nervous system

Question 1

what are the 9 brain structures associated with pain include?

Answer 1

somatosensory cortex,
secondary somatosensory cortex,
anterior cingulate cortex (ACC),
prefrontal cortex (PFC),
insular cortex,
amygdala,
thalamus,
cerebellum,
and Peri-acqueductal grey.

Question 2

what is multiple sclerosis?

Answer 2

a chronic autoimmune disease that affects the CNS. it causes inflammation and damage to the myelin sheath, the protective covering around the nerve fibres.

Question 3

what does multiple sclerosis affect?

Answer 3

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

Question 4

what are the symptoms of ms

Answer 4

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

Question 5

what are the risk factors of getting MS?

Answer 5

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

Question 6

what are the 4 types of MS?

Answer 6

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

Question 7

what is the cause of MS?

Answer 7

destruction of the mylein. immune attack

Question 8

what are the complications of multiple sclerosis?

Answer 8

difficulty walking with assistance
loss of bowel or bladder control
memory loss
sexual dysfunction
depression and anxiety

Question 9

what is the treatment for multiple sclerosis?

Answer 9

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

Question 10

what is the treatment for MS?

Answer 10

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

Question 11

what is Alzheimers disease?

Answer 11

brain condition that causes an progressive decline in memory, thinking, learning and organising skills. eventually affects a persons ability to carry out basic activities.

Question 12

what are the symptoms of alzhimers disease?

Answer 12

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

Question 13

what is the cause of Alzheimer’s disease?

hint:
-neural atrophy
– amyloid plaques
- protein tau

Answer 13

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.

Question 14

what are the first 2 lobes that are mostly affected in Alzheimer’s?

Answer 14

hippocampus and temporal lobes

Question 15

what is the diagnosis of Alzheimer’s disease?

Answer 15

physical and neurological exam
mental statis, assess memory, problem solving, attention, basic maths and language

brain imaging tests to rule out other possible conditions

Question 16

what are the treatments of alzhimers?

Answer 16

cholinestrase inhibiters- treat symtoms mild to moderate

nmda antagonists-moderate to severe symptoms

Question 17

what is visceral pain?

Answer 17

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

Question 18

what are symptoms of visceral pain?

Answer 18

• 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

Question 19

what is the pathophysiology of visceral pain

Answer 19

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

Question 20

what is the diagnosis of viseral pain

Answer 20

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

Question 21

what can visceral pain be an indication of - specific conditions

Answer 21

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

Question 22

whats the difference between somatic and visceral pain?

Answer 22

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

Question 23

what is the clinical significance of multiple sclerosis?

Answer 23

the potential for significant disability over time. the disease often follows a relapsing- remitting course. = symptoms followed by periods of recovery

Question 24

what is the pathophysiology of Alzheimers disease?

Answer 24

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

Question 25

what is the clinical significance of alzhimers?

Answer 25

as the disease progresses, pt may experience severe cognitive impairment, loss of independence and changes in behavior and personality.

Question 26

what part of the brain receives nerve signals sent from visceral pain?

Answer 26

primary the thalamus (acting as a relay station for sensory information including pain signals)

then transmitted to various areas of the cerebral cortext.
particulary the somatosensory cortex (responsible for processing and interpreting pain sensations)

the insular and anterior cingulate cortext are cognitive aspects of pain perception, especially visceral pain.