st110 concorde career college, portland. define the term nerve. identify the divisions of the...
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ST110Concorde Career College,
Portland
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Define the term nerve. Identify the divisions of the nervous
system. Describe the functions of the nervous
system.
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List and identify the structures of the nervous system and describe the function of each.
Identify the types of nervous tissue. Understand the physiology of a nerve
impulse.
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Describe the mechanism by which the nervous system helps to maintain homeostasis.
Describe common diseases, disorders, and conditions of the nervous system including signs and symptoms, diagnosis, and available treatment options.
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Demonstrate knowledge of medical terminology related to the nervous system verbally and in the written form.
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A nerve is a bundle or a group of bundles of nerve fibers outside the central nervous system which connects the brain and spinal cord with the various parts of the body.
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Brain and spinal cord Control center for the whole system All body sensations and changes in
the environment are relayed to the CNS
All responses are generated by the CNS
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All the nerves that connect the brain and spinal cord with sensory receptors, muscles and glands• Afferent or sensory neurons
Convey information from the outside of the nervous system to the brain and spinal cord
• Efferent or motor neurons Convey information from the brain and spinal
cord to muscles, organs, and glands
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12 pairs Need to know
• Name• Number• Function• Type (sensory, motor, or mixed)
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First (I) Cranial NerveOlfactory
Sensory Carries smell impulses from receptors
in the nasal mucosa to the brain
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Second (II) Cranial NerveOptic
Sensory Carries visual impulses from the eye
to the brain
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Third (III) Cranial NerveOculomotor
Mostly motor; partly sensory Movement of the eyeball, eyelid, and
pupil constriction (motor) Proprioception (sensory)
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Fourth (IV) Cranial NerveTrochlear
Mostly motor; partly sensory Movement of the eyeball - superior
oblique (motor) Proprioception (sensory)
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Fifth (V) Cranial NerveTrigeminal
Mixed Three divisions1. Ophthalmic - Skin sensation above the orbit
(sensory)2. Maxillary - Skin sensation from orbit to mouth
(sensory)3. Mandibular - Sensation of the anterior tongue,
lower teeth, and cheek (sensory) and chewing (motor)
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Sixth (VI) Cranial NerveAbducens
Mostly motor; partly sensory Movement of the eyeball - lateral
rectus (motor) Proprioception (sensory)
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Seventh (VII) Cranial NerveFacial
Mixed Proprioception and taste (sensory) Facial expression, tear and saliva
production (motor)
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Eighth (VIII) Cranial NerveVestibulocochlear
Sensory Hearing and balance Also known as the auditory or
acoustic nerve
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Ninth (IX) Cranial NerveGlossopharyngeal
Mixed Blood pressure regulation, taste,
proprioception (sensory) Saliva production (motor)
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Tenth (X) Cranial NerveVagus
Mixed Visceral sensation and proprioception
(sensory) Smooth muscle contraction/relaxation
and production of digestive fluids Longest cranial nerve “wanderer”
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Eleventh (XI) Cranial Nerve(Spinal) Accessory
Mostly motor; partly sensory Proprioception (sensory) Swallowing and movement of the
head and neck (motor)
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Twelfth (XII) Cranial NerveHypoglossal
Mostly motor; partly sensory Proprioception (sensory) Movement of the tongue (motor)
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http://www.wisc-online.com/objects/ViewObject.aspx?ID=NUR5104
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Conducts impulses from the brain and spinal cord to skeletal muscle
Sensory and motor neurons
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ANS
Internal organ control via glands, smooth and cardiac muscle
Maintenance of HB rate, breathing, blood flow
Sympathetic Parasympathetic
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Conducts impulses from the brain and spinal cord to smooth and cardiac muscle tissue
Involuntary• Sympathetic Division (emergency
situations, stress, emotions) Stimulates or speeds up activity Epinephrine/norepinephrine
• Parasympathetic Division Slows down many activities Adrenocortical hormone (ACH)
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The nervous system acts as the “Control Center” by directing functions of the body’s organs.
1. Receive stimuli (internal or external)
2. Interpret stimuli3. Reacts to stimuli
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Nerve Cells or Neurons Functional cells of the nervous
system Transmit information via impulses
• Dendrites conduct impulses to the cell body• Axons conduct impulses away from the cell
body Nerve
• Bundle (fascicle) of nerve cells
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Cytoplasmic extentions - Dendrite: receives information Cells may have several, one or none Typically short and branched
Axon: Transmits impulses away Cell has only one Long Surrounded by a thin wrapping of fiberous
connective tissue called endoneuriumBranch at their ends – Axon Terminals
Make contact with dendrites of other neurons
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Neuron Classification
Multipolar• Several dendrites and one axon• Schwann cells (neurolemmocytes) surround the
axon to form myelin sheath• Nodes of Ranvier
Bipolar Neurons• One dendrite and one axon
Unipolar Neurons• Axon extends directly from the cell body
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Sensory (afferent) neurons• Receive first impulses from receptors• Unipolar• Impulse is conducted toward brain or spinal
cord Internuncial (association) neurons
• Multipolar• Brain and spinal cord• Transmit impulses to appropriate area
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Motor (efferent)• Final nerve cell• Multipolar• Impulse is conducted away from brain or
spinal cord• Brings reaction to stimulus
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Myelin= A soft, white, fatty material wrapped around the membrane of Schwann cells, the substance of the myelin sheath.
Neurilemma=outer cover Insulating material that covers axon of neuron
Similar to plastic around electrical wire Gives nerves there white appearance
Made up of Schwann Cells (neurolemmocytes) Nodes of Ranvier: Gaps on myelin sheath
Gaps allow substances (needed for energy) to flow from extracellular fluid to axons
Capable of regeneration. Not found in brain or spinal cord.
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Insulate, support, and protect neurons Do not conduct nerve impulses
Schwann CellsAstrocytes:
Star shaped Glial cells that attach to small blood vessels to form
the BBBOligodendrocytes:
Support • Produce fatty sheath of myelin that protects many
neurons of the central nervous systemMicroglial cells:
Protect neurons (phagocytosis)Ependymal Cells:
Line ventricles and produce CSF
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Area between the terminal branches of an Axon and the ends of a branched Dendrite
Synapse= where impulses are transmitted from one neuron to another
Axons and Dendrites never actually touch. Nerve signals “jump” the space between the two called the synaptic cleft (space between the synaptic knob and the plasma membrane of the postsynaptic neuron)
How do nerve signals jump? Neurotransmitters
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Neurotransmitters: chemical messengers, found in synaptic knobs• Acetycholine • Epinephrine (autonomic)• Dopamine • Seratonin • Endorphins (function as natural pain killers)• Enkephalins
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Involuntary reaction Reflex Arc
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Involuntary reaction to an external response
Two neuron and three neuron arcs
Only allow impulse conduction in one direction
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The dendrites of the sensory neuron pick up a signal and send it to the cell body in the ganglion.
The axon of the sensory neuron travels from the cell body and ends near the dendrites of a motor neuron.
The signal jumps the synapse and is sent down the dendrites to the cell body and to the axon of the motor neuron to the “effectors” organ
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3 Neuron Reflex
The sensory neuron’s axon synapses with the dendrites of the interneuron
The signal is sent down the interneuron to the dendrites of the motor neuron
The “withdrawal” reflex occurs
All interneurons lie within the gray matter of the brain and spinal cord
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White Matter• Myelinated axons
Gray Matter• Nerve cell bodies and dendrites
CNS• Nuclei• Tracts
PNS• Ganglia• Nerves
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White and Gray Matter
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A group of peripheral nerve fibers/one or more bundles of neurons
Each axon is surrounded by endoneurium
Wrapped axons are grouped fascicles
Fascicles are surround by perineurium
The whole nerve is covered by epineurium
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A self-propagating wave of electrical disturbance
Must be initiated by a stimulus
Resting neurons have a slight positive charge on the outside and a slight negative charge on the inside
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When the membrane is stimulated, sodium rushes in causing a reverse of the charges
If the membrane is covered in myelin, the impulse jumps in what is called saltatory conduction
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Resting or membrane potential• Na (sodium) ions greater outside• K (potassium) ions greater inside• Cl (chlorine)
Depolarization or action potential Repolarization (return to resting
state) All-or-none law
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Watch the Animation
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Brainstem• Medulla oblongata• Pons Varolii• Midbrain
Diencephalon• Thalamus• Hypothalamus
Cerebrum Cerebellum
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Ventricles (4) Cerebrospinal fluid (CSF)
• Choroid Plexus Meninges (coverings)
• Dura mater (outermost)• Arachnoid mater (middle)• Pia mater (innermost)
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Protective tissues that surround the brain and spinal cord
Subarachniod space contains cerebrospinal fluid
Dura (outermost)Tough fibrous connective tissue Does not attach directly to the vertebrae. Space
between vertebra and dura is termed Epidural spaceArachnoid
Thin, weblike Pia (innermost)
Space between the arachnoid and pia layers is termed the subarachnoid space
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Medulla oblongata• Connects brain to spinal cord• Ascending and descending tracts• Decussation (crossing) of pyramids• Reticular formation
Consciousness and arousal• Reflex centers
Vasomotor center Cardiac center Medullary rhymicity area
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Pons Varolii• Connects spinal cord with the brain• Help control breathing
Midbrain (mesencephalon)• Ventral Cerebral peduncles
Convey impulses to the pons and spinal cord Visual and auditory responses
• Dorsal tectum Controls the movement of the eyeballs and head
in response to visual stimuli
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Between two cerebral hemispheres Thalamus
• Main relay station for sensory impulses to cerebral cortex from spinal cord
• Interpretation center for pain recognition Hypothalamus
• Homeostasis• Controls ANS• Controls pituitary• Mind control, rage, thirst, maintains waking
state, sleep, food intake
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Bulk of the brain Cerebral Cortex Cerebral Hemispheres
• Longitudinal fissure• Gyri (prominence)• Sulci (groove or furrow)• Corpus callosum (commissure of nerve
fibers between hemispheres)
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Right Hemisphere: • Nonverbal, intuitive behaviors
Left Hemisphere:• Speech, computational, analytical skills • The two hemispheres are connected at the
lower midpoint by the corpus callosum
What hemisphere dominates you?
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Frontal lobe• Anterior, controls voluntary muscle
functions, moods, aggression, smell reception and motivation
Parietal lobe• Behind frontal behind central sulcus• Evaluates sensory info of touch, pain,
balance, taste, and temperature
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Temporal lobe• Beneath frontal and parietal separated by
lateral fissure• Evaluates hearing input and smell • Some memory processes• Abstract thoughts and judgment decisions
Occipital lobe• Back portion• Receives and interprets visual input
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Beneath the occipital lobes and behind the pons and medulla
Coordinates complex skeletal muscle movements, maintains body posture, body balance
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Optic Tracts and Optic Chiasma• Nerves cross• Pituitary Gland and mamillary bodies
Memory and emotional response to odor• Pineal gland
Affects moods and behavior
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Carotid artery
Anterior cerebral artery
Middle cerebral artery
Median anterior spinal artery
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Circle of Willis
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Smell (Olfaction) Taste
• Tongue anatomy Sight
• Eye anatomy Hearing and Equilibrium
• Inner and outer ear
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Drug Use• Depressants
Valium Codeine Heroine Marijuana Hashish
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Stimulants• Cocaine• LSD• Amphetamines
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Alzheimer’s disease Amyotrophic lateral sclerosis Anencephaly Bell’s palsy Brain abscess Carpal tunnel syndrome
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Amyotrophic Lateral
Sclerosis (ALS)
Lou Gehrig Disease
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Lack of brain except for a rudimentary brainstem and absence of overlying skull.
Due to a failure of closure of the anterior neural tube - a neural tube defect.
These infants rarely live past a month of age. May be candidates for organ donation.
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Cerebral contusion Cerebral palsy Cerebrovascular accident Concussion Degenerative disk disease Encephalitis Epilepsy
• Grand mal seizure• Petit mal seizure
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coup/contrecoup (acceleration/ deceleration)
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MRI of a brain with the area of a “bleed” visible in the lower right
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Guillain-Barré syndrome Cephalalgia Migraine headache Cluster headache Tension headache Hematoma
• Epidural• subdural
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Acute inflammatory demyelinating polyneuropathy
Rapid onset of weakness and, often, paralysis of the legs, arms, breathing muscles and face (may require the use of a ventilator)
The majority of patients eventually return to a normal or near normal lifestyle
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Herniated Disk Huntington’s chorea Hydrocephalus Intracranial tumors Primary intracranial tumors
• Gliomas Metastatic intracranial tumors
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Often appears as facial twitching or as twitching and writhing of the distal extremities (choreic movements).
Fast eye movements are impaired. As HD disease progresses, the movement disorder
becomes more generalized. Eventually, the patient's gait is impaired.
Rigidity and dystonia predominate in later stages of the disease in adults. In juvenile cases, rigidity and dystonia may appear as the initial symptoms.
Symptoms become worse with anxiety or stress. A mental status examination may reveal depression. Impaired cognitive abilities may be detected on
physical examination.
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MRI of brain - Tumor is visible in the upper left (frontal) region
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Meningitis Multiple Sclerosis Myasthenia gravis Neuroblastoma Parkinson’s Disease Peripheral neuritis Poliomyelitis
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Multiple Sclerosis (MS) Chronic disease of the central nervous system. Viral and autoimmune etiologies are postulated. Genetic
and environmental factors are known to contribute to MS, but a specific cause for this disease is not identified.
Pathologically, MS is characterized by the presence of areas of demyelination.
Early symptoms may include numbness and/or paresthesia, mono- or paraparesis, double vision, optic neuritis, ataxia (loss of balance), and bladder control
problems.
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Most common primary disorder of neuromuscular transmission.
Usual cause is an acquired immunological abnormality, but some cases result from genetic abnormalities at the neuromuscular junction.
Patients with myasthenia gravis come to the physician complaining of specific muscle weakness and not of generalized fatigue. Ocular motor disturbances, ptosis or diplopia, are the initial symptom of myasthenia gravis in two-thirds of patients; almost all had both symptoms within 2 years. Oropharyngeal muscle weakness, difficulty chewing, swallowing, or talking, is the initial symptom in one-sixth of patients, and limb weakness in only 10%. Initial weakness is rarely limited to single muscle groups such as neck or finger extensors or hip flexors.
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Motor system disorder that results in the loss of dopamine-producing brain cells. Dopamine is a chemical messenger responsible for transmitting signals within the brain.
Occurs when certain nerve cells, or neurons, die or become impaired. Normally, these neurons produce dopamine. Loss of dopamine causes the nerve cells to fire out of control, leaving patients unable to direct or control their movement in a normal manner.
Four primary symptoms of Parkinson's are tremor or trembling in hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability or impaired balance and coordination. Patients may also have difficulty walking, talking, or completing other simple tasks.
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Poliomyelitis is an acute viral infection that involves the gastrointestinal tract and, occasionally, the central nervous system.
It is acquired by fecal-oral transmission. Clinical manifestations of poliovirus
infection range from asymptomatic (the majority of infections) to symptomatic, including acute flaccid paralysis of a single limb to quadriplegia, respiratory failure, and, rarely, death.
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Reye’s Syndrome Spina bifida cystica Meningocele Meningomyelocele Spina bifida occulta Spinal cord injuries
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Involves brain damage (encephalopathy) and liver damage of an unknown cause. It is associated with the use of aspirin in children to treat chickenpox or influenza.
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Paraplegia Quadriplegia Tay-Sachs Disease Trigeminal neuralgia
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Fatal genetic disorder in children of European Jewish origin that causes progressive destruction of the central nervous system.
Caused by the absence of a vital enzyme called hexosaminidase A (Hex-A). Without Hex-A, a fatty substance or lipid called GM2 ganglioside accumulates abnormally in cells, especially in the nerve cells of the brain. This ongoing accumulation causes progressive damage to the cells. The destructive process begins in the fetus early in pregnancy, although the disease is not clinically apparent until the child is several months old. Children with TSD die early in childhood, usually by the age of five.