The case of the man with the weak arm

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Nervous System and Mental Health

Chapter 10

Related Combining Forms

Structure Related Combining Forms
Brain cerebr/o, encephal/o
Spinal cord myel/o
Nerves neur/i, neur/o

Functions of Nervous System

Coordinates and controls all activities of the body

Structures of Nervous System

Nerves

Brain

Spinal cord

Sensory organs

Eyes, ears, nose, skin, tongue

Divisions of Nervous System

Two primary parts

Central nervous system (CNS)

Includes brain and spinal cord

Receives and processes information

Regulates all activities of the body

Peripheral nervous system (PNS)

12 pairs of cranial nerves

31 pairs of spinal nerves

Transmits signals to and from CNS

Nerves

Nerve

One or more bundles of neurons connecting brain and spinal cord with other parts of the body

Tract

Bundle of nerve fibers located within the brain or spinal cord

Nerves

Ganglion

Cluster of nerve cell bodies outside the CNS

Innervation

Supply of nerves to specific body part

Plexus

Network of intersecting spinal nerves

Nerves

Receptors

Sites in sensory organs receiving external stimulation

Sensory neurons send stimulus to the brain for interpretation

Stimulus

Anything that activates a nerve and causes an impulse

Reflexes

Automatic, involuntary response to some change, either inside or outside the body

Examples

Changes in heart rate, respiratory rate, and blood pressure

Responses to painful stimuli

Neurons

Basic cells of nervous system

Allow different parts of the body to communicate with each other

Parts

Dendrites

Carry impulses toward the cell body

Axon

Carries impulses away from the cell body

Neurons

Terminal end fibers

Branching fibers at the end of an axon that lead a nerve impulse from the axon to the synapse

Synapse

Space between two neurons or between a neuron and a receptor organ

Neurotransmitters

Chemical substances allowing messages to cross from synapse of a neuron to a target receptor

Examples

Acetycholine, dopamine, endorphins, norepinephrine

Glial Cells

Four main functions

Surround neurons and hold them in place

Supply nutrients/oxygen to neurons

Insulate one neuron from another

Destroy and remove dead neurons

Myelin Sheath

Protective covering made of glial cells

Myelinated nerve fibers = white matter

(myelinated: having a myelin sheath)

Unmyelinated nerve fibers = gray matter

(unmyelinated: lacking a myelin sheath)

Central Nervous System

Brain and spinal cord

Protected externally by bones of cranium and vertebrae of spinal column

Meninges

Enclose brain and spinal cord

Three layers

Dura mater: outermost membrane

Arachnoid membrane: second layer; resembles spider web

Pia mater: inner layer; nearest to brain/spinal cord

Cerebrospinal Fluid

Produced within the four ventricles in the middle region of cerebrum

Clear, colorless, watery fluid

Cools and cushions brain and spinal cord

Nourishes brain and spinal cord by transporting nutrients/chemical messengers to these tissues

Parts of Brain

Parts of Brain

Parts of Brain

Cerebrum

Largest and uppermost portion of brain

Responsible for thought, judgment, memory, emotion, integration of motor and sensory functions

Cerebral cortex (cerebr: brain; -al: pertaining to)

Outer layer of cerebrum; made of gray matter

Gyri: folds of gray matter in cerebral cortex

Sulci: fissures of cerebral cortex

Cerebral Hemispheres

Two hemispheres

Left

Controls majority of functions on right side of the body

Right

Controls most of functions on left side of the body

Connected at lowest midpoint by corpus callosum

Cerebral Lobes

Divisions of cerebral hemispheres

Frontal lobe

Controls skilled motor functions, memory, behavior

Parietal lobe

Receives/interprets nerve impulses from sensory receptors in tongue, skin, and muscles

Cerebral Lobes

Occipital lobe

Controls eyesight

Temporal lobe

Controls senses of hearing and smell

Controls ability to create, store, and access a new information

Thalamus

Located below the cerebrum

Relays impulses to and from cerebrum and the sense organs

Hypothalamus

Located below the thalamus

Regulates

Autonomic nervous system

Emotional responses

Body temperature

Food intake and water balance

Sleep-wakefulness cycle

Pituitary gland/endocrine system activity

Cerebellum

Second-largest part of the brain

Located at the back of the head below the posterior portion of cerebrum

Receives messages regarding movement within joints, muscle tone, and positions

Produces coordinated movements, maintains equilibrium, sustains normal postures

Brainstem

Stalk-like portion of brain that connects cerebral hemispheres with spinal cord

Three parts

Midbrain

Pons

Medulla oblongata

Spinal Cord

Tube-like structure that begins at the end of the brainstem and continues down to almost the bottom of the spinal cord

Surrounded by cerebrospinal fluid and meninges

Pathway for impulses to and from the brain

Peripheral Nervous System

12 pairs of cranial nerves extending from the brain

31 pairs of spinal nerves extending from the spinal cord

Three specialized peripheral nerves

Autonomic nerve fibers

Sensory nerve fibers

Somatic nerve fibers

Cranial Nerves

Originate from under surface of the brain

Identified as Roman numerals

Named for area or function

Nerves of a pair are identical in function and structure

Each nerve of a pair serves half of the body

Peripheral Spinal Nerves

Named based on the region they innervate

Referred to by numbers

Cervical (C1–C8)

Thoracic (T1–T12)

Lumbar (L1–L5)

Sacral (S1–S5)

Autonomic Nervous System

Controls involuntary actions of the body

Two divisions

Sympathetic nerves

Fight-or-flight (response to emergencies)

Increases respiratory rate, heart rate, blood flow

Parasympathetic nerves

Returns body to normal after a response to stress

Maintains body functions when no emotional or physical stress occurs

Medical Specialties Related to Nervous System

Anesthesiologist

(an-: without; esthesi: feeling; -ologist: specialist)

Specializes in administering anesthetic agents before/during surgery

Anesthetist

(esthet: feeling; -ist: specialist)

Medical professional (not a physician) specializing in administering anesthesia

Medical Specialties Related to Nervous System

Neurologist

(neur: nerve)

Specializes in diagnosing/treating diseases/disorders of nervous system

Neurosurgeon

Specializes in surgery of nervous system

Medical Specialties Related to Nervous System

Psychiatrist

(psych: mind)

Specializes in diagnosing/treating chemical dependencies, emotional problems, mental illness

Psychologist

Specializes in evaluating/treating emotional problems and mental illness

Doctoral degree, but is not a medical doctor

Pathology of the Nervous System

Head and Meninges

Cephalgia

Headache

(cephal: head; -algia: pain)

Migraine headache

Often accompanied by nausea, vomiting, and sensitivity to light; warning aura may be perceived

Cluster headaches

Repeatedly affect one side of the head

Conditions of Head and Meninges

Encephalocele (encephala/o: brain; -cele: hernia)

Congenital herniation of brain tissue through gap in the skull

Meningocele (mening/o: meninges)

Congenital herniation of meninges through defect in skull or spinal column

Hydrocephalus (hydr/o: water; cephal: head)

Excess cerebrospinal fluid accumulates in the ventricles of the brain

Conditions of Head and Meninges

Meningioma (mening/i: meninges; -oma: tumor)

Slow-growing, usually benign tumor of meninges

Meningitis (mening: meninges; -itis: inflammation)

Inflammation of meninges of the brain and the spinal cord

May be bacterial or viral

Disorders of Brain

Dementia

Progressive decline in mental abilities, often accompanied by personality changes

Vascular dementia

Due to stroke or other restriction of blood flow to the brain

Encephalitis (encephal: brain)

Inflammation of the brain

Disorders of Brain

Reye's syndrome

May follow viral illness treated with aspirin

Tetanus

Potentially fatal infection of CNS caused by toxin produced by tetanus bacteria

Tourette syndrome

Neurological disorder characterized by involuntary movements and sounds

Neurodegenerative Diseases

Alzheimer's disease

Progressive deterioration that affects memory and reasoning capabilities

Parkinson's disease

Degenerative disorder leading to progressive loss of the control of movements

Due to inadequate level of dopamine

Neurodegenerative Diseases

Amyotrophic lateral sclerosis

Rapidly progressive disease attacking nerve cells responsible for controlling voluntary muscles

Brain Injuries

Amnesia

Total or partial inability to recall past experiences

Concussion

(concuss: shaken together; -ion: condition or state of)

Violent shaking or jarring of the brain, which may result in temporary loss of awareness

Brain Injuries

Cerebral contusion

Bruising of brain tissue due to brain bouncing against rigid bone of the skull

(contus: bruise; -ion: condition)

Cranial hematoma

Collection of blood trapped in the tissues of the brain

(hemat: blood; -oma: tumor)

Traumatic Brain Injury

Damage to the brain ranging from mild to severe

Example

Shaken baby syndrome

Results from child being violently shaken

May result in brain injury, blindness, fractures, seizures, paralysis, and death

Levels of Consciousness

Conscious

Awake, alert, aware, responding appropriately

Unconscious

Unaware and unable to respond to stimuli

Lethargy

Lowered level of consciousness marked by listlessness, drowsiness, and apathy

Levels of Consciousness

Stupor

Unresponsive; arouses only briefly despite repeated attempts

Syncope

Brief loss of consciousness due to decreased blood flow to the brain; fainting

Levels of Consciousness

Coma

Deep state of unconsciousness; no spontaneous eye movements or response to painful stimuli or speech

Persistent vegetative state

Alternating sleep/wake cycles, but person remains unconscious

Delirium

Acute confusion, disorientation, disordered thinking/memory, agitation, and hallucinations

Brain Tumors

Malignant brain tumor

Destroys brain tissue

May be primary or secondary

Benign brain tumor

Does not invade brain tissue, but pressure may damage tissue

Intracranial pressure (intra-: within; crani: cranium; -al: pertaining to)

Amount of pressure inside the skull

Strokes

Cerebrovascular accident

Damage to the brain due to disrupted blood flow

FAST

Facial droop (one side of face droops)

Arm drift (arm drifts down when extended)

Speech abnormality (slurred speech)

Time (early emergency treatment)

Ischemic Stroke

Due to blockage of the carotid artery

Transient ischemic attack

Temporary interruption in blood flow to the brain

Asphasia

(a-: without; -phasia: speech)

Loss of ability to speak, write, or comprehend written/spoken word

Often results from a stroke

Hemorrhagic Stroke

Occurs due to leakage of blood vessel in the brain

Arteriovenous malformation

(arteri/o: artery; ven: vein; -ous: pertaining to)

May cause hemorrhagic stroke

Abnormal connections between arteries and veins in the brain

Sleep Disorders

Insomnia

(in-: without; somn: sleep; -ia: abnormal condition)

Prolonged or abnormal inability to sleep

Narcolepsy

(narc/o: stupor; -lepsy: seizure)

Sudden uncontrollable brief episodes of falling asleep during the day

Sleep Disorders

Sleep deprivation

Lack of restorative sleep resulting in physical or psychiatric symptoms; affects routine performance

Somnambulism

Sleep walking

(somn: sleep; ambul: walk; -ism: condition of)

Spinal Cord

Myelitis

Inflammation of the spinal cord

(myel: spinal cord or bone marrow)

Myelosis

Tumor of the spinal cord

Spinal Cord

Poliomyelitis

Contagious viral infection of brainstem and spinal cord

May lead to paralysis

(poli/o: gray matter; myel: spinal cord)

Pinched Nerves

Radiculitis

Inflammation of the root of the spinal nerve causing pain and numbness radiating down the affected limb

(radicul: root or nerve root)

Named for the area affected

Cervical radiculopathy

Lumbar radiculopathy

Multiple Sclerosis

Progressive autoimmune disorder

Demyelination of myelin sheath due to inflammation that scars brain, spinal cord, optic nerves

Scarring disrupts transmission of nerve impulses

Nerves

Bell's palsy

Temporary paralysis of 17th cranial nerve

Guillain–Barré syndrome

Inflammation of myelin sheath of the peripheral nerves

Muscle weakness leads to temporary paralysis

May occur after viral infection

Nerves

Neuritis (neur: nerve)

Inflammation of nerve accompanied by pain and/or loss of function

Sciatica

Inflammation of sciatic nerve resulting in pain, burning, tingling along the course of nerve

Trigeminal neuralgia

Pain due to inflammation of the fifth cranial nerve

Cerebral Palsy

Poor muscle control, spasticity, speech defects due to damage of the cerebrum

Occurs most frequently in premature or low-birth-weight infants

Usually caused by injury during pregnancy, birth, or soon after birth

Epilepsy and Seizures

Chronic neurological condition characterized by seizures of varying severity

Seizure

Sudden surge of electrical activity in the brain affecting how person feels/acts for a short time

Epilepsy and Seizures

Tonic–clonic seizure (grand mal seizure)

Involves entire body

Tonic phase: body becomes rigid

Clonic phase: uncontrolled jerking

Absence seizure (petit mal seizure)

Brief disturbance in the brain leading to the loss of awareness

Abnormal Sensations

Causalgia

Persistent, severe burning pain following injury to the sensory nerve

(caus: burning; -algia: pain)

Hyperesthesia

(hyper-: excessive; -esthesia: sensation or feeling)

Abnormal/excessive sensitivity to touch, pain or other sensory stimuli

Abnormal Sensations

Paresthesia

Burning, prickling sensation in hands, arms, legs, or feet

(par-: abnormal; -esthesia: sensation or feeling)

Peripheral neuropathy

(neur/o: nerve; -pathy: disease)

Disorder of peripheral nerves

Produces pain, loss of sensation, and inabilty to control muscles, particularly in arms/legs

Abnormal Sensations

Restless legs syndrome

Uncomfortable feelings in legs, producing strong urge to move them

Usually most noticeable at night or when trying to rest

Diagnostic Procedures of Nervous System

Magnetic resonance imaging and computed tomography

Facilitate examination of soft tissues of the brain and the spinal cord

Functional MRI

Detects changes in blood flow in the brain when patient is asked to perform a specific task

Diagnostic Procedures of Nervous System

Carotid ultrasonography

Ultrasound study of the carotid artery to detect plaque buildup or to diagnose a stroke

(ultra-: beyond; son/o: sound; -graphy: the process of producing a picture or record)

Echoencephalography

Use of ultrasound imaging to create visual image of the brain for diagnostic purposes

(ech/o: sound; encephal/o: brain)

Diagnostic Procedures of Nervous System

Electroencephalography

Recording electrical activity of the brain through the use of electrodes attached to the scalp

(electr/o: electric)

Myelography

Radiographic study of the spinal cord

Requires contrast medium through lumbar puncture

(myel/o: spinal cord)

Diagnostic Procedures of Nervous System

Electromyography

Uses electrodes taped to skin to measure transfer of electrical signals in peripheral nerves to muscles

Lumbar puncture

Insertion of needle into subarachnoid space of lumbar region to withdraw specimen of cerebrospinal fluid

Treatment Procedures of Nervous System

Sedative and hypnotic medications

Hypnotic

Depresses CNS; produces sleep

Anticonvulsant

Prevents seizures

Barbiturates

Class of drugs producing calming or depressed effect on CNS

Treatment Procedures of Nervous System

Sedative

Depresses CNS to produce calm and diminished responsiveness

Does not induce sleep

Anesthesia

Absence of normal sensation, especially sensitivity to pain

Anesthetic

(an-: without; esthet: feeling; -ic: pertaining to)

Induces anesthesia

May be topical, local, regional, or general

Epidural anesthesia

Regional anesthesia produced by injecting medication into the epidural space of lumbar or sacral region of the spine

Anesthesia

Spinal anesthesia

Regional anesthesia produced by injecting medication into the subarachnoid space

Provides numbness from toes to waist or lower chest

Patient remains conscious

Brain

Deep brain stimulation

Neurosurgical procedure for the treatment of dystonia, tremors, and Parkinson's disease

Gamma knife surgery

Radiation treatment for brain tumors

Uses gamma radiation to destroy diseased tissue

Brain

Electroconvulsive therapy

Small amounts of electric current are passed through brain, triggering brief seizure in an attempt to reverse the symptoms of certain mental illnesses

Lobectomy

Surgical removal of portion of the brain

Treats brain cancer or seizure disorders that are not controlled with medication

Brain

Thalamotomy

Surgical incision into thalamus

(thalam: thalamus; -otomy: surgical incision)

Transcranial magnetic stimulation

Brief powerful electromagnetic pulses to alter electrical pathways in the brain

Nerves

Neuroplasty

(neur/o: nerve; -plasty: surgical repair)

Surgical repair of nerves

Neurorrhaphy (-rrhaphy: surgical suturing)

Surgically suturing together ends of a severed nerve

Neurotomy (-otomy: surgical incision)

Surgical division/dissection of nerve

Mental Health

Disorders may include congenital abnormalities, physical changes, substance abuse, or medications

Diagnostic and statistical manual of mental disorders (DSM)

Assists in diagnosing mental disorders

Anxiety Disorders

Generalized anxiety disorder

Chronic, excessive worrying

Panic disorder

Fear of panic attacks

Panic attack

Sudden experience of fear even in the absence of danger

Anxiety Disorders

Post traumatic stress disorder

Develops after event involving actual or threatened death or injury to individual or someone else during which the person felt fear, helplessness, or horrified

(post-: after; trauma: injury; -tic: pertaining to)

Phobias

Acrophobia

Excessive fear of heights

(acr/o: top; -phobia: abnormal fear)

Agoraphobia

Excessive fear of environments outside the home

(agor/a: marketplace)

Phobias

Claustrophobia

Abnormal fear of small, enclosed spaces

(claustr/o: barrier)

Social anxiety disorder

Excessive fear of social situations where person feels negative evaluation by others or fears embarrassing himself in front of others

Obsessive–Compulsive and Related Disorders

Obsessive–compulsive disorder

Recurrent obsessions (repetitive, distressing thoughts) and/or compulsions (repeatedly feeling compelled to do things)

Hoarding disorder

Over accumulation of belongings in a way that interferes with daily living

Can create unsafe/unsanitary living conditions

Nondevelopmental Disorders

Attention deficit/hyperactivity disorder

Short attention span and impulsive behavior inappropriate for developmental age

Dyslexia

Substandard reading achievement due to inability of the brain to process symbols

Nondevelopmental Disorders

Learning disabilities

Children of normal intelligence having difficulty learning specific skills

Intellectual disability

Significant below-average intellectual and adaptive functioning present from birth or early infancy

Nondevelopmental Disorders

Autistic spectrum disorder

Child has difficulty of developing normal social relationships and communication skills

Dissociative Disorders

Dissociative identity disorder

Presence of two or more distinct personalities, each with its own characteristics within the same individual

Disruptive and Impulse Control Disorders

Failure to resist impulse despite potential negative consequences

Kleptomania (-mania: madness)

Repeated stealing

Pyromania

Repeated arson

Oppositional defiant disorder

Disruptive behavior toward authority figures

Bipolar and Depressive Disorders

Bipolar disorder

Cycles of severe mood changes shifting from highs to severe lows

Manic behavior

Elevated mood with increased irritability, insomnia, poor judgment, and inappropriate social behavior

Bipolar and Depressive Disorders

Depression

Lethargy and sadness with the loss of interest or pleasure in normal activities

Persistent depressive disorder

Low-grade chronic depression present on the majority of days for two or more years

Seasonal affective disorder

Depression associated with winter months

Eating Disorders

Anorexia nervosa

Voluntary starvation and excessive exercising related to false perception of body appearance

Bulemia nervosa

Frequent episodes of binge eating followed by self-induced vomiting, excessive exercising, misuse of laxatives

Personality Disorders

Antisocial personality disorder

Disregard for the rights of others

Borderline personality disorder

Impulsive actions, mood instability, and chaotic relationships

Narcissistic personality disorder

Preoccupation with self and lack of empathy for others

Psychotic Disorders

Catatonic behavior

Lack of responsiveness, stupor, and tendency to remain in a fixed posture

Delusion

False personal belief

Hallucination

Sensory perception experienced in the absence of external stimulation

Psychotic Disorders

Schizophrenia

Withdrawal from reality, with illogical patterns of thinking, delusions, and hallucinations

May be accompanied by other emotional, behavioral, or intellectual disturbances

Somatic Symptom Disorders

Physical complaints or concerns about one's body that are out of proportion to physical findings or disease

Factitious disorder

Person acts as if he/she has physical or mental illness although not really sick

Somatic Symptom Disorders

Conversion disorder

Temporary or ongoing changes in function triggered by psychological factors

Malingering

Intentional creation of false or exaggerated physical or psychological symptoms motivated by incentive such as avoiding work

Substance Related Disorders

Substance abuse

Addictive use of tobacco, alcohol, medications, or illegal drugs

Alcoholism

Chronic alcohol dependence

Delirium tremens

Sudden, severe mental changes or seizures caused by abrupt withdrawal of alcohol

Substance Related Disorders

Drug abuse

Excessive use of illegal or recreational drugs, or misuse of prescription drugs

Drug overdose

Accidental or intentional use of illegal drug or prescription medication in amount higher than the safe or normal

Gender Identity

Gender dysphoria

Person identifies himself/herself opposite to his/her biological sex

Medications to Treat Mental Disorders

Psychotropic drug

Acts primarily on CNS by producing temporary changes affecting mind, emotions, and behavior

(psych/o: mind; -tropic: having an affinity for)

Antidepressant

Prevents or relieves depression

Medications to Treat Mental Disorders

Antipsychotic drug

Treats symptoms of severe disorders of thinking and mood associated with neurological and psychiatric illness

(anti-: against; psych/o: mind; -tic: pertaining to)

Anxiolytic drug

Temporarily relieves anxiety and reduces tension

(anxi/o: anxiety; -lytic: to destroy)

Medications to Treat Mental Disorders

Mood-stabilizing drugs

Treat mood instability and bipolar disorders

Stimulant

Increases activity in certain areas of brain to increase concentration and wakefulness

Overuse can cause sleeplessness and palpitations

Psychological Therapies to Treat Mental Disorders

Psychoanalysis

Determination of mental disorders stemming from childhood; gaining insight into one's feelings/behavior

Behavioral therapy

Focuses on changing behavior by identifying problem behaviors, and using reward if appropriate behaviors are performed

Psychological Therapies to Treat Mental Disorders

Cognitive behavioral therapy

Focuses on changing thoughts that affect person's emotions and actions

Attempts to change problematic beliefs

Hypnotherapy

Producing altered state of focused attention by use of hypnosis, making person to be more willing to believe and to act on suggestions