Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1 The Language Of Medicine 9 th edition Davi-Ellen Chabner

Chapter 10 Nervous System Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 2

3 Chapter Goals  Name, locate, and describe major organs of the nervous system and their functions.  Learn nervous system combining forms and use them with suffixes and prefixes.  Define pathological conditions affecting the nervous system. 3

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 4 Chapter Goals (cont’d)  Describe laboratory tests, clinical procedures, and abbreviations that pertain to the system.  Apply your new knowledge to understanding medical terms in the proper contexts, such as medical reports and records. 4

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 5 Chapter 10 Lesson 10.1

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 6 Introduction Nervous system:  Complex: 10 billion nerve cells  Voluntary and involuntary functions  Carries electrical messages  External and internal receptors

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 7 Introduction (cont’d) Nerve cells:  Microscopic  Collected into macroscopic nerves  Carry electrical messages all over the body

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 8 General Structure of the Nervous System Two major divisions:  Central nervous system—CNS  Brain  Spinal cord  Peripheral nervous system—PNS  cranial nerves  spinal nerves

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 9 General Structure of the Nervous System (cont’d)  Cranial and spinal nerves  Sensory nerves carry messages toward the brain.  Motor nerves carry messages from the brain.  Mixed nerves carry both sensory and motor fibers.  Sensory receptors

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 10 General Structure of the Nervous System (cont’d) Autonomic nervous system:  Carries impulses from the central nervous system to organs.  Sympathetic nerves stimulate body under stress.  Parasympathetic nerves balance sympathetic system.  Slow heart rate  Lower blood pressure

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 11 Divisions of the Central and Peripheral Nervous System

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 12 Neurons, Nerves, and Glia Neuron = individual nerve cell  Dendrite  Cell nucleus  Axon  Myelin sheath  Neurilemma  Terminal end fibers (secrete neurotransmitters)  Neurotransmitters transfer impulse across synapse Ganglia = small clusters of nerve cell bodies

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 13 Neurons, Nerves, and Glia (cont’d) Label the parts of a neuron, and review the path of a nervous impulse.

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 14 Neurons, Nerves, and Glia (cont’d) The image shows the parts of a neuron. Review the path of a nervous impulse.

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 15 Neurons, Nerves, and Glia (cont’d) Glia cells:  Maintain health of nervous system  Do not transmit impulses

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 16 Neurons, Nerves, and Glia (cont’d) Three types:  Astrocytes (astroglial cells)  Microglia (microglial cells)  Oligodendroglia (oligodendroglial cells)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 17 Chapter 10 Lesson 10.2

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 18 The Brain

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 19 The Brain (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 20 The Brain (cont’d)  Cerebrum  Is the largest section of brain  Surface nerve cells called cerebral cortex  Manages speech, vision, smell, movement, hearing, and thought

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 21 The Brain (cont’d)  Cerebellum  Coordinates voluntary movements  Maintains balance  Thalamus  Integrates and monitors impulses from skin (pain)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 22 The Brain (cont’d)  Hypothalamus  Controls body temperature, sleep, appetite, sexual desire, and emotions  Regulates release of hormones from pituitary gland  Monitors sympathetic and parasympathetic nervous systems

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 23 The Brain (cont’d) The Brainstem  Pons  Bridges cerebrum and cerebellum with rest of the brain  Houses nerves for face and eyes

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 24 The Brain (cont’d) The Brainstem  Medulla oblongata  Connects spinal cord to brain  Nerve tracts from side to side  Regulates: Blood vessels Blood vessels Heart Heart Respiratory system Respiratory system

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 25 The Spinal Cord and Meninges Spinal cord

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 26 The Spinal Cord and Meninges (cont’d) Meninges

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 27 The Spinal Cord and Meninges (cont’d) Meninges

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 28 Vocabulary  acetylcholine  afferent nerve  arachnoid membrane  astrocyte  autonomic nervous system

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 29  axon  blood-brain barrier  brainstem  cauda equina  cell body Vocabulary (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 30  central nervous system  cerebellum  cerebral cortex  cerebrospinal fluid (CSF)  cerebrum Vocabulary (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 31  dendrite  dura mater  ependymal cell  efferent nerve  ganglion/ganglia  glial cell or neuroglial cell  gyrus Vocabulary (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 32  hypothalamus  medulla oblongata  meninges  microglial cell  motor nerve  myelin sheath Vocabulary (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 33  nerve  neuron  neurotransmitter  oligodendroglial cell  parasympathetic nerves  parenchyma  peripheral nervous system Vocabulary (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 34  pia mater  plexus  pons  receptor  sciatic nerve  sensory nerve  spinal nerves Vocabulary (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 35  stimulus/stimuli  stroma  sulcus  sympathetic nerves  synapse  thalamus  vagus nerve  ventricles of the brain Vocabulary (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 36 QUICK QUIZ: QUICK QUIZ: 1. A sheet of nerve cells that produces a rounded fold on the surface of the cerebellum A. microglial B. gyrus C. parenchyma D. stroma

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved The thin, delicate inner membrane of the meninges A. pia mater B. dura mater C. parenchyma D. stroma QUICK QUIZ: (cont’d) QUICK QUIZ: (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 38 Terminology ORGANS AND STRUCTURES  cerebell/ocerebellum  cerebr/ocerebrum  dur/odura mater  encephal/obrain  gli/oglial cells Combining FormMeaning

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 39 ORGANS AND STRUCTURES  lept/othin, slender  mening/o, membranes, meningi/o meninges  my/omuscle  myel/ospinal cord  neur/onerve Combining FormMeaning Terminology (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 40 ORGANS AND STRUCTURES  pont/opons  radicul/o nerve root  thalam/othalamus  thec/osheath (refers to meninges)  vag/ovagus nerve Combining FormMeaning Terminology (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 41 SYMPTOMS  alges/o, -algesia  -algia  caus/o  comat/o  esthesi/o, -esthesia  kines/o, -kinesia excessive sensitivity to pain painburning deep sleep feeling, nervous sensation movement Combining Form Meaning Terminology (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 42 SYMPTOMS  -kinesis, kinetic  -lepsy  lex/o  -paresis  -phasia movementseizure word, phrase slight paralysis speech Combining Form Meaning Terminology (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 43 SYMPTOMS  -plegia  -praxia  -sthenia  syncop/o  tax/o paralysisactionstrength cut off order, coordination Combining Form Meaning Terminology (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 44 QUICK QUIZ: QUICK QUIZ: 3. Which term means nerve pain? A. cephalgia B. analgesia C. hypalgesia D. neuralgia

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 45 QUICK QUIZ: (cont’d) QUICK QUIZ: (cont’d) 4. Which type of hematoma occurs between the skull and the dura as a result of a ruptured meningeal artery, usually after a fracture of the skull? A. subdural B. epidural C. intracerebral

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 46 Chapter 10 Lesson 10.3

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 47 Pathology Congenital Disorders  Hydrocephalus  Spina bifida  Spina bifida cystica  Spina bifida occulta

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 48 Degenerative, Movement, and Seizure Disorders  Alzheimer disease (AD)  Amyotrophic lateral sclerosis (ALS)  Epilepsy  Huntington disease  Multiple sclerosis (MS)  Myasthenia gravis (MG)  Palsy  Parkinson disease  Tourette syndrome

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 49 Infectious Disorders  Herpes zoster (shingles)  Meningitis  Human immunodeficiency virus (HIV) encephalopathy

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 50 Traumatic Disorders  Cerebral concussion:  Temporary brain dysfunction after injury  Usually clears within 24 hours  Cerebral contusion:  Bruising of brain tissue through direct trauma to head  Neurological deficits persist longer than 24 hours

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 51 Vascular Disorders  Cerebrovascular Accident (CVA)  Thrombotic — blood clot in artery leaving to the brain  Embolic — dislodged clot that travels to cerebral arteries  Hemorrhagic — a blood vessel, such as the cerebral artery breaks, and bleeding occurs  Migraine — severe, recurring, unilateral, vascular headache

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 52 Vascular Disorders (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 53 Clinical Procedures X-ray Tests  Cerebral angiography  Computed tomography (CT) of the brain  Myelography Other Procedures  MRI—Magnetic resonance Imaging  PET—Positron emission scan  EEG—Electroencephalography

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 54 Abbreviations Abbreviations Abbreviations  AD  AFP  ALS  AVM  CNS  CT  CSF  CVA Alzheimer disease alpha-fetoprotein amyotrophic lateral sclerosis arteriovenous malformation central nervous system cerebrospinal fluid computed tomography cerebrovascular accident

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 55  EEG  GABA  ICP  LP  MAC  MG  MRA  MRI electroencephalogram gamma-aminobutyric acid (neurotransmitter) intracranial pressure; normal pressure is 5 to 15 mmHG lumbar puncture monitored anesthetic care myasthenia gravis magnetic resonance angiography magnetic resonance imaging Abbreviations (cont’d) Abbreviations (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 56  1/2 P  PCA  PNS  PET  Sz  TBI  TENS  TIA  TLE  tPA  hemiparesis  patient-controlled anesthesia  peripheral nervous system  positron emission tomography  seizure  traumatic brain injury  transcutaneous electrical nerve stimulation  transient ischemic attack  temporal lobe epilepsy  tissue plasminogen activator Abbreviations (cont’d) Abbreviations (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 57 Practical Applications  What symptoms signal nervous system problems?  What tests are conducted to diagnose these problems?  Why are an MRI and an MRA ordered?  What are common pathologies of the nervous system?

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 58 Review Sheet COMBINING FORMS  alges/o ___________  angi/o ___________  caus/o ___________  cephal/o ___________  cerebell/o ___________  cerebr/o ___________ Combining Form Meaning

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 59 COMBINING FORMS  alges/osensitivity to pain  angi/ovessel, blood  caus/oburn, burning  cephal/ohead  cerebell/ocerebellum  cerebr/ocerebrum Combining Form Meaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 60 COMBINING FORMS  comat/o ___________  crani/o ___________  cry/o ___________  dur/o ___________  encephal/o ___________  esthesi/o ___________ Combining FormMeaning Combining Form Meaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 61 COMBINING FORMS  comat/odeep sleep  crani/oskull  cry/ocold  dur/odura mater  encephal/obrain  esthesi/onervous sensation Combining FormMeaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 62 COMBINING FORMS  gli/o _________  hydr/o _________  kines/o _________  lept/o _________  lex/o _________  mening/o, meningi/o _________  my/o _________ Combining FormMeaning Combining Form Meaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 63 COMBINING FORMS  gli/o glue  hydr/o water  kines/o movement  lept/o thin, slender  lex/o word, phrase  mening/o, meningi/o membranes, meninges  my/o muscle Combining Form Meaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 64 COMBINING FORMS  myel/o ___________  narc/o ___________  neur/o ___________  olig/o ___________  pont/o ___________  radicul/o ___________ Combining FormMeaning Combining Form Meaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 65 COMBINING FORMS  myel/ospinal cord  narc/osleep  neur/onerve  olig/oscanty  pont/opons  radicul/o nerve root Combining FormMeaning Combining Form Meaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 66 COMBINING FORMS  spin/o ___________  syncop/o ___________  tax/o ___________  thalam/o ___________  thec/o ___________  troph/o ___________  vag/o ___________ Combining FormMeaning Combining Form Meaning Review Sheet (cont’d)

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 67 COMBINING FORMS  spin/ospine  syncop/ocut off  tax/oorder  thalam/othalamus  thec/osheath (refers to meninges)  troph/onourishment  vag/ovagus nerve Combining FormMeaning Combining Form Meaning Review Sheet (cont’d)