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Introduction
1. Cardiopulmonary system
2. Pulmonary system
3. Neuromuscular system
3.1 Central nervous system
3.2 Anatomy and function of spinal cord
3.3 Peripheral nervous system
3.4 Compare and contrast central nervous systems pathologies part 1
3.5 Compare and contrast central nervous systems pathologies part 2
3.6 Peripheral nervous system conditions
3.7 Other neurological conditions
3.8 Interventions for neurological conditions
3.9 Vestibular system
4. Pediatrics
5. Musculoskeletal system
6. Other system
7. Non systems
Wrapping up
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3.1 Central nervous system
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3. Neuromuscular system
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Central nervous system

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Upper motor neuron units

Definitions
Upper motor neuron units
A network of neurons in which cell bodies originate in the cerebral cortex (brain), brainstem, and spinal cord. Characteristics of disease processes that are upper motor neuron units are weakness, hyperreflexia, and hypertonia.

Anatomy of the brain

  • The brain is divided into two (2) hemispheres, divided externally by the longitudinal fissure and internally by the corpus callosum
    • Right hemisphere:
      • Spatial awareness
      • Emotional processing
      • Facial recognition
      • Creativity
      • Abstract thought
      • Controls the left side of the body
    • Left hemisphere
      • Language
      • Logic and reasoning
      • Analytical thinking
      • Controls the right side of the body
External features of brain
External features of brain
  • The brain is divided into six (6) lobes with distinct characteristics that work collectively to assist function:
    • Frontal lobe:
      • Executive function
      • Voluntary movement
      • Problem solving
      • Learning
      • Behavior
      • Impulse control
      • Personality
      • Social behavior
      • Expressive language (Broca’s area)
    • Parietal lobe:
      • Awareness of somatic sense — touch, pain, temperature, pressure, vibration
      • Processing somatic sensation- analyzing, recognizing, and developing of memory of somatic sense
      • Spatial and body awareness
      • Coordination of visual, auditory, and somatosensory stimuli
    • Temporal lobe:
      • Hearing
      • Receptive language (Wernicke’s area)
      • Memory
        • Declarative: memory regarding names of people, places, or things
        • Procedural: memory of how to perform activities such as brushing teeth, putting on makeup, etc.
    • Occipital lobe:
      • Awareness of visual stimuli
      • Processing of visual stimuli
    • Cerebellum:
      • Motor learning
      • Coordinate movement
      • Balance and equilibrium
      • Proprioception sense
      • Maintain posture
    • Brainstem:
      • Ascending and descending tracts are located in the brainstem
      • Heart rate and respiration rate
      • Sleep and wake cycles
      • Digestion
      • Body temperature
      • Vomiting
      • Swallowing
Lobes of the brain
Lobes of the brain
Functions of the brain
Functions of the brain

Other important brain structures

  • Thalamus

    • Receives sensory information from the body
    • Sends these signals to the appropriate areas of the cerebral cortex for further processing.
    • Helps coordinate movements by sending signals to the motor cortex.
    • Assists with memory processing

  • Hypothalamus

    • Maintains homeostasis within the body by regulation of hormones

  • Basal ganglia

    • Initiation of movements
    • Assists with maintaining posture and muscle tone
    • Assists with controlling voluntary movements

Arterial circulation of the brain

Vascular sections of brain
Vascular sections of brain

Circle of Willis

  • A network of arteries that provides blood supply to the brain
  • Major arteries
    • Anterior cerebral artery (ACA)
      • Supplies frontal, prefrontal, and supplementary motor cortex, as well as circulation to primary motor and sensory cortex
      • Injury to the ACA can cause hemiparesis with weakness of the lower extremity > upper extremity, with sparing of face, apraxia, abulia, akinetic mutism, and urinary incontinence
    • Anterior communicating artery
      • The blood supply that connects the left and right ACA
      • Injury to the anterior communicating artery can cause visual disturbances, memory deficits, cognitive impairment, severe headache, altered mental status, and impaired executive function
    • Middle cerebral artery
      • Blood supply to the frontal, temporal, parietal, and deeper structures
      • Injury to the middle cerebral artery can cause hemiparesis with weakness of the upper extremity > lower extremity; it innervates both Broca’s area and Wernicke’s area, and neglect
    • Internal carotid artery
      • Provides oxygenation to the brain
      • Injury can lead to blurred vision, confusion, memory loss, hemiparesis, or sudden death
    • Posterior cerebral artery
      • Supplies blood to the occipital and temporal lobes
      • Injury can cause visual field loss, visual impairment, headache, confusion, and memory impairment
    • Posterior communicating artery
      • Connects the internal carotid artery to the posterior cerebral artery
      • Injury can cause visual field loss, ptosis, diplopia, headache, confusion, memory impairment, hemiparesis

Other Important arteries of the brain

  • Basilar artery
    • Supplies: Brainstem, occipital lobe, cerebellum, thalamus, medial temporal lobes
    • Functions: Supports autonomic regulation
    • Injury Signs: Hemiparesis or quadriparesis, facial paralysis, dizziness, headache, dysarthria
    • Involvement: Combines with vertebral artery → vertebrobasilar system → damage to both can cause locked-in syndrome
  • Vertebral artery
    • Supplies: Brain and spinal cord
    • Injury Signs: Headache, neck pain, dysarthria, dysphagia, seizures, impaired coordination, sensory/motor deficits to the face and body
    • Involvement: Joins basilar artery → vertebrobasilar system → dual injury may result in locked-in syndrome
  • Posterior inferior cerebellar communicating artery (PICA, Wallenburg syndrome, or Lateral medullary syndrome)
    • Supplies blood flow to the medulla, fourth ventricle, and cerebellum
    • Injury can cause diplopia, ptosis, facial pain, vertigo, slurred speech, hoarseness, balance deficits, and sensory deficits on the same-side face and the contralateral body
Definitions

Locked-in syndrome: Paralysis of all voluntary muscles, with only eye movement remaining intact. The individual remains conscious but is unable to speak or move.

Circle of willis
Circle of willis

Upper motor neuron units

  • Neurons originate in cerebral cortex, brainstem, spinal cord
  • Disease signs: weakness, hyperreflexia, hypertonia

Anatomy of the brain

  • Two hemispheres:
    • Right: spatial awareness, emotion, creativity, controls left body
    • Left: language, logic, analytical, controls right body
  • Six lobes:
    • Frontal: executive function, voluntary movement, personality, Broca’s area
    • Parietal: somatic sensation, spatial/body awareness
    • Temporal: hearing, Wernicke’s area, memory (declarative & procedural)
    • Occipital: visual awareness and processing
    • Cerebellum: motor learning, coordination, balance, posture
    • Brainstem: vital functions (HR, respiration, sleep, digestion, swallowing)

Other important brain structures

  • Thalamus: sensory relay, movement coordination, memory processing
  • Hypothalamus: hormone regulation, homeostasis
  • Basal ganglia: initiates movement, posture, muscle tone, voluntary movement control

Arterial circulation of the brain

  • Circle of Willis: main arterial network supplying brain
    • Anterior cerebral artery (ACA): frontal/sensory cortex; injury—lower extremity weakness, apraxia, abulia
    • Anterior communicating artery: connects ACAs; injury—visual/cognitive deficits, headache
    • Middle cerebral artery: frontal/temporal/parietal; injury—upper extremity weakness, language deficits, neglect
    • Internal carotid artery: brain oxygenation; injury—vision loss, confusion, hemiparesis, possible death
    • Posterior cerebral artery: occipital/temporal lobes; injury—visual loss, headache, confusion
    • Posterior communicating artery: connects ICA to PCA; injury—visual field loss, ptosis, memory impairment

Other Important arteries of the brain

  • Basilar artery: supplies brainstem, occipital, cerebellum; injury—hemiparesis, facial paralysis, locked-in syndrome (if vertebrobasilar system damaged)
  • Vertebral artery: supplies brain/spinal cord; injury—headache, dysphagia, coordination/motor deficits, locked-in syndrome (if both vertebral and basilar arteries involved)
  • Posterior inferior cerebellar artery (PICA): supplies medulla, cerebellum; injury—diplopia, vertigo, hoarseness, balance/sensory deficits (Wallenburg syndrome)

Locked-in syndrome

  • Complete paralysis except eye movement
  • Consciousness preserved, unable to speak or move

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Central nervous system

Upper motor neuron units

Definitions
Upper motor neuron units
A network of neurons in which cell bodies originate in the cerebral cortex (brain), brainstem, and spinal cord. Characteristics of disease processes that are upper motor neuron units are weakness, hyperreflexia, and hypertonia.

Anatomy of the brain

  • The brain is divided into two (2) hemispheres, divided externally by the longitudinal fissure and internally by the corpus callosum
    • Right hemisphere:
      • Spatial awareness
      • Emotional processing
      • Facial recognition
      • Creativity
      • Abstract thought
      • Controls the left side of the body
    • Left hemisphere
      • Language
      • Logic and reasoning
      • Analytical thinking
      • Controls the right side of the body
  • The brain is divided into six (6) lobes with distinct characteristics that work collectively to assist function:
    • Frontal lobe:
      • Executive function
      • Voluntary movement
      • Problem solving
      • Learning
      • Behavior
      • Impulse control
      • Personality
      • Social behavior
      • Expressive language (Broca’s area)
    • Parietal lobe:
      • Awareness of somatic sense — touch, pain, temperature, pressure, vibration
      • Processing somatic sensation- analyzing, recognizing, and developing of memory of somatic sense
      • Spatial and body awareness
      • Coordination of visual, auditory, and somatosensory stimuli
    • Temporal lobe:
      • Hearing
      • Receptive language (Wernicke’s area)
      • Memory
        • Declarative: memory regarding names of people, places, or things
        • Procedural: memory of how to perform activities such as brushing teeth, putting on makeup, etc.
    • Occipital lobe:
      • Awareness of visual stimuli
      • Processing of visual stimuli
    • Cerebellum:
      • Motor learning
      • Coordinate movement
      • Balance and equilibrium
      • Proprioception sense
      • Maintain posture
    • Brainstem:
      • Ascending and descending tracts are located in the brainstem
      • Heart rate and respiration rate
      • Sleep and wake cycles
      • Digestion
      • Body temperature
      • Vomiting
      • Swallowing

Other important brain structures

  • Thalamus

    • Receives sensory information from the body
    • Sends these signals to the appropriate areas of the cerebral cortex for further processing.
    • Helps coordinate movements by sending signals to the motor cortex.
    • Assists with memory processing

  • Hypothalamus

    • Maintains homeostasis within the body by regulation of hormones

  • Basal ganglia

    • Initiation of movements
    • Assists with maintaining posture and muscle tone
    • Assists with controlling voluntary movements

Arterial circulation of the brain

Circle of Willis

  • A network of arteries that provides blood supply to the brain
  • Major arteries
    • Anterior cerebral artery (ACA)
      • Supplies frontal, prefrontal, and supplementary motor cortex, as well as circulation to primary motor and sensory cortex
      • Injury to the ACA can cause hemiparesis with weakness of the lower extremity > upper extremity, with sparing of face, apraxia, abulia, akinetic mutism, and urinary incontinence
    • Anterior communicating artery
      • The blood supply that connects the left and right ACA
      • Injury to the anterior communicating artery can cause visual disturbances, memory deficits, cognitive impairment, severe headache, altered mental status, and impaired executive function
    • Middle cerebral artery
      • Blood supply to the frontal, temporal, parietal, and deeper structures
      • Injury to the middle cerebral artery can cause hemiparesis with weakness of the upper extremity > lower extremity; it innervates both Broca’s area and Wernicke’s area, and neglect
    • Internal carotid artery
      • Provides oxygenation to the brain
      • Injury can lead to blurred vision, confusion, memory loss, hemiparesis, or sudden death
    • Posterior cerebral artery
      • Supplies blood to the occipital and temporal lobes
      • Injury can cause visual field loss, visual impairment, headache, confusion, and memory impairment
    • Posterior communicating artery
      • Connects the internal carotid artery to the posterior cerebral artery
      • Injury can cause visual field loss, ptosis, diplopia, headache, confusion, memory impairment, hemiparesis

Other Important arteries of the brain

  • Basilar artery
    • Supplies: Brainstem, occipital lobe, cerebellum, thalamus, medial temporal lobes
    • Functions: Supports autonomic regulation
    • Injury Signs: Hemiparesis or quadriparesis, facial paralysis, dizziness, headache, dysarthria
    • Involvement: Combines with vertebral artery → vertebrobasilar system → damage to both can cause locked-in syndrome
  • Vertebral artery
    • Supplies: Brain and spinal cord
    • Injury Signs: Headache, neck pain, dysarthria, dysphagia, seizures, impaired coordination, sensory/motor deficits to the face and body
    • Involvement: Joins basilar artery → vertebrobasilar system → dual injury may result in locked-in syndrome
  • Posterior inferior cerebellar communicating artery (PICA, Wallenburg syndrome, or Lateral medullary syndrome)
    • Supplies blood flow to the medulla, fourth ventricle, and cerebellum
    • Injury can cause diplopia, ptosis, facial pain, vertigo, slurred speech, hoarseness, balance deficits, and sensory deficits on the same-side face and the contralateral body
Definitions

Locked-in syndrome: Paralysis of all voluntary muscles, with only eye movement remaining intact. The individual remains conscious but is unable to speak or move.

Key points

Upper motor neuron units

  • Neurons originate in cerebral cortex, brainstem, spinal cord
  • Disease signs: weakness, hyperreflexia, hypertonia

Anatomy of the brain

  • Two hemispheres:
    • Right: spatial awareness, emotion, creativity, controls left body
    • Left: language, logic, analytical, controls right body
  • Six lobes:
    • Frontal: executive function, voluntary movement, personality, Broca’s area
    • Parietal: somatic sensation, spatial/body awareness
    • Temporal: hearing, Wernicke’s area, memory (declarative & procedural)
    • Occipital: visual awareness and processing
    • Cerebellum: motor learning, coordination, balance, posture
    • Brainstem: vital functions (HR, respiration, sleep, digestion, swallowing)

Other important brain structures

  • Thalamus: sensory relay, movement coordination, memory processing
  • Hypothalamus: hormone regulation, homeostasis
  • Basal ganglia: initiates movement, posture, muscle tone, voluntary movement control

Arterial circulation of the brain

  • Circle of Willis: main arterial network supplying brain
    • Anterior cerebral artery (ACA): frontal/sensory cortex; injury—lower extremity weakness, apraxia, abulia
    • Anterior communicating artery: connects ACAs; injury—visual/cognitive deficits, headache
    • Middle cerebral artery: frontal/temporal/parietal; injury—upper extremity weakness, language deficits, neglect
    • Internal carotid artery: brain oxygenation; injury—vision loss, confusion, hemiparesis, possible death
    • Posterior cerebral artery: occipital/temporal lobes; injury—visual loss, headache, confusion
    • Posterior communicating artery: connects ICA to PCA; injury—visual field loss, ptosis, memory impairment

Other Important arteries of the brain

  • Basilar artery: supplies brainstem, occipital, cerebellum; injury—hemiparesis, facial paralysis, locked-in syndrome (if vertebrobasilar system damaged)
  • Vertebral artery: supplies brain/spinal cord; injury—headache, dysphagia, coordination/motor deficits, locked-in syndrome (if both vertebral and basilar arteries involved)
  • Posterior inferior cerebellar artery (PICA): supplies medulla, cerebellum; injury—diplopia, vertigo, hoarseness, balance/sensory deficits (Wallenburg syndrome)

Locked-in syndrome

  • Complete paralysis except eye movement
  • Consciousness preserved, unable to speak or move