Download Free Medical ADVANCED ASSESSMENT - Nervous System PowerPoint Presentation

ADVANCED ASSESSMENT - Nervous System PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Neurology, which is titled "ADVANCED ASSESSMENT - Nervous System", to know about the Nervous System.

Tags : Neurology, Nervous System

Published on : Aug 23, 2021 | Views : 1431 | Downloads : 4

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

ONTARIO BASE HOSPITAL GROUP ADVANCED ASSESSMENT Nervous System 2007 Ontario Base Hospital Group QUIT
Slide 2-

ADVANCED ASSESSMENT Nervous System AUTHORS Mike Muir AEMCA, ACP, BHSc Paramedic Program Manager Grey-Bruce-Huron Paramedic Base Hospital Grey Bruce Health Services, Owen Sound Kevin McNab AEMCA, ACP Quality Assurance Manager Huron County EMS REVIEWERS/CONTRIBUTORS Rob Theriault EMCA, RCT(Adv.), CCP(F) Peel Region Base Hospital Donna L. Smith AEMCA, ACP Hamilton Base Hospital 2007 Ontario Base Hospital Group
Slide 3-

Nervous System Divisions
Slide 4-

Central Nervous System
Slide 5-

Largest most complex mass of nervous tissue Divisions of the Brain: Cerebrum, Cerebellum, Brain Stem Other structures: thalamus, hypothalamus, pituitary gland, meninges Brain
Slide 6-

Brain
Slide 7-

Largest part of the brain divided into left and right hemispheres One more dominant than the other, connected by Corpus Callosum Cerebral Cortex- outer layer of grey matter (unmyelinated) Cerebral Medulla-white matter (myelinated) 4 Distinct Lobes of Cerebrum Frontal, Parietal, Temporal, Occipital Interprets Sensory Impulses, Controls Voluntary Muscles, Memory, Thought, Reasoning Cerebrum
Slide 8-

Functional Areas of the Cerebrum
Slide 9-

Controls posture and fine muscle control Cerebellum
Slide 10-

3 layers of protection of brain and spinal cord Outermost to inner Dura matter Arachoid Pia matter Meninges
Slide 11-

Brain Stem
Slide 12-

Consists of: 1) Midbrain Just below cerebellum Connects cerebrum to lower brain centers 2) Pons Located between Mid brain and Medulla Conduction network between spinal cord and brain Part of respiratory center Brain Stem
Slide 13-

3) Medulla Oblongata Enlargement of the cord as it enters the cranial nerve through the foramen magnum Cardiac Center (controls heart rate) Vasomotor Center (control of blood vessel diameter) Respiratory Center(functions with Pons to regulate rate, depth and rhythmicity of breathing Vomiting Illness or injury affecting Medulla can result in death due to compromise of vital control center Brain Stem
Slide 14-

Continues from Medulla approx 45 cm to level of L1 Same protective coverings as brain Spinal Cord
Slide 15-

Cauda Equina
Slide 16-

Pia Arachnoid Dura Around the spinal cord
Slide 17-

Reticular Activating System Collection of neurons responsible for wakefulness RAS
Slide 18-

Fluid mostly made up of water that circulates in subarachnoid space around brain and spinal cord Acts as a cushion to protect brain and spinal cord Cerebrospinal Fluid
Slide 19-

Receives 16% of total cardiac output and utilizes 20% of total oxygen consumption Supplied through carotid arteries 10 sec reserve of oxygen Brain relies on a constant supply of glucose as well as oxygen Prolonged hypoglycemia can result in brain death Blood supply drained by jugular veins Blood Supply to Brain
Slide 20-

Broken into Somatic and Autonomic 1) Somatic Nervous System Conscious control (willed movements) Somatic nerves are in two groups: spinal and cranial nerves Spinal Nerves 31 pairs of spinal nerves Peripheral Nervous System
Slide 21-

Cranial Nerves 12 Cranial Nerves 2) Autonomic Sympathetic Parasympathetic Peripheral Nervous System
Slide 22-

1) Transmission of nerve impulses 2) Interpretation 3) Storage (memory) Functions of Nervous Tissue
Slide 23-

Interconnected Functions: 1. Receptors Nerve endings that respond to environmental stimulus 2. Sensory Input Transmit information into command center 3. Integration Center Interprets signal and formulates response 4. Motor Output Transmits response to periphery 5. Effectors Performs commands from integration center 1 2 3 4 5 Nervous System Function
Slide 24-

Relay impulses from various areas of the body to spinal cord and brain Send messages from brain and spinal cord to all compartments of the body Neurons
Slide 25-

Afferent (sensory): carry impulses toward brain and spinal cord from tissues and organs Efferent (motor): carry impulses away from brain and spinal cord Interneurons: exclusive to brain and spinal cord are inter or association neurons Divided into 2 Types
Slide 26-

Spinal Nerve Neuron Types
Slide 27-

Anatomy of the Nerve
Slide 28-

1) Dendrite: receives information, conveyed to cell body 2) Cell Body: contains nucleus 3) Axon: carries information away from cell body Neurons Made Up of Three Parts
Slide 29-

ppt slide no 29 content not found
Slide 30-

Motor (efferent nerve fibers) differ in peripheral nervous system Somatic: one neuron Autonomic: two neurons
Slide 31-

Nervous tissue has property of Excitability (responds to change in environment) Conductivity (transmits nerve impulses) Resting neuron has a potential to depolarize A stimulus changes the neurons permeability to sodium allowing a rush of sodium into nerve cell (depolarizing cell) This action is conveyed along the whole nerve fiber (all or none principal) Excitability and Conductivity
Slide 32-

ppt slide no 32 content not found
Slide 33-

SYNAPTIC CLEFT: Space between one neuron and (presynaptic neuron) and the dendrite of an adjacent neuron (postsynaptic neuron) At the end of each presynaptic neuron are tiny sacs called vesicles, each containing a chemical neurotransmitter When an action potential (wave of depolarization) reaches the end of the presynaptic neuron the vesicals move to the surface of the axon membrane and release their contents into the synaptic cleft This neurotransmitter will fill the cleft and continue the wave of depolarization of postsynaptic neuron Cleft between neurons and effector organs have same principal Synaptic Transmission of a Nerve Impulse
Slide 34-

Reflex = Negative Feedback
Slide 35-

Paired Numbered from front to back of brain Usually named for area served Sensory – general and special senses Motor – voluntary and autonomic Mixed Cranial Nerves
Slide 36-

Olfactory Optic Occulomotor Trochlear Trigeminal Abducens facial Vestibulocochlear/auditory Glossopharyngeal Vagus spinal accessory Hypoglossal Cranial Nerves
Slide 37-

31 pairs 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal Lumbar and sacral form cauda equina Spinal Nerves
Slide 38-

C1-C4 Skin and muscles of neck and shoulders Diaphragm Phrenic nerve – diaphragm (from C3, C4, and C5) Injury below C5 – breathing continues Spinal Nerves - Cervical Plexus
Slide 39-

C5-C8, T1 Skin and muscles of the arm Axillary – muscles of shoulder Radial – back of arm, forearm, hand, thumb, 2 fingers (wrist drop) Medial –forearm, hand (carpal tunnel) Ulnar – wrist and hand muscles (claw hand) Spinal Nerves - Brachial Plexus
Slide 40-

T12, L1-5, S1-4 Lower torso and legs Sciatic Nerve – back of leg, buttocks Femoral – lower abdomen, front of thigh, medial leg & foot Peroneal – Lateral leg, foot Tibial – back of leg, foot Spinal Nerves - Lumbosacral Plexus
Slide 41-

Autonomic Nervous System
Slide 42-

Acetylcholine & epinephrine Neurons that release Acetylcholine are cholinergic Neurons that release epinephrine are called adrenergic Autonomic Neurotransmitters
Slide 43-

Parasympathetic pre and post ganglionic neurons are cholinergic Sympathetic preganglionic are also cholinergic Sympathetic post ganglionic neurons are adrenergic Adrenergic and Cholinergic
Slide 44-

ppt slide no 44 content not found
Slide 45-

Sympathetic axon collaterals bridge between adjacent ganglia This occurs in the same side of vertebral column Sympathetic Chain Ganglia
Slide 46-

ppt slide no 46 content not found
Slide 47-

3 cervical 11 thoracic 4 lumbar and 4 sacral 22 Sympathetic Chain Ganglia
Slide 48-

Some of the neurons pass the celiac ganglion and goes to adrenal medulla. There they synapse with modified neurons that produce epinephrine and norepinephrine Adrenal Medulla
Slide 49-

ppt slide no 49 content not found
Slide 50-

Alpha1 – Blood Vessels Vasoconstriction Alpha2 – Presynaptic neuron – eliminates further release of Norepinepherine. Beta1 – Heart - increases contractility and heart rate Beta2 – Lungs, Skeletal Muscle - dilation Adrenergic Receptors
Slide 51-

Has two main types of receptors Alpha and beta receptors are the main types They both have some subtypes Norepinephrine
Slide 52-

Is different on organs based on type of the receptor Epinephrine that comes from the adrenal medulla prolongs its effect Norepinephrine Effect
Slide 53-

Occurs by means of two enzymes mao and comt It happens slower than deactivation of Acetylcholine Norepinephrine Deactivation
Slide 54-

Their cell bodies are in the ganglion near the effector organ They usually synapse with one postganglionic neuron Parasympathetic Neurons
Slide 55-

Restores vegetative function Slows body functions Heart rate Speeds up body functions GI Motility Parasympathetic Effect
Slide 56-

Acetycholinesterase Occurs in synaptic cleft Acetylcholine Deactivation
Slide 57-

NERVOUS SYSTEM DISEASES
Slide 58-

Myasthenia Gravis Bell’s Palsy Guillian-Barre Syndrome Parkinson’s Disease Amyotropic Lateral Sclerosis Meningitis Nervous System Diseases
Slide 59-

Knowing a basic knowledge of some of these Diseases will help us understand the problems our patients are having Can anticipate and be ready for complications Prepare equipment Understand the frustrations patients have with the progression of their disease Better understanding of the disease process Ultimately better treatment and understanding Why Do We Need to Know About Those Diseases???
Slide 60-

MYASTHENIA GRAVIS PNS
Slide 61-

ppt slide no 61 content not found
Slide 62-

Myasthenia Gravis Auto immune neuromuscular disorder Shows signs of muscle weakness of voluntary muscles: occulomotor, facial, laryngeal, pharyngeal, and RESPIRATORY There is a 70-89% reduction in Acetylcholine receptors per each post synaptic cleft…therefore muscle weakness Improves with rest and drug administration (anti-cholinesterase meds)
Slide 63-

Drooping eyelids Double vision Slurred speech Nasal quality to speech Inability to speak Drooling Nasal regurgitation Weak cough Problems chewing and swallowing (choking) Trouble sitting up/holding head erect Trouble walking Feeling SOB Signs and Symptoms
Slide 64-

Myasthenic Crisis (insufficient acetylcholine) Cholinergic Crisis (SLUDGE) due to an overdose of med’s Pneumonia Sepsis Complications related to immobility Respiratory Distress Choking Complications
Slide 65-

BELL’S PALSY
Slide 66-

ppt slide no 66 content not found
Slide 67-

Comes on rapidly 15-60 years old Effects 7th cranial nerve Causes unilateral or bilateral facial weakness Majority of patients have full recovery Bell’s Palsy
Slide 68-

Infection Hemorrhage Tumor Meningitis Local trauma Blockage of 7th Cranial Nerve By:
Slide 69-

Unilateral facial weakness Aching pain around angle of jaw/behind ear Headache Tearing Unilateral mouth drooling and drooping Inability to control facial expression in smiling, squinting, blinking/closing eyelid Loss of sensation of taste (front 2/3rds) Signs and Symptoms
Slide 70-

Corneal ulceration and blindness Impaired nutrition Long-term psycho social problems Complications
Slide 71-

GUILLIAN-BARRE SYNDROME
Slide 72-

Acute syndrome characterized by widespread inflammation or demyelination of ascending/descending nerves in the peripheral nervous system (conduction) Causes weakness, paralysis Muscles unable to respond to commands sent from brain due to decreased conduction Guillian-Barre Syndrome
Slide 73-

Unknown >50% patients had non-specific infection 10-14 days prior to GBS symptoms (possible sensitized lymphocytes may produce demyelination) Which causes decrease conduction Cause
Slide 74-

Saltatory Conduction Myelinated fibers The action potential jumps around the insulating myelin rapidly Increases conduction times Normal Myelinated Nerve
Slide 75-

Demyelination delays nerve conduction Therefore decreasing conduction times Muscles are unable to respond to commands sent from the brain Fewer incoming sensory signals to be interpreted as heat, pain, etc. Demyelinated Nerve Segments
Slide 76-

Lower extremity weakness leads to upper extremity and facial weakness Sensory and motor loss Complete paralysis with respiratory failure within 48 hours (33% of GBS patients need to be intubated) Paralysis can progress in 2-3 weeks (30% quadriplegics, 30% bed bound) Signs and Symptoms
Slide 77-

Sympathetic and parasympathetic involvement leads to : Hypertension Hypotension Dysrhythmias Circulatory collapse Continued
Slide 78-

Cardiac failure Respiratory failure Infection and sepsis Venous thrombosis Pulmonary embolus Complications
Slide 79-

PARKINSON’S DISEASE Parkinsonism
Slide 80-

Mainly a disease of movement Progressive disease becoming worse over 10 years Parkinson’s Disease
Slide 81-

Our brain (basal ganglia) directs all of our movements It uses many chemicals to transmit messages Dopamine, acetylcholine, Norepinephrine In the basal ganglia the most important chemical for the transmission of messages is Dopamine Parkinson’s Disease
Slide 82-

In Parkinson’s, cells that produce Dopamine die off The remaining cells can’t relay information from cell to cell therefore causing the signs and symptoms of this disease. Cause
Slide 83-

Muscle rigidity and akinesia Jerky tremor (begins in fingers) Difficulty walking due to akinesia High pitched monotone voice, drooling Mask like facial expression Loss of posture control Difficulty speaking/swallowing Decreases with purposeful movement and sleep Signs and Symptoms
Slide 84-

AMYOTROPIC LATERAL SCLEROSIS aka...Lou Gehrig’s Disease
Slide 85-

Terminal neurological disorder Progressive degeneration of nerve cells in spinal cord and brain Does not effect mental functioning or senses such as hearing or seeing Not contagious No cure Age group 40-70 years old 50% of patients die within 18 months Amyotropic Lateral Sclerosis
Slide 86-

A- without Myo- muscle Tropic- nourishment Lateral- side (of spinal cord) Sclerosis- hardening/scaring Amyotropic Lateral Sclerosis
Slide 87-

Unknown Theory- excess of a neurotransmitter called Glutamate, clogs the synapse of the nerve cell not allowing a neural impulse to be transmitted. Cause
Slide 88-

Twitching and cramping of muscles(hands/ feet) Loss of motor control in hands and arms Increased weakness in diaphragm and chest muscles Tripping and falling Persistent fatigue Slurred/thick speech As the disease progresses: Difficulty breathing & swallowing Paralysis Cardiac arrhythmia Pneumonia Respirator arrest Signs and Symptoms
Slide 89-

MENINGITIS
Slide 90-

Meningitis
Slide 91-

Inflammation of the meninges due to: Bacteria Viruses Trauma Lumbar puncture Ventricular shunting procedure Fungi Parasites Other toxins Meningitis
Slide 92-

Bacterial Most common Can lead to death Viral Aseptic Develop post variety of viral infection If found early—treatment with antibodies = prognosis good Meningitis
Slide 93-

Involves pia-arachnoid layers, subaracnoid space and ventricular system Bacteria enters which causes an inflammatory response, thickening the CSF Decreases flow causing an obstruction of arachnoid villi Causing Hydrocephalus and increased ICP Meningitis
Slide 94-

Severe headache Increased temperature (bacterial) Decreased LOA to stupor to coma Malaise Confusion, agitation Photophobia Skin rash with petechial hemorrhage (meningococcal meningitis) Cerebral edema Hydrocephalus Nuchal rigidity (positive Brudzinski’s and Kernig’s signs) Signs and Symptoms
Slide 95-

Increased ICP Hydrocephalus Cerebral infarction Cranial nerve deficits Brain abcess Visual impairment Seizures Endocarditis Deafness Intellectual deficits Complications
Slide 96-

Kernig’s and Brudzinski’s Sign
Slide 97-

ONTARIO BASE HOSPITAL GROUP Ontario Base Hospital Group Self-directed Education Program Well Done! START QUIT