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Nurse Practioner MSN > Patho: Neuro, Fluid Balance, Immunity > Flashcards

Patho: Neuro, Fluid Balance, Immunity Flashcards

1
Q

What are the cranial nerve names?

A

“Oh, oh, oh, to touch and feel very great vaginas. AH!”

1) Olfactory
2) Optic
3) Oculomotor
4) Trochlear
5) Trigeminal
6) Abducens
7) Facial
8) Vestibulocochlear
9) Glossopharyngeal
10) Vagus
11) Accessory
12) Hypoglossal

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2
Q

How many pairs of spinal nerves are there?

A

31

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3
Q

What does the peripheral nervous system consist of?

A

Cranial nerves and spinal nerves, including their branches and ganglia

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4
Q

What cranial nerve are you testing when you shrug your shoulders?

A

Accessory (#11)

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5
Q

What cranial nerve is known as “The Wanderer?”

A

Vagus (#10); most extensive reaches beyond the head/neck

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6
Q

How many pairs of cranial nerves are there?

A

12: sensory, motor, or mixed

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7
Q

What does the Olfactory nerve do?

A

Purely sensory for smell

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8
Q

What does the optic nerve do?

A

Purely sensory for vision

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9
Q

What does the oculomotor cranial nerve do?

A

Contains motor fibers to extraocular muscles that direct eyeball; Moves eyelid, iris and ciliary body; proprioception (sensory) to brain from extraocular muscles

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10
Q

What does Trochlear cranial nerve do?

A

Sensory and motor fibers for superior oblique muscle of eye

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11
Q

What does Trigeminal cranial nerve do?

A

Motor and sensory for face; conducts sensory impulses from mouth, nose, surface of eye, and dura mater. Motor fibers for chewing muscles

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12
Q

What does the Abducens cranial nerve do?

A

Contains motor fibers to lateral rectus muscle (eye) and proprioceptor (sensory) fibers from same muscle to brain

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13
Q

What does the Facial nerve do?

A

Sensory and Motor:

Muscles of facial expression and salivary glands; Sensory fibers from taste buds of anterior part of tongue

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14
Q

What does the Vestibulocochlear nerve do?

A

Purely sensory: transmits impulses for sense of equilibrium and sense of hearing

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15
Q

What does the Glossopharyngeal nerve do?

A

Mixed:
Motor fibers for throat and salivary glands; sensory fibers for carrying impulses from pharynx, posterior tongue (taste buds), and pressure receptors of carotid artery

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16
Q

What does the Vagus nerve do?

A

Sensory and motor impulses for pharynx; parasympathetic motor fibers, which supply smooth muscle of abdominal organs; receives sensory impulses from viscera

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17
Q

What does the Spinal Accessory nerve do?

A

Sensory and motor fibers for SCM

muscle and trapezius muscle and muscles of soft palate, pharynx, and larynx.

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18
Q

What does the Hypoglossal nerve do?

A

Motor fibers to muscles of tongue and sensory impulses from tongue to brain

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19
Q

What is the mnemonic to remember which cranial nerves are sensory, motor, or both?

A

“Some say marry money, but my brother says big boobs matter most.”

1) Olfactory: Sensory
2) Optic: Sensory
3) Oculomotor: Motor
4) Trochlear: Motor
5) Trigeminal: Both
6) Abducens: Motor
7) Facial: Both
8) Vestibulocochlear: Sensory
9) Glossopharyngeal: Both
10) Vagus: Both
11) Accessory: Motor
12) Hypoglossal: Motor

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20
Q

Exit ganglion, head to effector or through spinal nerve;
exist at every level of the spinal cord and are responsible for carrying postganglionic (unmyelinated) nerve fibers from the paravertebral ganglia to their destination

A

Gray rami

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21
Q

Preganglionic (myelinated), exits spinal nerve and go to ganglion;
exist only at the levels of the spinal cord where the intermediolateral cell column is present (T1-L2) and are responsible for carrying preganglionic (myelinated) nerve fibers from the spinal cord to the paravertebral ganglia

A

White rami

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22
Q

Bundles of myelinated axons in the PNS:

A

Fascicles

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23
Q

Spinal nerves split into anterior and posterior _____

A

Rami

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24
Q

Networks of nerve fibers called _____; examples: brachial, lumbar, or sacral

A

Plexuses

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25
Q

Area of the skin that is mainly supplied by branches of a single spinal sensory nerve root. These spinal sensory nerves enter the nerve root at the spinal cord, and their branches reach to the periphery of the body:

A

Dermatomes

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26
Q

Which cranial nerve helps with hearing and balance?

A

Vestibulocochlear

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27
Q

Cranial nerves 2-6 (except 5) innervate the ____

A

Eye

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28
Q

Which cranial nerve is both sensory and motor and involves sensation of face/motor of jaw muscles?

A

Trigeminal

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29
Q

Hypernatremia will cause a ___ in blood pressure and a ___ in cell excitability.

A

Increase; increase

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30
Q

Alkalosis has the effect of decreasing ionized ca++ concentration in the blood as it becomes bound to plasma proteins more frequently (due to less H+ binding of those proteins). This will result in clinical signs of ______ neuromuscular excitability.

A

Increased

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31
Q

Which of the following is NOT a feature of the Adaptive immune system?
A. Inducible and long-lived
B. Specific in targeting
C. Has memory (responds differently to re-infection of the same organism)
D. All of the above are features of the adaptive immune response

A

D

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32
Q

Increased capillary permeability will result in
A.Increased net movement of fluid into the vessels
B.Increased plasma oncotic pressure
C.increased loss of fluids, as proteins also leave from vessels
D.Increased capillary hydrostatic force

A

C

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33
Q 
Which of the following is a sentinel cell that constantly checks the environment in peripheral organs and skin, then moves to the lymph nodes upon detecting potential pathogens?
A. Lymphocyte
B. Dendritic cell
C. Natural killer cell
D. Giant cell
A

B

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34
Q 
Aspirin and other NSAIDs work by blocking an enzyme active in the formation of:
A. Leukotrienes
B. Eicosanoids
C. Histamine
D. Prostaglandins
A

D

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35
Q

The effect of hypocalcemia on the neuromuscular system is:
A. Does not affect the neuromuscular system
B. Increased neuromuscular excitability
C. Decreased neuromuscular excitability
D. Flaccid paralysis

A

B

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36
Q 
A lowering pH due to an increase in blood levels of ketoacids, such as found in diabetic ketoacidosis, would be an example of:
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
A

C

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37
Q 
\_\_\_\_\_\_ are small secreted intercellular signaling molecules that are responsible for activating other cell and regulating the inflammatory response.
A. Toll-like receptors
B. Cytokines
C. Tissue factor
D. NOD- like receptors
A

B

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38
Q

Hypovolemic hyponatremia will have all of the following effects except:
A. Swelling of cells due to influx of water
B. Drop in ECF Osmotic Pressure
C. Tachycardia and decrease in urine output
D. Increased BP/volume

A

D

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39
Q 
How much of the water found in our bodies is intracellular? 
A.Two-thirds (66%)
B. Three fourths
C. One third
D. One fourth
A

A

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40
Q 
A rise in H+ levels in the blood (acidosis) will result in \_\_\_\_\_ levels of CO2 and will be compensated by \_\_\_\_ breathing rate. 
A.Increased, increased
B.increased, decreased
C.Decreased,increased
D.Decreased, decreased
A

A

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41
Q 
Which of the following is NOT associated with chronic inflammation? 
A. Serous exudate
B. Granuloma formation
C. Epithelioid cells
D. Giant cells
A

A

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42
Q

Which of the following is not an example of active immunity?
A. Previous vaccination against measles
B. Previous infection with chickenpox
C. Recover from the flu infection
D. Protection from infection of an infant through breastfeeding

A

D

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43
Q 
15. The most common type of leukocyte and predominates in early inflammatory responses is the:
A. neutrophil
B. Eosinophil
C. Basophils
D. Lymphocyte
A

A

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44
Q

pH can have a significant impact on the effectiveness of local anesthetics because the pH will help determine how much the local anesthetic is in a charged or uncharged state.
A. True
B. False

A

A

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45
Q 
Papilledema indicates:
A. Loss of capillary hydrostatic pressure
B. Increased intracranial pressure
C. Excessive capillary oncotic pressure
D. Reduced cerebrospinal fluid pressure
A

B

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46
Q

A loss of proteins, such as albumin, from the plasma (as seen in some kidney and liver diseases) will result in:
A. An increase in plasma hydrostatic pressure
B. A decrease in plasma hydrostatic pressure
C. An increase in plasma oncotic pressure
D. A decrease in plasma oncotic pressure

A

D

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47
Q 
Where is most of the Na+ in our bodies found?
A. Synovial fluid
B. Cerebrospinal fluid
C. Extracellular fluid
D. Intracellular fluid
A

C

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48
Q 
What type of exudate is found in early inflammation and is watery
A. Purulent
B. Fibrinous
C. Hemorrhagic
D. Serous
A

D

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49
Q

The law of mass action dictates that if CO2 levels in the tissue or blood rise, the equilibrium will shift toward:
A. Decreasing level oh H+ and HCO3
B. Increasing levels of H+ and HCO3-
C. Increasing levels of H+ and decreasing levels of HCO3-
D. Decreasing levels of H+ and increasing levels of HCO3

A

B

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50
Q

ADH is released in response to ___ and results in _____
A.Dehydration, increased water retention
B. Dehydration, increased Na+ retention
C. Volume overload, increased water retention
D. Volume overload increase Na+ retention

A

A

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51
Q

The fluid exchange between the arterial end and the venous end of a capillary bed in tissue such as muscle and skin results in all the fluid that leaked out of the capillary being retained in within the vessels with no net loss of fluid.

True or false?

A

False

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52
Q

A loss of proteins, such as albumin, from the plasma (as seen in some kidney and liver diseases) will result in:
A. An increase in plasma hydrostatic pressure
B. Decrease in plasma hydrostatic pressure
C. Increase in plasma oncotic pressure
D. Decrease in plasma oncotic pressure

A

D

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53
Q 
Of the amount of water that is found outside of the cells (extracellular), how much is found in the intravascular space?
A. two thirds (66%)
B. three fourths (75%) 
C. one third (33%)
D. One fourth (25%)
A

D

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54
Q

The renin-angiotensin-aldosterone system when activated will ultimately result in the _________through effects on the kidneys
A. Loss of Na+ and water
B. Retention of Na+, water and loss of K+
C. Reduction in plasma oncotic pressure
D. Increase in plasma oncotic pressure

A

B

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55
Q 
The ion that is best represented by the following concentrations, 150 mM extracellular and 15 mM intracellular is:
A. Na+
B. Cl-
C. K+
D. A- (anionic protein
A

A

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56
Q 
C3a is capable of inducing degranulation of mast cells and rapidly inducing an increase in vasodilation and increased capillary permeability, thus it is considered a (n):
A. Opsonin
B. Chemotactic factor
C. Anaphylotoxin
D. Angiogenic factor
A

C

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57
Q 
Which of the following is NOT a circulating plasma protein system related to the inflammatory response?
A. Complement
B. Clotting
C. Kinin
D. Carbonic anhydrase
A

D

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58
Q 
Interstitial fluid would be considered\_\_\_\_\_\_\_fluid
A. Intracellular
B. Extracellular
C. Synovial
D. intravascular
A

B

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59
Q

Hypocalcemia will result in which of the following signs and symptoms?
A. Acidosis
B. Bone pain and decreased neuromuscular excitability
C. Neuromuscular excitability and spasm, intestinal cramping, and tingling
D. Constipation and muscle weakness

A

C

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60
Q

Hyperkalemia will result in:
A. Excessive swelling
B. Peaked T waves and early neuromuscular excitability
C. Muscle weakness and early decrease in neuromuscular excitability
D. High blood pressure and tachycardia

A

B

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61
Q

Infants are at greater risk of dehydration because they, relative to adults, have:
A. Less surface area and less percentage of body weight as water
B. Less surface area and a higher percentage of body weight as water
C. A greater surface area and less percentage of body weight as water
D. A greater surface area and a higher percentage of body weight as water

A

D

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62
Q 
Carbon dioxide is an important molecule produced through many metabolic processes to remove excess CO2 the body transports most of the CO2 in the blood in the form of?
A.    Dissolved CO2
B.    CO2 bound to hemoglobin
C.    HCO3- (bicarbonate)
D.    Fatty acids
A

C

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63
Q

Leukotrienes are similar to histamine in function but differ in that leukotrienes:
A. Cause an anti-inflammatory effect
B. Only affect immune cells
C. Effects start slower and last longer
D. Don’t involve the bronchi or bronchioles

A

C

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64
Q

A keloid is:
A. A healing wound
B. A hypertrophic scar that extends well beyond the initial wound
C. A collection of immune cells and activated fibroblasts unable to clear the offending system
D. A multinucleated cell

A

B

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65
Q

Tumor necrosis factor alpha (TNF-alpha) is secreted in response to toll-like receptor activation and has all of the following effects EXCEPT:
A. Induce fever (endogenous pyrogen)
B. Increases synthesis of inflammation-related serum proteins by the liver
C. Causes muscle wasting and intravascular thrombosis
D. Suppress growth of lymphocytes and reduce production of proinflammatory cytokines

A

D

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66
Q 
Colloid osmotic pressure is the pressure created by \_\_\_\_\_\_\_
A. All ions and protein in that fluid
B. Only the ions in that fluid
C. Only the protein in that fluid
D. Only the ions that are not permeable
A

C

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67
Q 
What is the next step in dealing with pathogens or debris after the phagosome has formed?
A. Adherence
B. Engulfment
C. Fusion with the lysosome
D. Destruction of the target
A

C

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68
Q

Which of the following is a likely effect of hypercalcemia?
A. Bradycardia and generalized fatigue/weakness
B. Tachycardia and hyper-excitable muscles/nerves
C. Consistent, unresponsive and unchanging heartrate
D. Diarrhea

A

A

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69
Q

The fluid exchange between the arteriole end and the venous end of a capillary bed in tissues such as muscle and skin results in all of the fluid that leaked out of the capillary being retained within the vessels with no loss of fluid.

True or False?

A

False

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70
Q 
Bradykinin has effects that are most similar to those of \_\_\_\_\_:
A. Fibrin
B. Histamine
C. C1-inhibitor
D. Tissue factor
A

B

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71
Q

Starling forces affect the movement of fluid between the plasma and interstitial space. Which of the following, when increased will promote a shift from the plasma into the interstitial space?

a. Capillary oncotic pressure
b. Interstitial oncotic pressure and plasma hydrostatic pressure
c. Plasma hydrostatic pressure and plasma oncotic pressure
d. Interstitial hydrostatic pressure

A

B

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72
Q

The type of leukocyte most associated with allergic responses and parasitic infection is the:

a. Neutrophil
b. Eosinophil
c. Basophil
d. Lymphocyte

A

B

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73
Q

A loss of proteins, such as albumin, from the plasma (as seen in some kidney and liver diseases) will result in:
A. A shift of fluid from the interstitial fluid to the plasma
B. A shift of fluid from the plasma to the interstitial fluid
C. No change in overall fluid movement between the plasma and the interstitial fluid
D. A swelling of cells due to increased intercellular fluid

A

B

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74
Q

Tumor necrosis factor-alpha (TNF-alpha) is secreted in response to Toll-like receptor activation and has all of the following EXCEPT:
A. Induce fever (endogenous pyrogen)
B. Increase synthesis of inflammation-related serum proteins by the liver
C. Causes muscle wasting and intravascular thrombosis
D. Suppress growth of lymphocytes and reduce production of proinflammatory cytokines

A

D

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75
Q 
Movement of potassium down its electrochemical gradient will result in what effect on membrane potential?
A. Hyperpolarization
B. Depolarization
C. Stabilization
D. Could be any of the above
A

A

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76
Q

A stronger stimulus will result in a greater membrane depolarization of a neuron resulting in ___.
A. Stronger (higher amplitude) action potentials
B. More frequent action potentials
C. Longer lasting (greater duration of) action potentials
D. All of the above

A

B

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77
Q

All of the following are true regarding graded potential EXCEPT:
A. They can be added together for increased effect
B. They can be added to opposing potentials and be reduced in effect
C. They fade over time and distance
D. The all look alike (in amplitude

A

D

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78
Q 
A stroke affecting the temporal lobe is most likely to show signs and symptoms affecting the: 
A. Patients vision
B. Autonomic nervous system
C. Facial nerve (Bell’s Palsy)
D. Patients speech or hearing
A

D

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79
Q

The frontal lobe is responsible for conscious:
A. Control of voluntary motor area and limbic system
B. Awareness of sensation (somatic sensory area)
C. Primary visual cortex
D. Primary auditory cortex

A

A

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80
Q

The cerebellum is most responsible for:
A. Regulation of breathing and blood pressure
B. Control of fine motor control and balance/posture
C. Conscious awareness of sensation
D. Voluntary control of muscles

A

B

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81
Q

The beta-2 receptor, upon binding to its ligand, will result in which of the following effects?
A. Vasoconstriction of arterioles serving the skin
B. Stimulation of GI tract motility and relaxation of sphincters
C. Excitation of somatic muscle cells
D. Vascular smooth muscle relaxation and dilation in cardiac arterioles

A

D

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82
Q 
8.  The peripheral nervous system division that arises from the thoracic and lumbar regions is the :
A. Central
B. Somatic
C. Parasympathetic
D. Sympathetic
A

D

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83
Q 
Ephedra is a sympathomimetic, meaning it has sympathetic nervous system activating effects.  As such have all of the following side effects EXCEPT:
A. Increased heart rate
B. Increased blood pressure
C. Pale, clammy (moist) skin
D. Diarrhea and abdominal cramping
A

D

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84
Q

The ___ division of the autonomic nervous system helps conserve energy and the body’s resources (rest) and uses ____ as its neurotransmitter(s).
A. Sympathetic; acetylcholine and norepinephrine
B. Sympathetic; norepinephrine
C. Parasympathetic; acetylcholine and norepinephrine
D. Parasympathetic; acetylcholine

A

D

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85
Q

Saltatory conduction:
A. Occurs across the entire axon membrane
B. Occurs in both myelinated and unmyelinated axons
C. Occurs only at the Nodes of Ranvier
D. Does not affect axon conduction velocities

A

C

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86
Q
  1. Graded potentials are all of the following EXCEPT:
    A. Impulses which travel without diminishing over distance
    B. Localized membrane potential changes as a result of ion channels opening
    C. Graded potentials can be added to achieve a combined effect on membrane potential
    D. Can be either hyperpolarizing or depolarizing
A

A

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87
Q

Calcium has an equilibrium potential of 123mV. This means that under normal resting potential, if Ca++ became more permeable the membrane potential would:
A. Become more positive until the inside of the cell became positive
B. Become more negative to balance out the positive charges
C. Stabilize the membrane potential and remain unchanged
D. Have no effect on membrane potential

A

A

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88
Q

The basal ganglia (cerebral nuclei) are most involved in:
A. Interpreting sensation from the body
B. Executive functions (judgment and focus)
C. Emotional response to events
D. Inhibiting unwanted movement (coordinating movement

A

D

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89
Q

The parasympathetic nervous system is associated with which of the following:
A. Neuron axons exiting from the thoracic and lumbar regions of the spine
B. Ganglia that are close to the target organ
C. Use of norepinephrine as a neurotransmitter
D. An excitatory effect on GI sphincter muscles

A

B

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90
Q 
The receptive (incoming signal) portion of the neuron is called the:
A. Cell body
B. Axon
C. Dendrite
D. Lysosome
A

C

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91
Q 
When both Na and K are permeable at the same time (as in opening ion chemicals at the neuromuscular junction allowing both to cross), what will happen to the membrane potential?
A. The cell membrane depolarizes
B. The cell membrane hyperpolarizes
C. The cell membrane stablilizes
D. The cell membrane is unchanged
A

A

92
Q 
Making the inside of the cell membrane more negative relative to the outside of the membrane would be considered:    
A. Depolarization
B. Hyperpolarization (repolarization)
C. Action potential
D. Active transport
A

B

93
Q

Changes in the Broca’s area is most likely to cause:
A. Loss of vision
B. Loss of hearing
C. Inability to receive or interpret words (receptive aphasia)
D. Inability/difficulty in forming words (expressive aphasia)

A

D

94
Q

The reticular formation is responsible for:
A. Vision and meaning of what is seen
B. Stimulating hormone release from the pituitary
C. Wakefulness and vital reflexes
D. Balance and motor control

A

C

95
Q

Parasympathetic system stimulation causes all of the following effects except:
A. Increasing pancreatic secretion
B. Increasing digestive system motility
C. Constriction of bronchiole muscle
D. Increasing vasodilation of vascular smooth muscle

A

D

96
Q

Demyelinating diseases, such as multiple sclerosis and Guillain Barre syndrome, may not initially damage the axon but still can result in symptoms and dysregulation because:
A. The rate of AP transmission, thus the information is altered
B. Action potentials (AP) are no longer able to be transmitted
C. The speed of AP’s is unchanged but the amplitude (strength of depolarization) is altered
D. The number of receptors on the post-synaptic membrane has been reduced

A

A

97
Q

Upon opening, voltage gated Na+ channels will allow ions to flow until:
A) The resting membrane potential is returned
B) The Na+ equilibrium potential is reached
C)The inactivation gates close
D) The activation gates close

A

C

98
Q 
Which of the following receptor types does not activate G proteins (ie does not use a second messenger system:
A) Muscarinic
B) Nicotinic
C) Alpha 1 adrenergic
D) Beta 1 adrenergic
A

B

99
Q 
A stroke in the occipital lobe is most likely to show signs and symptoms affecting the:
A) Patients vision
B) Autonomic Nervous system
C) Facial Nerve (Bells Palsy)
D) Patients speech or hearing
A

A

100
Q

The alpha-1 receptor will, upon binding to its ligand, will result in which of the following effects?
A) Relaxation of sphincters in the GI tract
B) Excitation and vasoconstriction of vascular smooth muscle
C) Relaxation of bronchial smooth muscle
D) Increased heart rate and contractility

A

B

101
Q

Which of the following is a correct statement regarding the comparison of the Autonomic and Somatic Nervous System?
A) They both use only excitatory neurotransmitters
B) They both originate in the CNS and end in the PNS, so are a part of the Peripheral Nervous System
C) They both synapse at a ganglion before reaching the target effector organ
D) They both use norepinephrine as a neurotransmitter

A

B

102
Q

The effect of Sympathetic Nervous System activation on metabolism includes all of the following EXCEPT:
A) Storage of glucose as glycogen is enhanced
B) Increased gluconeogenesis by the liver
C) Increased lipolysis at adipose cells
D) Increased glycolysis by the liver

A

A

103
Q

The frontal lobe is responsible for conscious:
A. Control of voluntary motor area and limbic system
B. Awareness of sensation (somatic sensory area
C. Primary visual cortex
D. Primary auditory cortex

A

A

104
Q

If the K+ channels opened and stayed open in an otherwise normal person, what would happen to the resting membrane potential of -70mV?
A) Become more negative indefinitely
B) Become more negative until the membrane potential reached -94mV
C) Become more positive until the membrane potential reached +26mV
D) Become more positive indefinitely

A

B

105
Q 
The minimum depolarization needed to open voltage-gated Na+ channels and form an action potential is term:
A) Equilibrium potential 
B) Resting membrane potential 
C) Graded potential 
D) Threshold
A

D

106
Q

Any given spinal nerve arises from (is formed by):
A) The combination of cords
B) The separation of divisions into spinal nerves
C) The combination of an anterior spinal root with posterior spinal root
D) The combination of rami communicantes

A

C

107
Q 
Vascular smooth muscle is most impacted by what type of receptor ( what receptor is most present)? 
A) Alpha 1
B) Alpha 2
C) Beta 1
D) Beta 2
A

A

108
Q

Name two demyelination syndromes:

A

MS and GBS

109
Q

Allows for action potential to jump from one node to the next; increases speed of conduction:

A

Node of Ranvier

110
Q

3 Parts of neuron:

A

1) cell body (soma)
2) Dendrites
3) axons

111
Q

What is the receptive part of the neuron?

A

Dendrite

112
Q

Part of neuron that carries impulses away from cell body?

A

Axons

113
Q

Cone-shaped process where the axon leaves the cell body:

A

Axon hillock

114
Q

Chemical gradients move from ___ concentration to ___ concentration.

A

High; low

115
Q

A way to describe the voltage conditions necessary to counterbalance the chemical gradient forces of a GIVEN SINGLE ION so that equilibrium is established (movement in = movement out) for that ion alone.

A

Equilibrium Potential

116
Q

Moving a membrane potential from -70mV to -50mV would be characterized as a _____ polarizing event.

A

Depolarizing;

FYI: Not all depolarizations lead to action potentials

117
Q

If a membrane is depolarized enough to trigger voltage-gated ion channels, a _______ starts.

A

Action potential

118
Q

Brief changes in membrane potentials that decrease over distance; May be hyperpolarizing or depolarizing; Magnitude varies:

A

Graded Potential

119
Q

Part of neuron:

Segmented layer of lipid material; Insulating substance; Formed and maintained by the Schwann cell in the PNS:

A

Myelin

120
Q

Damage to the Broca’s area is most likely to cause:
A) Loss of vision
B) Loss of hearing
C) Inability to receive or interpret words (receptive aphasia)
D) Inability/difficulty in forming words (expressive aphasia

A

D

121
Q

Chloride has an equilibrium potential nearly the same as the resting potential. As a result, a resting membrane potential CL- (when permeable to the membrane) will move:
A) Out of the cell
B) Equally in both directions
C) Into the cell
D) Unable to tell with the information given

A

B

122
Q

Atropine blocks the ____ nervous system, so it will have effects like the ____ nervous system.

A

Parasympathetic; sympathetic

123
Q

The sympathetic nervous system has ___ outflow, while the parasympathetic has ___ outflow.

A

Thoracolumbar (T1-L2); Craniosacral

124
Q

The sympathetic preganglionic fibers use ___ and ____ receptors.

A

Acetylcholine and cholinergic

125
Q

The sympathetic postganglionic fibers use __ and __ receptors.

A

Norepinephrine and adrenergic

126
Q

The parasympathetic preganglionic and postganglionic fibers use __ and ___ receptors.

A

Acetylcholine ; cholinergic

127
Q

The neuroreceptors of the ANS all use acetylcholine, except the ____ use norepinephrine and adrenergic receptors.

A

Sympathetic postganglionic fibers

128
Q

The sympathetic nervous system mobilizes energy stores in times of need; it affects __ cells which increase gluconeogenesis/glycolysis and ___ blood glucose.

A

Liver; increase

129
Q

The parasympathetic system ___ (increases or decreases) digestion/gastric motility and ___ (inc. or dec.) tone of sphincters.

A

increase; decreases

130
Q

The sympathetic nervous system has ___ (short or long) preganglionic fibers and ___ postganglionic fibers.

A

short; long

131
Q

The parasympathetic nervous system has ___ (short or long) preganglionic fibers and ___ postganglionic fibers.

A

long; short

132
Q

Ganglia for sympathetic nervous system are located at ____; Parasympathetic ganglia are located ____

A

Paravertebral/thoracolumbar; close to target organ usually

133
Q

The vascular system only has ____ innervation.

A

sympathetic

134
Q

Do beta 2 receptors cause vasodilation or vasoconstriction?

A

Vasodilation

135
Q

What does the SNS do for GI motility, secretions, and sphincters?

A

Decreased motility, secretions and closed sphincters

136
Q

Epinephrine causes vaso___ of the bronchi.

A

Vasodilation

137
Q

The SNS causes vaso___ of the bronchi; the PSNS causes vaso___ of the bronchi.

A

Vasodilation; Vasoconstriction

138
Q 
A stroke affecting the temporal lobe would most likely affect:
A. Primary visual cortex
B. Primary auditory cortex
C. Somatic sensory input
D. Primary motor area
A

B

139
Q

Which part of the brain contains all cell bodies and dendrites of neurons?

a. gyri
b. sulci
c. white matter
d. gray matter

A

D: The gray matter contains cell bodies and dendrites of neurons. The white matter contains myelinated nerve fibers. The gyri are the convolutions of the cerebrum. The sulci are the grooves between adjacent gyri.

140
Q

When a patient experiences a brain injury and the medulla oblongata is affected, it is reasonable to expect the client will experience:

A

Alterations in heart rate, respiration, blood pressure, swallowing, etc.; The medulla is responsible for heart rate, respiration, blood pressure, coughing, sneezing, swallowing, and vomiting.

141
Q

Successive, rapid impulses received from a single neuron on the same synapse best describes:

a. temporal summation
b. spatial summation
c. actuation
d. facilitation

A

A. Temporal summation refers to the effects of successive, rapid impulses received from a single neuron on the same synapse. Spatial summation refers to the combined effect of impulses from a number of neurons on a single synapse at the same time. Facilitation refers to the effects of excitatory postsynaptic potentials (EPSPs) on the plasma membrane potential. Actuation is not a process that relates to neural impulse transmission.

142
Q

Which structure is involved in pain transmission?

a. posterior horn
b. substantia gelatinosa
c. anterior horn
d. dorsal root ganglia

A

B: The substantia gelatinosa is a structure involved in pain transmission. The anterior or ventral horn contains nerve cell bodies for efferent pathways leaving the spinal cord. The posterior horn (dorsal horn) is composed primarily of interneurons and axons from sensory neurons. The dorsal root ganglion is part of the sensory ganglion.

143
Q

Which is a function of the thalamus?

A

The thalamus is a major integrating center for afferent impulses. The thalamus is a large mass of gray matter in the dorsal part of the diencephalon of the brain with several functions such as relaying of sensory signals, including motor signals to the cerebral cortex, and the regulation of consciousness, sleep, and alertness.

144
Q

The neurotransmitter released from the postganglionic parasympathetic axon terminal is:

a. acetylcholine
b. epinephrine
c. norepinephrine
d. dopamine

A

A: Both the pre- and postganglionic neurons of the parasympathetic nervous system release acetylcholine. The preganglionic neurons of the sympathetic nervous system release acetylcholine, while the postganglionic neurons release norepinephrine. Dopamine is produced by the hypothalamus. Preganglionic sympathetic fibers cause the rapid release of epinephrine.

145
Q

Which option is composed of endoplasmic reticulum and ribosomes?

a. Nissl substances
b. Dendrites
c. Microfilaments
d. Microtubules

A

A: The Nissl substances, endoplasmic reticulum, and ribosomes, are involved in protein synthesis. Microfilaments are composed of structural proteins and responsible for support. The dendrites are extensions that carry nerve impulses toward the cell body. Microtubules are involved in transport of cellular products.

146
Q

The major divisions of the brain include:

A

Forebrain, midbrain, hindbrain

147
Q

The midbrain contains the:

a. cerebral hemisphere
b. tegmentum
c. cerebellum
d. medulla oblongata

A

B: The tegmentum, corpora quadrigemina, and basis pedunculi are all part of the midbrain. The cerebral hemispheres are part of the forebrain. The brainstem is composed of the midbrain, medulla oblongata, and pons. The cerebellum is located in the hindbrain.

148
Q

Which is an insulating substance for the neuron?

a. Schwann cells
b. Myelin
c. Neuroglial cells
d. Nodes of Ranvier

A

B: Myelin is an insulating substance. Schwann and neuroglial cells provide structural support and nutrition for the neurons. The nodes of Ranvier are interruptions at regular intervals that occur in the myelin.

149
Q

It is true that the cerebellum:

a. makes up fibers of the corticospinal tract
b. maintains posture or balance
c. controls respiration
d. contains cranial nerves 5-8

A

b: The cerebellum is responsible for balance and posture and conscious and unconscious muscle synergy. The pons controls respirations and is the location of cranial nerves V through VIII. The fibers of the corticospinal tract are made up in the basis pedunculi.

150
Q

What is Broca’s area responsible for?

A

The Broca area is found on the left and is responsible for motor speech. Deficits in this area result in the inability to form words, also called expressive or motor aphasia.

151
Q

All of the alpha and beta receptors are excitatory except ____

A

Beta 2

152
Q

Atropine ____ (inc. or dec.) secretions?

A

Decrease

153
Q

Beta 3 affects ____ tissue.

A

Adipose

154
Q

Sympathetic stimulation causes pupils to _____; PSNS stimulation causes pupils to ______.

A

Dilate; Constrict

155
Q

What is the difference between a nicotinic and muscarinic receptor?

A

You can find muscarinic receptors in the brain, heart and smooth muscle. Like nicotinic receptors, they are found in both the parasympathetic and sympathetic nervous systems. To summarize, the main difference between them is their mechanism of action: one uses ions and the other uses G-proteins.

156
Q

Pheochromocytoma secretes _______.

A

Excess catecholamines (Norepi, Epi, Dopamine)

157
Q

The adrenal medulla secretes _______.

A

Catecholamines (Norepi, Epi, Dopamine)

158
Q

Receptors that bind Acetylcholine are called ____

A

Cholinergic receptors

159
Q

Receptors responding to norepinephrine are called _____

A

Adrenergic

160
Q

Cholinergic Receptors:
____ is always excitatory
____ may be excitatory or inhibitory

A

Nicotinic; Muscarinic

161
Q

Epinephrine binds to ___ on liver cells, activating ___ within.

A

Beta adrenergic receptor; G protein

162
Q

What are 5 adrenergic receptors?

A

Alpha (1 or 2) and Beta (1,2,3)

163
Q

3 things included in the hindbrain:

A

Cerebellum, pons, and medulla

164
Q

Parts of brain:
___ is where conscious thought occurs and voluntary action.
___ relays info back and forth between body and brain.
___ controls reflexes/automatic things (blood pressure, breathing, etc.)

A

Forebrain; Midbrain; Hindbrain

165
Q

Midbrain includes (3):

A

Corpora quadrigemina, tegmentum, and cerebral peduncles

166
Q

Central sulcus separates __ and __ lobes.

A

Frontal and parietal

167
Q

Nuclei that play role in Parkinson’s:

A

Basal ganglia (central nuclei)

168
Q

____ is the primary motor cortex.

A

Precentral gyrus

169
Q

____ is the primary somatosensory cortex.

A

Postcentral gyrus

170
Q 
Lobes: 
Primary motor area=\_\_\_
Somatic sensory input=\_\_\_
Primary visual cortex=\_\_\_
Primary auditory cortex=\_\_\_
A

Frontal; Parietal; Occipital; Temporal

171
Q

Responsible for interpretation and understanding of speech:

A

Wernicke’s area (temporal lobe, left side)

172
Q

Damage leads to receptive aphasia:

A

Wernicke’s

173
Q

Area involved in production of speech:

A

Broca’s

174
Q

Cerebral medulla is ___ matter.

A

white

175
Q

Basal ganglia located in ____ matter

A

white

176
Q

Cerebral cortex is ___ matter.

A

gray

177
Q

___ matter is in the outer 2-4 millimeters of cerebrum; ___ matter is deeper.

A

Gray; white

178
Q

Responsible for voluntary actions, social norms, emotions (limbic system), executive functioning, planning, judgment

A

Frontal lobe

179
Q

What secretes melatonin?

A

The epithalamus: part of dorsal forebrain, including the pineal gland

180
Q

Relay center able to perceive sensations but needs to relay it to cerebral cortex for interpretation:

A

Thalamus:
a vital structure that has several important functions. There are extensive nerve networks that send signals all around the structures of the brain including the cerebral cortex. The thalamus is involved in sensory and motor signal relay and the regulation of consciousness and sleep

181
Q

Progressive failure of many cerebral functions including impairment of intellectual processes:

A

Dementia

182
Q

With dementia, which loss usually occurs–short term or long term memory?

A

Short term

183
Q

Dementia causes:

A

Neuron degeneration, brain tissue compression, atherosclerosis, brain trauma, Genetics, decreased vitamin b12, Ischemia

184
Q

Theories for causes of Alzheimer’s Disease:

A

Mutation for encoding amyloid precursor protein, alteration in apolipoprotein E, genetic issues with chromosome 21 or chromosome 19, a buildup of plaques (from amyloid proteins) in the hippocampus/cerebral cortex, degeneration of forebrain cholinergic neurons, and intraneuronal neurofibrillary tangles (result from microtubule connections called Tau proteins). Brain atrophy can result from the loss of neurons, shrinking the gyri and widening the sulci. Loss of acetylcholine, synapses, and other neurotransmitters contributes to the symptoms associated with AD. Decrease in brain mass and increase in ventricular size can occur.

185
Q

Clinical manifestations of Alzheimer’s?

A

Forgetfulness, emotional upset, disorientation, confusion, lack of concentration, a decline in abstraction/problem solving/judgment

186
Q

Seizures are caused by what?

A

abnormal excessive discharges of cortical neurons; Etiologic factors include metabolic disorders, congenital malformations, genetic predisposition, perinatal injury/postnatal trauma, myoclonic syndromes, infection, brain tumor, vascular disease, substance abuse

187
Q

Epilepsy is thought to be caused by what?

A

Genetic mutations interacting with environmental effects

188
Q

Period before seizure happens where different symptoms can begin:

A

Prodromal stage

189
Q

Status epilepticus is a seizure lasting longer than ___ minutes

A

5

190
Q

Caused by severe degeneration of the basal ganglia (corpus striatum) involving the dopaminergic nigrostriatal pathway

A

Parkinson’s; Secondary Parkinson’s caused by non-hereditary or secondary reason like head trauma (i.e. Muhammad Ali)

191
Q

Symptoms of Parkinson’s:

A

Parkinsonian tremor (happens at rest and when you start to move it goes away), rigidity, bradykinesia, postural disturbances (stooped forward, flexure at knees, shuffling gait), autonomic and neuroendocrine symptoms, cognitive-affective symptoms (hallucinations, depression)

192
Q

The reflex arc will still be intact in ___ motor neuron syndromes.

A

Upper

193
Q

What is spinal shock?

A

Spinal shock is a combination of areflexia/hyporeflexia and autonomic dysfunction that accompanies spinal cord injury. The initial hyporeflexia presents as a loss of both cutaneous and deep tendon reflexes below the level of injury accompanied by loss of sympathetic outflow, resulting in hypotension and bradycardia.

194
Q

Can see fasciculations with ___ motor neuron syndromes and fibrillation with ___ motor neuron syndromes.

A

Upper; lower

195
Q

___ motor neuron syndromes reflect brain damage or CNS damage; ___ motor syndromes are outside the CNS and connect directly to the muscle.

A

Upper; lower

196
Q

Name some lower motor neuron diseases:

A

Paralytic poliomyelitis (polio), Guillain-Barre syndrome, Progressive spinal muscular atrophy, Progressive bulbar palsy

197
Q

What is Guillain-Barre Syndrome? What is it caused by?

A

A demyelinating syndrome where the immune system attacks the nerves. The condition may be triggered by an acute bacterial or viral infection. Symptoms start as weakness and tingling in the feet and legs that spread to the upper body. Paralysis can occur. Special blood treatments (plasma exchange and immunoglobulin therapy) can relieve symptoms. Physical therapy is needed.

198
Q

What is the treatment for myasthenia gravis?

A

Acetylcholinesterase inhibitors (along with steroids and immunosuppressant drugs) are the primary treatment for myasthenia gravis. They act on acetylcholinesterase and increase the acetylcholine available at the neuromuscular junction. They also inhibit the breakdown of acetylcholine, which is an important neurotransmitter.

199
Q

Neurodegenerative disorder involving the upper and lower motor neurons (but more of the lower) that starts with muscle weakness and progresses to muscle atrophy, spasticity, and loss of manual dexterity and gait

A

ALS (Lou Gehrig’s, Stephen Hawking)

200
Q

Large bundles of axons that help to connect neurons to each other or effector organs such as muscle, glands, or sensory receptors such as taste/touch/pressure

A

Spinal tracts

201
Q

Nerve fibers to the brain are ___ and ones away from the brain to muscles are ____.

A

Afferent; Efferent:
Afferent neurons are sensory neurons that carry nerve impulses from sensory stimuli towards the central nervous system and brain, while efferent neurons are motor neurons that carry neural impulses away from the central nervous system and towards muscles to cause movement.

202
Q

A collection of cells in the gray area (dorsal horns) of the spinal cord. Found at all levels of the cord, it receives direct input from the dorsal (sensory) nerve roots, especially those fibers from pain and thermoreceptors.

A

Substantia gelatinosa

203
Q

Name whether afferent or efferent:
Posterior/dorsal route ganglion are ____
Anterior/ventral are ____

A

Afferent; Efferent

204
Q

Name 3 layers of connective tissue helping to cover the brain and spinal cord:

A

1) Pia mater: physically touches spinal cord/brain; gives rise to denticulate ligaments; can extend all the way to the coccyx.
2) Arachnoid mater: middle of the 3 layers; web-like (hence, arachnoid–(spider)); connects dura mater to pia mater; fragile (like a spider web)
3) Dura mater: “dura= tough”; thick fibrous connective tissue; outermost of meningeal layers

205
Q

A spinal tap or lumbar puncture given where? Epidural given where?

A

Goes thru dura mater; outside of dura mater

206
Q

Occurs when the nucleus pulposus starts to bulge thru the annulus fibrosis:

A

Herniated disc

207
Q

Flaccidity is caused by damage to the ___ or ___ thus the muscles receive no signals at all; involves ___ motor neurons

A

anterior horn cells; ventral root; Lower

208
Q

Spasticity is damage to ___ motor neurons in the motor cortex, allowing some sporadic stimulation from spinal cord reflexes; no voluntary control; reflex arc still intact

A

Upper

209
Q

What are paresthesias?

A

loss of sensory function

210
Q

Spinal cord transection between __ and __ affects both legs and is termed ____

A

T1 and L1; paraplegia

211
Q

Spinal cord transection in the ___ region affects all four limbs and is termed ____

A

cervical; quadriplegia

212
Q

Disease where anterior horn neurons are affected, as well as fibers of the pyramidal tract.

A

ALS

213
Q

For cervical vertebrae, the spinal nerves exit ___ (above or below) the vertebrae. However, there is no corresponding vertebra for ___ nerve; it is between C7 and T1. After this point, the nerves are ____ (above or below) the vertebrae.

A

Above (i.e. C1 spinal nerve is right above C1 vertebrae); C8; below (i.e. T1 spinal nerve comes out below T1)

214
Q

How many cervical, thoracic, lumbar, sacral and coccygeal nerves are there?

A

8 Cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal (31 total)
FYI: The spinal vertebrae numbers are 7, 12, 5,5, 4 (33 total)

215
Q

The roots, trunks, divisions, cords, and branches of plexuses form the ___ ___.

A

Terminal nerves

216
Q

4 required components for the reflex arc to be intact:

A

Receptor: senses change, Afferent (sensory) neuron: signal change, Efferent neuron: signal a response, Effector: carry out response

217
Q

____ motor neurons are completely contained within the CNS and control fine motor movement and influence/modify spinal reflex arcs. They are not a part of the reflex arc, per se, b/c the reflex arc can continue without their input.

A

Upper

218
Q

___ motor neurons have direct influence on muscles. Their cell bodies originate in the gray matter of the ___, but their axons extend into the PNS. They are part of the reflex arc b/c if you lose them, you will not be able to signal to the muscle.

A

Lower; spinal cord

219
Q

Cerebral Palsy is a ___ motor neuron lesion.

A

Upper

220
Q

What can cause Cerebral Palsy?

A

Temporary loss of oxygen at birth, exposure to radiation, various drugs and infections, etc.

221
Q

Neuromuscular disorder with partial loss of control or paralysis of voluntary muscles leading to spasticity and often times contractures

A

Cerebral palsy

222
Q

Pathological condition of decreased acetylcholine and decrease in ridges within the synaptic cleft causes decrease in ability to signal from the axon to the muscle…leads to weakness, decreased contractions

A

Myasthenia gravis

223
Q

Protective membranes surrounding the brain and spinal cord:

A

Meninges: the three membranes (the dura mater, arachnoid, and pia mater) that line the skull and vertebral canal and enclose the brain and spinal cord.

224
Q

CSF is made in the ___ and produced by the ___; it is reabsorbed through the ____

A

ventricles; choroid plexuses; arachnoid villi

225
Q

Why is the Circle of Willis important?

A

The Circle of Willis is a circular formation of blood vessels in the human brain. Its importance is that it can provide redundant blood flow should certain portions of the blood supply to the brain become occluded.

226
Q

Cellular structures that selectively inhibit certain potentially harmful substances in the blood from entering the interstitial spaces of the brain or CSF

A

Blood-Brain Barrier

Nurse Practioner MSN (3 decks)

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