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Nervous System

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CHAPTER 8 Nervous System Nervous System Overview Nervous System Brain Spinal cord Nerves Functions of nervous system Regulates and coordinates all body activities ... – PowerPoint PPT presentation

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Title: Nervous System


1
Nervous System
  • CHAPTER 8

2
Nervous System Overview
  • Nervous System
  • Brain
  • Spinal cord
  • Nerves
  • Functions of nervous system
  • Regulates and coordinates all body activities
  • Center of all mental activity, including thought,
    learning, and memory

3
Nervous System Divisions
  • Central Nervous System (CNS)
  • Brain
  • Spinal Cord
  • Processes and stores sensory and motor
    information
  • Controls consciousness

4
Nervous System Divisions
  • Peripheral Nervous System (PNS)
  • 12 Pairs of Cranial Nerves
  • 31 Pairs of Spinal Nerves
  • Transmits sensory and motor impulses back and
    forth between CNS and rest of body

5
Nervous System Divisions
6
Peripheral Nervous System
  • Afferent (sensory) nerves
  • Carry impulses from the body to the central
    nervous system
  • Efferent (motor) nerves
  • Carry impulses from the central nervous system to
    muscles and glands
  • Cause the target organs to do something in
    response to commands

7
Peripheral Nervous System
  • Somatic Nervous System (SNS)
  • Provides voluntary control over skeletal muscle
    contractions
  • Autonomic Nervous System (ANS)
  • Provides involuntary control over smooth muscle,
    cardiac muscle, and glandular activity and
    secretions in response to the commands of the
    central nervous system

8
Autonomic Nervous System
  • Sympathetic nerves
  • Increase heart rate
  • Constrict blood vessels
  • Raise blood pressure
  • Fight-or-flight response
  • Parasympathetic nerves
  • Slow heart rate
  • Increase peristalsis of intestines
  • Increase glandular secretions
  • Relax sphincters

9
Cells of the Nervous System
  • Neuron
  • Cell body
  • Contains the nucleus and cytoplasm
  • Axon
  • Conducts impulses away from the cell body
  • Some axons are covered with a myelin sheath
  • Dendrite
  • Conducts impulses toward the cell body
  • Synapse
  • Space between two nerves which the impulse must
    cross

10
Cells of the Nervous System
11
Cells of the Nervous System
  • Neuroglia
  • Connective tissue
  • Support system for neurons
  • Do not conduct impulses
  • Protect nervous system through phagocytosis
  • Types of Neuroglia Cells
  • Astrocytes
  • Microglia
  • Oligodendrocytes

12
Central Nervous System
  • Brain
  • Surrounded by bone for protection
  • Enclosed in cranium
  • Spinal cord
  • Surrounded by vertebrae for protection
  • Surrounded by meninges and cerebrospinal fluid

13
Meninges
  • Dura mater
  • Outermost layer of meninges
  • Tough, white connective tissue
  • Epidural space
  • Located outside of the dura mater
  • Contains supporting cushion of fat and connective
    tissue
  • Subdural space
  • Located beneath the dura mater
  • Cavity is filled with serous fluid

14
Meninges
  • Arachnoid membrane
  • Middle layer of the meninges
  • Resembles a spider web
  • Subarachnoid space immediately beneath
  • Contains cerebrospinal fluid
  • Pia mater
  • Innermost layer of the meninges
  • Tightly bound to the surface of the brain and
    spinal cord

15
Structures of the Brain
  • Cerebrum
  • Largest and uppermost portion of the brain
  • Controls consciousness, memory, sensations,
    emotions, voluntary movements
  • Cortex outer surface
  • Gyri elevations
  • Sulci grooves
  • Longitudinal fissure divides cerebrum into two
    hemispheres

16
Structures of the Brain
  • Cerebellum
  • Attached to the brain stem
  • Maintains muscle tone
  • Coordinates normal movement and balance
  • Diencephalon
  • Located between cerebrum and midbrain
  • Consists of thalamus, hypothalamus, and pineal
    gland

17
Structures of the Brain
  • Brain Stem
  • Region between diencephalon and spinal cord
  • Consists of midbrain, pons, and medulla oblongata
  • Serves as pathway for impulses between brain and
    spinal cord
  • Controls respiration, blood pressure, and heart
    rate

18
Spinal Cord
  • Pathway for impulses traveling to and from brain
  • Carries 31 pairs of spinal nerves
  • Affects limbs and lower part of body

19
PATHOLOGICAL CONDITIONS
  • Nervous System

20
Alzheimers Disease
  • Pronounced
  • (ALTS-high-merz dih-ZEEZ)
  • Defined
  • Progressive and extremely debilitating
    deterioration of a persons intellectual
    functioning

21
Amyotrophic Lateral Sclerosis (ALS)
  • Pronounced
  • (ah-my-oh-TROFF-ik LAT-er-al skleh-ROH-sis)
  • Defined
  • Severe weakening and wasting of the involved
    muscle groups
  • Usually begins with hands
  • Progresses to shoulders, upper arms, then legs

22
Anencephaly
  • Pronounced
  • (an-en-SEFF-ah-lee)
  • Defined
  • Absence of the brain and spinal cord at birth
  • Condition is incompatible with life

23
Bells Palsy
  • Pronounced
  • (BELLZ PAWL-zee)
  • Defined
  • Temporary or permanent unilateral weakness or
    paralysis of muscles in the face

24
Brain Abscess
  • Pronounced
  • (BRAIN AB-sess)
  • Defined
  • Accumulation of pus located anywhere in the brain
    tissue

25
Carpal Tunnel Syndrome
  • Pronounced
  • (CAR-pal TUN-el SIN-drom)
  • Defined
  • Pinching or compression of median nerve within
    the carpal tunnel
  • Inflammation and swelling of tendons cause
    intermittent or continuous pain

26
Cerebral Concussion
  • Pronounced
  • (seh-REE-bral con-KUSH-un)
  • Defined
  • Brief interruption of brain function usually with
    loss of consciousness lasting for a few seconds

27
Cerebral Contusion
  • Pronounced
  • (seh-REE-bral con-TOO-zhun)
  • Defined
  • Small, scattered venous hemorrhages in the brain
  • Bruise of the brain tissue
  • Occurs when brain strikes the inner skull

28
Cerebral Palsy
  • Pronounced
  • (seh-REE-bral PAWL-zee)
  • Defined
  • Collective term used to describe congenital brain
    damage that is permanent but not progressive
  • Characterized by the childs lack of control of
    voluntary muscles

29
Cerebral Palsy
  • Spastic
  • Damage to cortex of the brain
  • Tense muscles
  • Very irritable muscle tone
  • Ataxic
  • Damage to cerebellum
  • Affects equilibrium

30
Cerebral Palsy
  • Athetoid
  • Damage to basal ganglia
  • Causes sudden jerking
  • Rigidity
  • Causes child to be in continual state of tension
  • Mixed cerebral palsy

31
Cerebrovascular Accident (CVA)
  • Pronounced
  • (seh-REE-broh-VASS-kyoo-lar AK-sih-dent)
  • Defined
  • Death of a specific portion of brain tissue
  • Results from decreased blood flow to that area of
    the brain
  • Also called a stroke

32
Cerebrovascular Accident
  • Causes
  • Transient ischemic attacks (TIAs)
  • Also known as mini strokes
  • Cerebral thrombosis
  • Occurs largely in individuals older than 50
  • Cerebral embolism
  • Embolus causes an occlusion
  • Cerebral hemorrhage
  • Cerebral vessel ruptures

33
Degenerative Disk
  • Pronounced
  • (deh-JEN-er-ah-tiv disk)
  • Defined
  • Deterioration of the intervertebral disk
  • Usually due to constant motion and wear on the
    disk

34
Encephalitis
  • Pronounced
  • (En-seff-ah-LYE-tis)
  • Defined
  • Inflammation of the brain or spinal cord tissue
  • Virus enters CNS when person experiences viral
    disease such as mumps, measles, or through tick
    or mosquito bite

35
Epilepsy
  • Pronounced
  • (EP-ih-lep-see)
  • Defined
  • Syndrome of recurring episodes of excessive
    irregular electrical activity of the central
    nervous system, called seizures

36
Grand Mal Seizure
  • Pronounced
  • (grand MALL SEE-zyoor)
  • Defined
  • Epileptic seizure characterized by sudden loss of
    consciousness and generalized involuntary
    muscular contraction
  • Vacillates between rigid body extension and an
    alternating contracting and relaxing of muscles

37
Petit Mal Seizure
  • Pronounced
  • (pet-EE MALL SEE-zyoor)
  • Defined
  • Small seizures in which there is a sudden,
    temporary loss of consciousness
  • Lasts only a few seconds
  • Also known as absence seizures

38
Guillain-Bàrré Syndrome
  • Pronounced
  • (GEE-yon bah-RAY SIN-drom)
  • Defined
  • Acute polyneuritis of the peripheral nervous
    system
  • Myelin sheaths on the axons are destroyed
  • Decreased nerve impulses
  • Loss of reflex response
  • Sudden muscle weakness
  • Usually follows viral gastrointestinal or
    respiratory infection

39
Headache (Cephalalgia)
  • Pronounced
  • (seff-ah-LAL-jee-ah)
  • Defined
  • Pain anywhere within the cranial cavity varying
    in intensity from mild to severe
  • May be chronic or acute
  • May occur as result of a disease process
  • May be totally benign

40
Migraine Headache
  • Pronounced
  • (MY-grain headache)
  • Defined
  • Recurring, pulsating, vascular headache
    developing on one side of the head
  • Characterized by slow onset
  • May be preceded by an aura during which sensory
    disturbance occurs

41
Cluster Headache
  • Pronounced
  • (KLUSS-ter headache)
  • Defined
  • Headache occurring typically two to three hours
    after falling asleep
  • Described as extreme pain around one eye that
    wakens the person from sleep

42
Tension Headache
  • Pronounced
  • (TEN-shun headache)
  • Defined
  • Headache that occurs from long, endured
    contraction of the skeletal muscles around the
    face, scalp, upper back, and neck

43
Epidural Hematoma
  • Pronounced
  • (eh-pih-DOO-ral hee-mah-TOH-mah)
  • Defined
  • Collection of blood located above the dura mater
    and just below the skull

44
Subdural Hematoma
  • Pronounced
  • (sub-DOO-ral hee-mah-TOH-mah)
  • Defined
  • Collection of blood below the dura mater and
    above the arachnoid layer of the meninges

45
Herniated Disk
  • Pronounced
  • (HER-nee-ay-ted disk)
  • Defined
  • Rupture or herniation of the disk center through
    the disk wall and into the spinal canal
  • Causes pressure on the spinal cord or nerve roots

46
Huntingtons Chorea
  • Pronounced
  • (HUNT-ing-tonz koh-REE-ah)
  • Defined
  • Inherited neurological disease characterized by
    rapid, jerky, involuntary movements and increased
    dementia
  • Progressive, degenerative disease

47
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

48
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

49
Primary Intracranial Tumors
  • Pronounced
  • (PRIGH-mah-ree in-trah-KRAY-nee-al TOO-morz)
  • Defined
  • Tumors that arise from gliomas and the meninges
  • Gliomas malignant glial cells that are a
    support for nerve tissue

50
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

51
Metastatic Intracranial Tumors (Secondary)
  • Pronounced
  • (met-ah-STAT-ik in-trah-KRAY-nee-al TOO-morz)
  • Defined
  • Tumors occurring as a result of metastasis from a
    primary site such as the lung or breast

52
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

53
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

54
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

55
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

56
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

57
Parkinsons Disease
  • Pronounced
  • (PARK-in-sons dih-ZEEZ)
  • Defined
  • Degenerative, slowly progressive deterioration of
    nerves in the brain stems motor system,
    characterized by a gradual onset of symptoms
  • Classic Symptoms stooped posture with body
    flexed forward, bowed head, shuffling gait,
    pill-rolling gestures, expressionless mask-like
    facial appearance

58
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

59
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

60
Post Polio Syndrome
  • Pronounced
  • (POST POH-lee-oh SIN-drom)
  • Defined
  • Progressive weakness occurring at least 30 years
    after the initial poliomyelitis attack

61
Reyes 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

62
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

63
Shingles
Image courtesy of Robert A. Silverman, M.D.,
Pediatric Dermatology, Georgetown University
64
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

65
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

66
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

67
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

68
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

69
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

70
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

71
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

72
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

73
DIAGNOSTIC TECHNIQUES, TREATMENTS, AND PROCEDURES
  • Nervous System

74
Diagnostic Techniques, Treatments, and Procedures
  • Babinskis Reflex
  • Reflex tested by stroking the sole of the foot,
    beginning at mid-heel and moving upward and
    lateral to the toes.
  • Positive Babinskis occurs when there is
    dorsiflexion of the great toe and fanning of the
    other toes

75
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

76
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

77
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

78
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

79
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

80
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

81
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

82
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

83
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

84
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

85
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

86
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

87
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

88
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)

89
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

90
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

91
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

92
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

93
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
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