NATIONAL UNIVERSITY OF PHARMACY

DEPARTMENT OF PHYSIOLOGY AND

PATHOLOGICAL PHYSIOLOGY

Pathophysiology of the nervous system

 PLAN OF LECTURE
1. Types of nervous system disorders.
Violation of sensitivity.
2. Disorders of motor functions.
3. Myasthenia, etiology, pathogenesis,
clinical manifestations.
4. Epilepsy, etiology, pathogenesis,
clinical manifestations.
5. Mental disorders.
 Questions of Independent work

1. The concept of stress. Stages of

development of the general adaptation
syndrome.
2. Diseases of adaptation. Disturbance of the
sensory, vegetative and trophic functions of
the nervous system.
 Suggested Reading
Basic
1.General and clinical pathophysioilogy/ Editer by Anatoliy V. Kubyshkin.
– Vinnytsa : Nova Knyha Publishers, 2016. – 656 p.
2.Lecture notebook pathological physiology. Manual for working in
lectures / N.M. Kononenko, S.I. Kryzhna, V.A. Volkovoy at al.; Kh.:
NPhаU, 2013. – 99 p.
3.Pathological Physiology: The textbook for the students of higher
pharmaceutical educational institutions and pharmaceutical faculties og
higher medical educational institutions III-IV levels of accreditation / S/I/
Kryzhna, N.M. Kononenko, I.Yu. Tishenko et al.: under edition of the
professor A.I. Bereznyakova. – Kharkiv: NphaU, 2006. – 416 p.

Auxiliary
1.Professional guide to Pathophysiology / M.H. Birney, C. L. Brady, K.T.
Bruchak et al. – Lippincott Williams and Wilkins. – 2002. – 696 p.
2.Crowley L.V. An introduction to human disease: pathology and
pathophysiology correlations / L.V. Crowley . – London : Lones and
Bartlett Publishers International Bard House. 2001. – 790 p.
 CNS includes brain and spinal cord and it consists of separate nerve cells
- the neurons, which contact between themselves with the aid of the
special connections - synapses. Activity CNS is achieved according to
the principle of reflex, i.e., answer to the irritation

The function of the nervous system is to send signals from one cell
to others, or from one part of the body to others. There are multiple
ways that a cell can send signals to other cells.
 Disorders sensitive function of
the nervous system
• 1. Violation of reception. Increase of the excitation threshold of receptors
leads hypoesthesia, decrease - hyperesthesia.
• 2. Damage to peripheral nerves. All kinds of sensitivity fall out in the zone
of innervation of the nerve.
• 3. Damage to the posterior columns of the spinal cord. It is
characterized by loss of all types of sensitivity in the zone of the
corresponding segments.
• 4. Damage to the spinal cord. Complete damage of the spinal cord is
accompanied by the disappearance of all types of sensitivity on both sides
below the level of damage.
• 5. Dysfunction of subcortical structures involved in the implementation
of sensory functions. The most important is the damage to the nuclei of the
thalamus.
• 6. Damage to the sensory areas of the cerebral cortex. Disruption of the
neurons of the postcentral gyrus leads to disorders of complex tactile and
proprioceptive sensitivity on the opposite side of the body.
 DISTURBANCES OF THE SENSITIVITY

Anesthesia – Hyperesthesia - increase

complete loss of of the sensitivity
the sensitivity
Hypoesthesia - decrease
of the sensitivity

tactile
painful (analgesia)
thermal
loss by deep (proprioceptive
sensitivity)
 MOTOR DISORDERS OF THE NERVOUS SYSTEM

Paralysis – it complete, and paresis is a

partial loss of active moving in limbs

hemiparesis Upper paresis low paresis monoparesis

 occurs when damage to the central descending
motor pathways.
Reasons:
spinal cord injuries and strokes.
Signs:
1. Hypertonia - increase in muscle tone
2. Hyperreflexia – intensivication of spinal reflexes
3. The appearance of pathological reflexes
(Babinski reflex, etc.)
Etiology:
Occurs when the injured peripheral motor nerves and degeneration of a-
motor neurons of the spinal cord (poliomyelitis)

Symptoms :
1. Hypotonia - a decrease in their tone of muscles;
2. Hyporeflexia - the absence or weakening of the spinal
reflexes in the implementation of which involved nerve injury
or motor neuron;
3. Muscle atrophy caused by their hypofunction.
 Myasthenia
a chronic neuromuscular disease caused by the immune-
mediated loss of acetylcholine receptors, the main
manifestation of which is the pathological weakness
striated muscles (skeletal, facial, oculomotor, pharyngeal
muscles).

Pathogenesis:
due to the blocking of conduction at the level of synapse.
An important role is played by autoimmune mechanisms,
and hyperplasia of the thymus.
Women at younger ages get sick more often.
 Epilepsy is a central nervous system disease in which
brain activity becomes abnormal, causing convulsions
or periods of unusual behavior, sensations.
 Etiology
• Hereditary diseases of the
nervous system;
• Pre-and postnatal brain
injury (hypoxia, infection)
• Alcoholism mother;
• Birth trauma;
• Toxins, carbon monoxide,
lead;
• Brain Tumors;
• Multiple sclerosis, etc.

Pathogenesis.
There is sudden high voltage flash in groups of neurons epileptic
focus.
Stage “aura” is condition that occurs each time before the attack
convulsions‘ stage
Stage of convulsions
Tonic phase:
loud cry, loss of consciousness, falling to the ground, opisthotonus
(convulsive posture with a sharp arching of the back, head dropping
backward, stretching the legs, flexing the arms, hands, feet and
fingers due to tonic contraction of the muscles of the limbs, back and
neck), the insufficient breathing, cyanosis (a few seconds - 3 min)
Clonic phase:
clonic convulsive, biting of the tongue, the foam from his mouth,
urinary incontinence.
Stage “sleep”
A few minutes later the patient regains consciousness and falls
asleep.

Amnesia is developed after seizures

 Begins suddenly and continues less than 30 seconds.
Patient suddenly stop any activity. The patient does not
respond to questions. The paroxysm stopes
unexpectedly, and the patient continues the interrupted
activity
 PARKINSON'S DISEASE
• Etiology - not installed
• Pathogenesis - the main role has to the deficiency of
the dopaminergic systems of the brain.
 PARKINSON'S DISEASE
• Clinical signs:
✓ hypokinesia – decrease of muscles activity, slowed
movement. The face becomes mask-like, gestures are
poor, movements are slow. Walking is characterized by
very small steps and the absence of a natural swing of
the arms
✓ muscular rigidity - hypertone of the muscles
✓ tremor - trembling fingers and hands, as well as the
lower jaw.
 HYPERKINETIC SYNDROME
• Hyperkinesia is abnormally heightened, sometimes
uncontrollable muscle movement
` chorea – disorderly involuntary movements with
pronounced locomotor effect, accompanied by muscle
hypotension
 HYPERKINETIC SYNDROME
• athetosis – is a symptom characterized by slow,
involuntary, convoluted, writhing movements of the
fingers, hands, toes, and feet and in some cases, arms,
legs, neck and tongue.
 HYPERKINETIC SYNDROME
• hemiballismus is
characterized appearance
of flailing, ballistic,
undesired movements of
the limbs.
• Neurosis – this is a condition based on the
violation of the strength, mobility and balance of
the main nervous processes - excitation and
inhibition
 HYSTERIA
• is a mental disorders which arises from
intense anxiety
• is ungovernable emotional excess.

.
• Psychosis a disease of the central nervous
system that is accompanied by organic
(irreversible) changes in the cerebral cortex.