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Nervous Flashcards

1
Q

What are the divisions of the nervous system?

A

CNS and PNS
PNS splits into somatic and autonomic
Autonomic splits into sympathetic and parasympathetic

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2
Q

What is the somatic nervous system?

A

A division of the peripheral nervous system
Voluntary control
Sensory perception

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3
Q

What is the structure of a neuron?

A

Cell body contained nucleus
Dendrites project off cell body and receive signals
Axon is a long projection covered in myelin sheath that carries signal to the synapse

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4
Q

What is the myelin sheath?

A

Fatty covering on axon which insulates to speed up the signal transmission
Gaps in this are nodes of ranvier which help to propagate the signal

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5
Q

What is multiple sclerosis?

A

Immune mediated disease that destroys myelin sheath and the cells that produce it.
Causes slow signal transmission and nerves become prone to damage
SX: reduced strength and motor control, reduced sensation, pain

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6
Q

What are the 3 types of neuron?

A

Sensory (afferent): detects stimulus and sends to CNS
Interneuron: bridges sensory and motor neurons/integrates signals
Motor (efferent): transmit motor signal from CNS to body

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7
Q

What are the 4 functional properties of neurons?

A

Excitability: stimulated to generate signals
Action potentials: neuron membrane depolarises to send signal
Synapse: junctions between neurons
Neurotransmitters: transmit signal across junction

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8
Q

What is the fight/flight NT?

A

Adrenaline

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9
Q

What is the concentration NT?

A

Noradrenaline

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10
Q

What is the pleasure NT?

A

Dopamine

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11
Q

What is the mood NT?

A

Serotonin

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12
Q

What is the calming NT?

A

GABA

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13
Q

What is the learning NT?

A

Acetylcholine

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14
Q

What are the 6 phases of an action potential?

A

Resting state
Stimulus and depolarisation
Threshold and AP
Repolarisation
Hyperpolarisation and Refractory
AP propagation

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15
Q

What is the resting state phase of an AP?

A

The cell is at rest with a stable membrane voltage
Inside cell is more negative than outside

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16
Q

What is the stimulus and depolarisation phase of an AP?

A

A stimulus causes the voltage across the membrane to change
This opens sodium channels (voltage-gated) allowing sodium ions to enter the cell
The cell becomes less negative inside charged than outside = depolarised

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17
Q

What is the threshold and AP phase of an AP?

A

If depolarisation of cell meets the threshold, further sodium channels open rapidly causing a mass depolarisation of the cell (the inside becomes way less negatively charged than outside)
Positive feedback loop allows the AP to travel along the neuron

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18
Q

What is the repolarisation phase of an AP?

A

Sodium channels close and potassium channels. No more sodium can enter the cell but potassium exits allowing the cell to become more negatively charged

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19
Q

What is the hyperpolarisation and refractory phase of an AP?

A

Repolarisation overshoots so inside of cell becomes more negatively charged than it should be at rest.
Therefore the cell cannot fire another AP, ensuring these move in one direction only

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20
Q

What is the AP propagation phase of an AP?

A

AP travels along axon to terminal, triggering release of NTs into synapse

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21
Q

What is a synapse?

A

Junction between cells
Presynaptic cell releases NTs that stimulate receptors of postsynaptic cell
NTs housed in vessicles which fuse with membrane at axon terminal to be released into cleft

Once complete, postsynaptic cell releases the NTs which are reuptaken by presynaptic cell

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22
Q

What is the synapse, NT and receptor of a neuron to muscle connection?

A

Synapse is called neuromuscular junction
NT is acetylcholine
Receptor is nicotinic

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23
Q

What is the foramen magnum?

A

Hole in cranium that allows cord to extend from brain into spinal column

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24
Q

What are meninges?

A

Protective layers of brain
Periosteal Dura Mater (adhered to skull)
Meningeal Dura Mater (adhered to deeper structures)
Subdural space
Arachnoid Mater
Subarachnoid space (CSF)
Pia Mater
Brain

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25
What is CSF?
Cerebrospinal fluid Housed in subarachnoid space Made by choroid plexus in ventricles of brain Supply and remove waste from brain/cord to prevent blood borne issues affecting them ‘Floats’ brain/cord to protect
26
What are the 3 main structures of the brain?
Cerebrum (main upper part) Cerebellum Brain stem
27
What is the cerebrum?
Main upper region of brain Two hemispheres connected by corpus callosum Four lobes divided by sulci - frontal, parietal, temporal, occipital Many gyri (rises) and sulci (grooves) exist to increase surface area
28
What is the frontal lobe for?
High cognitive functions Personality Motor control
29
What is the parietal lobe for?
Processes sensory information Spatial awareness
30
What is the occipital lobe for?
Visual processing
31
What is the temporal lobe for?
Auditory processing Language Memory (hippocampus)
32
What is the cerebellum?
Major motor centre!! Receives multiple information (e.g. posture, balance, motor, vision, muscles) and coordinates it to produce movement Receives information from all over body; send information mainly to stem/cord Has extra folds = folia 3 lobes = anterior, posterior and flocculonodular
33
What is the brain stem?
Connects brain to cord Acts as relay station for signals and controls life sustaining functions + reflexes Has 3 regions: medulla oblongata, pons and midbrain (thalamus at the top)
34
What is grey matter?
Composed of neuron cell bodies, dendrites and axons Makes up outermost brain layer but inner H in spinal cord Pink/grey colour Processes information
35
What is white matter?
Composed of bundled axons coated in myelin Connects brain areas Connection/communication: Carries signals between grey matter and to receiving cells
36
What is the brain blood supply?
Left and right internal carotid artery Left and right vertebral artery These converge in brain at circle of Willis and then feed into other vessels. This ensures continual supply of O2 and glucose to brain even if one vessel fails.
37
What is cerebral palsy?
Damage to brain tissue during development Result ranges from mild weakness to paralysis
38
What is dementia?
Group of disorders affecting cognitive brain function Multiple causes (inc. Parkinson’s, infection, trauma, HIV, huntingtons) SX: memory loss, reduced cognition, reduced communication, reduced visual perception, changed mood Progressively worsens over time TX: control SX, maintain safety, support
39
What is the spinal cord?
Cylindrical bundle of nerve tissue extending from brain through foramen magnum down to L1/2 Relays signals between brain and body Brain to body = motor Body to brain = sensory Inner H grey matter with white matter surrounding it Same 3 layer meninges Nerve roots of sensory and motor connect to cord at each vertebral level connecting the PNS to CNS
40
What are the 2 pathways of the somatic nervous system?
The afferent pathway is sensory (carries signals away from body to CNS) The efferent pathway is motor (carries signals away from CNS to body)
41
What is a nociceptor?
Senses pain E.g. skin receptor
42
What is a proprioceptor?
Senses position/movement E.g. tendon receptor
43
What are the 4 stages of pain?
1. Transduction: nociceptor detects and creates an AP 2. Transmission: AP travels afferent pathway to cord + brain 3. Modulation: process of modifying/controlling pain 4. Perception: brain interprets pain signal and creates conscious experience
44
What is substantia gelatinosa modulation?
At spinal cord, pain signal may interact with interneuron causing an increase or decrease in the signal
45
What is gate control theory?
Cord can open/close gate go pain signals Will close the gate if stimulus is not ‘painful’ Emotional/cognitive factors can open gate
46
What is descending pain modulation?
Brain can send signal down the pain pathway to inhibit signals Serotonin and endorphins can act as a painkiller
47
What are neuromodulation techniques?
Medications, blocks or electrical therapies can interfere with pain signal transmission
48
What are spinal reflexes?
Rapid, involuntary response to a specific stimulus Mediated by spinal cord (no brain input) Achieved with interneurons - direct connection between sensory and motor
49
What are the 6 PNS nerve groups?
Cranial (12 pairs) - head/neck Spinal (31 pairs) - spine to body Brachial plexus - low C to high T spine to arms Sciatic nerve - L/S spine to back of legs Femoral - L spine to legs Vagus - PNS innervation to organs
50
What is the stress response?
Threat perceived Signal to hypothalamus activates stress response Cortisol (increases glucose availability) and adrenaline (immediate physical action) released Sympathetic nervous system outcomes Once threat gone, parasympathetic system will restore balance
51
How is the paediatric nervous system different?
Skull not fused = brain less protected Developing brain = trauma more damaging Mental health presents differently Undeveloped thermoregulation system = vulnerable to hot/cold Undeveloped control/coordination = falls Big head with weak neck muscles = high risk damage
52
How does the nervous system of geriatrics differ?
Reduced neural tissue = brain loose in skull Signal transmission speed reduced = slow movement and reflex Reduced peripheral sensation = injury risk Reduced memory and decision making
53
What is a stroke/CVA?
Blood supply to part of brain interrupted leading to tissue damage Can be haemorrhagic or ischemic (80%) Brain needs constant oxygen and glucose supply SX: F (facial drop), A (arms can’t raise), S (slurred, confused) E TX: transport to ED, support
54
What is an ischemic stroke?
Blood vessel is blocked or narrowed (artherosceloris) Thrombolic stroke - blood clot in brain Embolic stroke - blood clot from elsewhere travels to brain
55
What is a haemorrhagic stroke?
Blood vessel ruptures causing bleeding Intracerebral - weakened vessel or AVM bleeds into brain tissue Subarachnoid - bleed into space between brain and layers (usually aneurysm)
56
What is a cerebral TIA?
Transient ischemic attack Mini/warning stroke Temporary disruption to brain blood flow which eventually resolves SX the same as CVA
57
What is a seizure?
Abnormal electrical activity in the brain Big surge in excitation Can be focal (partial) or generalised
58
What is a focal/partial seizure?
Originates in specific area of one hemisphere Simple: remain conscious, tingling, flashing lights, jerking Complex: ALOC, repetitive movement, purposeless actions, emotional change
59
What is a generalised seizure?
Both hemispheres are involved and there is often a loss of conscious 6 types SX: uncontrolled muscle movement, ALOC, staring, weird sensation, no tone, stiffness, confusion, fatigue TX: transport to ED, remove objects/protect from harm, treat cause of seizure, midazolam
60
What is an absent seizure?
Generalised seizure often in children SX: brief loss of awareness, staring, blinking/lip smacking
61
What is a tonic seizure?
Generalised seizure SX: stiffening usually in arms, legs and back
62
What is a clonic seizure?
Generalised seizure SX: rhythmic jerking of muscles usually in face, neck and arms
63
What is a myoclonic seizure?
Generalised seizure SX: sudden, brief twitches
64
What is an atomic seizure?
Generalised seizure SX: sudden loss of tone causing collapse
65
What is a tonic-clonic/grand mal seizure?
Severe generalised seizure SX: tonic and clonic phases (stiff and rhythmic jerking), ALOC, convulsion, dyspnoea
66
What can cause a seizure?
Epilepsy Fever Brain injury Infection Tumour Drugs Metabolic disturbance
67
What is a traumatic brain injury?
External mechanical force causing brain tissue damage. Acceleration or deceleration of brain within cranium. Focal: localised damage e.g. haematoma Diffuse: widespread e.g. concussion
68
What is a concussion?
Temporary TBI Caused by blow to head or violent shaking Symptom onset can be immediate or delayed SX: reduced concentration and memory, balance and coordination issues, headaches, N+V, fatigue, mood change, speech slurred, sleep issues, ALOC, seizure TX: moderate/severe transport to ED, manage pain, stabilise head/neck, monitor ABC
69
What is a spinal cord injury?
Movement/force exceeds structures capacity resulting in damage to cord Level affected = level of dysfunction Paraplegia = T, L or S spine; torso/leg dysfunction Tetraplegia/quadriplegia = all limb dysfunction
70
What are the 6 mechanisms of SCI?
Flexion: head/neck bends forward Compression: cord squeezed together Hyperflexion: neck bent back Flexion-rotation: spine twists Penetration: FB Distraction: cord stretched apart
71
What is autonomic dysreflexia?
Life threatening condition with SCI above T6 Exaggerated response to a stimulus below T6 (usually bladder/bowel related). Signal cannot ascend above spinal cord injury so triggers the sympathetic nervous system Need urgent medical treatment to correct stimulus
72
What are the SX of SCI?
Consider mechanism Neck/back pain worsens with movement Reduced sensation/movement in limbs Respiratory issues Abnormal positioning Bladder/bowel incontinence
73
What is meningitis?
Inflamed meninges caused by a pathogen Bacterial is the most aggressive
74
What is meningococcal?
Neisseria miningitidus bacteria multiples in the blood damaging vessel walls Marked by non-blanching rash
75
What are SX of meningitis/meningococcal?
Sudden fever/chills Extreme headache Stiff neck Photophobia Altered mental status N+V Non-blanching rash Fatigue Cold extremities Body pain High RR
76
What are SX of drug overdose?
Sedation Altered mental state Slurred speech Reduced RR Cyanosis Weak/loss muscle control N+V ALOC Low HR and BP Pinpoint pupils

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