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