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NEURO TUTE – 12/9/11

NEURO TUTE – 12/9/11. Neuroanatomy 1. Developmental: the 5 “- cephalons ” Structural: Lateral view of cerebrum, midline sagittal section, brainstem / inferior view, basal ganglia section Cerebellum Vasculature: circle of Willis Meninges Venous sinuses Ventricles Spinal cord.

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NEURO TUTE – 12/9/11

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  1. NEURO TUTE – 12/9/11

  2. Neuroanatomy 1 • Developmental: the 5 “-cephalons” • Structural: • Lateral view of cerebrum, midline sagittal section, brainstem / inferior view, basal ganglia section • Cerebellum • Vasculature: circle of Willis • Meninges • Venous sinuses • Ventricles • Spinal cord

  3. Neuroanatomy 2 • Functional • Frontal lobe • Parietal lobe • Motor and sensory homunculus • Temporal lobe • Occipital lobe • Cerebellum • Brainstem • Ascending SC tracts • Descending SC tracts • Basal ganglia • Limbic system

  4. Cranial nerves • Skull foramina they pass through • Functions etc • Way to think of and test groups together

  5. Neurological disease • Definitions • DYSarthria/ phagia / phasia / phonia / graphia / diadochokinesis • HEMIparesis / plegia / anopia • Anomia / gnosia / taxia / praxia • Tone / spasticity / clonus / fasciculation • Decerebrate / decorticate • Neglect • Lower motor neuron lesion • Upper motor neuron lesion

  6. Language and speech • Functional anatomy • Broca’s, Wernicke’s, dominant vs non-dominant • Expressive aphasia • Receptive aphasia • Communication tips • Allow extra time, allow silence, be patient • Avoid appearing condescending • Written communication / tools • Electronic tools

  7. STROKE • 10 things you should know about stroke • 1.    Stroke is Australia’s second single greatest killer after coronary heart disease and a leading cause of disability. 12.    In 2011, Australians will suffer around 60,000 new and recurrent strokes – that’s one stroke every 10 minutes.  23.    One in five people having a first-ever stroke die within one month and one in three die within a year. 34.    The number of strokes will increase each year due to the ageing population unless something is done to       reduce the incidence rate. 45.    The FAST test is an easy way to recognise and remember the signs of stroke. Using the FAST test involves asking        three simple questions: • •    Face – Check their face. Has their mouth drooped? •    Arms – Can they lift both arms? •    Speech – Is their speech slurred? Do they understand you?•    Time – Time is critical. If you see any of these signs call 000 now! • 6.    In the next ten years more than half a million people will suffer a stroke. 57.    Stroke kills more women than breast cancer and more men than prostate cancer. 68.    About 88 per cent of stroke survivors live at home and most have a disability. 79.    Close to 20 per cent of all strokes occur to people under 55 years old. 810.   Strokes cost Australia an estimated $2.14 billion a year.  9

  8. Stroke 1 • Definitions: CVA vs TIA • Epidemiology • Risk factors • Symptoms and signs • Public health: FAST • Types of stroke

  9. Stroke 2 • Investigation / diagnosis • Pathophysiology • Acute management • Complications • Rehabilitation • MDT approach and members of the team

  10. Anatomy (4) • Anatomy of the skull • Anatomy of the eye • Extrinsic eye muscles

  11. Retina & Eyeball

  12. Extraocular muscles Lateral view (above) Superior view (left)

  13. Physiology of the visual system • Visual pathways • Refractive function • Retinal structure • Rods and cones, bipolar cells, horizontal cells • Phototransduction • Reflexes • Pupillary light reflex • Accommodation reflex • Corneal reflex • Vestibulo-ocular reflex

  14. Visual system lesions / disease • CNIII lesion • CNIV lesion • CNVI lesion • Internuclearophthalmoplegia (super briefly) • Diplopia • Nystagmus

  15. Memory • Which structures are involved • Short term memory • Long term memory • Testing

  16. Vitamins • Fat soluble • Water soluble • Specifically, some brief stuff on: • Vit A • Vit D • Vit K • B9 (folate) • B12 • Vit C

  17. Vitamins 2 • Thiamine • Roles / pathways (3) • Sources / absorption • Thiamine deficiency states • WKS • Wernicke’s • Korsakoff’s • Beriberi

  18. Alcohol … ……. ……………… IS SO GOOD!

  19. Alcohol 2 • Pharmacology • Metabolic pathways • ADH • MEOS • Effects on different body systems

  20. Alcohol 3 • Alcoholic liver disease • Public health aspects • Abuse / dependence

  21. Steatosis What caused this? Increased peripheral triglyceride mobilisation Impaired metabolism of fatty acids to triglycerides Lack of apoprotein synthesis Impaired lipoprotein release into the circulation Asymptomatic and reversible

  22. Alcoholic hepatitis Generally acute presentation Mallory's hyaline is seen here, but there are also neutrophils, necrosis of hepatocytes,collagen deposition, and fatty change. These findings are typical for acute alcoholic hepatitis. Such inflammation can occur in a person with a history of alcoholism who goes on a drinking "binge" and consumes large quantities of alcohol over a short time.

  23. Cirrhosis Irreversible and progressive change Liver is scarred and fibrosed with nodules of regeneration Remodelling of vascular architecture causing increased vascular resistance  portal hypertension

  24. Public Health EtoH • What are some strategies used for controlling alcohol missuse? • What are the CAGE questions? • Why do we care? • In Australia, the 12 month prevalence of harmful use of alcohol is 3.0% while the prevalence of dependence is 3.5%. Men are twice as likely to experience dependence compared with women. • Liver disease, MVC, accidents/trauma, mental health, drug dependence, loss of income…

  25. Drug Abuse/Dependence Abuse Dependence (>=3 in 12 months) Tollerence Withdrawal Taken in larger amounts/over a longer period than intended Repeated unsuccessful attempts to cut down Great deal of time taken obtaining/using/recovering from drug effects Important social/occupational/recreational activities given up or reduced due to substance use Continued use despite harm (at least one of in 12 months) • Recurrent use in situations in which it is physically hazardous • Recurrent use related legal problems • Recurrent use despite social of interpersonal problems due to substance use • Recurrent use resulting in failure to fulfil major obligations at school/work or home • LIVER LOVER LAWYER LIVELIHOOD

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