotherapist. You may have a little bruising around the needle side, same as after an injection but not always. There are no lasting side effects of dry needling. On rare occasions, people may feel very happy, tearful, sweaty or cold.

Dry needling can be useful in endless conditions including muscular, orthopaedic, neurological, sports, paediatric and women health as well. During pregnancy when there is no option left for pain relief, this is one of the best resort.

Though it can help in numerous diseases and conditions but to enumerate a few in sports and musculoskeletal conditions are osteoarthritis, frozen shoulder, back and neck pain (commonly known as sciatica and cervical), plantar fasciitis (heel pain), myofascial pain syndrome(1st stage of fibromyalgia), acute and chronic sports injuries, muscle and ligament strains and sprains, muscle, tendon and ligament repairs, tendonitis, foot or ankle conditions, Post-surgery rehabilitation, Aching and stiff joints and muscles, restriction in range of motion, vertigo, etc.

Small kids and adolescents suffering from Cerebral palsy, development delay, Developmental co-ordination disorder, Neuromuscular conditions, Acquired brain injury, and other musculoskeletal injuries can get a lot of improvement in their deformities.

People suffering from Stroke, Parkinson’s Disease, Multiple Sclerosis, Spinal Cord Injury, Neuromuscular Disorders, Guillain-Barre Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, Multifocal Motor Neuropathy, Inflammatory Myopathies, Muscular Dystrophies, Headaches etc. can improve their life.

The treatment given through dry needling can solve the tough, chronic problems with which the patient is suffering from. But don’t go to a novice as dry needling is a great technique which can do magic but only through a skilled therapist.

Wish you a Pain free life !!

Dr. Chakshu Bansal Kathuria


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