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Nervous System( 신경계 )

Nervous System( 신경계 )

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Nervous System( 신경계 )

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  1. Nervous System(신경계) 신경외과 장 경 술

  2. The Nervous System Major Subdivisions: Central Nervous System(중추신경계): CNS The brain(뇌) The spinal cord.(척수) Autonomic Nervous System: (자율신경계) :ANS Sympathetic nervous system(교감신경) Parasympathetic nervous system(부교감신경)

  3. Divisions of the Nervous System

  4. Nervous Tissue(신경조직) • Neurons(신경세포) - transmit impulses • sensory (afferent, ascending) • motor (efferent, descending) • Neuroglia(신경아교세포) - support neurons

  5. Neuron • Dendrites(가지돌기)-rootlike structures that receive impulses and conduct them to the cell body • cell body(세포체) - contains nucleus • Axon(축삭)-extends away from the cell body and conducts impulses away from the nerve cell

  6. Neuron Anatomy • Myelin sheath(말이집)- • insulation • accelerates impulse transmission • appears as white covering • myelin on axons in brain and spinal cord gives white appearance • unmyelinated fibers, dendrites, and nerve cell bodies comprise gray matter of brain and spinal cord

  7. Neuron Anatomy(peripheral nerves) • Schwann cell • type of neuroglial cell wrapped around axon • forms the myelin sheath • Neurolemma (neurolemmal sheath) • permits a damaged axon to regenerate • neurolemma NOT found in Central nerves

  8. Neuroglia(신경아교세포) • gli/o or nerve glue • neuroglia or glial cells • Astrocytes(별아교세포) - blood brain barrier • Oligodendrocytes(희소돌기아교세포) - facilitate myelin development • Microglia(미세아교세포) - phagocytic properties • Ependyma(뇌실막세포) - assist in CSF circulation

  9. Neuroanatomy • The Study of Nervous System • Two Levels • General Structure(일반구조) • Function of Structure(기능적 구조)

  10. 뇌(brain) • 대뇌(cerebrum) • 중뇌(midbrain) • 뇌교(pons) • 연수(medulla) • 소뇌(cerebellum)

  11. Surface • Gyrus(회,이랑) • A convolution • Sulcus(구,고랑) • A small in-folding (small groove) • Fissure(틈새,열구) • A large in-folding ( a large groove) Two-thirds of the cortex is hidden in the grooves

  12. Major Structures of the Cortex • 4 Lobes • Frontal Lobe(전두엽) • Parietal Lobe(두정엽) • Occipital Lobe(후두엽) • Temporal Lobe(측두엽) • Major Fissures • Central Sulcus • Longitudinal Fissure • Sylvian Fissure Longitudinal Fissure • The lobes are distinguished both structurally and functionally Sylvian Fissure

  13. Cortical Function • Frontal Lobe • Higher thought processing; decision making; abstract thinking • Primary “precentral” motor area • Parietal Lobe • Primary “postcentral” somatosensory area: sensation of muscles, organs, and skin

  14. Cortical Function • Occipital Lobe • Visual processing • Temporal Lobe • Auditory & equilibrium processing • Left temporal lobe involved in speech and comprehension of language

  15. 뇌실질 (brain parenchyme) • Gray Matter(회질): Neural Cell Bodies(세포체) • Nuclei – Collection of neural cell bodies of similar shape • White Matter(백질): Axons • Tract - A bundle of axons

  16. Basal Ganglia(기저핵) :운동기능 Basal Ganglia a collection of subcortical nuclei involved in the control of movement

  17. Basal Ganglia: Caudate nucleus Putamen Globus pallidus 3 Major structures Caudate nucleus (미상핵) Globus pallidus(담창구) Putamen(피각부)

  18. Diencephalon(간뇌) • 2 Major Structures • -Thalamus(시상) • 터미널기능 • Hypothalamus(시상하부)

  19. Diencephalon • Thalamus • - Two lobes that relay sensory projection fiber info to the cerebral cortex • Hypothalamus • Lies at the base of the brain • Controls and regulates the endocrine system (hormones), autonomic system, species survival (the four Fs) and sleeping. • Contains many nuclei and fiber tracts

  20. Thalamus • All sensory modalities relay through the thalamus

  21. Brain Stem:숨골 Surrounds the 4th ventricle • Mid brain(중뇌) • Pons(뇌교) • Medulla(연수)

  22. Pons(뇌교) • Fiber Tracts & Nuclei important in sleep and arousal

  23. Medulla(연수) • Regulates cardiovascular system, respiration, skeletal muscle tonus

  24. Cerebellum(소뇌) • Two hemispheres • Integrates and coordinates standing, walking,coordinated movements cerebellum

  25. The Brain: A Well-Protected Organ (두개골) (두피) . (경막) . . . . .

  26. The Skull(두개골) • The First Line of Defense

  27. Meninges(수막) . . . . . .

  28. Meninges • 3 Tough Layers of Connective Sheath • Dura Mater (outer:경막) • Arachnoid Mater (middle:지주막) • Pia Mater (inner:연막 )

  29. Meninges • Provide three layers of protection & padding around the brain & spinal cord • Enclose, protect blood vessels • Contains CSF

  30. 임상 • Meningitis (뇌수막염) • Meninigioma(뇌수막종) • Epidural hematoma (경막외혈종) • Subdural hematoma (경막하혈종) • Craniotomy (두개골절개술) • Craniectomy (두개골절제술) • Duroplasty (경막성형술) • Cranioplasty(두개골성혈술)

  31. The Cerebrospinal Fluid(CSF:뇌척수액) • Liquid cushion for brain and spinal cord; reduces shock of head movements (The brain floats in a bath of CSF) • Nourishes brain(영양) • Removes waste • Filtrate of blood

  32. CSF Circulation Total Volume: 70 – 120 ml • Produced in Choroid Plexus • 500 ml/day

  33. The Four Ventricles Lateral Ventricles: 측뇌실 largestThird Ventricle: 3뇌실 “wall” divides brain into symmetrical halvesCerebral aqueduct:도수관long tube that connects 3rd to 4th ventricleFourth Ventricle: 4뇌실

  34. 임상 • Vetriculitis (뇌실염) • EVD (extra ventricular drainage) 뇌실외배액술 • CSF study( 뇌척수액 검사) • V-P shunt( ventriculo-peritoneal shunt: 뇌실복강단락술 _

  35. Spinal Cord(척수): The Peripheral Nervous System말초신경계 Spinal cord sections indicated by the exit point of nerves Sensory and motor peripheral nerves connect to sensory and motor neurons in the CNS Major Divisions of the Peripheral Nervous System: The Autonomic Nervous System The Somatic Nervous System

  36. Spinal CordGross Anatomy Four Major Regions Cervical(경추) Thoracic(흉추) Lumbar(요추) Sacral(천추)

  37. 임상 • Vertebra(척추) • Spinal stenosis(척추협착증 • Spondylolisthesis(척추전방전이증) • Spondylolysis(척추분리증) • Spondylitis(척추염) • Laminectomy(협궁절제술)

  38. Cerebrovascular Disease • Arteriosclerosis • cerebrovascular accident (CVA, apoplexy) • ischemia • transient ischemic attack(TIA) • hemiparesis • hemiplegia • aphasia • ataxia

  39. Oncology • Intracranial tumors • Astrocytoma ,globlastoma,oligodendroglioma, • Ependymoma, • metastatic sites • Signs and Symptoms • headaches • papilledema • personality changes

  40. cerebral palsy • closed head trauma • coma • Concussion • Huntington’s chorea • hydrocephalus • paraplegia • paresis

  41. Paresthesia • poliomyelitis • quadriplegia • sciatica • syncope • transient ischemic attack (TIA)

  42. Cerebral angiography • echoencephalography • electroencephalography (CCG) • myelography • computed tomography (CT scan)

  43. spinal puncture, spinal tap • trephination

  44. Pharmacology • Analgesics • anticonvulsants • antidepressants • hyponotics • opiates • sedatives • tranquilizers

  45. Abbreviations • ALS • ANS • CP • CSF • CT scan • CVA • CVD

  46. Abbreviations • EEG • ICP • LP • MRI • MS • R/O • TIA