Exam 1: The Nervous System Flashcards

1
Q

neuroepithelium

A

gives rise to all CNS neurons and glial cells (except microglia)
tissue outside of neural tube
sclerotome mesoderm

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2
Q

3 regions the neuroepithelium can be divided into

A

ventricular, mantle, marginal

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3
Q

ventricular neuroepithelium

A

gives rise to the ependymal cells (produce CSF)

closer to the inner membrane

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4
Q

Mantle neuroepithelium

A

gives rise to most of the grey matter and neuron cell bodies , gives most macroglia (astrocytes)
- between the ventricular and marginal layers

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5
Q

marginal neuroepithelium

A

gives rise to white matter, myelinated axons

highest concentration of glial cells is oligodendrocytes

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6
Q

development of neuroepithelium in the brain vs spinal cord

A

in the brain it will be flipped so the myelination is on the inside and the grey matter is on the outside

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7
Q

sulcus limitans

A

groove that separates dorsal region from the ventral region

near the midline

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8
Q

alar plate

A

dorsal region

sensory function

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9
Q

basal plate

A

ventral region
motor function
(sends info out forward / ventrally)

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10
Q

As the spinal cord matures you get _____ showing up

ventral and dorsal which is for info coming in ?

A

horns
ventral - cell bodies and tracts going out
dorsal - tracts coming in (NOT cell bodies)

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11
Q

where are cell bodies in dorsal horn located?

A

dorsal root ganglion

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12
Q

what protective layers does the sclerotome mesoderm give rise to?

A

vertebrae
annulus fibrosis of discs
meninges

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13
Q

sclerotome mesoderm

A

not part of nervous system
part of protective layers
connective tissue supportive

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14
Q

annulus fibrosis

A

outer, tougher, connective portion to the intervertebral discs, encase the discs

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15
Q

meninges

A

protective layer wrap around brain and spinal cord

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16
Q

vertebral discs are formed from what 2 regions of the mesoderm

A
  • notochord which initiates neurulation

- nucleus pulposus - remnant of notochord

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17
Q

nucleus pulposus composition and function

A

gel-like center of the disc (collagen and elastin fibers)
- loose matrix
- living cells that produce proteoglycan (mostly protein but have carb chains - attract water)
more proteoglycan = more hydration
responsible for shock absorbency of disc from elastin fibers

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18
Q

annulus fibrosis

A

made of fibrocartilage
- cells of sclerotome that surround the notochord in many layered structure (lamination)
- layers:
collagen parallel fibers
elastin fibers between each layer to lock them together

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19
Q

what keeps the vertebrae together at each joint?

A

one = 2 vertebrae with a disc in between

thin layer of hyaline cartilage on either side of disc to lock in place

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20
Q

What happens to the vertebral discs as you age?

A

get less proteoglycan produced by the cells, cells die off in pulposus, degeneration of discs
- not putting out as much proteoglycan = not as much hydration - no osmotic pressure
- does not hold shape easily, collapses when pressure on it
- disorganization:
not static , have living cells , branching, weak points, fissures forming , can cause bulging, herniation

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21
Q

How many cervical vertebrae? thoracic? lumbar? sacral? coccyx?

A

cervical: 7
thoracic: 12
lumbar: 5
sacral: 5
coccyx: 3-5

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22
Q

primary curvatures

A

thoracic and sacral

  • convex, bending over
  • fetal position curved like a C
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23
Q

secondary (compensatory) curvatures

A

cervical (begins in utero to 3 months)
lumbar (begins at 12 months) - can stand up

  • concave
  • babies lift head and get more control
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24
Q

abnormal curvature of spine also occurs if irregularity is more lateral

A

scoliosis

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25
Q

kyphosis

A

extreme curvature in upper thoracic

bending over, hunched back

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26
Q

lordosis

A

extreme curvature in lumbar region

  • bending backwards
  • in pregnant women in last trimester or overweight in abdominal region
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27
Q

contains adipose and areolar CT that supports blood vessels and spinal nerves

A

epidural space

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28
Q

epidural anesthesia

A

administered into epidural space

  • labor and delivery
  • have patient curl up to open the space, insert needle or catheter and constantly add more anesthesia to numb nerves in the area and below it
  • to numb higher up areas recline patient - it goes towards gravity
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29
Q

dense CT, double layered - no separation of layers in the spinal cord

A

dura mater

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30
Q

supportive network of CT

extensions of CT to pia

A

arachnoid

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31
Q

outer region of CSF circulation

extensions from arachnoid reabsorb into venous system

A

subarachnoid apace

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32
Q

spinal anesthesia - injection

taking a sample of CSF if think someone has meningitis

A

take from subarachnoid space

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33
Q

surface of spinal cord
composed of astrocytes and CT
cannot separate from spinal cord or brain without ripping it off - it is fused to the surface

A

pia mater

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34
Q

differences between meninges of spinal cord and brain

A
  • brain has no epidural space
  • dura connects to the skull directly in the brain
  • layers of dura separate in brain
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35
Q

2 parts of the dura mater and what they are

A

periosteal: stays with inside of skull
meningeal: inner layer that follows contours of brain
- meningeal goes down into fissures and sulci of brain, periosteal stays - get sinuses that reabsorb CSF and drain into venous system

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36
Q

similarity between meninges of brain and spinal cord

A

arachnoid and pia the same

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37
Q

subdural hematoma

A
  • rupture of bridging veins, slow development, under the dura (where arachnoid is CSF)
  • MIDLINE shift - crosses suture lines
  • crescent shape
  • slow bleed
  • elderly, alcoholics, shaken baby, whiplash
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38
Q

epidural hematoma

A
  • damaged artery - middle meningeal artery usually
  • rapid expansion due to high P in arteries
  • usually secondary to temporal fracture or concussion
    NO midline shift - does not cross suture lines
  • oval shape
    traumatic
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39
Q

subarachnoid hemorrhage

A
  • rupture of an aneurysm or bleed from arteriovenous malformation
  • blood into sulci
  • hemorrhagic stroke - bleed in brain, not blockage
  • thunderclap headache (do not want to give clot busters bc it would make worse)
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40
Q

gray matter

A

neuron cell bodies arranged in functional aggregates or nuclei

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41
Q

sensory nuclei located…

motor nuclei located…

A

sensory: dorsally/posteriorly
motor: ventrally/anteriorly

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42
Q

somatosensory

A

proprioception

ex: romberg exercise - close your eyes and can feel body shifting to maintain balance

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43
Q

visceral sensory

A

monitoring BP, whether or not you should be secreting digestive enzymes

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44
Q

visceral motor

A

step up peristalsis ways

if sat down, relaxing, bringing BP down

45
Q

somatic motor

A

felt changes in shifting result in you sending somatic motor responses down so you did not fall over

46
Q

white matter

A

formed by bundles of axons - most myelinated

47
Q

funiculi or tracts

A

bundles of axons that create white matter

48
Q

what are groups or tracts referred to as

A

columns

49
Q

ascending tracts carry…

descending tracts carry…

A

ascending carry sensory info

descending carry motor info

50
Q

somatosensory neuron orders (1,2,3)

always do 1 and 2

A

1: sensory neuron entering dorsal root ganglion
2: interneuron in spinal cord or brainstem
3: to thalamus (conscious)

51
Q

Breaking down nomenclature:
spinothalamic
corticospinal

A

spinothalamic: coming from the spine and going to the thalamus
ascending so sensory

corticospinal: coming from cortex going to spinal cord
descending so motor

52
Q

fasiculus gracilis

extrapyramidal tracts

A

fasiculus gracilis: fasiculus is a bundle, gracilis is in the medulla, so it is heading for the medulla, ascending so it is sensory

extrapyramidal tracts: coming out from medulla, descending so motor

53
Q

3 major sensory, ascending tracts

A

dorsal/posterior column
spinothalamic tract
spinocerebellar tract

54
Q

dorsal column function

A

conscious awareness
proprioception
fine touch
pressure and vibrations (highly localized)

large diameter, highly myelinated - rapid conduction

55
Q

Does the dorsal column decussate, if so where?

A

YES
at medulla
contralateral

56
Q

Divisions of the dorsal column

A

fasciculus cuneatus

fasciculus gracilis

57
Q

fasciculus cuneatus

A

somatosensory from T6 and above

arms, torso, neck

58
Q

fasciculus gracilis

A

somatosensory below T6

think a ballerina is graceful on pointe and the pointe shoes are the lower half of body

59
Q

How to test for lesion to dorsal column

A

usually have them close eyes, if gracilis start at bottom of tract like big toe have them tell you if you bent their toe up or down
could also use vibration with a tuning fork

2 part discrimination test

60
Q

spinothalamic function

A

conscious
pain, T, crude touch and pressure (poorly localized)
small diameter and sparsely myelinated - slower conduction

61
Q

does the spinothalamic pathway decussate, if so where?

A

YES
at entry - spinal cord
contralateral

62
Q

divisions of spinothalamic and their functions

A

lateral: pain and T
anterior: crude touch and pressure

63
Q

how to test spinothalamic damage?

A

pin test or cold water

64
Q

spinocerebellar function

A

unconscious!!!
proprioception

moderate diameter, moderately myelinated

65
Q

does spinocerebellar decussate, if so where?

A
  • dorsal: NONE ipsilateral

- ventral: double decussation ipsilateral (at entry and at cerebellum)

66
Q

divisions of spinocerebellar

A
  • dorsal: proprioception

- ventral: monitors activity within spinal cord

67
Q

spinal cord descending motor tracts

A

pyramidal

extrapyramidal

68
Q

pyramidal tracts

A

conscious
voluntary control
variation in diameter and myelination

69
Q

where do pyramidal tracts decussate?

A

medulla

contralateral

70
Q

what are the divisions of the pyramidal tracts

A
  • lateral corticospinal
  • anterior corticospinal
  • corticobulbar
71
Q

lateral corticospinal pyramidal tract

A

90%

movement of limbs - arms, legs - need more fine motor control in hands and legs

72
Q

anterior corticospinal pyramidal tract

A

10%

pectoral and pelvic girdles, core - helps keep you upright

73
Q

corticobulbar pyramidal tract

A

neurons from motor cortex synapse with cranial nerves (spinal accessory, facial, trigeminal, oculomotor, hypoglossal
extraocular facial movement and voice production
- comes down same tracts as lateral and anterior corticospinal but does not extend to same extent
- facial expressions, voice production, gestures, speaking

74
Q

ocular saccade - corticobulbar tract

A

voluntary
eye movement from one spot to another
- looking from one finger to another - if no nerve issues they have no problem focusing

75
Q

extrapyramidal tracts

A

unconscious control - reflexive
- neurons originate in subcortical regions of midbrain
diameter and myelination vary

76
Q

where do extrapyramidal tracts decussate?

A

if it happens, in midbrain (does not have to occur)

- higher up than medulla

77
Q

divisions of extrapyramidal tracts

A

vestibulospinal
tectospinal
rubrospinal
reticulospinal (medial and lateral)

78
Q

vestibulospinal - extrapyramidal tract

A

ipsilateral
maintains equilibrium
postural reflexes and ocular saccades
- helps pull you back up when you start to fall asleep in class
- ocular saccades- if loud noise your eyes automatically go to it involuntarily

79
Q

tectospinal extrapyramidal tract

A

both contralateral and ipsilateral
postural reflexes to auditory and visual stimuli
- bright light shining in eyes, loud noise and you jump

80
Q

rubrospinal extrapyramidal tract

A

contralateral - upper body especially upper limb postural reflexes
- from red nucleus , part of midbrain
interacts with reticulospinal

81
Q

reticulospinal extrapyramidal tract

A

muscle tone - walking coordination - modulates pain - extensors and flexors

medial: ipsilateral stimulate extensors, inhibits flexors
lateral: contralateral inhibits extensors, stimulates flexors

82
Q

progressive neurodegenerative disease involving loss of neurons in anterior ventral horns and progressive demyelination of corticospinal tracts

A

ALS

83
Q

dorsal rami

A

innervate skin and muscles of the back

84
Q

ventral rami

A

innervate ventrolateral body wall and limbs - sides and abdominal region

85
Q

spinal nerves are part of what nervous system?

A

peripheral nervous system (PNS)

86
Q

endoneurium
perineurium
epineurium

A

endoneurium: surrounds a single neuron
perineurium: surrounds fassicle
epineurium: surrounds entire nerve

87
Q

how are spinal nerves named

A
  • identified by vertebrae under which they are located T1 spinal nerve comes out under T1
  • EXCEPT for cervical vertebrae it begins above the atlas C1 is above atlas
88
Q

4 spinal nerve plexuses

A

cervical
brachial
lumbar
sacral

89
Q

cervical plexus

A

C1-C5 and cranial nerve 12 (hypoglossal)
- innervates neck muscles and some shoulder muscles
-phrenic nerve (C3-C5) innervates diaphragm
ansa cervicalis
BOTH sensory and motor

90
Q

ansa cervicalis

A

C1-C3
in carotid triangle
innervates infrahyoid muscles involved in swallowing and larynx movement
btw strap muscles

91
Q

brachial plexus

A

rami from C5 to T1
innervates shoulder, axillary region, arm
sensory and motor

92
Q

organization of brachial plexus

A

roots: rami
trunks: superior, middle, inferior where the roots fuse
division: each trunk divides into anterior and posterior regions
cords: lateral, posterior, medial - refusion in diff combo
branches: peripheral nerves

93
Q

Brachial Plexus nerves

A
musculocutaneous
axillary 
radial
medial
ulnar
94
Q

musculocutaneous nerve

A

flexes upper arm (“make a muscle”)

95
Q

axillary nerve

A

lifting arm to show armpit, trying to elevate arm by shrugging

96
Q

radial nerve

A

goes down radial surface - supination and extension

when you put your arm out “here take this”

97
Q

medial nerve

A

comes down , only nerve to go through a tunnel (carpal tunnel)
to first 3.5 fingers
allows you to flex fingers and all of them move at once - grabbing things
can get inflamed, tendon is tough and does not give, tingling, numbness and pain from compressed nerve
- can get muscular atrophy thenar muscles rounded part near thumb

98
Q

ulnar nerve

A

flexes 4th and 5th fingers
bend pinky and other fingers go with it
goes all around ulnar when you hit funny bone you get tingling from this nerve

99
Q

lumbar plexus

A

rami from T12 - L4
innervates abdomen, skin on butt and genitalia, quadriceps, majority of adductors, majority of skin on thigh and leg

femoral and octurator

100
Q

lumbar plexus - femoral

A

L2-L4

innervates quads, hip flexors, some adductors, anteromedial skin of thigh, leg, foot

101
Q

lumber plexus - obturator

A

L2-L4

innervates adductors, and small area of medial skin of thigh

102
Q

sacral plexus

A

rami from L4-S4
innervates butt muscles, hamstrings, muscles of external genitalia and perineum, muscles of lower leg and foot, skin of posterior region of leg

sciatic nerve

103
Q

sciatic nerve

A

sacral plexus
L4-S3
innervates hamstrings, adductor magnus, branches extend to lower leg and foot

104
Q

Erb’s Palsy

A

common during baby delivery
injury to brachial plexus
cervical stingers or burners from football can lead to same thing
stretched nerve, ruptured, or evulsed
trouble grasping things - one arm droops one arm grasps in babies

105
Q

reflex arc

A

sensory info coming in, motor info going out

106
Q

reflex arc

A

sensory info coming in, motor info going outmo

106
Q

reflex arc

A

sensory info coming in, motor info going out

107
Q

monosynaptic reflex

A

sensory info directly to motor in spinal cord
stretch receptors - patellar reflex, achilles reflex
ALWAYS ipsilateral

108
Q

polysynaptic reflex

A

most common
ALWAYS has interneuron between sensory and motor
touch something and you pull your hand back
can be ipsilateral or contralateral
shifting weight in feet when walking - contralateral
ALL contralateral are polysynaptic