NEU 409 Exam 2 Flashcards

Question

Cerebrospinal Fluid (CSF)

Answer 1

Produced by choroid plexus 1 located in each ventricle Modified ependymal cells with tight junctions (barrier between blood and CSF) CSF found in: Brain ventricles Arachnoid space Brain Spinal cord Functions: Protection Buoyancy Removes waste Transports nutrients and hormones

Answer 2

Helps in planning, monitoring, and correction of motor movement using sensory feedback Coordinates fine motor activity. Monitor head and body position. Participates in learning new motor skills Cerebellar damage is ipsilateral (same side) to the affected side! Can be stroke in cerebellum in that artery Artery supplied to cerebellum vertebral basilar system - posterior cerebral artery

Answer 3

Finger to nose test Diadochokinesia test (pa-ta-ka) Uncoordinated, sloppy movement may indicate cerebellar damage

Answer 4

Ataxia: Discoordinated clumsy movements Dysmetria: over or undershooting touching a mark Dysdiadochokinesia: Inability to perform rapid alternating movements of hand or mouth Nystagmus: Fast involuntary eye movements either side to side or up and down Ataxic Dysarthria: Slurred or scanning (broken into syllables) speech Hypotonia: Reduced muscle tone and reflexes; muscles tire

Answer 5

Regulates major life functions (e.g., heart beat, respiration). Mediates head and neck reflexes (e.g., gag) via cranial nerves Regulates alertness and wakefulness. Brainstem disorders: Pons Locked-in syndrome Quadriplegia Cranial nerve paralysis (except for eye movements) Diving Bell & the Butterfly

Answer 6

I. Olfactory Nerve II. Optic Nerve III. Oculomotor Nerve IV. Trochlear Nerve V. Trigeminal Nerve VI. Abducens Nerve VII. Facial Nerve VIII. Vestibulocochlear Nerve IX. Glossopharyngeal Nerve X. Vagus(wandering nerve) Nerve XI. Spinal Accessory Nerve XII. Hypoglossal Nerve (7 and 9 is only tongue sensation)

Answer 7

Origin = olfactory bulb Functional category = special sensory Function(s) = smell Problem(s) = anosmia (loss of smell first symptoms in alzheimerizer)

Answer 8

Origin = thalamus Functional category = special sensory Function(s) = vision Problem(s) = visual disturbances; loss of vision

Answer 9

Origin = midbrain Functional category = motor & parasympathetic Function(s) = motor: moves eyes up/down, in/out; upper eyelid - side to side parasympathetic: pupil constrictor Problem(s) = loss of pupillary light reflex; ptosis (droopy eyelid)

Answer 10

Origin = midbrain Functional category = motor Function(s) = moves eyes in & down Problem(s) = diplopia (double vision); nystagmus (repetitive movements); difficulty moving eyes in & down

Answer 11

Origin = pons Functional category = Sensory & Motor Function(s) = sensory: touch, pain, temperature, vibration for face, mouth, anterior 2/3 of tongue motor: chewing muscles Problem(s) = loss of above sensations; difficulty chewing; abnormal jaw-jerk reflex

Answer 12

Origin = pons Functional category = motor Function(s) = rotates eyes out Problem(s) = eye rotates in (strabismus) & diplopia; nystagmus

Answer 13

Origin = pons Functional category = motor, sensory, special sensory, parasympathetic Function(s) = motor: muscles of face, some eyelid muscles sensory: sensation near ears special sensory: taste in ant. 2/3 of tongue parasympathetic: salivary glands Problem(s) = facial paralysis; taste loss

Answer 14

a.k.a., auditory nerve Origin = pons/medulla junction Functional category = special sensory Function(s) = hearing & balance Problem(s) = hearing loss; balance problems

Answer 15

Origin = pons/medulla junction Functional category = motor, parasympathetic, sensory, special sensory Function(s) = motor: pharyngeal movement parasympathetic: parotid gland (salivation) sensory: middle ear, pharynx, post. 1/3 of tongue special sensory: taste on post. 1/3 of tongue Problem(s) = absent gag & swallow reflex; loss of taste; loss of pharyngeal movement

Answer 16

Origin = medulla Functional category = motor, parasympathetic, sensory, special sensory Function(s) = motor: pharyngeal & laryngeal muscles parasympathetic: heart, lungs; digestive tract; blood pressure sensory: pharynx special sensory: taste from epiglottis & pharynx Problem(s) = absent gag & swallow reflex; loss of velar movement; loss of voice

Answer 17

Origin = medulla, spinal cord Functional category = motor Function(s) = neck & shoulder muscles Problem(s) = droopy shoulder; movement of neck

Answer 18

Origin = medulla Functional category = motor Function(s) = muscles of tongue Problem(s) = loss of tongue movement; tongue fasciculations, tongue atrophy

Answer 19

Spinal nerves all are mixed (sensorimotor) Cranial nerves that are Sensory only – CN I, II (CN I & II not in brainstem!), VIII Cranial nerves that are Motor only – CN III, IV, VI, XI, XII Cranial nerves that are Mixed (Both-sensorimotor) - CN V, VII, IX, X Location of Cranial Nerves Most nuclei are in the brainstem (CN I & II are not) Midbrain – CN III & IV, part of CN V Pons – CN V, VI, VII, VIII Medulla – part of CN V, VII, & VIII; in addition CN IX, X, XI, XII exit from here

Answer 20

gray inside for cell bodies and white outside) - gray is cell body and axon - inner structure gray butterfly Ascending tracts - sensory Dorsal columns: fasciculus gracilis and fasciculus cuneatus → and spinothalamic tract and spinoreticular tract Descending tracts - motor Lateral corticospinal tract Dorsal ramus: Sensory/motor from/to dorsal (back) of body Ventral ramus: Sensory/motor from/to anterior (front) of body Spinal nerve: Mixed nerve Sensory/motor Dorsal root: Sensory info from body GSA, GVA fibers Ventral root: Motor info to body GSE, GVE fibers

Answer 21

Crude Touch and pressure: (anterior spinothalamic) Crude touch receptors Afferent dorsal sensory root 1st order neuron ipsilateral comes in - from right arm right dorsal root 2nd order neuron crosses over to contralateral side To thalamus in brain Pain and temp: (lateral spinothalamic) - threatening immediately go to opposite side Pain/temp receptors Afferent dorsal sensory root - synapse in dorsal horn 1st order neuron ipsilateral 2nd order neuron crosses over to contralateral side To thalamus in brain 3rd order primary somatosensory cortex Discriminative(fine,light,precise) touch, vibration, and proprioception(awareness of body part or joints in space: (dorsal columns cross medulla) Discriminative touch, vibration, and proprioception receptor Afferent dorsal sensory root 1st order neuron ipsilateral To medulla - no 2nd order neuron yet 2nd order neuron crosses over to contralateral side after lower medulla Synapse in medulla

Answer 22

Muscle Lower motor neurons Spinal cord Two neuron sequence Brain Upper motor neurons Primary motor cortex Lateral Corticospinal Tract (Voluntary Motor Movement) - two steps Start in primary motor cortex if grab with left side will do it with right side Spinal cord Medulla Motor cortex Steps: from motor cortex medulla to muscle: upper motor neuron cross upper motor neuron, efferent ventral motor root, muscle Motor cortex ipsilateral - medulla contralateral

Answer 23

Pathway: Lateral corticospinal Tract → Function: Motor Pathway: Dorsal (posterior) column- Medial Lemniscal pathway → Function: Vibration, joint position, fine (discriminative) touch Pathway: Anterolateral pathway (Spinothalamic tract) → Function: Pain, temperature, crude touch, pressure

Answer 24

A systematic examination of the nervous system performed by a neurologist Purposes: Identify abnormalities in the nervous system Differentiate CNS from PNS problems 1. The Interview 2. The Physical Exam 3. The Neurological Exam 4. Laboratory Tests The Neurological Exam Mental State Evaluation (includes language, memory, attention) Cranial Nerves Evaluation Motor System Evaluation (posture, limb movement) Reflex Testing Sensory System Evaluation Equilibrium Evaluation (coordination, balance; walking, DDK rates)

Answer 25

Bradykinesia: slowed movements Akinesia: without movement Rigidity: Stiff or tight muscles that resist passive movement to a limb, Leg pipe also called Example: A relaxed joint will resist being bent or straightened. Chorea (Gk. for “dance”): quick, involuntary movements of the hands and/or feet that have a dance-like quality Athetosis: slow, twisting, involuntary movements of the hands and/or feet Ballism: Quick, involuntary flinging of a limb When it occurs on just one side of the body, it is called hemiballismus. Myoclonus: Sudden, involuntary muscle jerks Example: hiccups Tremor: = rhythmic shaking Intention tremor = rhythmic shaking that occurs when trying to do something voluntarily Resting tremor = rhythmic shaking that occurs while hand is at rest, but disappears when intentionally using hand Pill-rolling tremor = associated with Parkinson’s disease; appear to be rolling something with thumb and first two fingers Fasciculations: Muscle twitches When occurring in the tongue, it has the appearance of worms or snakes quivering in a bag.

Answer 26

Corpus striatum – caudate nucleus + lentiform nucleus deep within each cerebral hemisphere Lentiform nucleus – consists of several segments that form the putamen + globus pallidus Striatum – caudate nucleus + putamen Inhibits globus pallidus + substantia nigra a.k.a., Corpus Striatum Parts: Globus pallidus Putamen Caudate nucleus (Substantia nigra) - Part of midbrain (Subthalamic nucleus) - Part of diencephalon

Answer 27

Set of interconnected loops that inhibit or facilitate movement (each separate function) Four anatomical loops (circuits) First, largest central loop transmits sensory motor impulses to striatum, globus pallidus, & thalamus (sensory motor integration-voice/auditory feedback) Other three loops small and act as “subloops” to first basal ganglia loop BG activities are strongly connected to indirect pathway

Answer 28

Lesions result in movement disorders Regulates posture & muscle tone, adjusts automatic motor movements (follow through during throwing, facial expressions, etc); & suppresses extraneous motor movements when indicated ( hence posture disturbance and altered muscle tone), assists in learning, selection and initiation of movements No UMNs or LMNs in basal ganglia; therefore, no paralysis occurs with lesions here; however, contralateral control Lesions result in loss of inhibitory control Regulates complex motor function such as posture, locomotion, balance, arm swinging Inhibits function Coordinates motor behavior Uses dopamine

Answer 29

Function of basal ganglia depends on balance of several major neurotransmitters (acetylcholine, dopamine, GABA) Balance is vital to motor regulation Impairments result in Parkinson’s disease (dopamine & acetylcholine imbalance) or Huntington’s chorea (GABA)

Answer 30

Motor activity regulation (Hypokinetic dysarthria affects speech motor control-preparation, maintenance, and switching of motor programs, thus inferencing role of BG in speech motor control) Mood & personality regulation (psychiatric disorders) Inappropriate release of movement & loss of inhibitory control Hypokinetic ( decreased voluntary movement) or Hyperkinetic Dysarthria (increased movement causing involuntary movements)

Answer 31

Bradykinesia Rigidity (due to increased muscle tone) Tics Tremor Gait issues Dystonia Chorea Athetosis

Answer 32

Progressive neurological disease First described by Dr. James Parkinson in 1817. Also known as the “shaking palsy.” Caused by degeneration of midbrain’s substantia nigra and loss of dopamine to basal ganglia Symptoms: muscle rigidity, masked face, micrographia, dyskinesias, resting & pill rolling tremors, shuffling gait, weak voice, dysarthria, flat affect, poor posture, and dysphagia, about 20% will also develop cognitive processing difficulties Faces of Parkinson’s Disease Cognitive impairment and dementia in PD PD is primarily a motor impairment BUT mild cognitive impairment is very common (NOT the same as dementia) Dementia is severe loss of cognitive abilities Across a wide range of cognitive skills About 20% of PD patients will develop dementia Why do some progress to dementia and others don’t? No clear answer to this, but some possibilities: Other neurotransmitter changes (e.g., acetylcholine) Medications used to treat PD Evidence that L-DOPA (and others) are linked to dementia symptoms BUT, usually rapid onset PD is more common in older adults More likely to develop dementia if PD onset after age 60 Risk for dementia increases with age (regardless of PD diagnosis)

Answer 33

Medications Levodopa is “gold standard” - Works by replacing dopamine Pallidotomy: cells in the globus pallidus are selectively destroyed using a heated probe, reducing Parkinsonian symptoms Deep Brain Stimulation (DBS): surgical insertion of a brain pacemaker that stimulates the basal ganglia, reducing Parkinsonian symptoms

Answer 34

Progressive, hereditary neurological disease due to degeneration of the basal ganglia Autosomal dominant pattern of inheritance If you have the gene, you get the disease Average onset around 35 years of age Survival about 10-20 yrs after diagnosis Symptoms: severe chorea, athetosis, emotional & personality changes, torticollis (twisting of the neck), dysarthria, dysphagia, and dementia.

Answer 35

No cure, medications can help manage disease Tetrabenazine Suppress involuntary jerking and writhing movements (chorea) Serious side effect Worsening or triggering depression or other psychiatric conditions Antipsychotic drugs, such as haloperidol (Haldol) and chlorpromazine Side effect of suppressing movements, can be beneficial in treating chorea They may worsen involuntary contractions (dystonia) and muscle rigidity

NEU 409 Exam 2 Flashcards

(59 cards)