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Flashcards in Exam 4 lectures NERVES Deck (75):
1

How did Abe Lincoln die?

the bullet passed through the occipital lobe of his cerebrum into the second ventricle (left lateral ventricle) causing his death

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The bullet stopped near the back of the left orbit

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How did Jon Wilkes Booth Die?

he died from a cavalry revolver severed his spinal cord between his 4th and 5th cervical vertebrae.  He then suffocated two hours later

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What is the Cerebellum responsible for?

controls balance

muscle movement

coordination

has two highly folded hemispheres connected by a thick band of nerves

referred to as 'little brain'

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chiari malformation

associated with inadequate room in the skull for the cerebellum.

this causes inferior projections of the cerebellum (cerebellar tonsils) to be be pushed out of the foramen magnum!

This leads to slowly developing symptoms of headache, nausea, muscle weakness, difficulty swallowing, impaired coordination and blockage of the normal flow of spinal fluid, particularly in the central canal of the spinal cord

1 per 1,000 births but likely higher

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how is chiari malformation treated?

decompressive surgery

involves removing the lamina of the first and sometimes the second or third cervical vertebrae and part of the occipital bone of the skull to relieve the pressure

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alternative way to treat chiari malformation

Cytoreduction of cerebellar tonsils using bipolar electrocautery

 have the cerebellar tonsils burned off by electrocautery to releive pressure

 

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reticular formation

loosely organized core of gray matter that projects vertically through the core of the midbrain, pons, and medulla.  

It also extends slightly into the diencephalon and the spinal cord as well

*has a motor and sensory component

network of nerves that are involved and spread through different parts of your brain

 

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reticular formation

motor component

communicates with the spinal cord and is responsible for regulating muscle tone (especially when the muscles are at rest)

also assists with the autonomic centers in the medulla and pons to help control respirations, blood pressure and heart rate

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reticular formation

sensory component

*reticular activating system

RAS

responsible for alerting the cerebrum to incoming sensory information

contains sensory axons that project to the cerebral cortex

responsible for maintaining a state of awareness or conciousness

what wakes you up in the morning

 

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what happens then the RAS (reticularing activating system) is traumatized by a blow to the head?

 

the person will become unconcious or perhaps go into a coma

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limbic system

 "emotional brain"

composed of structures that ring the diencephalon.

it exerts important influence upon the endocrine and autonomic motor systems

functions affect motivational and mood states (fear, happiness and sadness)

with odors, it can provoke certain emotions or memories

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rostrocaudal brain deterioration

can occur whenever there is increased pressure in the brain

occurs when the cerebrum pushes down through the tentorial incisure (tentorial notch) becuase of head trauma

bleeding, tumors, infections etc

 

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sequence of rostrocaudal brain deterioration

as pressure builds in the cranial cavity, about 50cc of CSF can be squeezed out of the cranium to allow more room

some blood can also be squeezed out, but this quickly leads to progressive loss of oxygen (hypoxia) which will then lead to increased brain swelling

Pressure on the RAS will soon lead to unconciousness

As the cerebrum pushes down on the midbrain, "decorticate posturing" (like holding a cord of wood) will occur

if not stopped, the crerbrum and midbrain will push down on the upper pons and "decerebrate posturing" (like a waiter with his arm at his side reaching for a tip) will occur, this is the last reversible phase 

as everything continues to shift caudally and compresses the lower pons and medulla brain death will occur, the cerebellum may even begin to herniate out the foramen magnum!

 

 

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how do you treat rostrocaudal brain deterioration

high flow oxygen

barbiturate-induced coma

diuretics

decompressive craniectomy

 

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Le Fort classified different fracture trends

classified as 

Le Fort I

Le Fort II

Le Fort III

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Le Fort I

 

Transverse fracture through the maxilla = upper teeth move.

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Le Fort II

 

Fracture of the maxilla, nasal bridge, lacrimal bones, orbital floor and rim = teeth and nose move.

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Le Fort III

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Craniofacial disjunction = whole face moves

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another name for stoke

cerebrovascular accident

CVA

 

*two-thirds of stoke victims die within three years

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another name for mini-stroke

Transient ischemic attack

TIA

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how do

cerebrovascular accidents (stokes)

occur?

 

formation of a thrombus (clot) in a cerebral artery that can lead to a cerebral "infarc" (local area of dying or dead tissue)

an intracerebral hemorrhage

a bulge in the wall (aneurysm) of a cerebral artery that ruptures

build up of fatty plaques in a cerebral arterial wall (atherosclerosis) that disrupts blood flow

 

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Peripheral Nervous System (PNS)

composed of cranial nerves and spinal nerves that relay information to and from the central nervous system (CNS)

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Cranial nerve

0

may be related to the sensing of pheromones

involved in regulating sexual behavior in mammals

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Cranial Nerve

I

responsible for our sense of smell

purely sensory and bypasses the thalamus

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Cranial Nerve

II

relays visual nerve impulses to the occipital lobes

purely sensory

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responsible for our temporal field of view

medial portion of the retina

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responsible for our nasal field of view

lateral portion of our retina

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such tumors can put pressure on the central portion of the optic chiasma where nerve fibers for the temporal view normally pass

pituitary tumor

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funduscopic examination of the retina is being performed

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controls certain extrinsic (outside muscles) and intrinsic muscles (inside muscles) of the eye

passes through the superior orbital fissure of the sphenoid bone

 

oculomotor nerve

(cranial nerve III)

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pressure on this can lead to inactivation of one, or both, oculomotor nerves

pressure on the tentorial incisure

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goes to a single muscle with a "pulley-like" arrangement to cause the eyeball to look downward and lateral

trochlear nerve

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has both motor and sensory functions in the face

has three divisions that serve defined regions of the face

damage or disease to the branch in one division will lead to problems in that one division

trigeminal nerve

(cranial nerve V)

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often done to temporarily deaden the second and third divisions of cranial nerve V

dental anesthesia

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stimulates the muscles of mastication: masseter, temporalis, and medial/lateral pterygoids

trigeminal nerve

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stimulates a single muscle that causes the eye to move laterally

abducens nerve

(cranial nerve VI)

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has both motor and sensory functions in the face

innervate the epicranius, buccinator, orbicularis oris, and the platysma

sweet taste detected by this nerve

facial nerve

(cranial nerve VII)

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created by the vestibular branch (which monitors equilibrium and balance) and by the cochlear branch (which is responsible for hearing) 

relays information to the brain so we can maintain balance and equilibrium

purely sensory nerve

vestibulocochlear nerve

(cranial nerve VIII)

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relays information to the auditory portions of the brain so we can hear

cochlear branch of cranial nerve VIII

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has motor functions for swallowing and the parotid salivary gland and sensory functions for taste from chemoreceptors on the posterior 1/3 of the tongue

glossopharyngeal nerve

(cranial nerve IX)

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the only cranial nerve to leave the regions of the head and neck

a parasympathetic nerve that reduces the activity of many visceral organs

(parasympathetic nerves inhibit all body systems, except for the digestive system where they have a stimulatory effect!)

also called "the wanderer"

vagus nerve

(cranial nerve X)

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the motor component of this nerve innervates most throat and larynx muscles

the sensory component recieves input from the external auditory canal and eardrum, throat, larynx, heart, lungs, esophogus, and most abdominal organs

vagus nerve

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arises from both the spinal cord and the brain

it innervates the trapezius and sternocleidomastoid muscles to move the head, neck, and shoulders

also innervates throat muscles to aid in swallowing

accessory nerve

(cranial nerve XI)

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nerve that innervates muscles of the tongue for swallowing and speech.  It is NOT involved in taste!

hypoglossal nerve

(cranial nerve XII)

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provides a vital link between the brain and the rest of the body, and yet  it exhibits some functional independence from the brain.

spinal cord

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travels from the foramen magnum and terminates within the vertebral foramen of the first lumbar vertebra (L1)

adult spinal cord

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spinal cord can be subdivided into five parts:

cervical part, thoracic part, lumbar part, sacral part, and coccygeal part (which has only one pair of nerves).

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spinal cord terminates at the level of the first lumbar vertebra (L1)

adult spinal cord

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can extend to the level of the second lumbar vertebra (L2)

developing child's spinal cord

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The tapering end of the spinal cord is called the

conus medullaris

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composed of nerves that arise from the conus medullaris and extend inferiorly.

cauda equina

(horse's tail)

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The diameter of the spinal cord is the largest in the

cervical part and there is a larger proportion of white matter compared to gray matter.

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is the smallest  and the proportion of gray matter is largest in the spinal cord

The diameter of the sacral part of the spinal cord (which is surrounded by the T12/L1 vertebrae)

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contains the neurons that innervate the upper limbs

cervical enlargement

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contains the neurons that innervate the lower limbs.

lumbosacral enlargement