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Neuro Test 2 > Brain 1 > Flashcards

Brain 1 Flashcards

1
Q

What are the functions of the cerebrum?

A 
Sensory perception
Voluntary movement
Memory
Thought
Reasoning
Emotion
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2
Q

What separates the left from the right hemisphere?

A

The central fissure

Or longitudinal fissure

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3
Q

What type of matter is the cortex?

A

Grey matter

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4
Q

What is a Gyrus?

A

A convolution in the cortex (upper ridge)

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5
Q

What is a sulcus?

A

A shallow groove in the cortex

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6
Q

What is a fissure?

A

A deep groove in the cortex

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7
Q

What is the corpus callosum?

A

A tract of white matter that connects the 2 hemispheres

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8
Q

What are the 4 lobes of the cerebrum?

A

Frontal
Parietal
Occipital
Temporal

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9
Q

What are the functions of the frontal lobe?

A

Motor
Personality
Judgement

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10
Q

What is the precentral gyrus? Where is it located?

A

The primary motor cortex

On the gyrus directly anterior to the central sulcus in the frontal lobe

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11
Q

What are the functions of the parietal lobe?

A

Sensory perception

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12
Q

What is the postcentral gyrus? Where is it located?

A

The primary sensory cortex

The gyrus directly posterior to the central sulcus in the parietal lobe

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13
Q

What is the cortical homunculus

A

Pictographic representation of the sensory and motor distribution of the cerebral cortex

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14
Q

What are the functions of the temporal lobe?

A

Auditory functions

Inputs from the ear

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15
Q

What is Wernicke’s area? Where is it located?

A

Part of the temporal lobe where recognition of spoken and written word occur

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16
Q

What are the functions of the occipital lobe?

A

Vision

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17
Q

What is the tentorium? Where is it located?

A

A dural fold that separates the occipital and temporal lobe from the cerebellum

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18
Q

What catastrophic event can occur with the tentorium?

A

It can tear

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19
Q

Where are the speech and language centers USUALLY located? Why?

A

In the left hemisphere because they are located in the dominant side and most people are left dominant (= right handed)

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20
Q

What is Broca’s area? Where is is located?

A

Broca’s area is responsible for the motor function for speech. It is located in the frontal lobe

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21
Q

What is beneath the cerebral cortex (grey matter)

A

White matter - myelinated axons

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22
Q

What 3 functions can the myelinated axons beneath the cortex carry out?

A

Association fibers carry information within one hemisphere.
Commissural fibers carry information between hemispheres.
Projection fibers carry information on ascending and descending tracts.

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23
Q

What is the basal ganglia? Where is is located?

A

Clusters of (paired) grey matter within the mater matter of the cortex

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24
Q

What are the functions of the basal ganglia

A

Crude motor

Unconscious contraction of skeletal muscles

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25
Q

Name 2 diseases of the basal ganglia

A

Parkinson’s

Huntington’s

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26
Q

What structures does the diencephalon consist of?

A

Thalamus
Hypothalamus
Pituitary
Epithalamus

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27
Q

Where is the diencephalon located and what does it surround?

A

It is located between the hemispheres and it surrounds the third ventricle

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28
Q

What are the functions of the thalamus?

A

It is the relay center for all sensory information except smell
General awareness of sensation

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29
Q

Where does the thalamus relay sensory information to?

A

To the appropriate area in the cortex for further processing.

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30
Q

What are the functions of the hypothalamus?

A

Regulates visceral activities: cardiovascular, temperature
Water and electrolyte balance - contains the osmotic sensors and thirst center
Hunger
Emotions
Sleep/wakefulness
Endocrine functions

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31
Q

How is the pituitary connected to the hypothalamus?

A

By the stalk infundibulum

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32
Q

What is another name for the anterior pituitary

A

Adenohypophysis

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33
Q

What is another name for the posterior pituitary? Why is it called this?

A

Neurohypophysis. Because neurons connect the hypothalamus to the posterior pituitary

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34
Q

What is the sella turcica?

A

A saddle shaped depression in the sphenoid bone where the pituitary sits

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35
Q

What is the clinical significant of the sella turcica?

A

Give surgical access to the pituitary

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36
Q

What are the functions of the limbic system?

A

Emotional response

Apex also includes olfaction, behavioral activities and memories

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37
Q

What components are included in the brainstem?

A

Midbrain
Pons
Medulla

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38
Q

What important structure in contained in the midbrain and what is it’s purpose?

A

The cerebral aqueduct. It connects the 3rd and 4th ventricle

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39
Q

What nuclei is contained within the midbrain?

A

Cranial nerve nuclei

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40
Q

What important centers are in the Pons?

A

Respiratory centers:
Apneustic
Pneumotaxic

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41
Q

What neuclei are contained in the pons?

A

Cranial nerve nuclei

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42
Q

What structure contains white matter fiber tracts that cross forming striations or “pyramids” that are the reason motor and sensation crosses in the brain?

A

Medulla

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43
Q

What important centers are located in the medulla

A

Cardiac - receives signals from the hypothalamus
Vasomotor center
Respiratory centers - DRG and VRG
Sneeze, swallow, cough, vomit

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44
Q

How are inhibitory signals sent to the medulla?

A

Via the vagus nerve

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45
Q

How are excitatory signals sent to the medulla?

A

Via T1-T4

46
Q

What is the reticular activating system

A

A diffuse complex network of fibers in the brainstem

47
Q

What kind of information does the reticular activating system receive?

A

Sensory information

48
Q

What does the reticular activating system signal

A

The cortex into wakefulness

49
Q

What occurs with absence of RAS function

A

Unconsciousness and unaware

50
Q

What is believed to produce hypnosis by depressing the RAS

A

General anesthetics

51
Q

Where is the cerebellum

A

Below the tentorium (and occipital lobe)

52
Q

Describe the structure of the cerebellum

A

2 hemispheres

Outer grey cortex with deeper white matter

53
Q

What are the functions of the cerebellum

A

Equilibrium
Tone
Coordination of skeletal muscle contraction

54
Q

What are cranial fossa?

A

Depressions on the inside of the skull that align with structures of the brain

55
Q

What does the anterior fossa cover

A

Frontal lobe

56
Q

What does the middle fossa cover

A

Temporal lobe

57
Q

Where are the anterior and middle fossa located

A

Supratentorial

58
Q

What does the posterior fossa cover

A

Brainstem and cerebellum

59
Q

Where is the posterior fossa located

A

Infratentorial

60
Q

Describe the lateral ventricle(s)

A

There are 2, one in each hemisphere
Lined with ependymal cells
Contains CSF - most CSF is created here

61
Q

How many ventricles are there?

A

4

62
Q

Where is the third ventricle located

A

In the diencephalon

63
Q

Where is the fourth ventricle located

A

Brainstem

64
Q

What is the interventricular foramina?

A

The foramina of Monroe - there are 2

They connect the lateral ventricles with the third ventricle

65
Q

What is the cerebral aqueduct?

A

Aqueduct of Sylvius

It connects the third ventricle with the fourth ventricle

66
Q

What are the foramina of Lushka

A

There are 2

They connect the fourth ventricle with the subarachnoid space

67
Q

What is the foramen of Magendie

A

There is one

It connects the fourth ventricle with the subarachnoid space

68
Q

What is the purpose of CSF

A

Performs lymph-like functions

Cushions, buoys the CNS

69
Q

Describe the production of CSF

A

It is continually produced by the ependymal cells in the choroid plexus of the ventricles (mostly the lateral ventricles). It is ultrafiltration of plasma that uses active transport

70
Q

How much CSF is there at any given time

A

100-150 mL

71
Q

Starting in the lateral ventricle, describe the flow of CSF

A

Lateral ventricle
Interventricular foramina - foramina of Monroe
Third ventricle
Cerebral aqueduct - aqueduct of sylvius
Foramina of Lushka and Foramen of Magendie
Fourth ventricle
Subarachnoid space

72
Q

What is the cisterna magna

A

Is a space located behind the cerebellum in the posterior fossa, it communicated with the fourth ventricle via the foramina of Lushka and foramen of Magendie

73
Q

Where does CSF circulate

A

Through the subarachnoid space

74
Q

How is CSF reabsorbed

A

Into arachnoid villi

75
Q

Where does CSF go once absorbed by arachnoid villi

A

The arachnoid villi project into the dural venous sinuses

76
Q

How much CSF is produced each day

A

500 mL

77
Q

What is the normal CSF pressure

A

10-15 mmHg

78
Q

What is the significant of saying villi act like valves

A

The more pressure in the CSF the more the “valves” will open and allow more to be reabsobed. They also keep it flowing in one direction

79
Q

What usually causes CSF pressure problems

A

Blocked reabsorption

Formation of CSF is rarely a problem

80
Q

What can block reabsorption of CSF

A

RBC
Infection
Tumor

81
Q

What is communicating hydrocephalus

A

CSF flows normally from ventricles into the subarachnoid space
There is a problem with absorption - blockage of arachnoid villi or blockage of subarachnoid space

82
Q

Where does CSF collect with communicating hydrocephalus

A

Inside the ventricles AND outside of the brain within the subarachnoid space

83
Q

What is another name for communicating hydrocephalus

A

Non obstructive hydrocephalus

84
Q

What is non-communicating hydrocephalus

A

CSF flow is blocked within the ventricles

85
Q

Where does CSF collect with non-communicating hydrocephalus

A

In the ventricles behind the obstruction

86
Q

What is another name of non-communicating hydrocephalus

A

Obstructive hydrocephalus

87
Q

What is a common treatment for hydrocephalus

A

Ventriculo-peritoneal shunt

Excess fluid is shunted to the abdomen and absorbed by the peritoneum

88
Q

What is Craniosynstosis

A

Premature closure of the cranial sutures

89
Q

What the the problem with carniosynostosis

A

Increased ICP

90
Q

When must correct occur for craniosynostosis

A

Surgical correction before 1 year of age

91
Q

What else can occur with carniosynostosis

A

Other craniofacial abnormalities causing a difficult airway

92
Q

During surgical correction of craniosynostosis what should you monitor for

A

blood loss
Hypothermia
VAE

93
Q

What creates the blood brain barrier

A

Capillaries in the brain do not have pores between adjacent endothelial cells- tight junctions

94
Q

What cell maintains the BBB

A

Astrocytes

95
Q

What other substance maintains the BBB

A

Endogenous steroids

96
Q

What areas of the brain does the BBB not exist

A

Areas called circumventricular organs:
Part of the hypothalamus
Pineal gland
Area postrema

97
Q

What substances are highly permeable at the BBB

A

water
CO2
O2
Lipid soluble substances like alcohol and anesthetics

98
Q

What is slightly permeable at the BBB

A

Electrolytes

99
Q

What substances is the BBB almost impermeable to

A

Non-lipid soluble substances like proteins, non lipid soluble drugs

100
Q

What are the anesthesia implications of the BBB

A

Besides drug sensitivity in crossing the BBB

If the BBB is disrupted by trauma or surgery, this allows increased cerebral edema

101
Q

What is often given to patients with known BBB disruption

A

Steroids

102
Q

What type of fluid is preferred with neuro and why

A

Isotonic fluid that does not contain dextrose. Dextrose is metabolized and leaves free water behind

103
Q

Why else is glucose bad with cerebral events

A

High serum GLU at time of cerebral event worsens resulting neuro deficits

104
Q

What is a general rule with fluids and neuro sx

A

Limit fluids but maintain hemodynamics

105
Q

Compare crystalloids to colloid use with altered BBB

A

Theoretically the colloid pressure could draw in more fluid

106
Q

What alters the BBB

A 
Surgical manipulation or retraction
Renal failure to the point of uremia
HTN crisis
Seizures
Cerebral hypoperfusion
Extremes of age
107
Q

What are the 3 components of anesthesia

A

Immobility/paralysis
Blunted stress response
Unconsciousness

108
Q

How is unconsciousness defined

A

Only negatively:
Absence of wakefulness
Absence of memory
Absence of awareness

109
Q

Define reactive

A

Unconscious, responsive to stimuli

110
Q

Define aware

A

Conscious, responds to command

111
Q

Define recall

A

Forms memory of an event

112
Q

Are awareness and recall related

A

Maybe, maybe not

Awareness is the conscious ability to respond, recall is the memory of that response. We have seen one without the other

Neuro Test 2 (4 decks)

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