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52 year old female patient has symptoms that include muscle weakness and…

- - - - degeneration of upper motor neurons cause spasticity and modest weakness
      - degeneration of lower motor neurons cause disabling weakness and muscles to atrophy
        
        ability of the brain to initiate and control muscle movement is lost
        
        eventually leading to respiratory failure or death
    - - ALS link to PersianGulf war veterans
        
        environmental toxin exposure? its uncertain
      - heredity
        
        familial
      - age
        
        40's- 60's is most common
      - gender
      - family history of ALS make her more susceptible to contacting the disease
      - smoking
        
        risk is greatest for women
- - - - meninges
        
        dura mater
        
        surrounds and supports the dural sinuses
        
        arachnoid mater
        
        allow cerebrospinal fluid (CSF) to enter and exit the blood stream
        
        pia mater
        
        allows blood vessels to pass through and nourish the brain
      - neurons in spinal cord
        
        dorsal root ganglion
        
        dorsal grey horns
        
        lateral grey horns
        
        ventral grey horns
        
        ventral root
        
        2 more items...
        
        motor info.
        
        somatic motor neurons
        
        visceral motor neurons
        
        interneurons
        
        sensory neuron cell bodies
    - - ascending
        
        to brain from body
        
        sensory neurons
        
        1st, 2nd, 3rd, order neurons
        
        info. travels to thalamus then to the cerebral cortex
        
        examples
        
        2 more items...
      - descending
        
        from brain to body
        
        motor neurons
        
        upper/lower motor neuron
        
        info. travels from brain/brainstem to the skeletal muscles
        
        examples
        
        2 more items...
    - - occipital lobe
        
        primary visual cortex
        
        vision
      - temporal lobe
        
        amygdaloid body
        
        anger/fear impulses
        
        hippocampus
        
        memory
      - parietal lobe
        
        sensory homunculus
        
        sensory info. map
        
        sensory neurons
        
        divided by the central sulcus
        
        postcentral gyrus
        
        sensory info.
      - the insula
        
        taste
      - frontal lobe
        
        motor homunculus
        
        motor info. map
        
        motor neurons
        
        control muscle movements
        
        pre-central gyrus
        
        motor info
      - other
        
        basal nuclei
        
        helps against unwanted movements
        
        cerebral cortex
        
        RAS
        
        alert and awake cerebral cortex
        
        tissues
        
        white matter
        
        myelinated neurons
        
        association
        
        commisural
        
        projection
        
        grey matter
        
        myelinated/ unmyelinated neurons
        
        cell bodies
        
        dendrites
    - - descending tract
        
        Visual information
        required to locate target
        
        frontal lobe: pre-central gyrus plan the reach and command the movement
        
        Spinal cord carries
        information to hand
        
        motor neurons carry message to muscles of the hand and forearm
      - ascending tract
        
        sensory receptors on the fingers send message to sensory cortex saying the cup has been grasped
        
        spinal cord carries sensory information to brain
        
        basal ganglia judge grasp forces, and cerebellum corrects movement errors
        
        sensory cortex receives the message that the cup has been grasped
  - - - ascending
        
        to brain from body
        
        sensory neurons
        
        1st, 2nd, 3rd, order neurons
        
        info. travels to thalamus then to the cerebral cortex
      - descending
        
        from brain to body
        
        motor neurons
        
        upper/lower motor neuron
        
        info. travels from brain/brainstem to the skeletal muscles
    - - Neurons in spinal cord
        
        dorsal root ganglion
        
        dorsal grey horns
        
        lateral grey horns
        
        ventral grey horns
        
        ventral root
        
        2 more items...
        
        somatic motor neurons
        
        visceral motor neurons
        
        interneurons
        
        sensory neuron cell bodies
      - meninges
        
        arachnoid mater
        
        subarachnoid space
        
        CSF
        
        arachnoid granulation
        
        pia mater
        
        dura mater
        
        dural venous sinus
      - nerves
        
        cervical nerves
        
        brachial nerves
        
        thoracic nerves
        
        lumbar nerves
        
        conus medullaris
        
        1 more item...
      - plexus
        
        cervical plexus
        
        brachial plexus
        
        axillary nerve
        
        musculocutaneous nerve
        
        radial/median/ulnar nerve
        
        1 more item...
      - vertebrae
        
        axis
        
        cervical
        
        atlas
        
        lumbar
        
        thoracic
    - - descending tract
        
        Visual information
        required to locate target
        
        frontal lobe: pre-central gyrus plan the reach and command the movement
        
        Spinal cord carries
        information to hand
        
        motor neurons carry message to muscles of the hand and forearm
      - ascending tract
        
        sensory receptors on the fingers send message to sensory cortex saying the cup has been grasped
        
        spinal cord carries sensory information to brain
        
        basal ganglia judge grasp forces, and cerebellum corrects movement errors
        
        sensory cortex receives the message that the cup has been grasped
    - - occipital lobe
        
        primary visual cortex
      - temporal lobe
        
        amygdaloid body
        
        hippocampus
      - parietal lobe
        
        divided by the central sulcus
        
        sensory homunculus
        
        sensory neurons
        
        postcentral gyrus
      - the insula
        
        operculum
        
        frontal
        
        orbital
        
        parietal
      - frontal lobe
        
        motor homunculus
        
        precentral gyrus
        
        motor neurons
      - other
        
        basal nuclei
        
        corpus callosum
        
        right cerebral hemisphere
        
        left cerebral hemisphere
        
        cerebral cortex
        
        RAS
        
        tissues
        
        white matter
        
        tracts
        
        commissural
        
        projection
        
        association
        
        myelinated neurons
        
        grey matter
        
        myelinated/ unmyelinated neurons
        
        cell bodies
        
        dendrites
- - - - (NSAIDs), the anticonvulsant gabapentin, tricyclic antidepressants, and morphine
    - - Neurodex, which is a combination of vitamins B-1, B-6, and B-12
    - - medication
        
        quinine bisulphate, baclofen, and diazepam
    - - choking
        
        ventilator
      - pneumonia
        
        antibiotics
        
        ephalosporins, fluoroquinolones, vancomycin, penicillins, and aminoglycosides.
      - drooling
        
        botulinum toxin B
        
        low-dose radiation therapy to the salivary glands
      - involuntary emotional expression
        
        combined dextromethorphan and quinidine