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Amyotrophic Lateral Sclerosis (ALS) (Background information (Anatomy…
Amyotrophic Lateral Sclerosis (ALS)
Background information
Anatomy
Cerebrum
Cerebral Hemisphere
Cerebral cortex
Contains three types of functional areas
Sensory areas
Primary somatosensory area
Postcentral gyrus
Primary olfactory area
Medial aspect of temporal lobe
Primary auditory area
Temporal lobe
Primary gustatory area
In insula
Primary visual area
Occipital lobe
Vestibular cortex
Posterior part of insula
Adjacent parietal cortex
Association areas
Somatosensory area
Visual association area
Surround primary visual cortex
Auditory association area
Posterior to primary auditory cortex
Sites of long-term memory storage
Motor areas
Voluntary motor intiation
Primary motor area
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Motor speech area
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Contralateral
Corpus callosum
83% of brain mass
Surface markings
Gyri
Ridges
Sulci
Shallow grooves
Fissures
Deep grooves
Longitudinal fissure
Transverse cerebral fissure
5 Lobes
Frontal lobe
Parietal lobe
Temporal lobe
Occipital lobe
Insula lobe
Cerebral White Matter
basic region of cerebral hemisphere
Classified according to direction they run
Commissural fibers
horizontal fibers
Projection fibers
vertical fibers
Association fibers
Horizontal running fibers
Consists of myelinated fibers
Basal nuclei
Each hemisphere's basal nuclei include a
Caudate nucleus
Globus palidus
Putamen
Spinal cord
Enclosed in vertebral column
Gross anatomy and protection
Bone
Meninges
Arachnoid mater
Pia mater
Dura mater
CSF
Epidural space
Conus medullaris
The cone-shaped end of the spinal cord itself
Filum terminale
Extension of the pia mater
Spinal nerves
Part of PNS
Cauda equina
Extend end off the spinal cord
Cervical and lumbosacral enlargements
Spinal cord cross-sectional anatomy
Gray matter and spinal roots
Ventral horn
Anterior in the spinal cord
Has motorneuron
Lateral horn
Lateral in the spinal cord
Has autonomic motor neuron
Dorsal horn
Posterior in the spinal cord
Has interneuron
Ventral roots
Bundle of motor neuron
Spinal nerves
Dorsal roots
Bundle of motor sensory neuron
Dorsal root ganglion
Cell bodies of sensory neurons
Gray commissure
Bridge of gray matter
White matter
White matter funiculi
The columns of myelinated axons
Outer surface of the spinal cord
Surround the gray matter horn
Ascending tracts
refer to the neural pathways
sensory information from peripheral nerve is transmitted to cerebral cortex
have 3 neurons
2nd order neuron
cell body located in posterior horn or a brainstem nucleus
3rd order neuron
Cell body located in thalamus
1st order neuron
cell body located in posterior root ganglion or brainstem nucleus
Example
Spinothalamic Tracts
Spinocerebella tract
Descending tract
the pathway
which motor signals are sent from the brain to lower motor neurons
have two neurons
Upper motor neurons
Cell body located in cerebral cortex or a brain stem
Lower motor neuron
Cell body located in anterior horn or a brainstem nucleus
Example:
Corticospinal tract
Vestibulospinal tract
Physiology
Function
Parietal lobe
General sensory function
Temporal lobe
Processing the senses of hearing and smell
Frontal lobe
Motor function
Occipital lobe
Visual information
Transverse cerebral fissure
Separates cerebrum and cerebellum
Insula
Interpretation of taste
Longitudinal fissure
Separates two hemispheres
Motor areas
Control voluntary movement
Sensory areas
Conscious awareness of sensation
Association areas
Integrate diverse information
Primary somatosensory cortex
Receives sensory infotation from skin and proprioceptor
spatial discrimination
Visual association area
Interpret visual stimuli
Primary motor area
Control voluntary contractions of skeletal muscle on other side
Motor speech area
Production of speech
Control of tongue & airway
Primary auditory cortex
Interprets information from inner ear as
Loudness
Location
Pitch
Auditory association area
Stores memories of sound
Permits perception of sound stimulus
Primary olfactory cortex
Involved in conscious awareness of odors
Gustatory cortex
Involved in perception of taste
Vestibular cortex
Responsible for conscious awareness of balance
Cerebral White Matter
Responsible for communication between
Cortex
Lower CNS
Cerebral areas
Projection fibers
Connect hemispheres with lower brain or spinal cord
Commissural fibers
Connect gray matter of two hemispheres
Association fibers
Connect different parts of same hemisphere
Basal nuclei
Regulate muscle movement
Prevent unwanted movement
Spinal cord
Provide two-way communication to and from brain and body
Reflexes
Filum terminale
Anchors spinal cord
Motor neuron
Transmits the motor impulse from the CNS to effector
Interneuron
Process sensory impulse then predict the correct motor response
Sensory neuron
Transmits the sensory impulse to CNS
Ascending tracts
2nd order neuron
transmit impulses to the third-order neurons
3rd order neuron
Conduct impulses from thalamus to the somatosensory cortex
1st order neuron
sensory neuron has receptor & brings the information to the spinal cord
Upper motor neuron
Send signals to lower motor neurons
Lower motor neuron
Send signal to muscle to make them contract
Process of movement
Role of Basal nuclei
receive information from cerebral cortex and thalamus through input nuclei
information has been processed and sent to output nuclei
information from output nuclei, information is sent to thalamus
thalamus passes the information on to cerebral cortex
Role of Cerebellum
Cerebellum receives information about the intended movement from the sensory and motor cortexes
then it sends information back to the motor cortex about the required direction, force, and duration of this movement
Role of Precentral gyrus
Primary motor cortex
generate neural impulses that control the execution of movement.
Role of descending tract
Motor signals are sent from the brain to lower motor neurones.
The lower motor neurones then directly innervate muscles to produce movement.
Causes
Indirect cause
Age
ALS risk increases with age
Heredity
5 to 10 percent of the people with ALS inherited it
Environment factor
Military service
Environment toxin exposure
Direct cause
ALS affects the motor neuron
Motor neurons gradually deteriorate and then die
motor neuron stop sending message to muscles
Muscle cannot function
Effect
Complication
Speaking problem
mild slurring of words, becomes more severe
Speech eventually becomes difficult for others to understand
Eating problem
Malnutrition
Dehydration
Breathing problem
ALS paralyzes the muscle use to breath
Respiratory failure
Fatal
Dementia
Problem with memory and decision-making
Frontemporal dementia
Treatment
Therapies
Breathing care
provide with devices to assist breathing at night.
Physical therapies
help maintain your cardiovascular fitness,
Help muscle strength
help improve your sense of well-being
help prevent pain
help muscles function at their best.
Occupational therapy
help find ways to remain independent
Speech therapy
Medication
Riluzole (Rilutek)
Increase life expectancy by three to six month
Edaravonce (Radicava)
Reduce the decline in daily functioning
Nutrition support
ensure patient eating foods that are easier to swallow