Patho Exam #2 Review Flashcards
(250 cards)
1
Q
dWhat are the paired bones of the neurocranium?
A
Parietal bone and the temporal bone
2
Q
What are the unpaired bones of the neurocranium?
A
Frontal bone, sphenoid bone, occipital bone and the ethmoid bone
3
Q
What are the paired bones of the viscerocranium?
A
Maxilla bone, zygomatic bone, palatine bone, lacrimal bone and the nasal bone
4
Q
What are the unpaired bones of the viscerocranium?
A
Mandible and the Vomer bone.
5
Q
How many total bones make up the skull (cranium) of the axial skeleton?
A
22
6
Q
What is the suture that separates the frontal bone from the parietal bones?
A
The Coronal Suture
7
Q
What suture line separates the right and left parietal bones?
A
The Sagittal suture
8
Q
What suture line separates the occipital bone of the skull from the parietal bones?
A
The Lambdoid suture
9
Q
What other bones does the Lambdoid suture line separate the Occipital bone from?
A
The left and right temporal bones
10
Q
What is the bone that is filled with air that conducts sound impulses from the outer ear to the inner ear. It is also part of the Temporal bone?
A
The Mastoid Process
11
Q
What paired bone does the first vertebrae (Atlas) of the vertebral column articulate with?
A
The Occipital condyles
12
Q
What large bone of the skull forms the tops of the eye orbits?
A
The Frontal bone
13
Q
What is the name of the suture line that separates the Temporal bone from the Parietal bone?
A
Squamous suture
14
Q
What is the name of the condyle in which the mandible articulates with the Temporal bone?
A
The Mandibular Condyle
15
Q
The Zygomatic arch is part of what bone?
A
The Temporal bone
16
Q
The proper name of the jawbone is what?
A
The mandible
17
Q
What is the name of the bone that is superior to the mandible located between the oral cavity and the nares?
A
The Maxilla
18
Q
What does the description of the word foramen?
A
Its an opening
19
Q
What is a fissure of a bone?
A
A fairly wide separation between bones
20
Q
How does a canal differ from a foramen or a fissure?
A
They are an elongated area in which something passes through.
21
Q
What part of the eye orbit does the Frontal bone contribute?
A
The roof of the orbit
22
Q
What part of the eye orbit does the Sphenoid bone contribute?
A
Part of the roof and the lateral wall
23
Q
What two parts of the orbit of the eye does the Zygomatic bone contribute?
A
Part of the roof and the lateral wall
24
Q
What bone makes up the floor of the eye orbit?
A
The Maxilla
25
What three bones compose the medial wall of the eye orbit?
The Lacrimal, Ethmoid and Palatine bones
26
What part of the eye orbit does the Frontal bone contribute?
The roof of the orbit
27
What part of the eye orbit does the Sphenoid bone contribute?
Part of the roof and the lateral wall
28
What two parts of the orbit of the eye does the Zygomatic bone contribute?
Part of the roof and the lateral wall
29
What bone makes up the floor of the eye orbit?
The Maxilla
30
What three bones compose the medial wall of the eye orbit?
The Lacrimal, Ethmoid and Palatine bones
31
Is the Infraorbital Foramen in the eye orbit?
No it is located below the orbit as part of the Mandible
32
What is the name of the structures of the frontal bone that holds the inferior parts of the frontal lobes of the brain?
Left and Right Anterior Cranial Fossa
33
What is the importance of the Crista galli?
The dura mater that surrounds the brain attaches to the Crista galli which helps to hold the brain in place
34
What bone is the Critsa Galli part of?
The Ethmoid bone
35
What does the name Crista galli mean?
Cocks Comb
36
The optic foramen is located within what unpaired bone of the skull?
Within the Lesser Wing of the Sphenoid Bone
37
What is the name of the structure in which the anterior posterior pituitary glands sit?
Sella turcica
38
What is the meaning of the name Sella turcica?
Turkish saddle
39
What bone is the Sella turcica part of?
The greater wing of the Sphenoid bone
40
What is the only part of the pituitary gland that is not surrounded by bone?
The most superior aspect-→if the pituitary enlarges its only option is to grow up and out of Sella turcica into the space that optic nerves lie.
41
Due to the anatomy, what deficit is created if the pituitary gland enlarges?
Visual field deficit due to its impeding upon the optic nerves on the Sella turcica’s superior aspect
42
What two areas make up the unpaired Sphenoid bone?
Greater and Lesser Wing of the Sphenoid
43
Where do the inferior parts of the temporal lobes of the brain sit?
Middle Cranial Fossa right and left
44
What is the opening that cranial nerve 8 passes through?
Internal acoustic meatus
45
Where does the superior part of the spinal cord junction with the inferior part of the brain stem?
Foramen magnum-→junction between spinal cord and brain stem
46
What is the largest opening of the skull?
Foramen magnum
47
What does the inferior parts of the occipital lobes of the brain sit in?
Posterior cranial fossa
48
The Frontal sinuses are ____ - filled.
air
49
what is the inferior perspective of the skull?
From the bottom
50
What articulates with the Occipital condyle?
C1 atlas
51
In adults the Foramen lacerum is…
Filled with cartilage
52
In what bone is the Carotid canal found?
Temporal
53
What passes through the carotid canal?
Internal carotid artery and Sympathetic nerve plexus
54
In what bone is the External auditory meatus found?
Temporal bone
55
What passes through the External auditory meatus?
Sound waves to the eardrum
56
In what bone is the Internal auditory meatus found?
Temporal bone
57
What passes through the Internal auditory meatus?
CN VII (facial exits) and CN VIII (auditory)
58
Between what two bones is the Jugular foramen found?
Between the temporal and occipital bones
59
What structures pass through the Jugular foramen?
Internal jugular vein (most venous blood from brain to right side of the heart), CN IX (glossopharyngeal, CN X (vagus), CN XI (spinal accessory)
60
In what bone is the Optic foramen located?
Sphenoid bone
61
What structures pass through the Optic foramen?
CN II (optic) and the Ophthalmic artery (major artery that perfuse eyeball
62
In what bone are the Superior orbital fissures located?
Sphenoid
63
What structures pass through the Superior orbital fissures?
CN III (oculomotor), CN IV (trochlear), CN V (trigeminal ophthalmic division), CN VI (abducens), Ophthalmic veins
64
What bone does the Foramen magnum pass through?
Occipital bone
65
What structures pass through the Occipital bone via the Foramen magnum?
Spinal cord/inferior medulla oblongata, CN XI (spinal accessory), Vertebral arteries (pass upwards…also passes blood to brain)
66
What separates the right and left hemisphere of the brain?
Longitudinal fissure
67
What is a fissure?
A wide and deep separation between anatomical structures
68
What is the Longitudinal fissure?
It runs the entire length of the brain separating the right and left hemispheres
69
What separates the Parietal lobe from the Frontal lobe?
The Central sulcus
70
What is a sulcus?
an indentation of the surface of the brain
71
What are gyri(gyrus)?
Up foldings on the surface of the brain
72
Where is the Pre central gyrus located?
Located in the Frontal lobe, it is anterior to the Central sulcus
73
Where is the Post central gyrus located?
Located in the Parietal lobe, it is posterior to the Central sulcus
74
What is the specific anatomical separation between the Parietal and the Occipital lobes of the brain?
There is no specific anatomical separation. The division is based on function.
75
What is the Lateral fissure of the brain?
The Lateral fissure separates the Temporal lobe from all of the Frontal lobe and most of the Parietal lobes of the brain
76
What is the Corpus callosum?
Located in the middle of the brain, consist of axons of tracks from one cerebral hemisphere to the other cerebral hemisphere, it connects the right and left hemispheres
77
What is the Corpus callosum function?
Allows the right and left brain a connection so each hemisphere knows what the other hemisphere is doing. If severed the right and left sides of the brain/body do know communicate with the other side.
78
What is the largest component of the Diencephalon?
Thalamus
79
What are the 4 components of the Diencephalon?
Thalamus
Hypthalamus
Epithalamus
Subthalamus
80
Where is the Optic chasm located and what is it associated with?
It is located right below the hypothalamus and right above the pituitary gland It is associated with CN#2-the optic nerve
81
What happens if the pituitary gland becomes enlarged?
The pituitary gland which is surrounded on 3 sides by the bones of the Sellica turcia if it becomes enlarged has no other place to go but to push up on the optic chasm causing visual disturbances
82
What separates the right and left cerebrum hemispheres?
Longitudinal fissure
83
Where is the precentral gyrus located?
Precentral gyrus:located anteriorly to the Central sulcus, in the Frontal lobe.
v aka,PRIMARY MOTOR CORTEX
84
Where is the postcentral gyrus located?
Postcentral gyrus: located posteriorly to the Central sulcus, in the Parietal lobe.
v aka, the PRIMARY SENSORY CORTEX
85
Inward foldings of brain tissue is called?
Inward foldings = sulcus (singular), sulci (plural)
86
Outward foldings of brain tissue is called?
Gyrus (Gyri – plural): the upfoldings on the surface of the brain.
87
What is the function of the prefrontal lobe of the frontal lobe?
Its the area of the brain that is responsible for PERSONALITY (creative talents, abstract reasoning talents, mathematical talents, and our “ARTSY-FARTSY talents.
*If someone loses their function of the prefrontal lobes, they lose their personality and all the above*
88
What is associated with the Premotor area of the frontal lobe?
Broca’s premotor speech area (left frontal lobe in most people)
89
What is the function of the Precentral gyrus(primary motor cortex)?
origin of many upper motor neurons for lateral and anterior corticospinal tracts for conscious muscular movements
*MOTOR HOMUNCULUS:the larger the body part or area, the more muscles that have to carry out very carefully synchronized function*
90
List the areas of the body from lateral to medial that are associated with the primary motor cortex and the motor humonculus.
pharynx, tongue,face,lips/jaw, eye lid/eyeball, neck,thumb,finger,hand,wrist,forearm, elbow, arm, shoulder, trunk, hip, knee, ankle, toes
91
List the areas of the body from lateral to medial that are associated with the primary sensory cortex and the sensory humonculus.
intra abdominal, pharynx, tongue, lips, teeth, gums, jaw, face, nose, eyes, thumb, finger, hand, wrist, forearm, elbow, arm, shoulder, hand, neck, trunk, hip, leg, foot, toes, genitals
92
What is the function of the Postcentral gyrus?
primary somatic(sensory) cortex -termination
of tertiary neurons for most sensory pathways (except visual and
auditory); conscious interpretation and localization of stimuli on surface
of body
93
What is the function of the Sensory Association Area?
Sensations are recived from the primary sensory cortex, Sensory association area prepare that sensation with previous experience
with the SAME SENSATION AND begins to determine the
relative significance of the sensation and what the brain and the body need to do about those sensations
94
The percentile gyrus on the left side receives sensations from where?
from the right side of the body...because ascending sensory pathways cross over
95
What pathways cross over at the decussation of pyramids of the medulla?
descending motor pathways....NOT sensory pathways
96
Where is the nuclei of origin for CN#9?
MEDULLA OBLONGATA
97
Where is the nuclei of origin for CN#10?
MEDULLA OBLONGATA
98
Where is the nuclei of origin for CN#11
MEDULLA OBLONGATA
99
Where is the nuclei of origin for CN#12?
MEDULLA OBLONGATA
100
Where is the nuclei of origin for CN#5?
The Pons
101
Where is the nuclei of origin for CN#6
The Pons
102
Where is the nuclei of origin for CN#7
The Pons
103
Where is the nuclei of origin for CN#8
The Pons
104
Where is the nuclei of origin for CN#4
The Midbrain
105
Where is the nuclei of origin for CN#3
The Midbrain
106
Where is the origin os the CN#2 the optic nerve?
Rods and cones of the retina
107
What is the function of Wernicke's area of the brain?
Wwernicke's area is invovled in the the actual interpretation of the word that was recieved from the optic nerve to the Primary visual cortex
108
What is the fuction of Broca's area and where is it located?
Broca's area is located in the frontal lobe; it is the motor area for speaking
109
What is the relationship between the hypothalamus and the posterior pituitary gland?
Nerve cell bodies located in the nuclei of the hypothalamus have axon bodies that extend down the hypothalamohypophosial tract and terminate in the posterior pituitary gland. *hormones produced in the hypothalamus are transmitted through the axoplasm, then released from the posterior pituitary gland through action potentials*
110
What are two hormones that are produced in the hypo plasm that is released by the posterior pituitary gland?
1. Anti diuretic hormone(ADH)--->also known as vasopressin
| 2. Oxytocin
111
What is the relationship between the hypothalamus and the anterior pituitary gland?
hormones from hypothalamus influence synthesis and secretion of hormones from anterior pituitary gland
112
SO, how are hormones from the anterior pituitary first regulated?
BY hormones from the hypothalamus. *HORMONES (from hypothalamus)-hypothalamohypophosial portal system -anterior pituitary-regulate synthesis and secretion of specific hormones from the anterior pituitary*
113
What connects the posterior pituitary gland to the hypothalamus?
hypothalamohypophosial tract
114
What system connects the hypothalamus and the anterior pituitary gland that helps carry out their functions?
hypothalamohypophosial portal system
115
How does the Hypothalamohypophosial portal system work.
-Capillary networks from the hypothalamus join together to form a portal vein. -this vein travels down the Infundibulum and terminates in another capillary network in the anterior pituitary gland -through this portal system, hormones that are synthesized in the hypothalamus can be transmitted and bind to receptors located in the anterior pituitary gland to regulate hormone synthesis and secretion
116
What is the corresponding anterior pituitary response to these hypothalamus hormones: Growth hormone releasing hormone
Growth hormone synthesis and secretion
117
What is the corresponding anterior pituitary response to these hypothalamus hormones: Growth hormone inhibiting hormone (somatostatin)
Inhibition of growth hormone synthesis and secretion
118
What is the corresponding anterior pituitary response to these hypothalamus hormones: Thyroid stimulating hormone releasing hormone
Thyroid stimulating hormone synthesis and secretion
119
What is the corresponding anterior pituitary response to these hypothalamus hormones: Adrenocorticotrophic hormone releasing hormone
ACTH synthesis and secretion
120
What is the corresponding anterior pituitary response to these hypothalamus hormones: Gonadotrophin releasing hormone
Follicle stimulating hormone and Luteinizing hormone synthesis and secretion
121
What is the corresponding anterior pituitary response to these hypothalamus hormones: Prolactin releasing hormone
Prolactin synthesis and secretion
122
What is the corresponding anterior pituitary response to these hypothalamus hormones: Prolactin inhibiting hormone
Inhibition of Prolactin synthesis and secretion
123
What connects the posterior pituitary gland to the hypothalamus?
hypothalamohypophosial tract
124
What nuclei of the hypothalamus is ADH production and the posterior pituitary associated with?
supraoptic and paraventricular nuclei of hypothalamus
125
What is the function of ADH as related to its relationship with the hypothalamus and posterior pituitary gland?
Osmoreceptors in hypothalamus monitor osmolality of body fluids. Increased osmolality causes osmoreceptors to secrete ADH from posterior pituitary gland. Decreased osmolality causes osmoreceptors to inhibit secretion of ADH from posterior pituitary gland. ADH secretion causes water reabsorbtion in the renal tubules for hyper osmolality ADH inhibits water reabsorbtion in the renal tubes for hypo osmolality Body osmolality ~300
126
Where is the thermoregulation centers of the body(shivering/sweating)?
The anterior portion of the hypothalamus in the pre optic area
127
What cranial nerves are associated with the Solitary nucleus?
CN# 9(glossopharyngeal) and CN# 10(vagus)
128
What cranial nerves are associated with the Nucleus ambiguus?
CN#9(glossopharyngeal), #10(vagus) and #11(spinal accessories)
129
As related to these two structures and cranial nerves, where is the location of important baroreceptors which are involved in the regulation of central BP?
CN#9 associated with baroreceptors in the carotids and CN#10 associated with baroreceptors in the aortic arch
130
As the sensory fibers of CN #9 and 10 approach the medulla they combine to form the _____ which terminates into the _____.
tractus solitarius; nucleus solitarius
131
Trace the nerve pathway of high blood pressure.
Sensory baroreceptors in the aortic arch(CN#10) and in the carotids(CN#9) are stimulated and excited--->they send impulses up the fibers--->the fibers join and form the tracts solitarius as they approach the nucleus solitarius--->impulses are then sent to the Nucleus ambiguus(which is the CV control center)--->alpha 2 receptors are excited which decreases sympathetic outflow and increases parasympathetic outflow(HR decreases, blood vessels dilate bringing BP down) BARORECPTOR RESPONSE REGULATES BP ON A SEC-BY-SEC BASIS!!!
132
Trace the nerve pathway of low blood pressure.
Sensory baroreceptors in the aortic arch(CN#10) and in the carotids(CN#9) are inhibited and not excited--->they send less impulses up the fibers--->the fibers join and form the tracts solitarius as they approach the nucleus solitarius--->fewer impulses are then sent to the Nucleus ambiguus(which is the CV control center)--->alpha 2 receptors are no longer excited so there is an increase in outflow of sympathetic and a decrease in parasympathetic outflow(HR increases, SV increases, strength of contraction increases) BARORECPTOR RESPONSE REGULATES BP ON A SEC-BY-SEC BASIS!!!
133
Which nerve transmits from baroreceptors in the aortic arch?
sensory fibers and CN X (Vagus)
134
Which nerve transmits from internal carotid baroreceptors?
sensory fibers and CN IX (Glossopharyngeal)
135
What are the 3 important neuro tracts that pass through the Pons?
1. Ascending(Sensory) tracts to higher brain centers
2. Descending(Motor) tracts from higher brain centers
3. Tracts connecting the Cerebrum to the Cerebellum
136
What is the function of the Inferior colliculi located in the Corpora quadrigemina of the Tectum in the Midbrain?
neurons from inner ear synapse before transmitting impulses to primary auditory center Ø Sound impulses from the inner ear are transmitted thru the inferior colliculi before they get to the primary auditory center (where the sound is interpreted). *sounds are not interpreted in the inferior colliculi, they just pass through on their way to primary auditory centers*
137
What is the function of the Superior colliculi located in the Corpora quadrigemina of the Tectum in the Midbrain?
visual reflexes and visual tracking of moving objects; receive impulses from inferior colliculi, eyes, skin, and cerebrum -Involved in tracking images with your eyes -Input into the superior colliculi, from CN II, vision. *IF, someone comes behind me and taps me on the back, you have to have an intact superior colliculi in order to turn. Ø EX. duck hunting*
138
What is the primary function of the Thalamus?
The Thalamus is a Sensory Relay Center.
139
Define how the Thalamus functions as a Sensory Relay Center.
-Sensations ascend up the SC from various parts of the body. -at some point these sensations terminate in the Thalamus at their specify nuclei -from there they synapse with other pathways that relays the sensory information to the appropriate place in the brain ***most important role of Thalamus is once the sensation reaches it, it must know where in the higher brain to send the impulse*****
140
What is the function of the Lateral geniculate bodies, and where are they located?
Located in the thalamus their function is associated with CN#2-Visual Impulses/Visual Pathways -CN II have their origin in rods and cones of the retina -When they enter the brain, CN II stops at the lateral geniculate bodies. - Then there are synapses w/ neurons that continue from the lateral geniculate body, back to primary visual centers and the occipital lobe.
141
What is the function of the Medial geniculate bodies, and where are they located?
Located in the thalamus § associated with CN VIII Auditory input § CN VIII fibers will terminate first in the medial geniculate bodies § Then synapse with neurons that transmit the auditory impulses to the primary auditory centers in the temporal lobes.
142
What is the function of the Ventral posterior and medial nuclei and where are they located?
Located in the thalamus There function is related to most other sensory input
143
Almost all sensory input projects to the thalamus and then are projected to the _____ _____ for _____ _____.
cerebral cortex; conscious recognition
144
What fills the third ventricle which is located between the two lobes of the Thalamus?
CSF
145
Anatomically where is the decussations of pyramids located?
In the inferior Medulla Oblongata;
146
What is the happens at the decussations of pyramids?
Many of the DESCENDING SOMATIC MOTOR PATHWAYS get to the pyramidal decussation, they cross over and continue descending on the opposite side of the spinal cord.
147
What is the function of the Periaqueductal gray matter that is found in the Pons?
Concerned with modulation of PAIN TRANSMISSION. Lots of opioid receptors (Mu, Kappa, Delta) and many opioid peptides are found at the synapses within these areas. o Part of pain modulation pathways. Built in systems for decreasing the severity of pain transmissions
148
What is the function of the part of the Locus ceruleus that is located in the Pons?
major neurotransmitter is NE § One part of the brain that keeps us awake and alert when it is active. § When it is not active or inhibited, alertness decreases, and allows sleep to occur.
149
What is the function of the Pyramidal decussation?
It is the area in the lower medulla where many descending somatic motor pathways cross over and continue descending on the opposite side of the spinal cord. They decussate or cross over ----->(hence Pyramidal DECUSSATION!) and continue descending. Because of the Pyramidal decussation, motor centers on the right side of the brain can regulate moment on the left side of the body and motor control centers on the left side of the brain can regulate movement on the right side of the body.
150
What is the related functions of the Raphe magnus nucleus, Reticularis paragigantocellularis of the Medulla and the Periaqueductal gray matter of the Pons?
These structures are concerned with modulation of pain transmission. They have lots of opioid(kappa delta) receptors and many opioid peptides are found within the synapses of this area. ****PAIN TRASMISSION PATHWAYS*****
151
What is the function of the prefrontal lobe of the frontal lobe?
Its the area of the brain that is responsible for PERSONALITY (creative talents, abstract reasoning talents, mathematical talents, and our “ARTSY-FARTSY talents.
*If someone loses their function of the prefrontal lobes, they lose their personality and all the above*
152
What are the characteristics of Left prefrontal dominant people?
L prefrontal lobe dominant:
v VERY organized
v VERY detailed oriented
v (usually) have high mathematical/ scientific reasoning abilities
v (most) people are R hand dominant
153
What are the charcteristics of Right prefrontal dominant people?
R prefrontal lobe dominant:
v (sometimes) drives L prefrontal lobe people crazy
v artsy-fartsy people
v (sometimes) rather disorganized and disheveled
v produce beautiful art, music, and creative designs
v (often) they are L handed
154
Where is the termination of the optic pathways?
Primary visual cortex
155
Where is the Visual association area and what is its fuction?
It lies adjacent to the primary visual cortex and its funciton is to compare visual imput with previous input and recognition, BUT NOT INTERPRETATION!
156
What intially happens when we see an image?
- The image is seen and tranmited via nerve fibers of CN#2 first to the thalamus
- Then from the thalamus to the primary visual cortex(the primary visual cortex is where the image is seen but not interpreted)
- the image is tranmitted from the primary visual cortex to the visual association area
- the visual association area compares that image with previous experiences with that image; the VAA starts making a decision about the significance of that image and how much attention the brain needs to pay to it
- depending on what the image is, the VAA often transmits it to other parts of the brain for final processing; for example if its a word it must go to Wernicke's area for actual interpretatino of the word
157
What occurs in the Primary Visual Cortex?
The image is seen but not interpreted
158
What happens in the Visual associaton area?
The image is compared with previous experiences and a decison is made if the brain needs to pay attention to it. If so the VAA transmits it to the part of the brain associated with it for final processing
159
What is the function of Wernicke's area of the brain?
Wernicke's area is invovled in the the actual interpretation of the word that was recieved from the optic nerve to the Primary visual cortex
160
What is the fuction of Broca's area and where is it located?
Broca's area is located in the frontal lobe; it is the motor area for speaking
161
What is the sequence of events related to seeing a word, understanding that word and then speaking the word.
1. The image of the "WORD" is transmitted through the pupils to the rods and cones of the retina(the origin of CN#2-optic nerve_
2. Action potential impulses transmit the image through CN#2 fibers and they terminate in the lateral geniculate bodies of the thalamus
3. In the thalamus, they synapse with other neurons that extend from the lateral geniculate bodies back to the primary visual cortex
4. In the primary visual cortex, the image of the "WORD" is seen only, no interpretation there!
5. The image is transmitted to the visual association which compares and recognizes the "WORD" from prevous associations.
6. The image is then transmitted to Wernicke's area for final interpretation of the "WORD"
7. The "WORD" is chosen in Wernicke's area and is then transmitted to Broaca's area(the motor area for speaking, in the frontal lobe).
8. Broca's area transmits the impulse to the primary motor cortex(according to the handout, the muscles involved with speaking ar on the lateral sides).
9. The primary motor cortex excites the nerve pathways--->to the muscles that are involved with speaking
162
If a person has a dysfunctional Wernicke's area, that then are said to have? because of what? what is the S&S?
receptive aphasia;
d/t ischemia,hypoxia or stroke;
they cannot understand spoken or written words
163
Someone with a lesion in the Broca's area with a normal Wernickes area is said to have what?why?
they have expressive aphasia
they can understand spoken or written words they just cannot inititate the sequence of muscle activities involved with speaking that word
164
What is the sequence of events of repeating a word that you have heard spoken?
§ Sound waves enter the inner ear (CN VIII)
§ CN VIII terminates below the nucleus of thalamus
§ Synapses with pathways that transmit that sound, from the thalamus to the primary auditory cortex (in the temporal lobe)
§ Primary auditory cortex hears the sound but does not interpret the sound
§ Sound is then transmitted to the auditory association area, which associates that sound with previous experience with that sound, and begins to determine the relative significance of that sound
§ Depending on what the sound is, determines where that sound will transmit for final interpretation
§ IF the sound is perceived as a word, it is transmitted to Wernicke’s area
§ If you are going to speak the word, its chosen in the Wernicke’s area
§ Transmitted to Broca’s area, which transmits it to the primary motor cortex
165
Where is the Basal Nuclei located and what is its function?
Located in many parts of the brain(intergrated with primary moter cortex and their pre-motor areas in the crebral hemispheres);
>inhibition of unwanted muscular movements for controlled, coordinated movements<
work together to regulate skeletal muscle movements operating at the UNCONSCIOUS LEVEL--->as opposed to primary motor cortex which is conscious muscle movement
*all components have to be functional in order for normal skeletal muscle movement to occur*
166
What structures are associated with the Basal nuclei?
-Substantia nigra (midbrain)—nigrostriatal tract
-Subthalamic nuclei (diencephalon)
-Corpus striatum (cerebrum)
>Caudate nucleus
>Lentiform nucleus
^Globus pallidus
^Putamen
167
What is the function of the Limbic system?
Limbic system structures are involved in many of our emotions and motivations, particularly those that are related to survival. Such emotions include fear, anger, and emotions related to sexual behavior. The limbic system is also involved in feelings of pleasure that are related to our survival, such as those experienced from eating and sex.
168
Where is the nigrostriatal tract located and what is its function?
nigrostriatal tract is located in the midbrain
originates with the substantia nigra, where the nerve cell bodies are.
§ Extends upward into the cerebral hemispheres, and synapses on the caudate nucleus.
§ The neurotransmitter released at that synapse is DOPAMINE
169
The Substantia nigra is part of the _____ _____, it is located in the _____ and its fuction is?
basal nuclei
midbrain
orgin of the nigrostrital tract with nerve cells that produce dopamine that synapse on the caudate nucleus
170
What is the result of the release of the specific neurotransmitter of the nigrostriatal tract?
Dopamine binding with dopaminergic receptors is INHIBITORY to the output of the caudate nucles
171
Where is the Corpus striatum located, what are the 2 major divisions and what are their overall function?
cerebrum
Caudate nucleus & Lentiform nucleus
inhibition of unwanted muscular movements for controlled, coordinated movements
172
Where is the Caudate nucleus located?
in the Cerebrum; it is a part of the Corpus striatum
173
What three types of neurotransmitters affect the Caudate nucleus and what is the response?
Dopamine receptors-dopamine via the nigrostriatal tract--->inhibits
Glutamate-binds with nicotinic receptors-from globus pallidus--->excitatory
Acetylcholine-nicotinic receptors-from primary motor cortex--->excitatiory
THERE NEEDS TO BE A VERY DELICATE BALANCE OF THESE NEUROTRANSMITTERS, TO REGULATE OUTPUT FROM ALL PARTS OF THE BASALNUCLEI, WHICH THEN REGULATES SKELETAL MUSCLE MOVEMENT, PRETTY MUCH AT THE UNCONSCIOUS LEVEL
174
What is an example of an inbalance in the Caudate nucleus?
Parkinson's Disease
175
What is the imbalance associated with Parkinson's disease?
If there is a deficit of inhibitory dopamine at that synapse, excitatory glutamate and acetylcholine dominates at that synapse causing Parkinson disease
176
What are some S&S of Parkinson's and their progression?
Ø Resting (non-intentional) tremors: when a person is AT REST, they have a pill rolling movement of their fingers and thumbs, and an alternating supination/ pronation of their hands.
Ø In the early stages of Parkinson dz, those tremors may go away during intentional movement
Ø Person with Parkinson’s dz has very stout posture, gait is abnormal (slow, shuffling, unsteady gait), ability to speak is hindered, drooling d/t inability to swallow secretions well, handwriting becomes very small (micrographia)
177
What is the function of the Globus pallidus?
There’s a tract that has its origin in the globus pallidus that synapses on the caudate nucleus and that neurotransmitter is (probably, perhaps maybe, but not necessarily) glutamate
v Glutamate is always excitatory
178
What is the anterior commissure?
is a bundle of nerve fibers (white matter), connecting the two cerebral hemispheres across the midline
involved in pain and pain sensation
179
What are the results of abnormalities of the cerebellum?
Abnormalities of the cerebellum are also motor movement abnormalities, which are usually called INTENTION TREMORS
o aka, cerebellar intention tremor
o So when a person consciously starts to do something, that is when the tremors start
o If the cerebellar is dysfunctional, body parts are unknown in time and space
180
What drugs should be avoided for Parkinson's patient?
Drugs that block dopamine: These drugs include Prochlorperazine (Compazine), Promethazine (Phenergan), and Metoclopramide (Reglan). They should be avoided.
Cholinergic meds should be avoided
anticholinergic medications block acetylcholine which helps decrease the tremors of parkinsons
181
What is the difference between cholinergic and anticholinergic drugs in parkinson?
anticholinergic medications block acetylcholine which helps decrease the tremors of parkinsons
182
What is the Supratentorial structures?
Supratentorial: structure ABOVE the tentorium cerebelli
§ cerebral hemispheres and everything that is contained in
the cerebral hemispheres
183
What are the Infratentorial structures?
Infratentorial: structures BELOW the tentorium cerebelli
§ Cerebellar hemispheres
§ Midbrain: sitting right at the
tentorium
§ Pons
§ Medulla
184
If a lesion is classified as being infratentorial or supratentorial; which do you suppose is more lethal?
Usually lesions that are SUPRATENTORIAL, there is more room for it to expand before it causes increase ICP.
INFRATENTORIAL IS WORSE: starts growing and there is little room for it to expand,
and it can very quickly cause herniation of the medulla, down thru the foramen magnum and down to the SC.
MEDULLA: CV and respiratory control centers; all of the ascending and descending pathways from the SC to the brain and brain to the SC
185
What is the function of the Dura mater?
(1st meningeal membrane)composed of two layers that around most of the brain are fused together into a single layer; to form the functional layer
186
What is the Tentorium(tent/roof) cerebelli?
Tentorium (tent/ roof) cerebelli: infolding of the dura mater between the
cerebral and cerebellar hemispheres
187
What is the sequence of CSF formation and flow?
```
EPENDYMAL CELLS(FROM PLASMA TO CSF)
CHPOROID PLEXUSES
INTERVENTRICULAR FORAMEN
THIRD VENTRICLE
CEREBRAL AQUEDUCT
FORTH VENTRICLE
EXITS AT THE 3 FORMINA
TO THE BRAIN AND SC(ARACHNOID SPACE)
```
188
Is the a sample of CSF or Serum/Blood?
total protein 15 - 45 mg/dl
CSF
189
Is the a sample of CSF or Serum/Blood?
Clear amber fluid
serum/blood
190
Is the a sample of CSF or Serum/Blood?
total protein 6 - 8.5 gm/dl
serum/blood
191
Is the a sample of CSF or Serum/Blood?
colorless/clear fluid
CSF
192
Is the a sample of CSF or Serum/Blood?
albumin 10 - 30 mg/dl
CSF
193
Is the a sample of CSF or Serum/Blood?
Chloride level 98 - 106
serum/blood
194
Is the a sample of CSF or Serum/Blood?
albumin 3.5 - 5 gm/dl
serum/blood
195
Is the a sample of CSF or Serum/Blood?
chloride 18 - 132
CSF
196
Is the a sample of CSF or Serum/Blood?
WBC 5K - 10K/microl
serum/blood
197
Is the a sample of CSF or Serum/Blood?
Mag level 0.78 - 1.26
CSF
198
Is the a sample of CSF or Serum/Blood?
WBC 0 - 5/microl
CSF
199
Is the a sample of CSF or Serum/Blood?
mag level 0.65 - 1.05
serum/blood
200
Is the a sample of CSF or Serum/Blood?
RBC of 0
CSF
201
Is the a sample of CSF or Serum/Blood?
K 4.0 - 5.1
serum/blood
202
Is the a sample of CSF or Serum/Blood?
RBC 4 - 6 X 10/microl
serum/blood
203
Is the a sample of CSF or Serum/Blood?
K 2.8 - 3.2
CSF
204
Is the a sample of CSF or Serum/Blood?
glucose of 70 - 110
serum/blood
205
Is the a sample of CSF or Serum/Blood?
Na 147 - 151
CSF
206
Is the a sample of CSF or Serum/Blood?
glucose of 50 - 75
CSF
207
Is the a sample of CSF or Serum/Blood?
Na 135 - 145
serum/blood
208
Bacterial or Viral Meningitis?
yellow/turbid appearance
marked increase in Polymorpho nuclear WBCs
Light increase or normal Lymphocytes
Protein slight increase or normal
Glucose decreased
Pyogenic bacterial meningitis
209
Bacterial or viral meningitis?
Clear appearance
slight increase or normal polymorphonuclear WBCs
marked increase in Lymphocytes
marked increase in protein
normal glucose
Viral meningitis
210
What is the modified Monroe-Kelly Doctrine?
Increase in volume of one of the compartments (volumes) of the brain must be compensated for by a
reciprocal decrease in the volume of one or more of the other compartments for the total brain volume to
remain fixed and for the ICP to remain unchanged
211
What is the formula concerning perfusing the brain?
CPP = MAP – ICP
212
What are the effects of pO2 and pCO2 on ICP?
High pCO2 causes brain tissue to vasodialte therby increasing ICP
Low pO2(50mmHg) causes brain tissue to vasodialte therby increasing ICP
213
What are the two pathways of blood flow from the Right side?
R SIDE BRAIN CIRCULATION PATHWAY(via internal carotid patway):
L VENTRICLE
AORTIC VALVE
ASCENDING AORTA
R BRACHIOCEPHALIC ARTERY
R COMMON CAROTID ARTERY
INTERNAL CAROTID ARTERY
FURTHER DIVISIONS
LATERAL (PARIETAL AND FRONTAL LOBES) AND MEDIAL (FRONTAL LOBE)
R SIDE BRAIN CIRCULATION PATHWAY(via the subclavian pathway):
```
L VENTRICLE
AORTIC VALVE
ASCENDING AORTA
R BRACHIOCEPHALIC ARTERY
R SUBCLAVIAN ARTERY
VERTEBRAL ARTERY
THROUGH THE FORAMINA OF THE TRANSVERSE PROCESSES OF THE CERVICAL VERTEBRAE
FORAMEN MAGNUM
TO THE BRAIN TISSUE
```
214
At what anatomical point does the internal carotid enter the skull?
carotid canal
215
At what anatomical point does the vertebral arteries enter the skull?
foramen magnum
216
What is the circulation pathway of blood from the left ventricle to the brain from the left side?
The common carotid branches directly off the aorta (NO brachiocephalic artery on the L side)
* Then pretty soon the L subclavian branches directly off the aorta
* The common carotid of the L continues up the neck
* Divides into the external carotid and internal carotid
o internal carotid enters thru the carotid canal and continue on up to the brain tissue
* From the L subclavian, the L vertebral artery passes thru the foramina of transverse processes of the cervical vertebrae
* continues on up to the base of the skull and enters thru the foramen magnum
* up to the brain tissue
SAME THING ON BOTH SIDES MINUS THE BRACHIOCEPHALIC ARTERY
217
Once blood flow reaches the brain via the internal carotid, what is the bloodflow pathway?
o Internal carotids divide into the middle cerebral artery and then very
quickly the anterior cerebral artery
o The middle cerebral arteries will perfuse: Right Lateral Parietal, Frontal & Temporal lobes & parts of diencephalon
o Anterior cerebral arteries will perfuse: Prefrontal & Medial Frontal & Parietal lobes
o Anterior communicating artery: connects the two anterior cerebral arteries
* from this point the anterior communicating artery joins the right and left verterbral artery and blood flows into the Basilar Artery(perfuses Pons, cerebellum and parts of brainstem)*
* next the basilar artery flows into right and left Posterior cerebral arteries which perfuse right and left occipital, right and left temporal lobes and part of the diencephalon(right and left depending on which side is being perfused*
218
Once bloodflow reaches the brain via the vertebral arteries what is the blood flow pathway?
o coming up on the anterior part of the brainstem
o one of the first divisions is the posterior inferior cerebellar artery(going to perfuse part of the cerebellar hemisphere)
o next is the anterior inferior cerebellar artery(going to perfuse the other part of the cerebellar hemisphere)
o then the TWO vertebral arteries diverge into the BASILAR artery; branching off of the basilar artery are the:
§ pontine arteries (bilaterally) perfuse parts of the pons, medulla, and the midbrain
§ superior cerebellar artery (bilaterally) perfuses the rest of the cerebellum
o the basilar artery then divides to form the posterior cerebral arteries (bilaterally)
§ the POSTERIOR cerebral arteries perfuse: the occipital lobes (laterally and medially) and almost all of the temporal lobe (inferiorly, laterally and medially) and parts of the diencephalon
219
What is the anatomical relationship to the brain and the Circle of Willis?
§ in the middle of the circle of willis, CN II passes thru there
§ just inferior to that in the sella turcica, is the pituitary
§ just above that is the hypothalamus of the diencephalon
§ the infundibulum that connects the hypothalamus to the pituitary, passes right thru there
§ THIS IS VERY VERY VERY IMPORTANT ANATOMIC RELATIONSHIPS
220
How does blood exits the brain?
BLOOD exits the brain:
o First into the venous sinuses
o then the venous sinuses empty into various veins, primarily empty into the internal jugulars
o then eventually into the superior vena cava
o back to the R atrium
221
What arteries make up the Circle of Willis?
R&L anterior cerebral arterys
posterior communicating artery
Anterior Communicationg artery
R&L posterior cerebral arterys
222
What does the Right anterior cerebral artery perfuse?
prefrontal
medial frontal
parietal lobes
223
What does the left anterior cerebral artery perfuse?
prefrontal
medial frontal
parietal lobes
224
What does the left post. cerebral artery perfuse?
left occipital lobe
left temporal lobes
part of the diencephalon
225
What does the right post cerebral artery perfuse?
right occipital lobe
right temporal lobe
parts of the diencephalon
226
What doe sthe right middle cerebral artery perfuse?
right lateral parietal lobes
right frontal lobes
right temporal lobes
parts of the dienephalon
227
What does the left middle cerebral artery perfuse?
leftlateral parietal lobes
left frontal lobes
left temporal lobes
left of the dienephalon
228
What are the 4 herniation syndromes?
Cingulate
Central transtentorial
Uncal
Tonsillar
229
What are the characteristics of Cingulate Herniation syndrome?
Cingulate: medially and above the corpus callosum
§ cingulate gyrus herniates underneath the falx cerebri
§ the anterior cerebral artery on the side of the herniation is compressed
§ so if there is decreased blood flow thru the anterior cerebral artery these will become ischemic
§ PARTS OF THE BRAIN AFFECTED:
v prefrontal lateral
v prefrontal medial
v medial part of the frontal lobe
v medial parietal lobe
230
What are the characteristic of Central transtentorial Herniation syndrome?
Central transtentorial:
§ both cerebral hemispheres
§ diencephalon
§ midbrain
§ tentorial ring/notch
§ rapid loss of consciousness (because of the reticular activating system)
§ inability to follow movement lost
§ decerebrate or decorticate posturing
231
What are the characteristics of Uncal herniation syndrome?
Uncal
§ Little projection of the temporal lobe called the uncus,
§ herniates through the tentorial ring/ notch
§ usually s/t supratentorial lesions, increased ICP, about the tentorium
§ as an outcome, the pupil on the same side is dilated and fixed
§ compressing CN III on the same side as the herniation
§ rapid decrease of LOC, from the reticular activating fibers are cut-off
§ abnormal posturing, more decerebrate than decorticate
§ usually hyperventilation
§ AND THE POSTERIOR CEREBRAL ARTERY ON THE SIDE OF HERNIATION IS OBSTRUCTED, FLOW IS CUT OFF
§ POSTERIOR CEREBRAL ARTERY, POSTERIOR CEREBRAL ARTERY,
§ POSTERIOR CEREBRAL ARTERY, POSTERIOR CEREBRAL ARTERY
§ PERFUSES: occipital lobe, inferior and lateral parts of the temporal lobe
232
What are the characteristics of Tonsillar herniation syndrome?
Tonsillar
§ r/t to the tonsils of the cerebellar hemispheres
§ sitting right above the foramen magnum
§ is when the tonsils of the cerebellar hemispheres herniate down thru the foramen magnum
§ that cuts off connection between the SC and the brain; and the brain and the SC
§ literally the medulla herniates fown thru the foramen magnum into the SC
§ medulla: medullary CV system and respiratory centers
§ HENCE: usually rapid in progression and rapidly lethal, with very little successful interventions
233
What are the layers of the brain from the Skull inward(8)?
SKULL
PERIOSTEUM
DURA MATER
SUBDURAL SPACE
ARACHNOID MATER
SUBARACHNOID SPACE
PIA MATER
CEREBRUM
234
What system is the hippocampus associated with?
The Limbic system~located in the temporal lobe
235
Why is the hippocampus so important?
part of transfer of short-term memory to long-term memory and recall of long-term memories and their emotional
associations
236
What disease state is associated with the hippocampus?
Major advance dementia, the hippocampus shrinks
§ They cannot store memory
§ Initially people can recall long term memory better than short-term
§ No TX for dementia
237
Bruit in common carotid...what part of the brain is not well perfused?
If these areas are not well perfused which deficit will you see?
Vasculature:
◦common carotid divides into external and internal carotid ‣goes in the left cerebral canal ‣divides into anterior cerebral and middle cerebral arteries - decreased blood flow to ‣these arteries on the left side middle cerebral feeds the lateral parietal ◦anterior cerebral feeds the lateral frontal•lateral prefrontal ◦medial prefrontal ◦medial frontal ◦medial parietal
What symptoms might you see:
◦prefrontal ‣abstract reasoning •mathematical reasoning •lateral frontal ‣primary motor cortex of the right upper body •lateral parietal ‣primary sensory cortex of the right upper body
•medial frontal ‣primary motor cortex of the right lower body •medial parietal ‣sensations of the right lower part of the body
238
The major control of the respiratory cycle is in the ___ and the ___.
MEDULLA, PONS
239
What is the sequence events that occurs related to inspiration and the Medullary Inspiratory Center.
1. spontaneous active neurons(Meaning they spontaneously initiate and discharge action potentials) transmits impulses from MIC towards the spinal cord.
2. This collateral nerve synapses with the phrenic nerve which innervates the diaphragm.
3. when the diaphragm is ineervated by the phenic nerve, it contracts(becomes shorter) and pulls the lungs downward, increasing the longitudinal size of the thorax(lungs).
4. The other collateral continues on down the SC and synapses w/ intercostal nerves to the external intercostal muscles.
5. When the external intercostal muscles contract, they pull the ribs UP and OUT, which increases the anterior-posterior size of the thoracic and lungs. v It increases the size of the lungs, which increases the VOLUME in the lungs.
6. As intrapulmonary volume increases, the intrapulmonary pressure decreases. Intrapulmonary pressure is less than atmospheric pressure, AIR FOLLOWS THE PRESSURE GRADIENT. Air moves thru the tracheobronchial tree, into the alveoli.
7. AIR STOPS when the AIR EQUILIBRATES.
240
What is the other location and sequence of events occurring as the impulse is innervating the Phrenic/Intercostal nerve?
At the same time that impulses are being sent down to the phrenic n. and intercostal nerves; impulses are also being transmitted to the pontine pneumotaxic center [PPC]. 1. Once the PPC is excited, it sends an inhibiting impulses to the MIC. 2. Once inhibiting is stops sending impulses to the phrenic/intercostal nerves. 3. When the diaphragm is no longer excited, it relaxes, or domes back up. Pushes the lungs up. External intercostal muscles relax, and the ribs move DOWN and IN. 4. THIS decreases the size and volume of the lungs. Intrapulmonary pressure INCREASES and moves passively out of the tracheobronchial tree with the pressure gradient 5. When the pressures equilibrate, the movement of AIR stops.
241
What is the sequence of events involved with the Medullary Expiratory Center?
1. When it does become excited, it transmits impulses to the INTERNAL INTERCOSTAL NERVES that innervate the INTERNAL INTERCOSTAL MUSCLES.
2. When the internal intercostal muscles are excited, that REALLY pulls the ribs DOWN and IN. If the ribs were really pulled DOWN and IN, the volume of the lungs decrease even more, the pressure increases even more for an ACTIVE outflow of air *USUALLY does not come in to play except for active, forceful expiration.*
242
How does the central chemoreceptors involved in the regulation of respiration function?
Primarily monitors pH of CSF § pH of CSF is determined (on an ongoing, breath-by-breath basis) by the amount of CO2 in the body fluids (CO2 diffuses very readily into blood and CSF). § As CO2 accumulates in CSF, and the pH of CSF drops down to the acid side, which is detected by the central chemoreceptors;. § Positive input to the respiratory centers to increase rate and depth of ventilations. § As rate and depth of ventilation increases, then the excess CO2 should be exhaled, bringing the pH of the CSF back into a normal range.
243
Where are the peripheral chemoreceptors located?
Located in the aortic arch and the bifurcation of the carotid.
244
Where are the central chemoreceptors involved in the regulation of respiration located?
Medulla
245
How does the peripheral chemoreceptors involved in the regulation of respiration function?
o Primarily monitors pO2 at these locations. o Strategic location: blood has just returned to the lungs where it has been oxygenated, then ejected into the aorta, and then onto the carotids. o pO2 has to drop below ~60mmHg (some references say ~50) before there is any response from the peripheral chemoreceptors. o When they are excited, activated, from the low pO2; that has an excitatory affect on the respiratory centers, to INREASE rate and depth of respirations.
246
So what does the central chemoreceptors and the peripheral chemoreceptors monitor in relation to the regulation of respiration. Which is more involved in the minute-by-minutes regulation of respiration?
central chemoreceptors = CO2 peripheral chemoreceptors = pO2 *For normal people, the CENTRAL chemoreceptors that has a much more minute-to-minute role in regulating respiratory cycles than the PERIPHERAL chemoreceptors.*
247
What is the function of stretch receptors?
monitors the stretch of the lungs. Inhibits(negative) affect * As the lungs expand, those stretch receptors are excited, and as they become excited they send an inhibitory impulse to the MIC to STOP INSPIRATION to prevent OVER-INFLATION of the lungs.*
248
What is the function of the Proprioceptors?
involved in muscle tension, has a + affect on respiration. As tension INCREASES, that tends to have a positive impact on INREASING rate and depth of respiration
249
What happens once the external intercostal muscles relax?
The ribs move down and in. THIS decreases the size and volume of the lungs. Intrapulmonary pressure INCREASES and moves passively out of the tracheobronchial tree with the pressure gradient. When the pressures equilibrate, the movement of AIR stops.
250
When excited, what type of impulse does the Pontine Pneumotaxic Center send to the Medullary Insp. Center?
Which excites the PPC. When the PPC is excited, it then sends INHIBITORY impulses to the MIC.
