Patho-physiology of nervous System Talk 2– Syndromes in … · Patho-physiology of nervous System...
Transcript of Patho-physiology of nervous System Talk 2– Syndromes in … · Patho-physiology of nervous System...
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Patho-physiology
of nervous System
Talk 2 –
Syndromes in neurosciences
Petr Maršálek
Dept pathological physiology
1.Med. F. CUNI
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Talks on NS
Talk 1 - Pain and Motor disorders
Talk 2 - This - Syndromes in neurosciences
Talk 3 - Disorders of special senses
Talk 4 - Cognitive functions, dementias, etc.
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Syndromes
Hypoxia of CNS
carbon mono-oxide poisoning
liquor circulation disorders
cerebral oedema
intra-cranial hypertension
intra-cranial hemorrhage
systemic neuro-muscular plate disorders
epilepsy
migraine
sleep/ wake cycle disorders
vomiting as a sign of NS
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Hypo-perfusion, brain hypoxia
Cerebrovascular brain disease.
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Topic
signs
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Unconsciousness after 2-3 breaths. Death in less than three minutes.12,800 ppm
(1.28%)
Headache and dizziness in one to two minutes. Convulsions, respiratory
arrest, and death in less than 20 minutes.6,400 ppm (0.64%)
Headache, dizziness and nausea in five to ten minutes. Death within 30
minutes.3,200 ppm (0.32%)
Headache, tachycardia, dizziness, and nausea within 20 min; death in
less than 2 hours1,600 ppm (0.16%)
Dizziness, nausea, and convulsions within 45 min; insensible within 2
hours800 ppm (0.08%)
Frontal headache within one to two hours400 ppm (0.04%)
Slight headache within two to three hours; loss of judgment200 ppm (0.02%)
Slight headache in two to three hours100 ppm (0.01%)
Headache and dizziness within six to eight hours of constant exposure35 ppm (0.0035%)
SymptomsConcentration
Acute carbon-monooxide poisoning
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Acute CO poisoning – blood gases affinity to Hb
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Blood
gases
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Intracranial
hypertension,
subjective and objective signs
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Obstructive hydrocephalus
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Angiografic
findings
in intra-cranial
expansions
(Bartko, 1985)
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Intracranial hemorrhage
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Glasgow Coma Scale
1 2 3 4 5 6
Eyes Does not
open eyes
Opens eyes in
response to
painful stimuli
Opens eyes
in response
to voice
Opens eyes
spontaneously N/A N/A
Verbal Makes no
sounds
Incomprehensible
sounds
Utters
inappropriate
words
Confused,
disoriented
Oriented,
converses
normally
N/A
Motor Makes no
movements
Extension to
painful stimuli
(decerebrate
response)
Abnormal
flexion to
painful
stimuli
(decorticate
response)
Flexion /
Withdrawal to
painful
stimuli
Localizes
painful
stimuli
Obeys
commands
The scale comprises three tests: eye, verbal and motor responses. The three values
separately as well as their sum are considered. The lowest possible GCS (the sum) is 3
(deep coma or death), while the highest is 15 (fully awake person).
Q 22 Glasgow coma scale
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Disorders of Neuromuscular transmission
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Disorders of Neuromuscular transmission
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Artificial ventilation/ Iron lung
Ventilation can be delivered via:
Hand-controlled ventilation such as:
Bag-Valve-Mask Resuscitator Continuous-
flow or Anaesthesia (or T-piece) bag
•A mechanical ventilator.
•Iron lung is a historical type of mechanical
ventilator
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Demyelination – sclerosis multiplex
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Normal findings: EEG waves:
Alpha waves, 8-13 Hz, parieto-occipital region, marked in closed eyes
Beta waves, 14-30 Hz, frontal region
Gamma waves, 40-60 Hz, are not regularly used due to interference
with electric power net.
Delta waves, < 4 Hz, e.g in synchronous phase of sleep.
Theta waves, 4-7 Hz, e.g in synchronous phase of sleep.
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Epilepsy:
Cortico-
Thalamic
and
Thalamo-cortical
feedback
system
modulating
sensory inputs
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Migraine –
phosphenes
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Migraine -
scotomas
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Q 24/1 Sleep/ wake cycle
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Sleep/ wake cycle
+
narkolepsy
and
reticular
formation
effects
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Vomiting center/ causes of vomiting
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Causes of vomiting
1 Intracranial
hypertension -
irritation
2 Drugs – nicotine,
apomorphine, etc
3 Kinetosis
4 Radiation diesease
5 Pregnancy
6 Psychogenic
7 Pharyngeal irritation
8 Local gastric
irritation – food
poisoning
9 Peritoneal irritation,
ileus
10 Other internal
organs – heart etc
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Autonomous nervous system disorders.
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