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52 year old Female with ALS (Downstream Causes (Breathing Problems…
52 year old Female with ALS
Upstream Causes
Indirect causes
Heredity
5-10% inherited ALS
their children have a 50-50 chance of getting it
Age
risk increases with age
most common between ages 40-mid 60s
Sex
before 65, slightly more men develop ALS
Environmental factors
Smoking
Environment
Military service
Direct Causes
ALS both the upper and lower motor neurons are smaller than they are supposed to be
They do not send the message to the muscle cells to contract
Muscles become weaker due to lack of usage
Downstream Causes
Breathing Problems
paralyzes the muscles you use to breath
Treatment
device to help you breathe at night
tracheostomy- surgically created hole at the front of the neck leading to the trachea
respiratory failure is the most common cause of death for people with ALS
Eating Problems
Develop malnutrition and dehydration from damage to the muscles that control swallowing
High risk of getting food, liquids or saliva into the lungs, which causes pnemonia
Treatment
feeding tube
Dementia
some have problems with memory or decision making
some are eventually diagnosed with a form of dementia
Background Information
Physiology
Cerebrum
Precentral Gyrus- primary motor area
Central sulcus- separates frontal and parietal lobes
Postcentral Gyrus- primary sensory srea
Lobes
Occipital- visual information (stores visual memories)
Parietal - general sensory functions
Frontal- motor functions
Temporal- hearing and smelling
Insula- taste
Cerebellum- regulate motor movements and assist with equilibrium
Diencephalon
Corpus Callosum- connect the two cerebral hemispheres
Pineal Gland- secretes Melatonin and controls circadian rhythm
Intermediate Mass of the Thalamus- connects the right and left sides of the thalamus
Hypothalamus- controls the release of hormones and controls homeostasis in the body
Thalamus- relay center to and from the cerebrum and filters out sounds and sights
fornix- carry information out of the hippocampus
Pituitary gland- secretes several hormones
Brainstem
Medulla Oblongata- reflex center for GI functions and has cardiac and breathing control centers
Pons- "bridge" between Medulla and higher brain regions
Midbrain- location of the corpora quadrigemina and regulates eye movement
Corpora Quadrigemina- four bumps involved in visual and auditory reflexes
Spinal Cord
Dorsal gray horn- interneurons( processing neuron)
Central Canal- open space in the middle that contains CSF
Ventral root- takes the motor neurons from the spinal cord to the rest of the body
White matter tracts- the axons of the neurons
Ventral gray horn- cell bodies of the motor neurons traveling to the skeletal muscles
Dorsal root- bundle of sensory neurons that are going to the spinal cord
Lateral gray horn- autonomic motor neurons
Dorsal root ganglion- sensory neurons cell bodies
dorsal median sulcus- narrow groove (posterior side)
Ventral median fissure- slightly wider groove (anterior side)
Neurons (structures)
oligodendrocytes- form myelin sheaths around axons in the Central Nervous System
Nissl Bodies- granules of rough endoplasmic reticulum in the cytoplasm of neurons
Axons- carries impulses away from the cell body
Cell body- the nucleus and most of the organelles are found
Schwann cells- form myelin sheaths around axons in peripheral Nervous System
Nodes of Ranvier- gap between Schwann cells on axon
Axon terminals- ends of the axon that contains synaptic vesicles
Dendrites- receives incoming signals and conveys to cell bodies
Myelin Sheath- fatty layer surround and electrically insulate the axon; speed up impulses
Axon Hillock- cone shaped area where the axon leaves the cell body
Process of movement
General sensory information is sent to the postcentral gyrus
the Precentral gyrus initiates the contraction of bodies skeletal muscles
cerebellum assists the precentral gyrus, it enables smooth coordinated movements
Descending tracts take the message for contraction to the muscle, aiding in movement
Basal nuclei prevent unwanted movements
The Normal function of the cell is to send impulses all over the body
Anatomy
Cerebrum
Precentral Gyrus
central sulcus
postcentral Gyrus
lobes
occipital
Parietal
Temporal
Insula
Diencephalon
Corpus Callosum
Pineal Gland
Intermediate mass of the Thalamus
Hypothalamus
Thalamus
Fornix
Pituitary Gland
Spinal Cord
Dorsal Gray Horn- has cell bodies of interneurons
Central canal- middle open space, contains CSF
Ventral root- bundle of motor neurons
White matter tract- columns of myelinated axons
Ventral Gray Horn- contains the cell bodies of motor neurons traveling to skeletal muscles and glands
Dorsal root- bundles of sensory neurons
Dorsal median sulcus- narrow groove on the posterior side
Ventral medial fissure- slightly wider groove on anterior side
Neurons
Types
Unipolar- one extension off of the cell body
Bipolar- two extensions off of the cell body
Multipolar- multiple extensions off of the cell body
Structures
Oligodrocytes
Nissl bodies
axons
cell bodies
Schwann cells
Nodes of Ravier
axon terminals
dendrites
Myelin sheaths
axon hillock
Ascending Tracts
1st order neurons- has receptors and brings the info to the spinal cord
2nd order neurons- interneuron in the dorsal horn of the spinal cord
3rd order neurons- neuron in the thalamus that connects with cerebral cortex
Examples
Spinothalamic tract- starts in the spinal cord and ends in the thalamus
Spinocerebellar tract- starts in the spinal cord and ends in the cerebellum
Descending Tracts
Upper Motor Neuron- in the brain or the brainstem
Lower Motor Neuron- neuron that synapses with the muscles
Examples
Corticospinal tract- starts in the cerebral cortex and ends in the spinal cord
Vestibulospinal tract- Starts in the vestibule and ends in the spinal cord
Brainstem
Medulla Oblongata
Pons
Midbrain
Corpora Quadrigemina
Meninges
Dura Mater-most superficial
Arachnoid Mater- middle layer
Pia Mater- deepest
Subarachnoid space- filled with CSF
Dural Venous space- filled with blood