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Chapter Twelve Nervous System Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 1 Quote “Anything’s possible if you’ve got enough nerve.” --J.K. Rowling Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 2 Functions and Specialties/Specialists Functions Sensing Interpreting Acting Specialty Neurology Specialist Neurologist Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 3 Organization of the Nervous System Central nervous system (CNS) Brain (encephal/o) and spinal cord (myel/o) The nervous system Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 4 Organization of the Human Body Peripheral nervous system (PNS) Cranial nerves and spinal nerves • Afferent/sensory • Efferent/motor Somatic Autonomic – Sympathetic – Parasympathetic Efferent vs. Afferent The nervous system Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 5 Cells of the Nervous System Neurons (neur/o) Dendrites (dendr/o) Cell body Axon • Myelin sheath • Schwann cells Terminal fibers Synapse Nerve cell Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 6 Did You Know? The myelin sheath that coats the axons gives the neuron a white appearance, which inspired the term “white matter.” Gray matter is the appearance of cell bodies without myelin sheath. Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 7 Cells of the Nervous System (cont’d) Glia/neuroglia (gli/o) Astrocytes (astr/o) Blood-brain barrier (BBB) Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 8 Did You Know? Glia means glue because they hold the neurons together. Dendrite means tree and astr/o means star because of their appearances. Small collections of nerve cell bodies outside the brain and spinal cord (i.e., in the PNS) are called ganglia. Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 9 The Central Nervous System Brain Cerebrum (cerebr/o) Cerebellum (cerebell/o) Diencephalon Brainstem Spinal cord (cord/o, myel/o) Brain Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 10 Clicker Question The combining form for the part of the central nervous system responsible for thinking, reasoning, and memory is: A. cerebell/o B. cerebr/o C. crani/o D. encephal/o Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 11 The Central Nervous System: The Brain Cerebrum Cerebral cortex • Gyrus vs. sulcus • Lobes Frontal Temporal Parietal Occipital Cerebrum Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 12 The Central Nervous System: The Brain (cont’d) Cerebellum Diencephalon Thalamus Hypothalamus Brainstem Midbrain Pons Medulla oblongata The brain Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 13 The Central Nervous System: The Spinal Cord Spinal cord Medulla oblongata to L1 Cauda equina Nerve roots (radicul/o, rhiz/o) Spinal cord Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 14 The Central Nervous System: The Spinal Cord Meninges (mening/o, meningi/o) Dura mater (dur/o) Subdural space Arachnoid membrane Subarachnoid space • Cerebrospinal fluid (CSF) Pia mater Meninges Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 15 The Peripheral Nervous System Cranial nerves Spinal nerves Dermatomes Plexus Dermatomes Autonomic nervous system Sympathetic nervous system Parasympathetic nervous system Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 16 Clicker Question The outer covering of the meninges is the: A. arachnoid membrane B. dura mater C. pia mater D. plexus Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 17 Terms Related to Signs and Symptoms Amnesia Aphasia Dysphasia Dysarthria Athetosis Aura Dysphagia Dyssomnia Insomnia Hypersomnia Fasciculation Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 18 Terms Related to Signs and Symptoms (cont’d) Gait, abnormal Hypokinesia Neuralgia Paresthesia Seizure Spasm Syncope Tremors Vertigo Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 19 Clicker Question Which of the following is an abnormal feeling of burning, prickling, or numbness? A. athetosis B. fasciculation C. paresthesia D. syncope Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 20 Terms Related to Learning and Perceptual Differences Acalculia Ageusia Parageusia Agnosia Agraphia Anosmia Apraxia Dyslexia Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 21 Did You Know? The term acalculia comes from the Greek word for stone. Shepherds once used stones to keep track of (calculate) the number of sheep in the fields, using one stone for each sheep that went out in the morning and the same number and stones when the sheep returned that evening. Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 22 Terms Related to Congenital Disorders Cerebral palsy (CP) Huntington chorea Hydrocephalus Spina bifida Meningocele Meningomyelocele Tay-Sachs Meningomyelocele From Zitelli: Atlas of pediatric phsyical diagnosis, ed 5, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 23 Terms Related to Traumatic Conditions Coma Concussion Cerebral contusion Hematoma Epidural Hematomas Subdural Herniated intervertebral disk Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 24 Clicker Question What is a condition in which the patient has lost his or her sense of smell? A. ageusia B. agnosia C. apraxia D. anosmia Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 25 Terms Related to Degenerative Disorders Alzheimer’s disease (AD) Alzheimer’s disease Normal brain From Damjanov: Pathology: A color atlas, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 26 Terms Related to Degenerative Disorders (cont’d) Amyotrophic lateral sclerosis (ALS) Lou Gehrig disease Guillain-Barré syndrome Multiple sclerosis (MS) Parkinson disease (PD) Demyelination seen in MS Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 27 Terms Related to Nondegenerative Disorders Bell palsy Epilepsy Tonic clonic seizures Absence seizures Status epilepticus Pseudoseizures Narcolepsy Tourette syndrome Coprolalia Bell palsy Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 28 Terms Related to Infectious Diseases Encephalitis Meningitis Neuritis Polyneuritis Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 29 Terms Related to Infectious Diseases (cont’d) Radiculitis Sciatica Shingles Shingles From Thibodeau and Patton: Anatomy and physiology, ed 6, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 30 Clicker Question What is the term that means a seizure of sleep? A. Bell palsy B. narcolepsy C. sciatica D. coprolalia Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 31 Terms Related to Vascular Disorders Cerebrovascular accident (CVA) Migraine Transient ischemic attack (TIA) CVA Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 32 Terms Related to Paralytic Conditions Paralysis -plegia -paresis Diplegia Hemiplegia Monoplegia Paraplegia Quadriplegia Paralysis Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 33 Terms Related to Paralytic Conditions (cont’d) Hemiparesis Monoparesis Paraparesis Quadriparesis Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 34 Clicker Question Paralysis of the arms, legs, and trunk is: A. hemiparesis B. paraplegia C. paraplegia D. quadriplegia Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 35 Terms Related to Benign Neoplasms Neuroma Neurofibroma Meningioma Meningioma From Kumar: Robbins basic pathology, ed 8, Saunders Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 36 Terms Related to Malignant Neoplasms Astrocytoma Glioblastoma multiforme Medulloblastoma Neuroblastoma Glioblastoma multiforme From Kumar: Robbins basic pathology, ed 8, Saunders Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 37 Clicker Question Which of the following is a benign tumor? A. glioblastoma multiforme B. medulloblastoma C. meningioma D. neuroblastoma Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 38 Age Matters Pediatrics Congenital • Cerebral palsy • Tay-Sachs • Hydrocephalus • Spina bifida Meningitis • Viral vs. bacterial Geriatrics Cerebrovascular disease • CVA • TIA Alzheimer’s disease Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 39 Terms Related to Imaging Brain scan Cerebral angiography Computed tomography (CT) scan Angiography Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 40 Terms Related to Imaging (cont’d) Echoencephalography Magnetic resonance imaging (MRI) Myelography Single-photon emission computed tomography (SPECT) MRI of spine From Frank et al: Merrill’s atlas, ed 11, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 41 Terms Related to Imaging (cont’d) Positron emission tomography (PET) PET scan Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 42 Clicker Question What is a recording of the spinal canal? A. echoencephalography B. PET scan C. myelography D. SPECT Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 43 Terms Related to Electrodiagnostic Procedures Electroencephalography (EEG) Evoked potential (EP) Multiple sleep latency test (MSLT) Nerve conduction test Polysomnography (PSG) EEG Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 44 Terms Related to Other Diagnostic Tests Babinski reflex Cerebrospinal fluid (CSF) analysis Deep tendon reflexes (DTR) Gait assessment rating scale (GARS) Neuroendoscopy Babinski reflex. From Seidel: Mosby’s guide to physical examination, ed 6, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 45 Terms Related to Other Diagnostic Tests (cont’d) Lumbar puncture (LP) Lumbar puncture Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 46 Clicker Question Which of the following is a measure of many functions during sleep that is used to diagnose sleep apnea? A. CSF B. DTR C. GAR D. PSG Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 47 Terms Related to Brain and Skull Interventions Craniectomy Stereotaxic radiosurgery Ventriculoperitoneostomy Endoscopic ventriculostomy Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 48 Craniotomy From Monahan et al: Phipps’ medical-surgical nursing, ed 8, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 49 Terms Related to Peripheral Nervous System Interventions Vagotomy Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 50 Terms Related to General Interventions Microsurgery Nerve block Neurectomy Neurolysis Neuroplasty Neurorrhaphy Neurotomy Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 51 Terms Related to General Interventions (cont’d) Carotid endarterectomy Carotid endarterectomy Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 52 Terms Related to Pain Management Cordotomy Rhizotomy Sympathectomy Transcutaneous electrical nerve stimulation (TENS) TENS Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 53 Clicker Question Removal of the fatty plaque from the lining of a carotid artery is a/n: A. craniectomy B. carotid endarterectomy C. neurolysis D. TENS Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 54 Pharmacology Analgesics Anesthetics Anticonvulsants Antiparkinsonian drugs Antipyretics Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 55 Pharmacology (cont’d) Hypnotics Neuromuscular blockers Sedatives Stimulants Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 56 Clicker Question Which of the following medications is used to reduce a fever? A. antipyretic B. anticonvulsant C. hypnotic D. sedative Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 57 Sort these terms into their correct categories Terms 1. neurolysis 2. GARS 3. hydrocephalus 4. synapse 5. neuroglia Categories __ A+P __ Pathology __ Diagnostic Procedures __ Therapeutic Interventions Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 58 Parting Thought “This one step—choosing a goal and sticking to it—changes everything.” –Scott Reed Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 59
