Anatomy and Physiology Nervous system: brain, spinal cord, nerves Central Nervous System (CNS) and Peripheral Nervous System (PNS) CNS: brain and

Anatomy and Physiology

Nervous system: brain, spinal cord, nerves

Central Nervous System (CNS) and Peripheral Nervous System (PNS)

CNS: brain and spinal cord PNS: autonomic nervous system, cranial

and spinal nerves

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Common Signs and Symptoms Common signs and symptoms

HeadacheNausea and vomitingWeaknessMood swingsFever

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Common Signs and Symptoms Symptoms specific to CNS

Stiffness in neck, back, or extremitiesInability to move any part of the bodySeizures or convulsionParalysisVisual difficulties

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Common Signs and Symptoms Symptoms specific to CNS

Inability to speakParalysisExtreme or prolonged drowsinessStupor, unconsciousness, amnesia, extreme

forgetfulness

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Common Signs and Symptoms Common diagnostic tests

Cerebrospinal fluidMeasuring intracranial pressureX-rays of skull and vertebral columnMyelogram

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Common Signs and Symptoms Common diagnostic tests

AngiogramElectroencephlogramCAT ScanMRI

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Infectious Diseases

EncephalitisInflammation of brain tissue caused by

bacteria and virusesSymptoms:

○ Headache, stiff neck and back○ Fever and lethargy○ Confusion and even coma

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Infectious Diseases

EncephalitisTreatment:

○ Supportive○ Antiviral medication may be effective

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Infectious Diseases

MeningitisInflammation of meninges or coverings of

brain and spinal cordCauses:

○ Bacterial and viral○ Fungi○ Toxins such as lead and arsenic

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Infectious Diseases

MeningitisSymptoms

○ High fever○ Severe headaches○ Photophobia

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Infectious Diseases

MeningitisSymptoms

○ Stiffness and resistance in neck (nuchal rigidity)

○ Drowsiness○ Stupor○ Seizures○ Coma

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Infectious Diseases

MeningitisDiagnosis: collect spinal fluid to find causeTreatment

○ Antibiotics for bacterial infection○ Antipyretics○ Anticonvulsants○ Quiet dark environment

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Infectious Diseases

PoliomyelitisViral infection affecting brain and spinal cordVaccine has eliminated the disease in the

United StatesVirus is spread by oropharyngeal secretions

and infected feces

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Infectious Diseases

PoliomyelitisSymptoms

○ Muscle weakness○ Neck stiffness○ Nausea and vomiting

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Infectious Diseases

Poliomyelitis Diagnosis: clinical examination, throat,

feces, and spinal fluid cultureTreatment: supportive therapy including

analgesics and bedrest during acute phase

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Infectious Diseases

Poliomyelitis Long-term physical therapy and braces may

be neededIf respiratory system involved, mechanical

ventilation may be needed

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Infectious Diseases

TetanusHighly fatal infection of nerve tissue caused

by bacteria Clostridium tetaniFirst symptom is stiffness of the jaw,

commonly called “lockjaw”

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Infectious Diseases

RabiesCaused by virusPrimarily affects animals such as dogs, cats,

raccoons, squirrels Transmitted to humans through bite of an

infected animal

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Infectious Diseases

RabiesSymptoms

○ Fever and pain○ Convulsions and rage○ Spasms and paralysis of muscles for

swallowing

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Infectious Diseases

RabiesSymptoms

○ Throat spasms leading to hydrophobia○ Inability to swallow; drooling of frothy saliva

Treatment ○ Clean infection site and rabies vaccine

injectionsNo cure

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Infectious Diseases

ShinglesViral disease caused by herpes zosterItching, painful red rash, and small vesicles

on sensory nerve pathsSymptoms last ten days to several weeks

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Infectious Diseases

ShinglesDiagnosis

○ Appearance of lesions○ Viral culture test

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Infectious Diseases

ShinglesTreatment

○ Antiviral medications○ Analgesics○ Antipyretics○ Antipruritic medications

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Transient Ischemic Attacks TIAs or mini-strokes Insufficient blood to brain Symptoms

Weakness of arm and/or legDizzinessSlurred speechMild loss of consciousness

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Transient Ischemic Attacks Symptoms last few minutes to an hour Diagnosis is made by angiogram Surgery to improve blood flow

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Functional Disorders

Degenerative Disk Disease Headache Epilepsy Bell’s Palsy

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Degenerative Disk DiseaseDegeneration or wearing away of the

intervertebral diskWearing away allows vertebrae to bump or

rub against each other

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Degenerative Disk DiseaseSymptoms:

○ Difficulty walking○ Radiating pain in back and in one or both legs

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Degenerative Disk DiseaseDiagnosis:

○ X-ray○ Myelogram○ CAT or MRI

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Degenerative Disk DiseaseTreatment

○ Rest back and legs○ Back brace○ Analgesics and anti-inflammatory drugs○ Exercise to ease pain○ Surgery

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Headaches - one of the most common disorders in humans

Caused by two mechanismsTension on facial, neck, and scalp musclesVascular changes in arterial size of vessels

inside head

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Headaches Contributing factors

StressToxic fumesNoiseLack of sleepAlcohol consumption

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Headaches May be acute or chronicPain may be constant, pressure, throbbing,

stabbing, intermittentTension, cluster, following lumbar puncture,

migraine

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HeadachesDiagnosis

○ History and physical examination○ X-ray○ EEG, MRI, and CAT

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HeadachesTreatment

○ Analgesics○ Bedrest and muscle massage ○ Muscle relaxants○ Warm baths○ Biofeedback

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EpilepsyChronic disease of brainIntermittent episodes of abnormal electrical

activity in brainMost common symptom is seizureConvulsions include petit mal, grand mal

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EpilepsyDiagnosis

○ EEG○ CAT scan○ Cerebral angiogram○ Blood tests

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EpilepsyTreatment

○ Anticonvulsive medications○ Close monitoring and adjusting of medications

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Bell’s PalsyAffects facial nerve (7th cranial), causing

unilateral paralysisAffects individuals 20 to 60 years of age

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Bell’s PalsySymptoms

○ Drooping weakness of eye○ Drooling of saliva○ Unable to whistle or smile○ Distorted facial appearance

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Bell’s PalsyDiagnosis

○ History and symptomsTreatment

○ Analgesics and anti-inflammatory medication

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DementiaLoss of mental ability due to loss of neurons

or brain cellsMost common dementia is senility Most common cause of senile dementia is

Alzheimer's disease

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Alzheimer's DiseaseForm of dementiaAffects individuals 70 and olderEarly symptoms

○ Short-term memory loss○ Inability to concentrate○ Slight changes in personality

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Alzheimer's DiseaseSymptoms of disease progression

○ Diminished communication skills○ Meaningless words○ Inability to form sentences○ Increased forgetfulness○ Irritability and agitation

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Alzheimer's DiseasePositive diagnosis: autopsyInitially may be made by ruling out other

brain diseasesTreatment is supportiveNo cure

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Vascular DementiaAtrophy and death of brain cells due to

decreased blood flowAtherosclerotic plaque can cause decreased

blood flow and is common with aging

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Vascular DementiaSymptoms

○ Changes in memory, personality, and judgment

○ Irritability, depression, and sleeplessness○ Lacks personal hygiene

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Vascular DementiaDiagnosis

○ Blood flow testing and history and physicalTreatment

○ Increasing blood flow to brain○ Carotid endarterectomy

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Head Trauma DementiaDeath of brain cells due to head traumaSymptoms

○ Decrease in mental intellect and cognitive function

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Head Trauma DementiaDiagnosis

○ History○ Cranial X-rays○ MRI and CT

Treatment○ Correct damage if possible

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Substance-Induced DementiaBrain cell death from drug toxicity and toxinsCauses mental impairment and decreased

cognitive ability

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Sleep Disorders

InsomniaInability to fall or stay asleepRelated to stress, pain, fear, depression,

caffeine, alcohol, nicotine, and bronchodilators

Treatment○ Identifying and removing cause

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Sleep Apnea

Sleep disorder characterized by periods of breathlessness

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Sleep Apnea

SymptomsDaytime sleepinessExtreme snoringPersonality changesDepressionImpotence

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Sleep Apnea

DiagnosisMonitor affected individual during sleep for

apnea and low blood oxygen levels

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Sleep Disorders

Sleep ApneaTreatment

○ Based on cause○ Weight loss○ Surgery to correct nasal obstruction○ Oxygen during sleep○ Medications to stimulate breathing

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Tumors

Primary and secondary Benign and malignant Symptoms

HeadacheVomiting and seizuresMood and personality changesVisual disturbance and loss of memory

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Tumors

DiagnosisClinical symptomsX-ray, CT, and MRIBiopsy

Treatment: surgery, radiation, and chemotherapy

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Trauma

Concussions and ContusionsBlow to head by an object, fall, or other

trauma such as an automobile accidentDisruption of normal electrical activity in

brain

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Trauma

Concussions and ContusionsCauses immediate unconsciousnessMay last a few seconds to several hoursConcussion is less serious than a contusion

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Trauma

Concussions and ContusionsContusion is bruising of the brain Outcomes:

○ Can lead to a hematoma○ Increased intracranial pressure (ICP)○ Permanent brain damage

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Trauma

Concussions and ContusionsDiagnosis

○ History of injury○ Neurologic examination○ Cranial X-ray○ CT and MRI

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Trauma

Concussions and ContusionsTreatment

○ Bedrest and direct observation○ Individual should be checked every 2 to 4

hours ○ Monitor changes in consciousness, eye pupil

size, mood, and behavior

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Trauma

Concussion and ContusionsTreatment

○ Analgesics, stimulants, and sedatives should not be given to individuals with a head injury

○ Medications may mask the symptoms and make assessment difficult

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Trauma

Skull FractureGreatest danger is brain tissue damage

from bony fragments Potential of cutting brain, severing a vessel,

and causing a hematomaBrain damage may be temporary or

permanent

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Trauma

Skull FractureFracture near base of skull may injure

respiratory center and impair breathingInfection of brain tissue may be a problem

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Trauma

Skull FractureTreatment

○ Dependent on type and position of fracture○ Craniotomy may be necessary to relieve ICP○ Protective headgear may be necessary until

fracture is healed

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Trauma

Epidural and Subdural HematomaBlood vessels rupture and hemorrhageBlood seeps between bony skull and outer

meninges Pushes dura mater away from inner bony

skull

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Trauma

Epidural and Subdural HematomaEpidural Hematoma symptoms

○ Headache○ Dilated pupils○ Nausea, vomiting, and dizziness

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Trauma

Epidural and Subdural HematomaSubdural Hematoma

○ Usually the result of head hitting a stationary object

Blood collects between the dura mater and arachnoid layer

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Trauma

Epidural and Subdural HematomaSubdural Hematoma

○ Develops slowly over period of daysSymptoms

○ Hemiparesis○ Nausea, vomiting, dizziness○ Convulsions and loss of consciousness

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Trauma

Epidural and Subdural HematomaDiagnosis

○ Clinical history○ Cranial X-ray, CT or MRI

Treatment○ Decrease intracranial pressure○ Craniotomy called “bur holes”

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Spinal Cord Injury—Quadriplegia and Paraplegia

Injury to spinal cordResults in varying degrees of loss of

movementResults in varying degrees of loss of feeling

below the area of injury

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QuadriplegiaLoss of movement and feeling in the trunk

and all four extremities Loss of bowel, bladder, and sexual function

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ParaplegiaLoss of movement and feeling in trunk and

both legsLoss of bladder, bowel, and sexual function

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Emergency treatmentImmediate treatment is necessaryDo not move the victim unless surroundings

are unsafeMaintain position of spine with special

collars and backboards

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DiagnosisHistory of injuryNeurologic examSpinal X-rays, MRI, and CAT scan

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TreatmentRealignment and stabilization of the bony

spinal column Decompression or release of pressure on

spinal cordPrevent further injury

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Rare Diseases

Amyotrophic Lateral Sclerosis (ALS)“Lou Gehrig’s” diseaseDestructive disease of motor or movement

neurons

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Rare Diseases

Amyotrophic Lateral Sclerosis (ALS)Atrophy of muscles leading to progressive

loss of movement of hands, arms, and legsTreatment is supportive No cure

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Rare Diseases

Guillian-Barré SyndromeAcute, progressive disease affecting the

spinal nervesBegins 10 to 21 days after febrile illness

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Rare Diseases

Guillian-Barré SyndromeEarly symptoms include nausea, fever, and

malaiseWithin 24 to 72 hours paresthesia, muscle

weakness, and paralysis usually begins

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Rare Diseases

Guillian-Barré SyndromeSymptoms may progress for several days to

weeksOnce progression ceases, recovery beginsTreatment is supportiveRecovery is usually complete

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Rare Diseases

Huntington’s ChoreaInherited diseaseAppears during middle ageProgressive degenerative disease of brain

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Rare Diseases

Huntington’s ChoreaLoss of muscle control and choreaLeads to mental deteriorationPersonality change, moody behavior, loss of

memory, dementiaTreatment is supportiveNo cure

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Rare Diseases

Multiple Sclerosis (MS)Causes:

○ Demyelination of the nerves of the CNS ○ Allows information to “leak” from the nerve

pathway ○ Leads to poor or absent nerve transmission

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Rare Diseases

Multiple Sclerosis (MS)Symptoms:

○ Muscle weakness and lack of coordination○ Paresthesia○ Speech difficulty○ Loss of bladder function○ Visual disturbance especially diplopia

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Rare Diseases

Multiple SclerosisAffects adults between ages 20 and 40Periods of remission and exacerbationTreatment

○ Physical therapy○ Muscle relaxants in order to maintain muscle

tone and reduce spastic movement

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Rare Diseases

Parkinson’s DiseaseSlow, progressive brain degenerationDevelops between ages 50 and 60

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Rare Diseases

Parkinson’s Disease Classic symptoms

Rigidity and immobility of handVery slow speech pattern“Pill rolling” motion of fingersExpressionless facial appearance

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Rare Diseases

Parkinson’s DiseaseSymptomsAbnormal “bent forward” postureShort, fast-running steps, shuffling

appearance

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Rare Diseases

Parkinson’s DiseaseTreatment

○ Symptomatic○ Dopamine replacement○ Physical and psychological therapy

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Documents

Anatomy and Physiology Nervous system: brain, spinal cord, nerves Central Nervous System (CNS) and Peripheral Nervous System (PNS) CNS: brain and