Neurology: First and Second Day

The study of nervous system anatomy, physiology, and pathology, as well as

the treatment of its disorders

All of us will face the effects of nervous system problems (or already have) – in ourselves, our friends and family, and/or in our professional lives.

Former President Reagan

• Now the personality, intellect and behavior America was once familiar with is lost to Alzheimer’s disease – a plight faced by 4,000,000 Americans.

• This stroke survivor is going through rehab. There are over 4,000,000 U.S. stroke survivors living with varying degrees of disability due to some disruption of normal blood supply to regions of brain.

Traumatic
Brain
Injury (TBI)

• ~3,000,000 cases

Evaluation of an Infant’s Seizures

• ~2,000,000 Americans live with epilepsy

Michael J. Fox - just 1 of the at least 500,000 Americans with Parkinson’s Disease

Richard Pryor

• Two of the ~300,000 Americans suffering from multiple sclerosis (MS)

Christopher Reeves

• Loss of bodily movement, sensation, and even normal breathing due to damage to a region of the spinal cord no bigger than your little finger. There are about 200,000 survivors of spinal cord injury in the US.

• Laura Downey (left) has just been diagnosed with Huntington’s Disease. Like 30,000 others she faces a gradual deterioration of motor control, cognitive functioning, personality and emotional control. There is a 50/50 chance that her daughter has also inherited the disease-producing gene.

Stephen Hawkins

• The mind of a great physicist trapped in an almost unmoving body due to amytrophic lateral sclerosis (ALS). There are ~25,000 cases of this tragic condition also known as “Lou Gehrig’s disease)

Baby Tom had a hemispherectomy - half of his cerebrum was removed to control seizures.

Relating Brain Anatomy or Function to Psychological Disorder

Ongoing longitudinal study of the gradual loss of cortex in childhood schizophrenia

Brain Less Active in Depression

Decreased Cortical Activity in ADHD

• The cingulum is one brain region which appears to malfunction in obsessive-compulsive disorder. Some desperate patients have received a cingulotomy to try to treat their disorder

• More and more “mental disorders” are being recognized as disorders associated with distinctive nervous system changes.

• Recent studies suggest therapies, both medical and psychological, bring about changes in brain function.

• We also learn about the nervous system to better understand NORMAL or even exemplary nervous system functioning:

• Michel Flatley (Lord of the Dance) has been clocked at 35 taps per second. It is his nervous system commanding his performance.

An Olympic gymnast is just one example of the precision, timing, & coordination provided by the nervous system

Whoever your favorite composers or performers, they owe their music to the nervous system.

Feats of mind - creative or scientific - also products of the brain.

In a community of ~100,000 (like Cedar Falls/Waterloo), you’ll find, on average:

Over 2000 will suffer from migraines.

There will be over 500 with
back pain.

Over 350 will have experienced a herniated disc.

Over 250 will have
cerebral palsy.

Over 130 will be experiencing serious aftereffects of a concussion
(post-concussive syndrome)

Over 80 will suffer from shingles (herpes zoster)

Over 80 will have problems with their peripheral nerves
(peripheral neuropathy)

Over 80 will have brain tumors.

Over 70 will have been born with a congenital malformation of their nervous system
(like spina bifida)

Over 15 will have an infection of the brain (encephalitis) or meninges (meningitis)

Over 250 will be born with
Down Syndrome.

Over 300 will suffer from Meniere’s Disease.

ALL will be making continuous use of their nervous systems for all aspects of mental activity and behavior, as well as to regulate bodily functioning.

Over 800 individuals with traumatic brain injuries

Over 250 will suffer from dementia.

Over 650 who have had strokes (cerebrovascular accidents)

Over 200 will suffer from Parkinson’s Disease.

Over 60 will have
multiple sclerosis.

Over 50 will have a spinal cord injury.

Over 30 will have Lou Gehrig’s Disease (ALS)

Over 650 will experience epileptic seizures.

Some Basic Neuroanatomy

Parts of the Neuron

Gray & White Matter

• Brain areas with a high concentration of neuron cell bodies/dendrites look darker (“gray matter”) and function like information processors – receiving and combining/processing input

• Areas with lots of myelinated axons appear lighter (“white matter”) and function like cables connecting regions

• A group of neuron cell bodies = “nucleus” (in CNS) or “ganglion” (in PNS)

• A group of axons = “tract” or “pathway” (in CNS) or “nerve” (in PNS)

Neurology: First and Second Day

The study of nervous system anatomy, physiology, and pathology, as well as

the treatment of its disorders

All of us will face the effects of nervous system problems (or already have) – in ourselves, our friends and family, and/or in our professional lives.

Former President Reagan

• Now the personality, intellect and behavior America was once familiar with is lost to Alzheimer’s disease – a plight faced by 4,000,000 Americans.

• This stroke survivor is going through rehab. There are over 4,000,000 U.S. stroke survivors living with varying degrees of disability due to some disruption of normal blood supply to regions of brain.

Traumatic Brain Injury (TBI)

• ~3,000,000 cases

Evaluation of an Infant’s Seizures

• ~2,000,000 Americans live with epilepsy

Michael J. Fox - just 1 of the at least 500,000 Americans with Parkinson’s Disease

Richard Pryor

• Two of the ~300,000 Americans suffering from multiple sclerosis (MS)

Christopher Reeves

• Loss of bodily movement, sensation, and even normal breathing due to damage to a region of the spinal cord no bigger than your little finger. There are about 200,000 survivors of spinal cord injury in the US.

• Laura Downey (left) has just been diagnosed with Huntington’s Disease. Like 30,000 others she faces a gradual deterioration of motor control, cognitive functioning, personality and emotional control. There is a 50/50 chance that her daughter has also inherited the disease-producing gene.

Stephen Hawkins

• The mind of a great physicist trapped in an almost unmoving body due to amytrophic lateral sclerosis (ALS). There are ~25,000 cases of this tragic condition also known as “Lou Gehrig’s disease)

Baby Tom had a hemispherectomy - half of his cerebrum was removed to control seizures.

Ongoing longitudinal study of the gradual loss of cortex in childhood schizophrenia

Brain Less Active in Depression

Decreased Cortical Activity in ADHD

• The cingulum is one brain region which appears to malfunction in obsessive-compulsive disorder. Some desperate patients have received a cingulotomy to try to treat their disorder

• More and more “mental disorders” are being recognized as disorders associated with distinctive nervous system changes.

• Recent studies suggest therapies, both medical and psychological, bring about changes in brain function.

• We also learn about the nervous system to better understand NORMAL or even exemplary nervous system functioning:

• Michel Flatley (Lord of the Dance) has been clocked at 35 taps per second. It is his nervous system commanding his performance.

An Olympic gymnast is just one example of the precision, timing, & coordination provided by the nervous system

Whoever your favorite composers or performers, they owe their music to the nervous system.

Feats of mind - creative or scientific - also products of the brain.

In a community of ~100,000 (like Cedar Falls/Waterloo), you’ll find, on average:

Over 2000 will suffer from migraines.

There will be over 500 with back pain.

Over 350 will have experienced a herniated disc.

Over 250 will have cerebral palsy.

Over 130 will be experiencing serious aftereffects of a concussion (post-concussive syndrome)

Over 80 will suffer from shingles (herpes zoster)

Over 80 will have problems with their peripheral nerves (peripheral neuropathy)

Over 80 will have brain tumors.

Over 70 will have been born with a congenital malformation of their nervous system (like spina bifida)

Over 15 will have an infection of the brain (encephalitis) or meninges (meningitis)

Over 250 will be born with Down Syndrome.

Over 300 will suffer from Meniere’s Disease.

ALL will be making continuous use of their nervous systems for all aspects of mental activity and behavior, as well as to regulate bodily functioning.

Over 800 individuals with traumatic brain injuries

Over 250 will suffer from dementia.

Over 650 who have had strokes (cerebrovascular accidents)

Over 200 will suffer from Parkinson’s Disease.

Over 60 will have multiple sclerosis.

Over 50 will have a spinal cord injury.

Over 30 will have Lou Gehrig’s Disease (ALS)

Over 650 will experience epileptic seizures.

Some Basic Neuroanatomy

Parts of the Neuron

Gray & White Matter

• Brain areas with a high concentration of neuron cell bodies/dendrites look darker (“gray matter”) and function like information processors – receiving and combining/processing input

• Areas with lots of myelinated axons appear lighter (“white matter”) and function like cables connecting regions

• A group of neuron cell bodies = “nucleus” (in CNS) or “ganglion” (in PNS)

• A group of axons = “tract” or “pathway” (in CNS) or “nerve” (in PNS)

Cortex is Gray Matter

White Matter Under Cortex

CNS vs PNS

• Central Nervous System (CNS): brain and spinal cord

• Peripheral Nervous System (PNS): all the nerves outside of the brain & cord

5 levels of spinal cord

Cross Section of Cord

Dermatomes Related to the 31 Pairs of Spinal Nerves

5 Chunks of Brain

Book Fig. 1.10 and 1.12

5 Vesicles in Embryonic Brain

Brainstem

Triune Brain

Midline View of Brain

Limbic System

Basal Ganglia

Central Sulcus and Lateral Fissure; Precentral Gyrus and Postcentral Gyrus

Lobes

Motor Cortex & Somatosensory Cortex

Ventricles

Traumatic
Brain
Injury (TBI)

There will be over 500 with
back pain.

Over 250 will have
cerebral palsy.

Over 130 will be experiencing serious aftereffects of a concussion
(post-concussive syndrome)

Over 80 will have problems with their peripheral nerves
(peripheral neuropathy)

Over 70 will have been born with a congenital malformation of their nervous system
(like spina bifida)

Over 250 will be born with
Down Syndrome.

Over 60 will have
multiple sclerosis.