Schwann cell dysfunction; damage to myelin sheath; loss of saltatory conduction, replacement has shorter internodes and thinner insulation; inc in NA channels; slower
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Damage to the PNS
damage to the axon: axonal degeneration(more lethal than SD), primary damage to axon followed by myelin sheath dissolution
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Focal axonal Damage
trauma or ischemia induced; wallerian dege: distal to a site of wound, sequence of axonal and myelin degneration; denervation atrophy
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Wallerian Degeneration
cleaning out dead portion; 1. swelling near cut; 2. hypertrophy of the neurofiliments; 3. shrinkage of myelin sheath; degeneration of the axon
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Nerve regeneration
the further you are from the cell body the more likely it will; may or may not; most likely not; permanent loss of function
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Ulnar Nerve Syndrom
compression of ulnar nerve; repair: move ulnar nerve on top; doesn't cure just preserves current function
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Guillanin-Barre Syndrome
Autoimmune PNS inflammatory neuropathy; preceded by viral infection; tcell mediated immune attack on myelin sheath; transient; treatable if caught within days; one person in 100,000; more prevalent with alcoholics
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Chronic Immune Demyelinating Polyneuropathy
Autoimmune PNS inflammatory neuropathy; Remissions and relapses; Demyelination mediated by serum antibodies(macrophage); segmental; thin myelin sheaths; loss of saltatory conduction; conduction block; slow nerve conduction speed; < 80% slower
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MS
Autoimmune CNS inflammatory neuropathy;Autoantibodies activate the complement system against myelin sheath; sclerotic plaques build up around myelin sheath; activates immune response
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Myasthenia Gravis
ACH & receptors autoantibodies; disrupts Ach; destruction of the muscle membrane; complement activation; destruction of neuromuscular junction; increase receptor trunover
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Leprosy
Infectious PNS Neuropathy; schwann cells invaded by mycobaterium leprae; segemental demyelination; multilayered thickening and endoneurial fibrosis; loss of pain fibers, loss of sensory function 1st
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The cognitive
normal consciousness; arousal; reticular activating system content of thought - sleep wake cycle; awareness: self, environment; mood
Patterns of Breathing(Concepts of Neurological Dysfunction[cognitive system])
16-20 bpm; indicate level of brain function based on rate, rhythm, and pattern; normal breathign is controlled by forebrain, as consciousness decreases lower brainstem regulates breathing in respsonse to co2 levels
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Vommiting(Concepts of Neurological Dysfunction[cognitive system])
lower brain functions; most cns disorders produce nausea and vomiting- over stimulated thalamus
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Pupillary changes(Concepts of Neurological Dysfunction[cognitive system])
indicates presence and level of brainstem dysfunction(hypoxia produces dilated fixed pupil)
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Oculomotor repsonses(Concepts of Neurological Dysfunction[cognitive system])
Reflexive eye movements change in various level of brain dysfunction
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motor responses(Concepts of Neurological Dysfunction[cognitive system])
motor respsonse evaluate the level and site of brain dysfunction
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Brain Death
brain cannot maintain bodies internal homeostasis
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Cerebral Death
irreversible coma; death of hemispheres not affecting brainstem and cerebellum
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Vegatative State
complete unawareness of environment and self
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Cerebral Hemodynamis
Cerbral Blood Volume: 75ml 15% of cardiac output; Cerebral blood flow: uses 20% of o2, affected by co2 and o2 levels; cerebral perfusion: normal 80mmHg, less than 70 insuffiant; intracranial pressure 5-15mmHg
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Alterations to Cerebral Hemodynamis
Increased intracranial pressure: tumor, edema, excess CSF(blocked drain), hemorrhage; Results in equal loss in volume of other contents: CSF, alt. in cerebral blood flow(stroke), structural changes(herniation - lethal - major structural changes
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