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PHYSIOTHERAPY > HUMAN FUNCTIONING NEURO > Flashcards

HUMAN FUNCTIONING NEURO Flashcards

1
Q

What are the four lobes of the brain?

A

Temporal, parietal, occipital and frontal

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2
Q

What are meninges?

A

3 layers of protective covering called meninges surrounding the brain and the spinal cord.

Outermost - dura - thick and tough. Periosteal layer lines the inner dome of the skull and the mineingeal layer is beneath that. Space between allows passage of veins and arteries for blood supplu.

Arachnoid matter - thin, connective tissue. Below is the cerebrospinal fluid. This fluid cushions the entire central nervous system.

Pia matter - thin membrane that hugs the surface of the brain.Rich with veins and arteries.

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3
Q

Briefly summarise the anatomy of the brain

A

2 hemispheres connected by corpus callosum.
4 lobes
Each hemisphere recieves sensory and sends motor commands to the opposite side of the body
Gyri - bumps/ridges in the cerebral cortex (grey matter) and increase the brain’s surface area so more neurones can be packed.
Sulci depression/grooves in cerebral cortex that help increase surface area.
The sulci form brain divisions by creating boundaries between lobes (dividing into 2 hemispheres)

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4
Q

What is the anterior/ posterior cingulate gyrus?

A

It is a component of the limbic system.

Anterior - Emotionl processing and the vocalisation of emotions. Amygdala (processes emotions - anterior). Anterior part is more linked to speech (Broca’s area)

Posterior - Process information relating to spatial orientation of objects (the posterior part)

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5
Q

What is the precentral gyrus?

A

The primary motor centre of the brain
Excecuting voluntary movements
Works by controlling the motor movement of the body’s contralateral side (opposite side to where it is located in the brain)

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6
Q

What is the superior temporal gyrus?

A

Contains the auditory cortex, processing of sounds.

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7
Q

What is the central sulcus?

A

Separates the parietal and the frontal lobes. Defines boundary between primary motor cortex and primary somatosensory cortex

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8
Q

What is the parieto-occipital sulcus?

A

Separates the parietal and occipital lobes of the brain

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9
Q

What is the lateral sulcus?

A

Seperates the parietal and temporal lobes.

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10
Q

What is the cerebral cortex?

A

An outer layer of tissue organised in 2 cerebral hemispheres, and composed of 4 distinct lobes

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11
Q

What is the frontal lobe?

A

Controls motor activity and tasks associated with the dopamine system (memory, attention)
Problem solving
Speech production (broca’s area)

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12
Q

What is the parietal lobe?

A

Touch sensation and spaital navigaton
Body orientation

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13
Q

What is temporal lobe?

A

Auditory processing and language comprehension
Memory/information retrieval

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14
Q

What is the occipital lobe?

A

Visual processing and sight perception.

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15
Q

What is the cerebellum?

A

Coordinates unconscious motor functions eg balance and movement coordination
Vision
Motor learning

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16
Q

What is the brain stem?

A

Posterior part of the brain connecting to the spinal cord.
Includes the pons, medulla oblongata and the midbrain.
The brainstem (via the medulla) controls the automatic and involuntary activities eg breathing, swallowing.

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17
Q

What is the hypothalamus?

A

Functions to maintain homeostasis via coordination of the nervous and endocrine systems
Also produces some hormones directly which are secreted by the posterior pituitary

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18
Q

What is the pituitary gland?

A

Considered the master gland - it produces hormones that regulate other glands are target organs
Anterior lobe: FSH, LH, growth hormone
Posterior lobe: ADH and oxytocin

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19
Q

What is the corpus calosum?

A

Bundle of nerve fibres that connects the 2 cerebral hemispheres.
White matter structure
If damaged, prevents info exchange between left and right

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20
Q

What is the medulla oblongata?

A

Connection between the brainstem and the spinal cord
Comprised of cardioresp regulation system, descending motor tracks, ascending tracts, craial nerves
Motor neurons cross from left motor cortex to right side of the spinal cord in the medulla.

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21
Q

What is the limbic system?

A

Located in the cerebrum of the brain.
Processing and regulating emotion, forming and storing memories, sexual arousal and learning.
Part of the brain involved in behavioural and emotional responses, especially when it comes to behaviour for survival. Body’s response to stress.
Cells in the limbic system are arranged in fewer layers, or more jumbled than in the cerebral cortex.

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22
Q

What is the hippocampus? LIMBIC SYSTEM

A

2 hippocampi located in each hemisphere.
Memory centres.
Episodic memories are formed here, and then filed away into long-term storage in other areas.
Spatial navigation and learning and emotions.
Damage can lead to memory impairments eg spatial memory, navigation, learning, memory

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23
Q

What is the amygdala? LIMBIC SYSTEM

A

Emotional responses, also key for formation of new memories. Workswith the hippocampus by attaching emotional content to memories.
Linked with fight or flight response by creating fearful memories.
Damage may result in more aggression, loss of control of emotions, and loss of ability to recognize fear.
Damage to both sides can result in fewer feelings of shame about breaking social rules.

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24
Q

Explain the cingulate gyrus in relation to the LIMBIC SYSTEM

A

Rgeulation of emotions, behaviour and pain. Control of autonomic motor function.
Damage can result in emotions being inappropriate, lack of fear, learning impairments

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25
Q

Explain the hypothalamus in relation to the LIMBIC system?

A

Homeostasis
Autonomic functions eg hunger, thirst, temp, bp, hr, sexual activity
Interface between endocrine system and nervous system
Response to stress
Damage:
Linked with mental health disorders eg hyperactivity linked to increased anxiety and agitation.

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26
Q

Explain the basal ganglia in relation to the LIMBIC system?

A

Main functions are to regulate voluntary movements, and help with balance as well as posture.
Areas of the basal ganglia involved in limbic system is cognitive and emotional behaviours and have a role in rewards and reinforcements.

Damage:
Tremors, involuntary muscle movements, abnormal posture and links to movement disorders.

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27
Q

What is the circle of Willis?

A

Part of the cerebral circulation and is a connection of arteries:
- anterior cerebral artery
-anterior communicating artery
-internal carotid artery
-middle cerebral arteries
-posterior communicating artery

Provides collatteral blood flow between the anterior and posterior circulations of the brain.
Prevents against ischemia in the event of vessel disease or damage.

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28
Q

What is the spinothalamic tract? ascending tract

A

The lateral spinothalamic tract carries information about pain and temperature. Whilst the anterior spinothalamic tract carries information about crude touch.

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29
Q

What is the dorsal column medial lemniscal pathway? ascending tract

A

Neural pathway, one of the ascending tracts, by which sensory information from the peripheral nerves is transmitted to the cerebral cortex. Conveys proprioception, light touch, vibration.

Transmitted through the dorsal column, and transmitted through the medial lemniscus.

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30
Q

What is the spinocerebellar tract?

A

Carry unconscious proprioceptive information (pain, touch and temperature) from the muscle spindles, golgi tendon organs and joint capsules in the cerebellum.

Cell bodies that bring this information are in the dorsal root ganglia.

Posterior spinocerebellar tract: from lower limbs to the cerebellum.
Cuneo cerebellar tract: upper limbs to cerebellum.
Anterior spinocerebellar tract: from lower limbs, decussate twice and terminate in the cerebellum.
Rostral spinocerebellar tract: from upper limbs to the cerebellum.

There are 3 spinocerebellar tracts.

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31
Q

How can motor tracts in the spinal cord be grouped?

A

Pyramidal: conscious control of muscles from the cerebral cortex to the muscles of the body and face

Extrapyramidal: unconscious, reflexive or responsive control of muscles from various brainstem structures to postural or anti-gravity muscles.

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32
Q

Describe the tracts in the extrapyramidal tracts?

A

All originate in the brainstem and do not pass through the pyramids. Allow for unconscious, relfexive or responsive movement of muscles to control balance, locomotion, posture and tone.

The reticulospinal tract:
Descending, white matter, locootion, postural control

Vestibuluspinal tract: 2
increases antigravity muscle tone in response to head tilting to one side.

Rubrospinal tract:
Descending, regulates activity of motor neurones.

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33
Q

Explain the ascending tracts?

A

Neural pathways by which sensory information from the peripheral nerves is transmitted to the cerebral cortex (may also be known as somatosensory pathways)

34
Q

What is the dorsal column medial lemniscal pathway?

A

Ascending tracts
Carries sensory modalities of fine touch, vibration and proprioception. In the spinal cord info travels visa the dorsal columns, and in the brainstem through the medial lemniscus.

Conscious tracts: dorsal column medial lemniscal pathways and the anterolateral system
Unconscious tracts: spinocerebellar tracts

3 groups of neurones:
First order - sensory info regarding touch, proprioception or vibration from the peripheral nerves to the medulla oblongata.

Signals from the upper limb (T6 and above): travel in the lateral part of the dorsal column (fasiculus cuneatus) and synapse in the nucleus cuneatus of the medulla oblongata.

Signals from the lower limb (below T6): travel in the medial part of the dorsal column (fasiculus gracilis)Synapse in the nucleus gracilis of the medulla oblongata.
Second order: delivers information to the third order neurones in the thalamus. In the medulla oblongata these fibres cross over to the other side of the CNS.
Third order neuones: transmit sensory signals from the thalamus to the primary sensory cortex of the brain.

35
Q

Describe the anterolateral system?

A

Consists of 2 seperate tracts:

Anterior spinothalamic tract: sensory modalities of crude touch and pressure
Lateral spinothalamic tract: pain and temperature

First order neurones arise from sensory receptors in the periphery. Synapse at the tip of the dorsal horn (called substantia gelatinosa)
Second order neurones carry sensory information from the substantia gelatinosa to the thalamus. Then decussate within the spinal cord (cross over) and form the two distinct tracts.

The tracts run alongside each other.

The third order neurones carry the sensory signals from the thalamus to the primary sensory cortex of the brain

36
Q

What is neurogenesis?

A

The process by which new neurones are formed in the brain. It continues in some brain regions throughout our lifespan.

37
Q

What basic type of cell is the CNS made up of?

A

Neurones - cells that send and recieve signals to different areas: 3 parts - cell body, axon and dendrite
Glia - cells that provide structure in the brain: asotrocytes and oligodendrocytes.

38
Q

What are neural stem cells?

A

Have the potential to generate all neural cell types.
They differentiate into neuronal progenitor cells, which give rise to neuron.

39
Q

What are the 3 regions of neurogenesis?

A

The subgranular (SGZ) zone - of the dentate gyrus in the hippocampus, which is a region involved in regulating learning and memory
The subventricular zone (SVZ) -
The amygdala -

Exercise increases neurogensis in the detate gyrus which increases production of newborn neurones
Depression found to decrease neurogenesis
Scientists interested in enhancing neural production to treat age associated cognitive disorders.

40
Q

What are the three kinds of neurones?

A

Sensory neurones: carry info from the sense organs to the brain
Motor neurones: control voluntary muscle activity such as walking, talking, and carry messages from nerve cells in the brain to the muscles
Interneurones

41
Q

What is a stroke?

A

An abrupt neurological outburst caused by impaired perfusion through the blood vessels in the brain. The blood flow to the brain is managed by 2 internal carotids anteriorly and 2 veretebral arteries posteriorly.

42
Q

What is a hemorrhagic stroke?

A

When blood from an artery suddenly begins bleeding into the brain.

Intracerebral - bleeding within the brain tissues

Subarachnoid - bleeding into the space between the inner and middle layers of the meninges.

Accounts for 10-15% of all strokes
Main reasons: hypertension, excessive use of anticoagulants, and thrombolytic agents, disrupted vasculature

43
Q

What is an ischemic stroke?

A

Occurs when a blockage cuts off blood supply to part of your brain, killing brain cells. This can be due to blood clots in arteries which travels from the heart to the brain.

Embolic - presence of blood clots. Necrosis following disruption of plasma membrane, organellse swelling, leaking of cellular contents, loss of neuronal function
Thrombotic - blood flow impaired due to fat deposits, on the wall of the blood vessels.

85% of strokes are ischemic

44
Q

What is a transient ischemic stroke?

A

A mini stroke caused by a temporary disruption in the blood supply to part of the brain.

45
Q

What are some risk factors for stroke?

A

Hypertension
Diabetes
Obesity
Metabolic syndrome
Diet and nutrition
Cigarette smoking
Alcohol consumption
Physical inactivity
Obstructive sleep apnoea
Carotid disease
Prosthetic heart valves
Cardiomyopathy
Myocardial infarction

46
Q

What is cognition?

A

Term referring to the mental processes involved in gaining knowledge and comprehension.

Social cognition, executive function, memory, attention, psychomotor speed, emotion recognition, mental flexibility, working memory, episodic memory, recognition memory, sustained attention, choice reaction time, emotional bias, planning, response inhibition, working memory

47
Q

What are cognitive assessments?

A

Objective measurements of distinct cognitive abilities such as working memory, inhibition, cognitive flexibility, psychomotor speed and sustained attention.

48
Q

What is the frontal lobe responsible for?

A

Motor control
Problem solving
Speech production

49
Q

What is the temporal lobe responsible for?

A

Auditory processing
Language comprehension
Memory information retrieval

50
Q

What are the cerebellum responsible for?

A

Balance and coordination

51
Q

What is the occipital lobe responsible for?

A

Sight
Visual reception and visual interpretation.

52
Q

What is the parietal lobe responsible for?

A

Touch perception
Body orientation and sensory discrimination

53
Q

What is the Pons responsible for?

A

Helps regulate breathing

54
Q

What is the medulla olongata responsible for?

A

Regulates our heart and other reflexes such as vomiting, sneezing and swallowing

55
Q

What is the hypothalamus responsible for?

A

Adrenaline

56
Q

What is the pituitary gland responsible for?

A

Growth
Pregnancy
Child birth
Body temperature

57
Q

What are some symptoms of a stroke?

A

Trouble seeing or blurry vision
Difficulty speaking
Weak arm or leg
Dizziness or loss of balance
Pain
Severe headache
Droopy face
Fatigue or mental changes
Hiccups
Breathlessness or heart palpitations

58
Q

What is a seizure?

A

Sudden abnormal electrical acitivty that temporarily interrupts normal brain function

A stroke can trigger this burst if electrical activity by damaging these connections between some of your brain cells.

Large groups of neurones fire at the same time

30 seconds to 2 minutes

59
Q

What are the different types of seizures?

A

Focal seizures: happen in just one part of the brain. There are two types. Motor (physical signs like moving your arms) or non-motor (affectes senses, awareness and emotions)
Generalised seizures occur all over the brain and affects the whole body. Motor seizure loss of conscioussness or muscle spasms and non motor where the person stops moving.

Post stroke seizures are categorised as:
Early seizures - experienced within 7 days after a stroke, generally indicate acute, reversible cerebral injury
Late seizures - occuring after the initial week of a stroke, generally indicate long lasting changes in the post stroke brain.

60
Q

Explain post stroke fatigure?

A

Fatigue affects 39-72% of stroke survivors.
It is defined as physical and mental exhaustion that is triggered by stress, medication, overwork and mental and physical illness or disease.

Management is best done with lifestyle changes.

61
Q

What are the sensory receptors for the different senses?

A

Spinothalamic
Light touch - meissner’s corpuscle and merkel’s discs
Pressure - pacinian corpuscle
Pain/pin prick - free nerve endings
Temperature - thermoreceptors

Dorsal column
Vibration - meissner’s cor[uscle and pacinian corpuscle
Proprioception - muscle spindle and ruffini endings
Touch localisation - meissner’s corpuscle and merkel’s discs

62
Q

What is the visual association area in the brain?

A

Occupies most of the occipital lobe and the inferior part of the temporal lobe.
It is involved in visual recognition and appreciation of its significance.

The primary visual cortex lays at the most posterior point of the occipital lobe and it recieves and processes visual signals.

The optic chiasma is where the optic nerves cross over, and is therefore of primary importance to the visual pathway. Located at the base of the brain, inferior to the hypothalamus.
Optic tract carry visual info from optic chiasm to left and right geniculate bodies. Each optic tract carries half of the visual field.

63
Q

How does the neural tube develop in embryonic brain development?

A

A portion of the ectoderm differentiates into tissue that will become the nervous system.

The cells begin to change shape, so the tissue buckles and folds inwards

A neural groove forms along the dorsal surface

The neural folds come together and converge.

The underlying structure forms the neural tube.

At this point, the early nervous system us a simple, hollow tube.

64
Q

Explain the primary vesicle stage of embryonic brain development

A

When the embryo is 3 to 4 weeks, the anterior end of the neural tube develops into the brain.

Three primary vesicles are formed:
Prosencephalon - form cerebrum
Mesencephalon - form midbrain
Rhombencephalon - become rest of brain stem and spinal cord

65
Q

Explain the secondary vesicle stage of brain development

A

5 week old embryo
Vesicles differentiate further
Telenchephalon and diencephalon (thalamus and hypothalamus). Mesencephalon does not divide further. Metencephalon becomes pons and the cerebellum and myencephalon will become the medulla.
3 primary vesicles become 5 secondary vesicles

The mesencephalon (midbrain) remains an established region of the brain.

66
Q

Describe the development of the spinal cord

A

The cells of the neural tube migrate to form the mantle layer of gray matter which differentiates into:
- alar plate (sensory neurones)
- basal plate (motor neurones)
These are seperated by sulcuc limitans.

The cells of the mantlelayer have axons which collect in the marginal layer of white matter.

67
Q

What is the order of reflexes?

A

Stimulus
Receptor
Sensory
Spinal cord
Relay neurone
Motor neurone
Effector muscle
Response

68
Q

What are Piaget’s 4 stages of cognitive development?

A

Sensorimotor stage: birth to 2 years. Begins to interact with the environment.
Preoperational stage: 2 to 7 years. Begins to represent te world symbollically. Eg play pretend.
Concrete operational stage: 7 to 11 years. Learns rules such as conversation. Games with rules.
Formal operational stage: 12 years and up. Can transcend the concrete situation and think about the future.

69
Q

What are the benefits of children playing?

A

Communication skills
Self regulation
Cognitive skills
Learn new information
Learn and practice social skills
Extend thinking
Resolve conflicts
Problem solve
Cooperation
Learn about themselves
Explore roles, interests, skills and relationships.

70
Q

What are some causes of birth defects?

A

Smoking, drinking alcohol or taking certain drugs during pregnancy.
Medical conditions eg obesity or uncontrolled diabetes.
Certain medications such as isotretanoin
Having someone in yur family with a birth defect
Some infections during pregnancy such as Zika Virus and CMV.
Experiencing a feever greater than 40 degrees or heat exposure
Older mother. Risk of chromosomal abnormalities increases with age.

71
Q

What is spastic cerebral palsy?

A

Stiff muscles (spasticity) associated with demage to or developmental differences in the cerebral cortex.
Involuntary movements, stiffness and mobility impairments.

Spastic hemiplegia: circumductive gait so reduced flexion on affected side, requires swiming outward of leg to walk. Decreased use of affected side hand, preference for unaffected side.

Spastic diplegia: scissor gait, increased tone in the hip adductor muscles causes legs to adduct past midline whilst walking. Commando crawl, draws legs behind due to lower limb weakness.

Spastic quadriplegia: all limbs affected, and swallowing. High liklihood of seizures and cognitive impairment.

72
Q

What is dyskinesia/athetoid cerebral palsy?

A

Uncontrolled movement associated with damage to the basal ganglia
Characterised by mixed muscle tone, hypertonia and hypotonia
Postural impairments, fine motor functionproblems and poor physical control.

73
Q

What is ataxia cerebral palsy?

A

Poor balance and coordination (ataxia) associated with damage to the cerebellum.
Generally hypotonia (low muscle tone), tremors, motor impairments, imbalance and visual and auditory processing problems.

74
Q

What is mixed cerebral palsy?

A

Result in damage to multiple parts of the brain.

75
Q

What is cerebral paulsy?

A

An umbrella term that described a disorder of movement or posture caused by an abnormaility in the immature brain. It is non progressive.

Majority causes occur before the time of birth, eg brain not developed normally, or infection or trauma.

Risk factor premature birth.

A risk is that the muscles become short and contractures develop because the muscles aren’t working properly.

Use splints, or injections to relax and lengthen muscles. Some may need surgery to lengthen muscles.

76
Q

Name some CNS birth defects

A

Spina bifida - the bones of the spine fail to fuse (a gap in the spine)
Anencephaly - when the neural tube doesn’t close at the head, which may cause the uppermost brain tissue, the meninges and the scalp to be missing (not able to live)
Encephalocele - the meninges and brain tissue bulge out through a gap in the skull.

77
Q

What are some risk factors for cerebral palsy?

A

Antenatal - prematurity and low birth weight, intrauterine infections, multiple gestation, pregnancy complications
Perinetal - birth asphyxia, complicated labour and delivery
Postnatal - non-accidental injury, head trauma, meningitis, cardio-pulmonary arrest

78
Q

What is dystonia?

A

Movement seen in dyskinetic Cerebral Palsy. Movements that are involuntary. Unusual twisting movements, repeitive movements etc.
Arises from basal ganglia damage.

79
Q

Briefly summarise the 3 types of CP?

A

Spasticity - severe increase in muscle tone, damage to the motor cortex, most common form
Dyskinetic - dystonia and athetosis included, hyperactivity in the muscles of face and tongue, repetitive, uncontrollable writhing movements
Ataxic - least common, poor coordination and difficulty with precise movements, damage to the cerebellum.

80
Q

What is the difference between rigidity and spasticity?

A

Rigidity is the uniform resistance in the entire range of motion or rachet like interruptions in resistaicene. Lead pipe rigidity or cog wheel rigidity

Spasticity is lengthening reaction (catch-yield sequence). Velocity dependence of resistance. Clasp knife and seatbelt phenonomemn.

81
Q
A

PHYSIOTHERAPY (13 decks)

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