52 year old female diagnosed with amyotrophic lateral sclerosis (ALS)…
52 year old female diagnosed with amyotrophic lateral sclerosis (ALS)
Hereditary: Patient has a family history of ALS. Her brother died from it & her father is suspected of having it as well.
Studies indicate that people who have served in the military are at higher risk of ALS. Patient is Gulf War Veteran.
ALS risk increases with age, and is most common between the ages of 40 and the mid-60s.
Genetic variations might make people more susceptible to ALS.
Smoking is the only likely environmental risk factor for ALS.
Some evidence suggests that exposure to lead or other substances in the workplace or at home might be linked to ALS.
Speech Problems: Most people with ALS develop trouble speaking.
communication technologies to communicate.
Eating Problems: People with ALS can develop malnutrition and dehydration from damage to the muscles that control swallowing.
percutaneous endoscopic gastrostomy (PEG) or a radiologically inserted percutaneous (RIG) tube.
Respiratory Issues: ALS paralyzes the muscles you use to breathe.
CPAP machine at night to assist with breathing
Tracheostomy: for full-time use of a respirator that inflates and deflates their lungs.
Memory Problems: Some people with ALS have problems with memory and decision-making, and some are eventually diagnosed with a form of dementia
Edaravone (Radicava) and Riluzole (Rilutek) are the only approved medications for motor neuron diseases that may help with memory problems with ALS.
Normal Cellular Functions:
Normal Function of a Motor Neuron:
Neurons normally move cellular materials along their axons, to keep nerve cell messages flowing and to maintain the health of the whole nerve cell itself.
Active transport along the extensive axons of motor neurons conveys newly made materials to even the farthest-reaching nerve endings and needed nutrients back to the cell body.
Motor neurons transmit impulses from the spinal cord to skeletal and smooth muscles (such as those in your stomach), and so directly control all of our muscle
Frontal Lobe: Involved with motor functions, concentration, decision making, planning & personality.
Longitudinal Fissure: divides the cerebrum into two halves (known as hemispheres)
Central Sulcus: Separates the frontal and parietal lobes of the cerebrum.
Parietal Lobe: involved with general sensory functions.
Occipital Lobe: processes visual information and stores visual memories.
Spinal Cord: transmission of nerve signals from the motor cortex to the body, and from the afferent fibers of the sensory neurons to the sensory cortex. I
Medulla Oblongata: reflex centers for vomiting, swallowing and other GI functions. receptors for stretch sensations; cardiac & breathing control centers.
Temporal Lobe: Processes the senses of hearing and smell
Cerebellum: coordinates voluntary movements such as posture, balance, coordination, and speech, resulting in smooth and balanced muscular activity.
Insula: involved with memory and interpretation of taste.
Pons: relays information between the medulla oblongata & higher brain regions.
Spinal Cord: transmission of nerve signals
Dura Mater: protect the central nervous system by containing the cerebrospinal fluid
Pia Mater: protect the central nervous system by containing the cerebrospinal fluid
Arachnoid Mater: protect the central nervous system by containing the cerebrospinal fluid
Visceral motor neurons: Automatic: activates smooth muscle
Somatic Sensory Neurons: Send information to interneurons about the body
Somatic motor Neurons: Activate skeletal muscle movement.
Visceral Sensory Neurons: send sensory info. to interneurons about hunger, bladder is full.
Sensory tracts. Receptors through the body collect information. That info is sent to the brain/brain stem/Cerebellum for processing.
2nd Order Neuron: Processes some of the information from 1st order by has to send to 3rd order neuron for further processing.
3rd Order Neuron: Sends sensory info. to the right places.
1st Order Neuron: Brings the information to the spinal cord. (Sensory)
are motor tracts. Motor neurons in the brain (or brain-stem) give the directions.
Skeletal muscles respond to these directions.
The upper motor neuron: makes the decision to contract.
The Lower motor neuron: Goes out to the muscle and contracts it.
The Process of Movement:
they process movement-related information.
coordinates voluntary movements such as posture, balance, coordination, and speech, resulting in smooth and balanced muscular activity.
responsible for controlling voluntary motor movements.
Descending spinal cord tracts:
These tracts originate in the cerebral cortex, carrying motor fibers to the spinal cord and brain stem.
Neurons in the motor cortex, controls voluntary movement, The spinal motor neurons project out of the cord to the correct muscles via the ventral root. These connections control conscious movements, such as writing and running.
Sensory neurons provide feedback to the brain via the dorsal root. Some of this sensory information is conveyed directly to lower motor neurons before it reaches the brain, resulting in involuntary, or reflex movements. The remaining sensory information travels back to the cortex.
Sulci: Small indentations in the surface of the cerebrum.
Gyri: raised bumps on the surface of the cerebrum
Precentral Gyrus: anterior to the central sulcus.
Post Central Gyrus: posterior to the central sulcus.
Frontal Lobe: in front of the precentral gyrus.
Parietal Lobe: in between the occipital lobe and the post central sulcus.
Occipital Lobe: back lobe above the cerebellum.
Cerebellum: below the Occipital lobe.
Medulla Oblongata: below the pons
Temporal Lobe: beside the occipital lobe.
Spinal Cord: extends from the brain through the vertebral column. It connects to the Medulla Oblongata.
Central Sulcus: between the frontal and parietal lobes
Longitudinal Fissure: very deep indentation in between the left and right hemispheres.
Insula: deep to the temporal lobe.
Pons: above the medulla oblongata. Acts like a bridge between the Medulla and the rest of the brain.
Spinal Cord: made of vetebral foramen
Meninges: covering the spinal cord.
Dura Mater: Superficial by the vertebrae
Arachnoid Mater: Middle layer
Pia Mater: deepest layer, attached to spinal cord
Lateral gray horn: Visceral motor neurons that activate smooth muscle.
Visceral Motor Neurons
Spinal nerve: where 2 roots meet.
Dorsal root ganglion: sensory neurons.
Ventral gray horn: Somatic motor neurons moves skeletal muscles.
Somatic Motor Neurons
Dorsal median sulcus: indentation
Ventral median fissure: deep indentation
Dorsal Gray horn: interneurons live here
Somatic sensory neurons & Visceral Sensory Neurons
White matter Funiculi (tract): group of axons that travel together.
have 2 neurons: Motor Neurons
The Upper Motor Neuron: in the brain or the brainstem.
The Lower Motor Neuron: is in the neuron that synapses with the muscle.
have 3 neurons: Sensory Tracts
2nd Order Neuron: Inter-neuron in the dorsal horn of the spinal cord
3rd Order Neuron: in the thalamus that connects with the cerebral cortex.
1st Order Neuron: has receptors
The Process of Movement:
deep within the cerebral hemispheres
receives information from the sensory systems, the spinal cord, and other parts of the brain.
anatomical location of the primary motor cortex
Descending spinal cord tracts
pathways by which motor signals are sent from the brain to lower motor neurons.
corticospinal tract connect with motor neurons in the spinal cord.
ventral root: these connections control conscious movements
Dorsal root: Some of this sensory information is conveyed directly to lower motor neurons