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NERVOUS SYSTEM DISEASES

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Presentation on theme: "NERVOUS SYSTEM DISEASES"— Presentation transcript:

Anatomy and Physiology for Emergency Care

Chapter 23: Communicable Diseases

Chapter 7: the Nervous System Bio 24. Organization of the nervous system.

Diseases of the Nervous System. Nervous System  Central nervous system – brain and spinal cord  Peripheral nervous system.

1 Anatomy Review Central Nervous System Peripheral Nervous System Meninges Blood Brain Barrier.

Unit 5: Classification and Kingdoms

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings PowerPoint ® Lecture Slide Presentation prepared by Christine L. Case Microbiology.

Medical Technology Department, Faculty of Science, Islamic University-Gaza MB M ICRO B IOLOGY Dr. Abdelraouf A. Elmanama Ph. D Microbiology 2008 Chapter.

Brain and Spinal Cord (CNS) Anatomy Support structures –(bone) –meninges –cerebrospinal fluid (CSF) Protective structure –blood-brain barrier General.

© 2012 Pearson Education Inc. Lecture prepared by Mindy Miller-Kittrell North Carolina State University Chapter 20 Microbial Diseases of the Nervous System.

Infections of the Central Nervous System

Meningitis.

Pages Physical Protection:  Bone: Skull and vertebral column  Membranes: Skin/Scalp, Meninges  Watery Cushion: Cerebrospinal fluid (CSF) Chemical.

What are the three major causative agents of bacterial meningitis?

Diseases Essential Question: How do microbes influence the treatment/prevention of a disease?

MICR 201 Microbiology for Health Related Sciences

20.3 Bacterial & Viral Diseases pg Pathogen- microorganisms that cause disease 2 ways: 1. destroy living cells; tuberculosis- destroys lung tissue.

Nervous System Infections Chapter 20. Nervous system Central nervous system (CNS) – Brain Encephalitis – Spinal cord Peripheral nervous system (PNS) –

© 2013 Pearson Education, Inc. Chapter 22: Microbial Diseases of the Nervous System $100 $200 $300 $400 $500 $100$100$100 $200 $300 $400 $500 The Nervous.

Viruses “They Are Not Alive!”.

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Neurological Disorders Presentation

• Published 29 Jun 2017
• Reviewed 29 Jun 2017
• Author Emma Lindberg
• Source BrainFacts/SfN

Students will use their research skills to learn about the diseases and disorders that affect the brain and nervous system.

Students will work individually to research a neurological disease or disorder. After completing their research, students will give a brief oral presentation that covers the history of the disease or disorder, how it affects the brain and nervous system, and what kind of treatments that are available. Their presentations should include a visual aid such as a poster, PowerPoint presentation, or a class handout.

At the end of this activity students will:

• Be able to research a scientific topic
• Be able to clearly and concisely explain a neurological disorder    

Teacher Background

The National Institute of Neurological Disorders and Strokes (NINDS) has compiled a list of more than 400 neurological disorders. These disorders range from epilepsy, immune system disorders, psychiatric disorders, and disorders related to brain injury.

Integration Into Curriculum

• Biology, AP Biology
• Anatomy and Physiology
• Direct your students to the Neurological Disorders A-Z page.
• Have students review the list of disorders and ask them to select 3-5 diseases or disorders they are interested in researching.
• Ask each student to list their selections on their student sheet, including a short rationale of their selections. Collect and review.
• Assign each student one of the disorders based on their lists. Do your best not to have several students assigned to the same topic. The fewer students per topic, the more unique each   presentation will be.
• Students can search BrainFacts.org and other scientifically-vetted resources for further information on the subject they are assigned. These may include scientific papers from Google Scholar or course textbooks. Students should provide a bibliography of at least five scientifically-vetted resources they used for their research. This can be done in APA, MLA, or Chicago format.
• Ask students to prepare an outline and notes for their oral presentation. The presentation should incorporate a visual aid in the form of a PowerPoint, a poster, or a class handout (e.g., flier, brochure, etc.). The presentation should last no more than five minutes.
• After completing their oral presentation, students will submit their presentation outline and notes on their research topic.
• Suggestions on how to grade oral presentations and notes are provided in the rubric.

Materials Needed

• Student Sheet

             Download  (PDF file, 428 KB)

• Disorders Rubric 

             Download (PDF File, 445 KB)

About the Author

Emma Lindberg

Emma is the former Outreach Associate at the Society for Neuroscience. She helped find and create Educator Resources for BrainFacts.org , as well as promote the site at conferences and events across the country.

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Ch. 7 – The Nervous System

• Overview & Organization of the Nervous System

Functions of the Nervous System

The master controlling & communicating system of the body…

• Sensory input —gathering information
• To monitor changes occurring inside and outside the body
• Changes = stimuli
• Integration
• To process and interpret sensory input and decide if action is needed
• Motor output
• A response to integrated stimuli
• The response activates muscles or glands
• Structural Classification �of the Nervous System
• Central nervous system (CNS) – dorsal body cavity; integrating and command centers; interpret sensory information & give out instructions

Spinal cord

• Peripheral nervous system (PNS) – outside of CNS
• Nerves outside the brain and spinal cord
• Spinal nerves – carry impulses to and from spinal cord
• Cranial nerves – carry impulses to and from brain
• Functional Classification of �the Peripheral Nervous System
• Sensory (afferent) division
• Nerve fibers that carry information to the CNS
• Somatic sensory fibers – deliver impulses from skin, skeletal muscle, and joints
• Visceral sensory fibers (afferents) – deliver impulses from viscera
• Motor (efferent) division
• Nerve fibers that carry impulses away from the CNS
• Somatic (voluntary) NS – voluntary control of skeletal muscles
• Autonomic (involuntary NS – involuntary control of smooth & cardiac muscle and glands
• Divided into sympathetic and parasympathetic NS

Answer Did You Get It? #1

• Structure & Function of Nervous Tissue
• Support Cells
• Support cells in the CNS are grouped together as neuroglia (AKA glia or glial cells ) = “nerve glue”
• Functions: support, insulate, and protect neurons
• Cannot transmit nerve impulses (as can neurons)
• Never lose their ability to divide (as neurons do)
• Most brain tumors are gliomas
• Glia of the Central Nervous System:
• Ependymal cells
• Oligodendrocytes
• Glia of the Peripheral Nervous System:
• Schwann cells
• Satellite cells

Support Cells, continued…

• Abundant (~1/2 of neural tissue)
• Star-shaped cells
• Brace & anchor neurons to capillaries
• Form living barrier between capillaries and neurons (exchange) (blood-brain barrier)
• Control brain’s chemical environment
• Absorb leaked K + ions
• Absorb released neurotransmitters
• Spiderlike phagocytes
• Protect from infection
• Dispose of debris
• Dead brain cells & bacteria
• Line cavities of the brain and spinal cord
• Beating cilia circulate cerebrospinal fluid (CSF)
• CSF fills brain & spinal cord cavities & serves as cushion
• Wrap around nerve fibers in the CNS
• Produce fatty insulating coverings = myelin sheaths
• Protect neuron cell bodies
• Form myelin sheath around nerve fibers in the PNS

Answer Did You Get It? #’s 2-3

• Neurons = nerve cells
• Cells specialized to transmit nerve impulses from one part of body to another
• Two major regions of neurons:
• Metabolic center: contains nucleus, large nucleolus
• No centrioles = no mitosis
• Nissl substance = specialized RER
• Neurofibrils (intermediate cytoskeleton)
• Maintain cell shape

Neurons, continued…

• Processes outside the cell body
• Microscopic to 3-4 ft in length
• Longest = from lumbar region of spine to great toe
• Dendrites —conduct impulses toward the cell body
• A neuron may have hundreds
• Axons —conduct impulses away from the cell body
• Arises from cone-like region of cell body called axon hillock
• Collateral branches
• End in highly branched axon terminals
• Axon terminals contain vesicles with neurotransmitters
• Axonal terminals are separated from the next neuron by a synaptic cleft
• Synapse —junction between nerves ( syn = clasp/join)

Neuron processes, continued…

• Myelin sheath —whitish, fatty material covering axons
• Protects & insulates fibers
• Increases rate of nerve impulse transmission
• Schwann cells —produce myelin sheaths in jelly roll–like fashion
• Schwann cells in the PNS; oligodendrocytes in the CNS
• Neurilemma – portion of cell membrane on outer layer of coil where most of its cytoplasm resides
• Nodes of Ranvier —gaps in myelin sheath along the axon
• Aid in speeding up nerve impulses – saltatory conduction
• Homeostatic imbalance – multiple sclerosis = gradual destruction of myelin sheaths (become hardened = sclerosis), autoimmune disease (sheath protein)
• Visual & speech disturbances, loss of muscle control, increasingly disabled
• Interferon injections provide relief; no cure
• Terminology of Neurons
• Most neuron cell bodies are found in the CNS
• Nuclei —clusters of cell bodies within the white matter of the CNS (protected within the brain case and vertebral column)
• Ganglia —small collections of cell bodies in the PNS
• Tracts = bundles of nerve fibers in CNS
• White matter – myelinated tracts in CNS
• Gray matter —cell bodies and unmyelinated tracts in CNS
• Nerves = bundles of nerve fibers in PNS
• Functional Classification of Neurons

Direction of nerve impulse with respect to CNS

• Sensory (afferent) neurons
• Carry impulses from the sensory receptors to the CNS
• Ganglion outside of CNS
• Dendrite endings associate with receptors
• Cutaneous sense organs in muscles and tendons
• Proprioceptors —detect stretch or tension

Naked nerve ending; pain/temp

Meissner’s corpuscule: touch

Pacinian corpuscule: deep pressure

Golgi tendon organ & muscle spindle;: proprioception

Functional Classification of Neurons, continued…

• Motor (efferent) neurons
• Carry impulses from the central nervous system to viscera, muscles, or glands
• Cell bodies always in CNS
• Interneurons (association neurons)
• Connect sensory and motor neurons in neural pathways
• Structural Classification of Neurons
• Multipolar neurons—many extensions from the cell body
• most common
• Bipolar neurons—one axon and one dendrite
• Rare in adults
• Act in sensory processing – eye, nose
• Unipolar neurons—have a short single process leaving the cell body
• Divides into proximal (central) and distal (peripheral) processes
• Dendrites only at peripheral end
• Conducts action potentials both ways
• Found in sensory neurons of PNS ganglia

Answer Did You Get It? #’s 4-7

• Physiology of the Nervous System
• Functional Properties of Neurons
• Irritability - ability to respond to stimuli and convert to nerve impulses
• Conductivity - ability to transmit an impulse to other neurons, muscles, or glands
• Nerve Impulses
• Electrical conditions of a resting neuron’s membrane
• Polarized – resting/inactive neuron
• Fewer positive ions on inner face of plasma membrane than on outer face
• Depolarized – stimulated neuron
• More positive ions inside the cell than outside

Nerve Impulses, continued…

• Action Potential Initiation and Generation
• Stimuli excite neurons: light, sound, pressure, mostly neurotransmitters released by other neurons
• Cause a temporary change in the cell membrane’s permeability
• Stimulus causes sodium channel gates to open, and sodium to rush in
• Causes depolarization of the neuron’s membrane
• Inside more positive, outside less positive = graded/local potential
• If stimulus is strong enough, a long distance signal called an action potential or nerve impulse occurs
• Nerve impulses are all-or-nothing responses – they are either propagated over the entire axon or not at all
• Repolarization
• Membrane immediately becomes impermeable to sodium, but permeable to potassium ions
• K + ions rush out of the neuron, restoring electrical conditions to polarized = repolarization
• Repolarization must occur before another impulse can be conducted
• The sodium-potassium pump, using ATP, restores the original concentrations of Na + and K + .
• Saltatory conduction = In myelinated fibers, propagation occurs more quickly since the nerve impulse jumps from node to node.
• Homeostatic imbalance: factors that impair impulse conduction:
• Sedatives & anesthetics block sodium entry
• Cold & continuous pressure interrupt blood circulation (nutrients & O 2 ) – e.g. ice creates numbness, foot “goes to sleep”; prickly feeling caused by impulse transmission starting back up
• Transmission of the Signal at Synapses
• Neurotransmitter is released from vesicles within the axon terminal
• Neurotransmitter molecules diffuse across the synapse
• Neurotransmitters bind to receptors in the membrane of the next neuron
• If enough neurotransmitters are released, another nerve impulse will be generated in this neuron
• Enzymes remove the neurotransmitters from the receptors
• Impulse transmission is an electrochemical event – electrical along the neuron’s membrane; chemical within the synapses

Axon�terminal

Synaptic�cleft

Action�potential�arrives

Axon of�transmitting�neuron

Receiving�neuron

Neurotrans-�mitter is re-�leased into�synaptic cleft

Neurotrans-�mitter binds�to receptor�on receiving�neuron’s�membrane

Vesicle�fuses with�plasma�membrane

Synaptic cleft

Neurotransmitter�molecules

Ion channels

Receiving neuron

Transmitting neuron

Neurotransmitter

Neurotransmitter�broken down�and released

Ion channel opens

Ion channel closes

• Reflex — rapid, predictable, and involuntary response to a stimulus
• Always travel in one direction
• Occurs over pathways called reflex arcs
• Reflex arc — direct route from a sensory neuron, to an interneuron, to an effector
• Neural pathway involving the CNS and PNS

Stimulus at distal�end of neuron

(in cross section)

Interneuron

Sensory neuron

Motor neuron

Integration�center

Reflexes, continued…

• Types of Reflexes
• Somatic reflexes
• Reflexes which stimulate the skeletal muscles
• Example: moving hand away from a hot stove
• Autonomic reflexes
• Regulate the activity of smooth muscles, heart, and glands
• Examples: salivary reflex, pupillary reflex
• Regulate: digestion, elimination, blood pressure, and sweating
• Parts of a reflex arc
• Sensory receptor – reacts to a stimulus
• Integration center
• Effector organ – muscle or gland which is stimulated
• Patellar (knee-jerk) reflex is an example of a two-neuron reflex arc

Figure 7.11d

Figure 7.11b–c

Sensory (afferent)�neuron

Motor�(efferent)�neuron

Sensory receptors�(stretch receptors�in the quadriceps�muscle)

Effector�(quadriceps�muscle of�thigh)

Synapse in�ventral horn�gray matter

Inter-�neuron

Sensory receptors�(pain receptors in�the skin)

Effector�(biceps�brachii�muscle)

• Flexor (withdrawal) reflex is an example of a three-neuron reflex arc
• Withdrawal reflex arc has an interneuron
• The more neurons involved, the slower the communication because of the time it takes for neurotransmitters to diffuse
• Many spinal reflexes do not involve the brain
• Other reflexes require the brain to evaluate different types of information
• Reflex testing evaluates condition of the nervous system
• Exaggerated, distorted, and absent reflexes indicate nervous system disorders

Answer Did You Get It? #’s 8-11

• Central Nervous System (CNS)
• CNS develops from the embryonic neural tube
• Runs along the dorsal median plane
• 4 th week – anterior end expands = brain formation
• Rest of tube = spinal cord
• The central canal of the neural tube enlarges into 4 chambers = ventricles
• Filled with cerebrospinal fluid
• Functional Anatomy of the Brain
• ~3 lbs, wrinkled, texture similar to cold oatmeal
• 4 major regions:
• Cerebral hemispheres (cerebrum)
• Diencephalon

Regions of the Brain: Cerebrum

• Cerebrum (cerebral hemispheres)
• Paired, superior parts of the brain
• Includes more than half of the brain mass; obscures most of the brain stem
• The surface is made of ridges ( gyri = “twisters”) and grooves ( sulci = “furrows”)
• Fissures (deep grooves) divide the cerebrum into lobes
• Occipital lobe
• Temporal lobe

Figure 7.13b

• Cerebral Cortex
• Functions : speech, memory, logic, emotion, consciousness, sensation interpretation, & voluntary movement
• Cell bodies of neurons in cerebral cortex in outermost gray matter
• Primary somatic sensory area
• In parietal lobe posterior to central sulcus
• Receives & interprets impulses from the body’s sensory receptors
• Detects: pain, cold, light touch

Sensory & motor homunculus – the more neurons there are for a function, the larger the area represented by that body region

Figure 7.14

• Visual area in occipital lobe
• Auditory area in temporal lobe
• Olfactory area deep in temporal lobe
• Primary motor area in frontal lobe
• Conscious movement of skeletal muscle
• Axons of these motor neurons form the corticospinal or pyramidal tract
• Descends to spinal cord
• Broca’s area at base of precentral gyrus
• Involved in our ability to speak
• Only located in one (usually left) hemisphere
• Damage here can cause inability to speak – conscious of what you want to say, but unable to do it
• Frontal association areas – higher intellectual reasoning & socially acceptable behavior
• Complex memories stored in temporal and frontal lobes
• Speech/language (Wernicke’s) area – junction of temporal, parietal, & occipital lobes
• Allows us to sound out words
• Usually in just one hemisphere
• Damage: Wernicke’s aphasia – lack of language comprehension; clear speaking though
• Frontal lobes – language comprehension (word meaning)
• Gustatory area – taste – base of primary somatic sensory area (parietal)
• General interpretation area – temporal & parietal
• Cerebral White Matter
• White matter—fiber tracts carrying impulses to, from, and within the cortex
• Corpus callosum – large tract connecting hemispheres; allows hemispheres to communicate with one another
• Called commisures
• Association fiber tracts connect areas within hemispheres ; projection fiber tracts connect cerebrum to lower CNS centers
• Basal nuclei (basal ganglia ) — islands of gray matter buried within the white matter
• Regulate voluntary

motor activities

• Homeostatic Imbalance:
• Problems with basal

nuclei cause difficulty in

walking or other voluntary

movements: Huntington’s

disease & Parkinson’s

Answer Did You Get It? #’s 12-13

• Regions of the Brain: Diencephalon (Interbrain)
• Sits on top of brain stem; enclosed by the cerebral hemispheres
• Made of three parts: Thalamus, Hypothalamus, Epithalamus
• Thalamus – relay station for sensory impulses traveling up to sensory cortex
• Crude awareness of a pending sensation being pleasant or not
• Hypothalamus – floor of diencephalon
• Autonomic NS center: helps body temp, water balance, & metabolism
• Limbic system – “emotional-visceral brain” where thirst, appetite, sex, pain, and pleasure centers are
• Regulates the pituitary gland ; secretes hormones
• Mammillary bodies – reflex centers involved in olfaction

Regions of the Brain: Diencephalon

• Epithalamus
• Forms the roof of the third ventricle
• Houses the pineal body (an endocrine gland)
• Includes the choroid plexus —complex of capillaries which form cerebrospinal fluid

Regions of the Brain: Brain Stem

• Small: ~thumb in diameter & ~3” long
• 3 regions: midbrain, pons, & medulla oblongata
• Provides a pathway for ascending & descending tracts
• Contains nuclei with rigidly programmed autonomic behaviors necessary for survival
• Some connected to cranial nerves controlling breathing & blood pressure
• From mammilary bodies to pons
• Cerebral aqueduct – canal connecting 3 rd ventricle of diencephalon to 4 th ventricle
• Has two bulging fiber tracts — cerebral peduncles : convey ascending & descending impulses
• Mostly composed of tracts of nerve fibers
• Has four rounded protrusions— corpora quadrigemina (“gemini” = twins)
• Reflex centers for vision and hearing
• Pons (“bridge”)
• Rounded part of brain stem just below midbrain
• Mostly composed of fiber tracts
• Includes nuclei involved in the control of breathing
• Medulla Oblongata
• Most inferior part of the brain stem
• Merges into the spinal cord
• Includes important fiber tracts
• Contains nuclei which control:
• Blood pressure
• Fourth ventricle
• Reticular Formation
• Diffuse mass of gray matter along the length of the brain stem
• Involved in motor control of visceral organs
• Reticular activating system (RAS) plays a role in awake/sleep cycles and consciousness
• Damage here can cause a coma (permanent unconsciousness)
• Regions of the Brain: Cerebellum
• Cauliflower-like, dorsally projecting from under the occipital lobe
• Two hemispheres with convoluted surfaces
• Outer cortex composed of gray matter; inner region composed of white matter
• Provides precise timing for skeletal muscle activity and controls balance & equilibrium
• “Automatic pilot” – compares brain’s intentions with body’s actual performance; initiates appropriate corrective measures
• Ataxia – damage to cerebellum can result in clumsy & disorganized movements; appear to be drunk

Answer Did You Get It? #’s 14-16

• Protection of the Central Nervous System
• Nervous tissue is soft and delicate; neurons injured easily
• Brain and spinal cord protected by
• Scalp and skin
• Skull and vertebral column
• Meninges (membranes)
• Cerebrospinal fluid (watery cushion)
• Blood-brain barrier – protection from harmful substances in the blood

Figure 7.17b

• Connective tissue membranes which cover & protect the CNS
• Double-layered, outermost layer; leathery
• Periosteal layer (periosteum)—attached to inner surface of the skull
• Meningeal layer —outer covering of the brain; fuses with the dura mater of the spinal cord
• Layers are fused except in dural venous sinuses where venous blood is collected
• Inward folds attach brain to cranial cavity
• Falx cerebri & tantorium cerebelli
• Arachnoid mater (“spider”)
• Middle layer
• Attached to the pia mater, forming the subarachnoid space
• Filled with cerebrospinal fluid (CSF)
• Arachnoid villi – projections of arachnoid mater; protrude through dura mater
• CSF passes into dural sinuses through these structures
• Pia mater (“gentle mother”)
• Innermost membrane
• Clings tightly brain and spinal cord surfaces
• Epidural injections – “upon the dura”
• Homeostatic Imbalance :
• Meningitis – inflammation of the meninges
• Bacterial or vial infections
• Serious threat to brain if spreads into CNS
• Encephalitis – inflammation of the brain
• Diagnosed by sampling CSF

Cerebrospinal Fluid (CSF)

• Similar to blood plasma composition
• Less protein, more vitamin C, different ion composition
• Formed from blood by choroid plexuses
• Clusters of capillaries hanging from each of brain’s ventricles
• Forms a watery cushion to protect the brain from trauma
• Circulated in arachnoid space, ventricles, and central canal of the spinal cord
• CSF continually circulates in brain
• From two lateral ventricles, to 3 rd ventricle, through cerebral aqueduct, to 4 th ventricle
• Some CSF continues to spinal cord
• Normally circulates at a constant rate
• Changes to CSF composition may indicate meningitis, tumors, or MS
• Lumbar/spinal tap – sample the CSF
• Remain lying down for 12 hrs or “spinal headache”
• Homeostatic Imbalance - Hydrocephalus
• If something obstructs CSF drainage, it accumulates and exerts pressure on the brain
• “Water on the brain”
• Results in enlarged head in newborns with increasing brain size
• Would cause brain damage in adults
• Treated by surgically inserting a shunt (plastic drain); drains excess fluid into a vein
• Blood-Brain Barrier
• Brain is super sensitive to having a constant internal environment
• Neurons kept separated from bloodborne substances by the blood-brain barrier
• Composed of least permeable capillaries of the body
• Bound by tight junctions
• Allowed to enter:
• Water, glucose, and essential amino acids pass easily through
• Metabolic wastes (urea, toxins, proteins, most drugs), nonessential amino acids, K +
• Useless as a barrier against some substances
• Fats and fat soluble molecules
• Respiratory gases

Answer Did You Get It? #’s 17-19

• Traumatic Brain Injuries
• Head injuries are leading cause of accidental death in US; caused by damaging blow to head
• Further damage caused by brain ricocheting on opposite end of skull
• Slight brain injury
• Dizzy/”see stars,” briefly lose consciousness
• No permanent brain damage
• Marked tissue destruction occurs
• May remain conscious if cerebral cortex injury; may be in coma if brain stem is injured severely (especially RAS)
• Nervous tissue does not regenerate
• Intracranial hemorrhage
• Bleeding from ruptured vessels
• May cause death
• Cerebral edema
• Brain swelling from the inflammatory response
• May compress and kill brain tissue – neurological deterioration
• Cerebrovascular Accident (CVA/Stroke)
• 3 rd leading cause of death in US
• Blood circulation to brain is obstructed by a blood clot or ruptured blood vessel
• Brain tissue supplied with oxygen from that blood source dies
• Loss of some functions or death may result; undamaged neurons can spread into damaged areas and take over some lost functions (= neuroplasticity )
• Hemiplegia – one-sided paralysis ( e.g. right-sided paralysis = damage to left motor cortex)
• Apahsia – damage to language areas
• Motor/Broca’s aphasia – loss of ability to speak
• Sensory/Wernicke’s aphasia – loss of ability to understand written & spoken language
• Transient ischemic attack (ITA) – temporary restriction of blood flow (ischemia) to brain
• Last 5-50 min; numbness, temporary paralysis; impaired speech
• Warning of impending, more serious CVA

Answer Did You Get It #20

• The Terrible Three
• Alzheimer’s Disease
• Progressive degenerative brain disease, results in dementia (mental deterioration)
• Mostly seen in the elderly, but may begin in middle age
• Victims experience: memory loss, short attention span, disorientation, eventual loss of language, irritability, moodiness, confusion, sometimes violent, and ultimately, hallucinations.
• Structural changes in the brain include: low Ach, shrinking gyri, brain atrophy (especially in areas of thought and memory), abnormal protein (senile plaque – beta amyloid peptide ) deposits, and twisted tau fibers within neurons
• Treat with acetylcholinesterase inhibitors
• Parkinson’s Disease
• Problem associated with basal nuclei; cause not known
• Typically affects people in 50’s-60’s
• Degeneration of dopamine-releasing neurons in the substantia nigra, causing basal nuclei to become overactive
• Symptoms: persistent tremor (even at rest), head nodding, “pill-rolling” of fingers, forward-bent walking posture, shuffling gait, stiff facial expressions, difficulty in initiating movements
• Treatments: L-dopa for some symptoms (bad side effects); deprenyl to slow degeneration; thalamic stimulation via electrodes alleviates tremors; implants of embryonic tissue promising
• Huntington’s Disease
• Genetic disorder (dominant) – typically occurs at middle-age
• Massive degeneration of basal nuclei and later of the cerebral cortex
• Progressive symptoms: wild, jerky movements ( chorea ), later marked mental deterioration
• Typically fatal within 15 years
• Overstimulation of motor cortex
• Treat with drugs that block dopamine; fetal tissue implants are promising
• Spinal Cord
• 2-way conduction pathway to and from the brain
• Major reflex center (spinal reflexes)
• Extends from the foramen magnum of the skull to the first or second lumbar vertebra
• Cushioned & protected by meninges
• 31 pairs of spinal nerves arise from the spinal cord
• Cervical & lumbar enlargements – origin of upper & lower limb nerves
• Cauda equina (horse’s tail) is a collection of spinal nerves at the inferior end

Spinal Cord Anatomy

• Gray matter of Spinal Cord and Spinal Roots
• Gray matter surrounds the central canal (filled with CSF)
• Dorsal (posterior) horns – project posteriorly
• Contain interneurons
• Sensory neuron cell bodies in dorsal root ganglia ; enter spinal cord through dorsal root
• Anterior (ventral) horns – project anteriorly
• Motor neuron cell bodies in ventral horns; axons exit spinal cord through ventral root
• Homoeostatic imbalance – flaccid paralysis – damage to ventral root = no stimulation of muscles
• Spinal nerves – fusion of dorsal and ventral roots
• White matter of the Spinal Cord
• Myelinated fiber tracts (see 7.22)
• Dorsal, lateral, ventral columns
• Sensory/afferent tracts – conduct sensory impulses to brain
• Motor/efferent tracts – conduct impulses from brain to skeletal muscles
• Dorsal column tracts are all ascending carrying sensory input to brain
• Lateral & ventral tracts contain both ascending & descending tracts
• Homeostatic imbalance – spastic paralysis : transected (cut crosswise) or crushed spinal cord – affected muscles stay healthy b/c still stimulated, but moments become spastic; loss of feeling below injury
• Quadriplegic = 4 limbs affected
• Paraplegic = legs only

Answer Did You Get It? #’s 21-23

• Peripheral Nervous System (PNS)
• Nerves and ganglia outside CNS
• Structure of a Nerve
• Nerve = bundle of neuron fibers outside the CNS
• Neuron fibers are bundled by connective tissue
• Delicate endoneurium surrounds each fiber
• Groups of fibers are bound into fascicles by coarser perineurium
• Fascicles are bound together by tough, fibrous epineurium
• Forms cordlike nerve

Structure of a Nerve, continued…

• Nerves are classified according to the direction in which they transmit impulses:
• Mixed nerves – nerves with both sensory and motor fibers
• Sensory (afferent) nerves – nerves carrying impulses toward the CNS
• Motor (efferent) nerves – nerves carrying impulses away from the CNS
• Cranial Nerves
• 12 pairs of nerves that mostly serve the head and neck
• Only the pair of vagus nerves extend to thoracic and abdominal cavities
• Numbered in order; names typically match the structures they control
• Most are mixed nerves, but three are sensory only (optic, olfactory, & vestibulocochlear)

Cranial Nerves, continued…

• Olfactory nerve — sensory for smell
• Optic nerve — sensory for vision
• Oculomotor nerve — motor fibers to eye muscles (most movements, lens shape, & pupil size)
• Trochlear nerve — motor fiber to eye muscle (superior oblique)
• Trigeminal nerve — sensory for the face, nose, & mouth; motor fibers to chewing muscles
• Abducens nerve — motor fibers to eye muscles (lateral movement)
• Facial nerve — sensory for anterior taste buds; motor fibers for facial expression and lacrimal & salivary glands
• Vestibulocochlear nerve — sensory for balance and hearing
• Glossopharyngeal nerve — sensory for posterior taste buds; motor fibers to the pharynx (swallowing & saliva production); carotid artery pressure sensors
• Vagus nerves — sensory and motor fibers for pharynx, larynx, and thoracic & abdominal viscera (mostly parasympathetic = promote digestion & regulate heart activity)
• Accessory nerve — motor fibers to sternocleidomastoid & trapezius
• Hypoglossal nerve — motor fibers for tongue movements; sensory impulses from tongue
• O h O nce O ne T akes T he A natomy F inal V ery G ood V acations A re H eavenly.
• O nly O wls O bserve T hem T raveling A nd F inding V oldemort G uarding V ery S ecret H orcruxes
• Spinal Nerves & Nerve Plexuses
• There are 31 pairs formed by the combination of the ventral and dorsal roots of the spinal cord
• Named for the region from which they arise
• Spinal nerves divide after leaving the spinal cord
• Dorsal rami — serve the skin and muscles of the posterior trunk
• Ventral rami — for nerves T 1 -T 12 forms intercostal nerves (muscles between ribs & skin and muscles of anterior trunk); for rest of nerves forms a nerve networks ( plexus ) for limb sensory & motor

Answer Did You Get It? #’s 24-27

Spinal Nerves & Nerve Plexuses, continued…

• Cervical plexus – from C 1 –C 5 ventral rami
• Phrenic nerve – diaphragm; shoulder/neck muscles
• Brachial plexus – from C 5 –C 8 and T 1 ventral rami
• Axillary nerve – deltoid muscle, shoulder skin; superior thorax muscles & skin
• Radial nerve – triceps & extensor muscles; upper limb posterior skin
• Median nerve – flexor muscles; forearm skin; some hand muscles
• Musculocutaneous nerve – arm flexor muscles; lateral forearm skin
• Ulnar nerve – some forearm flexor muscles; wrist & hand muscles; hand skin
• Lumbar plexus – from L 1 –L 4 ventral rami
• Femoral nerve – lower abdomen , hip flexors & knee extensors; leg & thigh anteromedial skin
• Obturator nerve – adductor & small hip muscles; medial thigh & hip joint skin
• Sacral plexus – from L 4 –L 5 and S 1 –S 4 ventral rami
• Sciatic nerve – largest nerve in body; splits into two nerves; lower trunk & posterior thigh surface (hip extensors & knee flexors)
• Common fibular nerve – lateral leg & foot
• Tibial nerve – posterior leg & foot
• Superior & inferior gluteal nerves – gluteal muscles

Distribution of Major Peripheral Nerves of the �Upper and Lower Limbs

Spinal Nerve Plexuses

Autonomic Nervous System (AKA Involuntary NS)

• Motor subdivision of the PNS
• Controls body activities automatically
• Special neurons that regulate cardiac muscle, smooth muscle (visceral organs & blood vessels), and glands
• Helps to maintain homeostasis – constantly makes adjustments to keep internal conditions stable
• Consists only of motor nerves

Note the differences between ANS & SNS

Autonomic Nervous System, continued…

• Somatic vs. Autonomic nervous systems (both PNS)
• Different effector organs and neurotransmitters
• Somatic NS has cell bodies in CNS and an axon that extends to the effector organ
• Autonomic NS has a chain of two motor neurons
• Preganglionic axon – 1 st neuron; in the CNS (“before the ganglion”)
• Postganglionic axon – 2 nd neuron; outside of CNS; goes to organ
• Two divisions of ANS
• Sympathetic & parasympathetic division
• Regulate the same organs, but with opposite effects (counterbalance one another)
• Sympathetic division – mobilizes body during extreme situations (“fight vs. flight”)
• Parasympathetic division – rest and digest; unwind & conserve

Brain & Spinal Cord Cranial & Spinal Nerves

Sensory Division Motor Division

(Periphery → CNS) (CNS → Periphery)

Afferent/Incoming Efferent/Outgoing

Cranial Spinal Somatic Motor NS Autonomic NS

Nerves Nerves Voluntary Involuntary

Sympathetic Parasympathetic Enteric

Stimulatory Inhibitory GI

• Anatomy of the Parasympathetic Division
• Originates from brain nuclei of cranial nerves (III, VII, IX, & X) and S 2 -S 4
• AKA craniosacral division
• Cranial neurons synapse with ganglionic motor neuron in terminal ganglia (basically are at the effector organs)
• Sacral preganglionic neurons form pelvic splanchnic nerves (pelvic nerves) – pelvic cavity
• Always uses acetylcholine as a neurotransmitter
• Anatomy of the Sympathetic Division
• Originates from gray matter in spinal cord from T 1 through L 2
• AKA thoracolumbar division
• Ganglia are at the sympathetic trunk (near the spinal cord)
• Short pre-ganglionic neuron and long post-ganglionic neuron transmit impulse from CNS to the effector
• Norepinephrine and epinephrine are neurotransmitters to the effector organs
• Sympathetic Functioning —“fight or flight”
• Response to unusual stimulus
• Takes over to increase activities
• Remember as the “E” division
• Exercise, excitement, emergency, and embarrassment
• Homeostatic Imbalance – excessive sympathetic NS stimulation
• Type A personality – never slows down; may be susceptible to heart disease, high blood pressure, ulcers
• Parasympathetic Functioning —“housekeeping” activites
• Conserves energy (rest & digest)
• Maintains daily necessary body functions
• Remember as the “D” division
• digestion, defecation, and diuresis

Answer Did You Get It? #’s 28-30

• Tracking Down CNS Problems
• EEG – electroencephalography
• Recording of brain neuron’s electrical impulse transmission
• Attach electrodes on scalp
• Record speed of brain waves (unique to each individual)
• Alpha = awake, relaxed state
• Beta = awake, alert state
• Theta = common in children, not normal adults
• Delta = deep sleep

Tracking Down CNS Problems, continued…

• CT, MRI & PET scans
• CT (computed axial tomography) & MRI (magnetic resonance imaging) – easily identify tumors, intracranial lesions, MS plaques & areas of dead brain tissue (infarcts)
• PET scans – localize lesions that cause epileptic sezures; used for Alzheimer’s diagnosis, and in cancer tumor activity

CT Scan: normal vs. tumor

PET Scan: normal vs. Alzheimer’s disease

• Cerebral angiography
• Used to visualize arteries in brain
• Used to guide a catheter carrying clot-busting drugs (tPA)

Cerebral angiogram showing an aneurism

87-year-old man with acute onset left hemiplegia. . The image on the left (A) obtained preoperatively. The image on the right (B) was obtained after intra-arterial thrombolysis.

• Development Aspects of the Nervous System
• The nervous system is formed during the first month of embryonic development; therefore, any maternal infection can have extremely harmful effects
• Maternal measles (rubella) = deafness
• Lack of O 2 for minutes can cause neuron death
• Smoking decreases amount of O 2 in blood; less O 2 to developing fetus’s brain (potentially brain damage)
• Radiation & drugs (alcohol, opiates, cocaine, etc.) can all damage fetal nervous system development
• Homeostatic imbalances :
• Cerebral palsy – poor control and spastic movements of voluntary muscles, seizures, mental retardation, impaired hearing & vision
• Can be caused by lack of O 2 during difficult delivery
• Anencephaly – failure of the cerebrum to develop; cannot hear, see, or process sensory inputs
• Spina bifida – “forked spine”; vertebra fail to completely form; can result in varying degrees of paralysis & loss of bowel and bladder control

Development Aspects of the Nervous System, cont’d

• The hypothalamus is one of the last areas of the brain to develop (regulates body temperature_
• Premature babies can’t thermoregulate well
• Continued growth & maturation of nervous system through childhood
• Myelination: cranial to caudal; proximal to distal
• Brain is maximum weight as young adult
• Neurons then continue to get damaged and die
• Steady decline of brain weight and volume
• Can still learn throughout life; unlimited neural pathways available
• Sympathetic NS becomes less efficient (especially in constricting blood vessels)
• Orthostatic hypotension – pooling of blood in the feet due to lack of activation of vasoconstrictor fibers and lightheadness; common in elderly when they stand up quickly
• Arteriosclerosis (plaque build up in arteries) and high blood pressure result in less O 2 supply to brain
• Can causes senility – forgetfulness, irritability, confusion, and difficulty in concentrating and thinking clearly
• Some drugs, low blood pressure, constipation, poor nutrition, depression, dehydration, and hormone imbalances can cause “reversible senility”
• Professional boxers (& other high impact sports) and chronic alcoholics hasten the effects of aging on the brain
• “Punch drunk” – slurred speech, tremors, abnormal gait, dementia in retired boxers
• Reduced brain size in both

Answer Did You Get It? #’s 31-32

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NERVOUS SYSTEM DISORDERS

Jan 05, 2020

1.33k likes | 1.38k Views

NERVOUS SYSTEM DISORDERS. And Associated Nursing Care. Conciousness Increased Intracranial Pressure (ICP) Head Injury Degenerative and Autoimmune Nervous System Disorders. Consciousness. Consciousness.

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• cerebral blood
• intracranial pressure
• blood volume
• cerebral blood volume
• blood flow pressure gradient

Presentation Transcript

NERVOUS SYSTEM DISORDERS And Associated Nursing Care

Conciousness • Increased Intracranial Pressure (ICP) • Head Injury • Degenerative and Autoimmune Nervous System Disorders

Consciousness

Consciousness Is a condition in which the person is aware of self and the environment and is able to respond appropriately to stimuli (McLeaod, 2004). Two components: • Arousal: (or awakeness) reflects activity of RAS, thalmus and upper brain stem. • Content: cognitive mental functions reflects cerebral cortex activity (thought processes, memory, perception, problem solving, & emotion)

Altered Consciousness • Definition: condition of being less responsive to and aware of environmental stimuli (Smeltzer & Bare, 2004). Unconsciousness • Definition: physiological state in which the client is unresponsive to sensory stimuli and lacks awareness of self and the environment (Hickey, 2003)

Unconsciousness • Can be brief, lasting a few second to a few hours or longer. • To produce unconsciousness a disorder must: • Disrupt the RAS which extends up to the thalmus. • Significantly disrupt the function of both cerebral hemispheres • Metabolically depress overall brain function

Coma Coma is a prolonged state of unconsciousness in which the client is unaware of self or the environment for sustained periods of time from hours to months. (Hickey, 2003) Because of: -disorders that affect BOTH cerebral hemispheres - disorders that affect any part of the RAS - direct compression on parts responsible for conciousness ie: hemorrhage, tumors - metabolic disorders (hypoglycemia, hypoxia) - toxins ** Duration of coma is associated with mortality & outcome****

Major Causes and manifestations of Altered Consciousness Reduction in level of consciousness may be caused by extracranial or intracranial causes.

Intracranial Causes Supratentorial lesions (above the cerebellum) • A lesion must affect the cerebral hemispheres directly and widely to cause diffuse bilateral hemispheric dysfunction and subsequent coma (Hickey, 2003) Infratentorial Disorders Involve cerebellum and brain stem • Cause sudden LOC • Usually produce: • Early coma - Abnormal respiratory patterns - Oculorvestibulary abnormalities - Pupillary changes

Extracranial Causes: Metabolic Disorders or Toxins • Usually produces confusion first • Findings are symmetrical or bilateral • Physical symptoms include tremors, asterexis,, myoclonus & seizures. • Pupillary response is normal unless related to drug overdose.

Examples • Hypoxemia • Hypercapnia/acidosis • Hypotension • Blood sugar alterations (DKA, hypoglycemic coma) • Liver dysfunction • Fluid/electrolyte disorders • Multiorgan dysfunction • Drug effects

Psychogenic Coma • Although rare, pychogenic disorders such as hysteria, catatonia, and severe depression can cause alterations in LOC • Despite outward appearances the person is physiologically awake.

Assessment • Glasgow Coma Scale • Mini-mental • Diagnostic Tests • CT and MRI • Lumbar Puncture • EEG • Laboratory Tests • Tests for Abnormal Reflexes • Oculocephalic Reflex Response • Oculovestibular Reflex Response

The Glasgow Coma Scale The Glasgow Coma Scale (GCS) is a universally used neurological assessment tool to assess degree of consciousness impairment. CGS measures eye, verbal, and motor response. It is an excellent scale to measure arousal. It is less helpful related to content measurement. Know the difference b/t content & arousal

GLASGOW COMA SCALE SCORE (GCS) Eyes 1 Closed at all times 2 Opens to pain 3 Opens to voice command 4 Open spontaneously Motor 1 No response 2 Extension (decerebrate) 3 Flexion posturing (decorticate) 4 Flexion withdrawal 5 Localizes painful stimulus 6 Obeys commands Verbal 1 No response 2 Incomprehensible sounds 3 Inappropriate words 4 Disoriented and converses 5 Oriented and converses 15 (top score) A score of 10 or less indicates a need for emergency attention A score less than 7 is interpreted as coma

*Level of consciousness is the single most important indicator of neurological function and change* * Important!

CONTENT Besides orientation to time, place and person the following cognitive abilities should also be assessed: • Attention and vigilance • Memory – short, intermediate, long term • Language – understanding of spoken and written word • General fund of information • Construction ability • Sequencing activities • Problem solving • Abstraction • Insight and judgment The Mini Mental Status Exam is an example of a test for cognitive function. (Used on GARU).

Diagnostic Tests • CT or MRI: data on structural causes such as tumor or hemmorhage. -Metabolic – will be unremarkable • LP: infection or bleeding (cloudy or bloody) • EEG: structural or metabolic, seizure activity • Lab tests: LFTs, kidney function, glucose levels, toxicology, ABGS

Diagnostic Tests for Abnormal Reflexes • Oculocephalic reflex response – abnormal if eyes remain in fixed position when head turned • Oculovestibular reflex response – absence of eye movement when water instilled in ear = brain death

Medical Management: goal is to preserve brain function & prevent further damage • Determine Level of Involvement • Reverse Common Causes of Coma • Prevent Complications

Nursing Diagnoses • Altered Tissue Perfusion • Risk for Suffocation/Aspiration • Altered Oral Mucous Membranes • Risk for Impaired Skin Integrity • Risk for Contractures • Altered Nutrition: Less than Body Requirements • Fluid volume deficit • Risk for Injury • Altered family processes

Maintaining the airway Protecting the patient Fluid balance Mouth care, skin and joint integrity Corneal integrity Thermoregulation Nursing management

Nursing Assessment: Brain Injury • ABCDs • Maintaining airway • History if possible • Determine LOC, ability to respond to verbal commands, reactions to tactile stimuli, status of reflexes. • Glasgow Coma scale • Fluid and electrolyte balance • Monitoring/managing potential complications

Increased Intracranial Pressure

Intracranial pressure • ICP is the pressure exerted by the brain tissue, CSF, and cerebral blood within the intracranial vault.

There is a delicate balance that exists between the volume of the intracranial contents within this rigid compartment (80% brain tissue, 10% blood, 10%CSF) • The normal ICP is 0-15 mmHg (15 is the upper limit). • Pressures over 20mm Hg represent severely increased ICP,which seriously impairs cerebral perfusion.

Important Parameters Affecting ICP • Cerebral perfusion pressure (CPP) • Cerebral blood volume (CBV) • Cerebral blood flow (CBF)

Cerebral perfusion pressure (CPP)is the amount of blood flow (pressure gradient ) from the systemic circulation that is required to provide adequate oxygen and glucose for brain metabolism. • It is the difference between mean arterial pressure (MAP) and ICP. CPP = MAP – ICP • Mean arterial pressure (MAP)represents the average pressure during the cardiac cycle. Calculate by: systolic pressure + 2 X diastolic divided by 3. Example BP 70/34. MAP= 46

Cerebral blood volume (CBV) is dependent on cerebral blood flow (CBF). • If CBF increases, so does CBV. CBF depends upon cerebral perfusion pressure (CPP). When MAP & ICP are equal there is no CPP & blood flow stops! )

Maintenance of ICP Autoregulation is the compensatory changes in the diameter of the intracranial blood vessels designed to maintain a constant blood flow during changes in systemic arterial pressure (cerebral perfusion pressure).

Critical point may be reached when either: • the ICP is greater than 30 to 35 mm Hg • systemic blood pressure is less than 60 mm Hg • Systemic BP greater than 160 mm Hg. Autoregulation is lost with increasing ICP. After this the CBF will vary passively with systemic blood pressure.

The Munro-Kellie Hypothesis Know this! The Munro-Kellie Hypothesis states that a change in volume of any of the normal components (brain, cerebral blood volume and cerebrospinal fluid) of the intracranial vault must be accompanied by a reciprocal change in one or more of the other components. If this reciprocal change is not accomplished the result is an increase in intracranial pressure (ICP).

How does the body compensate for changes in ICP? 1. Compliance • Displacement of CSF into the spinal subarachnoid space • Increased absorption of CSF • Decreased secretion of CSF

Compensatory mechanisms cont’d 2. Reduction of blood volume in the brain. • Venous blood may be shunted to allow more room for expansion. • As this ability decreases, the venous pressure increases, & CBV and ICP rise • This stage of compensation alters cerebral metabolism, eventually leading to brain tissue hypoxia and areas of ischemia.

Compensatory mechanisms cont’d 3. Herniation displacement of brain tissue. Most lethalstage of compensation. Process often results in death from brain stem compression. Always an emergency!

Results! • Compression • Laceration • Vascular compromise • Necrosis of structures • Blocked flow CSF • Brain compression and death

Common Causes • Increases in tissue volume • Space occupying lesions: brain tumor, abscess, hemorrhage, • Cerebral edema: infarction, interstitial edema, infection, metab0olic disorders, toxins, electrolyte imbalances • Abscess • Increases in CSF • hydrocephalus • Deficient CSF absorption or overproduction of CSF (Hogan & Hill, 2004)

Causes Cont’d • Increases in blood volume • epidural & subdural hematoma. • impaired blood flow to and from brain, • CO2, O2, • Hypertension

HYPERCAPNIA AND HYPOXIA • Any systemic process that affects blood levels of carbon dioxide will affect CBF, CPP and CBV because of cerebral vasodialation. • These conditions include respiratory inadequacy, poor ventilation, hyperventilation, drugs, and inadequate amounts of oxygen. Important!

Any process that results in increased ICP will produce impairment of content and arousal. Manifestations include any alteration in level of consciousness (restlessness, drowsiness, confusion) and a decrease in Glasgow Coma Scale (GCS) Clinical manifestations of increased ICP aresubtle!!!Diligent observation for changes in client’s condition. (Porth, C., 2004) Manifestations of Increasing Intracranial Pressure #1 RESTLESSNESS

Decreased level of consciousness Behavioral changes Headache Nausea & Vomiting Change in speech pattern Abnormal pupillary reactions Changes in body temperature Change in sensorimotor status Blurred or double vision (diplopia) Changes in cardiac rate & rhythm ataxia Seizures Cushing’s triad Abnormal posturing In addition may have:

Nerve compression with IICP

CUSHING’S TRIAD! A response involving three classis signs: • widening pulse pressure: increased systolic BP with diastolic remaining the same or slightly elevated. • Bradycardia • Slowing respirations Cushing’s triad indicates increased severe ICP! Very Important!

Emergency Care • ABCs • Airway maintenance, intubation with oxygenation (PO2 > 90mmHg), mild hyperventilation – avoid hypercapnia. • Ensure adequate fluid however avoid lowering the blood osmolarity. • Initial neuro assessment and Glasgow Coma Scale • Etiology of the brain injury will dictate further evaluation & treatment

Emergency Care Cont’d • osmotic diuretics (mannitol IV) • steroids (controversial) • vasoactive medication (100-150mmHg systolic) • elevate HOB (30 degrees) • sedate as needed (barbituates IV) • drain CSF (keep ICP < 20) • maintain fluid status (normal serum Na & osmolality)

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Brain Tumors Clinical Case

Are you in oncology? This brain tumor clinical case template has the simple design that serious medical topics require. Use it to convey information clearly. With its simple typography and elegant design with a grid background and windows that simulate those of a web browser, this presentation manages to work...

Brain Infographics

This presentation contains many brain infographics. They are great to express ideas, metaphorically speaking. You can add steps, express the sections of a brainstorming session… They are great in different areas in which creativity is key, such as education, business, education of health. You’ll find tables, arrows, icons and flat...

Traumatic Brain Injury Clinical Case

Medical presentations tend to be a bit too serious—of course, injuries and the like are not a matter of laughter. However, you can turn your slideshows a bit more dynamic and enjoyable for all kinds of audiences. With this new template, you can talk about a clinical case on traumatic...

Pastel Watercolor Mental Health Clinic

Sometimes we are more concerned about physical health than mental health, when we should be aware that being both inside and out is essential to our overall well-being. Fortunately, there are medical centers, such as mental health clinics, full of psychology professionals who are in charge of treating our mental...

Neurology Healthcare Center

Neurology is one of the most fascinating branches of medicine, and we still know very little about the amazing organ that is the brain. If you have a medical center specializing in neurology we encourage you to make it known with this fun wave template with doodle style. Its light...

Nervous System Breakthrough

Presenting breakthroughs in the nervous system just got cooler! With this amazing presentation template, you can showcase your research with a vintage vibe. Its design style is all sepia, even the illustrations, so it evokes the feeling of finding an old doctor's notebook- like you've unlocked a fascinating secret! This...

Learn More About the Nervous System

Discover the fascinating world of the nervous system with this creative template. With calming colors and engaging visuals, you'll be able to explore the different components of the nervous system in a fun and informative way. Plus, you'll get an in-depth look at the neurons, neurotransmitters, and the effects of...

Brain Teasers for High School

Do you want to test the ingenuity of your high school students? In this editable template you will find different examples of brain teasers, with which you can get inspired and add your own. As for the design, it contains maze-like shapes on the backgrounds, using different flashy colors that...

Computed Tomography Breakthrough

Experience the avant-garde of technology with a computed tomography breakthrough. Present a breakthrough with this vivid infographics of soft colors and cool illustrations of computed tomography. Its easy-to-navigate functionality lets you explore new frontiers in diagnostics. Make this breakthrough an integral part of your healthcare solution and navigate the future...

Cerebellar Disorders

Download the Cerebellar Disorders presentation for PowerPoint or Google Slides. Taking care of yourself and of those around you is key! By learning about various illnesses and how they are spread, people can get a better understanding of them and make informed decisions about eating, exercise, and seeking medical attention....

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Writing tone, number of slides, cerebrovascular accident recovery breakthrough.

Download the "Cerebrovascular Accident Recovery Breakthrough" presentation for PowerPoint or Google Slides. Treating diseases involve a lot of prior research and clinical trials. But whenever there’s a new discovery, a revolutionary finding that opens the door to new treatments, vaccines or ways to prevent illnesses, it’s great news. Should there...

Cranioencephalic Trauma Case Report

Download the "Cranioencephalic Trauma Case Report" presentation for PowerPoint or Google Slides. A clinical case is more than just a set of symptoms and a diagnosis. It is a unique story of a patient, their experiences, and their journey towards healing. Each case is an opportunity for healthcare professionals to...

Infectious Disease: Meningitis

Download the "Infectious Disease: Meningitis" presentation for PowerPoint or Google Slides. Taking care of yourself and of those around you is key! By learning about various illnesses and how they are spread, people can get a better understanding of them and make informed decisions about eating, exercise, and seeking medical...

Child's vs Adult's Brain Plasticity - Thesis Defense

Research works and dissertations are created anew every year, and it's great because human knowledge keeps growing thanks to them. How about making a thesis on brain plasticity and how it differs between children and adults? If you want to try something different for your thesis defense, download this template....

Laterality and Learning Difficulties

Left-handed, right-handed, ambidextrous, cross laterality... all this can have an influence on the ways of learning. For example, the students with more learning difficulties are left-handed. Do you want to continue learning and teaching about this topic? Teacher Sandra Medina has provided us with some very interesting content on laterality...

Stroke (CVA) Disease

Download the Stroke (CVA) Disease presentation for PowerPoint or Google Slides. Taking care of yourself and of those around you is key! By learning about various illnesses and how they are spread, people can get a better understanding of them and make informed decisions about eating, exercise, and seeking medical...

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