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Flashcards in CNS Part 1 Deck (96):
1

Somatic responsible for

Voluntary muscle movement

2

Autonomic responsible for

Involuntary muscle movement. Mildly influenced by conscious thought

3

Sympathetic

Fight or flight

4

Parasympathetic

Rest and digest

5

Afferrent

Info coming back into brain.

6

Efferent

Info leaving brain to get a response

7

General functions CNS 3

Sensory perception
Info processing, integration, storage
Motor and behavior

8

White matter

What concentration of myelin
General number of neurons

High, few. Highly vascular

9

Gray matter

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

Neurons, dendrites, axons. ATP. Vascular

10

Nucleus: a cluster of neurons ___ CNS

In

11

Ganglion: cluster of ___ ___ the CNS

Neurons outside

12

Cortex is ___ layers of ___

Dense, neurons

13

Tract: ___ within CNS traveling as a ___

Example

Axons, group

Spine cerebellum

14

Pathway

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

Tract, synaptically, function

15

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

Gray, white

16

1st order neurons

2nd order neurons

Third order neurons

Dorsal root ganglion

Spinal cord

Thalamus

17

Associated nerves with spinal cord: __ and __ __
Primary functions 3

Dorsal and ventral roots

Sensory input, reflex circuits, somatic and autonomic motor output

18

The brain stem is composed of 3

Medulla, pons, midbrain

19

The brain stem
Associated nerves

12 cranial nerves

20

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

Head, neck, and face

Taste, hearing, balance

21

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

CO and BP
Peristalsis
Constriction

22

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

Ascending and descending
Sensory and motor
CNS

23

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

Brain stem
Filter info
Irrelevant stimuli
Arousal

24

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

25

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

5-8

Respiratory, urinary, eye

26

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

27

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

3-4

Acoustic, eye, lens and pupillary

28

Midbrain functions

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

Pain

Critical, motor, substantia Nigra

29

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

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

30

Cerebellum functions
___ learning, __ association/___

Motor, sensory/language

31

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

II

Cerebral hemispheres, lower CNS

Sensory

32

Thalamus functions

Regulation of __ activation (__ and __)
__ input

Cortical, attention, consciousness

Visual

33

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

Autonomic/endocrine

Superchiasmatic: circadian

Motivated: reward

34

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

Thalamocortical, inhibition

Fine

35

Amygdala primary functions:
__ behavior and expression of __

Social, emotion

36

Hippocampus function

Memory

37

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

I

Lower, wakefulness

38

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

Fine tunes

Perception

Cognition and learning

39

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

Memory
Motor, voluntary
Language

40

Grooves that allow brain to have more surface area

4 major lobes

Sulci

Frontal, parietal, occipital, temporal

41

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

Motor, pre, cingulate, supplementary, frontal eye

42

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

Speech, brocas, inferior, gyrus

Personality and emotional, rostral

43

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

Perception and processing, somatosensory and parietal association

44

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

45

Parietal lobe

__hemisphere sends somatosensory to ___ area

Establishment of __ context in __ hemisphere

Dominant, wernicke's

Spatial, nondominant

46

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

47

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

Sound and vestibular

Higher order, facial

48

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

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

49

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

50

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

Dominant

51

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

Internal carotid arteries, vertebral arteries

52

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

Middle cerebral, collaterals flow

53

__ artery is a small artery

Smaller vessels have higher __ __ _

Pial

Cerebral vascular resistance

54

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

Glutamate, cytotoxicity, tone

55

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

Cervical, lumbar

56

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

57

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

Anterior. Touch. Posterior, collaterals flow

58

Posterior cord supplied by __ __ __. Has __ control

2 spinal arteries, sensory

59

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

60

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

61

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

8-12
Fixed
Cellular and ICF, 80
12
8

62

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

CPP, ICP. Volume, exhaustion

63

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

MAP

64

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

65

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

MAP- ICP (CVP)
80-100
Rare

66

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

50, 750
Metabolism

67

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

68

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

Flow metabolism
Glial, neuronal, vascular

69

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

Localized, 100-150, seconds, activity, sensory

70

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

71

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

1-2

72

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

__ml difference for 15 mmHg change

0.5

10

73

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

6, bicarb

74

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

75

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

76

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

77

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

78

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

79

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

80

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

Right, minor, BP, stroke, hemorrhagic

81

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

82

Decrease in HCT will __ CBF but __ o2 capacity of blood

Severe ___ can reduce CBF

Increase, decrease

Polycythemia

83

CSF is CNS __ system and protection from __ __

Lymphatic, mechanical force

84

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

85

CSF formed by __ plexuses at __ml/min

Reabsorbed by __ __ function like __ __ valves

Choroid, 0.35

Arachnoid villi, one way

86

Fluid flows when CSF pressure is __mmhg __ than venous pressure

1.5, greater

87

Lumbar CSF: NA, k, Cl

148
2.9
120-130

88

Lumbar CSF: glucose, protein, pH

50-75, 15-45, 7.3

89

Blood: Na, k, Cl

135-145, 3.5-5, 100-106

90

Blood: glucose, protein, pH

70-100, 6.8x10^3, 7.4

91

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

92

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

93

__ __ 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

94

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

Hypothalamus, pituitary, area postrema

95

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

Size, charge, lipid, protein

96

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