病理生理学18ppt课件

Brain Dysfunction,Department of pathophysiology, Tongji medical college, HUST,Introduction,Structural Characteristics,It is located inside the skull, protects brain from injury, confines the brain It is composed of neurons and glial cells The blood supply is from twin vertebral arteries and carotis interna The brain blood barrier protects brain from invasion of toxic insults,View the Brain,Cellular composition,Neuron Glia,Structure of Neuron,Cellular Functions,Neuron is in charge of different functions Glia nourishes and protects the neurons,Characteristics of Metabolism,The most active organ in energy metabolism Glucose is almost the only source of brain energy The storage of glucose in the brain is very limited,Characteristics of Brain Diseases,Region-dependent consequences to injuries Limited capacity for self repair Acute brain damages will cause disturbance in consciousness whereas chronic lesions usually lead to cognitive dysfunction,Cognitive Disorders,Cognition The ability of the brain to process and store information in order to solve problems. It involves a series of voluntary psychological and social behaviors, such as study, memory, language, thinking, emotion etc.,Structural Basis of Cognition,Lateral (A) and medial surface (B) of brain,Cognitive Disorder The disturbance of the mental process related to learning and memory, reasoning and judgment, accompanied by aphasia, apraxia, agonasia or disturbance in executive functioning,Major Manifestations,Learning and memory disorders Aphasia Agonosia Apraxia Dementia,Learning and memory deficits,Etiology and Pathogenesis,Chronic brain damage Chronic systemic diseases Mental and psychic disorders Other factors,Chronic Brain Damage,Imbalance of regulating molecules in the brain Protein aggregation in the brain Chronic cerebral ischemic injury Environmental and metabolic toxins Cerebral trauma Brain aging,Imbalance of Regulating Molecules,Dopamine Norepinephrine Acetylcholine (Ach) Glutamate Aberrant neuropeptide Lack of neurotrophic factors,Dopamine Pathway,Dopamine,Dopamine,Parkinson Disease (Cerebral trauma? ),Norepinephrine,Glutamate,Protein Aggregation in The Brain,Gene mutations Abnormal post-translational modification Infection of slow virus in the brain,Lewy bodies (accumulation of synuclein in PD) Stained by haematoxylin/eosin, and by synuclein, Composed of a dense granular core and a halo of radiating filaments by EM,Alzheimer Disease,Alzheimers Disease,Gradual memory loss Decline in the ability to perform routine tasks Disorientation Difficulty in learning Loss of language skills Impairment of judgment and planning Personality changes,Accumulation of tau and A in AD,Senile plaques: A Neurofibrillary tangles: P-tau,PHF and NFT by EM,Normal tau,AD p-tau,Ser Thr,p,p,p,p,p,p,p,p,ADP,ATP,p,p,Protein kinases ?,Protein phosphatases ,Imbalanced phosphorylation system leads to tau hyperphosphorylation,Ser Thr,Pi,Morris water maze test from Control and model rats,Mad cow disease (accumulation of prion),Chronic Cerebral Ischemic Injury,Energy exhaustion and acidosis Intracellular calcium overload Free radical injury Excitatory toxicity Inflammatory reaction by cytokine,Glutamate,Chronic Brain Damage,Imbalance of regulating molecules in the brain Protein aggregation in the brain Chronic cerebral ischemic injury Environmental and metabolic toxins Cerebral trauma Brain aging,Pathogenesis of Cognition Disorder,Principles for Treatment of Cognitive Disorders,General neuroprotective treatments Maintenance of normal neurotransmitter level Surgery,Consciousness Disorder,Consciousness is denoted in brief as the sense of awareness of self and the environment. It consists of two aspects: state of arousal and content of consciousness.,Consciousness disorder is defined as parenchymal mental disorders in which there is impairment of the ability to maintain awareness of self and environment and to respond to environmental stimuli.,Structural Basis for Consciousness,Dysfunction of brain stem reticular formation Dysfunction of thalamus Dysfunction of cerebral cortex,Structural Basis for Consciousness,Major Manifestations,Delirium,Confusion,Drowsiness,Coma,Etiology and Pathogenesis,Acute brain injury eg. diffuse encephalic infection, diffuse brain trauma, subarachnoid hemorrhage,etc. Acute brain intoxication,Acute Brain Intoxication,Endogenous toxins injury Alteration in neurotransmitter Aberrant energy metabolism Nerve cell membrane injury Exogenous toxins injury Intracranial extrusion and destructive lesion,GABA released by one cell either binds to another cell or be reabsorbed Enough GABA binding to the other cells prevents over excitation in the brain.,GABITRIL increases the level of GABA by blocking its reabsorption This blocking helps make more GABA available for binding to the other cells,Etiology and Pathogenesis of Consciousness Disturbance,Systemic Disturbance,Respiratory disorders Disturbance of fluid-electr