Neurological Disturbances<br />Ma. Tosca Cybil A. Torres, RN, MAN <br />
Review of Anatomy and Physiology <br />
Functions of the Nervous System<br />1. Sensory input – gathering information<br /><ul><li>To monitor changes occurring in...
The response activates muscles or glands</li></li></ul><li>Structural Classification of the Nervous System<br /><ul><li>Ce...
Brain
Spinal cord
Peripheral nervous system (PNS)
Nerve outside the brain and spinal cord</li></li></ul><li>Functional Classification of the Peripheral Nervous System<br />...
Nerve fibers that carry information to the central nervous system</li></li></ul><li>Functional Classification of the Perip...
Two subdivisions
Somatic nervous system = voluntary
Autonomic nervous system = involuntary</li></li></ul><li>Organization of the Nervous System<br />
Nervous Tissue: Support Cells (Neuroglia or Glia)<br /><ul><li>Astrocytes
Abundant, star-shaped cells
Brace neurons
Form barrier between capillaries and neurons
Control the chemical environment of the brain (CNS)</li></li></ul><li>Nervous Tissue: Support Cells<br /><ul><li>Microglia...
Spider-like phagocytes
Dispose of debris
Ependymal cells (CNS)
Line cavities of the brain and spinal cord
Circulate cerebrospinal fluid</li></li></ul><li>Nervous Tissue: Support Cells<br /><ul><li>Oligodendrocytes(CNS)
Produce myelin sheath around nerve fibers in the central nervous system</li></li></ul><li>Neuroglia vs. Neurons<br />Neuro...
Support Cells  of the PNS<br /><ul><li>Satellite cells
Protect neuron cell bodies
Schwann cells
Form myelin sheath in the peripheral nervous system</li></ul>Figure 7.3e<br />
Nervous Tissue: Neurons<br /><ul><li>Neurons = nerve cells
Cells specialized to transmit messages
Major regions of neurons
Cell body – nucleus and metabolic center of the cell
Processes – fibers that extend from the cell body (dendrites and axons)</li></li></ul><li>Neuron Anatomy<br /><ul><li>Cell...
Nucleus
Large nucleolus</li></ul>Figure 7.4a<br />Slide 7.9b<br />
Neuron Anatomy<br /><ul><li>Extensions outside the cell body
Dendrites – conduct impulses toward the cell body
Axons – conduct impulses away from the cell body</li></ul>Figure 7.4a<br />Slide 7.10<br />
Axons and Nerve Impulses<br /><ul><li>Axons end in axonal terminals
Axonal terminals contain vesicles with neurotransmitters
Axonal terminals are separated from the next neuron by a gap
Synaptic cleft – gap between adjacent neurons
Synapse – junction between nerves</li></li></ul><li>
Nerve Fiber Coverings<br /><ul><li>Schwann cells – produce myelin sheaths in jelly-roll like fashion
Nodes of Ranvier – gaps in myelin sheath along the axon</li></ul>Figure 7.5<br />Slide 7.12<br />
Functional Classification of Neurons<br /><ul><li>Sensory (afferent) neurons
Carry impulses from the sensory receptors
Cutaneous sense organs
Proprioceptors – detect stretch or tension
Motor (efferent) neurons
Carry impulses from the central nervous system</li></li></ul><li>Functional Classification of Neurons<br /><ul><li>Interne...
Found in neural pathways in the central nervous system
Connect sensory and motor neurons</li></li></ul><li>Neuron Classification<br />
How Neurons Communicate at Synapses<br />Figure 7.10<br />
The Reflex Arc<br /><ul><li>Reflex – rapid, predictable, and involuntary responses to stimuli
Reflex arc – direct route from a sensory neuron, to an interneuron, to an effector</li></li></ul><li>Simple Reflex Arc<br ...
Types of Reflexes and Regulation<br /><ul><li>Autonomic reflexes
Somatic reflexes</li></li></ul><li>Central Nervous System (CNS)<br /><ul><li>CNS develops from the embryonic neural tube
The neural tube becomes the brain and spinal cord
The opening of the neural tube becomes the ventricles
Four chambers within the brain
Filled with cerebrospinal fluid</li></li></ul><li>Regions of the Brain<br /><ul><li>Cerebral hemispheres
Diencephalon
Brain stem
Cerebellum</li></li></ul><li>Lobes of the Brain<br />Parietal lobe<br />Frontal lobe<br />Occipital lobe<br />Temporal lob...
Functional areas of the brain<br />Motor<br />function<br />area<br />Motor<br />function<br />area<br />Sensory<br />area...
Layers of the Cerebrum<br /><ul><li>Gray matter
Outer layer
Composed mostly of neuron cell bodies</li></ul>Figure 7.13a<br />
Layers of the Cerebrum<br /><ul><li>White matter
Fiber tracts inside the gray matter
Example: corpus callosum connects hemispheres</li></ul>Figure 7.13a<br />
Diencephalon<br /><ul><li>Sits on top of the brain stem
Enclosed by the cerebral hemispheres
Made of three parts
Thalamus
Hypothalamus
Epithalamus</li></li></ul><li>Diencephalon<br />Figure 7.15<br />
Thalamus<br /><ul><li>Surrounds the third ventricle
The relay station for sensory impulses
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Nervous System-Review

  1. 1. Neurological Disturbances<br />Ma. Tosca Cybil A. Torres, RN, MAN <br />
  2. 2. Review of Anatomy and Physiology <br />
  3. 3. Functions of the Nervous System<br />1. Sensory input – gathering information<br /><ul><li>To monitor changes occurring inside and outside the body (changes = stimuli)</li></ul>2. Integration –<br /><ul><li>to process and interpret sensory input and decide if action is needed.</li></ul>3. Motor output<br /><ul><li>A response to integrated stimuli
  4. 4. The response activates muscles or glands</li></li></ul><li>Structural Classification of the Nervous System<br /><ul><li>Central nervous system (CNS)
  5. 5. Brain
  6. 6. Spinal cord
  7. 7. Peripheral nervous system (PNS)
  8. 8. Nerve outside the brain and spinal cord</li></li></ul><li>Functional Classification of the Peripheral Nervous System<br /><ul><li>Sensory (afferent) division
  9. 9. Nerve fibers that carry information to the central nervous system</li></li></ul><li>Functional Classification of the Peripheral Nervous System<br /><ul><li>Motor (efferent) division
  10. 10. Two subdivisions
  11. 11. Somatic nervous system = voluntary
  12. 12. Autonomic nervous system = involuntary</li></li></ul><li>Organization of the Nervous System<br />
  13. 13. Nervous Tissue: Support Cells (Neuroglia or Glia)<br /><ul><li>Astrocytes
  14. 14. Abundant, star-shaped cells
  15. 15. Brace neurons
  16. 16. Form barrier between capillaries and neurons
  17. 17. Control the chemical environment of the brain (CNS)</li></li></ul><li>Nervous Tissue: Support Cells<br /><ul><li>Microglia (CNS)
  18. 18. Spider-like phagocytes
  19. 19. Dispose of debris
  20. 20. Ependymal cells (CNS)
  21. 21. Line cavities of the brain and spinal cord
  22. 22. Circulate cerebrospinal fluid</li></li></ul><li>Nervous Tissue: Support Cells<br /><ul><li>Oligodendrocytes(CNS)
  23. 23. Produce myelin sheath around nerve fibers in the central nervous system</li></li></ul><li>Neuroglia vs. Neurons<br />Neuroglia divide.<br />Neurons do not.<br />Most brain tumors are “gliomas.”<br />Most brain tumors involve the neuroglia cells, not the neurons.<br />Consider the role of cell division in cancer!<br />
  24. 24. Support Cells of the PNS<br /><ul><li>Satellite cells
  25. 25. Protect neuron cell bodies
  26. 26. Schwann cells
  27. 27. Form myelin sheath in the peripheral nervous system</li></ul>Figure 7.3e<br />
  28. 28. Nervous Tissue: Neurons<br /><ul><li>Neurons = nerve cells
  29. 29. Cells specialized to transmit messages
  30. 30. Major regions of neurons
  31. 31. Cell body – nucleus and metabolic center of the cell
  32. 32. Processes – fibers that extend from the cell body (dendrites and axons)</li></li></ul><li>Neuron Anatomy<br /><ul><li>Cell body
  33. 33. Nucleus
  34. 34. Large nucleolus</li></ul>Figure 7.4a<br />Slide 7.9b<br />
  35. 35. Neuron Anatomy<br /><ul><li>Extensions outside the cell body
  36. 36. Dendrites – conduct impulses toward the cell body
  37. 37. Axons – conduct impulses away from the cell body</li></ul>Figure 7.4a<br />Slide 7.10<br />
  38. 38. Axons and Nerve Impulses<br /><ul><li>Axons end in axonal terminals
  39. 39. Axonal terminals contain vesicles with neurotransmitters
  40. 40. Axonal terminals are separated from the next neuron by a gap
  41. 41. Synaptic cleft – gap between adjacent neurons
  42. 42. Synapse – junction between nerves</li></li></ul><li>
  43. 43. Nerve Fiber Coverings<br /><ul><li>Schwann cells – produce myelin sheaths in jelly-roll like fashion
  44. 44. Nodes of Ranvier – gaps in myelin sheath along the axon</li></ul>Figure 7.5<br />Slide 7.12<br />
  45. 45. Functional Classification of Neurons<br /><ul><li>Sensory (afferent) neurons
  46. 46. Carry impulses from the sensory receptors
  47. 47. Cutaneous sense organs
  48. 48. Proprioceptors – detect stretch or tension
  49. 49. Motor (efferent) neurons
  50. 50. Carry impulses from the central nervous system</li></li></ul><li>Functional Classification of Neurons<br /><ul><li>Interneurons (association neurons)
  51. 51. Found in neural pathways in the central nervous system
  52. 52. Connect sensory and motor neurons</li></li></ul><li>Neuron Classification<br />
  53. 53. How Neurons Communicate at Synapses<br />Figure 7.10<br />
  54. 54. The Reflex Arc<br /><ul><li>Reflex – rapid, predictable, and involuntary responses to stimuli
  55. 55. Reflex arc – direct route from a sensory neuron, to an interneuron, to an effector</li></li></ul><li>Simple Reflex Arc<br />Slide 7.24<br />
  56. 56. Types of Reflexes and Regulation<br /><ul><li>Autonomic reflexes
  57. 57. Somatic reflexes</li></li></ul><li>Central Nervous System (CNS)<br /><ul><li>CNS develops from the embryonic neural tube
  58. 58. The neural tube becomes the brain and spinal cord
  59. 59. The opening of the neural tube becomes the ventricles
  60. 60. Four chambers within the brain
  61. 61. Filled with cerebrospinal fluid</li></li></ul><li>Regions of the Brain<br /><ul><li>Cerebral hemispheres
  62. 62. Diencephalon
  63. 63. Brain stem
  64. 64. Cerebellum</li></li></ul><li>Lobes of the Brain<br />Parietal lobe<br />Frontal lobe<br />Occipital lobe<br />Temporal lobe<br />
  65. 65. Functional areas of the brain<br />Motor<br />function<br />area<br />Motor<br />function<br />area<br />Sensory<br />area<br />Broca’s area<br />Somatosensory<br />Association<br />area<br />Auditory area<br />Higher<br />mental<br />functions<br />Visual area<br />Association area<br />Wernicke’s area<br />
  66. 66. Layers of the Cerebrum<br /><ul><li>Gray matter
  67. 67. Outer layer
  68. 68. Composed mostly of neuron cell bodies</li></ul>Figure 7.13a<br />
  69. 69. Layers of the Cerebrum<br /><ul><li>White matter
  70. 70. Fiber tracts inside the gray matter
  71. 71. Example: corpus callosum connects hemispheres</li></ul>Figure 7.13a<br />
  72. 72. Diencephalon<br /><ul><li>Sits on top of the brain stem
  73. 73. Enclosed by the cerebral hemispheres
  74. 74. Made of three parts
  75. 75. Thalamus
  76. 76. Hypothalamus
  77. 77. Epithalamus</li></li></ul><li>Diencephalon<br />Figure 7.15<br />
  78. 78. Thalamus<br /><ul><li>Surrounds the third ventricle
  79. 79. The relay station for sensory impulses
  80. 80. Transfers impulses to the correct part of the cortex for localization and interpretation</li></li></ul><li>Hypothalamus<br /><ul><li>Under the thalamus
  81. 81. Important autonomic nervous system center
  82. 82. Helps regulate body temperature
  83. 83. Controls water balance
  84. 84. Regulates metabolism</li></li></ul><li>Hypothalamus<br /><ul><li>An important part of the limbic system (emotions)
  85. 85. The pituitary gland is attached to the hypothalamus</li></li></ul><li>Epithalamus<br /><ul><li>Forms the roof of the third ventricle
  86. 86. Houses the pineal body (an endocrine gland)
  87. 87. Includes the choroid plexus</li></li></ul><li>Brain Stem<br /><ul><li>Attaches to the spinal cord
  88. 88. Parts of the brain stem
  89. 89. Midbrain
  90. 90. Pons
  91. 91. Medulla oblongata</li></li></ul><li>Brain Stem<br />Cortex<br />Corpus callosum<br />3rd ventricle<br />Septum pellucidum<br />Thalamus<br />Fornix<br />Hypothalamus<br />Optic chiasma<br />Hypophysis<br />Cerebellum<br />4th ventricle<br />Brain stem<br />Spinal cord<br />
  92. 92. Brainstem<br />
  93. 93. Midbrain<br /><ul><li>Mostly composed of tracts of nerve fibers
  94. 94. Reflex centers for vision and hearing
  95. 95. Cerebral aquaduct – 3rd-4th ventricles</li></li></ul><li>Pons<br /><ul><li>The bulging center part of the brain stem
  96. 96. Mostly composed of fiber tracts
  97. 97. Includes nuclei involved in the control of breathing</li></li></ul><li>Medulla Oblongata<br /><ul><li>The lowest part of the brain stem
  98. 98. Merges into the spinal cord
  99. 99. Includes important fiber tracts
  100. 100. Contains important control centers
  101. 101. Heart rate control
  102. 102. Blood pressure regulation
  103. 103. Breathing
  104. 104. Swallowing
  105. 105. Vomiting</li></li></ul><li>Cerebellum<br /><ul><li>Two hemispheres with convoluted surfaces
  106. 106. Provides involuntary coordination of body movements</li></li></ul><li>Protection of the Central Nervous System<br /><ul><li>Scalp and skin
  107. 107. Skull and vertebral column
  108. 108. Meninges</li></li></ul><li>Protection of the Central Nervous System<br /><ul><li>Cerebrospinal fluid
  109. 109. Blood brain barrier</li></li></ul><li>Meninges<br />Skin<br />Bone<br />Dura mater<br />Arachnoid<br />Pia mater<br />Cerebral cortex<br />
  110. 110. Meninges<br /><ul><li>Dura mater
  111. 111. Double-layered external covering
  112. 112. Periosteum – attached to surface of the skull
  113. 113. Meningeal layer – outer covering of the brain
  114. 114. Folds inward in several areas</li></li></ul><li>Meninges<br /><ul><li>Arachnoid layer
  115. 115. Middle layer
  116. 116. Web-like
  117. 117. Pia mater
  118. 118. Internal layer
  119. 119. Clings to the surface of the brain</li></li></ul><li>Cerebrospinal Fluid<br /><ul><li>Similar to blood plasma composition
  120. 120. Formed by the choroid plexus
  121. 121. Forms a watery cushion to protect the brain
  122. 122. Circulated in arachnoid space, ventricles, and central canal of the spinal cord</li></li></ul><li>The CSF is composed of water, glucose, protein, and several ions, especially sodium ion (Na) and chloride ion. <br />Buoyancy- 1,500 g when removed, when suspended 50 g., it neither sinks nor floats<br />Protection from striking the cranium when jolted.<br />Transport of nutrients, chemical messages and removal of waste products.<br />Stability of chemical environment.- homeostatically regulates the env. Of the CNS neurons., slight change can cause malfunction<br />Clear, colorless liquid that fills and surrounds the CNS.<br />500 to 800 ml/day produced but 100 to 160 ml is present at one time.<br />
  123. 123. Ventricles and Location of the Cerebrospinal Fluid<br />Figure 7.17a<br />
  124. 124. Ventricles and Location of the Cerebrospinal Fluid<br />Figure 7.17b<br />
  125. 125.
  126. 126. Blood Brain Barrier<br /><ul><li>Includes the least permeable capillaries of the body
  127. 127. Excludes many potentially harmful substances
  128. 128. Useless against some substances
  129. 129. Fats and fat soluble molecules
  130. 130. Respiratory gases
  131. 131. Alcohol
  132. 132. Nicotine
  133. 133. Anesthesia</li></li></ul><li>Spinal Cord<br /><ul><li>Extends from the medulla oblongata to the region of T12
  134. 134. Below T12 is the caudaequina (a collection of spinal nerves)
  135. 135. Enlargements occur in the cervical and lumbar regions</li></li></ul><li>Spinal Cord Anatomy<br /><ul><li>Exterior white mater – conduction tracts</li></ul>Figure 7.19<br />
  136. 136. Spinal Cord Anatomy<br /><ul><li>Internal gray matter - mostly cell bodies
  137. 137. Dorsal (posterior) horns
  138. 138. Anterior (ventral) horns</li></ul>Figure 7.19<br />
  139. 139. Spinal Cord Anatomy<br /><ul><li>Central canal filled with cerebrospinal fluid</li></ul>Figure 7.19<br />
  140. 140. Spinal Cord Anatomy<br /><ul><li>Meninges cover the spinal cord
  141. 141. Nerves leave at the level of each vertebrae
  142. 142. Dorsal root
  143. 143. Associated with the dorsal root ganglia – collections of cell bodies outside the central nervous system
  144. 144. Ventral root</li></li></ul><li>Peripheral Nervous System<br /><ul><li>Nerves and ganglia outside the central nervous system
  145. 145. Nerve = bundle of neuron fibers
  146. 146. Neuron fibers are bundled by connective tissue</li></li></ul><li>CRANIAL NERVES<br />
  147. 147.
  148. 148.
  149. 149. Spinal Nerves<br /><ul><li>There is a pair of spinal nerves at the level of each vertebrae.</li></li></ul><li>Spinal Nerves<br />Figure 7.22a<br />
  150. 150.
  151. 151. C1<br />C2<br />C2<br />C3<br />C3<br />C4<br />C2<br />C5<br />C5<br />C3<br />C6<br />C6<br />C7<br />C4<br />C4<br />T1<br />T1<br />T2<br />T2<br />T3<br />T3<br />T2<br />T4<br />T4<br />T5<br />T3<br />T5<br />T6<br />C5<br />C5<br />T7<br />T4<br />C6<br />C6<br />T6<br />T8<br />T2<br />T2<br />T7<br />T9<br />T5<br />T10<br />T8<br />T11<br />T9<br />T12<br />T6<br />L1<br />T10<br />C6<br />C6<br />L2<br />T7<br />T1<br />T1<br />T11<br />L3<br />S1<br />T8<br />L1<br />T12<br />S2<br />S3<br />S4<br />T9<br />S2<br />L2<br />L2<br />S5<br />C8<br />C8<br />S1<br />C7<br />C7<br />C7<br />C7<br />T10<br />C8<br />C8<br />T11<br />L3<br />L3<br />T12<br />L1<br />L2<br />L3<br />S1<br />S1<br />L4<br />S2<br />S2<br />L4<br />L4<br />L5<br />L5<br />L5<br />S1<br />S2<br />S3<br />S4<br />S1<br />S1<br />S5<br />DERMATOMES<br />
  152. 152. Autonomic Nervous System<br /><ul><li>The involuntary branch of the nervous system
  153. 153. Consists of only motor nerves
  154. 154. Divided into two divisions
  155. 155. Sympathetic division
  156. 156. Parasympathetic division</li></li></ul><li>Comparison of Somatic and Autonomic Nervous Systems<br />
  157. 157. Autonomic Functioning<br /><ul><li>Sympathetic – “fight-or-flight”
  158. 158. Response to unusual stimulus
  159. 159. Takes over to increase activities
  160. 160. Remember as the “E” division = exercise, excitement, emergency, and embarrassment</li></li></ul><li>The neurotransmitter of the preganglionic sympathetic neurons is acetylcholine (ACh). It stimulates action potentials in the postganglionic neurons. <br />The neurotransmitter released by the postganglionic neurons is noradrenaline (also called norepinephrine). <br />
  161. 161. Sympatheticnervous system<br />T1<br />T2<br />T3<br />T4<br />T5<br />T6<br />T7<br />T8<br />T9<br />T10<br />T<br />1<br />1<br />T12<br />L1<br />L2<br />L3<br />Pupils<br />Salivary glands<br />Heart<br />Bronchi of lungs<br />Liver<br />Stomach<br />Small intestines<br />Adrenal gland<br />Large intestine<br />Kidney<br />Rectum<br />Bladder<br />Genitals<br />
  162. 162. Autonomic Functioning<br /><ul><li>Parasympathetic – housekeeping activites
  163. 163. Conserves energy
  164. 164. Maintains daily necessary body functions
  165. 165. Remember as the “D” division - digestion, defecation, and diuresis</li></li></ul><li>Parasympatheticnervoussystem<br />Pupils<br />Salivary glands<br />Heart<br />Bronchi of lungs<br />Liver<br />Stomach<br />Small intestines<br />Large intestine<br />Rectum<br />Bladder<br />Genitals<br />
  166. 166. Brainarteries<br />
  167. 167. Brainarteries<br />Circle of Willis<br />
  168. 168. Development Aspects of the Nervous System<br /><ul><li>The nervous system is formed during the first month of embryonic development
  169. 169. Any maternal infection can have extremely harmful effects
  170. 170. The hypothalamus is one of the last areas of the brain to develop</li></li></ul><li>Development Aspects of the Nervous System<br /><ul><li>No more neurons are formed after birth, but growth and maturation continues for several years (new evidence!)
  171. 171. The brain reaches maximum weight as a young adult
  172. 172. However, we can always grow dendrites!</li>
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