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Central and Peripheral Nervous Systems

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Basic Sciences in Anesthesia

Abstract

The central nervous system (CNS) is composed of the brain and spinal cord. The peripheral nervous system (PNS) consists of the rest of the neuronal pathways outside the brain and spinal cord. Functionally, the brain is organized in two main sections: the cerebral cortex and the subcortical areas; the latter includes the basal ganglia, hippocampus, internal capsule, brainstem, and cerebellum. The spinal cord extends from the foramen magnum to the L1-L2 level in adults. It consists of neuronal tracts that carry signals between the brain and peripheral nervous system.

Cerebral blood flow (CBF) fluctuates minimally with cerebral perfusion pressure (CPP) due to corresponding changes in cerebral vascular resistance (CVR) attributed to cerebral autoregulation. CPP and CVR are influenced by pH, PaCO2, PaO2, and cerebral metabolic rate for O2 (CMRO2). CPP below the lower limit of cerebral autoregulation can lead to cerebral ischemia. Anesthetic medications can affect CBF and CMRO2 although no anesthetic drugs have definitively been shown to be neuroprotective in humans. During neurosurgical procedures, evoked potentials are the most commonly used neurophysiological monitors to evaluate ischemia in the central nervous system.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Jia W. Romito, Ravi Bhoja & David L. McDonagh

Authors
  1. Jia W. Romito
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  2. Ravi Bhoja
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  3. David L. McDonagh
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Corresponding author

Correspondence to David L. McDonagh .

Editor information

Editors and Affiliations

  1. Departments of General Anesthesia and Outcomes Research, Anesthesiology Institute, Cleveland Clinic Lerner College of Medicine, Case Western University, Cleveland, OH, USA

    Ehab Farag

  2. Center for Anesthesiology Education, Anesthesiology Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA

    Maged Argalious

  3. Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA

    John E. Tetzlaff

  4. Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA

    Deepak Sharma

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Romito, J.W., Bhoja, R., McDonagh, D.L. (2018). Central and Peripheral Nervous Systems. In: Farag, E., Argalious, M., Tetzlaff, J.E., Sharma, D. (eds) Basic Sciences in Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-319-62067-1_16

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  • DOI: https://doi.org/10.1007/978-3-319-62067-1_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-62065-7

  • Online ISBN: 978-3-319-62067-1

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