Introduction to the Neurology Introduction to the Neurology Module 2005Module 2005

Theatre Event 2.1Theatre Event 2.1

ContentContent

Overview of the moduleOverview of the module Basic structure of the central nervous Basic structure of the central nervous

systemsystem Basic structure of the peripheral nervous Basic structure of the peripheral nervous

systemsystem Overall functions of the nervous systemOverall functions of the nervous system

Unit OutlineUnit Outline

5/52 unit5/52 unit Theatre eventsTheatre events Practical TutorialsPractical Tutorials TutorialsTutorials WorkshopsWorkshops HydrotherapyHydrotherapy Skills sessionsSkills sessions Room OB305Room OB305

Assessment

• Poster presentation

• Skills exams

Conditions Studied in the ModuleConditions Studied in the Module

Spinal cord injuriesSpinal cord injuries Guillan - Barre Syndrome (GB)Guillan - Barre Syndrome (GB) Stroke / Cerebro Vascular Accident (CVA)Stroke / Cerebro Vascular Accident (CVA) Multiple Sclerosis (MS)Multiple Sclerosis (MS) Parkinson's Disease (PD)Parkinson's Disease (PD) Head Injuries (HI)Head Injuries (HI)

Organisation of Nervous SystemOrganisation of Nervous System

Nervous System

Central Nervous System Peripheral Nervous System

Brain Spinal Cord Sensory Motor

Somatic Autonomic

Sympathetic

Parasympathetic

Overview of the CNSOverview of the CNS

The Brain – component partsThe Brain – component parts

Cerebral HemispheresCerebral Hemispheres CerebrumCerebrum ThalamusThalamus HypothalamusHypothalamus Basal Ganglia Basal Ganglia CerebellumCerebellum Brain stem Brain stem MidbrainMidbrain Pons Pons MedullaMedulla

Lobes of the BrainLobes of the Brain

Brain stemBrain stem

CerebellumCerebellum

Anatomy of the spinal cordAnatomy of the spinal cord

Spinal nerves divide into dorsal and ventral Spinal nerves divide into dorsal and ventral roots near to the cord.roots near to the cord.

Dorsal roots carry afferent fibresDorsal roots carry afferent fibres Ventral roots carry efferent fibresVentral roots carry efferent fibres Separation of cell bodies from nerve fibres Separation of cell bodies from nerve fibres

gives a “H” or butterfly shape gives a “H” or butterfly shape Four extensions of grey matter project to Four extensions of grey matter project to

wards the dorsal/ventral roots of the spinal wards the dorsal/ventral roots of the spinal cord = dorsal / ventral hornscord = dorsal / ventral horns

Spinal cordSpinal cord

Spinal reflexSpinal reflex

Grey and White matter, Nuceli and Grey and White matter, Nuceli and TractsTracts

Grey matterGrey matter Areas rich in nerve cell bodiesAreas rich in nerve cell bodies

White matterWhite matter Nerve processes (usually axons) often myelinatedNerve processes (usually axons) often myelinated

NucleiNuclei Groups of nerve cell bodies with similar anatomical Groups of nerve cell bodies with similar anatomical

connection and functionsconnection and functions

TractsTracts Nerve processes sharing common connections and Nerve processes sharing common connections and

functions with tendency to follow the same course or functions with tendency to follow the same course or pathwaypathway

Decussation of sensory / motor Decussation of sensory / motor pathwayspathways

Pathways conveying sensory information to Pathways conveying sensory information to a conscious level cross over (decussate)a conscious level cross over (decussate)

The same is true of most descending The same is true of most descending pathways that control movementpathways that control movement

In In general general each cerebral hemisphere each cerebral hemisphere perceives sensation from and controls the perceives sensation from and controls the movement of the contra lateral side of the movement of the contra lateral side of the bodybody

Principle TractsPrinciple Tracts

AscendingAscending Dorsal columns (Fasciculis Gracilis, Fasciculis Cuneatus)Dorsal columns (Fasciculis Gracilis, Fasciculis Cuneatus) SpinothalamicSpinothalamic SpinocerebellarSpinocerebellar

DescendingDescending CorticospinalCorticospinal VestibulospinalVestibulospinal ReticulospinalReticulospinal RubrospinalRubrospinal

Support SystemsSupport Systems

Cerebrospinal fluid (CSF)Cerebrospinal fluid (CSF)

Vascular systemsVascular systems

MeningesMeninges

Cerebral arteriesCerebral arteries

MeningesMeninges

Peripheral Nervous System (PNS)Peripheral Nervous System (PNS)

Divided into 2 halvesDivided into 2 halves Sensory (Afferent)Sensory (Afferent) Motor (Efferent system)Motor (Efferent system) 31 pairs of spinal nerves (CSP, TSP, LSP, 31 pairs of spinal nerves (CSP, TSP, LSP,

Sacral, coccygeal )Sacral, coccygeal ) 12 pairs of cranial nerves (originating from 12 pairs of cranial nerves (originating from

the brain stem)the brain stem)

Afferent, Efferent and Inter neuronesAfferent, Efferent and Inter neurones

Afferent Neurones Afferent Neurones Nerve cells that carry information from peripheral Nerve cells that carry information from peripheral

receptors to CNSreceptors to CNS

Efferent NeuronesEfferent Neurones Nerve cells that carry impulses away from the Nerve cells that carry impulses away from the

CNSCNS

Interneurones / Relay neuronesInterneurones / Relay neurones Make up the vast majority of neurones in the CNSMake up the vast majority of neurones in the CNS

Afferent, efferent and interneuronsAfferent, efferent and interneurons

Essential readingEssential reading

Stokes, M (1998) Neurological Stokes, M (1998) Neurological physiotherapy. London: Mosby.physiotherapy. London: Mosby.

Edwards, S (2002) Neurological Edwards, S (2002) Neurological physiotherapy – a problem solving physiotherapy – a problem solving approach. 2approach. 2ndnd edition. New York: Churchill edition. New York: Churchill Livingston.Livingston.

Trew, M and Everett, T (2001) Human Trew, M and Everett, T (2001) Human Movement. 4Movement. 4thth edition. Edinburgh: Churchill edition. Edinburgh: Churchill Livingston.Livingston.

Useful WebsitesUseful Websites

http://fb4d.comhttp://fb4d.com

http://www.postgradmed.comhttp://www.postgradmed.com

http://www.emedicine.comhttp://www.emedicine.com

Study packStudy pack

Study tasks that need to be completed for Study tasks that need to be completed for tutorial sessions are clearly outlined within tutorial sessions are clearly outlined within the unit study pack.the unit study pack.

Please note the study tasks for tutorial 2.1 Please note the study tasks for tutorial 2.1 and 2.2and 2.2