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Chapter 10.docx

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Chapter 10Topic 10ANeuropsychological Assessment and Screening THE HUMAN BRAIN AN OVERVIEW The nervous system is divided into the central nervous system consisting of the brain and spinal cord and the peripheral nervous system that includes the cranial nerves and the network of nerves emanating form the spinal cordThe brain is beyond doubt the most protected organ in the bodyfirst line of defense is the skull beneath that is the meninges the cerebrospinal fluid also forms protection The brain literally floats in a snugly fitting bath of cerebrospinal fluidThe brain is composed principally of five elements gray matter white matter glial cells CSF and the blood vessels of the vascular system that provide the brain with oxygen and nutrientsGray Matter and White Matter The gray matter consists of densely packed cell bodies of neurons which are also called nerve cells The myelin sheath that surrounds axons gives white matter its distinctive appearance Demyelinating diseases attack the white matter and impair the ability of cells to communicate with one anothermost famous is MS It has been believed that neurons that compose the gray matter and white matter do not produce however recently it has been found that they do and especially in the areas of learning and memoryGlial CellsGlial cells provide structural support for the neurons transport nutrients to the neurons cleaning up brain debris and insulating axons in the central and peripheral nervous system Cerebrospinal Fluid and the Ventricular SystemCSF is a clear liquid that is continuously produced and replenished within the ventricles produced by the choroid plexusThe ventricles are hollow interconnected chambers found in the middle of the brainfour ventricles two lateral ventricles and two midline ones known as the third and fourth ventricles The CSF flows from the lateral down through the third and fourth ventricles until it reaches the meninges on the outer surface of the brain and spinal cordThe Vascular System of the Brain The brain needs substantial supplies of oxygen and glucose to function effectively and these energy sources are supplied by the flow of blood through the cardiovascular system Two pairs of arteries carry blood to the brain These are the left and right internal carotid arteries found the in the front of the neck and the left and right vertebral arteries found in the back of the brain The vertebral arteries come together to form the basilar artery These three arteries left and right internal carotids and the basilar artery feed into a circular arterial structure at the base of the brain known as the circle of WillisThe anterior cerebral artery supplies blood to the frontal lobes and some midline structures The middle cerebral arteries provide blood to the frontal parietal and temporal lobes The posterior cerebral arteries supply blood to the occipital lobes and some subcortical structuresWhen an artery in the brain becomes completely obstructed the brain tissue dies and is called an infarct which is one kind of stroke or CVA Another kind of CVA occurs when an aneurysm bursts open arterial rupture One form of capsular impairment know as multiinfarct dementia MID occurs when the hardly noticeable individual effects of many small infarcts accumulate over a number of yearsSTRUCTURE AND SYSTEMS OF THE BRAINThe most basic element of the nervous system is the cerebrum most recently developed in the brain consisting of the left and right cerebral hemispheres which are connected by the corpus callosum and the cerebrum is where thought perception imagination judgement and decision occur Some essential structures are located beneathbasal ganglia and the cerebellum coordinated movement diencephalon the midbrain the pons connecting the cerebrum with the cerebellum and the spinal cord and the medulla mediating essential bodily functions Corpus Callosum The corpus callosum is the major commissure that serves to integrate the functions of the two cerebral hemispheres The functions of the corpus callosum was poorly understood until patients with epilepsy whose corpus callosum were severed were studied split brain patientsCerebral Cortex The cerebral cortex the outermost layer of the brain is the source of the highest levels of sensory motor and cognitive processing It is the functional capacity of this brain system 6 layers deep that most dramatically separates humans from the lower animals The tissue of the cerebral cortex neocortex is folded over into bulges gyri and grooves sulci A small portion of the cerebral cortex is committed cortex The committed cortex of the frontal lobe is dedicated to motor control the parietal lobe is concerned the processing of touch and other somatosensory information the occipital lobe is involved in visual perception and the temporal lobe is essential to the processing of auditory information SURVIVAL SYSTEMS THE HINDBRAIN AND MIDBRAIN The lowest part the brain located at the top of the spinal cord consists of the hindbrain first brain system to develop in terms of evolution which includes the medulla oblongata the pons the reticular formation and the cerebellum Many of the vital bodily functions are governed by this brain areaLowest section is the medulla oblongata which mediates several essential bodily functions and significant damage is usually fatal The pons and cerebellum are the highest structures in the hindbrain and together help coordinate muscle tone posture and hand eye movement
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