neuropathophysiology iii trauma, stroke and toxins
DESCRIPTION
NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins. Nancy Long Sieber, Ph.D. September 27, 2010. Disease and Trauma of the Peripheral Nerves. Dermatomes are the regions on the body that correspond with specific cranial or spinal nerves. Damage to a nerve will cause loss of sensation - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/1.jpg)
NEUROPATHOPHYSIOLOGY IIITrauma, Stroke and Toxins
Nancy Long Sieber, Ph.D.
September 27, 2010
![Page 2: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/2.jpg)
Disease and Trauma of the Peripheral Nerves
![Page 3: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/3.jpg)
Dermatomes are the regions on the body that
correspond with specific cranial or spinal nerves.
Damage to a nerve will cause loss of sensation and motor function in that region of the body.
![Page 4: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/4.jpg)
Guillain-Barre Syndrome involves demyelinization of peripheral nerves
http://www.monografias.com/trabajos37/sindrome-guillain-barre/Image8645.jpg
![Page 5: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/5.jpg)
Adaptation to Sensory Loss:
Blindness
See link: http://www.the-scientist.com/blog/display/55315/
![Page 6: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/6.jpg)
![Page 7: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/7.jpg)
Anatomy of the Visual System
http://www.kellogg.umich.edu/theeyeshaveit/anatomy/visual-pathway.html
![Page 8: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/8.jpg)
The Braille Alphabet
![Page 9: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/9.jpg)
Governor Paterson of New York is legally blind. He does not read Braille, but he does have a tremendous memory.
To be legally blind, a person must have vision worse than 20/200 in their best eye, or a visual field of 20 degrees or less.
![Page 10: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/10.jpg)
Injury and Trauma to the CNS
![Page 11: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/11.jpg)
http://dailyme.com/gallery/medical-condition/head-injury.html
![Page 12: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/12.jpg)
from http://www.cureparalysis.org/faq/spine.gif
Injury to the spinalcord causes loss offunction below the lesion site.
Causes:45% motor vehicle18% falls17% violence13% sports, esp. diving
Who:80% maleAvg age 31.5 yrs.
![Page 13: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/13.jpg)
Sequence of events following spinal cord injury
• Spinal shock – transient (hours to days) loss of reflexes in area below lesion. Muscles become flaccid, motor function lost due to injury & inflammation. May lose sympathetic tone.
• Reflexes gradually return over the next few days to weeks. – Axons of surviving cells begin to recover
• Patient may experience hyperreflexia, as normal inhibitory signals that descend down the spinal cord are blocked by the injury. Gradually stabilizes.
![Page 14: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/14.jpg)
Sensory pathways cross to the opposite side of the spinal cord or
medulla before ascending to the cortex.
http://thalamus.wustl.edu/course/bsen1.gif
![Page 15: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/15.jpg)
From: McPhee, Lingappa, Ganong & Lange Pathophysiology of Disease 1995
Injury to one side of the spinal cord can cause loss of function on both sides of the body.
![Page 16: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/16.jpg)
Concerns with spinal cord injury
• Loss of function below site of lesion – may be complete or partial, depending on the injury.
• Loss of thermoregulation
• Pressure wounds
• Autonomic dysreflexia
![Page 17: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/17.jpg)
Stroke:Hemorrhagic and Ischemic
![Page 18: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/18.jpg)
Adaptations to Maintain Brain Blood Flow
• Anastomoses – interconnections between blood vessels, compensate for blocked vessels.
• Autoregulation:– Myogenic autoregulion brain blood vessels dilate in
response to a fall in blood pressure, and constrict in response to an elevation in blood pressure
– Metabolic autoregulation – matches brain bloodflow to metabolic activity
– Helps maintain blood flow if vessel is partially occluded.
![Page 19: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/19.jpg)
![Page 20: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/20.jpg)
http://ww2.heartandstroke.ca/images/english/stroke_isc_web.jpg
![Page 21: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/21.jpg)
http://ww2.heartandstroke.ca/images/english/stroke_hem_web.jpg
![Page 22: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/22.jpg)
Neurotoxins
• Organophosphates
• Strychnine poisoning
• Tetanus toxin
• Heavy Metals– Lead– Mercury
![Page 23: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/23.jpg)
http://www.environmentalhealthnews.org/ehs/newscience/depressed-about-pesticides/
Organophosphate pesticidesinhibit acetylcholinesterase.
![Page 24: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/24.jpg)
![Page 25: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/25.jpg)
http://www.drugstoremuseum.com/sections/level_info2.php?level=1&level_id=74
Strychnine
http://animalpetdoctor.homestead.com/PoisonRat.html
Strychnine blocks the activity of glycine, an inhibitory neurotransmitter.
![Page 26: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/26.jpg)
Tetanus
A soldier dying from tetanus. Painting by Charles Bell in the Royal College of Surgeons, Edinburgh.
![Page 27: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/27.jpg)
Heavy Metals
• Lead
• Mercury– Elemental mercury (quicksilver)– Methylmercury
![Page 28: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/28.jpg)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247191/pdf/ehp0112-000987.pdf
Intelligence quotient as a function of lifetime average blood lead concentration.
Koller, et al. Recent Developments in Low-Level Lead Exposure and IntellectualImpairment in Children. Envtl. Health Persp. • VOLUME 112 | NUMBER 9 | June 2004
![Page 29: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/29.jpg)
http://www.ghana-mining.org/ghweb/en/pmu-mssp/mer-abate.html
Elemental mercury is used in artisanal gold mining
![Page 30: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/30.jpg)
http://www.worstpolluted.org/projects_reports/display/56
![Page 31: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/31.jpg)
http://www.nimd.go.jp/archives/english/tenji/a_corner/a03.html
![Page 32: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/32.jpg)
1. Gait disturbance, loss of balance (ataxia), speech disturbance (dysarthria)
2. Constriction of the visual fields
3. Stereo anesthesia
4. Muscle weakness, muscle cramp
5. Loss of hearing
6. Disturbance of sense of pain, touch or temperature.
Adverse effects to nervous system caused by methylmercury.
http://www.nimd.go.jp/archives/english/tenji/a_corner/a03.html
![Page 33: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/33.jpg)
Lupus and the nervous system
• About 10-15% of people with lupus have CNS effects, typically fatigue, headaches, disorientation.
• More common: peripheral neuropathy, typically as a result of vasulitis. Pain, loss of function of extremities, esp. feet. Sometimes autonomic systems is affected as well.
![Page 34: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/34.jpg)
![Page 35: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/35.jpg)
![Page 36: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/36.jpg)
![Page 37: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/37.jpg)
Spi
nal
Cor
d
Organ
{
NT= acetylcholine receptor= nicotinic
Neurotransmitters and receptors of the autonomic nervous system
Parasympathetic (cholinergic)Sympathetic (adrenergic)
Preganglionic neuron
Organ
Preganglionic neuron
Postganglionic neuron
NT= acetylcholine receptor= nicotinic
Spi
nal
Cor
d NT = acetylcholine receptor = muscarinic
NT = norepinephrine receptor= or ß adrenergic
Postganglionic neuron
![Page 38: NEUROPATHOPHYSIOLOGY III Trauma, Stroke and Toxins](https://reader035.vdocument.in/reader035/viewer/2022062422/56813050550346895d95fddb/html5/thumbnails/38.jpg)