神经病学和神经科学PPT英文课件

1、TerminologyNeurology & NeurosciencePretest-1COLUMN A COLUMN B1. SCLEROSIS A. INFLAMMATION2. PTOSIS B. PLASTIC REPAIR3. TROPHY C. INVOLUNTARY CONTRACTION4. ITIS D. OPENING/INCISION INTO5. MEGALY E. HARDENING6. PLASTY F. TUMOR7. TOMY G. GROWTH/NOURISHMENT8. OMA H. DOWNWARD9. ALGIA I. ENLARGEMENT10. SP

2、ASM J. PAIN/ACHEPretest-2COLUMN A COLUMN B1. HYPO A. BETWEEN2. NOX, NOCT B. LOW/UNDER3. POLY C. DIFFICULT/PAINFUL4. CYANO D. FAST5. INTER E. AROUND/SURROUNDING6. PERI F. ONE7. DYS G. EXCESSIVE/TOO MUCH8. TACHY H. MANY/MUCH9. MONO I. BLUE10. HYPER J. NIGHTNeurology is learned “stroke by stroke”Stroke

3、 as a model example of brain and vascular disease1. Knowledge of the symptoms and signs in patients with focal brain infarcts and hemorrhages has been instrumental in developing an understanding of the fuctioning of various brain structures and regions.2. Study of stroke patients and stroke animal m

4、odels has improved understanding of brain electrophysiology, chemistry, pharmacology, and overall physiology.Churchill, Roosevelt, and Stalin at a conference in Yalta after World War II.“Apoplexy ”: struck suddenly with violence“Stroke”: being suddenly strickenSymptoms of Stroke/TIAsCarotid Territor

5、yMonocular visual loss Unilateral weaknessDysphasia Hand symptoms Vertebrobasilar TerritoryDiplopia Bilateral visual loss Vertigo “plus” Bilateral or crossed weaknessJerking/posturing-like movementsAltered LOCEitherDysarthria Hemianopia Unsteadiness Hemisensory loss in limbsCombining Forms cerebr/oC

6、erebrovascular diseaseCerebromalaciaCerebroatrophyCerebrospinal (fluid)CerebrostomyCerebromaCombining Forms neur/oNeuralgiaNeuroanatomyNeuroarthropathyNeurobiologyNeuromuscularNeurotransmitterPolyneuritisCombining Forms crani/oCraniotomyCraniofacial painCranioplastyCombining Forms encephal/oEncephal

7、otomyEncephaloceleEncephalocentesisEncephalomyelitisEncephalopathyHippocrates was the first to write about the medical aspects of strokePersons are most subject to apoplexy between ages of 40-60“When persons in good health are suddenly seized with pains in the head and straightway are laid down spee

8、chless and breathe with stertor, they die in seven days when fever comes on.” This description of subarachnoid hemorrhage shows the Hippocrates emphasis on observation and prognosis.Hippocrates 400 BCHippocrates also observed that there were many blood vessels connected to the brain, most of which w

9、ere “thin”, but two were stout.The Greeks recognized that interruption of these blood vessels to the brain could cause loss of consciousness, and so they named the arteries carotid, from the Greek word Karos, meaning “deep sleep”.A few hundreds years after Hippocrates, Galen described the anatomy of

10、 the brain and its blood vessels from the dissections of animals. However, much of his works combined mostly theorizing and speculation.Galen and his writings dominated the 1300 yearsGalen(131-201AD) During the last half of the 17th century, Johann Jakob Wepfer performed examinations of the brains o

11、f patients dying of apoplexy. He described the appearance of the carotid siphon and the course of the MCA in the Sylvian fissure. Obstruction of the carotid and vertebral arteries was recognized as a cause of apoplexy.Johann Jakob Wepfer (1620-1695) 14Combining Forms (4) gli/oGliomaGlioblastomaGliof

12、ibrosarcomaGliosisGlioependymomaCombining Forms (6) mening/oMeningocyteMeningoceleMeningocephalitisMeningococciMeningomaCombining Forms (7) myel/oMyelogramMyeloceleMyelocystMyelodysplasiaMyelofibrosisMyelomaCombining Forms thalam/oThalamectomyThalamolenticularThalamosensoryThalamotomyThalamostriateC

13、ombining Forms (12) ventricul/oVentriculostomyVentriculo-atrial shuntVentriculocentesisVentriculographyVentriculomegalyThomas Willis (1621-1675) Willis described the collateral circulation in the head and neck“The cephalic arteries, whether they be carotid or vertebrals, communicate one with the oth

14、er reciprocally in various waysThis we have demonstrated by injecting dark substances in only one branch and observing that the whole brain becomes colored.”John Cheyne (1777-1836)He sought to separate the phenomenology of lethargy and coma from apoplexy.Cheyne found a person preserved the power of

15、voluntary motion of the left side, but the right was completely paralytic. She seemed perfectly conscious, attempted to speak, but could not articulate.Giovanni Morgagni (1682-1771) He had a vision that the secret to understand disease was to carefully perform necropsies on humans with illnesses and

16、 then to correlate the pathologic findings with their symptoms during life.-clinicopathologic methodHe described the phenomenology of in situ antemortem thrombosis with subsequent embolism.He described his classic triad of vascular thrombosis: (1) Stasis of blood in a vessel,(2) Injury to the wall o

17、f the blood vessel,(3) An abnormality in the balance between blood procoagulant and anticoagulant factorsBefore his reports, blood factors and thrombosis were given little attention. Rudolf Virchow (1821-1902)Charles Miller FisherMid-twentieth centuryFisher described a patient with episodes of trans

18、ient monocular blindness that has heralded a hemisphere stroke.Fisher reasoned that the causative occlusive process was likely in the internal carotid artery in the neck or head. A patient with transient monocular blindness then dies suddenly. After death, Fisher dissected the neck and found that th

19、e internal carotid artery was occluded.Fisher emphasized the frequent occurrence of warnings before stroke that he later dubbed TIA.Combining Forms narc/oNarcoticNarcolepsyNarcologyPrefixes a-/an-AphasiaAnalgesiaAnesthesiaAgrammaphasiaAnencephalusPrefixes brady-BradykinesiaBradycardiaBradyesthesiaBr

20、adyphagiaBradypneaCombining Forms ton/oTonometerTonogramDystoniaDiagnostic, symptomatic, and related termsParesisParesthesiaQuadriplegiaSciaticaSyncopeTransient ischemic attack (TIA)Technological advances Mid-1960s, Computed tomographymid-1980s, Magnetic resonance imageB-mode ultrasound 1982, transc

21、ranial doppler ultrasound (TCD)By the end of 20th century, advanced image with CT, MRISpecial proceduresCerebral angiography / arteriographyCT scan (cranial)EchoencephalographyMyelographyPositron emission tomography (PET) scanEarly CT Signs of Ischemia Hyperdense MCA signLoss of the insular ribbon S

22、ulcal effacementHypoattenuation of the BG IntracerebralHemorrhageCT hypodensity, effacement or swelling of 1/3 of the MCA territoryT2* multiple areas of microbleeds Diffusion- and Perfusion-Weighted MRI DWIPWIMRASuffixes -algesia/-algiaAnalgesiaSynalgiaNeuralgiaVisceralgiaHyperalgia HypalgesiaCombin

23、ing form blephar/oBlepharoptosisBlepharoadenomaBlepharoconjunctivitisBlepharolithiasisBlepharoplastyBlepharopyorrheaCombining form choroid/oChoroidopathyChoroidoiritisChoroidoretinitisChoroidotomySuffixes -esthesiaHyperesthesiaDysesthesiaBradyesthesiaHypesthesiaAnesthesiaSuffixes -lepsyNarcolepsyEpilepsyCatalepsyHysterocatalepsySuffixes -phasiaTachyphasiaAgrammaphasiaAphasiaDactylophasiaHyperphasiaSchizophasiaEndovascular Therapy Mechanical Clot RetrievalCan be used in conjun