hb. nervous system

brain, spinal cord

12 pairs of cranial nerves

31 pairs of spinal nerves

voluntary

skeletal muscles

involuntary

smooth/cardiac muscles/glands

sympathetic/parasympathetic

contains nucleus/organells

main part

many, short, branched fibers

receives stimuli, carries message to cell body

single, long fiber from cell body,

carries message from cell body to other neuron/effector

white fatty material,

insulates/protects

myelin shealth

outermost membrane on schwann cell

damage nerves in PNS to regrow/repair within it

myelin shealth in CNS

damage is permanent

protect, nourish, support

do not transmit impulse

regenerate when damage

excessive brow- brain tumor

star shaped

btwn neurons & blood vessels

"blood brain barrier"

small

phagocytic when pathogens invade or degeneration/inflammation of brain tissue

hold nerve fibers together

lines brain cell ventricles, central canal of spinal cord

produces CSF

PNS,

made of cranial/spinal nerves

CNS

located in brain/spinal cord, where transmit impulse to/from brain

surrounds individual fiber

surrounds fascile

surrounds whole nerve/tract

resting state

potassium inside, sodium outside

• inside is neg.
• outside is pos.

reversal of particle concentration on either side

sodium rushes out making it positive inside

return of neuron's membrane to normal

potassium leaves

act move sodium/potassium back to original concentration

(potassium inside, sodium outside)

synaptic cell @ a junction called "synapse"

synaptic cleft

post-synaptic cell (a dendrite)

adrenal gland

adrenal gland

neuron

PNS regulates- skeletal, smooth, cardiac

CNS- learning, memory

brain

"Parkinson disease"

brain

"mood, sleep, depression"

tissue

constricts bronchial smooth muscle, vasodilate small blood vessels,

drop in bp,

"immunity"

brain

"morphine like high"

"exercise high"

diffusing into presynaptic neuron (reuptake)

diffusing slowly away from synapse

deactivated by enzymes

completely pathway through nervous system from stimuli to response

sensory impulse enters spinal cord

motor impulse leaves spinal cord

motor neurons attach to spinal cord

sensory neurons attach to spinal cord

opening where impulses leave spinal cord

motor impulses to neck

receive sensory impulses from neck, back of head

"phrenic nerve"

• nerve supply to shoulder, arm, forearm, wrist, hand
• "radial nerve"

nerve supply to legs, pelvis

"sciatic nerve"

• dura- outermost
• arachonid-middle layer
• pia- innermost , blood supply

canal that connects 3rd n 4th ventricle

produced by CSF

filters blood & release additional secretions

outer layer of gray matter

made of white matter

connects w/ other parts of brain

• voluntary movement
• conscious thought, memory, reasoning, abstract thinking

divides right/left sides (hemisphers)

white matter connecting the hemispheres

allows impulses to pass from one side to another

elevations

grooves

btwn forntal/parietal

right angle to longitudinal fissuer

separate temporal/frontal/parietal

alongside each hemisphere

• anetior to central sulcus,
• superior to lateral sulcus

primary motor area- conscious control of voluntary skeletal muscle

damage- motor aphasia

posterior to central sulcus, superior to later sulcus

primary sensory area- receives interprets from sensory receptors

estimate distance, size, shape

inferior to lateral sulcus, folding under hemispher

auditory area- impulse form ear

auditory receiving area- sounds from environment

auditory association area- interprets sounds

Wernicke area- speech comprehension

olfactory- nose

posterior to parietal love, extends over cerebellum

visual area- receiving & association area- come from retina in eye

5th lobe,

inside

cant see from outside

between cerebrum, brain stem

thalamus- sorts incoming sensory impulse

hypothalamus- homeostasis, controls pituitary gland & parasympathetic, sympathetic divisionn of AS

bordering diecephalon, cerebrum

emotional state/behavior

hippocampus- learning, long-term memory

reticular formation- controls wakefulness/sleep, along brain stem

links conscious functions of cerebral cortex w/ automatic brain stem

superior section of brain stemp

reflex of eye/ear

visual/auditory integration

connects cerebrum to other parts of brain/spinal cord

cranial nerves 3 & 4 exit

middle section

connects cerebellum to other parts of brain/spinal cord

respiratory centers (involuntary reflexes)

cranial 5-8 exit

bottom part

contralateral control

vital centers- respiratory, cardiac, vasmotor- contraction of smooth muscle in blood vessels, regulates blood flow/bp

cranial nerves 9-12 exit

"little brain"

two hemispheres & vermis

equilibrium/balance

• produce smooth coordinated movements
• maintains normal muscle tone

disorders- tremors/jerky movements

voluntary control of skeletal muscle

involuntary control of glands, cardiac muscle, smooth muscle

sensory

sensation, smell

sensory

sensation, vision

sensory

eye muscles

motor

one eye muscle

mixed

sensation (pain, touch, temp)

face (eyes, jaw,)

mandibular, maxillary, opthalmic

motor

one eye muscle

mixed

facial muscles, lacrimal glands, small salivary glands

sensation of taste- 2/3 tongue

sensory

hearing/equilibrium

from inner ear

mixed,

taste from posterior 1/3 of tongue

• innervates parotid salivary gland
• muscle involved in swallow

mixed

inneravation- thoracic/abdominal cavitites

motor

muscle of neck (trapeziuz, sternocledimastoid, larynx)

motor

tongue muscles

permanent, non-progressive disorder, affects motor control of brain, leads to paralysis

spastic most common

from brain trauma- before, during, after birth

affects- arms, legs, one or both side

mri, ct

orthopedic devices, visual/hearing aides, muscle relaxants, anticonvulsants

progressive neurmuscle disease, death of motor neurons

"Lou Gehrig's disease"

subtle initially, no effect on involuntary muscles

generalized weakness, clumsiness, twitching/cramping, slurred speech, difficulty breathing

men more often, neuromuscular exam (weakness, atrophy, abnormally rapid knee-jerk reflex)

electromyography- abnormal

• nerve conduction velocity- slowed speed of nerve conduction, decreased muscle action potential
•  
• treatment- no cure, riluzole (Rilutek) to slow progression

muscle relaxants, respiratory

activity of cerebral cortex

daginose sleep disorders, tumors, epilepsy, brain

signals in muscles,

nerve damage

how fast impulse travels thorugh anerve,

done w/ an EMG

radiopaque injected for an x-ray

• paresis- partial
• paralysis- complete
• quadriplegia- all four, trunk,
• paraplegia- lower
• hemiplegia- one side/half of body

from spinal cord/nerve/brain/ injury

neurological assessment, MRI, CT, myelogrpahy

inner material of disk protrudes outward

from spinal trauma, intervertebral joint degeneration

x-ray, MRI, CT myelography

rest, PT, NSAIDS, analgesics, muscle relaxants, steroid injections, surgery

degeneration of nerves

• infection: bacterial (lyme disease,)
• viral- varicella zoster virus
• metabolic disease
• toxins
• vitamin deficiency
• autoimmune disease (lupus, RA, Guillain-Barre syndrome)

nerve conduction velocity, electromyography

treatment- elimination of causative factors, supportive

viral infection along course of nerve

reactivation of varicella-zoster (chicken pox)

unilateral pain, burning of spine

diagnose- clinical,

treatment- antivirals

shingles (herpes-zoster)

• antivirals,
• analgesics,
• corticosteroids,
• eye patch

acute, rapidly progression autoimmune disorder

attacks myelin on peripheral nerve, rare

affects young

bilateral muscle weakness, in legs ascends to upper body, paralysis, loss of reflexes, respiratory muscles

• clinical
• NCV
• electromyography

shows demyelination and slowed conduction

csf shows increased protein

plasmapheresis (removes harmful plasma)

high dose immunoglobulin medications

mechanical ventilation

spine do no close, menginges spinal cord don't protrude

meninges protrude, requires surgery

meninges, spinal cord broth protrude growing a sac

• lack of bladder/bowel control
• lack of sensation
• paralysis of legs
• hydrocephalus

prenatal- blood tests has trip/quadruple screen show high levels of alpha fetoprotein, a sonogram, amniocentesis

post natal- surgery

CSF accumulates, causing compression/swelling of brain

from fetal infections, developmental abnormalities, bleeding in brain, head/brain injury, spinal tumor

treatment- shunt

evaluation of CSF after lumbar puncture

• viral- more common
• bacterial- rare, more serious

• antivirals
• hospitalization w/ aggressive IV antibiotics

inflammation/swelling of brain, cause intervertebral hemorrhage/brain damage

• viral- more common
• bacterial- rare, more serious

EEG, MRI (swelling & increase in ICP (intracranial puncture)

lumbar puncture (elevated CSF, ICP)

antivirals

hospitalization w/ aggressive administration of IV antibiotics

• antivonsulants- prevent seizures
• corticosteroids- reduce swelling
• sedatives
• analgesics

vaccination of Hib, pneumococcal

• vaccinations (MMR, varicells)
• use of insect repellent

one part of brain, no loss of consciousness

simple- jerking, spasms, head turning, alters perception, no loss of awareness of surroundings

complex- automatic, purposeless behaviors, loss of awareness of surroundings

entire brain, loss of consciousness

absence- brief loss of consciousness

tonic lonic (grand mal)- tonic (loss of consciousness, muscle contraction, body stiffening) clinic (relaxation of muscles, tongue biting, incontinence of urinary/fecal, foaming of mouth) post-ictal (sleepiness, HA, confusion)

one seizure follows another/w no recovery lasting 10-15 minutes

• medical emergency
• IV anticonvulsants

EEG, MRI, CT

treats epilepsy

• observe aura
• cushion head
• loosen neck attire
• nothing in mouth
• look for med alert ID
• do not restrain them
• stay/offer help
• call 911 if it lasts more than 5 mins

• stroke
• 80 ischemic- occlusion of vertebral artery by atherosclerosis, thrombosis, emboli

hemorrhage- sudden rupture of artery, HTN, aneurysm, head injury, blood dyscrasias

STAT IV thrombolytic called tissue plasminogen activator  (TPA)

• anticoagulants, antiplatelet (ASA)
• carotid endarterectomy, angioplasty
• stend

chronic, brain, deterioration, neurons in cerebral cortex die replaced by plaques & tangles

dementia consistent w/ Alzheimer's disease

neuropsychological testing- memory, problem solving, attention span, numeric/langue skills

MRI, CT, Pet scan

Alzheimer's Disease

progressive, deficiency of dopamine in brain

resting tremor- tremors of small muscle

bradkinesai- slowing of motions

neuroligcal exam- 2 of 3 cardinal Parkinson's symptoms- tremor, slowing of motion, muscle rigidity

response to levodopa

• levodopa/carbidopa (Sinemet, Atamet) is main treatment,
• changes into dopamine

Parkinson's disease

parkinson's disease

parkinson's disease

parkinson's disease

• neurological examinat
• MRI-reveals lesions
• evoked potential test- measure response to sensory stimulation, visual, auditory, general (slows w/ scaring)
• lumbar puncture- indicates immune response w/I CNS

immunomodulation medications - cause flu like symptoms, liver abnormalities

MS

MS