病理生理学--Brain-Dysfunction--课件

Brain Dysfunction1 1pptppt课件课件Introduction2 2pptppt课件课件Structural Characteristicsl lIt is located inside the skull,protects brain from injury,confines the brain l lIt is composed of neurons and glial cells l lThe blood supply is from twin vertebral arteries and carotis internal lThe brain blood barrier protects brain from invasion of toxic insults3 3pptppt课件课件View the Brain4 4pptppt课件课件Cellular compositionNeuronGlia5 5pptppt课件课件Structure of Neuron6 6pptppt课件课件Cellular FunctionslNeuron is in charge of different functions lGlia nourishes and protects the neurons7 7pptppt课件课件Characteristics of Metabolisml l The most active organ in energy metabolisml l Glucose is almost the only source of brain energyl l The storage of glucose in the brain is very limited8 8pptppt课件课件Characteristics of Brain Diseasesl l Region-dependent consequences to injuriesl l Limited capacity for self repair l l Acute brain damages will cause disturbance in consciousness whereas chronic lesions usually lead to cognitive dysfunction 9 9pptppt课件课件Cognitive Disorders1010pptppt课件课件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.1111pptppt课件课件Structural Basis of Cognition Lateral(A)and medial surface(B)of brain1212pptppt课件课件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 functioning1313pptppt课件课件 Major Manifestationsl l Learning and memory disorders l lAphasia l lAgonosia l lApraxia l lDementia 1414pptppt课件课件Learning and memory deficits1515pptppt课件课件Etiology and Pathogenesis l l Chronic brain damage l l Chronic systemic diseases l l Mental and psychic disorders l l Other factors 1616pptppt课件课件Chronic Brain Damagel lImbalance of regulating molecules in the brain l lProtein aggregation in the brain l lChronic cerebral ischemic injury l lEnvironmental and metabolic toxins l lCerebral trauma l lBrain aging 1717pptppt课件课件Imbalance of Regulating Moleculesl lDopamine l lNorepinephrine l lAcetylcholine(Ach)l lGlutamate l lAberrant neuropeptidel lLack of neurotrophic factors 1818pptppt课件课件Dopamine PathwayDopamine1919pptppt课件课件2020pptppt课件课件Dopamine2121pptppt课件课件Parkinson Disease(Cerebral trauma?)2222pptppt课件课件Norepinephrine2323pptppt课件课件Glutamate2424pptppt课件课件Protein Aggregation in The Brainl lGene mutations l lAbnormal post-translational modification l lInfection of slow virus in the brain 2525pptppt课件课件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 EM2626pptppt课件课件Alzheimer Disease2727pptppt课件课件Alzheimers Disease l lGradual memory lossGradual memory lossl lDecline in the ability to Decline in the ability to perform routine tasksperform routine tasksl lDisorientationDisorientationl lDifficulty in learningDifficulty in learningl lLoss of language skillsLoss of language skillsl lImpairment of Impairment of judgment and planning judgment and planning l lPersonality changesPersonality changes2828pptppt课件课件Accumulation of tau and A in ADSenile plaques:A Neurofibrillary tangles:P-tau 2929pptppt课件课件3030pptppt课件课件NormaltauAD p-tauSerThrp pp pp pp pp pp pp pp pADPADPATPATPp pp pProtein kinases?Protein phosphatases SerThrPiPi3131pptppt课件课件 a b d cMorris water maze test from Control and model rats 3232pptppt课件课件Mad cow disease(accumulation of prion)3333pptppt课件课件3434pptppt课件课件Chronic Cerebral Ischemic Injury l l Energy exhaustion and acidosis l lIntracellular calcium overload l lFree radical injury l lExcitatory toxicity l lInflammatory reaction by cytokine 3535pptppt课件课件Glutamate3636pptppt课件课件Chronic Brain Damagel lImbalance of regulating molecules in the brain l lProtein aggregation in the brain l lChronic cerebral ischemic injury l lEnvironmental and metabolic toxins l lCerebral trauma l lBrain aging 3737pptppt课件课件Pathogenesis of Cognition Disorder3838pptppt课件课件Principles for Treatment of Cognitive Disorders l l General neuroprotective treatmentsl lMaintenance of normal neurotransmitter level l lSurgery 3939pptppt课件课件Consciousness Disorder 4040pptppt课件课件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.4141pptppt课件课件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.4242pptppt课件课件Structural Basis for Consciousnessl lDysfunction of brain stem reticular formation l lDysfunction of thalamus l lDysfunction of cerebral cortex 4343pptppt课件课件Structural Basis for Consciousness4444pptppt课件课件Major ManifestationsDeliriumDeliriumConfusionDrowsinessComa4545pptppt课件课件Etiology and PathogenesislAcute brain injury eg.diffuse encephalic infection,diffuse brain trauma,subarachnoid hemorrhage,etc.lAcute brain intoxication 4646pptppt课件课件Acute Brain Intoxicationl lEndogenous toxins injury Alteration in neurotransmitter Alteration in neurotransmitter Aberrant energy metabolism Aberrant energy metabolism Nerve cell membrane injury Nerve cell membrane injury l lExogenous toxins injury l lIntracranial extrusion and destructive lesion 4747pptppt课件课件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 cells4848pptppt课件课件Etiology and Pathogenesis of Consciousness Disturbance 4949pptppt课件课件Systemic Disturbancel lRespiratory disordersl lDisturbance of fluid-electrolyte and acid-base balance l lCirculation dysfunction l lOthers 5050pptppt课件课件 Principles of Prevention and Therapy l lUrgent management l lMaking a definite diagnosis as soon as possible l lMonitoring vital signs and consciousness state l lBrain protections 5151pptppt课件课件Production&release of dopamine5252pptppt课件课件5353pptppt课件课件