NEURO 3 Flashcards

(57 cards)

1
Q

The three external components of the brainstem:

A
  1. Medulla
  2. Pons
  3. Midbrain
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2
Q

Medulla

A

below the pons
- 80% of nerves cross here
- Cranial nerve XII hypoglossal is housed at the lower boundary of the medulla
-the upper boundary of the medulla is the FORAMEN CECUM, which marks the boundary between the medulla and the pons

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3
Q

Pons

A

-attached to the cerebellum through the cerebellar peduncles
+Function- acts as a bridge to relay neural fibers b/n the cerebrum, the cerebellum, and the lower structures. Nuclei in the pons help with respiration, swallowing, hearing, eye movements, facial expressions, and general sensations.
-several cranial nerve nuclei are in the pons

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4
Q

Midbrain

A

-anterior of the midbrain consists of two cerebral peduncles
-The front peduncle is called the crus cerebri, and the back is called the tegmentum
-between these two peduncles is a layer of dark matter called the substantia nigra, and dopamine is produced here (lack of dopamine can result in Parkinson’s)

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5
Q

Tectum

A

the back part of the midbrain, and contains the paired inferior and superior colliculi.
-auditory center of the midbrain, and is responsible for our startle response to loud noises, and turning our heads and eyes to the source of sound

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6
Q

Cranial Nerve V

A
  • TRIGEMINAL NERVE
    -motor and sensory
    -3 branches (ophthalmic, maxillary, and the mandibular branch)
    -motor portion is the opening and closing movements of the jaw
    -sensory portion is responsible for sensation of the face, the nose, the mouth, the scalp, the jaw, the anterior 2/3 of the tongue, and the mucus membranes of the mouth
    -also reads proprioceptive muscles for chewing
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7
Q

Cranial Nerve VII

A

-FACIAL NERVE
-both motor and sensory
-the motor portion has 2 branches, intracranial and extracranial. The extracranial innervates the facial muscles for speech
-its sensory portions are responsible for taste on the anterior 2/3 of the tongue

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8
Q

Cranial Nerve VIII

A

-VESTIBULARCOCHLEAR NERVE
-auditory nerve and has a cochlear and a vestibular nerve which is used for both HEARING & BALANCE

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9
Q

Cranial Nerve IX

A

-GLOSSOPHARYNGEAL NERVE
-motor portion elevates the pharynx and larynx, which is important for phonation. This nerve also mediates the gag reflex
-the sensory portion relays sensory info from the eustachian tube, pharynx, and tongue back to the brainstem

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10
Q

Cranial Nerve X

A

-VAGUS
-mixed nerve
-has 3 branches
spinal
-control pharyngeal constriction and palatal elevation: important for the production of non-nasal sounds
-Main nerve in relation to voice; innervates laryngeal muscles that are responsible for VF vibration
-Velopharyngeal incompetence: velum does not connect to the pharyngeal wall to create a seal; does not allow intro-oral pressure to create plosives

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11
Q

Cranial Nerve XI

A

-SPINAL ACCESSORY NERVE
-motor nerve
-controls the muscles of the head, neck, and shoulders
-cranial and spinal portions
Spinal portion: controls the muscles that control the head, neck, and shoulder movements

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12
Q

Cranial Nerve XII

A

-HYPOGLOSSAL NERVE
-motor nerve
originates in the lower portion of the medulla
-controls the muscles of the tongue (main muscle for articulation)
crucial component for swallowing

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13
Q

3 phases of swallowing?

A

oral prep, pharyngeal, and esophageal phase

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14
Q

What are the tegmental regions?

A

the tegmentum is the core of the brainstem, which is continuous at each level of the brainstem.
The tegmental areas include:
-reticular formation
-inferior olivary nucleus
-red nucleus

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15
Q

What is the reticular formation?

A

The nuclei or the groups of specialized cells of the RF that are scattered throughout the tegmentum.
What do these nuclei do? receive axon collaterals from special senses and project axons throughout the brainstem, cerebellum, diencephalon, and cerebral hemispheres

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16
Q

What does the RF do?

A

it inhibits, facilitates, modifies, and regulates all cortical functions.
-Integrates internal thoughts, emotions, and cognition with sensory and motor stimuli
-Responsible for consciousness, sleep-wake cycle, cardiovascular functions, and respiration, partially responsible for the homeostatic state of the brain.

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17
Q

What forms the reticular activating system (ras)?

A

within this RF, the multisynaptic ascending projection of the RF to the* brain, thalamus, hypothalamus, and basal ganglia* forms the reticular activating system

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18
Q

what does the RAS do?

A

controlling influence on levels of cortical arousal and consciousness. the level of alertness is correlated with the electro encephalic activity of the brain. While the cerebral hemisphere is sleeping, the specialized nuclei turn on the metabolic repair systems. After this repair is completed and energy is replenished, the rf clock turns on and awakens the brain.
-RF also functions to regulate respiration and swallowing.

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19
Q

What is the inferior olivary nucleus?

A

bulge on the medulla, which receives axons from the cerebral cortex and sends the information to the cerebellum

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20
Q

What is the red nucleus?

A

-paired structure next to the substantia nigra (where dopamine is produced)
-receives projections (axons) from the cerebral cortex, and its axons make up the rubrospinal tract that descends the brainstem, inputting into the ventral horn cells of the spinal cord
-modulates flexor tone in the upper extremities

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21
Q

What are the 3 non-tegmental regions?

A

-tectum
-cerebral peduncles
-ventral pons

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22
Q

Tectum?

A

-superior colliculi: connected to vision
-inferior colliculi- involved with hearing, as it projects axons to the auditory center in the thalamus, which then projects to the auditory areas in the cerebral cortex

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23
Q

Cerebral peduncles?

A

-anterior portions, known as the crus cerebri, bulges on the front side of the midbrain
-lateral corticospinal and lateral corticobulbar tracts runs through here
-lateral corticobulbar tract plays an important role in speech production

24
Q

Ventral Pons?

A

-corticopontine fibers originate from the motor cortex and input into ventral pons nuclei, these projections then course to the cerebellum
-thought to play a role in movement error correction when learning new motor skills, and it is involved with learning a new language

25
Cerebellum
-"Little brain" -lies inferior to the cerebral hemispheres and posterior to the pons -on the outside, you see tightly packed folia, and folia is composed of white matter overlayed with gray matter- folia gives the cerebellum a large amt of surface area
26
4 components of the cerebellum?
1. 2 hemispheres 2. vermis- tissue that separates the 2 hemispheres of the cerebellum at the midline 3. 3 lobes: anterior, posterior, flocculonodular 4. 3 large peduncles connecting the cerebellum to the brainstem -INFERIOR & MIDDLE peduncles carry AFFERENT info to the cerebellum -Superior peduncle carries mostly EFFERENT info from the cerebellum to the spinal cord
27
Cerebellar functions
-the cerebellum does NOT initiate movement, it coordinates it -through direct and indirect projections to the motor cortex, basal ganglia, and SC. The cerebellum coordinates and modifies the tone, speed, and range of muscle excursions in the execution of motor functions
28
Cerebellar functions part 2
It monitors in head and body position at rest, muscle tension, and SC activity -Participates in planning, monitoring, and correcting motor movements using sensory info and maintains equilibrium through projections to the vestibular system. -Also involved in the learning of new motor skills, cerebellar control is ipsilateral as opposed to the cerebral cortex, which is contralateral most of the time. damage to one side leads to injury on that same side of the body.
29
Signs of cerebellar dysfucntion
1. Symptoms are usually ipsilateral 2. Deficits are usually related to motor functions, without sensory loss or paralysis 3. can be gradual improvement unless it's related to a progressive degenerative disease
30
Ways to test cerebellar function
1. Finger to nose: examiner is looking for accurate and coordinated movement 2. Diadochokinetic Movements: rapid, alternating movements- the examiner is looking for uncoordinated, sloppy movements that can indicate damage 3. Hopping: hopping on 1 leg and then the other; testing balance and equilibrium 4. Alternating Movement: arm swings while walking, looking for good coordination 5. limb rebounding: pushing on the arm and seeing how well the patient can control rebound movement
31
Cerebral impairments
1. ataxia- lack of order and coordination in motor activity 2. dysdiadochokinesia- displayed by clumsiness in rapid and alternating movements 3. dysarthria- commonly seen in bilateral cerebellar lesions, makes speech slow, slurred, and disjointed 4. dysmetria- error in judgement of a movement's range 5. intention tremor- the closer to the target, the worse the tremor gets, and then it disappears during rest 6. hypotonia- not enough tone in the muscle 7. rebounding- impaired motor tone adjustment 8. disequilibrium- impaired vestibular processing, walking like they're drunk
32
Diencephalon?
Rests above the midbrain, and it connects the cerebral hemispheres to the rest of the body, also connecting the NS to the endocrine system -4 parts (thalamus, subthalamus, hypothalamus, epithalamus)
33
Thalamus
-processes all sensory information except olfaction, routing it to the cerebral cortex and other structures. -It is made up of small nuclei serving different functions, projecting to different parts of the brain. -It is involved in motor functions through directing some extrapyramidal fibers to the basal ganglia.
34
Damage to the thalamus (1)
produces contralateral somatic sensation -Contralateral somatic sensation: burning, tingling, low pain threshold; sometimes you won't feel sensations that are usually painful, but can also have hypersensitivity to things that would normally not be painful
35
Damage to the thalamus (2)
a fluent aphasia characterized by fluent verbal output and jargon-like speech; have intact repetition, or their repetition is minimally impaired-mild auditory comprehension impairment
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subthalamus
-lies below the thalamus and contains a set of specialized cells called the subthalamic nuclei - similar to the basal ganglia when it comes to function
37
Damage to subthalamus
-Hemiballismus: involuntary flinging of the limbs -OCD: impulsiveness
38
Hypothalamus
- hypothalamus is a linker and a regulator -connects NS to the endocrine system and controls our hormones by way of the pituitary gland 4 primary functions 1. autonomic: controls ANS 2. endocrine: releases hormones into the blood system 3. regulatory: maintains body temp, blood volume, food/water intake, body mass, reproduction, and circadian rhythm 4. drive/emotion: has projections to the limbic system & contributes to drives/emotions
39
Damage to Hypothalamus
-lack of regulation -hormonal imbalances, disturbances to autonomic functions
40
Epithalamus
-lies superior and posterior to the thalamus -contains the pineal gland: produces melatonin -contains habenula: group of nuclei involved in olfactory and gag reflexes- also involved in our stress responses and reward processing system -contains stria medullaris: a white matter tract connecting the habenula to the limbic system
41
basal ganglia
-made up of 3 large nuclei that lie deep within the cerebral hemispheres -Caudate nucleus, Globus Pallidus, and Putamen Nucleus are all key components of the extrapyramidal NS --Using dopamine, the BG regulates motor functions and muscle tone specifically, extrapyramidal functions: posture, balance, and arm swinging
42
What are the 3 large nuclei (components) that make up the basal ganglia? What other system are they important for?
Caudate nucleus, globus pallidus, and putamen nucleus are all key components of the extrapyramidal NS -extrapyramidal system
43
What do the two major pathways that run through the basal ganglia do?
Direct- facilitates Indirect-inhibits movement
44
What happens when the basal ganglia is damaged?
Increased muscle tone and rigidity. Dyskinesias like tremor, you also see choreoathetosis, slow involuntary movements. -A lot of you see Huntington's and Parkinson's -Lead to a variety of deficits, including dysarthria, dysphonia, as well as comprehension, naming, and repetition problems.
45
Internal Capsule (medullary centers)
subcortical band of fibers that contains all ascending fibers to the cerebral cortex and descending fibers projecting downward as they pass b/n the basal ganglia and the thalamus -if this is damaged, it can affect the corticobulbar tract, which is a motor pathway that affects speech, and can lead to hemiparesis
46
Corona Radiata (medullary center)
fibers between the cortical surfaces and the thalamus create a fan-shaped sheet of axons called the corona radiata. It carries all neuronal traffic to and from the cerebral cortex. -MS greatly affects this area and can cause motor, cognitive, and psychiatric problems
47
The brain has ____ ventricles which are the.....
4 and they are the right lateral ventricle, left lateral ventricle, 3rd ventricle, and the 4th ventricle
48
Lateral ventricles
-Right and left ventricle - have 3 horns, which are each located in a different lobe of the brain -anterior horn is in the frontal lobe -posterior horn is in the parietal lobe -the inferior lobe is in the temporal lobe
49
3rd Ventricle
-located at the midline in the diencephalon -joins w/the 2 lateral ventricles by way of the inter-ventricular foramen -narrows near the midbrain to form the cerebral aqueduct, which leads to the 4th ventricle
50
4th ventricle
-located behind the pons and in front of the cerebellum
51
What is the ventricular system?
-it is continuous with the Subarachnoid space, meaning it is uninterrupted -Ventricles are filled with CSF -CSF is found in the SC, ventricles, and subarachnoid space of the meninges -EACH ventricle contains the choroid plexus, which produces CSF at a rate of 400-500mL/day
52
Cerebrospinal fluid
-moves btwn the ventricles by way of the inter-ventricular foramen and the cerebral aqueduct -replenished every 7 hours -Old CSF is absorbed into the Venous System and enters the bloodstream. This is done through the arachnoid villi, which are small protrusions of the arachnoid layer **protrude through the dura mater into the venous sinuses of the brain allowing the CSF to exit the subarachnoid space into the bloodstream
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Functions of CSF
1. protect the brain tissue by acting as a shock-absorbing water cushion 2. lightens the weight of the brain through buoyancy 3. reduces waste by removing metabolic waste from the NS 4. helps transport nutrients and hormones throughout the body
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Disorders of the Ventricles
-2 types of Hydrocephalus
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what is hydrocephalus
can be congenital, in embryonic stages, or can be acquired via TBI, tumor, or meningitis. causes a buildup of intracranial pressure=brain damage or death; shunt put in to drain but can cause bleeding/infection
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Obstructive Hydrocephaluys
narrowing of the passageways that connect the ventricles which leads to CSF buildup
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NON-Obstructive hydrocephalus
a problem in the absorption and sometimes the production of CSF, causing ventricles to swell