Transcript NERVOUS SYSTEM

Huntington’s Chorea
• Pronounced
– (HUNT-ing-tonz koh-REE-ah)
• Defined
– Inherited neurological disease characterized
by rapid, jerky, involuntary movements and
increased dementia
• Progressive, degenerative disease
1
Hydrocephalus
• Pronounced
– (high-droh-SEFF-ah-lus)
• Defined
– Abnormal increase of cerebrospinal fluid in
the brain that causes the ventricles of the
brain to dilate
• Results in increased head circumference in infant
with open fontanel
• Congenital disorder
2
Intracranial Tumors
• Pronounced
– (in-trah-KRAY-nee-al TOO-morz)
• Defined
– Tumors occurring in any structural region of
the brain
• May be malignant or benign
• Classified as primary or secondary
• Named according to the tissue from which they
originate
3
Primary Intracranial Tumors
• Pronounced
– (PRIGH-mah-ree in-trah-KRAY-nee-al TOOmorz)
• Defined
– Tumors that arise from gliomas and the
meninges
• Gliomas = malignant glial cells that are a support
for nerve tissue
4
Primary Intracranial Tumors
• Glioblastoma multiforme
– Most rapidly growing of the gliomas
• Astrocytomas
– Tend to invade surrounding structures
• Ependymomas
– Occur more commonly in children and
adolescents
– Usually encapsulated and benign
5
Metastatic Intracranial Tumors
(Secondary)
• Pronounced
– (met-ah-STAT-ik in-trah-KRAY-nee-al TOOmorz)
• Defined
– Tumors occurring as a result of metastasis
from a primary site such as the lung or breast
6
Meningitis
(Acute Bacterial)
• Pronounced
– (men-in-JYE-tis ah-KYOOT back-TEE-ree-al)
• Defined
– Serious bacterial infection of the meninges
• Can have residual debilitating effects or even a
fatal outcome
• Must be diagnosed and treated promptly with
appropriate antibiotic therapy
7
Multiple Sclerosis (MS)
• Pronounced
– (MULL-tih-pl SKLEH-roh-sis)
• Defined
– Degenerative inflammatory disease of the
central nervous system attacking the myelin
sheath in the spinal cord and brain
• Leaves area sclerosed (hardened) or scarred
8
Myasthenia Gravis
• Pronounced
– (my-ass-THEE-nee-ah GRAV-is)
• Defined
– Chronic progressive neuromuscular disorder
• Causes skeletal muscle weakness (without
atrophy) and fatigue
• Occurring at different levels of severity
9
Narcolepsy
• Pronounced
– (NAR-coh-lep-see)
• Defined
– Rare syndrome of uncontrolled, sudden
attacks of sleep
– Main features of narcolepsy are daytime
sleepiness and cataplexy
– Sudden loss of muscle tone
10
Neuroblastoma
• Pronounced
– (noo-roh-blass-TOH-mah)
• Defined
– Highly malignant tumor of the sympathetic
nervous system
• Most commonly occurs in the adrenal medulla with
early metastasis to liver, lungs, lymph nodes, and
bone
11
Parkinson’s Disease
• Pronounced
– (PARK-in-sons dih-ZEEZ)
• Defined
– Degenerative, slowly progressive
deterioration of nerves in the brain stem’s
motor system, characterized by a gradual
onset of symptoms
• Classic Symptoms: stooped posture with body
flexed forward, bowed head, shuffling gait, pillrolling gestures, expressionless mask-like facial
appearance
12
Peripheral Neuritis
• Pronounced
– (per-IF-er-al noo-RYE-tis)
• Defined
– Inflammation of one or more peripheral nerves
– Effects are dependent upon particular nerve
involved
13
Poliomyelitis
• Pronounced
– (poh-lee-oh-my-ell-EYE-tis)
• Defined
– Infectious viral disease that affects the ability
of spinal cord and brain motor neurons to
receive stimulation
• Virus enters through the upper respiratory tract
• Muscles affected become paralyzed without the
motor nerve stimulation
14
Post Polio Syndrome
• Pronounced
– (POST POH-lee-oh SIN-drom)
• Defined
– Progressive weakness occurring at least 30
years after the initial poliomyelitis attack
15
Reye’s Syndrome
• Pronounced
– (RISE SIN-drom)
• Defined
– Acute brain encephalopathy along with fatty
infiltration of the internal organs that may
follow acute viral infections
• Occurs in children under the age of 18; often with a
fatal result
• Linked to aspirin administration during a viral
illness
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Shingles (Herpes Zoster)
• Pronounced
– (SHING-lz) (HER-peez ZOSS-ter)
• Defined
– Acute viral infection characterized by
inflammation of the underlying spinal or
cranial nerve pathway producing painful,
vesicular eruptions on the skin along these
nerve pathways
• Seen mainly in adults
17
Shingles
Image courtesy of Robert A. Silverman,
M.D., Pediatric Dermatology,
Georgetown University
18
Skull Fracture (Depressed)
• Pronounced
– (SKULL FRAK-chur, deh-PREST)
• Defined
– Broken segment of the skull bone thrust into
the brain as a result of a direct force, usually a
blunt object
19
Spina Bifida Cystica
• Pronounced
– (SPY-nah BIFF-ih-dah SISS-tih-kah)
• Defined
– Back portion of one or more vertebrae is not
closed normally and a cyst protrudes through
the opening in the back, usually at the level of
the 5th lumbar or 1st sacral vertebrae
• Congenital defect of the CNS
20
Meningocele
• Pronounced
– (men-IN-goh-seel)
• Defined
– Cystlike sac covered with skin or a thin
membrane protruding through the bony defect
in the vertebrae containing meninges and
CSF
21
Meningomyelocele
• Pronounced
– (men-in-goh-my-ELL-oh-seel)
• Defined
– Cystlike sac covered with skin or a thin
membrane protruding through the bony defect
in the vertebrae that contains meninges, CSF,
and spinal cord segments
22
Spina Bifida Occulta
• Pronounced
– (SPY-nah BIFF-ih-dah oh-KULL-tah)
• Defined
– Congenital defect of the central nervous
system in which the back portion of one or
more vertebrae is not closed
• A dimpling over the area may occur
23
Paraplegia
• Pronounced
– (pair-ah-PLEE-jee-ah)
• Defined
– Paralysis of the lower extremities caused by
severe injury to the spinal cord in the thoracic
or lumbar region
– Results in loss of sensory and motor control
below the level of the injury
24
Quadriplegia
• Pronounced
– (kwod-rih-PLEE-jee-ah)
• Defined
– Paralysis of the trunk, legs, and pelvic organs
with partial or total paralysis in the upper
extremities caused by severe injury to the
spinal cord between the 5th and 8th cervical
vertebrae
• The higher the trauma, the more debilitating the
motor and sensory impairments
25
Tay-Sachs Disease
• Pronounced
– (TAY SACKS dih-ZEEZ)
• Defined
– Congenital disorder caused by altered lipid
metabolism, resulting from an enzyme
deficiency
• Accumulation of this type of lipid occurs in the
brain, leading to progressive neurological
deterioration with both physical and mental
retardation
26
Trigeminal Neuralgia
(Tic Douloureux)
• Pronounced
– (try-JEM-ih-nal noo-RAL-jee-ah),
– (tik DOO-loh-roo)
• Defined
– Short periods of severe unilateral pain which
radiates along the fifth cranial nerve
(trigeminal nerve)
• Heat, chewing, or touching of the affected area
activates the pain
27
DIAGNOSTIC TECHNIQUES,
TREATMENTS, AND
PROCEDURES
Nervous System
Diagnostic Techniques,
Treatments, and Procedures
• Babinski’s Reflex
– Reflex tested by stroking the sole of the foot,
beginning at mid-heel and moving upward
and lateral to the toes.
• Positive Babinski’s occurs when there is
dorsiflexion of the great toe and fanning of the
other toes
29
Diagnostic Techniques,
Treatments, and Procedures
• Brain scan
– Nuclear counter scanning of cranial contents
two hours after an intravenous injection of
radioisotopes
• Isotopes concentrate in abnormal tissue of brain,
indicating a pathological process
30
Diagnostic Techniques,
Treatments, and Procedures
• Cerebral Angiography
– Visualization of the cerebral vascular system
via x-ray after injection of a radiopaque
contrast medium into an arterial blood vessel
• May use carotid, femoral, or brachial artery
31
Diagnostic Techniques,
Treatments, and Procedures
• Cerebrospinal fluid analysis
– Laboratory analysis of cerebrospinal fluid
– Obtained from a lumbar puncture for the
presence of bacteria, blood, malignant cells,
and amount of protein and glucose present
32
Diagnostic Techniques,
Treatments, and Procedures
• CT scan of the brain
– Analysis of a three-dimensional view of brain
tissue obtained as X-ray beams pass through
successive horizontal layers of the brain
• CT = computerized tomography
• Images look down through the top of the head
33
Diagnostic Techniques,
Treatments, and Procedures
• Chordotomy
– Neurosurgical procedure for pain control
accomplished through a laminectomy
• Surgical interference of pathways within the spinal
cord that control pain
34
Diagnostic Techniques,
Treatments, and Procedures
• Cisternal puncture
– Insertion of a short, beveled spinal needle into
the cisterna magna in order to drain CSF or to
obtain a CSF specimen
• Cisterna magna = shallow reservoir of CSF
between the medulla and the cerebellum
35
Diagnostic Techniques,
Treatments, and Procedures
• Craniotomy
– Surgical procedure that makes an opening
into the skull
• Echoencephalography
– Measurement of electrical activity produced
by the brain and recorded through electrodes
placed on the scalp
36
Diagnostic Techniques,
Treatments, and Procedures
• Electroencephalography (EEG)
– Measurement of electrical activity in the brain
and recorded through electrodes
– Sleep-deprived EEG
• Individual deprived of sleep for 24 hours before test
– Ambulatory EEG
• Provides prolonged readings of electrical activity of
brain over a 24-hour period of time, while person is
awake or asleep
37
Diagnostic Techniques,
Treatments, and Procedures
• Laminectomy
– Surgical removal of the bony arches from one
or more vertebrae in order to relieve pressure
from the spinal cord
38
Diagnostic Techniques,
Treatments, and Procedures
• Electromyography (EMG)
– Process of recording electrical activity of
muscle
– Insert small needle into the muscle, deliver
small current that stimulates the muscle
39
Diagnostic Techniques,
Treatments, and Procedures
• Lumbar puncture
– Insertion of a hollow needle and stylet into
subarachnoid space between third and fourth
lumbar vertebrae below level of the spinal
cord
– Performed under strict aseptic technique
40
Diagnostic Techniques,
Treatments, and Procedures
• Magnetic Resonance Imaging (MRI)
– Noninvasive scanning procedure that provides
visualization of fluid, soft tissue, and bony
structures without the use of radiation
• Provides far more preciseness and accuracy than
most diagnostic tools
– Not limited to scans of the brain
• May also be used to examine the abdomen, chest,
joints, nervous system, pelvis, and spinal column
41
Diagnostic Techniques,
Treatments, and Procedures
• Myelography
– Introduction of contrast medium into the
lumbar subarachnoid space through a lumbar
puncture in order to visualize the spinal cord
and vertebral canal through x-ray examination
42
Diagnostic Techniques,
Treatments, and Procedures
• Neurectomy
– Neurosurgical procedure to relieve pain in a
localized or small area by incision of cranial or
peripheral nerves
• Pneumoencephalography
– Process used to radiographically visualize one
of the ventricles or fluid occupying spaces in
the central nervous system (CNS)
43
Diagnostic Techniques,
Treatments, and Procedures
• Polysomnogram (PSG)
– Sleep study or sleep test that evaluates
physical factors affecting sleep
• Physical activity and level of sleep are monitored
by a technician while the patient sleeps
– Useful in evaluating sleep disorders such as
sleep apnea, sleep walking, night terrors,
restless leg syndrome, insomnia, and
narcolepsy
44
Diagnostic Techniques,
Treatments, and Procedures
• Positron Emission Tomography (PET
Scan)
– Computerized radiographic images of various
body structures produced when radioactive
substances are inhaled or injected
• Romberg test
– Examination used to evaluate cerebellar
function and balance
45
Diagnostic Techniques,
Treatments, and Procedures
• Stereotaxic Neurosurgery
– Neurosurgery on a precise location of an area
within the brain that controls specific
function(s)
• May involve destruction of brain tissue with various
agents such as heat, cold, and sclerosing or
corrosive fluids
46
Diagnostic Techniques,
Treatments, and Procedures
• Sympathectomy
– Surgical procedure used to interrupt a
portion of the sympathetic nerve pathway, for
the purpose of relieving chronic pain
• Trichotomy
– Through a craniotomy, the anterolateral
pathway in the brain stem is surgically
divided in an attempt to relieve pain
47
Diagnostic Techniques,
Treatments, and Procedures
• Transcutaneous Electrical Nerve
Stimulation (TENS)
– Form of cutaneous stimulation for pain relief
that supplies electrical impulses to the nerve
endings of a nerve close to the pain site
48