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A 52-year-old female (a proud Gulf War veteran) came in complaining of…

- - - - the motor neurons are being damaged which causes them to stop sending messages to the muscles
        
        the outcome is that the muscles cant function properly
- - - - it is most common between the ages of 40 to mid 60's
  - - - most people with familial ALS, their children have a 50/50 chance of developing the disease
  - - - this sex difference disappears after the age 70
  - - - These genetic variations might make people more susceptible to ALS
- - - - risk seems to be greater in women, specifically after menopause
  - - - studying has been done but no single agent or chemical has been consistently associated with ALS
  - - - its unclear what about military service might trigger the development of ALS
        
        it might include exposure to certain metals or chemicals, traumatic injuries, viral infections, and intense exertion
- - - - small indentations in the surface
      - the central sulcus
        
        separates the frontal and parietal lobes of the cerebrum
    - - raised bumps on the surface
      - precentral gyrus
        
        found anterior to the central sulcus
        
        location of the primary motor area of the brain
        
        regulates many of the bodys motor functions
      - postcentral gyrus
        
        found posterior to the central sulcus
        
        location of the primary sensory area of the brain
        
        involves in many of the bodys sensory functions
  - - - these halves are known as cerebral hemispheres
        
        is divided into 5 different lobes
        
        occipital lobe
        
        processes visual information and stores visual memories
        
        frontal lobe
        
        involved with motor functions, concentration, decision making, planning, and personality
        
        temporal lobe
        
        responsible for processing the senses of hearing and smell
        
        parietal lobe
        
        involved with general sensory functions
        
        insula
        
        deep to the temporal lobe
        
        involved with memory and interpretation of taste
- - - - filled with neuron cell bodies, dendrites, and unmyelinated axon
      - thinking/processing part
    - - filled with myelinated axons
      - connects gray matter so it can communicate
  - - - deepest layer
    - - intermediate layer
    - - superficial layer
  - - - dorsal gray horn
        
        posterior in the spinal cord
        
        contains the cell bodies of interneurons
      - ventral gray horn
        
        anterior in the spinal cord
        
        contains the cell bodies of motor neurons
        
        traveling to skeletal muscles and glands
      - lateral gray horn
        
        lateral in the spinal cord
        
        contains automatic motor neurons
    - - middle open space
        
        contains cerebralspinal fluid
    - - bundle of motor neurons
        
        leaves the anterior side of the spinal cord
        
        travels to muscles and glands
    - - bundle of sensory neurons
        
        enters the posterior side of the spinal cord
    - - columns of myelinated axons
        
        outer surface of the spinal cord
        
        surrounds the gray matter horns
    - - an enlargement along the dorsal root of the spinal nerve
        
        sensory cell bodies are found here
    - - narrow groove on the posterior side of the spinal cord
    - - slightly wider groove on the anterior side of the spinal cord
- - - - receptors throughout the body
        
        information is sent to the brain for processing
    - - 1st
        
        neuron that has receptors and brings the information to the spinal cord
      - 2nd
        
        interneuron in the dorsal horn of the spinal cord
      - 3rd
        
        neuron in the thalamus that connects with the cerebral cortex
    - - spinocerebellar tract
        
        information goes from the spinal cord to the cerebellum
        
        this is 1st order neurons and 2nd order neurons
        
        "spino" means
        
        spinal cord
        
        "cerebellar" means
        
        cerebellum
  - - - motor neurons in the brain (brain stem) give direction
        
        skeletal muscles respond to these directions
    - - upper motor neuron
        
        the brain or brainstem
      - lower motor neuron
        
        neuron that synapses with the muscle
        
        neuromuscular junction
    - - corticospinal tract
        
        "cortico" means
        
        cortex (cerebral cortex)
        
        this is a direct motor tract
        
        which means the movement comes from the brain
        
        lower motor neuron
- - - - the size of the body part indicates how many different motor neurons travel to the body part
  - - - it compares that to sensory information about what IS happening
      - if corrections are needed, it sends out the orders
- - - - the most common cause of death for people with ALS is respiratory failure
        
        on average, death occurs within three to five years after symptoms begin
        
        might need a device to help patient breathe at night
        
        similar to what someone with sleep apnea might wear
        
        patient may need a continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) to assist with breathing at night
        
        some people with advanced ALS choose to have a tracheostomy
        
        a surgically created hole at the front of the neck leading to the windpipe (trachea)
        
        respirator that inflates and deflates their lungs
  - - - usually starts off as slurring words
        
        but over time becomes more severe
        
        patient with ALS will have to rely on communication devices to communicate
  - - - are also at higher risk of getting food, liquids or saliva into the lungs
        
        can cause pneumonia
        
        a feeding tube can reduce these risks and ensure proper hydration and nutrition
  - - - some are eventually diagnosed with frontotemporal dementia
        
        no cure but medication can help
        
        some types of antidepressants, such as trazodone, may reduce the behavioral problems associated with this type of dementia