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Neuro Behavioral & Special Senses - Coggle Diagram
Neuro Behavioral & Special Senses
Neurology
Clinical Pathology
Neurology disease
CNS Disorder
Edema, Herniation, and Hydrocephalus
Cerebral Edema
Types
Cytotoxic edema
Increase intracellular fluid
Vasogenic edema
Increase extracellular fluid
Morphology
Flattened gyri
Narrowed sulci
Compressed cavities
Characteristic
Accumulation of excess fluid within the brain parenchyma
Hydrocephalus
Characteristic
Increase in the volume of the CSF within the ventricular system
Types
Noncommunicating hydrocephalus
Localized, a portion of the ventricles enlarges
Communicating hydrocephalus
Entire ventricular system is enlarges
Morphology
Enlarged ventricular system
Herniation
Morphology
Compressed tissue
Producing infarction
Additional swelling
Characteristic
Displacement of brain tissue from one compartment to another
Increased intracranial pressure
Types
Subfalcine (cingulate) herniation
Transtentorial (uncinate) herniation
Tonsilar herniation
Cerebrovascular Disease
Hypoxia, Ischemia, and Infarction
Global Cerebral Ischemia
Morphology
Early changes; 12-24 hours after the insult, include acute neuronal cell change
Subacute changes; 24 hours-2 weeks, with tissue necrosis, influx macrophage
Repair; >2 weeks, removal of necrotic tissue & gliosis
The brain is swollen with wide gyri and narrowed sulci
Characteristic
Widespread ischemic-hyypoxic injury
Focal Cerebral Edema
Characteristic
The size, location, and shape of the infarct and the extent of tissue damage that results may be modified by collateral blood flow
Leads first to focal ischemia and then to infarction in the distribution of the compromised vessel
Morphology
Embolic infarction
Thromboemboli
Cerebral infarction
Types
Hemorrhagic
Non-hemorrhagic
Intracranial Hemorrhage
Types
Cerebral Amyloid Angiopathy
Causes
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Morphology
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Types
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Vascular Malformation
Other Vascular Disease
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Arteriovenous Malformation
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Cavernous Malformations
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Capillary Telangiectasia
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Venous Angiomas
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Primary Brain Parenchymal Hemorrhage
Risk factors
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Causes
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Types
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Morphology
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General causes
Hypertension
Structural lesions
Tumors
Characteristic
Different regions of the brain disorders participate in different functions, the pattern of clinical signs and symptoms that follow injury depend as much on the region of brain involved as on the pathologic process
CNS Trauma
Traumatic Parenchymal Injury
Most suspectible to traumatic injury : crest of the gyri
Types
Coup injury
Brain injury occurs at the site of impact
Contrecoup injury
Opposite the site of impact on the other side of the brain
Morphology
Loss consciousness
Temporary respiratory arrest
Loss of reflexes
Pathology
Within a few hours
Blood extravasates throughout the involved tissue
After 24 hours
Undergoes neuronal injury & inflammatory
Old lesions
Lesions appear as depressed and yellowish brown patches involving the crest of gyri
Traumatic Vascular Injury
Epidural Hematoma
Traumatic displacement of the easily deformable skull
May tear a vessel, even in the absence of a skull fracture
Once a vessel tears, blood accumulates under arterial pressure and dissects the tightly applied dura away from the inner skull surface
Subdural Hematoma
Disruption produces bleeding into subdural space
Symptoms
Nonlocalizing
Headache
Confusion
Slowly progressive neurologic deterioration
General Characteristic
Significant trauma can cause of disability or death
Clinically silent
Affects frontal lobe
Severely disabling
Affects spinal cord
Fatal
Affects brain stem
Severe brain damage can occur in the absence of external signs of head injury
Severe lacerations and even skull fractures do not necessarily indicate damage to the underlying brain
Congenital Malformations &
Perinatal Brain Injury
Malformations
Forebrain Malformations
Microencephaly
Volume of brain is too small, causing small head
Megalencephaly
Excessive brain volume, lead to a large head
Holoprospencephaly
Disruption of normal midline patterning
Arrhinencephaly
Absence of the olfactory bulbs
Polymicrogyria
Increased number of irregularly formed gyri
Lissencephaly
Loss of gyri (complete/partial)
Cyclopia
Brain is not divided into hemispheres/lobes
Neural Tube Defects
General Causes
Folate deficiency during the first trimester of pregnancy
Types
Defects in the posterior end of the neural tube
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Myelomeningocele
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Anencephaly
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Encephalocele
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Posterior Fossa Anomalies
Definition
Misplacement or absence of portions of the cerebellum
Types
Chiary Type I Malformation
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Chiary Type II Malformation
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Dandy-Walker Malformation
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Perinatal Brain Injury
Cerebral Palsy
Spasticity, dystonia, ataxia or athetosis, and paresis attributable to injury occurring during the prenatal and perinatal periods
Hemorrhages
Intraparenchymal hemorrhage within the germinal matrix, most often adjacent to the anterior horn of the lateral ventricle, may extend into the ventricular system, causing hydrocephalus
Infarcts
Occur in the supratentorial periventricular white matter. The residu chalky yellow plaques consisting of discrete regions of white matter necrosis ans dystrophic calcification
Infections of the CNS
Epidural & Subdural Infections
Epidural abscesses such as sinusitis/osteonomy
If the abscesses occur in the spinal cord can cause s.c. compression
Infection of the skull may spread to the subdural space
A large subdural empyema may produce a mass effect
Clinical manifestation
Headache
Neck stiffness
Meningitis
Types
Aseptic Meningitis (Viral Meningitis)
Is an acute illness with meningeal signs
CSF shows lymphocytosis, moderate protein elevation
Brain swelling in some instances
Either no recognizable abnormality/mild to moderate leptomeningeal lymphocytic infiltrate
Chronic Meningitis
Causes
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Tuberculous Meningitis
Signs & symptoms
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Causes
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Leads to arachnoid fibrosis & hydrocephalus
Spirochetal Infections
General definition
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Patterns of CNS involement by shipilis
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Fungal Meningitis
Several fungal pathogens
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Acute Pyogenic Meningitis (Bacterial Meningitis)
Causes
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Signs & symptoms
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Morphology
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Definition
Is an inflammatory process involving the leptomeninges within the subarachnoid space
Parenchymal Infections
Viral Encephalitis
Arboviruses
Herpesviruses
Cytomegalovirus
Poliovirus
Rabies Virus
Human Immunodeficiency Virus
Polymavirus & Progressive Multifocal Leukoencephalopathy
Fungal Encephalitis
Other Meningoencephalitis
How to spread
Hematogenous
By arterial/venous blood supply
Direct implanation of microorganism
Due to open/penetrating trauma
Local extension
Infection of the skull/spine through air sinuses
Peripheral nerves
Such as rabies & herpes viruses
Neurodevelopment Disorder
Attention-Deficit Hyperactivity Disorder
Definition
Condition with sustained attention and increased impulsivity/hyperactivity
Epidemiology
7% - 8% in childrens
5% in adolescents
2.5% in adults
Boys >> girls
Etiology
Genetic heretability (75%)
Prenatal toxic exposures
Prematurity
Food additves, coloring, and preservatives
Signs & symptoms
Inattention
Hyperactivity
Irritability & hot temper
Impaired stress tolerance
Disorganization
Impulsivity
Treatment
Behavior therapy
Parent training in behavior management
Behavior therapy with children
Behavioral interventions in the clasroom
Medications
Stimulants
Nonstimulants
Methylphenidate
Dexamdetamine/Lisdexamfetamine
Atomoxetine
Guanfacine
Autism Spectrum Disorder
Definition
Characterized by difficulties with social interaction & communication, and restricted & repetitve behavior
Epidemiology
International prevalence 0.76%
4x more common in boys
ASD incedence is increasing globally, including Indonesia
In Indonesia, the incidence was 1:50 in 2014
Etiology
Genetic heretability
Environmental factors
Prematurity
Signs & symptoms
Can't do the socialization
Anxiety
Deficits in social-emotional peciprocity
Deficits in nonverbal communicative
Stereotyped or repetitive motor movement
Hyper/hyperactivity to sensory input or unusual interest in sensory aspect
Treatment
Psychosocial interventions
Parent training approaches
Social skills training
Cognitive-behavioral therapy
Interventions for comorbid symptoms
Educational interventions for children with ASD
Psychopharmacological interventions
Risperidone/Aripiprazole
Methylphenidate
Music therapy
Yoga
Melatonin
Tourette's Disorder
Definition
Repeated movements and sounds, can't control they movement
Epidemiology
Prevalence 3-8 :1000 in school age children
Males are affected 2x - 4x than females
Age 5-10 : the emergence & increasing of tics
After age 12 : decreased frequency & severity of tics
Etiology
Still unknown exact cause
Many gene involved
Dopamine receptor genes
Dopamine transporter genes
Several noradregenic genes
Serotonergic genes
Signs & symptoms
Motor
Eye blinking
Head jerking
Shoulder shrugging
Eye darting
Nose twitching
Mouth movements
Vocal
Grunting
Coughing
Throat clearing
Barking
Treatment
Pharmacological
Atypical antipsychotic
Haloperidol
Typical antipsychotic
Risperidone
Non-pharmacological
Psychoeducation
Behavioral therapy
Deep brain stimulation
Transcranial magnetic stimulation
Types
Motor
Vocal
Simple tics
Short in duration
Complex tics
Longer in duration
Combination of simple tics
Intelectual Disability
Definition
Characterized by significant, below average intelligence and impairment in adaptive functioning
Epidemiology
Prevalence 10-15 : 1000 in children
Highest incidence in children age 10-14 yo
1.5x more common in female
Etiology
Genetic abnormalities
Gene mutation
Neurodevelopmental defects
Neurodegeneration
Environmental exposures
Toxic/infectious agents
Trauma
Complications
Signs & symptoms
Sit up, crawl, or walk later than other children
Learn to talk later, or have trouble speaking
Find it hard to remember things
Have trouble understanding social rules
Have trouble seeing the result of their actions
Have trouble solving problems
Treatment
Pharmacological
Antipsychotics
Risperidone
Antidepressant
Paroxetine
Fluoxetine
Non-pharmacological
Educational interventions
Behavioral cognitive & interventions
Social interventions
Family education
Types
Profound
Severe
Moderate
Mild
Schizophrenia
Definition
Characterized by thought disorder, which reflect a break in reality/splitting of the cognitive from the emotional side of one side of one's personality
Epidemiology
Earlier onset in males than females
Common in young adults
Occurs 1% of the world pupulation
Etiology
Abnormalities in multiple neurotransmitter
Brain atrophy
Genetic heretability
Abnormal fetal development
Types
Paranoid
Delusion/hallucinations are prominent
Hebephrenic
Lack of goal directed behavior
Prominent thought disorder
Catatonic
Sustained evidence (min. 2 weeks) of catatonic behavior including stupor, excitement, posturing, and rigidity
Simple
Loss of personal drive
Progressive deepening of negative symptoms
Pronounced decline in social, academic, or employement
Treatment
Pharmacology
Typical antipsychotic
Risperidone
Atypical antipsychotic
Haloperidol
Psycotherapy
Electriconvulsive Therapy (ECT)
Signs & Symptoms
Positive Symptoms
Hallucinations
Delusions
Positive formal thought disorder
Bizzare behavior
Negative symptoms
Affecting flattening
Aloglia
Anhedonia-asociality
Inattention
Avolition-apathy
Cognitive symptoms
Inability to understand infofrmation & make proper decision
Difficulty paying attention
Problems with working memory
Lack of insight
Neurodegenerative Disease
Dementia
Alzheimer's Disease
Epidemiology
Global prevalence is 24 million
Predicted to increase 4x by the year 2050
Incidence of AD doubles every 5 years, after the age of 65
Prevalence rates increase from 10% after the age 65
Prevalence rates increase from 40% after the age 85
Higher in women
Etiology
Protein Amyloid-Beta agregat
Trisomy 21
Traumatic head injury
Higher parental age
Family history
Signs & Symptoms
Impaired memory
Severe cognitive & behavioral symptoms
Depression
Anxiety
Anger
Irritability
Insomnia
Difficult to walking
May not able to eat
Swallowing difficulties that lead to aspiration pneunomia
Treatment
Pharmacological
Donepezil
Rivastigmine
Galantamine
Memantamine
Non-pharmacological
Do some exercise to improve strength & balance
Creating an agenda/diary
Communicating with short & easy sentence
Definition
Most common cause of a dementia in adult
Increasing incidence as a function of age
Types
Mild
Moderate AD
First phase
Severe AD
Vascular Dementia
Definition
Decline in thinking skills because conditions that block or reduce blood flow to various regions of the brain, depriving them of oxygen and nutrients
Second most common dementia
Epidemiology
15% - 20% of dementia cases in North America & Europe
30% in Asia
Men affected more frequently than women
Etiology
Brain ischemia
Stroke
High blood pressure
High cholesterol
Smoking
Obesity
Signs & Symptoms
Confusion
Trouble paying attention & concentrating
Reduced ability to organize thoughts / actions
Difficulty to decide
Problems with memory
Unsteady gait
Depression / apathy
Treatment
Nonpharmacological
Avoid tobacco
Avoid excess alcohol
Avoid obesity & diabetes
Pharmacological
Donepezil
Galantamine
Rivastigme
Fronto Temporal Lobar Dementia
Definition
Several disorders that preferentially affect the frontal and/or temporal lobes
Epidemiology
The incidence is 2.2/100.000 between age 40-49
The incidence is 3.3/100.000 between age 50-59
The incidence peaks at 8.9/100.000 between age 60-69
Overall prevalence is 15-22/100.000 population
Mean age onset is 58
Etiology
Involved genes that associated with protein tau
17q21.32
9p21.2
Signs & Symptoms
Disinhibition
Loss of symphaty/emphathy
Dietary change & changes in appetite
Persevative
Treatment
Pharmacological
Antipsychotic
Antidepressants
Dopaminergic therapies
Nonpharmacological
Supportive care
Behavior change
Dementia with Lewy Bodies
Epidemiology
20% - 30% of all dementia cases
More common in men
The incidence increases with advancing age
Prevalent in Asian, African, and European races
Etiology
Still unknown
Risk factor
Smoking
Alcohol
Sex (common in men)
Caffeine consumption
Age (Common in elderly)
Signs & Symptoms
Early symptoms
Difficulty focusing
Poor memory
Visual hallucinations
Disorganized speech
Depression
Later symptoms
Resting tremors
Stiff & slow movement
Reduced facial expression
Sleep disorder
REM seleep behavior disorder
Excessive daytime sleepiness
Insomnia
Restless leg syndrom
Treatment
Pharmacology
Cholinesterase inhibitors (ChEIs)
N-Methyl D-aspartic acid (NMDA)
Levodopacardbiopa
Nonpharmacology
Social interaction
Environmental novelty
Basic Sciene
Embryology
Entoderm
Gastrointestinal Tract
Lungs
Liver
Mesoderm
Muscle
Connective tissues
Vascular Systems
Ectoderm
Columnar epithelium
Give rise to entire nervous systems
Development
During the 3rd weeks
Dorsal surface
Neural plate
pear-shape, wider cranially
Longitudinal neural groove
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Further development
Neural folds fuse
Neural tube
The cavity of the tube remains in communication with the
amniotic cavity through the anterior and posterior neuropores
Anterior neuropore closes
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Organology
Nervous System
Types
Central Nervous System
Brain
Forebrain
Cerebrum
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Diencephalon
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Hindbrain
Cerebellum
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Medulla Oblongata
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Pons
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Midbrain
Spinal Cord
Spinal nerves
12 Thoracic Segments
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5 Lumbar Segments
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5 Sacral Segments
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5 Coccygeal Segments
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8 Cervical Segments
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Spinal meninges
Spinal dura mater (outer)
Spinal arachnoid mater (middle)
Spinal pia mater (inner)
Subarachnoid space
Between arachnoid & pia mater, filled with CSF
Peripheral Nervous System
Cranial Nerves & Their Ganglia
12 Pairs that exit the skull through the foramina
Spinal Nerves & Their Ganglia
31 pairs that exited the vertebral column through the intervertebral foramina
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygneal
Connected by
Anterior route
Posterior route
Ganglia
Sensory Ganglia
Autonomy Ganglia
Cranial Meninges
Definition
Membranous coverings of the brain that lie immediately internal to the cranium
Types
Arachnoid mater
Thin intermediate layer
Pia mater
Delicate internal vasculated layer
Dura mater
Tough, thick external fibrous layer
Dural infolding
Falx cerebral
Separate cerebral and cerebellum
Tentorium cerebelli
Above falx cerebellt
Falx cerebri
Separate left and right cerebral
Diaphragmasellae
Covering the planum sphenoidale
Dural venous sinuses
Transverse sinus
Inferior sagital sinus
Sigmoid sinus
Occipital sinus
Cavernous sinus
Superior sagital sinus
Neurobiology
Varieties of neurons
Cell body
Bipolar
1 axon, 1 dendrite
Multipolar
1 axon, 2 or more dendrites
Unipolar
axon & dendrite in the same branch
Anaxonic
no true axon, many dendrites
Size
Golgi type-1 neurons
Have long axon
Golgi type-2 neurons
Have short axon
Definition
Neurons are excitable cells that are specialized for the reception of stimuli and the conduction of the nerve impulse
Structure
Nerve cell body
Nucleus
Cytoplasm
Nissl substance
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Golgi complex
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Mitochondria
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Microfilaments
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Microtubules
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Lysosomes
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Centrioles
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Lippofuscine, melanine,glycogen, lipid
Function
A.k.a. perikaryon/soma
Acts as a trophic center
Producing most cytoplasm
Contains of cell components
Plasma membrane
Axon
Branching off the soma, branch less profusely
Axolemma : the axon plasma membrane
Axoplasm : contents of axon
Axon hillock : pyramid-shaped region of the perikaryon
Collaterals : major branch
Dendrite
Typically short
Branching off the soma, become much thinner as they branch
Small processes emerging
Principal signal reception
Have dendritec spines
Synapses
Depending on the site
Axosomatic
Axon to cell body
Axoaxonic
Axon to axon
Axodendritic
Axon to dendrite
Neuroglia
Astrocyte
Types
Protoplasmic astrocyte
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Fibrous astrocyte
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Origin
Neural tube
Location
CNS axons
Unique markers
Has Glial Fibrillary Acid Protein (GFAP)
Function
Help form the blood brain barrier
Support the CNS
Replicates to occupy space of dying neurons
Oligodendrocye
Origin
Neural tube
Location
CNS axons
Shape
Small cell, condent & transparent nucleus
Unique markers
Produces myelin then forms myelin sheaths
Function
Myelinates & insulates CNS axons
Microglia
Origin
Bone marrow (monocyte)
Location
CNS
Shape
Smaller than others
Unique markers
Circulating
Function
Defense & immune-related activities
Produce immunoregulatory cytokines
Digest effete synapses
Ependymal cells
Types
Choroidal Epithelial Cells
Tanycytes
Ependymocytes
Origin
Neural tube
Location
Central canal of CNS
Shape
Cube/silindris, have vili
Unique markers
Have not basal lamina
Function
Lines ventricles of the brain & central canal of spinal cord
Assist in production & circulation of CSF
Satellite Cells
Origin
Neural crest
Location
Peripheral ganglian in PNS
Shape
Thin, intimate glial layer around the soma
Unique markers
Surrounding the soma
Function
Supporting effect to the neurons
Insulating & nourishing the neurons
Regulating their microenvironments
Schwann Cells
Origin
Neural crest
Location
PNS axon
Shape
Thin layers
Unique markers
Form myelin sheathes around a portion of only one axon
Function
Produces myelin
Electrical insulation
Cranial Nerves
CN 1
Olfactory nerve
Olfactory cilia
Olfactory glands
Olfactory bulb
Olfactory tract
CN 2
Optic nerve
Optic chiasm
Optic tract
Lateral geniculate nucleus
Retina
CN 3
Oculomotor nerve
Chief motor nerve to the ocular & extraocuular nerve
Innervation to 4 of 6 extraocular muscles
Arrange eye's accomodation
Divided to superior and inferior division
CN 4
Throclear nerve
Innervation 1 of 6 extraocular muscles
CN 5
Trigeminal nerve
CN V1
Opthalmic nerve
CN V2
Maxillar nerve
CN V3
Mandibular nerve
CN 6
Abduscens nerve
Eye movements
CN 9
Glossopharyngeall nerve
Pharinx
Touch pain
Temperature from ear
CN 10
Vagus nerve
Main parasympathetic nerve
CN 11
Spinal accessory nerve
Flexion of neck
Control head rotation
Elevates retracts scapula
CN 12
Hypoglossal nerve
Shape of tongue
Protect the tongue
Retract the tongue
Elevate and depress of the tongue
CN 7
Facial nerve
Lacrimination
Secretion
Taste
Touch
Pain
Temperature from ear
Muscle of facial expression
CN 8
Vestibulocochlear nerve
Dynamic equilibrium
Sound
Static equilibrium
Special Senses
Eye
Orbits
Definition
Bilateral bony cavities in the facial skeleton
Anatomy
Frontal bone
Zygomatic bone
Maxilla bone
Nasal bone
Sphenoid bone
Ethmoid bone
Lacrimal bone
Physiology
Protect the eyeballs and accessory visual structure
Eyeball
Anatomy
Fibrous layer (outer coat)
Sclera
5/6 of outer eye
Cornea
In the anterior 1/6 of the eye
Limbus
Encircling the cornea
Vascular layer (middle coat)
Choroid
In the posterior two-third of the eye
Ciliary body
Anterior expansion of the uvea that encircles the lens
Iris
The most anterior extension of the middle uveal layers
Lens
Behind the iris
Inner layer (inner coat)
Retina
Innermost tunic of the eye
Vitreous body
Behind the lens
Histology & Physiology
Fibrous layer (outer coat)
Sclera
Consist mainly of dense connective tissue
Provides sites for muscle insertion
0.5 mm in thickness
Protects internal structures
22 mm in diameter in adults
Supports eye shape
Cornea
Transparent & avascular
External corneal epithelium
5-6 layers thick
10% corneal thickness
Anterior limiting membrane
Bowman membrane
Stroma/substantia propia
90% of cornea thickness
60 layers of paralles collagen bundles
Posterior limiting membrane
Descement's membrane
Inner simple squamous endothelium
Focused the entry of light into the eye
Limbus
Transitional area where the transparent cornea with sclera
Bowman's membrane ends & becomes more stratified
Stroma becomes vascular & less well-organized
Descement's membrane replaced with trabecular meshwork
Scleral venous sinus/canal of shlemm for aqueous humor drainage
Vascular layer (middle coat)
Choroid
Consist of loose, well-vascularized connective tissue
Choroidocapillary lamina
The inner layers
Rich microvasculature
Bruch membrane
A thin extracellular sheet
Composed of collagen & elastic fibers
Act for supplying nourishment to retina
Ciliary body
Ciliary muscle
Consist of 3 groups of smooth muscle fibers
Contraction of this muscle affects the shape of the lens
Important for visual accomodation
Ciliary processes
Large surface area covered by a double layer of ciliary epithelium
Covering stroma
Contain melanine
Ciliary zonule
Composed of fibrillin-1 & 2
Iris
Covers part of the lens, leaving round central pupil
The anterior surface of the iris, exposed to aqueous humor
The stroma consist of loose connective tissue with melanocytes
Dilator pupillae muscle
Spinchter pupillae
Contains melanocytes to provide eye's color
Blue : very few lightly pigmented cells
Green, gray, brown : increase & densed melanocytes
Pink/albinism : almost no pigment
Lens
Transparent biconvex
To focused light on the retina
Lens capsule
Composed of proteoglycans type IV collagen
Provides the place of attachment for the fibers
Subcapsular lens epithelium
Consist of a single layer of cuboidal cells
Provides new cells
Lens fibers
Highly elongated and thin, 7-10 mm long
Highly specialized for light refraction
When the eye resting at distant objects
Flatter shape lens
When the eye focus on closer object
Rounded shape lens
Inner layer (inner coat)
Retina
Consist of cuboidal/low columnar cells
Neural Retina
Outer Nuclear Layer (ONL)
Inner Nuclear Layer (INL)
Ganglionic Layer (GL)
Consits ofthe nuclei of the interconnected neurons
Pigmented layer
Outer Limiting Layer (OLL)
Inner Limiting Membrane (ILM)
Plexiform regions
Outer Plexiform Layer (OPL)
Inner plexiform layer (IPL)
Containing only axons & dendrites
Vitreous Body
Occupies large vitreous chamber
Consist of transparent, gel like connective tissue
99% water (vitreous humor)
Hyalocytes : small mesenchymal cells
Specialized areas
Optic disc/blind spot
Lacks of photoreceptors
Fovea centralis
Where visual acuity/sharpness is maximal
Macula lutea
Surrounding the fovea centralis, protect the fovea
Eye's Accesory
Extra-ocular muscles
Nerves & vessels
Eyelids
Orbital Fascia
Mucous Membrane (Conjunctiva)
Ear
Organology
Anatomy
External Ear
Tymphanic membrane
Helix
Crura of antihelix
Scapha
Antihelix
Tragus
Antitragus
Auricle
External acoustic meatus
Middle Ear
Pharyngothymphanic tube
Walls of tymphanic cavity
Auditory osicles
Malleus
Incus
Stapes
Inner Ear
Bony labyrinth
Within the otic capsule of the petrous part of the temporal bone
Coclea
Vestibules
Semicircular canals
Membranous labyrinth
The vertibular labyrinth
The cochlear labyrinth
Consists of more parts than does the bony labyrinth
Physiology
External Ear
Collect sound
Middle Ear
Transmits sound
Inner Ear
Converting sound waves into nerve impulses and play a role in maintaining balance
Histology
External Ear
Auricle or pinna
Irregular funnel-shaped plate of elastic cartilage covered by adherent skin
Elastic cartilage
Supporting outer
External acoustic meatus
Lined with stratified squamous epithelium
Third of its opening contain hair follicles, sebaceous glands, ceruminous glands, and cerumen
Tymphanic membrane
Consist of fibroelastic connective tissue
Covered externally with epidermis and internally by the simple cuboidal epithelium
Middle Ear
Tymphanic cavity
Lined by simple cuboidal epithelium, rests on a thin lamina propria
Auditory tube
Simple epithelium is gradually replaced by ciliated pseudostratified columnar epithelium
Oval and round windows
Membrane-covered regions devoid of bone
Auditory ossicles
Articulate at synovial joints, which along with periosteum
Covered by simple squamous epithelium
Inner Ear
Bony labyrinth
Membranous labyrinth
A set of continuous fluid-filled,
Epithelium-lined tubes and chambers
Pathways of sound
Sound waves enter the outer ear and travels through ear canal
The eardrum vibrates and sends these vibrations into the ossicles
The ossicles amplify the vibrations and send them to the coclea
The fluid inside the coclea ripples and forms a travelling waves
Hair cells on bacillar membrane ride the wave and depolarized
Neurotransmitters are released, auditory nerves carry the signal to the brain
Mental Health
General Definition
Mental health is a state of well-being in which individual can :
Realizes his/her own abilities
Can cope with the normal stresses of life
Can work productively & able to make a contribution to his/her community
Determinants of Mental Health
Social factors
Syschological factors
Biological factors
Etiology
Genes/family history
Biological factors
Life experiences
Traumatic brain injury
Major Depression Disorder
General definition
Known as clinical depression
One of mood disorder
Common mental health disorder
Estimated to affect 15% of the adult population
Epidemiology
Common in women
Average age of onset it 20 years old
Etiology
Biological factors
Reduced levels of the neurotransmitter
Abnormal brain structures
Genetic factors
Psychosocial factors
Life event & environmental stress
Personality
Hopelessness theory
Types
Bipolar disorder
With Psychotic Features
Catatonic depression
Withatypical features
Postpartum depression
With Melancholic features
Seasonal affective disorder
Non-DSM-5 Types
Diagnostic criteria
Mild
2 major + 2 minor, min 2 weeks
Middle
2 major, 3-4 minor, min 2 weeks
Major
3 major, 4 minor, min 2 weeks
Signs & symptoms
Major criteria
Tiring easily
Lost ideas
Affect of depression
Minor criteria
Concentration decreases
Pessimistic about the future
Eating disorders
Sleep disturbance
Suicide attempt
Treatment
Hospitalization
Psychological therapy
Cognitive therrapy
Interpersonal therapy
Behavioral therapy
Pharmacological
Antidepressant, SSRIs
Electroconvulsive therapy
Bipolar Disorder
Definition
Chronic mood disorder
Epidemiology
Equal in women & men
Median age 30 years old
Early onset
Etiology
Biologic factors
Neuroregulatory defects
Genetic factors
Family inhereted
Psychosocial factors
Stress
Personality disorder
Signs & Symptoms
Mania episodes
Increased euphoria
Higher energy
Easily distracted
Talk-active
Elevated mood
Depression episodes
Depressed
Loss of interest & pleasure
Decreased self esteem
Feelings of worthless
Treatment
Pharmacology
Atypical antypsychotic
Antidepressant
Non-pharmacology
Interpersonal therapy
Cognitive-behavioral therapy
Electroconvulsive therapy
Psychoeducation
Types
Type 1
Have longer mania episodes
Type 2
Shorter mania episodes
Anxiety Disorder
Definition
An alerting signal to warns of impending danger and enables a person to take measures to deal with a threat
Epidemiology
Common in women
Prevalence rate : 17.7%
Etiology
Traumatic injuries
Deaths of significant others
Chronic illness
Separation & divorce
Financial difficulties
Sexual violence
Abuse & neglect
Signs & Symptoms
Palpilations
Sweating
Nervous
Frightened
Treatment
Psychotheraphy
Medication
Anorexia Nervosa
Etiology
Biological factors
Biochemical changes in the brain
Dysfunction in serotonin, dopamine, and norepinephrine
Social factors
Society ephasis on thinnes
Troubled relationship with others
Psychological
Lack of selfhood
Signs & Symptoms
Reducing food intake
Thinking about their food ingridients
Exccessive exercise
Amenorrhea in females
Epidemiology
Common in women
Age of onset in 14-18 years old
Severe in profession that require thinnes
Treatments
Hospitalization
Non-pharmacology
Cognitive behavioral therapy
Family therapy
Pharmacology
Definition
Loss of appetite
Types
Food-restricting category
Restricted daily food intake
Binge-purging category
Rigorous dieting with intermittent binge episodes
Insomnia
Etiology
Stress
Bad lifestyle
Others mental health disorders
Physical pain
Medical consumption
Signs & Symptoms
Loss of concentration
Overthinking
Anxiety & depression
Loss of motivation
Muscle aches
Hypertension
Daytime drowsiness
Epidemiology
Prevalence in 10%-30% of the population
Common in older adults
Common in females
Common in people with medical/mental ill health
Treatments
Pharmacological
Benzodiapines
Non-pharmacological
Stimulus control therapy
Sleep restriction therapy
Relaxation therapy
Definition
Difficulty initiating/maintaining sleep
Obsesive-Compulsive & Related Disorders
Etiology
Biological factors
Change in body's natural chemistry brain function
Genetic factors
Specific genes defects
Behavioral factors
Obsessive fears
Compulsive behavior
Signs & Symptoms
Pathologic doubt
Contamination
Symmetry obsession
Intrusive thoughts
Epidemiology
Prevalence in general population : 2% - 3%
Mean age of onset is 20 years old
Equal in women or men
Treatments
Pharmacology
SSRIs
Clomipramine
Non-pharmacolohy
Psychotherapy
Behavior therapy
Definition
Characterized by a diverse group of symptoms include obsession & compulsion
Kleptomania
Etiology
Biological factors
Brain diseases
Mental retardation
Genetic & familial factors
Higher in person with OCD
Psychosocial factors
Significant streess
Signs & Symptoms
Recurrent, intrusive, and irrestible urges to steal unneeded objects
Stealing ranged from 1-120 a month
Patients feel guilty & ashamed
Epidemiology
Prevalence of kelptomania is 0.6%
Common in female
Treatments
Pharmacological
SSRIs
Lithium
Non-pharmacological
Behavioral therapy
Electroconvulsive therapy
Definition
Failure to resist impulses to steal not needed objects