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A 52 year old female goes to the doctor complaining of recent trouble…

- - - - Established risk factors
        
        Heredity
        
        5 to 10 percent of people with ALS inherited it
        
        Patients genetic tests confirm she most likely inherited ALS
        
        Age
        
        ALS risk increases with age
        
        most commonly ages of 40 and the mid 60's
        
        Sex
        
        before the age of 65
        
        mostly more men than women
        
        Genetics
        
        studies done on the human genome found similarities in genetic variations with familial and non inherited ALS
      - Environmental risk factors
        
        Environmental toxins
        
        evidence suggests exposure to lead or other substances have been linked to ALS
        
        studies done but no single agent or chemical was directly associated
        
        Military Service
        
        patient is a Gulf War Veteran
        
        Military service members are at a higher risk for ALS. Possibly due to expossure to chemicals, certain metals, tamatic injuries, viral infections, and intense exertion
        
        Smoking
        
        only likely environmental risk factor
        
        the risk is greater for women, especially after menopause
    - - spreads to the rest of the body eventually
        
        advancement leads to nerve cells getting destroyed and muscles get weaker
        
        eventually affects chewing, swallowing, speaking, and breathing
    - - motor neurons slowly detoriorate
- - - - at a higher risk of getting pneumonia due to food and liquids or saliva getting into lungs
      - treatment:
        
        a feeding tube can reduce the risks and ensure proper hydration and nutrition
  - - - starts as occasional with mild slurring of words
        
        eventually becomes difficult for others to understand the person
        
        treatment:
        
        speech therapy
  - - - most common cause of death is respiratory failure
        
        death within 3 to 5 years, some people live 10 years or more
      - treatment:
        
        CPAP or BiPAP, a device to help you breath at night while sleeping or with advanced ALS a tracheostomy for permanent assistance
  - - - some are eventually diagnosed with a form of dementia called frontotemporal dementia
        
        caused by a progressive nerve cell loss of the brains frontal lobe
        
        treatment:
        
        there is no treatment, but there are medications used to reduce agitation, irritability and or/ depression
  - - - treatment:
        
        physical therapy might help with any pain or walking and mobility but there really is nothing to treat ALS symptoms. Medications can ease symptoms
- - - - white matter: connects gray matter and are in charge of sending messages
      - gray matter: processing and thinking
      - upper motor neurons send their axons to the brain stem and spinal cord
        
        synapse of the lower neurons which communicate to muscle and initiate movement
        
        if damaged, can lead to certain types of motor neuron diseases
        
        damage results in loss of muscular power and precision than total paralysis
    - - anteriorly-frontal lobe
      - posteriorly-occipital lobe
      - longitudenal fissure
        
        connected by corpus callosum
    - - central nervous system
      - deep to gray matter
      - myelinated axons
      - action potentials
      - three tracts
        
        commissural
        
        projection
        
        association
      - superficial parts of the spinal cord
    - - neuron cell bodies
      - non-myelinated neurons
      - basal nucli
        
        associated with a variety of functions, including control of voluntary motor movements, procedural learning, habit learning, eye movements, cognition, and emotion.
    - - precentral gyrus
        
        anterior to central gyrus
        
        primary motor cortex
        
        motor homunculus
      - postcentral gyrus
        
        posterior to central sulcus
        
        primary sensory cortex
        
        sensory homunculus
    - - central sulcus
        
        grove
        
        frontal lobe
        
        parietal lobe
    - - motor homunculus
        
        the size of the body part indicates how many different motor neurons travel to that body part
  - - - cerebellum
        
        thalamus
        
        Its important function is to regulate neural signals in other parts of the brain. Most is known about its regulatory actions on neurons that control movement and posture.
    - - dendrites
      - cell bodies
      - doral gray horn
        
        ventral gray horn
        
        lateral gray horn
        
        visceral motor (autonomic) neurons
        
        somatic motor neurons
        
        ventral root
        
        motor
        
        interneurons
        
        somatic sensory
        
        visceral sensory
        
        dorsal root
        
        sensory neurons
        
        dorsal root ganglion
        
        sensory neurons cell bodies
    - - thoracic nerves (T1-T12)
        
        conus medullaris
        
        lumbar nerves (L1-L4)
        
        cauda equina
    - - 1st order neuron
        
        has receptors and brings the information to the spinal cord
      - 2nd order neuron
        
        receive the information and deliver it to the third order
      - 3rd order neuron
        
        transmit the sensory signals from the thalamus to the ipsilateral primary sensory cortex of the brain
      - sensory tracts
      - spinothalamic tracts
        
        spinocerebellar tracts
        
        only has a 1st and 2nd order neuron
        
        anterior spinothalamic tract
        
        lateral spinothlamic tract
    - - motor tracts
      - corticospinal tract
        
        vestibulospinal tract
      - upper neurons
        
        their cell bodies are found in the cerebral cortex of the brain stem
      - lower neurons
      - motor neurons
        
        in the brain or brainstem. give the directions. Skeletal muscle respond to these directions
      - the pathways by which motor signals are sent from the brain to lower motor neurons. The lower motor neurons then directly innervate muscles to produce movement.