CNS Part 1 Flashcards by Hailey Haas

Somatic responsible for

Voluntary muscle movement

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Autonomic responsible for

Involuntary muscle movement. Mildly influenced by conscious thought

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Sympathetic

Fight or flight

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Parasympathetic

Rest and digest

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Afferrent

Info coming back into brain.

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Efferent

Info leaving brain to get a response

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General functions CNS 3

Sensory perception
Info processing, integration, storage
Motor and behavior

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White matter

What concentration of myelin
General number of neurons

High, few. Highly vascular

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Gray matter

High density of __ and ___. __ also present. Requires a lot of ___ and very ___

Neurons, dendrites, axons. ATP. Vascular

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Nucleus: a cluster of neurons ___ CNS

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Ganglion: cluster of ___ ___ the CNS

Neurons outside

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Cortex is ___ layers of ___

Dense, neurons

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Tract: ___ within CNS traveling as a ___

Example

Axons, group

Spine cerebellum

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Pathway

Similar to a ___ however it relates more to ___ connected neurons performing a ____

Tract, synaptically, function

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___ matter more metabolically active than ___ matter. Also more vascularized

Gray, white

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1st order neurons

2nd order neurons

Third order neurons

Dorsal root ganglion

Spinal cord

Thalamus

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Associated nerves with spinal cord: __ and __ __

Primary functions 3

Dorsal and ventral roots

Sensory input, reflex circuits, somatic and autonomic motor output

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The brain stem is composed of 3

Medulla, pons, midbrain

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The brain stem

Associated nerves

12 cranial nerves

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The brain stem primary functions:
Sensation and motor control of the __, __, and __
Input of special senses 3

Head, neck, and face

Taste, hearing, balance

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Brain stem primary functions

Mediate functions such as decreases __ and __, increased __ in gut, and pupillary ___

CO and BP
Peristalsis
Constriction

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Brain stem functions: a conduit of __ and __ pathways that carry __ and __ info to other areas in the __

Ascending and descending
Sensory and motor
CNS

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Reticular formation is part of __ __. Functions to __ __, exclude __ __, and regulate __

Brain stem
Filter info
Irrelevant stimuli
Arousal

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Medulla associated nerves: __-__
Functions: subconscious __ and __ control. Early relay nuclei in __, __, __, and __/__ input
___ reflexes

8-12
CV, respiratory
Balance, auditory, gestation, head/neck
Brain stem

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Pons: Nerves __-__ Functions: __ control, __ control, motor control of the __

5-8 Respiratory, urinary, eye

Pons functions: Sensation and motor control of the ___ Ventral: __ nuclei relay movement and sensation info from __ to __ Dorsal: __ and __

Face Pontine, cortex to cerebellum Taste and sleep

Midbrain Nerves __-__ Functions: __ relay and mapping. ___ movement, __ and __ reflexes

3-4 Acoustic, eye, lens and pupillary

Midbrain functions __ modulation Contains nuclei and relay pathways __ for __ coordination (ex in __ __)

Pain Critical, motor, substantia Nigra

Cerebellum Associated nerve: Functions: __&__ (___ input from __ __, __ __, vestibular organs of __ __)

VIII Coordination and equilibrium Somatosensory, spinal cord, cerebral cortex, inner ear

Cerebellum functions | ___ learning, __ association/___

Motor, sensory/language

``` Thalamus Assoc nerve: Functions: Sensory and motor relay between __ __ and __ __ regions __ modulation and gating ```

II Cerebral hemispheres, lower CNS Sensory

Thalamus functions Regulation of __ activation (__ and __) __ input

Cortical, attention, consciousness Visual

Hypothalamus functions __/__ control __ nucleus: ___ rhythms __ behavior: __ centers

Autonomic/endocrine Superchiasmatic: circadian Motivated: reward

Basal ganglia functions: Shapes patterns of __ motor __ Control of __ motor movements

Thalamocortical, inhibition Fine

Amygdala primary functions: | __ behavior and expression of __

Social, emotion

Hippocampus function

Memory

Cerebral cortex Associated nerve: Dependent on __ brain regions for __

I Lower, wakefulness

Cerebral cortex functions - __ __ lower brain functions - sensory ____ - __ and __

Fine tunes Perception Cognition and learning

Cerebral cortex functions Large ___ storehouse __ planning and __ movement ____

Memory Motor, voluntary Language

Grooves that allow brain to have more surface area 4 major lobes

Sulci Frontal, parietal, occipital, temporal

Frontal lobe: | -planning and carrying out __ behavior. __motor, ___ motor, and __ motor areas. __ __ field

Motor, pre, cingulate, supplementary, frontal eye

Frontal lobe: __ (__ area), from ___ frontal __ of dominant hemisphere __ and __ behavior (__ frontal lobe)

Speech, brocas, inferior, gyrus Personality and emotional, rostral

Parietal lobe: | -sensory __ and __ (__ cortex and __ __ cortex)

Perception and processing, somatosensory and parietal association

Parietal lobe: Projections to __ lobe carrying somatosensory info modulates __ __ behavior Parietal assoc cortex process ___ info from the __ lobe and sends projections to the __ lobe which influences motor behavior

Frontal, voluntary motor Visual, occipital, frontal

Parietal lobe __hemisphere sends somatosensory to ___ area Establishment of __ context in __ hemisphere

Dominant, wernicke's Spatial, nondominant

Occipital lobe __ perception and processing Projections to __ eye fields influence __ behavior of eyes Projection to the midbrain modulates __ eye movements, pupillary __, and ___

Visual Frontal, motor Convergent, constriction, accommodation

Temporal lobe Processing and perception of __ and __ info __ __ visual processing (__ recognition)

Sound and vestibular Higher order, facial

Temporal lobe __ __ transverse here A portion of ___ area (in __ region) __ behavior in __ region of lobe, __ system

Optic pathways Wernicke's, posterior Emotional, medial, limbic

Temporal lobe __ optic info from one region to another __ __ system regulation in __ region of lobe __ and __ from __

Transports Autonomic nervous, medial Learning and memory from hippocampus

More __ side is where their wernicke's area will be more dominant

Dominant

2 __ __ and 2 _ _ come into circle of Willis

Internal carotid arteries, vertebral arteries

Stroke in __ __ artery has more severe consequences because less __ __

Middle cerebral, collaterals flow

__ artery is a small artery Smaller vessels have higher __ __ _

Pial Cerebral vascular resistance

Atrocytes more important than just support. Take up __, protect neurons from __, influence __

Glutamate, cytotoxicity, tone

__ has good collaterals and won't suffer from BP drop as much as __ region of spinal cord

Cervical, lumbar

Artery of adamkiewicz supplies blood to __ __ of spinal cord. Comes off of __ at variable levels. Paraplegia can be caused if we don't know where this is when aorta __

Lower 2/3, aorta, clamped

1 __ artery supplies most of all of function that cord mediates except for __. More vulnerable than __ because less __ __

Anterior. Touch. Posterior, collaterals flow

Posterior cord supplied by __ __ __. Has __ control

2 spinal arteries, sensory

CBF vs cerebral blood vol Parallel but not __ relationship CBV: __-__ ml/100g brain tissue We care about flow because it influences total __ __ __

1:1 3-5 Cerebral blood volume

CBF vs CBV Consider not only arterial flow and __ but also ___ Obstruction to outflow can occur by __, __ vent with high __

Tone, venous Position, PP, PIP

``` ICP Normal __-__mmHg Rigid cranial vault __ volume Brain (__ and __) __% Blood (arterial and venous) __% CSF __% ```

``` 8-12 Fixed Cellular and ICF, 80 12 8 ```

Herniation risk when __ reduced and __ increased. May occurs from __ compensation mechanisms reaching __

CPP, ICP. Volume, exhaustion

If someone has high ICP need high __ to overcome pressure in brain

MAP

Intracranial elastance Determined by change in __ after a change in __ Compensatory mechanisms: 1. Initial displacement of CSF from __ to __ compartment 2. __ CSF absorption 3. Decreased CSF ___ 4. Decreased ___ (primarily __)

``` ICP, intracranial volume 1. Cranial to spinal 2. Increased 3. Production CBV, venous ```

Cerebral perfusion pressure __-__ (or __ whichever is greater) Normal is __-__ __ to actually find

MAP- ICP (CVP) 80-100 Rare

Cerebral blood flow Normal adult __ml/100g/min.= __ml/mi Blood flow closely linked with ___

50, 750 | Metabolism

Cerebral blood flow Factors affecting CBF during anesthesia __ agents, level of __, __ by products, blood __, ___, concentration of __ and __ ions, __

Anesthetic, arousal, metabolism, viscosity, temp, co2 and h, o2

Neuronal activity and local CBF __-__ coupling Metabolic by products from __,__,__

Flow metabolism | Glial, neuronal, vascular

Neuronal activity and CBF | CBF to __ brain regions change up to __-__% within __ in response to neuronal __ changes (__ input)

Localized, 100-150, seconds, activity, sensory

Co2 + h20= __ __ __ __ disassociates into __ H ions cause almost proportional ___ of cerebral vessels Other acidic metabolic substance can also __ CBF (__ and __ acid)

Carbonic acid Carbonic acid, h+ Vasodilation Increases, lactic, pyruvic

Each 1 mmHg change in paco2 leads to CBF change __-__ml/100g/min

1-2

Each 1 mmHg change paco2 CBV changes __ml/100g brain tissue. __ml difference for 15 mmHg change

0.5 10

Effect of increased paco2 lasts __ hours and then will return to normal despite maintenance of altered co2 levels due to __ transport

6, bicarb

Increased paco2 useful for anesthesia in short periods with __. Critical to see if a pt with ICP alterations has been hyperventilated for extended Period because of

VA Low o2 can cause ischemia

Brain metabolism - __% of body mass and __-__% of metabolism and cardiac output - cerebral metabolic rate (cmro2)= __-__ml/100g/min= __ml/min of o2 - peds cmro2= __ml/100g/min, mean age of __

2, 15-20 3-3.8, 50 5.2, 6

Brain metabolism Brain not capable of much __ metabolism (high metabolism coupled with low local __ and __ stores) Brain glucose consumption __mg/100g/min

Anaerobic, glucose, oxygen 5.5

CBF and o2 concentration -except for cases of intense brain activity o2 use remains within __ range. ___ml 02/100g brain tissue -if po2 of brain tissue drops below __mmhg (35-45 normal) or pao2 drops below __-__, CBF __

- narrow, 3.5 | - 30, 50-60, increases

Auto regulation of CSF and arterial BP - CBF auto regulated between map of __-__ mmHg - cerebral vasculature adjusts to changes in CBV/MAP in __-__ min - htn will shift to auto regulatory range to __ minimum values and maximums of __-__

70-150 1-3 180-200

Cerebral circulation has strong __ innervation especially in __ vessels Neither transaction of these nerves or mild stim causes much __. The auto regulation system __

SNS, larger Change, overrides

May shift auto reg curve to the ___. SNS __ role unless extreme __ rise (__ prevention). Or __ shock.

Right, minor, BP, stroke, hemorrhagic

CBF changes __-__% per 1 degree C change Hypothermia __ CBF and cmro2 Hyperthermia has __ effect Clinical evidence does not ___use of hypothermia

5-7 Decreases Opposite Support, 35

Decrease in HCT will __ CBF but __ o2 capacity of blood Severe ___ can reduce CBF

Increase, decrease Polycythemia

CSF is CNS __ system and protection from __ __

Lymphatic, mechanical force

Cavity enclosing brain and spinal cord has capacity of __-__ mls. __ml is CSF (rest brain and spinal cord), __ ml of CSF is in cerebral ventricles

1600-1700 | 125, 30

CSF formed by __ plexuses at __ml/min Reabsorbed by __ __ function like __ __ valves

Choroid, 0.35 Arachnoid villi, one way

Fluid flows when CSF pressure is __mmhg __ than venous pressure

1.5, greater

Lumbar CSF: NA, k, Cl

148 2.9 120-130

Lumbar CSF: glucose, protein, pH

50-75, 15-45, 7.3

Blood: Na, k, Cl

135-145, 3.5-5, 100-106

Blood: glucose, protein, pH

70-100, 6.8x10^3, 7.4

Part 1 Flow of CSF: from __ __ passes through __ foramina of __ to the __ ventricle. Additional fluid added and then it flows down along __ of __ to __ ventricle.

Lateral ventricles, intraventricular, Munro, third. Aqueduct of Sylvius, fourth

Part 2 flow CSF: more fluid added, goes out of fourth ventricle through 3 openings: __ lateral foramina of __ and a __ foramen of __ entering the __ __ which is continuous with __ space

Two, luschka, midline, magendie, cisterna magna, arachnoid

__ __ and __ __ __ are excluded from brain and spinal cord requiring active transport __ __ between CNS capillary endothelial cells. Fenestrations in brain __ of size in other areas __ also restrict movement by taking up K ions

Large molecules, high charged ions Tight junctions, 1/8th Astrocytes

Blood brain barrier exists in tissue capillary membranes in all areas of brain parenchyma except for __, __, and __ __

Hypothalamus, pituitary, area postrema

Movement across BBB depends on __, __, __ solubility, and degree of __ binding in the blood

Size, charge, lipid, protein

BBB Permeable: __, __, __, __, and __ Slightly permeable: 5 ions Impermeable: __ molecules, __ proteins, __ (facilitated diffusion only), non lipid soluble __ organic molecules like __

H20, co2, o2, anesthetics, etoh Na, Cl, k, ca, mg Polar, plasma, glucose, large, mannitol