CHAPTER 19 NERVOUS SYSTEM Lesson 2 Journal question: What are the signs of Parkinsonism disease?

Chapter 19 Learning Objectives Identify at least three methods used to assess the function of the nervous system. Describe at least five disorders of the nervous system. After students finish reading the chapter, remind them to re-read and fully answer each learning objective.

Assessment Techniques Evaluation of the nervous system includes assessment of the following: Mental status Cranial nerve function Motor and sensory nerve function Reflexes Coordination Gait (walking) Balance Internal body processes

Assessment Techniques Electroencephalography (EEG) Lumbar puncture Myelography Nerve conduction velocity Computed tomography (CT) Positron emission tomography (PET) Magnetic resonance imaging (MRI) Magnetic resonance angiography (MRA) Discuss each of the assessment techniques for the nervous system, and describe what each assesses.

Electroencephalogram Showing Waves FIGURE 19-9 A, Electroencephalogram showing wave types. (From Thibodeau GA, Patton KT: Human body in health and disease, ed 5, St Louis, 2010, Mosby.)

Scalp Electrodes FIGURE 19-9  B, Scalp electrodes detect electrical voltage changes in the cranium. (From Thibodeau GA, Patton KT: Human body in health and disease, ed 5, St Louis, 2010, Mosby.)

Magnetic Resonance Imaging FIGURE 19-10 Magnetic resonance imagery allows the visualization of the body without use of radiation. (From Elkin MK, et al: Nursing intervention and clinical skills, ed 4, St. Louis, 2008, Mosby.)

Disorders of the Nervous System Alzheimer’s disease Form of senile dementia Cerebrovascular accident (CVA) Commonly called a stroke, it is caused by loss of oxygen to an area of the brain when a clot blocks a vessel or when a vessel breaks. Down syndrome Genetic disorder caused by the presence of an extra chromosome Discuss the signs, symptoms, and treatment of these disorders.

Warning Signs of Alzheimer’s Ask students if they have anyone in their families or know anyone with signs of Alzheimer’s disease. What signs did they notice? How did the student react to the person?

Disorders of the Nervous System Encephalitis Inflammation of the brain caused by a viral or bacterial infection or by a chemical agent Guillain-Barré syndrome Also called infectious polyneuritis, it may appear shortly after a viral immunization or infection Headache The muscles around the occipital area of the brain constrict the blood flow to the area. Discuss the signs, symptoms, and treatment of these disorders.

Disorders of the Nervous System Migraine headaches Vascular headaches of unknown cause Pain results from narrowing of blood vessels in the brain Sinus headaches Caused by swelling of the membranes that line the sinus cavities Head injury Occurs when the brain impacts the skull as a result of a blow or rapid movement Discuss the signs, symptoms, and treatment of these disorders.

Disorders of the Nervous System Huntington’s chorea Degenerative neural disorder that affects brain tissues Hydrocephalus More cerebrospinal fluid is produced than is absorbed into the circulatory system. Excess fluid increases intracranial pressure and may enlarge the head. Intracranial tumors Usually involve neuroglia, blood vessels, or membranes rather than neurons Discuss the signs, symptoms, and treatment of these disorders.

Disorders of the Nervous System Meningitis Serious inflammation of the meninges caused by a bacterium, virus, or fungus Meningocele Birth defect that occurs when the membranes covering the brain or spinal cord protrude through a congenital defect in the skull or spinal column Multiple sclerosis Defect in electrical transmission of the neurons caused by degeneration of the myelin sheath Discuss the signs, symptoms, and treatment of these disorders.

Disorders of the Nervous System Neural tube defect Abnormal formation of the skull and spinal column Neurofibromatosis Defect in an autosomal dominant gene Parkinson’s disease Degeneration of certain brain cells Discuss the signs, symptoms, and treatment of these disorders.

Tumors of Nervous System Tissue FIGURE 19-12 Tumors of nervous system tissue develop with neurofibromatosis. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)

Signs of Parkinsonism FIGURE 19-13 The signs of Parkinsonism include rigidity and trembling of the head and extremities. (From Thibodeau GA, Patton KT: Human body in health and disease, ed 4, St Louis, 2005, Mosby.)

Disorders of the Nervous System Poliomyelitis Caused by a virus that spreads from the nose and throat to neural tissue Sciatica Usually a ruptured intervertebral disk and osteoarthritis, producing pressure on the nerve or other nerve injury Seizure Results from injury, infection, or epilepsy Discuss the signs, symptoms, and treatment of these disorders.

Disorders of the Nervous System Spina bifida Birth defect involving a malformed spinal column resulting from neural tube defects Spinal cord injuries Trauma occurring in the cervical and lumbar area of the spinal column Transient ischemic attack (TIA) Decreased blood supply to an area of the brain resulting from a small clot that temporarily lodges in a vessel Discuss the signs, symptoms, and treatment of these disorders.

Disorders of the Nervous System Trigeminal neuralgia Sudden, intense, unpredictable pain on one side of the face caused by pressure on or deterioration of the trigeminal facial nerve Refer to the next slide to discuss the location of trigeminal neuralgia or figure 19-12 in the student’s textbook.

Trigeminal Neuralgia FIGURE 19-14 One method used to relieve the pain of trigeminal neuralgia is surgically to remove the ganglion on the end of the nerve. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)

Issues and Innovations Memory research Memories are retained differently and in different parts of the brain. Ribonucleic acid (RNA) may play a role in storing and recalling information. Most memory research uses a marine slug called Aplysia or people who have sustained neurologic loss Slugs are used because their ganglia are large and their behavior pattern is limited. Computer networks are being designed to simulate actions of the brain. Discuss memory research and its impact . Why are slugs used in research on memory?

Issues and Innovations Correction of Parkinson’s disease Transplantation of adrenal cells to stimulate production of dopamine Fetal tissue research Deep brain stimulation Autologous neural stem cell transplantation Discuss each of the nervous system innovations

Summary Methods of assessment of the nervous system EEG Lumbar puncture Myelography CT PET