HLTH nervous system review Flashcards
1
Q
anatomy of sutures
A
fibrous CT
2
Q
choroid plexuses
A
areas of highly vascularized tissues in the ventricles that filter CSF
3
Q
largest opening in the skull
A
forearm magnum which passes through the occipital bone
4
Q
association area
A
refers to where sensory input is recognized and interpreted; ex. visual stimuli is identified here
5
Q
dominant hemisphere meaning
A
is the side of the brain controlling language, which is usually the left side
6
Q
broca’s area
A
motor speech area; located at the base of the premotor area of the left hemisphere
7
Q
wernicke’s area
A
sensory speech area; located in the posterior temporal lobe
8
Q
prefrontal cortex function
A
intellectual function, personality, and impulse control
9
Q
basal nuclei
A
part of the extrapyramidal system and prevents excessive movements as well as accessory movements (ex. swinging arms while walking)
10
Q
where is the limbic system located?
A
superior part of the brainstem
11
Q
epithalamus
A
acts as a connection between the limbic system and other areas of the brain
12
Q
2 arteries supplying the brain
A
internal carotid and vertebral
13
Q
anterior cerebral artery
A
supplies the frontal lobe
14
Q
middle cerebral artery
A
supplies the lateral sides of the temporal and parietal lobes
15
Q
basilar artery
A
supplies the brainstem and cerebellum; this branches to form the left and right posterior cerebral artery
16
Q
posterior cerebral artery
A
supplies the occipital lobe
17
Q
circle of willis
A
provides an alternative source of blood when obstruction occurs in the vertebral or internal carotid arteries; surrounds the pituitary gland and optic chiasm
18
Q
4 cranial nerves containing parasympathetic fibres
A
III, VII, IX, and X
19
Q
where does the spinal cord end?
A
L1; below this is the cauda equina
20
Q
lateral spinothalamic tract
A
ascending tract regulating temperature and pain
21
Q
dermatone
A
is an area of sensory innervation of the skin by a spinal nerve
22
Q
what cells create the myelin sheath?
A
schwann cells in the PNS and oligodendrocytes in the CNS
23
Q
glial cells
A
supporting cells for neurons
24
Q
astroglia
A
provide a link between neurons and capillaries, provide metabolic support, and help establish the blood-brain barrier
25
microglia
have phagocyte activity
26
ependymal cells
line ventricles and spinal cord and form choroid plexuses
27
where does neurogenesis usually occur?
in the hippocampus
28
electroencephalogram
measures brain waves and electrical activity
29
examples of cathecolimes
dopamine, norepinephrine, and epinephrine
30
most common inhibitory neurotransmitter in the brain
gamma-aminobutyric acid
31
most common inhibitory neurotransmitter in the spinal cord
glycine
32
serotonin role
is involved in mood, sleep, and emotions
33
histamine role
is involved in body temperature, emotions, and water balance
34
heart, blood vessel, and renin receptor
beta 1
35
skin, mucosa, and viscera receptors
alpha 1
36
skeletal muscle receptors
beta 2
37
respiratory system receptors
beta 2
38
what do alpha 1 receptors supply?
skin, mucosa, viscera, eye, sweat glands, digestive sphincters, and male genitalia
39
alpha 2 receptors
supply the digestive system
40
what receptors does norepinephrine act on?
alpha
41
what receptors does epinephrine act on?
alpha and beta
42
nicotinic receptors
are always stimulated by AcH and are part of the PNS
43
muscarinic
are either stimulated or inhibited by AcH and are part of the PNS
44
cholinergic blocking agents
block PNS activity
45
cholinergic or anticholinesterase agents
increase PNS activity
46
where are UMN located?
the motor cortex
47
where is the RAS found?
the midbrain
48
extrapyramidal tract function
modify and coordinate voluntary output and maintain posture
49
4 nerve plexuses
brachial, lumbar, sciatic, and cervical
50
saltatory conduction
involves the rapid AP along myelinated neurons
51
cholinergic fibers
refers to SNS preganglionic fibres that release AcH
52
adrenergic fibers
refers to SNS postganglionic fibres that release norepinephrine
53
local effects meaning
refers to damage in a localized area in which the effects are specific to that area; ex. damage to left frontal lobe results in damage to right arm
54
supratentorial lesions
occur above the tentorium cerebelli; this leads to specific dysfunction of an area
55
infratentorial lesions
occurs below the tentorium cerebelli or brainstem; lead to more generalized impairment due to nerves grouping together below this region
56
what determines levels of consciousness?
the RAS and cerebral cortex
57
first sign of those with brain disorders
decreased level of resposiveness
58
what systemic disorders can suppress brain function?
acidosis and hypoglycemia
59
coma
is when the person is unconscious, motionless, does not respond to visual or verbal stimuli, but some reflexes are still maintained
60
terminal stage of a coma
loss of all reflexes, dilated pupils, and slow/irregular pulse and respirations
61
vegetative state
loss of awareness of mental function but brainstem functions continue
62
locked in syndrome
the individual is paralyzed but is aware and capable of thinking
63
brain dead criteria
flat EEG, absence of reflexes, absence of brainstem function, absence of respirations, and irreversible
64
what can cause temporary brain death?
hypothermia or drug overdose
65
damage to UMNs
causes hyperreflexia and spastic paralysis on the contralateral side
66
damage to LMNs
causes flaccid paralysis and absence of reflexes on the same side
67
decorticate responses
flexion of upper limbs, abducted arms, internal rotation of hands, and lower limbs are extended; common due to damage in the hemispheres
68
decerebrate responses
upper and lower limbs are extended, and the body is arched; commonly results from brainstem damage or systemic effects to the CNS
69
where is the somatosensory cortex located?
the parietal lobe
70
damage to the optic chiasm
vision is lost in both eyes
71
damage to the medial optic fibres
results in damage to the contralateral side
72
damage to the lateral optic fibres
results in damage to the ipsilateral side
73
damage to the optic tract or occipital lobe
vision is lost from the medial half of one eye and the lateral half of the other; overall effect is loss of vision on the side opposite to the damage
74
homonymous hemianopia
is damage to the optic tract or occipital lobe resulting in damage to the medial half of one eye and the lateral half of the other
75
diplopia
refers to double vision
76
aphasia
refers to an inability to process or comprehend language; 3 types: recessive, expressive, or global
77
dysphasia
refers to partial loss of processing or comprehending language
78
expressive aphasia
refers to damage to the broca's area in the left frontal lobe; cannot create meaningful sentences
79
receptive aphasia
refers to damage to the wernicke's area in the left temporal lobe; cannot understand the spoken or written words; still capable of speaking, but it is meaningless
80
global aphasia
refers to damage to both the broca's and wernicke's areas
81
fluent aphasia
pace of speech is normal but includes made up words; associated with damage to the wernicke's area
82
nonfluent aphasia
slow and laboured speech with short phases; associated with damage to the broca's area
83
dysarthria
refers to words not being articulated clearly and is a motor dysfunction
84
agraphia
impaired writing ability
85
alexia
impaired reading ability
86
agnosia
loss of recognition or association
87
what are seizures caused by?
spontaneous excessive discharge of neurons in the brain and may be due to bleeding, inflammation, or hypoxia
88
signs of seizures
temporary confusion, a staring spell, rapid jerking of arms and legs, unconsciousness, and fear or anxiety
89
tardive dyskinesia
is a neurological disorder caused by the longtime use of neuroleptic drugs (used for psychartitic and GI disorders) or antipsychotic drugs
90
signs of tardive dyskinesia
repetitive involuntary movements like grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking
91
what disorders is increased ICP common in?
tumors, hemorrhage, cerebral edema, trauma, or accumulation of CSF
92
signs of increased ICP
headache, vomiting, decreasing level of consciousness, increasing BP, slow heart rate, and vision problems (including papilledema, fixed and dilated pupils, first in one pupil then in both, and ptosis)
93
papilledema
increased pressure of CSF causes swelling around the optic disc
94
compensation for increased ICP
increase venous return, shifting CSF into the spinal cavity, and vasodilation (which makes things worse), as well as systemic vasoconstriction and decreased respiratory rate
95
Cheyne–Stokes respirations
common with increased ICP and is alternating apnea and increasing and decreasing respirations
96
ptosis
means droopy eyelid and is common with increased ICP
97
where is lumbar puncture done?
L3-L4
98
pressure of CSF in increased ICP
> 20 mm Hg
99
transtentorial (central) herniation
occurs when the hemispheres, diencephalon, and midbrain are displaced downwards, affecting respiration, the RAS, and the flow of blood and CSF
100
uncal (uncinate) herniation
occurs when the uncus of the temporal lobe is displaced downwards past the tentorium cerebelli, creating pressure on cranial nerve III, the posterior cerebral artery, and the RAS
101
cerebellar, or tonsillar (infratentorial), herniation
occurs when the cerebellar tonsils are pushed downward through the forearm magnum which compresses the brainstem and vital centres
102
pulse pressure
the difference between systolic and diastolic pressure; this increases with ICP from the decreased heart rate and cushing reflex
103
most common brain tumor
gliomas which result from glial cells; can be further subdivided, in which astrocytomas are the most common
104
where do secondary tumors of the brain usually spread from?
lung or breast cancer
105
what brain tumors are common in younger children?
cerebellar and brainstem
106
signs of brain tumors
morning headaches, visual problems, vomiting, lethargy, irritability, and seizures
107
2 origins of vascular brain disorders
ischemia or hemorrhage
108
global cerebral ischemia
can result from shock or cardiac arrest and results in loss of function and cerebral edema
109
transient ischemic attack
results from a temporary decreased blood flow to the brain due to an atherosclerosis, vasospasm, embolus, or loss of autoregulation; results in increased risk for a CVA/stroke
110
signs of a transient ischemic attack
short periods of muscle weakness, visual disturbances, confusion, aphasia, or numbness may occur
111
cerebrovascular accident
aka stroke; is an infarction of brain tissue due to a lack of blood and O2
112
how does the brain change with a stroke?
the brain tissue necrosis, inflammation develops, tissue liquifies creating a cavity, and a loss of function of that area develops; this is eventually replaced with scar tissue and cysts
113
3 types of CVAs
hemorrhage, embolus, and thrombus
114
most common cause of a CVA
atheroma in a large artery; these may also develop in cerebral arteries
115
thrombus CVA
is a gradually developing atheroma in a cerebral artery, in which the onset is gradual and causes localized effects
116
embolic CVA
is an atheroma that breaks away from a larger artery and lodges in a cerebral artery, causing a rapid onset and localized effects
117
hemorrhage CVA
is caused by hypertension and an atheroma, in which the onset is rapid and ICP increases, with widespread effects
118
what are the effects of blood in the brain?
vasospasm, electrolyte imbalance, acidosis, and cerebral edema
119
risk factors for a CVA
hypertension, hyperlipidemia, atherosclerosis, diabetes, SLE, past TIAs, age, heart disease, obstructive sleep apnea, and a combination of smoking and oral contraceptives
120
signs of a CVA
sudden weakness and tingling, often on one side of the face or arm, flaccid paralysis, temporary loss of speech and vision, severe headache, and dizziness
121
hemorrhage CVA signs
severe headache and confusion
122
treatment for CVA
immediate administration of clot busting agents like tissue plasminogen activator
123
cerebral aneurysms
are localized dilations in an artery at weak points and commonly occur at points of bifurcation in the circle of willis due to hypertension
124
result of a ruptured aneurysm
bleeding into the subarachnoid space and CSF, inflammatory response, irritation to nerves, increased ICP, and vasospasm
125
small leak from an aneurysm
is likely to cause a headache, photophobia, intermediate periods of dysfunction like speech, confusion, or weakness, and nuchal rigidity
126
nuchal rigidity
is a stiff or extended neck due to blood irritating spinal nerves and causing contractions of the neck; common with a small leak from an aneurysm
127
massive leak from an aneurysm
blinding headache, vomiting, visual problems, seizures, and loss of consciousness
128
meningitis
is a viral, bacterial, or fungal infection of the meninges in which the microbe can reach the brain through the blood, a nearby tissue, or trauma
129
how does the microbe reach the brain in meningitis?
they can bind to nasopharyngeal cells, cross the mucosa, attach to the choroid plexus and enter the CSF
130
how does the brain appear in meningitis?
pia and arachnoid layers become edematous, purulent exudate fills in spaces between sulci, and the brain appears flat, and the vessels supplying the brain are dilated
131
classic meningitis pathogen
neisseria meningitidis, or meningococcus
132
most common meningitis pathogen in infants
E coli
133
most common meningitis pathogen in young children
Haemophilus influenzae
134
most common meningitis pathogen in the elderly
Streptococcus pneumoniae
135
signs of meningitis
fever, chills, headache, back pain, stiff neck, photophobia, and signs of increased ICP; Kernig sign and Brudzinski sign may also be present
136
Brudzinski sign
neck flexion causes flexion of hip and knee
137
Kernig sign
resistance to leg extension when lying with the hip flexed
138
meningococcal infections signs
rose-colored petechial rash or extensive ecchymoses over the body, feeding difficulties, and high pitched cry in newborn
139
fulminant meningitis
means severe; signs are disseminated intravascular coagulation and hemorrhage of the adrenal gland; causes vascular collapse, shock, and death
140
abscess
is a localized infection, usually in the temporal or frontal lobes, causing necrosis and edema in the brain
141
what do abscesses result from?
spread of infection from the throat, ear, lung, or sinus
142
common organisms causing abscesses
staphylococci, streptococci, and pneumococci
143
signs of a brain abscess
signs of neurological deficits and increased ICP
144
encephalitis
is an infection, usually viral, of the CT in the brain and spinal cord, particularly of the basal ganglia
145
signs of an encephalitis infection
headache, stiff neck, lethargy, vomiting, fever, and seizures
146
types of encephalitis spread by mosquitoes
western equine encephalitis, st. louis encephalitis, and west nile fever
147
neuroborreliosis causative organsism
aka lyme; is a spirochete called Borrelia burgdorferi that is transmitted by tick bites
148
sign of a tick bite
red with a pale centre that gradually increases in size; called bulls eye
149
signs of neuroborreliosis/lyme
fever, headache, sore throat, dry cough, inflammation in large joints, cardiac arrhythmias, and neurological effects
150
herpes simplex encephalitis
can cause necrosis and hemorrhage in the brain, often affecting the frontal and temporal lobes
151
amoebic meningoencephalitis
is spread from the amoeba Naegleria fowleri that thrives in warm water and is usually fatal
152
rabies
transmitted by wild animal bites and causes inflammation and necrosis in the brainstem and basal nuclei
153
signs of rabies
headache, fever, nervous hyperirritability, seizures, difficulty swallowing, and impaired respirations
154
tetanus causative organism
clostridium tetani, a spore-forming bacillus
155
signs of tetanus
jaw stiffness, muscle spasms, difficulty swallowing, stiff neck, and eventually respiratory failure
156
poliomyelitis
is a highly contagious virus that attacks motor neurons of the spinal cord and brainstem, causing effects ranging from flulike symptoms to respiratory failure and paralysis
157
signs of poliomyelitis
fever, vomiting, headache, stiff neck, and flaccid paralysis
158
herpes zoster causative agent
varicella-zoster virus often following the primary infection of chickenpox
159
herpes zoster signs
affects a single cranial nerve or dermatome, causing pain, paresthesia, and a vesicular rash to develop in a unilateral line usually on the face or lumbar trunk
160
postpolio syndrome
occurs 10-40 years after the original polio infection causing progressive muscle weakness, atrophy, and pain; the more severe the original infection, the more severe PPS will be
161
pathophysiology of postpolio syndrome
surviving motor neurons later degenerate and die, due to creating new axon branches to serve muscle cells but couldn't keep up
162
reye syndrome cause
is due to treating children with a viral infection, like influenza, with aspirin, causing changes in the brain and liver
163
signs of reye syndrome
lethargy, headache, vomiting, disorientation, hyperreflexia, hypoglycemia, hepatomegaly, and seizures
164
Guillain–Barré syndrome
is an inflammatory condition of the PNS which is thought to be an autoimmune response following viral infection, causing demyelination of motor nerves, then sensory nerves
165
how does Guillain–Barré syndrome progress?
inflammation and degeneration of nerves begins in the legs, and ascends to involve the spinal nerves of the trunk and neck; can be dangerous if respiratory muscles are affected
166
Guillain–Barré syndrome signs
progressive muscle weakness and lack of reflexes, parthesthia, muscle aching, vision and speech may be impaired, or even swallowing and respiration in serious cases
167
concussion
is reversible damage to the brain caused by injury, causing excessive movement of the brain, which can result in temporary confusion, memory loss, and headaches
168
amnesia
means memory loss
169
contusion
is bruising of the brain which may result from rupture of a small vessel and edema
170
closed head injury
is when the skull is not fractured but the brain tissue is injured and vessels may rupture
171
open head injury
involves fractures or penetrations of the brain by sharp objects
172
compound fractures
occur when the brain is exposed to the environment, in which risk of infection is high
173
depressed fractures
involve the displacement of a bone below the skull that compresses the brain tissue; blood supply is impaired and pressure is exerted on the brain
174
basilar fractures
occur at the base of the skull and often cause blood and CSF to leak through the nose or ears
175
contrecoup injuries
occur when an area contralateral to the injury is injured due to the brain bouncing off the skull
176
primary brain injuries
are direct injuries that involve lacerations and crushing of the brain structures
177
shearing injury
refers to the lobes against each other
178
secondary brain injuries
result from complications like hemorrhage, edema, vasospasm, hematoma, or infection; this is characterized by the development of additional injurious factors
179
hematoma
is a collection of blood under the tissue that results from a rupture
180
epidural hematoma
results from bleeding between the dura and the skull, usually caused by tearing of the middle meningeal artery in the temporal region
181
subdural hematoma
develops between the dura and the arachnoid, usually the result of a tear in a small vein
182
hygroma
refers to CSF leaking into the subdural space
183
subarachnoid hematoma
develops between the arachnoid and pia and is associated with bleeding at the base of the brain
184
intracerebral hematoma
results from contusions or shearing injuries and often develop several days after injury
185
complications of hematomas
leads to pressure on local structures and increased ICP, blood cells may undergo hemolysis, and this results in osmotic pressure draws more fluid into this area, exacerbating these effects
186
otthrea
refers to CSF leaking from the ear
187
rhinorrhea
refers to CSF leaking from the nose
188
possible signs of a head injury
seizures, cranial nerve damage, otthea or rhinorrhea, otorrhagia, fever, and stress ulcers
189
otorrhagia
is blood leaking through the ear at a fracture site
190
where do most spinal cord injuries occur?
at areas that provide more mobility and less support, ex. C1-C7 and T12-L2
191
what do cervical spine injuries often result from?
hyperflexion or hyperextension of the neck
192
types of spinal cord injuries
hyperflexion, hyperextension, compression fractures, dislocation of the vertebrae, and penetration injuries
193
types of vertebrae fractures
compression, wedge, dislocation, or simple
194
wedge fracture meaning
displaced angular section of bone
195
bruising of the spinal cord
will result in temporary bleeding and edema
196
efffects of cervical spinal cord injuries
inflammation can extend upwards, interfering with phrenic nerve innervation, thus affecting respiration; can also impair vasomotor tone, blood pressure, body temperature, and bladder and bowel emptying
197
spinal shock
occurs in the initial period following injury when conduction of impulses through nerves ceases, causing impairment at, slightly above, and below the level of injury
198
signs of spinal shock
varies depending on the level, but includes no reflexes, no control of skeletal muscle, and impaired autonomic function, including bladder and bowel
199
tetraplegia/ quadriplegia
paralysis of all four limbs
200
paraplegia
paralysis of the trunk and lower limbs
201
autonomic dysreflexia
can result from injury at the cervical level, and includes the triggering of a massive sympathetic response that cannot be controlled by the brain; usually is triggered by a distended bladder or debictus ulcers
202
signs of autonomic dysreflexia
vasoconstriction, increased heart rate, severe headache, and visual impairment
203
complications of autonomic dysreflexia
stroke and heart failure
204
complications of spinal cord injuries
decubitus ulcers, contractures, muscle spasms, impaired respiratory and urinary function, and impaired sexual function/reproduction
205
A criteria for a spinal cord injury
no motor or sensory function in the sacral reigons
206
E criteria for a spinal cord injury
motor and sensory function are normal
207
is sensory or motor function gained back first from spinal cord injuries?
sensory
208
leading cause of death for spinal cord injuries
pneumonia, second is renal failure
209
heart conditions that may cause a CVA
problems with the left ventricle, endocarditis, MI, prosthetic valves, and atrial fibrillation
