Neuro Anatomy & Assessment CE Flashcards by Justin Dominguez

Protective covering of brain and spinal cord is called:

Meninges

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Name types of meninges and relative location:

Dura mater (just below skull, tough mother); arachnoid mater; pia mater (comforting mother directly on brain)

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falx cerebri

named from its sickle-like form, is a strong, arched fold of dura mater that descends vertically in the longitudinal fissure between the cerebral hemispheres

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tentorium cerebelli

an extension of the dura mater that separates the cerebellum from the inferior portion of the occipital lobes

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Name the 3 potential neurological spaces

Epidural; subdural; subarachnoid

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sulcus (sulci)

depression or fissure in the surface of the brain

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gyrus (gyri)

a ridge on the cerebral cortex generally surrounded by one or more sulci (depressions or furrows)

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Name the 4 lobes of the brain

frontal; temporal; occipital; parietal

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diencephalon responsible for:

autonomic visceral activities

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diencephalon made up of:

the thalamus, the subthalamus, the hypothalamus and the epithalamus (and pituitary)

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brain stem includes (3 structures):

medulla oblongata (myelencephalon), pons (part of metencephalon), and midbrain (mesencephalon)

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brain stem responsible for:

main motor and sensory innervation to the face and neck via the cranial nerves

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midbrain responsible for:

vision, hearing, motor control, sleep/wake, arousal (alertness), and temperature regulation

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medulla (oblongota) responsible for:

lower half of the brainstem; cardiac, respiratory, vomiting and vasomotor centers and deals with autonomic, involuntary functions, such as breathing, heart rate and blood pressure

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pons is latin for:

bridge

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pons responsible for:

white matter that includes tracts that conduct signals from the cerebrum down to the cerebellum and medulla, and tracts that carry the sensory signals up into the thalamus

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pons location

cranial to the medulla oblongata, caudal to the midbrain, and ventral to the cerebellum

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cerebellum latin for:

little brain

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cerebellum responsible for:

motor control

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How much CSF produced daily

500mL

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Standard constant vol of CSF is:

120-150mL

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Pressure range of CSF:

75-180 mm/H2O

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Abnormal accumulation of CSF is:

hydrocephalus

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Most common cause of hydrocephalus:

CSF flow obstruction - hindering the free passage of cerebrospinal fluid through the ventricular system and subarachnoid space

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communicating hydrocephalus

impaired cerebrospinal fluid resorption in the absence of any CSF-flow obstruction between the ventricles and subarachnoid space

non-communicating hydrocephalus

CSF-flow obstruction ultimately preventing CSF from flowing into the subarachnoid space (either due to external compression or intraventricular mass lesions)

CSF produced in the:

choroid plexus

CSF absorbed in the:

across the arachnoid villi into the venous circulation

Circle of Willis is:

a circle of arteries that supply blood to the brain (considerable anatomic variation exists)

Circle of Willis significant because:

if one artery blocked, others can feed into the circle and thus the rest of the brain without symptoms

What percentage of cardiac output is directed to cerebral blood flow?

15-20%

Most likely location for aneurysm or subarachnoid bleed:

Circle of Willis

Aphasia is:

inability to communicate

loss of the ability to produce language:

expressive aphasia (Broca's aphasia)

inability to understand, but able to speak:

receptive aphasia (Wernicke’s or sensory aphasia)

Inability to recognize familiar objects (i.e. visual, auditory, or tactile)

agnosia

Inability to do simple tasks (i.e. brush teeth or hair)

apraxia

loss of intellectual abilities or cognitive function

dementia

Grading motor ability on scale of:

0 to 5

Motor ability grade 0

No movement

Motor ability grade 1

Flicker of contraction

Motor ability grade 2

Movement without gravity

Motor ability grade 3

Movement against gravity

Motor ability grade 4

Movement against resistance

Motor ability grade 5

Full strength movement

dermatome landmark: shoulder

dermatome landmark: thumb

dermatome landmark: little finger

C8/T1

dermatome landmark: nipple line

dermatome landmark: umbilicus

T10

dermatome landmark: groin

T12

dermatome landmark: knee

dermatome landmark: foot

Number and types of vertebrae:

Approx 33 total: C7, T12, L5, S5 (fused), C3-5 (fused)

Move ____ to ____ during neuro exam.

Head to foot.

Brown-Séquard syndrome is:

Loss pain/temp sensation on 1 side body; loss of motor on other side.

Brown-Séquard syndrome (hemiplegia) caused by:

lateral hemisection of spinal cord

anterior cord syndrome is:

loss of mvmt and pain sensation while retaining proprioception and vibratory sensation

proprioception

sense of the relative position of neighbouring parts of the body and strength of effort being employed in movement

exteroception

one perceives the outside world

interoception

one perceives pain, hunger, etc., and the movement of internal organs

Early Signs ICP (name 5)

LOC changes subtly (reassess if GCS dec by 2 or more); Headache (increasing intensity and/or not relieved); Facial Palsy; Pupil changes; Vomiting

Late Signs ICP

Posturing (flexion or extension); Cushing's Triad (Vital Signs - BP, RR; HR); Abnormal respirations; Pahologic or loss of protective reflexes

Why is INITIAL GCS SUPER IMPORTANT!!?

Influences treatment decisions and guides recovery predictions

Stroke sole of foot and toes spread (normal up to age 2) = ? reflex

Babinski Reflex

Put fingers pt palm -> pt grab fingers

Grab reflex: Not indication of improvement. "Squeeze my hand twice."

thigh is bent at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance)

Kernig's Sign (meningitis)

Forced flexion of the neck elicits a reflex flexion of the hips (knees draw up)

Brudzinski's Sign ( meningitis, subarachnoid haemorrhage and possibly encephalitis)

Level of consciousness triggered by ?

Reticular Activating System (RAS) - responsible for regulating arousal and sleep-wake transitions

Levels of mental alertness (RAS?)

Confusion; Lethargy; Obtundation; Stupor; Coma

Obtundation

less than full mental capacity in pt, typically result of a med condition or trauma. (obtund = dulled or less sharp)

Stupor

lack of critical cognitive function and LOC wherein sufferer almost entirely unresponsive (responds to base stimuli i.e. pain)

Progression of neurological compromise

Lose Reflex, then Sensory, then Motor

Doll's Eyes also called:

Oculocephalic Reflex or the Vestibulo-ocular Reflex

Doll's Eyes indicates what?

Intact brain stem

Cold Calorics / Caloric Reflex Test

test of the vestibulo-ocular reflex; can be used to test for brain stem death; cold water in ear and eyes turn toward that ear (conscious pt's can puke)

Neuro Anatomy & Assessment CE Flashcards

(76 cards)