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A 52 y/o female patient has been diagnosed with Amyotrophic Lateral…
A 52 y/o female patient has been diagnosed with Amyotrophic Lateral Sclerosis (ALS)
Symptoms
Stiff muscles
Muscle twitching
Muscle weakness
Difficulty speaking & swallowing
Inability to breathe
Background Information
Cerebrum
Occipital lobe
Parietal lobe
Frontal lobe
Temporal lobe
Insula
Processes of movement
Upper motor neurons
Precentral gyrus
Motor neurons contracts skeletal muscles
Cerebellum
Assists precentral gyrus with skeletal muscle movements
Enables smooth, coordinated movements
Collects motor information about what should be happening
Basal nuclei
Regulate muscle movement
Gray matter - interneurons
Prevent unwanted movements
Lower motor neurons
Synapses with muscle to make contraction happen
Cerebrum
Occipital lobe
Processes visual information
Stores visual memories
Parietal lobe
General sensory functions
Frontal lobe
Motor functions
Concentration
Decision making
Planning
Personality
Temporal lobe
Processes senses of hearing & smell
Insula
Memory
Interpretation of taste
Spinal Cord
Dorsal gray horns
Central canal
Ventral root
White matter tracts
Ventral gray horns
Dorsal root
Lateral gray horns
Dorsal root ganglion
Dorsal median sulcus
Ventral median fissure
Cervical enlargement
Conus medullaris
Cauda equina
Lumbar enlargement
Filum terminale
Pons
Medulla oblongata
Pia mater
Arachnoid mater
Dura mater
Neurons
Abducens nerve
Brachial nerves
Cervical nerves
Hypoglossal nerve
Lumbar nerves
Oculomotor nerve
Optic nerve
Sacral nerves
Thoracic nerves
Femoral nerve
Obturator nerve
Common fibular nerve
Sciatic nerve
Tibial nerve
Axillary nerve
Median nerve
Musculocutaneous nerve
Radial nerve
Ulnar nerve
Olfactory nerve
Nerves
Obturator nerve
Controls adductor muscle group
Collects information from skin of medial thigh
Axillary nerve
Controls deltoid muscle
Collects information from skin of the shoulder
Ulnar nerve
Controls flexor carpi ulnaris muscle
Femoral nerve
Controls rectus femoris muscle
Collects information from skin to anterior thigh
Common fibular nerve
Controls tibialis anterior muscle
Radial nerve
Collects information from skin of lateral forearm
Tibial nerve
Collects information from skin of posterior leg & foot
Optic nerve
Sense of vision
Olfactory nerve
Sense of smell
Oculomotor nerve
Movement of eyeball
Regulates pupil size & lens shape
Abducens nerve
Movement of eyeball
Hypoglossal nerve
Regulates contraction of tongue muscles
Spinal Cord
Cervical enlargement
Spinal cord enlargement from which nerves going to the arm arise
Conus medullaris
Cone-shaped end of spinal cord
Cauda equina
Group of spinal nerves that extend at end of spinal cord
Lumbar enlargement
Spinal cord enlargement from which nerves going to the leg originate
Filum terminale
extension of pia mater that anchors spinal cord in place
Dorsal gray horns
Gray matter that contains cell bodies of interneurons
Central canal
Middle open space that contains cerebrospinal fluid (CSF)
Ventral root
Bundle of motor neurons that travel to muscles & glands
White matter tracts
Myelinated axons on outer surface of spinal cord surrounding gray matter horns
Ventral gray horns
Gray matter that contains cell bodies of motor neurons traveling to skeletal muscles & glands
Dorsal root
Bundle of sensory neurons that enters posterior side of spinal cord
Lateral gray horns
Gray matter that contains autonomic motor neurons
Dorsal root ganglion
Enlargement along dorsal root where sensory neuron cell bodies are found
Dorsal median sulcus
Narrow groove on posterior side of spinal cord
Ventral median fissure
Slightly wider groove on anterior side of spinal cord
Medulla oblongata
Cardiac & breathing control centers
Reflex centers for vomiting, swallowing, coughing, & sneezing
Pons
Relays information between medulla oblongata & higher brain regions
Ascending tracts
2nd order neuron
3rd order neuron
1st order neuron
Spinothalamic tracts
Lateral
Anterior
Spinocerebellar tract
Descending tracts
Upper motor neuron
Lower motor neuron
Corticospinal tract
Vestibulospinal tract
Descending tracts
Upper motor neurons
Located in brain or brainstem
Makes decision to contract
Lower motor neurons
Synapses with the muscle
Ascending tracts
2nd order neuron
Interneuron in dorsal horn of spinal cord
3rd order neuron
Located in the thalamus that connects with cerebral cortex
1st order neuron
Brings information to the spinal cord
Spinothalamic tract
Starts in spinal cord
Ends in thalamus
Lateral - away from midline/ to the side
Anterior - front of body
Indirect
Military service
Family history of ALS
ALS increases b/w ages of 40 to mid 60's
Smoking
Environmental toxin exposure
Direct
Upper motor neurons
Lower motor neurons
Motor neurons stop sending messages to skeletal muscles
Treatment
Riluzole (Rilutek)
Increase life expectancy by 3-6 months
Edaravone (Radicava)
Reduce decline in daily functioning
Physical therapy
Occupational therapy
Speech therapy
Breathing care
Spinal Cord
Upstream causes
Downstream effects
Anatomy
Intracellular Processes
Physiology