Nervous System

Local & General anaesthetics

*Read written notes. Local anaesthetics – Musculoskeletal system General anaesthetics – Nervous system

Sedative hypnotics & anticonvulsants

*Refer written notes

Antidepressive & antipsychotics

Neuronal regulation Neurotransmitters GABA Glutamate Neurohormones oxytocin ADH Neuromodulators CO2 ammonia steroids adenosine prostaglandins Neuromediators cAMP cGMP inositol phosphates Neurotrophic factors brain derived neurotrophic factors When drugs for major depressive disorder (MDD)/ psychoses are administered There is prompt binding of drugs to receptor but clinical effect is delayed & slow to develop Actual drug effect…

Major mental illnesses

Schizophrenia Split mind not split personality Splitting of normal links between perception mood thinking behaviour contact with reality One of the most severe & debilitating form of mental disorder Various presentations Relapsing in nature Subtypes of schizophrenia Hebephrenic childish, silly behaviour mood is inappropriate giggling shallowness thoughts disorganised Catatonic psychomotor disturbance stupor to outburst of…

Dementia

Dementia Definition Diminution of cognition in clear consciousness Decrement of 2 or more intellectual functions Impairment of short and long term memory Changes of Dementia involve Cognition Memory Language Visuospatial Behavioural disturbance involve Restlessness Wandering Violence Delusions Social & Sexual disinhibition Types of dementia Alzheimer’s Global Vascular Pick’s disease Frontal Lewy body Parkinson’s Huntington’s CJD…

Higher functions of the nervous system

Integrated function Cerebral cortex Voluntary movement Language Language area= left hemisphere Wernicke’s area superior & posterior portion of the temporal lobe LANGUAGE COMPREHENSION comprehension of written words, sounds, signs Wernicke’s aphasia can speak, but makes no sense eg. says “chicken’ when pictures of chairs Broca’s area Frontal lobe LANGUAGE EXPRESSION speak/write word Broca’s aphasia can…

Neoplastic lesions of the brain

*Read from printed notes – Ian Brown _____________________________________________________________________ Notes from emedicine.com Background Brain tumors may originate from neural elements within the brain, or they may represent spread of distant cancers. Primary brain tumors arise from CNS tissue account for roughly half of all cases of intracranial neoplasms The remainder of brain neoplasms are caused by…

Physiology of sleep & consciousness

Definitions: SLEEP reversible behavioural state of unresponsiveness & perpetual dissociation from the environment CONSCIOUSNESS: Perception of sensations, voluntary initiation & control of movement, capabilities associated with higher mental processing Stages of consciousness _____________________________________________________________________ Sleep Not a period of absolute rest some parts of the brain are more active during sleep Dreams necessary Experiments where people…

Coma & Brain stem death

Coma Definition A state of prolonged unconsciousness characterized by loss of reaction to external stimuli or, a state of unrousable unresponsiveness. Differentiate from: Stupor Unconscious but can be aroused with repeated stimuli. Delirium Confused state often with restlessness and hallucinations. ‘Locked-in’ syndrome actually conscious but unable to speak or move may move eyes (massive brainstem…

Intracranial infections

Pyogenic meningitis (bacterial) Location brain stem cerebellum dorsum of brain Aetiological agents Neisseria meningitis Strep pneumoniae extremes of age Anaerobic/microaerophilic streptococci brain/epidural abscess trauma neurosurgery Group B streptococci neonates/infants Staph epidermitis intracranial shunts Staph aureus post operative surgery Bordetella pertusis children Haemophilus influenzae children E. Coli trauma surgery lumbar puncture Listeria monocytogenes extremes of age…