Final Flashcards
(239 cards)
1
Q
what does the cerebrum control
A
the frontal lobe
2
Q
4 fxns of the frontal lobe
A
executive fxn
attention
personality
problem solving
3
Q
frontal lobe contains what 2 cortices
A
motor
premotor
4
Q
where is Broca’s area located
A
frontal lobe
5
Q
what does Broca’s area control
A
speech formation
6
Q
what major cortex does the parietal lobe contain
A
somatosensory
7
Q
what does the central sulcus separate
A
frontal and parietal lobes → motor/sensory cortices
8
Q
what is Broca’s aphasia
A
lack of fluency of speech
preserved language comprehension
repetition
disordered syntax
9
Q
occipital lobe contains what major cortex
A
visual association areas
primary visual cortex
10
Q
major fxn of the temporal lobe
A
auditory association area
Wernicke’s area → language comprehension
11
Q
what lobe houses the limbic system
A
inferior portion of the temporal lobe
12
Q
5 functions of the limbic system
A
- emotions
- memory
- feeding
- mating
- homeostatic regulation → ANS and endocrine
13
Q
contents of the limbic system
A
hippocampus
amygdala
cingulate gyrus
thalamus
epithalamus
mammary body
14
Q
hippocampal damage causes
A
failure to convert short term memory to long term memory
15
Q
basal ganglia include
A
- lentiform nucleus (globus pallidus, putamen)
- caudate nucleus
- substantia niagra
- subthalamic nucleus
16
Q
the internal capsule is responsible for transmitting
A
motor and sensory fibers from the cortex to the brain stem and spinal cord
17
Q
a small stroke to the internal capsule causes
A
extensive changes to motor fxn
18
Q
the thalamus is responsible for
A
processing and relaying sensory information from the body to the cortex →
sleep/awareness
consciousness/arousal
motor role as well
19
Q
what is the control center for the ANS
A
hypothalamus
20
Q
what is another fxn of the hypothalamus
A
emotion
physiologic responses
anger
fear
well being
21
Q
the cerebellum connects the
A
spinal cord (sensory input) to the cortex
22
Q
the cerebellum controls
A
balance
posture
muscle tone
coordination of voluntary motor fxn
23
Q
s/sx of cerebellar injury are usually on the __ side
A
ipsilateral
24
Q
the Reticular Activating System (RAS) controls
A
arousal
alertness
25
the RAS involves which CN
II
VIII
***seeing and hearing***
26
all major sensory pathways connect with the
***ascending*** RAS
27
comatose states affect the
RAS
28
**descending RAS** controls
**involuntary** motor control
impulses from extrapyramidal motor system to voluntary muscles
29
motor fxn is divided into
pyramidal
extrapyramidal
30
pyramidal system __ movement
controls
31
the **extra**pyramidal system __ movement
coordinates
32
the extrapyramidal system connects the \_\_
with the \_\_
motor cortex
basal ganglia
33
extrapyramidal diseases include (4)
1. Parkinson's
2. Tardive Dyskinesia
3. Huntington's
4. Sydenham's chorea
34
leptomeninges include
pia
arachnoid
***2 innermost layers that cover the brain and the spinal cord***
35
CSF is produced by
epithelial cells in choroid plexuses w. in ventricles
36
components of CSF (4)
water
glucose
O2
CO2
37
foramen of monroe connects
lateral and third ventricles
38
CSF is absorbed by
arachnoid granulations in the superior sagittal sinus
38
CSF is absorbed by
arachnoid granulations in the superior sagittal sinus
39
cisterns are formed by
openings in the subarachnoid space
40
hydrocephalus is
water in the brain
41
what is the most common cause of hydrocephalus in kids
congenital obstruction of the aqueduct of sylvius
42
idiopathic hydrocephalus is also called
normal pressure hydrocephalus
43
normal pressure hydrocephalus triad
wacky, wobbly, wet
44
Cushing's Dz is caused by
anterior pituitary tumor
trauma
hemorrhage
stroke
45
CN innervation of the dura
CN V
C1-C3
46
intracranial hemorrhages can be \_\_
or \_\_
intraaxial → in the brain or spinal cord
extraaxial → outside the brain and spinal cord
47
epidural hematoma is usually caused by \_\_
and causes injury to the \_\_
trauma
middle meningeal a
48
epidural hemorrhages are __ on CT
crescent/convexP
49
epidural hemorrhages are characterized by
lucid interval → quick decline
50
subdural hemorrhages are caused by
old age → atrophy
rupture of bridging cerebral veins
51
subdural hematomas appear __ on CT
banana shaped → concave
52
always CT a patient that is \_\_
to catch \_\_
\>65 yo
subdural hemorrhage
53
subdural vs epidural hemorrhage
P
54
COW is incomplete in \_\_% of people
50%
55
most common location for a berry (saccular) aneurysm
anterior communicating artery
56
Alzheimer's Dz is characterized by
diffuse atrophy
enlarged sulci
thinned gyri
57
findings of increased ICP
**Cushing's Triad:**
increased BP
decreased pulse
decreased RR
*also, pupils fixed and dilated*
58
Uncal herniation impinges on which CN
CN III
59
uncal herniation affects which structures
**herniates into tentorial notch**
**may involve:**
posterior cerebral artery
visual cortex -\> +/- unilateral pupil dilation
may go through foramen magnum (cerebellar tonsils)
60
vascular distribution to the cerebrum and posterior fossa
vertebral arteries → combine to form basilar artery → divides into posterior cerebral arteries
61
ACA stroke affects
the legs
62
MCA stroke affects
arms
hands
head
63
ACA and MCA strokes involve \_\_
so there will be __ paralysis
UMN
spastic
64
PCA supplies
occipital lobe
posterior parietal lobe
inferior medial temporal lobe
65
PCA stroke symptoms
vision loss
paresthesias
limb weakness
dizziness
memory loss
66
ACA stroke symptoms (5)
**legs**
**disinhibition**
**primitive reflexes (grasping, sucking)**
impaired judgement
**contralateral** weakness and sensory deficits
**gait apraxia**
67
what does the ACA supply
basal ganglia
frontal lobe
anterior parietal lobe
68
what does the MCA supply
lateral surfaces of the hemispheres
part of the internal capsule and basal ganglia
69
symptoms of MCA stroke
contralateral deficits in movement and **sensation**
dysphagia
**impaired speech**
hemianopia
70
vertebrobasilar artery stroke affects
pons
brainstem
medulla
71
symptoms of vertebrobasilar artery stroke
vertigo
fainting
dropping 2/2 to weak quadricepts
hemianopsia
dysphagia
72
mass effects of strokes can cause severe \_\_
and __ through \_\_
**and/or \_\_**
severe edema
herniation
falx
tentorium
73
lacunar infarcts affect the
internal capsule
basal ganglia
thalamus
pons
74
symptoms of a lacunar stroke
**hemiparesis**
ataxia
sensory deficit
motor deficit of **one arm**
dysarthria
clumsy hand
purely motor
purely sensory
75
evaluation of stroke
1. non contrast CT
2. triple CT
3. contrast MRI blood flow analysis
76
herniation under falx
cingulate herniation
77
uncal herniation
uncus and hippocampal gyrus herniate into tentorial notch
78
tonsillar herniation
cerebellar tonsils herniate thru foramen magnum
79
what type of imaging will differentiate hemorrhagic stroke vs ischemic stroke
CT w.o contrast
80
what imaging will show acute hemorrhage
triple CT
81
C2 dermatome
sleep area
82
C4 dermatome
shoulder pads
83
C6 dermatome
tip of thumb
84
C7 dermatome
tip of the index finger
85
C8
tip of the little finger
86
T1 dermatome
medial elbow
87
T4 dermatome
nipple
88
T10 dermatome
umbilicus
89
L1 dermatome
inguinal
***1 for I***
90
L2 dermatome
lateral thigh
91
L3 dermatome
inner anterior thigh
92
L4 dermatome
great toe
93
L5 dermatome
dorsum of foot
## Footnote
**foot drop**
94
S1 dermatome
little toe
95
S2 dermatome
posterior thigh
96
S4/S5 dermatomes
perineum
coccyx
NOT anus
97
coccyx 1 dermatome
anus
98
making sense of dermatomes
99
referred pain happens when __ info comes into the
spinal cord from one location but is interpreted by the CNS as having come from another location by the \_\_
sensory
same spinal cord level
100
heart pain is referred to
T1-T5
left side of jaw and left arm
101
stomach pain is referred to
T5-T7
chest and groin
102
where is appendix pain referred to
T10-T11
RLQ pain
103
what anatomical landmark indicates the beginning of the aortic arch
sternal angle (Angle of Louis)
104
what carries referred pain
**visceral afferent fibers** converge at a spinal cord level
**somatic afferent fibers** at the same spinal cord level refer the pain
105
the anterior mediatsinum contains
thymus (behind manubrium)
internal mammary vessel
lymph nodes
loose CT
106
the middle mediastinum contains
**pericardia:** fibrous, serous, visceral, parietal
**heart vessels:** aorta, SVC/IVC/pulmonary aa/vv
**nerves:** vacus, sympathetics, phrenics
**trachea**
107
posterior mediastinum contains
**descending aorta**
esophagus
intercostal aa/vv
thoracic duct
azygos and hemozygous vv
108
superior mediastinum is above the
sternal angle
109
the superior mediastinum contains the
thymus
brachiocephalic vv
SVC
**aortic arch and branches**
trachea
esophagus
phrenic and vagus n
left recurrent laryngeal n
thoracic duct
110
location of the descending aorta
posterior mediastinum
111
location of the aortic arch and branches
superior mediastinum
112
aortic arch arises from the ascending aorta and runs slightly \_\_
to the __ of the trachea
posterior
left
113
descending aorta
lower 9 posterior intercostal aa
114
the main muscle of breathing is the
diaphragm
115
the external intercostals move the ribs
up and out
116
forced breathing occurs during
exercise
pathological states
117
forced breathing involves which extra bones
upper 2 ribs
sternum
118
expiration is primarily a __ process
passive
119
the internal intercostals move the ribs
down and inward
120
expiration involves which intercostals
internal intercostals
121
muscles of active breathing
internal intercostals
abdominal rectus
external/internal obliques
transverse abdominus
122
the medullary inspiration center is the
rhythm generator
123
the medullary inspiration center involves which CN
**sensory:** IX, X
**motor:** phrenic
124
the medullary expiration center is only active during
expiration
125
most important determinants of normal breathing (3)
1. central medullary chemoreceptors → pH of CSF
2. increased PCO2
3. decreased O2
126
what is the most sensitive peripheral mechanism affecting ventilation
PaO2
127
PaO2 of \< __ causes increased ventilation
60 mmHg
128
where is voluntary control of breathing mediated
cortex
129
gold standard for pulmonary embolism dx
pulmonary angiography
129
gold standard for pulmonary embolism dx
pulmonary angiography
130
in a pneumothorax, air enters the space
causing \_\_
pleural
atelectasis
131
where is a chest tube inserted
4th intercostal space
mid axillary line
just above the rib
132
where is the aortic (semilunar) valve auscultated
left sternal margin
2nd intercostal space
133
where is the pulmonary semilunar valve auscultated
left sternal margin
2nd intercostal space
134
where is the mitral valve auscultated
mid clavicular line
5th intercostal space
135
where is the tricuspid valve auscultated
right sternal margin
5th intercostal space
136
where do 75% of breast malignancies spread
axillary nodes
137
where do 25% of breast malignancies spread
internal mammary (internal thoracic nodes)
138
3 main places lung malignancies spread
1. hllum
2. subcarinal
3. mediastinal pretracheal nodes
139
brachial plexus
C5-T1
network of motor and sensory nerves
140
the brachial plexus carries nerves from the \_\_
to the **\_\_**
and \_\_
spinal cord
arms
hands
141
C4 muscle movement
shoulder shrug
142
C5 muscle movement
abducts arms at shoulder joing
143
C6 muscle movement
flexion at elbow joint
144
C7 muscle movement
extension of elbow joint
145
C8 muscle movement
flexion of the fingers
146
T1 muscle movement
abduction and adduction of the index, middle, ring fingers
147
where is the apex of the heart
mid clavicular line 5th intercostal space
148
the valsalva maneuver __ intrathoracic and intra abdominal pressures
increases
149
the valsalva maneuver __ venous return to the heart
and __ cardiac output
decreases
decreases
150
after valsalva pressure is released CO \_\_
increases
151
\_\_ L of plasma per day pass out of the capillaries via filtration
20
152
\_\_ pressure causes
\_\_ L of fluid to be reabsorbed into the capillaries
oncotic pressure
17
153
the __ system returns the remaining
\_\_ L of fluid to the venous system
lymph
3
154
which chamber of the heart is most anterior
right ventricle
155
which heart chamber is immediately in front of the esophagus
the left atrium
156
passive breathing involves which 2 muscles
diaphragm
external intercostals
157
during inspiration, the diaphragm \_\_, the
volume of the thoracic cavity \_\_,
and intrathoracic pressure
contracts
increases
decreases
158
during expiration, the diaphragm \_\_,
the volume of the thoracic cavity \_\_,
and intrathoracic pressure \_\_
relaxes
decreases
increases
159
muscles of active in**S**piration
**s**calenes
**s**ternocleidomastoid
pectorali**s** major and minor
**s**erratus anterior
lati**ss**mu**s** dor**s**i
160
most people are __ coronary artery dominant
right
161
the rca supplies the
RA
RV
portions of LA and LV
posterior 1/3 of IVS
SA node
AV node
162
LCA supplies
LA
LV
most of IVS
Bundle of His and its branches
163
which CN innervates the anterior sensory portion of the scalp
CN V
164
branches of CN V that innervate the anterior portion of the scalp
supratrochlear
supraorbital
zygomaticotemporal
auriculotemporal
165
which CN controls motor innervation of the scalp
CN VII
166
CN VII innervates which facial muscles
frontalis
occipital
167
the lymphatic system collects fluid lost from the
capillary beds
168
left and right jugular lymph trunks drain the
side of the head and neck
169
right and left subclavian trunks drain the
1. upper limbs
2. 2. superficial regions of the thoracic and upper abdominal wall
170
the left and right bronchomediastinal trunks drain teh
lungs
bronchi
mediastinal structures
thoracic wall
171
largest lymphatic vessel in the body
thoracic duct
172
the thoracic duct is in the __ area
pre vertebral
173
6 lymph nodes of the body
1. cervical
2. axillary
3. deep
4. precranial ring
5. tracheal
6. inguinal
7. femoral
174
the thoracic duct flows into the
subclavian trunk
175
what lymph structure drains the abdominal viscera, abdominal walls, pelvis, perineum, and lower limbs
cisterna chyli
176
the jugulardigastric node is in the __ area
tonsilar
177
the jugular omohyoid nodes are in the __ area
tongue
178
the apical nodes join the __ trunks
and drain into the right __ trunk
and left __ trunk
subclavian
subclavian
thoracic
179
25% of breast drainage is to the \_\_
into the __ on the left and
\_\_ on the right
parasternal
thoracic (mammary)
subclavian
180
parasternal chain lymph nodes include the
internal thoracic/internal mammary
181
intrathoracic drainage enters the __ on the left
thoracic duct
182
in fetal circulation, 75% of blood from the \_\_
and the __ is directed through
the \_\_
into the \_\_
ductus venous
IVC
foramen ovale
left atrium
183
PIOPED studies
Prospective Investigation of Pulmonary Embolism Diagnosis
184
PIOPED studies signs of pulmonary embolism
tachypnea → 70%
rales → 51%
tachycardia → 30%
4th heart sound
accentuation of 2nd heart sound
185
purpose of 3 fetal circulation shunts
1. bypass the lungs and liver
186
foramen ovale is in between the __ and
bypasses the \_\_
atria
lungs
187
in fetal circulation, the __ moves blood from the
\_\_ to
the \_\_
ductus arteriosus
pulmonary artery
aorta
188
in fetal circulation the __ bypasses the
**\_\_** to the
\_\_
ductus venosus
liver
IVC
189
the papillary muscles attach to the \_\_
and \_\_
via the
\_\_
tricuspid valve
mitral valve
chordae tendinae
190
what is the function of the papillary m
prevents regurgitation of ventricular blood
prevent prolapse and inversion during systole
191
components of the circle of willis
l/r anterior cerebral artery
anterior communicating artery
l/r internal carotid artery
l/r posterior cerebral
l communicating artery
192
CN V pathway
V1 → opthalmic
V2 → maxillary
V3 → mandibular
193
CN V has __ and
\_\_ fxn
somatic
autonomic
194
sensory fxn of V1
innervation of:
eye
cornea
conjunctiva
skin of upper face and anterior scalp
mucous membranes
nasal cavity
195
afferent limb of the corneal blink reflex
V1
195
afferent limb of the corneal blink reflex
V1
196
V2 sensory fxn
innervation to the:
sinuses
nasal cavity
palate
mid face
197
sensory fxn of V3
innervation of the:
mandibular teeth
mouth/buccal mucosa
meninges
external ear
198
which branch of V3 innervate the meninges
V3 → maxillary
199
which nerve provides sensation ***not taste*** to the anterior ⅔ of the tongue
lingual n → branch of V3
200
sensation to anterior ⅔ of the tongue is controlled by
lingual n via V3
201
which nerve provides taste to the anterior ⅔ of the tongue
chorda tympani via CN VII
202
somatic skeletal fxn of CN V
biting
chewing
mastication
203
muscles of mastication are innervated by
V3
204
what are the muscles of mastication
masseter
temporalis
lateral/medial pterygoid
205
muscle innervation of CN V
masseter
temporalis
medial/lateral pterygoid
mylohyoid
tensor velli palatini
tensor tympani
anterior digastric
206
what is the fxn of the mylohyoid
lifts posterior tongue
seals nasopharynx
207
tensor tympani fxn
dampens sound
208
important branches of CN V
alveolar n
maxillary n
auriculotemporal n
lingual n
mandibular n
208
important branches of CN V
alveolar n
maxillary n
auriculotemporal n
lingual n
mandibular n
209
where are dental blocks administered
1. superior alveolar n -→ CNV → maxillary teeth
2. inferior alveolar n → CN V → mandibular teeth
210
which muscle acts as a diaphragm in the floor of the mouth to confine bleeding w. a skull fx
mylohyoid → CN V
211
trigeminal neuralgia is also called
tic douloureux
212
CN V tests
1. sensation to face
2. movements of mandible
213
CN VII pathway
Temporal branch
Zygomatic branch
Buccal branch
Mandibular branch
Cervical branch
214
sensory innervation of CN VII
concha
external auditory meatus
skin behind ear
215
somatic motor fxn of CN VII
muscles of facial expression
dampening of sound in ear
216
which CN VII muscle dampens sound in the ear
stapedius
217
PSNS motor fxn of CN VII
lacrimal gland
submandibular gland
sublingual
efferent blink reflex
218
somatosensory fxn of CN VII
sensation from skin on concha and posterior auricular skin
218
somatosensory fxn of CN VII
sensation from skin on concha and posterior auricular skin
219
which salivary glands are innervated by CN VII
submandibular
sublingual
220
damage to CN VII can be caused by
acoustic neuroma
stroke
tumor
hemorrhage
Bell's Palsy
221
symptoms of CN VII damage
Bell's Palsy
loss of salivary gland secretion
hyperacusis
loss of sensation from concha/external ear
222
CN VII tests
muscles of facial expression
taste from anterior ⅔ of tongue
223
what muscle innervates the platysma
CN VII
224
what is the fxn of the platysma
draws skin around lower part of mouth down or out
225
muscle innervation of CN VII
frontalis
orbicularis oculi
buccinator
orbicularis oris
platysma
posterior belly of the digastric
stapedius
226
cavernous sinus → OTOMCAT
oculomotor n
trochlear n
ophthalmic n
maxillary n
carotid a (internal)
abducens
227
meckel's cave connects the __ to the
\_\_ cistern
cavernous sinus
prepontine cistern
228
meckel's cave houses the
trigeminal n ganglion
228
meckel's cave houses the
trigeminal n ganglion
229
the cavernous sinuses sit on either side of the
sphenoid bone
230
the cavernous sinus extends from the posterior aspect of the orbit to the __ part of the temporal bone
petrous
231
why is the cavernous sinus called the danger zone
infxns of the nose and injuries around the nose can easily spread here and result in cavernous sinus thrombosis
232
the veins of the face drain into the \_\_
via the \_\_
cavernous sinus
superior ophthalmic vein
233
what does the LCX supply
LA
LV
