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Neuro > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Choroid Plexus

A

-produces CSF
-web of capillaries
-blood filtered 3x

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2
Q

Lateral Ventricles

A

-above thalamus
-2
-connected to 3rd ventricle by inter-ventricular foramina (Monro)

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3
Q

3rd Ventricle

A

-surrounded by diencephalon
-connected to 4th ventricle via cerebral aqueduct (sylvius)

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4
Q

4th Ventricle

A

-behind pons/medulla
-connects to central canal of SC
-drains into subarachnoid space via foramina of Luschka and midline foramen of Magendie

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5
Q

Falx Cerebri

A

-dense projections in inner layer of dura
-separates 2 hemispheres

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6
Q

Tentorium Cerebelli

A

-dense projections in inner layer of dura
-separate cerebellum from cerebrum

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7
Q

Homunculus Motor Cortex

A

-Precentral Gyrus

Medial: Genitals, toes, ankle, knee

Superomedial: trunk, hip, shoulder, elbow, wrist, hand

Superolateral: Hand (fingers pinky-thumb), face

Lateral: Face (top to bottom), jaw (talking), tongue (swallowing)

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8
Q

Homunculus Sensory Cortex

A

-Postcentral gyrus

Medial: Genitals, toes, ankle, knee

Superomedial: trunk, hip, shoulder, head, arm

Superolateral: Hand (fingers pinky-thumb), elbow, forearm, wrist

Lateral: Face (top to bottom), jaw, tongue, gums, pharynx

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9
Q

Vertebrobasilar A.

A

-posterior circulation of brain

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10
Q

Posterior Inferior Cerebellar A. (Think of location)

A

-bottom, posterior cerebellum

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11
Q

Anterior Inferior Cerebellar A.

A

-front and bottom cerebellum

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12
Q

Superior Cerebellar A.

A

-top of cerebellum
-under CN III

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13
Q

Posterior Cerebral A.

A

-posterior cerebrum
-occipital lobe
-Posterior, medial, inferior temporal lobe
-above CN III

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14
Q

Internal Carotid A.

A

-anterior circulation of brain

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15
Q

Ophthalmic A.

A

eyes

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16
Q

Posterior Communicating A.

A

-connects PCerebralA and ICA
-connects 1 side of ant to post

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17
Q

Anterior Cerebral A.

A

-medial cerebral hemisphere to parietal lobe
-from ICA

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18
Q

Anterior Communicating A.

A

-between ant. cerebral A.

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19
Q

Middle Cerebral A.

A

-lateral cerebral hemisphere

EXCECPT:
-superior and front parietal
-inferior temporal

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20
Q

Vertebral A. Stroke

A

-prone to shear forces from AA joint from abrupt cervical rotation
-gait issues, ataxia, HA

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21
Q

Basilar A. Stroke

A

-complete blockage causes death
-partial: tetraplegia, numbness, CN damage, locked in syndrome (only movements)

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22
Q

Anterior Cerebral A. Stroke

A

-hemiparesis loss to contra side
-personality changes
-lower limb issues

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23
Q

Middle Cerebral A. Stroke

A

-hemiparesis loss to contra side
-face and upper limb issues

L side: aphasia
R side: spacial relationships, nonverbal communication

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24
Q

Posteror Cerebral A. Stroke

A

-midbrain issues (thalamic syndrome), eye movement issues, cortical blindness (brain cant comprehend vision)

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25
Q

Pontine Arteries

A

-supplies pons

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26
Q

Torcula

A

-confluence of sinuses
-drains straight sinus and sup. saggital sinus
-drains to sigmoid

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27
Q

Cavernous SInus

A

-drains from blood supply of face and brain
-drains to sigmoid

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28
Q

Superior and inferior Petrosal Sinus

A

-drains from cavernous sinus
-drains to sigmoid

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29
Q

Frontal Lobe

A

Voluntary Movement, language, higher level function

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30
Q

Parietal Lobe

A

Sensory perception, sensory integration (5 senses)

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31
Q

Occipital Lobe

A

-visual perception

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32
Q

Temporal Lobe

A

-auditory processing, vestibular, memory formation

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33
Q

Post central gyrus

A

-Primary sensory cortex
-proprioception
-sensory input

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34
Q

Pre central gyrus

A

-primary motor cortex
-voluntary movement of contralateral side

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35
Q

Central Sulcus

A

-boundary btwn motor/sensory and parietal/frontal lobes

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36
Q

Lateral Sulcus

A

-separates temporal from frontal and parietal lobes

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37
Q

Cerebellum

A

-coordinate movements

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38
Q

Pons

A

-unconscious processes
-sleep, breathings

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39
Q

Medulla

A

-vital processing (breathing, BP, HR)

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40
Q

Mammillary Bodies

A

-recollective memory

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41
Q

Fusiform Gyrus

A

-high level vision
-face perception, object recognition, reading

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42
Q

Inferior Olive

A

-learning and timing of movements and comparing them to intended movements

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43
Q

Pyramids and Decussation

A

-motor fibers that pass from brain to medulla oblongata
-SC nerves cross

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44
Q

Uncus

A

-olfaction
-emotions
-forming new memories

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45
Q

Parahippocampal Gyrus

A

-spatial awareness
-memory encoding

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46
Q

Midbrain

A

-vision, hearing, motor control, arousal, temperature regulation

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47
Q

Middle Cerebellar Peduncle

A

-connects cerebellum to pons
-largest
- contains afferent fibers

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48
Q

4th Ventricle

A

-protect brain
-form central canal

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49
Q

Inferior Colliculus

A

-sound localization
-pitch discrimination
-integration of auditory information

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50
Q

Superior Colliculus

A

-visual (directing eye movements), auditory processing for orienting toward environment , auditory, and somatosensory spatial information integration

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51
Q

Substania Nigra

A

-production of dopamine
-body movements
-part of basal ganglia
-on midbrain

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52
Q

Cerebral Peduncles

A

-refining fine motor movements
conversion of proprioceptive information into balance and posture

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53
Q

Gracile Fasciculus

A

-main touch pathway
-fine touch, vibrations, conscious proprioception
-lower body to brain stem

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54
Q

Cuneate Fasciculus

A

-only in cervical
-vibration and conscious perception and fine touch sensations from upper body

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55
Q

Gracile Nucleus

A

-medulla
-dorsal column nuclei
-fine touch sensation and proprioception of lower body

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56
Q

Cuneate Nucleus

A

-info from upper body
-medulla

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57
Q

Inferior Olivary Nucleus

A

-coordinate signals from SC to cerebellum to regulate coordination

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58
Q

Periaqueductal Grey Matter

A

-modulation and propagation of pain

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59
Q

Cranial Nerve Locations

A

Midbrain: CN III-IV
Pons: CN V-VIII
Medulla: CN IX-XII

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60
Q

CN I Exit Foramina

A

Cribriform plate

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61
Q

CN II Exit Foramina

A

Optic canal

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62
Q

CN III & IV & VI Exit Foramina

A

Superior orbital fissure

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63
Q

CN V Exit Foramina

A

V1: superior orbital fissure
V2: foramen rotundum
V3: foramen ovale

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64
Q

CN VII & VIII Exit Foramina

A

Auditory canal

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65
Q

CN IX & X & XI Exit Foramina

A

Jugular foramen

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66
Q

CN XII Exit Foramina

A

Hypoglossal foramen

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67
Q

CN I

A

Olfactory (sensory)
-smell (olfactory cortex: amygdala, parahippocampal gyrus, uncus, insula)
-only sensory input that reaches cortex before thalamus
1) cover 1 nostril and smell different

CI
Anosmia: loss of smell
-avulsion of olfactory fibers

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68
Q

CN II

A

Optic (sensory)
-visual acuity (visual cortex: occipital lobe)
Optic Nerve: from eyes
Optic Chiasm: crossing
Optic tract: to visual cortex
1) consensual contralateral light response (midbrain)
2) eye chart

CI
Homonymous Hemianopsia: damage in contralateral visual path results in ipsilateral 1/2 blindness

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69
Q

CN III

A

Oculomotor (motor)
-eye and eyelid movement
1) eye movements except lateral and down/in
2) consensual ipsi light response
3) cover eye and pupillary constriction of contra

CI
External Strabismus: ipsilateral eye fixed in abd

Ipsilateral ptosis: paralysis of upper eyelid

Diplopia: double vision

Mydriasis: Ipsilateral pupuil fully dilated

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70
Q

CN IV

A

Trochlear (Motor)
-ipsilaterally eye movement (down and in)
-only CN that exits dorsum of brainstem

1) H test

CI:
Cannot down and in
-double vision
-difficulty reading
-head tilt to opposite side

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71
Q

CN V

A

Trigeminal (Both)
V1: Opthalamic (sensory)
V2: Maxillary (sensory)
V3: mandibular (both)

Motor: clench jaw and feel masseter and temporalis

Sensory: check in forehead (ophamalic), checks (maxillary), and jaw (mandibular)

CI:
Corneal Blink Reflex
-tactile sensation on cornea
Trigeminal Neuralgia
-sharp pain in face

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72
Q

CN VI

A

Abducens (motor)
-lateral eye movements
-H test

CI:
-double vision

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73
Q

CN VII

A

Facial (both)
Motor: facial expression and salivary, stapedius of ear
Sensory: tongue and pharynx
Parasympathetic: salivary gland
Special Sensation: ant 2/3rd of tongue

Testing
-Motor:
1) smile
2) frown
3) move eyebrows

Sensory:
-close eyes and place sweet/salt on anterior 2/3rds of tongue

CI
Bell’s Palsy

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74
Q

CN VIII

A

Vestibulocochlear (sensory)
-hearing and vestibular

Hearing:
1) rub fingers together
2) whisper word identification
3) Weber Test: tuning fork on head
4) Rhine Test: tuning fork on mastoid

Vestibular:
1) touch nose then pt finger
2) turn head while looking at thumb

CI:
-vertigo, conductive or sensorineural deafness

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75
Q

CN IX

A

Glossopharyngeal (Both)
-Motor: stylopharyngeus
-Parasympathetic: parotid salivary gland, carotid a.
-Sensory: 1/3 pos tongue, soft palate, ear, gag reflex

Sensory:
1) sour/bitter taste on posterior 1/3 tongue

Motor:
1) swallowing

CI:
decreased gag reflex and salivation

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76
Q

CN X

A

Vagus (both)
Motor: larynx, pharynx, tongue, gag
Parasympathetic: decrease HR, bronchoconstriction, digesiton

Test
1) saw ah, uvula deviation to strong side
2)Swallowing

CI:
-hoarseness and swallowing difficulties, digestion issues

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77
Q

CN XI

A

Accessory (motor)
-SCM and trap
-Cell bodies in ventral horn of C1-C4
-travels through foramen magnum and exits jugular foramen

Test
1) shoulder shrug
2) head turning

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78
Q

CN XII

A

Hypoglossal (motor)
-tongue movements
-swallowing
-speaking

1) stick tongue out, deviates to weak side

CI:
-Dysphagia: difficulty swallowing
-Dysarthria: poor control of speech muscles
-LMN: flaccid tongue, deviates to weak
-UMN: tongue deviates to strong side

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79
Q

Thalamus

A

-interprets sensation information and perceives it

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80
Q

Name of Pathways

A

-origin and site of termination for 2nd order neruon

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81
Q

Types of Somatosensory Pathways to Brain

A

Conscious Relay:
-info about location and stimulus type to conscious awareness
-discriminative sensations

Divergent:
-info to many locations in brainstem and cerebrum
-conscious and non-conscious

Non-Conscious Relay:
-proprioceptive and other movement to cerebellum

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82
Q

Conscious Relay Pathways

A

-info about location and stimulus type to conscious awareness
-discriminative sensations
Crude Awareness: thalamus
Detailed Awareness: somatosensory cortex

Dorsal Column
Anterolateral Column

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83
Q

Divergent Relay Pathways

A

-info to many locations in brainstem and cerebrum
-conscious and non-conscious
-medial/slow nociception
-subconscious temperatue

Spinomesencephalic, spinoreticular and spino-emotional tracts

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84
Q

Non-Conscious Relay Pathways

A

-proprioceptive and other movement to cerebellum

Spinocerebellar Tracts

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85
Q

Descending Motor Fibers (2 types)

A

Pyramidal Tracts: cerebral cortex
Extrapyramidal Tracts: Brainstem

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86
Q

Flexor-Extensor Rule

A

-MNs that innervate flexors are located posteriorly to MNs that innervate extensors

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87
Q

Proximal-Distal Rule

A

-MNs that innervate distal muscles are located laterally to MNs that innervate proximal muscles

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88
Q

Lateral Corticospinal Tracts (function)

A

-crossed at pyramidal decussation of medulla
-fractionated movements
-primary motor cortex
-most CST fibers
-descends in lat funiculus

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89
Q

Medial Corticospinal Tracts (function)

A

-uncrossed
-postural movements
-originates from premotor cortex
-descends in venttral funiculus

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90
Q

Nonspecific Motor tracts

A

-facilitate activity of interneurons and MNs
-activate during intense emotions

Ceruleospinal and Raphespinal Tracts

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91
Q

Corticobrainstem Tracts

A

-voluntary control of many MM of head and neck
-originate in cortex motor areas and reach CN nuclei in brainstem

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92
Q

Secondary Somatosensory Gyrus

A

-post to primary
-processes info from primary and thalamus for stereognosis and sensory memory

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93
Q

Crista Gali

A

-separates olfactory bulbs

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94
Q

Cribiform Plate

A

Olfactory N.

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95
Q

Optic Canal

A

-optic N and ophthalmic A.
-loss of vision

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96
Q

Foramen Rotundum

A
  • Maxillary portion of Trigeminal
    -loss of function at maxilla
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97
Q

Foramen Ovale

A

-mandibular portion of trigeminal
-loss of function at mandible

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98
Q

Formamen Spinosum

A

-middle meningeal artery
-epidural hematoma

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99
Q

Foramen Lacerum

A

-filled with cartilage

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100
Q

Groove for Meningeal A.

A

-middle meningeal artery
-epidural hematoma

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101
Q

Grove For Petrosal Sinus

A

-sup. petrosal sinus
-improper drainage

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102
Q

Internal Auditory Meatus

A

-Facial N and Vestibularcochlear n
-Hearing loss and facial paralysis

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103
Q

Jugular Foramen

A

-CN 9,10,11
-int. jugular vein
-Loss of taste, uvula deviation, speech, neck muscles, bleeding out

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104
Q

Sulcus for Transverse Sinus

A

-transverse sinus
-improper drainage

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105
Q

Hypoglossal Canal

A

-Hypoglossal nerve
-weak tongue muscles

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106
Q

Foramen Magnum

A

-SC, vertebral arteries, Accessory N
-Death, paralysis

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107
Q

Sulcus for Superior Saggital Sinus

A

-sup. saggital sinus
-improper drainage

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108
Q

Superior Orbital Fissure

A

-Trigeminal N, opthalamic A, abducens N, occulomotor N, Trochlear N
-Loss of vision, pupil reaction, eye movements

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109
Q

Stylomastoid Foramen

A

-facial N
-Face paralysis and abnormal taste

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110
Q

Homonymous Hemianopsia

A

damage in contralateral visual path results in ipsilateral 1/2 blindness

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111
Q

External Strabismus

A

: ipsilateral eye fixed in abd

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112
Q

Ipsilateral ptosis:

A

paralysis of upper eyelid

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113
Q

Diplopia:

A

double vision

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114
Q

Mydriasis:

A

Ipsilateral pupuil fully dilated

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115
Q

Secondary Somatosensory Gyrus

A

-post to primary
-processes info from primary and thalamus for stereognosis and sensory memory

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116
Q

Dorsal Column Medial Leminiscus

A

-Ascending tract
-Light touch, proprioception, sterognosis

1st: Dorsal horn ganglion to FG or FC
2nd: Nucleus Gracilis or Cuneatus in Medulla

CROSS with Internal Arcuate Fibers at Medial Leminiscus
3rd: Thalamus to PSSC

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117
Q

Anterolateral System

A

-ascending tract
-crude touch
Anterior: crude touch
Lateral: Fast nociception and temp

1st: Dorsal root ganglion to DH

CROSS at Anterior Commissure

2nd: Anterior commisure and travels up LST to thalamus
3rd: Thalamus to PSSC

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118
Q

Medial Nociception

A

-dull/slow pain
-ascending, divergent pathway

1st: C fibers with free ending in DH

CROSS

2nd:
Spinomesencephalic: Sup. colliculi and periaqueductal grey

Spinoreticular: Reticular Formation

Spinoemotional: Cortex
-reaches consciousness

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119
Q

Dorsal Spinocerebellar

A

-ascending, LE, uncrossed
-Nonconsious postural movements
-coordination and proprioception

1st: DRG to via FG Clark’s Nucleus
2nd: Up DPT through Inferior Cerebellar Peduncle to Cerebellum

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120
Q

Ventral Spinocerebellar

A

-ascending, LE, crossed, bilateral
-Nonconsious postural movements
-coordination and proprioception

1st: Anterior Hron
CROSS
2nd: Up VPT through Superior Cerebellar Peduncle
CROSS to Cerebellum

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121
Q

Cuneocerebellar

A

-ascending, UE, uncrossed
-Nonconsious postural movements
-coordination and proprioception

1st: DRG to Nucleus Cuneatus
2nd: Up NC through Inferior Cerebellar Peduncle to Cerebellum

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122
Q

Rostrospinocerebellar

A

-ascending, UE, uncrossed
-Nonconsious postural movements
-coordination and proprioception

1st: DRG to Superior Cerebellar Peduncles to cerebellum

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123
Q

Medial/Ventral Corticospinal Tract

A

-automatic trunk movements, uncrossed
-pyramidal

Premotor cortex > internal capsule > Cerebral Peduncle (midbrain)> FG> medial/anterior horn

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124
Q

Lateral Corticospinal Tract

A

-voluntary limb mmts
-pyramidal

Primary Motor Cortex> internal capsule> Cerebral peduncles (midbrain)>crosses at decussation of medulla>FC>lateral horn

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125
Q

Corticobulbar Tract

A

-facial movements
-Pyramidal

Primary motor cortex> cerebral peduncles> crosses a lot at CNs> exits cervical ventral horn

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126
Q

Reticulospinal Tract

A

-extrapyramidal
-postural and gross movements (walking), extensors

Reticular formation in Pons>FG>ventral horn

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127
Q

Vestibulospinal Tract

A

-extrapyramidal
-postural and vestibular movements
Medial: head and neck motions to maintain position
Lateral: limb and trunk reactions to gravity

Vestibular Nuclei in Pons and medulla>lateral column>ventral horn

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128
Q

Spinal Cord I Zone

A

-dorsal horn
-marginal zone

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129
Q

Spinal Cord II Zone

A

-Dorsal horn
-Substantia gelatinosa

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130
Q

Spinal Cord III Zone

A

-dorsal horn
-Nucleus proprius

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131
Q

Spinal Cord IV Zone

A

-dorsal horn
-Nucleus proprius

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132
Q

Spinal Cord V Zone

A

-Dorsal horn

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133
Q

Spinal Cord VI Zone

A

-dorsal horn

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134
Q

Spinal Cord VII Zone

A

-intermediate zone
-Clark’s nucleus

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135
Q

Spinal Cord VIII Zone

A

-ventral horn
-commissural nucleus

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136
Q

Spinal Cord IX Zone

A

-ventral horn
-motor nuclei

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137
Q

Spinal Cord X Zone

A

-grey matter
-Grisea centralis

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138
Q

Glia Cells

A

-non-neuronal cells
-supportive, homeostasis, regulation

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139
Q

Neuron function

A

Reception, integration, transmission, and transfer of information

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140
Q

Bipolar Neurons

A

-1 dendrite, cell body and 1 axon
-sensory

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141
Q

Pseudounipolar Neurons

A

Dendrites, axon and cell body on side
-motor

142
Q

Multipolar Neurons

A

Multiple dendrites
-interneurons
-most common

143
Q

Macroglia

A

-larger supporting cells
-Astrocytes
-Oligodendrocytes
-Schwann Cells

144
Q

Microglia

A

-immune for CNS
-phagocytes

145
Q

Astrocytes

A

-macroglia cells in CNS
-support, signal, nutrtients

146
Q

Oligodendrocytes

A

-macroglia cells in CNS
-create myelin

147
Q

Schwann Cell

A

-PNS macroglia
-support PNS and make myelin
-does all the job

148
Q

Local Potential

A

-small, graded
-occurs in receptor or synapse
-spreads passively

149
Q

Action potential

A

Large “all or none”
-depolarizing

150
Q

Resting Membrane Potential

A

-70mV

151
Q

Ion Cell Distribution at Rest

A

More Na+ outside, more K+ inside
-Extracellular positive charge outside
-Intracellular negative charge inside
-more permeable to K+M

152
Q

Movement of K+ during AP

A

-diffuses down concentration gradient and towards negative charges
-chemical gradient force out, electrical gradient force in

2K+/3Na+

153
Q

4 Membrane Ion channels

A

Leak (non-gated): small amount leak, K+

Modality-gated: Sensory neurons only; mechanical, temp or chemicals

Ligand-gated: opens when stimulated by neurotransmitters

Voltage-gated: opens when reaction; Ca+

154
Q

Movement of Na+ during AP

A

-moves through leaky channels and then voltage gated negative charges

2K+/3Na+

155
Q

Spatial Summation

A

I…..I……I……I

156
Q

Temporal Summation

A

AP combine to form a large AP.
-Build up of multiple excitatory waves merging

157
Q

Depolarization

A

-voltage gated channels release Na+ into cell
- polarity becomes positive

158
Q

Repolarization

A

-Na+ channels close, K+ voltage channels open and release to the outside of the cell

159
Q

Hyperpolarization

A

K+ gates remain open and cause hypo
-90mV

160
Q

Absolute Refractory Period

A

completely unresponsive to stimuli
-Na+ has not reset yet

161
Q

Relative Refractory Period

A

May respond to higher stimuli
-Most Na+ resets

162
Q

Factors Influencing AP

A

-diameter of axon, larger=faster
-myelin, more=faster
-temperature, warm=faster

163
Q

Nodes of Ranvier

A

-site of saltatory conduction
-location of AP generation and depolarization
-high density of voltage gated ion channels

164
Q

Conduction Speeds of fibers

A

large myelinated: PNS sensory and motor

Thin unmeylinated:
-short axons in grey matter in CNS
-visceral ANS axons
-pain fibers

165
Q

Muscle Cell AP vs neuron

A

-90mV RMP
-AP 1-5msec
-18x slower than neuron

166
Q

Presynaptic Terminal

A

-neuron conducting impulse toward synapse
-feet
-release neurotransmitters/neuromodulators

167
Q

Postsynaptic terminal

A

-dendrite or cell body receiving neurotransmitter

168
Q

Axosomatic Synapse

A

-synapse that binds to cell body of another nerve
-local membrane potential

169
Q

Axoaxonic Synapse

A

-synapse that binds to axon of another nerve
-1st neuron activates second
-presynaptic effects

170
Q

Axodendritic

A

-synapse that binds to dendrite of another nerve
-local membrane potential

171
Q

Steps of Synaptic Transmission

A
  1. AP comes to presynaptic terminal
  2. Presynaptic membrane depolarizes and releases Ca+
  3. Ca+ causes vessicles to exocytose neurotransmitters
  4. Neurotransmitter binds to postsynaptic receptor
  5. Postsynaptic receptor opens ion channel or triggers intracellular messengers
172
Q

Excitatory Postsynaptic potential (EPSP)

A

-local depolarization with Na+ or Ca+ into neuron
-facilitates AP generation
-common throughout CNS and PNS

173
Q

Inhibitory Postsynaptic Potential (IPSP)

A

-local hyperpolarization with K+ out of neuron

174
Q

Presynaptic Facilitation

A

-1st presynaptic neuron (Axoaxonic) releases neurotransmitters that attaches to 2nd neurotransmitter (axosomatic) and slightly depolarizes it to releases Ca+

175
Q

Presynaptic Inhibition

A

-1st presynaptic neuron (axoaxonic) causes slight hyperpolarization to decreased Ca+ released from 2nd neuron (axosomatic)

176
Q

Neurotransmitters

A

-fast
-released from synapse
-EPSP and IPSP
-ms to mins

177
Q

Neuromodulators

A

-extracellular space
-alter gene expression, open iono channels, change metabolism, affects many neurons
-mins to days

178
Q

Ligand-Gated Ion Channels

A

-fast response
-aka ionotropic receptor
-some excitatory and inhibitory
-inactivate due to lack of neurotransmitter and resorption

179
Q

Guanine Nucleotide Binding Protein Activation of Ion Channels

A

-alters electrical excitability or neurons
-Neurotransmitter being to G protein and alter the shape
-Internal subunit breaks away and binds to membrane ion channel to change shape and open
-slower than ligand

-Mood disorders, Parkinson’s, Alzheimer’s

180
Q

Agonist

A

-drugs the bind to receptors and copy actions of neurotransmitter

181
Q

Antagonists

A

-drugs that block postsynaptic neurotransmitter
-drugs that inhibit release of neurotransmitter in presynaptic neurons

182
Q

Acetylcholine (Ach)

A

-Neurotransmitter produced in basal forebrain above eyes and midbrain (at top of brainstem)

-Skeletal Muscles: Ach for neuromuscular junctions for muscle contraction. Blocking: causes weakness, fatigue, paralysis

-Autonomic NS: slows HR, constricts pupils

-Brain: Arousal, pleasure, cognitive function, movement and attention. Pleasure seeking behaviors and alzheimers

183
Q

Glutamate

A

-amino acid principal fast neurotransmitter of CNS
-Neural changes w/ learning and development (neuroplasticity)

Excessive:
-excitotoxiciity and neuron death
-seizures

Associated with
-chronic pain, Parkinson’s, schizophrenia, neuron death, stroke

184
Q

GABA

A

-Glycine and y-aminobutyric acid
-animo acid primary inhibitory neurotransmitter that prevent excessive neural activities in CNS (downers)

Glycine: inhibits postsynaptic in brainstem and SC

Low Levels:
-seizure, involuntary muscle contractions, anxiety

185
Q

Huntington’s Disease

A

-causes loss of neurons that use GABA
-causes jerky, involuntary movements and cognitive decline

186
Q

Dopamine

A

-amine neurotransmitter produced in substantia nigra of the brain
-affects motor function, cognition, and behavior, reward seeking behaviors (good for eating, bad for addiction)
-2nd messenger systems

Abnormalities seen in:
-Parkinson’s: not enough dopamine; bradykinesia, treat with precursor
-Schizophrenia: signalling pathways, treat with drugs that prevent binding

Excessive:
-drug abuse by preventing reuptake of presynaptic terminals

187
Q

Norepinephrine

A

-amine neurotransmitter produced in brainstem, hypothalamus, and thalamus
-released by neurons of ANS and adrenal glands
-fight or flight

Excessive:
-fear, panic, PTSD
-beta blockers to treat

Low:
-sleeping
-depression

188
Q

Serotonin

A

-amine neurotransmitter involved with mood, pain, arousal, and motor acitivities

High
-alert and during REM

Low
-depression

189
Q

Opioid Peptides

A

-endogenous: endorphins, enkephalins, dynorphins
-produced in NS and bind to receptors for opium
-receptors in SC, hypothalamus, brainstem to inhibit pain

190
Q

Substance P

A

-peptide that stimulates nerves at injury site

Neurotransmitter: acts on CNS to cary info to brain

Neuromodulator:
-pain syndromes
-hypothalamus and cerebral cortex during long duration excitation
-modulate immune activity during stress

191
Q

Ways to Restrict of # Receptors

A

-internalize receptor
-inactivate receptor

192
Q

Increase of # receptors

A

-infrequent activate
-low levels of neurotransmitters

193
Q

Lamber-Eaton Syndrome

A

-antibodies damage Ca channels in presynaptic membrane
-no Ach release
-muscle weakness

194
Q

Myasthenia Gravis

A

-antibodies damage receptors on muscle cells
-Ach released but cannot bind
-muscle fatigue
-life threatening

195
Q

Pre-Embryonic Stage

A

0-14 days
-Inner cell mass of cells becomes embryonic disc
-endoderm and ectoderm

196
Q

Embryonic Stage

A

15dy- 8wks
-3 layers

197
Q

Ectoderm

A

-NS
-epidermis

198
Q

Mesoderm

A

-CS
-Excretory sys
-dermis
-muscles
-skeleton

199
Q

Endoderm

A

-Respiratory sys
-organs

200
Q

Fetal Stage

A

8wks - Birth
-myelination starts

201
Q

Neural Tube Development

A

18-26 days
-Neural groove done at 21d
-closes at cervical 1st
-Superior neuropore closes at 27d

Inner layer
-grey matter
-dorsal horn: sensory
-ventral horn: motor

Outer layer
-white matter

202
Q

Somites

A

-appear in occiput first, the caudally

Anteromedial: vertebrae and skull
Posteromedial: muscles of myotome
Later: dermis/dermatome

203
Q

Conus Medullaris

A

-end of SC
-l1-l2

204
Q

Cauda Equina

A

-individual nerves extending at end of SC
-starts at L1-L2

205
Q

Filum Terminale

A

-connection of meninges at end of SC

206
Q

SC Growth

A

-stops at 4-5
-vertebral column stops at 16-18y

207
Q

Grey and White Matter

A

SC:
Grey: outside, unmyelinated
White: inside, myelinated

Brain:
Grey: inside, unmeylinated, cell bodies
White: outside, myelinated

208
Q

Brain Development

A

Hindbrain: brainstem (w/o midbrain), 4th ventricle

Midbrain: cerebral aquaduct

Forebrain
Posterior: Diencephalon
Anterior: telencephalon (cortex, white matter, lateral ventricles

209
Q

Abnormal Neck and reflexes

A

-Asymmetric tonic reflex
-Symmetric tonic reflex
-Tonic labyrinth reflex

210
Q

Neural Tube Defects

A

-Anencephaly: head does not develop
-Chiari Malformation: foramen magnum contains part of brainstem
-Spina Bifida
-Tethered cord syndrome: filum terminale is stretched

211
Q

Geriatric Cognition

A

-decreases everywhere
-long term memory and procedural are stable
-retention of new info stable but needs more cues
-visual recognition of objects are stable
-decrease in vocabulary

212
Q

Atypical Cognition Aging

A

-mood changes
-visual-spacial changes
-memory changes
-difficulty communicating

213
Q

Mild cognitive impairment

A

-do not interfere with ADLS (unlike dementia and Alzheimer’s)
-90% develop alzheimer’s
-gradual, opposite of learning

214
Q

Causes of Aging Changes

A

-25% of motor neurons die
-myelin fragmented
-less dendrite density, less neurotransmitters, less synapses
-shrinkage

215
Q

3 Neuron Pathways

A

1st: sensory receptor to SC or BS
2nd: SC or BS to thalamus
3rd: Thalamus to cerebral cortex

216
Q

Stimulus

A

-when applied to a receptor, triggers graded membrane potential
-determines type of receptors activated

217
Q

Receptor

A

-converts stimulus into AP
-specialized and responds only to specific stimulus type and intensity

218
Q

Conduction

A

AP travels to CNS

219
Q

Translation

A

CNS receives, integrates info, prepares response

220
Q

Receptor Morphology

A

-different shapes/functions of receptors

Simple Receptors: unmyelinated, free nerve endings

Complex Neural receptors: myelinated, nerve endings enclosed in connective tissue

Special Senses Receptors: Myelinated, release neurotransmitters onto sensory neurons

221
Q

Special Senses Receptors

A

-somatic: tactile, thermal, pain, proprioceptive
-Visceral: internal organs

222
Q

Exteroceptors

A

-near body surface
-external stimuli

223
Q

Interoceptors

A

-deep
- comes from body
-BP, blood pH, proprioception

224
Q

Nociceptors

A

-occur in all receptors that are sensitive to stimuli that either damage or have damage potential
-can take a scenic route instead of going to the brain

225
Q

Proprioceptors

A

-muscles, tendons, ligaments, tendons
-position and kinesthetic sense

226
Q

Photoreceptors

A

-vision

227
Q

Tonic Receptors

A

-respond continuously if stimulus remains
-slow adapting
-detect object pressure (static)

Book laying on hand

228
Q

Phasic Receptors

A

-adapt to continuous stimulus and then stop responding even with stimulus
-fast adapting
-motion, vibration, rate of change

Wearing glasses, clothing on body

229
Q

Afferent Axon diameter decreasing diameter

A

Ia, Ib, II, III, IV
AB, ADelta, C

230
Q

Sensory neuron receptive field

A

-area of skin innervated by 1 afferent nerve
-smaller fields with greater densiy distally, more sensitivity
-larger fields proximally, less sensitivity

231
Q

Cutaneous Receptors

A

Superficial, subcutaneous, mechanoreceptors (AB), Free nerve endings (Adelta & C)

-all go to the same peripheral nerve bundle

232
Q

Superficial Cutaneous Receptors

A

-small receptive field, epidermis and dermal palpalae
-Meisner’s Corpuscles: light touch, vibration (superficial)
-Merkel’s Discs: pressure (deeper)

233
Q

Subcutaneous Cutaneous Receptors

A

-large receptive field, dermis
-Pacinian Corpuscle: touch, vibration (deeper)
-Ruffini’s ending: stretch (more superficial)

234
Q

Mechanoreceptors

A

-light touch, vibration, stretch, pressure
- AB fibers

235
Q

Free nerve endings

A

-ADelta & C fibers
-course touch, pain, temperature

236
Q

Conduction

A

-3rd step of sensory system

Determinants:
-Modality: specialized stimulation
-Location
-Intensity: # and frequency of activated receptors
-Duration

237
Q

Signal Integration Levels

A

3 Levels
-Receptor Level: normal receptor/stimulus interaction; more stimulus more reaction
-Circuit level
-Perceptual Level

238
Q

Circuit Level of Integration

A

-Divergence: synapses spread AP to several areas of CNS
-Convergence: synapses can focus action potentials from several sensory neurons on narrowed area

239
Q

Perceptual Level of Integration

A

-sensory tract caries impulse to respective region of the brain
-testing comes in to determine what level of integration is faulty

240
Q

Nerve Conduction Velocity Tresting

A

Electrical stimulation to peripheral nerves (NCV)
Looks at
-Distal latency: time from stimulation to distal recording sight (testing myelination)
-Amplitude: # of axons conducting
-Conduction Velocity: indication of myelin

Somatosensory evoked potentials (SSEP)
-tests peripheral and central pathways
stimulation at distal sight recording proximally

241
Q

Clinical Implications : Peripheral Nerve Lesions

A

-neuropathy
-Nerve compression: large first then small

Order of sensory loss
-proprioception and light tough
-cold
-fast pain
-heat
-slow pain

242
Q

Clinical Implications : Sensory Ataxia

A

-injury to dorsal column, roots, or nerves
-EC vs EO testing

Cerebellar: cannot adapt, same with EC/EO, intact proprioception

Sensory: can adapt with EO/EC, impaired proprioception

243
Q

Clinical Implications : Varicella Roster

A

-Shingles
-painful rash in dermatome pattern
-chicken pox remains dormant in sensory ganglia then travel to nerve endings

244
Q

Nociceptive Pain

A

-acute or chronic tissue injury stimulates nociceptors to become perception of pain

245
Q

Non-Nociceptive pain

A

-malfunction of neural pain without the presence of injury
-neuropathic pain, central sensitivity, pain syndromes

246
Q

Pain Control

A

Central Processing:
-cingulate and insula during perception of pain

Endogenous Opioids:
-endorphins bind to opiate receptors

Spinal Cord:
-inhibitory neurons
-enkephalin and dynorphin

Segmental Level of Control:
-Gate control theory
-non nociceptive fibers closes a gate for nociceptive fibers

247
Q

Pain inhibition (at each level)

A

Periphery: decreases prostaglandins,
-Gate control theory: non nociceptive fibers closes a gate for nociceptive fibers

Dorsal Horn: release enkephalin or dynorphin

Brainstem: descending system

Hormonal System: pituitary gland and periaqueductal grey

Cortical Level: prefrontal, insular, and cingulate lobes
-spinolimbic, spinomesencephslic, and spinoreticular tracts

248
Q

Referred Pain

A

-visceral tissues to skin
-convergence of nociceptive and somatic info

249
Q

Chronic Pain

A

Disease (Primary pain):
-no biological function or tissue damage
Ex: fibromyalgia, migraines

Symptom (secondary pain):
-symptom of another condition
-continuous stimulation of nociceptors from tissue injury
-even after healing
-damage to somatosensory system

250
Q

Central Sensitization

A

-CNS responds excessively to continuing nociceptive input
-cause changes to cells reactiveness
-pain top-down regulation disturbed

251
Q

Paresthesia

A

-abnormal sensation
-dysfunction of neurons

252
Q

Neuropathic Pain

A

-pain from direct lesion or disease
-Dysesthesias

253
Q

Dysesthesias

A
  • abnormal sensation that can occur on it’s own or from stimulation

Allodynia, hyperalgesia, spontaneous pain, temporal summation

254
Q

Allodynia

A

pain caused by something that normally doesn’t cause pain

255
Q

Hyperalgesia

A

-Primary: excessive sensitivity to normal pain
-Secondary: pain spreads to uninjured areas

256
Q

Spontaneous Pain

A

pain unrelated to external stimulus

257
Q

Temporal Summation

A

-increased pain due to repeated stimulus

258
Q

Fibromyalgia

A

-tenderness and stiffness of muscles and tissues
-widespread pain
-increased pain without stimuli

259
Q

Complex Regional Pain Syndrome

A

-not related to nerve or nerve root distribution
-affects distal limb
-abnormal response to trauma
-central sensitization with functional changes in brain

Sx: red or pale skin, edema, stiff joints, muscle atrophy, tremors

260
Q

Nonspecific Low Back Pain

A

-no specific injury
-muscle guarding and abnormal movements

261
Q

Ectopic Foci

A

-cause pain
-outside of nociceptors and become unmyelinated, increasing sensitivity to stimuli

262
Q

Ephaptic Transmission

A

-Cross Talk
-lack of insulation due to demyelination that allows 1 action potential to affect more than 1 neuron
-cause for allodynia

263
Q

Structural Reorganization

A

-long term central sensitization causes CNS rewiring
-new synapses carry more nociceptive information

264
Q

Small Fiber Neuropathy

A

Partial central sensitization cause by :
-post-herpetic neuralgia: shingles
-diabetes
-gulliain barre syndrome (polyneuropathies)

265
Q

Phantom Limb Sensations

A

-sensations related to posture, length, and movement of missing limb

Residual Limb Pain:
-easier to treat then Phantom limb pain

Phantom Limb Pain:
-absence of sensory inputs causing nociceptors to be overactive

266
Q

PT Clinical Implication (chronic pain)

A

-considered psychosocial aspects of chronic pain
-Consider: distress, disuse, and disability

267
Q

Muscle Spindle Components

A

-on skeletal muscles to sense stretch

Intrafusal Muscle in non-contractile regions
-Dynamic nuclear bag (1a, dynamic y)
-Static Nuclear Bag (1a, II, static y)
-Nuclear Chain (1a, II, static y)

Large Diameter myelinated sensory receptors
-central regions of fibers

Small Diameter myelinated motor endings
-innervate polar contractile regions

268
Q

Extrafusal Muscle Fibers

A

Outer skeletal muscle that generate movement by attaching to tendon

269
Q

Intrafusal Muscle Fibers

A

Inner skeletal muscles that form spindle
-non-contractile
-proprioceptors (length and velocity)

270
Q

Nuclear Bag Fibers

A

Type of Intrafusal Fibers
-centrally located
-large

Static

Dynamic

271
Q

Nuclear Chain Fibers

A

Type of intrafusal fiber
-smaller
-length dependent
-activate alpha motor neurons

272
Q

Ia Fibers

A

-primary sensory endings on muscle spindle
-phasic and tonic discharges
-changes to length

273
Q

IIa

A

-secondary sensory endings
-tonic discharges
-responds to steady state length

274
Q

Gamma Motor Neuron

A

-regulate sensitivity of muscle spindle fibers
-innervate polar regions and stretch
-motor supply to intrafusal fibers

Dynamic: innervate dynamic NB, increase sensitivity of Ia

Static: innervate NB and NC, increase tonic activity both, decrease dynamic sensitivity Ia

275
Q

Alpha-Gamma Co-activation

A

Gamma: innervate polar regions and initiate stretch causing; mechanical gated channels to depolarize on intrafusal fibers

Alpha: …. contract the muscle to maintain length-tension relationship

276
Q

Reciprocal Inhibition

A

-1 muscle contracts and opposing muscle is inhibited

  1. Intrafusal fiber senses stretch
  2. Info travels to dorsal horn
  3. Interneuron
    4.Travels to ventral horn
  4. Opposite muscle
277
Q

Golgi Tendon Organ

A

-proprioceptive structures at junction between muscle fibers and tendon
-sensitive to stretch in tendon/contraction of muscle
-innervated by Ib fibers that send AP to

278
Q

GTO Motor Control

A

-afferent signal from GTO relaxes muscles OR activates muscles depending on receptors and feedback

279
Q

Motor Neuron Pools

A

-clusters MNs in SC
-innervate a single muscle

Medal MN: innervate axial and proximal limb muscles, laterally, distal

Ventrally MN: innervate extensors and dorsal flexors

280
Q

Small MNs

A

-innervate slow twitch fibers
-less force
-long periods of time

281
Q

Large MNs

A

-fast twitch fibers
-large forces
-fatigue quickly

282
Q

Rate Coding

A

-MN signals amount of force exerted by muscle

283
Q

Size Principle of MNs

A

-smaller MNs are recruited and fire before larger
Ohm’s Law: V=IR (voltage= current x resistance)

284
Q

Transverse Tube

A

(T-tube)
-surrounds sarcoplasmic reticulum and propagates

285
Q

Sarcoplasmic Reticulum

A

-released acetylcholine
-stores Ca+

286
Q

Z Line

A

-fibrous disc at end of each sarcomere

287
Q

M line

A

-holds together fibers at sarcomere center

288
Q

Titin

A

-maintains actin/myosin positions to prevent them from being pulled apart

289
Q

Troponin

A

-calcium binding causes tropomyosin to move and uncover sites on actin

290
Q

Muscle Tone

A

Resistance to stretch of a muscle

291
Q

Muscles immobilized in shortened position

A

-lose sarcomeres

292
Q

Muscles immobilized in lengthened position

A

Gain sarcomeres

293
Q

Phasic Stretch Reflex

A

-DTR
-muscle contraction in response to quick stretch
-monosynaptic

294
Q

Cutaneous Withdrawl Reflex

A

-monosynaptic
-response to pain, withdrawal/flexion before consciously aware of pain

295
Q

Muscle Cramps

A

-painful contractions due to overstimulation of nerve tracts

296
Q

Fasciculations

A

-fast twitches of all motor fibers in a MU
-eyelash twitching

297
Q

Myoclonus

A

-brief contractions of a group of muscles

298
Q

Tremors

A

-involuntary rhythmic movements
-with movement or at rest

299
Q

Polio and post-polio syndrome (types)

A
  1. normal MU
  2. death of selected MUs
  3. Neuroplasticity cause giant motor units
  4. Muscle fatigue and pain
300
Q

CN of PNS

A

I and II

301
Q

Order of Nerve Naming (CNS to PNS)

A

Rootlets
Root
Spinal Nerve
Rami
Peripheral Nerve

302
Q

Axoplasm

A

-transports nutrients and chemicals
-allows nerves to glide
-becomes viscous when stationary

303
Q

A-Alpha Nerve Fibers

A

-fastest and thickest
-Muscle spindles and golgi, touch, MNs

304
Q

Ia Nerve Fibers

A

-fastest and thickest
-muscle spindle

305
Q

A-Beta Nerve Fibers

A

-2nd thickness and speed
-touch, muscle spindle

306
Q

A-Gamma Nerve Fibers

A

-3rd thickest
-touch, pressure, gamma MNs

307
Q

Ib Nerve Fibers

A

2nd-thickness
-golgi tendon organs

308
Q

II Nerve Fibers

A

3rd thickest
-touch, muscle spindle

309
Q

III

A

-pain, crude touch, pressure, temp
-touch, muscle spindle

310
Q

A-delta Nerve Fibers

A

-pain, crude touch, pressure, temp

311
Q

B Nerve Fibers

A

-preganglionic autonomic

312
Q

C Nerve Fibers

A

-slowest, thinnest
-pain, crude touch, pressure, temp
-postganglionic autonomic

313
Q

IV Nerve Fibers

A

-Slowest, thinnest
-pain, crude touch, pressure, temp

314
Q

Cervical Plexus

A

-C1-C4

315
Q

Lumbar Plexus

A

-L1-L4

316
Q

Sacral Plexus

A

-L5-S4

317
Q

Peripheral Neuropathy

A

-any disease of peripheral nerves

318
Q

Mononeuropathy

A

-single nerve involvement

Traumatic Myelinopathy:
-repeated mechanical pressure and myelin gets damaged
-carpal tunnel

Traumatic Axonopathy:
-crush injury or fracture
-can regrow if schwann and myelin remain (1mm/day)

Severance:
-poor prognosis
-wallerian degeneration within 3-5dy

319
Q

Polyneuropathy

A

-symmetric involvement
-distal to proximal distribution

Small fibers:
-pain, temp, numb loss

Large fibers:
-ataxia, proprioception loss

320
Q

Guillain-Barre Syndrome

A

-acute inflammatory demyelinating polyradiculoneuropathy
-occurs after viral infection
-motor issues
-can recover

321
Q

Spinal Levels Traveling Caudally

A

-L2-S5

322
Q

Medial Dorsal Rootlets

A

-Ia and AB for fine touch and proprioception

323
Q

Lateral Dorsal Rootlets

A

-AGamma and c fibers for pain and temp

324
Q

Propriospinal Tract

A

-only in SC
-surround grey matter

325
Q

Tract Cells

A

Long axon cells

326
Q

Clark’s Nucleus

A
  • T1-L3
    -proprioceptive info to cerebellum
327
Q

Substantia Gelatinosa

A

-glial and small nerve cells
-spinothalamic

328
Q

Lateral Horn

A

-T1-L2
-cell bodies of pregangilonic SNS neurons

329
Q

Preganglionic PNS Cell Bodies

A

-S2-S4

330
Q

Epidural Space

A

-L3-L4

331
Q

Order of Spinal Arteries

A

-Anterior Spinal Artery
-Segmental A.
-Segmental Marginal A
-Radicular A.

332
Q

Mmt of SC

A

-stretches 10% with flexion
-none for Cauda

333
Q

Jendrassik’s Maneuver

A

-changes descending input to alter motor function

334
Q

Central Pattern Generators

A

-Rhythmic activity patters generated by central circuits without external cues
-locomotion, swimming, breathing, swallowing, urinating

335
Q

Stepping Pattern Generators

A

-type of GPG for walking without cortical output
-flexor-extensor activation using proprioceptive information
-has to be activated

336
Q

Withdrawal Reflex

A

-remove noxious input by activating remaining LE to prevent falling
-crossed extension reflex

337
Q

Reciprocal Inhibition

A

-inhibits activated of antagonist while turning on agonist

338
Q

Recurrent Inhibition

A

-inhibit agonist and synergist muscles to turn on antagonist
-Renshaw cells

339
Q

SC Control of Bladder and Bowel

A

-afferent into needed
-T11-L2 and S2-S4

Frontal Cortex: tells pons to empty OR corticospinal tract to contract PF muscles

Pons: Sends signals to sacral cord center to contract bladder

Sacral Cord: signals parasympathetic neurons to contract bladder and relax sphincters

340
Q

SC Control of Sexual Function

A

Psychogenic processes: L1-L2
Reflexogenic Processes: S2-S4
Pudenal: L1-L2 and S2:S4 for orgasm

Injuries
-Above T12: loss of erection and genital sensation, reflexive erections
-L2-S2 intact circuits: normal function, no sensation
-S2-S4 circuit lesion: nothing

341
Q

Segmental SC Injuries

A

-dermatomal or myotomal patters

342
Q

Vertical Tract Impairments

A

-ipsi/contra deficits below lesion

343
Q

Anterior Cord Syndrome

A

-A. Spinal Artery issue

-Paralysis, analgesia, loss of discriminative sensation, loss of temp below lesion

-Keep proprioception and light touch (DCML)

344
Q

Central Cord Syndrome

A

-trauma induced

Small Lesion: pain and nociception impaired at level of lesion

Large Lesion: pain and nociception impaired at level of lesion AND UE motor issues

345
Q

Brown-Sequard (Hemicord) Syndrome

A

Ipsilateral segment:
-paralysis and analgesia of everything

Ipsilateral Below:
-Paralysis and loss of proprioception and light touch

Contralateral Below:
-nociceptive and temp impaired

346
Q

Cauda Equina Syndrome

A

-sensation impaired, pain, LE paralysis, bowel/bladder
-no hyperreflexia

347
Q

Tethered Cord Syndrome

A
  • stretch injury, scar tissue
    -LE, bowel/bladder, spine issues

Ant. Cauda equina: LMN
Excessive stretch: UMN

348
Q

Spinal Shock

A

-24h-3wks
-all reflexes, function and autonomic regulation lost
-end with return of anal reflexes

349
Q

Post-Traumatic SC Injury

A

-hyperexcitability and hyperreflexia
-more sensation
-poor thermoregulation
-orthostatic hypotension
-dysreflexia

350
Q

SC Bowel/Bladder Dysfunction

A

S2-S4: flaccid a-reflexive bladder

Above S2-S4: hyperreflexive bladder
-reflex emptying or spasms that cause urine to backflow into kidneys

351
Q

SC Injury and Sexual

A

Neuro (30 decks)

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