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The Nervous System
Chapter 13 Unit 2
1.0 Amyotrophic Lateral Sclerosis (ALS; Lou Gehregs disease)
A common motor neuron disease causing degeneration of the upper motor nerves in the medulla oblongata and the lower nerves in the spinal cord. This results in atrophy of the muscles. Onset occurs between the ages of 40-70 and is usually fatal within 3-10 years due to aspiration pneumonia or respiratory failure.
¾ Vitamin E deficiency (damages cel membranes)
¾ Metabolic interference in the production of nucleic acid by the nerves; auto
immune disorders and nutritional deficiency of the motor neurons.
¾ Weakness - especially of hands and forearms, plus problems with speech,
¾ If brain stem is involved - respirations will be affected (i.e., choking and
2.0 Bells Palsy
Origin is unknown. It is a disease of the 7th cranial nerve (the oculomotor). Causes weakness or paralysis on one side of the face. It occurs suddenly and within one to eight weeks and will usually spontaneously subside.
¾ Moist heat to the face and jaw helps relieve pain
3.0 Cerebral Palsy
Is associated with birth and involves both nerves and muscles. It is the most common crippler of children. There are three forms of cerebral palsy: spastic, athetoid, and ataxic.
Characteristics of the Spastic type (affects 70%):
¾ Rapid alteration between muscular contraction and relaxation.
¾ Underdevelopment of the affected extremities
¾ Prenatal conditions such as rubella, toxemia, maternal diabetes, and
¾ At birth: difficulties such as forceps delivery, breech presentation, premature
placental separation, premature birth and rapid or prolonged labor.
¾ Physical therapy; speech therapy; braces or splints, occupational therapy;
¾ Surgery for severe contractures; control of convulsions or seizures.
A severe brain inflammation. Onset is sudden and acute.
¾ Virus that causes polio, herpes, or mumps
¾ Following measles, rubella, or a vaccination
Fever, headache, vomiting, stiff neck and back, drowsiness, and eventual coma.
Supportive drug therapy to control restlessness, convulsions, reduce edema, and headache.
Associated with abnormal electrical impulses from the neurons of the brain.
¾ Petit or grand mal seizures (are of short duration)
¾ Grand mal lasts up to 5 min. with convulsions, loss of control of bodily
functions and unconsciousness. Diagnosis is made from evidence of seizures, a positive EEG, and various X-ray procedures.
Drug therapy to control seizures and psychological support.
Are classified as tensions (vascular, muscle contraction) or traction-inflammatory.
¾ Muscle spasms of the neck and shoulders
¾ Vasodilators (i.e., nitrates, alcohol & histamine)
¾ Aged or fermented food or drink (i.e., red wine)
¾ Chocolate (vasoconstriction of the arteries)
¾ Hypoglycemia (low blood sugar - vasodilation )
Is characterized by prodromal (early) symptoms including:
¾ Visual disturbances (zig-zag lines, bright lights)
Migraines frequently occur in people with compulsive personalities and within families. Usually happens on weekends and holidays.
¾ It cannot be prevented but medication can reduce frequency and intensity.
¾ There is no cure for migraine headaches, only control:
Lie quietly in a darkened room. Analgesics, ice bag to head, beta blockers, and antidepressants appear to be effective.
8.0 Herpes Zoster
This is an acute inflammation of the dorsal root ganglion by a herpes that also causes chickenpox. Characterized by fluid fil ed vesicle lesions on the skin and severe pain from the affected nerves.
¾ Abnormal skin sensations. The vesicles erupt in about 2 weeks and spread
around the thorax or vertically on the extremities. These vesicles last from 1 to 4 weeks.
¾ Narcotics to relieve pain and itching
¾ Systemic antibiotic if infection develops
Excessive accumulation of cerebral spinal fluid (CSF) within the ventricles of the brain.
¾ Obstruction of the flow of the CSF or lack of absorption.
Increased fluid compresses the brain tissue resulting in brain damage characterized by:
Surgery is the only treatment for hydrocephalus
Inflammation of the meninges of the brain and spinal cord.
Bacterial infection from the ears, sinuses or lungs or a brain abscess.
¾ High fever, chills, headache, and vomiting.
¾ A positive Brudzinski's and Kemig's signs (fig. 13-33)
11.0 Multiple Sclerosis (MS)
Causes the demyelination of the white matter of the brain and the spinal cord. The results are double or blurred vision and sensations of tingling and numbness.
¾ Allergic reaction to an infectious agent
¾ Steroids to relieve symptoms and haste remission
¾ Medication for emotional swings, urinary problems and muscular spasticity.
¾ Bedrest to prevent fatigue during acute phases
Term used to describe general nerve pain. Severe cutting pain along the course of a nerve.
13.0 Neuron and Spinal Cord Damage
Results in a loss of sensation and voluntary motion due to destruction of the neurons or nerve cells.
is the paralysis on one side of the body due to damage of the opposite side of the brain.
Unilateral paralysis of the tongue, face, arm, and leg. causing muscular contractures.
is a motor or sensory loss in the lower extremities due to spinal cord injury from trauma, most frequently from automobile, motorcycle, or sports related accidents.
is a paralysis of the arms, legs and body below the level of the injury to the spinal cord. Usually caused from auto, or a sporting accident.
14.0 Parkinson's disease
¾ Body becomes bent forward with head bowed
¾ Forward body inclination which often results in fal ing
¾ Surgical procedure to destroy a small area of the brain to prevent
¾ Drug therapy with Levodopa (serious side effects)
15.0 Reye's Syndrome
Usually follows an acute viral infection such as influenza, upper respiratory infection or chicken pox.
Fatty infiltration of the liver and increased intracranial pressure. Also occurs in the kidneys and possibly the muscle of the heart.
SYMPTOMS (occurs in stages of severity):
An inflammation and severe pain of the sciatic nerve.
¾ Impingement on the nerve by the spinous process
17.0 Spinal Cord Defects:
Spinal cord defects result from an improper closure of tissues during the first few months of birth. Occur most frequently in the lumbar sacral area.
¾ Spina Bifida Occulta - Incomplete closure of one or more vertebrae, but
without protrusion of the spinal cord or meninges. There is usually a depression, a tuft of hair, a port wine nevi, or a combination of these signs over the defect.
¾ Meningocele - In spina bifida with meningocele the sac contains meninges
¾ Myelomeningocele - The sac contains meninges, CSF, and a portion of the
Depends on the extent of the defect: usually surgical closure if CSF and meninges are involved. A shunt implant is often used to relieve pressure.
18.0 Subarachnoid Hemorrhage
Subarachnoid hemorrhage (SAH) implies the presence of blood within the subarachnoid space from some pathologic process. The common medical use of the term SAH refers to the nontraumatic types of hemorrhages, usually from rupture of a berry aneurysm or arteriovenous malformation (AVM).
Spontaneous rupture of a weakened blood vessel
19.0 Subdural Hematoma
The dura attaches to the brain, just beneath the skull bone. The dura normally protects the brain and keeps it nourished with blood and spinal fluid. A severe blow to the head causes the brain to bounce within the cavity and may cause shearing or tearing of the blood vessels surrounding the brain. When the blood vessels tear, blood accumulates within the space between the brain and the dura. This is known as a subdural hematoma (sub-door-ul hem-a-to-ma), or blood clot in the brain.
¾ Facial weakness on the side opposite of the hematoma
Surgical intervention to remove pressure
20.0 Transient Ischemic Attack (TIA)
A temporary condition resulting from a closing off of tiny arteries in the brain by clots. TIA is just a warning sign of near at hand stroke from a blood clot thrombotic CVA.
¾ Aspirin to reduce blood clot formation
21.0 Trigeminal Neuralgia (Tic Douloureux)
A disorder of the fifth cranial nerve, on one side of the face. This disease is characterized by episodes of extreme pain on stimulation of a trigger zone.
¾ Draft of air, smiling, drinking hot or cold liquids.
¾ Injection of alcohol or phenol into the nerve branch
¾ Surgical procedure is indicated for frequent severe attacks
Nervous System Exam
Multiple Choice. Circle the letter with the best answer:
1. The Nervous system is composed of all of the fol owing except:
2. The basic unit of the nervous system is the _________.
3. Nerve cells send and receive impulses from the _____ to the ____ and vice versa.
4. The ____ is the part of the nerve cell that carries the impulses toward
5. The ____ is the part of the nerve cell that carries the impulses away
from the cell
6. All of the following are characteristics of myelin, except:
7. Axons covered with myelin are called:
8. A neuron that transmits impulses toward
the CNS is called
9. A neuron that transmits impulses away
from the CNS is called
10. The cerebrum is the smallest part of the brain.
11. The meninges are _______________ that cover the brain and the spinal cord.
12. A medical term for an inflammation of the meninges is:
13. Bell's Palsy is a disease that affects the 7th cranial nerve and causes:
14. Parkinson's disease characterized by:
Match the following abbreviations with the appropriate meaning:
Define the following medical terms:
Fill in the missing word part, meaning, or example as appropriate:
EXTRA CREDIT (1 point each):
1. The basic unit of the nervous system is the ___________, meaning nerve
2. Each nerve cell has two types of fibers extending from the cell body:
The _______, which carries the impulses toward the cell body and the _________, which carries the impulses away from the cell body.
3. Some axons are covered with _______, a whitish fatty material that
insulates and protects the axon and speeds up electrical conduction.
4. Axons covered with __________ are called myelinated.
5. A neuron that transmits impulses toward
the CNS is a ________ neuron;
and a neuron that transmits impulses away
from the CNS is a __________
6. The cerebrum is the largest part of the brain. When we want to refer to the
largest part of the brain we say the ______/um.
7. The meninges are three membranes that cover the brain and the spinal
cord. An inflammation of the meninges would be called _______, and surgical cutting of the meninges is a __________.
8. A tumor (-oma) of the meninges is termed __________.
9. Encephal/o literally means inside the head or brain. An inflammation of the
10. Any disease (-pathy) of the brain is medical y called _________.
Anpassung des Klassifikationsmodells RxGroups speziellen Voraussetzungen in der GKV Gutachterliche Expertise Vorgelegt von Prof. Dr. Gerd Glaeske INHALTSVERZEICHNIS TABELLENVERZEICHNIS Tabelle 1: Die 100 am häufigsten verordneten Präparate (AVR 20041) mit Verordnungsrang (AVR 2004) ATC-Kode, Zuordnung zu RxGroup und Tabelle 2: Wirkstoffgruppen (n=259), fü
APO-SALBUTAMOL INHALER NAME OF THE MEDICINE Chemical Name: RS)-2-tert-butylamino-1-(4-hydroxy-3-hydroxymethyl-phenyl) ethanol sulfate. C13H21NO3.½ H2SO4 Structural Formula: CAS Registry Number: 51022-70-9 DESCRIPTION Salbutamol sulfate is a white or almost white powder. It is soluble in water but is only slightly soluble in alcohol, chloroform and ether. 1.2mg of s