NERVOUS SYSTEM CHAPTER 8. Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 1

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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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 2

3 Nervous System Divisions Central Nervous System (CNS) Brain Spinal Cord Processes and stores sensory and motor information Controls consciousness 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 3

Nervous System Divisions (continued) Copyright 2003 by Delmar

8 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 the muscles and glands Cause the target organs to do something in response to the commands Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 8

10 Peripheral Nervous System (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 10

11 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 11

12 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 12

Copyright 2003 by Delmar Learning, a division

15 Cells of the Nervous System (continued) Neuroglia Connective tissue support system for neurons Do not conduct impulses Protect nervous system through phagocytosis Types of Neuroglia Cells Astrocytes Microglia Oligodendrocytes Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 15

16 Central Nervous System Brain Surrounded by bone for protection Enclosed in the cranium Spinal Cord Surrounded by the vertebrae for protection Surrounded by the meninges and cerebrospinal fluid Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 16

18 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 18

19 Meninges (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 19

20 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 20

21 Structures of the Brain (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 21

22 Structures of the Brain (continued) Brain Stem Region between diencephalon and spinal cord Consists of the midbrain, pons, and medulla oblongata Serves as pathway for impulses between brain and spinal cord Controls respiration, blood pressure, and heart rate Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 22

25 Spinal Cord Pathway for impulses traveling to and from brain Carries 31 pairs of spinal nerves Affects limbs and lower part of body Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 25

27 Alzheimer s Disease Pronounced (ALTS-high-merz dih-zeez) Defined Progressive and extremely debilitating deterioration of a person s intellectual functioning Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 27

28 Amyotrophic Lateral Sclerosis (ALS) Pronounced (ah-my-oh-troff-ik LAT-er-al skleh-rohsis) Defined Severe weakening and wasting of the involved muscle groups Usually begins with hands Progresses to shoulders, upper arms, then legs Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 28

29 Anencephaly Pronounced (an-en-seff-ah-lee) Defined Absence of the brain and spinal cord at birth Condition is incompatible with life Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 29

30 Bell s Palsy Pronounced (BELLZ PAWL-zee) Defined Temporary or permanent unilateral weakness or paralysis of muscles in the face Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 30

32 Brain Abscess Pronounced (BRAIN AB-sess) Defined Accumulation of pus located anywhere in the brain tissue Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 32

33 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 33

34 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 34

36 Cerebral Contusion Pronounced (seh-ree-bral con-too-zhun) Defined Small, scattered venous hemorrhages in the brain A bruise of the brain tissue occurs when brain strikes the inner skull Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 36

39 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 child s lack of control of voluntary muscles Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 39

40 Spastic Damage to cortex of the brain Ataxic Tense muscles; very irritable muscle tone Damage to cerebellum Athetoid Affects equilibrium Damage to basal ganglia Rigidity Cerebral Palsy (continued) Causes sudden jerking Causes child to be in continual state of tension Mixed cerebral palsy Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 40

41 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 41

42 Cerebrovascular Accident (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 42

44 Degenerative Disk Pronounced (deh-jen-er-ah-tiv disk) Defined Deterioration of the intervertebral disk Usually due to constant motion and wearing on the disk Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 44

45 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 45

46 Epilepsy Pronounced (EP-ih-lep-see) Defined Syndrome of recurring episodes of excessive irregular electrical activity of the central nervous system, called seizures Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 46

47 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 47

48 Petit Mall 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 48

49 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 49

50 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 50

51 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 51

52 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 52

53 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 53

54 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 54

56 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 56

57 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 57

58 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 58

59 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 59

61 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 61

62 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 62

63 Primary Intracranial Tumors (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 63

65 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 65

66 Meningitis (Acute Bacterial) Pronounced (men-in-jye-tis ah-kyoot back-tee-reeal) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 66

67 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 67

68 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 68

69 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 69

70 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 70

72 Peripheral Neuritis Pronounced (per-if-er-al noo-rye-tis) Defined Inflammation of one or more peripheral nerves, the effects being dependent upon the particular nerve involved Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 72

73 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. Attacks gray matter. Virus enters through the upper respiratory tract Muscles affected become paralyzed without the motor nerve stimulation Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 73

74 Post Polio Syndrome Pronounced (POST POH-lee-oh SIN-drom) Defined Progressive weakness occurring at least 30 years after the initial poliomyelitis attack Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 74

75 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 75

76 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 76

77 SHINGLES (continued) Image courtesy of Robert A. Silverman, M.D., Pediatric Dermatology, Georgetown University Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 77

78 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 78

79 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 5 th lumbar or 1 st sacral vertebrae Congenital defect of the CNS Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 79

80 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 80

82 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 82

84 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 84

85 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 85

86 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 5 th and 8 th cervical vertebrae The higher the trauma, the more debilitating the motor and sensory impairments Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 86

87 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 87

88 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 88

90 Diagnostic Techniques 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 90

91 Diagnostic Techniques and Procedures (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 91

92 Diagnostic Techniques and Procedures (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 92

93 Diagnostic Techniques and Procedures (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 93

94 Diagnostic Techniques and Procedures (continued) 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 provided are as though you were looking down through the top of the head Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 94

95 Diagnostic Techniques and Procedures (continued) Medications: Analgesic relieves pain without affecting consciousness Non-narcotic for mild to moderate pain Narcotic used to relieve severe pain; may cause physical dependence or addiction Tranquilizers suppress anxiety and relax muscles Antidepressants prevent or relives depression Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 95

96 Sedative and Hypnotic Medications Sedative depresses the CNS and produces calm and diminished responsiveness without producing sleep Hypnotic depresses the CNS and usually produces sleep Barbiturate produces a calming or depressed effect on the CNS Anticonvulsant prevent seizures and convulsions Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 96

97 Diagnostic Techniques and Procedures (continued) Anesthesia the medication used to induce anesthesia Topical Local Regional Epidural Spinal General Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 97

98 Diagnostic Techniques and Procedures (continued) 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; uses ultrasound and can determine if there is a shift of the midline structure of the brain Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 98

100 Diagnostic Techniques and Procedures (continued) Laminectomy Surgical removal of the bony arches from one or more vertebrae in order to relieve pressure from the spinal cord Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 100

101 Diagnostic Techniques and Procedures (continued) Lumbar Puncture Insertion of a hollow needle and stylet into the subarachnoid space, generally between the third and fourth lumbar vertebrae below the level of the spinal cord under strict aseptic technique Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 101

102 Diagnostic Techniques and Procedures (continued) MRI of the Brain 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 102

103 Diagnostic Techniques and Procedures (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 103

104 Diagnostic Techniques and Procedures (continued) 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) Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 104

105 Diagnostic Techniques and Procedures (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 105

106 Diagnostic Techniques and Procedures (continued) 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 Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 106

107 Diagnostic Techniques and Procedures (continued) Sympathectomy Surgical procedure used to interrupt a portion of the sympathetic nerve pathway, for the purpose of relieving chronic pain Trachotomy Through a craniotomy, the anterolateral pathway in the brain stem is surgically divided in an attempt to relieve pain Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 107

108 Diagnostic Techniques and Procedures (continued) Transcutaneous Electrical Nerve Stimulation (TENS) A form or cutaneous stimulation for pain relief that supplies electrical impulses to the nerve endings of a nerve close to the pain site Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 108

109 Substance Related Disorders Addiction compulsive and overwhelming involvement with a specific activity, despite the significant health problems, legal and social problems that may occur Delirium tremens DTs; a form of organic brain syndrome due to alcohol withdrawal. Characterized by sweating, tremor, restlessness, anxiety, mental confusion, and hallucinations Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 109

110 Schizophrenia and Other Psychotic Disorders Psychotic disorder characterized as the derangement of personality, loss of contact with reality, and deterioration of social functioning Schizophrenia a psychotic disorder characterized by delusions, hallucinations, disorganized speech, and disruptive or catatonic behavior Delusion a false personal belief despite obvious proof or evidence to the contrary Hallucination a sense perception that has no basis in external stimulation Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 110

111 Mood Disorders Manic episode a distinct period where there is a distinct abnormally, persistent elevated mood Major depressive disorder a prolonged period during which there is a depressed mood or loss of interest Bipolar disorder manic-depressive; occurrence of main episodes and depressive episodes Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 111

112 Anxiety Disorders Obsessive-compulsive disorder pattern of specific disorders such as repeated hand washing. Obsessive thoughts are followed by compulsive behaviors. Posttraumatic stress disorder development of symptoms after a psychologically traumatic event. Symptoms are numbed responsiveness to external stimuli, sleep disorders, restlessness, difficulty concentrating, and depression Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 112

113 Phobias Acrophobia fear of high places Agoraphobia fear of leaving home Claustrophobia fear of narrow enclosed places Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 113

114 Other Disorders Hypochondriasis preoccupation with fears of having a serious disease Kleptomania recurrent failure to resist impulses to steal Pyromania recurrent failure to resist impulses to set fire Narcissistic personality disorder a pattern of exaggerated need for admiration and complete lack of empathy Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 114

115 Other Disorders Malingering characterized by intentional creation of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding work Munchausen syndrome The patient repeatedly makes up clinically convincing simulations of disease for the purpose of gaining medical attention Copyright 2003 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED 115

Nervous System. Unit 6.6 (6 th Edition) Chapter 7.6 (7 th Edition)

Nervous System. Unit 6.6 (6 th Edition) Chapter 7.6 (7 th Edition) Nervous System Unit 6.6 (6 th Edition) Chapter 7.6 (7 th Edition) 1 Learning Objectives Identify the main parts (anatomy) of a neuron. Identify the 2 divisions of nervous system. Classify the major types