Exam 5 Flashcards
(177 cards)
1
Q
which CN is affected with Bell’s Palsy
A
CN VII (facial)
2
Q
damage to CN VII leads to weakness on the _____ side of the face
A
ipsilateral
3
Q
what are the 2 major functions of CN VIII
A
balance and hearing
4
Q
what are the 3 functions of CN VIII auditory division in regards to our daily activities
A
orient head and eyes to sound
adjust arousal to sound
conscious awareness and recognition of sound
5
Q
what part of the brain adjusts our arousal to sound
A
reticular formation
6
Q
what part of the brain orients our head and eyes to sound
A
inferior colliculus
7
Q
what part of the brain gives us conscious awareness and recognition of sound
A
thalamus and primary auditory cortex
8
Q
Hearing loss can be either _____ or ______
A
Conductive
Sensorineural
9
Q
what is 2 of the biggest reasons for conductive hearing loss
A
wax or infection
10
Q
type of hearing loss that occurs either in the outer or middle ear where air is not conducted into water
A
conductive hearing loss
11
Q
type of hearing loss were there is a problem with the receptor cells. Can be an issue with peripheral sensory neuron (CN VIII) or damage to pathway inside the brain (central pathway)
A
sensorineural
12
Q
What are different types of CN VIII (vestibulocochlear) dysfunction
A
Hearing loss/deafness
Tinnitus
13
Q
ringing in the ear
A
tinnitus
14
Q
the (afferent) protector of the airway
A
CN IX (glossopharyngeal)
15
Q
what does CN IX innervate
A
soft palate pharynx posterior 1/3 of tongue (bitter taste) carotid sinus salivary gland
16
Q
CN IX is the ___ limb of the swallow/gag reflex
A
afferent
17
Q
detector or initiator of swallow reflex
A
CN IX (glossopharyngeal)
18
Q
CN X (vagus) is both afferent and efferent to 3 what places
A
pharynx
larynx
viscera
19
Q
executes the swallow reflex
A
CN X
20
Q
CN that moves your vocal cords through vibration
A
CN X
21
Q
S/S of CN X (vagus) dysfunction
A
difficulty speaking
hoarse voice
difficulty swallowing
asymmetric elevation of soft palate
Loss of efferent limb of gag & swallow reflexes
Poor digestion (can become constipated easily)
22
Q
When your patient speaks, his voice sounds hoarse. When you have him open his mouth and say, “Aah” you notice that the soft palate (back of the throat) does not elevate as usual. Damage to which of the following cranial nerves would most likely produce both of these signs?
A
CN X
23
Q
Function of CN XI (spinal accessory)
A
elevates shoulders and controls sternocleidomastoid (turns head)
24
Q
Function of CN XII (hypoglossal)
A
innervates extrinsic muscles of ipsilateral tongue
Especially important for speaking and swallowing
25
S/S of CN XII dysfunction
difficulty speaking (hard consonants not clearly articulated or any sound where tongue is pushed against palate)
difficulty swallowing
can't move food for chewing
tongue sticks out to weak side when asked to stick straight out
26
what CN are involved with the oral stage of swallowing
V (moves jaw up and down)
VII (closes the lips)
XII (moves food around to be chewed)
27
what CN are involved with the pharyngeal stage of swallowing
IX (detector of bolus to swallow)
| X (executes swallow reflex)
28
what CN are involved with the esophageal stage of swallowing
CN X (works bolus down throat)
29
difficulty swallowing
dysphagia
30
difficulty with mechanically producing speech
dysarthria
31
CN involved with larynx and soft palate for speech production
CN X (vagus)
32
CN involved with jaw in speech production
CN V (trigeminal)
33
CN involved with lips in speech production
CN VII (facial)
34
CN involved with tongue in speech production
CN XII
35
The most anterior piece of the brainstem that primarily has UMN axons and cell bodies of CN that have motor function
base
36
the back of the brainstem where axons of sensory function and the cell bodies of sensory associated cranial nerves
tegmentum
37
roof of the brainstem. Reflex movement
| of eyes. Plus reflex movement of head in response to sight and sound
tectum
38
as a group, what does the reticular formation do for us
Regulate consciousness and sleep/wake cycle
Regulate level of “arousal” within the central nervous system
Part of the descending pain control system that turns off pain in the dorsal horn of spinal cord
Provide autonomic control (control of “vital” and “visceral” functions)
Contain “non-specific” activating tracts that raise excitability of lower motor neurons in ventral horn of spinal cord.
39
as a group, where does the reticular formation project to
up to head, back to cerebellum, and down to spinal cord (back, side, and front)
40
what CN are geographically associated with the medulla
CN IX-XII (9-12)
41
Contains the cell bodies of neurons that go back to the cerebellum and tell the cerebellum what you meant to do
pons
42
what CN are geographically associated with the pons
CN 5-8
43
where do corticospinal UMN cross midline
bottom of pyramids
44
not only does the cerebellum coordinate movement, but what other 2 things does it do
helps plan movement (timing and targeting) and helps shift attention
45
what are the segments of the brainstem
cranial nerves
46
damage to the segments will produce ____ S/S
ipsilateral
47
damage to the vertical tract will produce ___ S/S
contralateral
48
what structure do the vertebral arteries lay over
pyramids
49
what CN might be damaged by a vertebral artery stroke
CN 9-12
50
where does the vertebral artery supply blood
corticospinal tract in pyramid (vertical tract)
medial lemniscus
cell bodies of hypoglossal (CN XII)
51
if you damage the medial lemniscus on the L, the patient will lose somatosensation on the __ side of the body
R
52
if the L brainstem is damaged, the ___ side of the tongue will be weak
L
53
if there were damage to the cerebellar pathways, it would produce ____ s/s
ipsilateral
54
if there were damage to autonomic control neurons, it would produce ____ s/s
ipsilateral
55
pattern of sensory and motor function for damage like a CVA leads to "face ___ side" and "body ____ side"
same, opposite
56
just for the ____ nuclei, there's one UMN that stays on the same side to help control eyes, eyebrows, and forehead
facial
57
one-sided weakness that is just the mouth, you can be confident that weakness is being caused by a ___ that damaged ___
CVA, UMN
58
if the entire side of the face is weak, you know that that is __ damage and is caused by ______
CN, Bell's Palsy
59
If CN ___ is damaged, all of one side of the face will be paralyzed
VII (facial)
60
Since some neurons in the reticular formation are autonomic control, what 3 changes might they see
HR, breathing, and BP regulation
61
A stroke in the vertebral artery would damage the hypoglossal nerve. What would be a sign of this?
dysarthria
62
what is the progression of consciousness (worst to best) seen especially with brain injury
```
coma
(persistent) vegetative state
minimally conscious state
stupor
obtunded
delirium
syncope
```
63
what 2 things will a tumor do
increase ICP and squeeze reticular formation
64
what is the hallmark of increased ICP
headache (esp that kind that wakes you up from sleep)
65
system that functions to keep us visually and physically steady in the world
vestibular system
66
the vestibular system contributes to maintenance of _____ and ______
balance, equilibrium
67
the vestibular apparatus has ______ canals
semicircular
68
what are the 3 semicircles of the semicircular canal
anterior, horizontal, posterior
69
semicircular canals are filled with ____ and contain _____ cells
water, hair
70
More action potentials are sent from the hair cells on the side you're turning _____, and fewer action potentials on the side you're turning _____ from.
toward, away
71
shaking your head "No" is what type of movement
angular
72
changes in _____ position make hair cells change their activity
head
73
action potentials go UP in the circle you're moving ____
toward
74
action potentials go DOWN in the circle you're moving _____
away from
75
how are seminarcular canals depolarized
angular/circular movement
acceleration
deceleration
76
part of your inner ear that has hair cells that signals action potentials when bent, but they are buried in jelly.
otolithic organs
77
crystals that sit on top of the jelly in otolithic organ.
otoconia
78
otoconia send ____ action potentials when pulled toward gravity
more
79
what depolarizes otoconia
gravity
linear movements
acceleration
deceleration
80
nuclei that help you maintain equilibrium
vestibular nuclei
81
what information (sensations) do vestibular nuclei receive
```
(every system that tells them how you're moving)
vestibular
vision
proprioception
tactile
auditory
```
82
what are the outputs of the vestibular nuclei
(every system that can keep you in equilibrium)
conscious awareness of head position and movement
eye movements
head movements
posture of head and body
(reticular formation) nausea and vomiting
(reticular formation) altered consciousness
cerebellum
83
what makes up the visual system
sight
eye movement control
sight information used in postural and limb movement control
84
part of the retina closest to the nose.
nasal retina
85
part of the retina closest to the temporal bone
temporal retina
86
Axons from nasal retina cross the midline here. This puts all information about the right side of space on the left side of the brain (and vice versa).
optic chiasm
87
help move the head when they get light information from the eyes
superior colliculi
88
Keep the eyes focused on an object of interest while the head is moving
gaze stabilization
89
Move the eyes to focus on an object of interest
direction of gaze
90
interaction between the inner ear and the eye muscles. This reflex adjusts the contraction of our eye muscles so that the eyes stay still while they head moves
Vestibulo-Ocular Reflex(es) (VOR)
91
reflex that helps to recenter your eyes on an object that's moving fairly slowly
optokinetic reflex
92
keeps your eyes steady while the head moves. Effectively, eyes move opposite in direction of head
VOR suppression
93
most powerful reflex for gaze stabilization
VOR suppression
94
consciously moving the eyes to follow a moving object while the head is still
smooth pursuit
95
jumps of the eye from one point of focus to another point of focus when the object is not moving
saccades
96
Involuntary back and forth movements of the eyes designed to keep the visual world as steady as possible when we’re moving (esp. turning or spinning)
nystagmus
97
s/s of disorders in the vestibular system
```
vertigo
nausea
nystagmus
dysequilibrium
vestibular ataxia
impaired gaze stabilization
```
98
What UMN are linked to vestibular apparatus
vestibulospinal neurons
99
peripheral disorder in the semicircular canals where 1 ear sends too many signals for the conditions
unilateral hyperfunction
100
damage to optic chiasm results in
bitemporal hemianopsia
101
one eye blindness leads to lack of _______ _______
depth perception
102
bitemporal hemianopsia leads to lack of _____ vision with _____ vision only
nasal retina (peripheral), temporal retina (central)
103
typically damage to the optic tract where all of the axons have been gathered that see 1/2 of visual space
Homonymous hemianopsia
104
disorder where 1/4 of the visual field is gone
Quandrantopsia
105
eye movements are associated with ___ nerves
cranial (III, IV, or VI)
106
hypofunction of vestibular system leads to
loss of gaze stabilization
107
hyperfunction of vestibular system leads to
nystagmus? (go back and check)
108
selective filter for cerebral cortex
thalamus
109
what are the relay nuclei of the thalamus that go to the cortex
sensory systems
basal ganglia
cerebellum
110
homeostasis coordinator. Part of the modulatory system of autonomic function.
hypothalamus
111
white fiber bundles that connect the R and L hemispheres in a side to side pattern
commissural fibers
112
largest commissural fibers
corpus callosum
113
white fiber bundles that go forwards and backwards within a hemisphere (can go from gyrus to gyrus or lobe to lobe)
association fibers
114
bundles of white matter that go up and down or in and out of head
projection fibers
115
largest projection fibers (every axon going into/out of head)
internal capsule
116
pyramids contain axons of what kind of cells
corticospinal cells (pyramidal cell)
117
part of the cortex that receives the sensory signal and does simple discrimination
primary sensory cortex
118
part of the cortex that makes meaning out of sensation
secondary sensory cortex
119
part of cortex that bring in all perception. Thinking parts of the brain that make meaning out of all of it.
association cortex
120
cortical area that discriminates shape, texture, or size of objects
primary somatosensory
121
cortical area that has conscious discrimination of loudness and pitch of sounds
primary auditory
122
cortical area that distinguishes intensity of light, shape, size, and location of objects
primary visual
123
cortical area that discriminates among head positions and head movements
primary vestibular
124
cortical area that functions in stereognosis and memory of the tactile and spatial environment
secondary somatosensory
125
cortical area that analyzes motion, color; control of visual fixation. Helps you name what you see.
secondary visual
126
cortical area that separates language from everything else and classifies sounds to give them meaning
secondary auditory
127
cortical area that helps to plan trunk and girdle movement, anticipatory postural adjustments
premotor area
128
cortical area that helps plan distal extremity movements. Organizes, sequences, and controls fine motor movements
supplementary motor area
129
cortical area that helps plan speech or how to say words
Broca's area
130
hemisphere that is dominant for language
L hemisphere
131
cortical area that plans the paraverbal and non-verbal aspects of speech
area analogous to Broca's in opposite hemisphere
132
what cells live in the precentral gyrus
corticospinal and corticobrainstem
133
cortical area that communicates with basal ganglia through executive loops. Setting goals, making plan to get there. Does divergent thinking
dorsolateral prefrontal association
134
cortical area that does sensory integration. It brings together all of your sensory information and makes meaning out of the whole thing. Does convergent thinking. Helps us understand spoken language and spatial relationships
parietotemporal association
135
cortical area behind eyebrows and above eyes loop with basal ganglia. Behind eyebrows is behavioral flexibility and control. Above eyes is limbic loop with basal ganglia. Controls mood and emotions, participates in motivation, socially appropriate bevaior, and gives you your personality.
Ventral prefrontal
136
short term subjective experience
emotion
137
sustained emotional response
mood
138
Damage to ______ cortex or its connections may reduce control over undesirable behaviors
orbitofrontal
139
When we’re under stress our _____ nervous system increases muscle tension
somatic
140
When we’re under stress our _____ nervous system shunts blood from skin & gut to muscles
autonomic
141
When we’re under stress our _____ system enhances cardiac function, relaxes intestines, increases metabolic rate
Neuroendocrine
142
How does cortisol help the "fight or flight response"
Mobilizes energy (glucose)
Suppresses immune system
Turns on anti-inflammatory system
Turns on “memory maker” cells (hippocampus)
143
What are the negative effects of chronic stress response
Increased blood sugar
Immunosuppression
Blood vessel changes
Damage to cells of the hippocampus
144
memory that maintains goal-relevant information for a short time
working memory
145
parts of brain that are connected with working memory
prefontrol cortex and parietotemporal cortex
146
explicit memory of facts, faces, dates, places
declarative memory
147
stages of declarative memory
```
Encoding
Consolidation
Synaptic
Systems
Retrieval
```
148
how is synaptic consolidation achieved
repetition
149
implicit memory of skills and habits
procedural memory
150
stages of procedural memory
Cognitive (“what to do”)
Associative (“how to do it”)
Autonomous (“do it”)
151
When does systems consolidation occur
sleeping
152
which hemisphere is dominant for language
L
153
the ability to put "bookmarks" in working memory
ability to divide attention
154
to pay attention to one stimulus and ignore the rest
selectively attend
155
what will be lost if the thalamus is damaged
contralateral somatosensation
156
if the internal capsule on one side of your body is damaged, what side will you lose motor function
contralateral side
157
damage to the brainstem leads to S/S face ____ side, body ____ side
same, opposite
158
MCA damage leads to S/S : face ___ side, body ____ side
opposite, opposite
159
people with basal ganglia damage would have trouble with
learning new tasks or executing old tasks (motor learning)
160
what will you lose if post central gyrus is damaged
discriminitive touch and conscious proprioception
161
how would you treat someone with a loss of proprioception
substitute another sensory system (i.e. vision)
162
If primary auditory area is damaged, what loss will occur
conscious localization of sounds and the ability to compare 2 ears
163
inability to identify and name something despite being able to see it and describe it
visual agnosia
164
inability to distinguish sounds even though you can describe them
auditory agnosia
165
inability to create and execute a motor program despite intact sensation, coordination, and strength
apraxia
166
Damage to dorsolateral prefrontal association results in
Loss of executive function
Loss of motivation and goal-directed behavior
Loss of divergent thinking (contrast with "convergent" thinking)
Loss of behavioral flexibility
167
Damage to parietotemporal association results in
Loss of problem solving (“convergent” thinking)
Disturbance of "receptive" communication (dominant hemisphere)
Difficulty interpreting the non-verbal and para-verbal aspects of communication (non-dominant hemisphere)
Difficulty comprehending spatial relationships (non-dominant hemisphere)
168
Damage to ventral and medial dorsal prefrontal association results in
Disturbances of personality and emotion
Impaired social judgment
Apathy
Lack of insight
169
abrupt mood shifts. Involuntary, inappropriate emotional expression in the absence of subjective emotion
emotional lability
170
loss of declarative memory
amnesia
171
aka PTA (post traumatic amnesia), amnesia for making new memories
anterograde
172
amnesia for things that have happened before/memory
retrograde
173
people with damage to basal ganglia may have what type of deficits in regards to memory
procedural learning deficits (calling up old motor plans)
174
expressive, non-fluent aphasia
Broca's aphasia
175
receptive, fluent aphasia
Wernicke's aphasia
176
the hypothalamus releases what 2 important ligands from the pituitary gland
beta-endorphin (pain reliever/feel good) and cortisol (mediates stress response)
177
what type of fibers make up the visual streams (dorsal and ventral)
association fibers going from lobe to lobe (long)
