52 year old female complaining of recent challenges w. completing tasks, one of them being able to play pool which she has played since her 20s due to muscle weakness; she can't go grocery shopping due to her legs getting tired too quickly & she recently tripped & hurt her knee; she also shared how her brother died from ALS when he was 31; she also suspects her dad died of the same reason; genetic testing confirms that she has ALS
upstream causes:
Direct causes:
indirect causes:
is a nervous system disease that affects nerve cells in brain & spinal cord causing loss of muscle control
Background information
Anatomy:
Physiology:
spinal cord
types of neurons in parts of the spinal cord
neurons/neurons structures
cerebrum (def/location)
types of tracts
examples of the tracts
process of movement (what is involved)
types of neurons in ascending & descending tracts
spinal cord
examples of ascending & descending tracts
cerebrum; functions
process of movement
Downstream causes:
Cerebellum
Basal nuclei
Precentral gyrus
Descending spinal cord tracts
in front of the central sulcus with motor functions
inferior to the cerebrum; underneath the occipital lobe
made of gray matter in the brain
taking motor information from the brain to the body
Ascending tracts
Descending tracts
the Spinothalamic tracts
the Corticospinal tract
the Spinocerebellar tract
in spinal cord to the thalamus; there is a lateral & anterior tract; 3 order neurons
in spinal cord & cerebellum; different order neurons
the Vestibulospinal tract
cortex/gray matter; direct motor tract
vestibule(saccule, utricle, semicircular canals); indirect motor tract
Ascending tracts
Descending tracts
motor tracts; motor neurons in the brain give the directions
sensory tracts; receptors through the body collect info
two neurons
upper motor neuron
lower motor neuron
3 neurons
1st order neuron
2nd order neuron
3rd order neuron
structural
functional
multipolar
bipolar
unipolar
interneuron
sensory neuron
motor neuron
one extension
multiple extensions
two extensions
in CNS integrate incoming sensory info & predict the proper motor function
transmit impulses from sensory receptors in skin/organs toward CNS
neurons that carry impulse away from CNS to effectors
Meninges
cross-section
CNS; nervous tissue
white matter
gray matter
arachnoid mater
dura mater
pia mater
dorsal root
lateral gray horns
ventral gray horn
dorsal root ganglion
white matter funiculi
dorsal median sulcus
ventral median fissure
Ventral root
Central canal
Dorsal gray horn
connected to spinal cord
intermediate
most superficial
filled with myelinated axons
filled with cell bodies, dendrites & unmyelinated axons
posterior of spinal cord
middle open space
bundle of neurons; leave anterior side
outer surface of spinal cord surrounding gray matter horns
anterior of spinal cord
bundle; enters posterior side
lateral in spinal cord
enlargement along dorsal root
narrow groove on posterior side
slightly wider groove on anterior side
pre-central gyrus
post-central gyrus
central sulcus
longitudinal fissures
outer surface is covered in:
lobes:
parietal lobe
occipital lobe
frontal lobe
temporal lobe
gyri
sulci
raised bumps
small indentations
separates the frontal and parietal lobes
anterior to the central sulcus
posterior to the central sulcus
very deep indentation in between the two halves
insula
anterior of the central sulcus
posterior of the central sulcus
posterior of parietal lobe
beneath lateral fissure
deep to the temporal lobe
longitudinal fissure
lobes
pre-central gyrus
post-central gyrus
central sulcus
separates frontal & parietal lobes
regulates motor functions
involved in sensory functions
divides the two cerebral hemispheres
occipital lobe
temporal lobe
parietal lobe
insula
frontal lobe
concentration, personality & decision making
general sensory functions
process visual info & stores memories
process of hearing and smell
involved with memory & taste
meninges
cross section
CNS nervous tissue:
white matter
gray matter
myelinated axons
nonmyelinated axons, cell bodies & dendrites
arachnoid mater
dura mater
pia mater
dorsal gray horn
contains cell bodies of interneurons
central canal
middle space containing CSF
ventral root
white matter funiculi
ventral gray horn
dorsal root
lateral gray horns
dorsal root ganglion
dorsal median sulcus
ventral median fissure
leave anterior side of spinal cord traveling to muscles & glands
columns of myelinated axons on outer surface of spinal cord
neurons traveling to skeletal muscles & glands
neurons enter posterior side
autonomic neurons
enlargement along dorsal root with sensory neurons
narrow groove on posterior side
slightly wider groove on anterior side
visceral
somatic
ex: setting heart rate
moving fingers
visceral
somatic
processing how full your stomach is
processing temperature sensations
ventral root
ventral gray horn
dorsal gray horn
dorsal root
lateral gray horns
dorsal root ganglion
interneurons; visceral/somatic
motor neurons
motor neurons; somatic motor neurons
sensory neurons
autonomic motor neurons; visceral motor
sensory neurons
Ascending tracts
Descending tracts
sensory tracts; receptors through the body collects info
2nd order neuron
1st order neuron
3rd order neuron
upper motor neuron
lower motor neuron
motor neurons in the brain give the directions
neuron that has receptors & brings the info to the spinal cord
interneuron in the dorsal horn of the spinal cord
neuron in the thalamus that connects with the cerebral cortex
is in the brain or the brainstem
neuron that synapses with the muscle
ascending tract ex:
descending tract ex:
spinothalamic tract
spinocerebellar tract
corticospinal tract
vestibulospinal tract
direct motor tract
indirect motor tract
this tract helps you stay balanced
decision to move from brain stem
movement directions are given in control of the precentral gyrus
lateral spinothalamic tract
anterior spinal thalamic tracts
temperature & pain
touch & pressure
has 1st,2nd & 3rd order neuron
muscle coordination
1st order neuron
2nd order neuron
receptor bring the info
order neuron goes into cerebellar
cerebellum
basal nuclei
precentral gyrus
descending spinal cord tracts
motor neurons in the brain give directions & skeletal muscles respond to these directions
assist the precentral gyrus with skeletal muscle movement
enables smooth movements
the contraction of the body skeletal muscle is initiated by the neurons in the precentral gyrus
help regulate muscle movements & prevent unwanted movements
risk factors
smoking
age 40-60s
environmental toxin exposure to lead
serving in the military being exposed to certain metals, chemicals, traumatic injuries & infections
complications
speaking problems
eating problems
breathing problems
ALS paralyzes the muscle used to breath
treatments
may be given a continuous positive airway pressure or an bilevel positive airway pressure to assist with breathing at night; or having a tracheostomy
slurring words but can become severe
treatments
rely on other communication technologies
damage to muscles that control swallowing causing malnutrition or dehydration; or they are also high risk of getting food, liquids or saliva into lungs
treatments
feeding tube
muscle complications
muscle cramps, stiffness, contractions
treatments
medications; physical therapy
mental health complications
depression, dementia
treatments
having a therapist or a mental health professional