nervous system Flashcards
what are the 9 brain structures associated with pain include?
somatosensory cortex,
secondary somatosensory cortex,
anterior cingulate cortex (ACC),
prefrontal cortex (PFC),
insular cortex,
amygdala,
thalamus,
cerebellum,
and Peri-acqueductal grey.
what is multiple sclerosis?
a chronic autoimmune disease that affects the CNS. it causes inflammation and damage to the myelin sheath, the protective covering around the nerve fibres.
what does multiple sclerosis affect?
the communication between the brain and the rest of the body by interrupting messages (signals) that your nerves send throughout your body to perform functions like vision, sensation and movement
what are the symptoms of ms
fatigue,
difficulty walking,
vision problems such as blurred vision,
problems controlling the bladder,
numbness or tingling in different parts of the body,
muscle stiffness and spasms,
problems with balance and co-ordination
problems with thinking, learning and planning
what are the risk factors of getting MS?
genetics,
vitamin D deficiency
cigarette smoking- can adversely affect course of disease progression
diet and obesity in early life
latitude- prevalence increase in northan latitude
epstein barr virus- every occurance of MS has had this virus previously
woman are twice as likely to be affected
what are the 4 types of MS?
clinically isolated syndrome:
first episode of MS but dont meet the criteria
relapsising- remitting MS.
85% of people diagnosed have this type. the most common way MS begins
secondary progressive MS-
RRMS progresses to this. nerve damage accumlates and symptoms gradually worsen
primary progressive MS-
symptoms start to slowly worsen over time
what is the cause of MS?
destruction of the mylein. immune attack
what are the complications of multiple sclerosis?
difficulty walking with assistance
loss of bowel or bladder control
memory loss
sexual dysfunction
depression and anxiety
what is the treatment for multiple sclerosis?
disease modifying therapies- reduce the frequency and severity of relapses and slow disease progression
corticosteroids- help reduce inflammation and shorten the duration of relapses
sympotamic treatments- various meds to help with symptoms such as muscle spasms, pain, fatigue, bladder issues.
physical theraphy-
help improve strength and mobility. occupational theaphy to.
lifestyle modifications- regular exercise and a balence diet
supportive care- counsiling
physcial overall health exam
neurological exam- evaluates the brain and nervous system functioning. assess mental status, reflexes and movement
what is the treatment for MS?
physical, occupational or speech theaphy
mental health counseling
wearing glasses
deep brain simulation for tremors
mobility devices
donepezi for cognitive symptoms
disease modifying theraphies- reduce how often you have relapxes, slow down MS progression and prevent new lesions from forming on your brain and spinal cord
for severe symptom attacks-
corlicosteroids like methylpredniislone quickly reduces inflammation by supressing the immune system.
increase speed recovery time after an attack
slow down damage to myelin sheath
what is Alzheimers disease?
brain condition that causes an progressive decline in memory, thinking, learning and organising skills. eventually affects a persons ability to carry out basic activities.
what are the symptoms of alzhimers disease?
Confusion, disorientation and getting lost in familiar places
Difficulty planning or making decisions
Problems with speech and language
Problems performing daily activities without assistance and performing self-care tasks
Personality changes such as becoming aggressive, demanding or becoming suspicious of other people
Hallucinations and delusions
Low mood or anxiety
what is the cause of Alzheimer’s disease?
hint:
-neural atrophy
– amyloid plaques
- protein tau
by loss or damage to the synapses in the brain, which in turn causes neural atrophy (loss of neurons and loss of neuron connections) within the brain.
This damage to the synapses usually occurs to a build up of proteins (amyloid plaques), which causes delays in the transmission of electrical signals within the brain.
Additionally, a build up of the protein Tau causes neural pathways to become “tangled” or “clumped”, further accelerating neural atrophy.
Over time, this causes certain parts of the brain (most commonly the hippocampus and temporal lobes) to shrink which causes the common signs and symptoms we see in Alzheimer’s.
what are the first 2 lobes that are mostly affected in Alzheimer’s?
hippocampus and temporal lobes
what is the diagnosis of Alzheimer’s disease?
physical and neurological exam
mental statis, assess memory, problem solving, attention, basic maths and language
brain imaging tests to rule out other possible conditions
what are the treatments of alzhimers?
cholinestrase inhibiters- treat symtoms mild to moderate
nmda antagonists-moderate to severe symptoms
what is visceral pain?
pain that originates from the internal organs such as the stomach, intestines, bladder and heart.
described as a deep, dull or cramping sensation and can be difficult to localise
what are symptoms of visceral pain?
- dull or aching discomfort
- cramping or pressure like sensations
- pain that may be diffuse and hard to pinpoint
-accompanied by other symptoms depending on the underlying condition such as nausea, vomiting, or changes in bowel movements
what is the pathophysiology of visceral pain
it occurs when the internal organs are damaged or inflamed. nerve fibers from the organs send pain signals to the brain.
these signals can be triggered by various factors including inflammation, distension or ischemia.
pain is often mediated by the autonomic nervous system and because of the way the brain interprets these signals, visceral pain can be referred to other areas of the body
what is the diagnosis of viseral pain
medical history
physical examination
may use imaging studies like an ultrasound or ct scan and laboratory tests to identify the underlying cause of the pain.
looking for signs of organ dysfunction, inflammation, or other conditions
what can visceral pain be an indication of - specific conditions
gastrointesinal disorders- appendicitis, pancretitis, gallbladder disease or bowel obstructions
cardiovascular issues- angina, MI
urinary tract- kidney stones, bladder infections
reproductive system- ovarian cysts, endometriosis, ectopic pregnancy
infections
inflammatory conditions- bowel disease or diverticulitis
whats the difference between somatic and visceral pain?
origin:
somatic- skin, muscles, bones etc
visceral- internal organs such as the stomach, intestines and heart
characteristics
somatic- sharp, localised and easier to pinpoint. describe as a aching, throbbing or stabbing
visceral- pain is dull and deep, cramping or pressure like.
nerve pathways:
somatic pain- transmitted through specific nerve pathways
visceral- infulenced by the autonomic ns, transmitted through less specific pathways
what is the clinical significance of multiple sclerosis?
the potential for significant disability over time. the disease often follows a relapsing- remitting course. = symptoms followed by periods of recovery
what is the pathophysiology of Alzheimers disease?
amyoid- beta plaques are formed from the abnormal processing of amyloid precurosor protein leading to the aggregation of these proteins outside the neuron.
this accumulation disrupts cell communication and triggers an inflammatory response
tau protein normally stabilizes microtubules in neurons, become hyperphosphorylated (excessive number of phosphate groups attached), leading to the formation of neurofibrillary tangles inside the cells.
this tangling distrupts the transport system within neurons, further impairing their function
