Neuro I Flashcards Preview

► Med Misc 42 > Neuro I > Flashcards

Flashcards in Neuro I Deck (272):
1

function of the NS

controls and coordinates the body's activities to maintain homeostasis

generation of sensory input to be processed

processing incoming data

generation of impulses that control voluntary and involuntary motor functions

storage of information

2

neurons

are the functional unit of the NS

3

cell body of neuron

main part of neuron, forms gray matter, center of the neuron

4

dendtites

recieve nerve impulses, branch like projections, carries impulses towards cell body

5

3 characteristics of a neuron

excitability

conductivity

influence

6

excitability

ability to generate an impulse

7

conductivity

ability to transmit an impulse within itself

8

influence

ability to influenec other neurons

9

axon

projects impulses away, found in myelin sheath

10

myelin sheath

speeds axon transmission, insulates & maintains white matter, nodes of Ranvier

11

axon with myelin sheath is myelinated or non myelinated

myelinated

12

multipolar neuron

multiple dendrites one axon

13

bipolar neuron

one dendrite, one axon

14

unipolar neuron

one process

15

lipid gives myelin what?

white color

insoluble in water-so need fat soluble Rx is needed to penatrate myelin sheath

16

classifications of neurons

structural-defined by the processes they have

functional-diretction of impulses conducted

17

sensory neurons

transmit nerve impulses toward CNS from peripheral sensory organs

Afferent-towards the brain (CNS)

18

motor neurons

transmit nerve impulses away from CNS to muscles, glands, organs

Efferent-away from CNS (brain)

19

Afferent

sensory neurons

20

Efferent

motor neurons

21

inter neurons

conduct impulses from one neuron to another

Sensory to motor or motor to sensory

22

two types of cells in the NS

neurons & neuroglia (glial) cells

23

Neuroglia cells

purpose: repair, support & protect neurons

more neuroglia than neurons

common source of primary tumors

24

types of neuroglia cells

astrocytes

ependymal cells

microglia

25

oligodendrocytes

produce the myelin sheath

26

astrocytes

found mostly in gray matter, Star of NS,

acumulate where neurons have been damaged

contribute to scar formation (gliosis)

feed neurons, from blood brain barrier

27

what forms the blood brain barrier

astrocytes

28

ependymal cells

aid in secretion and regulation of CSF

29

microglia

remove waste

30

can damaged nerves regrow

yes

in the CNS-it is limited

in the PNS- slow process

31

Nerve impulse conduction

travels by electrical transmission along axon and chemical transmission between neurons until it reaches its destination.

32

an electrical impulse is a result of what

K+ and Na+ ions moving in and out of the cells

33

Action potential

Our electrical impulses, has 3 states:

resting state

depolarization

repolarization

34

resting state of action potential

no impulse, increase of K+ within cell and decrease of Na+

35

depolarization

channels in cell membrance open & Na+ rushes in cell

36

repolarization

when the Na+ moves back out of cell and K+ moves back in cell

37

when the impulses reaches the end of the nerve fiber it is then transmitted across the junction between nerve cells at what?

the synapse

38

saltatory conduction

type of nerve conduction when nerve is myelinated

action potential jumps from one node of Raniver to the next, with saltatory conduction the Na+ and K+ ions only require to move in and out of cells at the Nodes of Tanvier

39

the synaptic transmission is compossed of what 4 components

presynaptic knob, synaptic cleft, neurotransmitter, and the receptor site

40

neurotransmitter

chemicals involved in the transmission of an impulse across the synapse

have excitatory or inhibitory

41

chemicals found in the neurotransmitters

acetylcholine

serotonin

norepinephrine

dopamine

42

name the two divisions of the nervous system

central and peripheral

43

the CNS consists of what

brain (cerebrum, brainstem, cerebellum)

and spinal cord

44

brainstem consists of what

midbrain

pons

medulla

45

the peripheral nervous system consists of what

12 pairs cranial nerves

31 pairs spinal nerves

autonomic nervous system (sympathetic & parasympathetic)

46

what are the protective structures of the NS

cranium

-14 facial bones, 8 cranial bones

47

foramen magnum

large hole, largest hole in skull, where brainstem and spinal cord connect

48

scalp

outermost layer of protection, fibrous, freely moving

49

dura mater

outer layer, thickest, toughest

50

arachnoid

middle layer, thin, delecate, loosly encloses the brain

51

pia mater

innermost layer, thin, vascular, mesh like

52

meninges

3, protective membranes that surround the brain and spinal cord

53

epidural space

between skull & dura mater, above dura mater

54

subdural space

below dura, between dura & arachnoid

55

subarachnoid space

between arachnoid & pia mater, holds CSF

56

name the layers of the protective structures of the nervous system

skin

bone

epidural space

dura mater

subdural space

arachnoid membrane

subarachnoid space

pia mater

brain

57

falx cerebri

dural fold that separates the 2 cerebral hemisphers

58

tentorium cerebelli

double dura later fold between the cerebral hemispheres and cerebellum

allows for some expansion

59

supratentorial

surgery above the tentorium (cerebrum)

60

infratentorial

surgery below the tentorium

(cerebella)

61

CSF

cerebrospinal fluid

clear, colorless, odorless

fills ventricles and subarachnoid space of brain and spinal column

no RBC in CSF

62

what is the purpose of CSF

protects and cusions

shock absorber

63

what is CSF made of

H2O, protein, O2, CO2, Na, K, Cl, glucose

64

CSF flow

termed the 3rd circulation,

it is a closed system

absorbed by the arachnoid villi projections

65

the brain requires ____% of the bodys total oxygen and glucose requirements

25%

66

Venous drainage of the brain

exits via 2 vascular channels called dural sinuses which empty into the jugular veins

has NO valves, gravity is needed for drainage of blood

67

where does the arterial supply for the brain enter

foramen magnum

68

the anterior circulation is supplied by

the common carotid -external & internal carotid

69

the posterior circulation of the brain is supplied by

the R & L subclavian artery which branhes into R &L  vertebral arteries then come together again to make the basiliar artery

70

circle of willis

allows blood to circulate from one hemisphere to another, acts as a safety valve, protects from occlusion or differential pressures, formed by the basilar artery and internal carotids

71

blood brain barrier

a pysicological barrier between blood capillaries and brain tissue, made of astrocytes and tight capilaries, protects brain from potential damaging agents, chemicals and toxins

72

what medications can get through the BBB

lipid souluable

 

73

3 divisions of the brain

cerebrum, brain stem, cerebellum

74

gyrus

convolution (folds) on the surface of the brain, increases surface area

75

fissure

deep seperations in the cerebral hemispheres

76

great longitudinal fissure

divides the cerebral hemispher into right and left

77

cerebrum

largest part of brain, contains nerve centers associated with sensory, motor and higher mental functions

78

cerebral cortex

outer layer of the brain, it is the gray matter, has billions of neuron cell bodies & dendrites

Made of cell bodies

79

2 hemispheresof the cerebrum

each hemisphere has 4 lobes

-frontal, parietal, temporal, occipital

have corresponding cortex layer

80

the white matter of the brain is made up of?

axons

81

frontal lobe of the brain

contralateral (left controls right, right controls left)

function: ig motor movements, memory, higher cognitive function (problem solving), judgement, broca's area

82

Broca's area is responsible for

expressive speech-ability to form words

damage to this area can cause stuttering, expressive aphasia

can be impaired by trauma or alcohol

83

cerbral dominacny for 90% of persons is which lobe

left frontal lobe

84

parietal lobe

primary sensory area

interprets sensory thought-touch, position

body awareness

spatial awareness-ability to comprehen out position in relation to our enviornment (so we are not clumsy)

85

temporal lobes

auditory reception-hear and interpret sound

Wernicke's area-reception of speech, ability to understand written & spoken language

receptive aphagia

86

Wernicke's area of the brain

temporal lobe

helps with ability to understand writeen and spoken language

 

87

damage to the temporal lobe can cause

88

occipital lobe

primary receptive area for vision and visual association

damage to this area will cause to not understand what is seen

89

basal ganglia

base/clump of neurons

deep in the hemispheres

responsible for execution, initiation, completion of voluntary movement and autonomic movements (blinking)

90

diencephalons

area of the brain just above brainstem

includes thalamus, hypothalamus

91

thalamus

major relay station for all sensations

92

hypothalamus

regulates autonomic nervous system

effects temperature, fluid balance, reproduction, metabolism, and hunger

93

limbic system

effects feeding and sexual behaviors and emotional responses

94

brain stem

connects spinal cord with cerebrum and cerebellum

contains ascending and descending pathways for impulses to go to and from the brain

attachment for crainal cerves III-XII

95

brainstems 3 main structures

midbrain, pons, and medulla oblongota

96

what is the medulla oblongata

primary rhythm center, responsible for RR, HR, BP cardiac function

97

Reticular formation

RAS

special neurons that control the sleep-wake cycle

98

reticular activating system controls what

attention span, conciousness, damage could cause issues with LOC

99

cerebellum

located in posterior fossa, above brainstem, below the occipital lope

responsible for fine motor moements, balance, truckal stability

100

spinal cord

continuious with the brain stem, mass of nervous fibers, extends from C1-L1

101

what is the spinal cord protected by

meninges (dura mater, arachnoid & pia mater)

and vertebrae

102

gray matter in the spinal cord

anterior/ventral-wider arms of the H

where primary motor neurons are located, hold motor tracks

103

the white matter is made up of what?

what does it do?

myelinated nerve tracks, carry messages between the brain and the perioheral muscles

104

Sensory

afferent messages ascending tracks, messages to the brain

105

motor

efferent messages, descending tracks, messages go down or away from the brain

106

ascending tracts of the spinal cord do what

carry sensory input to the brain from the periphery

such as touch, pressure, vibration, and kinesthesia

107

spinocerebelalr tracts effects what

muscle tension and body positon

108

nothalamic tracts effects what

temperature and pain

109

descending tracts in the spinal cord do what

carry motor messages

110

corticospinal

descending tract, cortex of frontal lobe & crosses at the medulla

its responsible for voluntary motor function

111

lesions in the upper motor neuron cause what

weakness, paralysis, hyperflezia, spastic muscle tone

112

lesions in the lower motor neuron cause what

weakness, paralysis, decrease muscle tone (flacid), hyporeflexia

113

do reflexes have cerebral input

NO

114

monosynaptic reflex steps

-receptor organ:arrival of stimulus& activiation of receptor

-sensory neuron: activation of sensory neuron

-information processed in spinal cord

-motor neuron: activation of motor neuron

115

peripheral nervous system includes what structures

all neuronal structures that lie outside of the CNS

-crainal nerves

-spinal nerves

-autonomic nervous system

116

which crainal nerves start at the brain stem

III-XII

117

Cranial Nerve I

Olfactory

-smell

-sensory

118

Oh, Oh, Oh To Touch And Feel A Guys Vein And Hotdog

-Olfactory

-Optic

-Oculomotor

-Trochlear

-Trigeminal

-Abduncens

-Facial

-Acoustic

-Glossopharyngeal

-Vagus

-Accessory (spinal)

-Hypoglossal

119

Crainal nerve II

Optic

-sensory

-vision

Snellen chart

120

Crainal nerve III

-oculomotor

-motor

-eye movement, eye lid, pupil constriction

121

What crainal nerves are tested together

III, IV, VI

&

IX & X

122

crainal nerve IV

Trochlear

-motor

-eye movement

123

Crainal nerve V

Trigeminal

-sensory & motor

-facial sensation, chewing, corneal reflex

124

crainal nerve VI

Abducens

-motor

-eye movement

125

crainal nerve VII

Facial

-sensory & motor

taste & facial expressions

126

crainal nerve VIII

acoustic

-sensory

-heaing and equilibruim

127

Crainal nerve IX

Glossopharyngeal

-sensory and motor

-taste on posterior part of tounge, swallow & gag

128

Crainal nerve X

Vagus

-smooth muscle of palate, pharynx and layrnyx, controls parasympathetic NS

129

Crainal nerve XI

Accessory (spinal)

-motor

-muscles of neck

130

Crainal nerve XII

Hypoglossal

-Motor

-Toungue movement

131

132

how many spinal nerves are there?

31 pairs

133

the dorsal root is the attachment for what

sensory fibers

134

the ventral root is the attachment for what

the motor fibers

135

dermatomes

area of skin that issupplied by sensory fibers of sensory root

136

myotome

137

cauda equina

horse tail, where the nerves come off

138

autonomic nervous system

effects involuntary function of caridac, smooth muscle, and glands

139

2 divisions of the autonomic nervous system

sympathetic and parasympathetic NS

140

sympathetic nervous system

Fight of Flight

causes casoconstriction of blood vessels,

increase BP

originates at T1-L2 (Thoraciolumbar division)

141

parasympathetic nervous system

rest and digest

conserves and stores bodys energy stores

decreases BP, HR, RR increases parastalsis

orginates in brain stem and sacral (craniosacral)

142

nursing assessment of the conscious patient contains an assessment of what?

mental status

LOC

crainal nerves

motor and sensory function

cerebellar function

reflexes

143

what kind of subjective data would you gather from a conscious patient

chief complaint (open ended ?'s)

medical history

any exposures to toxins, chemicals, etc..

learning disabilities?

recent and remote Hx

speech

nutritional/elimination

activity/sleep pattern

cognition

144

who will do an in depth assessment of speech

speech pathologist/therapist

145

expressive aphasia may show damage to what area of the brain

Brocha's (frontal lobe)

know what they want to say but they are unable to express or say

146

receptive aphasia may show damamge to what area of the brain

Wheinki's area (temporal lobe)

can form words but not cordinated

147

Romberg's test

feet together, arms at sides, eyes open then closed to show position sense and equilibrium

(swaying = +Rombergs)

148

cerebrallar function tests are used to show what

balance and coordination

 

-finger to exaimers finger

-walk heel to toe

-touch finger to nose

-Romberg's test

 

149

incontinence with back pain shows possible damage to what crainal nerve

Vagus

-X

150

what objective dada would you get with a conscious patient

mental state

crainal nerve functions

motor function

verebellar function

sensory function

reflex function

151

abnormalities with motor function

atrophy

contractures

tremors

twitching

hypertonia

hypotonia/flaccidity

152

2 point discrimination

2 points of an instrument on the same area

can they feel both

153

stereognosis

ability to ID a common object with just feel

154

astereognosis

inability to ID a common object with just feel

155

graphesthesia

ability to ID #'s and letters by feel when they are drawn on a body part with a finger

156

babinski

when stoke lateral aspect of foot

if you have fanning of toes = + Babinski

157

geriatric changes with nervous system are

loss of neurons (decrease in brain weight)

decrease in efficiency with regulating temperature

decrease blood flow

decrease of CSF (cushing and nurishment)

loss of myeling (decrease reaction time)

muscle atrophy

dinimished sense

slow reflexes

sleep patterns alter

158

 full conscious

alert, oriented, follows commands, answers ?'s

159

confusion

disoriented to time and place

160

lethargy

oriented but slow speech, mental process and motor activity

161

obtundation

difficult to arose requires constant stimulus to answer ?'s and floow commands

162

stupor

vigorous stimulation and doesnt follow commands

163

coma

sleep like state, doesnt respond to stimulus

164

glascow coma scale

calculate neuro status

15=fully intact

7=a level of coma

3 or less = deep coma/death

165

decortication

abnormal flexion response

towards cored

damage above brain stem

166

decerebration

abnormal extension response

brainstem disfunction

167

what crainal nerves are checked in a unconscious patient

III (oculomotor)

V (trigeminal)

IX & X (gag reflex)

 

168

pupil changes of slow or absent can indicate what

increase of crainal pressure or cerebral herniation

169

oculocephalic reflex

unconsious pt only

eyes are held open, head is turned side to side,

if the eyes move with the head = ABNORMAL

170

oculovestibular reflex

administer cool fluid into the pts ear, if the eyes deciate to side of the injection that is NORMAL

171

In the NIH stoke scale you want the over all # to be what

lower the better

172

Xray will indicate what

evaluate skull and vertebrae for abnormalities, fx, calcifications..etc

173

cerebral angiography

contrast medium into femoral artery

*flushing or warm feeling

visualize intracranial and extracrainal blood bessels

for occlusion, patency, narrowing, stenosis, abnormal bleed

*assess for bleeding, PT must lay flat, check 6 p's, increase fluids to flush dye out

174

CT Scan

cross sectional view of head and brain

bone=white

CSF=black

brain=gray

ID changes in tissue density, abnormal size, shape and location of structures, edema, infarction, growth, clots, bleeding, skull fx

Lay motionless for 15-20 minutes, murmur noise

175

MRI

NO RADIATION (use magnets)

clearer imagesof soft tissues

sharp detailed cross sections of brain,

LOUD, @ 1 hour, wear headphones

176

MRA

type of MRI to check blood flow and abnormalities, small vessels may be difficult to view

177

myelogram

visulize spinal column and subarachnoid space using a contrast medium (lumbar puncture)

not done frequently

178

CSF analysis

obtain by lumbar puncture

check for RBC

below L3

have transient pain (pain/twitching down leg)

179

manometer

used during lumbar puncture

measures pressure of CSF

pt is asked to extend thier legs

180

EEG (electroencephalopgraphy)

electordes are placed on scalp with paste mixture

shows electrical activity of brain

-seizures, sleep disorders, parkinsons, etc

181

why should you eat prior to a EEG

because low glucose can alter the brain patterns

182

EMG (electromyography)

needle electrodes are plcaed in muscle to measure nerve conduction

muscle at rest = no electrical activity

pt will have pain

183

evoked potentials

measures the electrical signals along nerve pathways

measure amount of time it takes a impulse to move through pathway

-visual

-auditoy

-somatosensory (electric shock)

184

PET

3D image of brain function

given a chemical substance that is inhaled

blood flow, brain metabolism

185

carotid duplex

blood flow velosity in carotid artery, looks for blockages or occlusions

186

transcrainal doppler

image flow velocity of intracrainal blood vessels (temporal/occipital area)

187

188

inner ear does what

sends into to brain (hearing & equilibrium)

189

auricle

is the outer part of the ear

AKA pinna

made of cartliage, collevts and transmits sound waves and sends them to tympanic membrane

190

external auditory canal is lined with what

fine hairs, sebacous glands and ceruminous glands

191

cerumen

ear wax

protective helps provent debris from entering the ear

192

tympanic membrane

eardrum

concave shape, shiny, pearly gray translucent

sound waves conducted by the tympanic membrane then the ossicles

193

ossicles

malleus, incus, stapes

194

what is the middle ear connected to

nasal pharnx by the eustacian tube

195

eustachian tube

helps to equalize pressure between outter and inner ear

to open you must yawn or swallow

196

inner ear contains

vestubule, cochlea, semicircular canals, membranous labyrinth, bony labyrinth

197

membranous labyrinth

holds semicircular canals, and orgin of cortie

surrounded by endolymph fluid

198

endolymph fluid

allows structures to float to prevent damage if have head injury

199

vestibule

separets cochlea from semicircular canals

entrance to inner ear

communicates between cochlea and semicircular canals

200

semicircular canals

sensory organs that help with equilibrium

if have excess of fluid in these canals have balance issues

201

cochlea

snail shape

within is the orgin of cortie

 

202

organ of corti

lined with tiny hair cells, when they are stimulated they transmit a electrical impulse of acustical nerve

203

transmission of sound is measured in what

dB and Htz

204

bone conduction bypasses what

external and middle ear

205

your equilibrium is controlled by what

vestibule amd semicircular canals

206

dynamic equilibrium

ability to remain stable with movement

207

static equilbrium

orientation to body to ground so we can maintain our posture

208

nystagmus

abnormal fine eye twitching

report if blurry vision or fluttering feeling

209

vertigo

sensation that you are spinning in space or moving

vertigo will contimue while you lay down, where dizziness will go away

210

hibituation

you should continue the activity in small incriments to acculmate yourself and it will eventually get better

211

what disease if a pregnant women has can affect the babies hearing

rubella

212

conductive hearing loss

problem with sound wave condiction

-hardening of ossicles

213

sensorineural hearing loss

problem with inner ear

cochlea, hair cells, nerve (acustic)

214

Presbycusis

hearing loss associated with aging

215

ear changes in the elderly

-eardrum thickens, decrease ability to produce sound waves

-in hair and cerumen

-califying of ossicles

-damage to hair cells over time

216

tinnitus

ringing of the ears

217

Rinne Test

vibrating fork is placed on patients mastoid bone then when they no longer hear sound the fork is moved to front of pinna

 

218

positive Rinne test

air conduction time is greater than bone conduction

219

Weber test

stem of an activated tuning fork is placed on the center of the skull

220

conductive hearing loss in weber test

sound will lateralize to the poor ear

221

sensorineural hearing loss in the weber test

sound will lateralize to the good ear

222

audiometry

sound proof room, sounds vary in frequency and intensity

single most important test for evaluating hearing

223

electrostagmography

irrigate the ear and watch for eye movement

224

otologist

MD, Dx ear problems, perform surgery

225

otolaryngologist (ENT)

perform surgery

226

audiologist

eval & Tx ear disorders

not an MD

227

for ear drops how do you palce pt

lay on unaffected side, pull ear up and back on aduld, down and back on kid

228

how should you place a pt for ear irrigation

pt should lean towards you

229

orbit of eye

bones, protective socket for eyeball

230

palpebral conjunctiva

eyelid, mucous membrane that lines eyelid

231

what is the purpose of the conjunctiva

secretes mucous and oil, keeps cornea moist clear and free of infection

232

function of lacrimal system

allows tears to flow from outer to inner eye

233

puncta

tiny openings in the lids that let tears drain into lacrimal duct, nose

234

pathway for vision is

light passes through cornea, pupil, posterior cavity, focused on retnia and then the optic nerve

235

ciliary muscles help with what

help to change the shape of the lens for focusing (accomadation)

236

what controls the constriction and dilation of the iris

sphincter and dilator iris muscles

237

sclera

toughest, thickest, outer layer

helps maintain shape and protects

white part of the eye

can be blue in children and yellow in african americans and the elderly

238

cornea

transparent and avascular

initial means of refraction = crude focus

239

iris

colored part of the eye highly vascular

240

choroid

below sclera

supplies blood to retinal layer

241

lens

directly behind pupil

biconvex

bends light rays to focus on retina

242

retina

made up of neurons, inner most layer

if it is damaged you have vision loss

converts image to a form that the brain can understand and process into vision

243

rod vs cone

rod-receptors for dim light

cones-color receptors

244

macula

area of retina responsible for central vision

free of blood vessels bc has concentraded cones

245

fovea centalis

center of macula

most sensitive area

sharpest visual acuity

246

optic disc

depression the optic nerve exits at the optic disk also where we get blood flow

247

anterior chamber

from cornea ro lense

248

posterior chamber

from iris to lense

249

light ray that enters the eye will travel through...

cornea

aqueous humor

pupil

lens

vitrous humor

retina

optic disc, nerve

optic chiasm

occipital lobes

250

pseudopedrin can do what to the eyes

dilate the pupils

251

longterm corticosteriods can put a pt at risk for what

glacoma and catarects

252

ptosis

drooping of eyelid

253

anisocoria

unequal pupil size

254

exopthalmos

bulging of eye

255

enopthalmos

sunken apperance of the eye

256

snellen chart

20 feet from chart and read the smallest letters, at least 50% of the letters must be correct

257

OD

right eye

258

OS

left eye

259

OU

both eyes

260

Jaegar chart

near vision

hold about 14 inches away

261

refractometry

multiple lenses used with snellen chart

262

opthamoscope

dark room, dilate eyeevaluating optic disk, retina and macula

263

absence of red reflex

abnormal

looking for a reflection of light off retina

264

intraoccular pressure

mearsured with puff of air

normal is 10-21 mHg

265

Ishihara test

dosts are arranaged in a simple pattern to test for color blindness

266

ophthalmologist

MD who provides total care, surgery etc

267

optometrist

dont perform eye surgery

268

optician

grinds and fits lenses according to a Rx

269

arcus senilis

milky white or yellow ring aound iris

due to cholestrol deposits

270

eye medications need to be spread out for how long

in between multiple eye medications 5-10 minutes

271

ointments

stay on longer

thicker

but can cause blurry vision

272