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Medical LanguageMedical LanguageImmerse YourselfImmerse Yourself

CHAPTER

THIRD EDITION

Medical Language, Third Edition Susan M. Turley

Neurology

Learning ObjectivesLearning Objectives

1. Identify the structures of the nervous system.

2. Describe the process of nerve transmission.

3. Describe common nervous system diseases, laboratory and diagnostic procedures, medical and surgical procedures, and drug categories.

4. Give the medical meaning of word parts and abbreviations related to the nervous system.

5. Build nervous system words from word parts and divide and define words.

6. Spell and pronounce nervous system words.

7. Analyze the medical content and meaning of a neurology report.

8. Dive deeper into neurology by reviewing the activities at the end of this chapter and online at www.myMedicalTerminologyLab.com.

Multimedia DirectoryMultimedia Directory

Autonomic Nervous System AnimationSlide 75 Aneurysms VideoSlide 81 Down Syndrome VideoSlide 86 Epilepsy VideoSlide 87 Febrile Seizures AnimationSlide 88 Seizures AnimationSlide 89 Seizures VideoSlide 95 Parkinson's Disease VideoSlide 100 C-Spine Immobilization VideoSlide 101 Spinal Cord Injury AnimationSlide 104 Carpal Tunnel Syndrome VideoSlide 106 Multiple Sclerosis Animation

Multimedia DirectoryMultimedia Directory

PET Scans AnimationSlide 122 Pharmacy Technician VideoSlide 123 Electrodiagnostic Technician VideoSlide 124 Speech Pathology VideoSlide 125 Speech Pathology and Ethical Situations Video

NeurologyNeurology

• The medical specialty that studies the anatomy and physiology of the nervous system and uses diagnostic tests, medical and surgical procedures, and drugs to treat nervous system diseases.

Figure 10-1 Nervous system.

Anatomy and PhysiologyAnatomy and Physiology

• Nervous System Found in every part of the body from the

head to the tips of the fingers and toes Divided into central nervous system

(CNS) and peripheral nervous system (PNS)

Anatomy and PhysiologyAnatomy and Physiology

• Nervous System CNS contains brain and spinal cord. PNS contains cranial nerves and spinal

nerves; can be divided into somatic and autonomic nervous systems.

Figure 10-2 Divisions of the nervous system.

Anatomy of theAnatomy of theCentral Nervous SystemCentral Nervous System

• Brain Located within the bony cranium Fills the cranial cavity Consists of the cerebrum (and its lobes),

thalamus, hypothalamus, ventricles, brainstem, and cerebellum

Surrounded by the meninges, three layers of membranes

• Cerebrum Largest and most obvious part of the

brain The cerebrum is divided into lobes. Each lobe has the same name as the

cranial bone that is above it.

• Frontal Lobe of the Cerebrum Originates conscious thought and

intelligence. Predicts future events and the benefits or

consequences of actions. Coordinates and analyzes information

coming from other lobes of the cerebrum. Exerts conscious, voluntary control over

the skeletal muscles.

• Frontal Lobe of the Cerebrum Coordinates the muscles of the mouth,

lips, tongue, pharynx, and larynx to produce speech.

Analyzes sensory information about taste from the taste receptors in the tongue and throat.

• Parietal Lobe of the Cerebrum Analyzes sensory information about

touch, temperature, vibration, and pain from receptors in the skin, joints, and muscles

• Temporal Lobe of the Cerebrum Analyzes sensory information about

hearing from receptors in the cochlea of the inner ear

Analyzes sensory information about smells from olfactory receptors in the nose

• Occipital Lobe of the Cerebrum Analyzes sensory information about

vision from receptors in the retina of the eye.

Figure 10-3 Lobes of the cerebrum.

Figure 10-4 Midline cut section of the brain.Custom Medical Stock Photo

• Cerebrum A very deep fissure divides the

cerebrum into right and left halves; each half is a hemisphere.

The only connection between the right and left hemispheres is the corpus callosum, an arch of nerves that allows the two hemispheres to communicate with each other and coordinate their activities.

• Right Hemisphere of the Cerebrum Recognizes faces, patterns, and three-

dimensional structures Analyzes the emotional content of words

but not the actual words

• Left Hemisphere of the Cerebrum Performs mathematical and logical

reasoning and problem-solving and coordinates the recall of memories

Contains the speech center and is important in language skills

Figure 10-5 Posterior half of the brain.

Figure 10-6 Left-brain thinking.

• Cerebrum surface has elevated folds (gyri) and narrow grooves (sulci).

• The cerebral cortex, or gray matter, is the outermost layer of tissue.

• Beneath the gray matter, the white matter of the cerebrum is composed of the axons of neurons.

• Most of these axons are covered by a fatty, white, insulating layer of myelin.

• Thalamus Located near the center of the cerebrum Acts as a relay station, receiving

sensory information from the cranial nerves and the spinal nerves and sending it to the midbrain and cerebrum

Part of the limbic system that deals with emotions

• Hypothalamus Located below the thalamus Has a stalk of blood vessels and nerves

that connects it to the pituitary gland; functions as part of both the endocrine and nervous systems

Coordinates the activities of the pons and medulla oblongata that control the heart rate, blood pressure, and respiratory rate

• Hypothalamus Regulates body temperature and

sensations of hunger and thirst Plays a role in emotions and the sexual

• Ventricles Four interconnected cavities within the

brain Lined with ependymal cells that produce

cerebrospinal fluid (CSF), a clear fluid that cushions and protects the brain and contains glucose and other nutrients

• Brainstem Column of tissue that begins in the

center of the brain and continues inferiorly until meeting the spinal cord

Composed of the midbrain, the pons, and the medulla oblongata

• Brainstem Midbrain coordinates immediate reflex

responses, maintains muscle tone and position of extremities, contains the substantia nigra that produces dopamine.

• Brainstem Pons is the middle part of the brainstem;

relays nerve impulses from the spinal cord to the midbrain, hypothalamus, thalamus, and cerebrum.

Medulla oblongata contains centers that set the respiratory rate and control the heart rate.

• Cerebellum Receives sensory information about

muscle tone and body position and uses this to help maintain balance

Receives information from the cerebrum about motor commands and makes minor adjustments to coordinate these movements

• Meninges The brain is surrounded by the

meninges, three separate membrane layers. • Dura mater

• Outermost, tough, fibrous layer that protects the brain.

• Arachnoid• Middle layer. Subarachnoid space is filled

with CSF.

• Meninges The brain is surrounded by the

meninges, three separate membrane layers. • Pia mater

• Innermost layer. This is a thin, delicate membrane next to the brain that contains many small blood vessels.

Figure 10-7 Meninges.

• Spinal Cord Part of the central nervous system A long, narrow column of neural tissue

within the spinal cavity (or spinal canal) Protected by the vertebrae

Figure 10-8 Spinal cord.

Anatomy of theAnatomy of thePeripheral Nervous System Peripheral Nervous System

• Cranial Nerves Part of the peripheral nervous system There are 12 pairs of them. Some receive sensory information from

the body.

Anatomy of theAnatomy of thePeripheral Nervous System Peripheral Nervous System

• Cranial Nerves Others send motor commands from the

brain to voluntary muscles (to move the face, head, neck) or to involuntary muscles (to slow heart rate)

Some carry both sensory and motor nerve impulses

Table 10-1 Cranial Nerves

Table 10-1 (continued) Cranial Nerves

Anatomy of theAnatomy of thePeripheral Nervous SystemPeripheral Nervous System

• Spinal Nerves Part of the peripheral nervous system There are 31 pairs that originate at

regular intervals along the spinal cord. Each spinal nerve has two different

groups of nerve roots that connect it to the spinal cord: dorsal nerve roots and ventral nerve roots.

Figure 10-9 Spinal nerves.

• Spinal Nerves Dorsal nerve roots receive sensory

information from the skin, muscles, and joints; afferent nerve root.

Ventral nerve roots carry motor commands from the spinal cord to skeletal muscles and involuntary smooth muscles; efferent nerve root.

• A reflex is a rapid, involuntary muscle reaction that is controlled by the spinal cord.

• The spinal cord reacts immediately to certain types of sensory information, such as sudden pain.

• Autonomic Nervous System Controls the involuntary contractions of

cardiac muscle in the heart, as well as smooth muscles around organs, glands, and other structures

Can be broken down into two divisions:• Parasympathetic division• Sympathetic division

• Parasympathetic Division Active during “rest and digest” activities Decreases heart rate, blood pressure,

and metabolic rate Changes the diameter of the pupils in

response to the level of light Increases peristalsis in the GI tract

• Parasympathetic Division Causes secretion of saliva, digestive

enzymes, and insulin Prepares the body for sexual activity Contracts the bladder for urination

• Sympathetic Division Active when body is active or exercising Increases mental alertness Dilates pupils to optimize vision Increases heart rate and metabolic rate Raises blood pressure Increases air flow to the lungs

• Sympathetic Division Increases respiratory rate Causes release of stored glucose to

meet increased energy needs Prepares the body for “fight or flight”

Autonomic Nervous System Autonomic Nervous System AnimationAnimation

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• Somatic Nervous System Controls the voluntary movements of

skeletal muscles Motor commands are the result of

conscious thoughts in the brain.

• Neurons and Neuroglia Neural tissue is made up of two

categories of cells: neurons and neuroglia.

A neuron, an individual nerve cell, is the functional unit of the nervous system.

Nerves are bundles of individual nerve cells (neurons).

Neuroglia perform specialized tasks to help neurons do their work.

Table 10-2 Neuroglia

Physiology of a Neuron and Physiology of a Neuron and NeurotransmittersNeurotransmitters

• A neuron is the functional unit of the nervous system and consists of three parts: Dendrites Cell body Axon

• Dendrites Multiple branching structures at the

beginning of the neuron

• Cell body Contains the nucleus, which directs

cellular activities Contains cytoplasm; structures in the

cytoplasm produce neurotransmitters as well as energy for the neuron

• Axon An elongated extension of cytoplasm at

the end of the neuron Larger axons are covered by a fatty,

white insulating layer of myelin that dramatically increases the speed at which an electrical impulse can travel along the axon

• Axon A neurotransmitter released by the axon

of one neuron travels across the synapse and binds with a receptor on the cell membrane of a dendrite of the next neuron, producing an electrical impulse.

Figure 10-10 Neuron.

Table 10-3 Neurotransmitters

DiseasesDiseases

• Brain Amnesia Anencephaly Aphasia Arteriovenous malformation (AVM) Brain tumor

Table 10-4 Types of Brain Tumors

Table 10-4 (continued) Types of Brain Tumors

Figure 10-11 Glioma.Simon Fraser/Photo Researchers, Inc.

DiseasesDiseases

• Brain Cephalalgia Cerebral palsy (CP) Cerebrovascular accident (CVA) Coma Concussion Dementia Down syndrome

Figure 10-12 Cerebrovascular accident.

Aneurysms VideoAneurysms Video

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Figure 10-13 Patient with a cerebrovascular accident.

Figure 10-14 Concussion.HENNY RAY ABRAMS/AFP/Getty Images

Figure 10-15 PET scan of a normal brain.Science Photo Lib./Custom Medical Stock Photo

Figure 10-16 PET scan of the brain of a patient with Alzheimer's disease.Science Photo Library/Custom Medical Stock Photo, Inc.

Figure 10-17 Down syndrome.PhotoLink/Getty Images

Down Syndrome VideoDown Syndrome Video

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DiseasesDiseases

• Brain Dyslexia Encephalitis Epilepsy

lex/o-

dys- = painful difficult; abnormal= word

= condition; state; thing

Figure 10-18 Dyslexia.Will & Deni McIntyre/Photo Researchers, Inc.

Figure 10-19 Epilepsy.K. Glaser & Associates/Custom Medical Stock Photos

Table 10-5 Seizures

Epilepsy VideoEpilepsy Video

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Febrile Seizures AnimationFebrile Seizures Animation

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Seizures AnimationSeizures Animation

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Seizures VideoSeizures Video

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DiseasesDiseases

• Brain Hematoma Huntington's chorea Hydrocephalus Meningitis

mening/o-

= meninges

= inflammation of; infection of

Figure 10-21 Hydrocephalus.

DiseasesDiseases

• Brain Migraine headache Narcolepsy Parkinson's disease Syncope

Figure 10-20 Subdural hematoma.Medical Body Scans/Photo Researchers, Inc.

Figure 10-22 Parkinson's disease.Kenneth Lambert/AP Wide World Photos

Parkinson's Disease VideoParkinson's Disease Video

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DiseasesDiseases

• Spinal Cord Neural tube defect Radiculopathy Spinal cord injury (SCI)

Figure 10-23 Meningomyelocele.JPD/Custom Medical Stock Photo, Inc.

Figure 10-24 Radiculopathy.

Figure 10-25 Spinal cord injury.

C-Spine Immobilization VideoC-Spine Immobilization Video

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Spinal Cord Injury AnimationSpinal Cord Injury Animation

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Spinal CordInjury

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DiseasesDiseases

• Nerves Amyotrophic lateral sclerosis (ALS) Anesthesia Bell's palsy Carpal tunnel syndrome (CTS) Guillain-Barré syndrome Hyperesthesia

Figure 10-26 Bell's palsy.Sally and Richard Greenhill/Alamy

Carpal Tunnel Syndrome VideoCarpal Tunnel Syndrome Video

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DiseasesDiseases

• Nerves (con't) Multiple sclerosis (MS) Neuralgia Neuritis Neurofibromatosis Neuroma Neuropathy Paresthesia

neur/o-

-pathy

= nerve

= disease

Multiple Sclerosis AnimationMultiple Sclerosis Animation

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Laboratory and Diagnostic Laboratory and Diagnostic ProceduresProcedures

• Laboratory Tests Alpha fetoprotein (AFP) Cerebrospinal fluid (CSF) examination

• Radiologic and Nuclear Medicine Procedures Cerebral angiography Computed axial tomography (CAT, CT) Doppler ultrasonography

Figure 10-28 Arteriogram.Larry Mulvehill/Corbis

• Radiologic and Nuclear Medicine Procedures Magnetic resonance imaging (MRI) Myelography Positron emission tomography (PET)

scan Skull x-ray

PET Scans AnimationPET Scans Animation

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• Other Diagnostic Tests Electroencephalography (EEG) Evoked potential testing Nerve conduction study Polysomnography

somn/o-

-graphy

poly- = many; much

= sleep

= process of recording

Figure 10-29 Electroencephalography (EEG).Science Photo Library/Alamy

Medical and Surgical ProceduresMedical and Surgical Procedures

• Medical Procedures Babinski's sign Glasgow Coma Scale (GCS) Lumbar puncture (LP)

Figure 10-30 Positive Babinski's sign.

Figure 10-31 Lumbar puncture.Mike Peres, RBP, Custom Medical Stock Photo

• Medical Procedures Mini mental status examination (MMSE) Neurologic examination Spinal traction Transcutaneous electrical nerve

stimulation (TENS) unit

Figure 10-32 Spinal traction with tongs.Vanstrum/Custom Medical Stock Photo, Inc.

• Surgical Procedures Biopsy Carotid endarterectomy Craniotomy Diskectomy Laminectomy Stereotactic neurosurgery Ventriculoperitoneal shunt

Drug CategoriesDrug Categories

• These categories of drugs are used to treat neurologic diseases: Analgesic drugs Antiepileptic drugs Corticosteroid drugs Drugs for Alzheimer's disease Drugs for neuralgia and neuropathy Drugs for Parkinson's disease

AbbreviationsAbbreviations

AFP alpha fetoproteinALS amyotrophic lateral sclerosisAVM arteriovenous malformationBAEP brainstem auditory evoked potentialBAER brainstem auditory evoked responseCNS central nervous systemCP cerebral palsyCRPS chronic regional pain syndromeCSF cerebrospinal fluidCT, CAT computed (axial) tomographyCTS carpal tunnel syndromeCVA cerebrovascular accidentEEG electroencephalogram,

electroencephalographyEND electroneurodiagnostic (technician)GCS Glasgow Coma Scale (or Score)HNP herniated nucleus pulposusICP intracranial pressure

LOC loss of consciousnessLP lumbar punctureMMSE mini mental status examinationMRI magnetic resonance imagingMS* multiple sclerosisNICU neurologic intensive care unit (pronounced”NIK-yoo”)PET positron emission tomographyREM rapid eye movementRIND reversible ischemic neurologic deficitSCI spinal cord injurySSEP somatosensory evoked potentialSSER somatosensory evoked responseTENS transcutaneous electrical nerve stimulation

(unit)TIA transient ischemic attackVEP visual evoked potentialVER visual evoked response

Pharmacy Technician VideoPharmacy Technician Video

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Electrodiagnostic Electrodiagnostic Technician VideoTechnician Video

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Speech Pathology VideoSpeech Pathology Video

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Speech Pathology and Speech Pathology and Ethical Situations VideoEthical Situations Video

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Combining Forms Match UpCombining Forms Match Up

1. cyt/o-2. encephal/o-3. esthes/o-4. fiss/o-5. nuch/o-

a. brainb. feelingc. celld. splittinge. neck

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