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CNM BIOMEDICINE II > 14. NERVOUS SYSTEM II > Flashcards

14. NERVOUS SYSTEM II Flashcards

1
Q

Describe the difference between the central nervous system and the peripheral nervous system.

A

The central nervous system includes the brain and spinal cord. The peripheral nervous system includes all nervous tissue in the body outside of the central nervous system.

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2
Q

Describe the role of the somatic nervous system

A

The somatic nervous system controls voluntary muscles and transmits sensory information to the central nervous system.

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3
Q

State TWO ways in which the following central nervous system components are protected:

a. Spinal cord
b. Brain

A

a. By the vertebral column and the meninges

b. By the cranium and the cranial meninges, CSF and the BBB

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4
Q

With regards to the layers of the meninges, compare functions of the:

a. Dura mater
b. Arachnoid mater
c. Pia mater

A

a. Dura mater is the tough outer layer that attach to the inside of the cranium and vertebral column for protection and support. It divides into two layers to create venous sinuses to drain blood out of the brain
b. Arachnoid mater is formed from collagen and elastic fibres helps to bridge the gap between the dura and pia mater.
c. Pia mater is a thin, transparent layer that contains blood vessels and it houses the subarachnoid space, filled with CSF

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5
Q

Name the spaces between:

a. Dura mater and arachnoid mater
b. Arachnoid mater and pia mater

A

a. Subdural space

b. Subarachnoid space

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6
Q

Name the neuroglial cell that maintains the BBB.

A

Astrocytes

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7
Q

Name TWO arteries that supply the brain.

A

Vertebral and Carotid arteries

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8
Q

List FOUR major parts of the brain.

A

Cerebrum
Cerebellum
Diencephalon (Thalamus; hypothalamus; epithalamus)
Brainstem (medulla oblongata; pons; midbrain)

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9
Q

Name the area of the brain that contains the ‘pineal gland’.

A

Diencephalon

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10
Q

List THREE factors that can damage the cerebellum.

A
  • Chronic alcohol abuse
  • Coeliac disease
  • Thiamine (Vit B1) deficiency
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11
Q

List TWO functions of the cerebellum

A
  • Maintenance of posture and balance
  • Co-ordinate and smooth complex sequences of movement
  • Correction of errors during ongoing movement
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12
Q

Name the area that connects the two cerebral hemispheres.

A

Corpus callosum

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13
Q

Name which cerebral lobe plays a role in:

a. Hearing
b. Vision
c. Motor skills
d. Sensory input

A

a. Temporal lobe
b. Occipital lobe
c. Frontal lobe
d. Parietal lobe

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14
Q

Which part of the brain may be damaged where symptoms of ‘ataxia’ are presenting?

A

The cerebellum

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15
Q

Describe how the left and right side of the brain co-ordinates the body.

A

The left side of the brain co-ordinates the right side of the body while the right side of the brain co-ordinates the left side of the body. This is because the corticospinal tracts cross over in the medulla oblongata.

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16
Q

Name THREE main structures within the limbic system.

A

Hypothalamus
Hippocampus
Amygdala

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17
Q

Name the area that plays a key role in emotions within the limbic system.

A

Amygdala

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18
Q

Name ONE cranial nerve which if damaged can lead to double vision.

A

Oculomotor (III)
Trochlear (IV)
Abducens (VI)

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19
Q

Name the largest cranial nerve of the autonomic nervous system.

A

Vagus nerve (X)

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20
Q

Name TWO cranial nerves that exhibit both sensory and motor functions.

A 
Facial nerve (V)
Trigeminal nerve (VI)
Glossopharyngeal (CN IX)
Vagus nerve (X)
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21
Q

State where the spinal cord terminates.

A

At the vertebral level of L2 as the ‘conus’

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22
Q

Describe the difference between ‘motor tracts’ and ‘sensory tracts’ in white matter.

A

The motor tracts in spinal white matter are descending and the control voluntary and involuntary movement.
The sensory tracts are ascending and they transmit impulses from the skin, tendons, muscles and joints to the brain.

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23
Q

Describe the difference between ‘dorsal horns’ and ‘ventral horns’ in grey matter

A

The dorsal (posterior) horn receives sensory impulses whilst the ventral (anterior) horn sends out motor impulses

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24
Q

With regards to the spinal cord tracts, which is responsible for:

a. Pain and temperature
b. Voluntary movement
c. Light touch, vibration, proprioception

A

a. Spinothalamic tract
b. Corticospinal tract
c. Dorsal columns

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25
Q

Explain what could happen if there is damage to any of the spinal tracts

A

It would lead to loss of the tract’s function below that level of the body

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26
Q

Describe in detail the ‘reflex arc’

A

A reflex is a very fast, automatic, unplanned sequence of actions that occurs in response to a stimulus and includes:

  1. Sensory receptor
  2. Sensory neuron
  3. Interneuron
  4. Motor neuron
  5. Effector organ
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27
Q

State one key function of the thalamus

A

It is a major relay centre of sensory information to the cerebrum and integrates sensory and motor information

28
Q

Name the three parts that make up the diencephalon

A

Thalamus
Epithalamus
Hypothalamus

29
Q

List TWO causes of raised intracranial pressure (ICP)

A 
Tumours (gliomas / metastases)
Haemorrhage (subdural / subarachnoid)
Hydrocephalus (excess CSF)
Meningitis
Encephalitis
30
Q

List TWO aggravating factors for a headache associated with ICP

A

Coughing
Moving head
Worse on awakening

31
Q

Explain what is meant by papilloedema in ICP

A

Bulging of the optical disc due to raised intracranial pressure

32
Q

Describe the Cushing triad witnessed in ICP

A

Cushing’s triad are symptoms arising from the body’s attempt to lower ICP: elevated blood pressure; slow breathing; slow, irregular pulse

33
Q

Describe the pathophysiology of hydrocephalus

A

The abnormal accumulation of CSF in the cerebral ventricles and subarachnoid space is usually due to impaired absorption but can be due to excessive secretion of the fluid.
It results in ventricular dilation and CSF permeating through the ependymal lining into the surrounding white matter.

34
Q

List ONE cause of hydrocephalus in:

a. Small children
b. Older children / adults

A

a. Infection; congenital malformation

b. Trauma; tumours; meningitis

35
Q

Explain why a headache associated with hydrocephalus is worse in the morning

A

From the build up of CSF that does not drain well whilst lying down

36
Q

Explain why meningitis could be a medical emergency

A

Meningitis can be life-threatening when it leads to raised intracranial pressure.

37
Q

Name TWO microorganisms that cause meningitis

A

Herpes simplex virus

Fungal or parasitic micro-organisms

38
Q

Describe ONE skin sign in meningitis

A

Petechiae: small purple/red spots that are non-blanching

39
Q

List TWO symptoms of meningitis

A
  • Marked neck stiffness
  • Fever and sudden severe headache
  • Photophobia
  • Vomiting
40
Q

Name TWO signs of meningitis

A
  • Kernig’s sign: pain resistance to knee extension when lying with hips fully flexed
  • Brudzinski sign: neck flexion causes flexion of hip and knee
41
Q

Using definitions, describe the difference between:

a. Concussion
b. Cerebral contusion
c. Coup and contrecoup

A

a. Concussion is a temporary loss of neuronal function resulting from a significant blow to the head
b. A traumatic brain injury that causes bruising of the brain with ruptured blood vessels and oedema
c. A common pattern of injury usually applied to cerebral contusions. Coup is the injury to the site of primary impact, while contrecoup is damage to the brain at a site contra-lateral to the site of trauma caused by the impact of the skull on the brain.

42
Q

List FOUR causes of headaches

A 
Dehydration
Cervicogenic (from the neck)
TMJ (structural problems)
Tension headache
Congested sinuses
Hypoglycaemia
Migraines / Cluster headaches
Medication induced
Intra-cranial: brain tumour, haemorrhage
43
Q

Compare the location of a migraine to that of a tension headache

A

A migraine is usually retro-orbital and frontal, while a tension headache is diffuse (bilateral).

44
Q

List TWO aggravating factors for a cervicogenic headache

A

Neck movement

Sustained posture

45
Q

List TWO relieving factors for a cervicogenic headache

A

Stretching and supporting neck

Massage

46
Q

Describe the difference in ‘headache duration’ with cervicogenic and migraine headaches

A

Migraine lasts from 4-72 hours while cervicogenic headace can last from one hour to weeks.

47
Q

Name TWO dietary causes of migraine

A

Dairy
Caffeine
Gluten

48
Q

Name ONE neurotransmitter deficiency in migraine

A

Serotonin

49
Q

Explain what is meant by the ‘aura’

A

A period of unusual visual, olfactory and sensory experiences preceding a migraine

50
Q

List TWO characteristic signs / symptoms of a brain tumour

A
  • Morning headaches with increasing frequency
  • Nausea and vomiting
  • Uneven pupils and double vision
  • Papilloedema
51
Q

Name TWO headache red flags

A
  • Thunderclap headache (subarachnoid haemorrhage)
  • Accompanying signs of meningitis
  • Signs of raised intracranial pressure (uneven pupils, double vision, papilloedema, vomiting without nausea
52
Q

Define epilepsy

A

Sudden, hyper-excitable and uncontrolled neuronal activity in the brain

53
Q

List TWO causes of epilepsy

A
  • Idiopathic
  • Brain tumours
  • Cerebral infarction/haemorrhage
  • Congenital malformation
  • Head trauma
  • CNS infections eg. meningitis
  • Chemical imbalances eg. hypoglycaemia/calcaemia
54
Q

List TWO trigger factors for epilepsy

A 
Hypoglycaemia
Fever
Dehydration
Stress
Flickering lights
Sleep deprivation
Pesticides
55
Q

Explain the difference between ‘tonic phase’ and ‘clonic phase’ of a tonic-clonic seizure

A

The tonic phase is a contraction of all body muscles causing patient to fall if sitting/standing.
The clonic phase is the rapid contraction and relaxation of muscles causing convulsions which can range from exaggerated twitches to violent shaking.

56
Q

Describe how spina bifida develops

A

Spina bifida develops due to the incomplete closure of the embryonic neural tube resulting in failure of the spinal column to fully enclose the spinal cord

57
Q

List ONE key nutrient deficiency that contributes to development of spina bifida

A

Folate (Vitamin B9)

58
Q

Describe how a herniated disc develops

A

The nucleus pulposus of the disc leaks through the annulus fibrosus, often compressing on spinal nerves.

59
Q

Describe the classic mechanism of injury with a herniated disc

A

Combined lumbar spine flexion and rotation

60
Q

List TWO signs / symptoms of a herniated disc

A
  • Radiating lower back pain (sharp and linear)

- Positive straight leg raise test

61
Q

Describe ONE way in which the pain of a herniated disc is aggravated

A

Aggravated by coughing/sneezing

62
Q

Name the longest and widest nerve in the body

A

The sciatic nerve

63
Q

List TWO signs / symptoms of sciatica

A
  • Pain in lower back and buttock
  • Unilateral pain radiating down posterior leg into foot
  • Pins and needles and numbness
  • Weak calf muscles and ‘foot drop’
  • Ankle jerk reflex often absent
64
Q

Name TWO causes of sciatica

A
  • Disc herniation at L4/5 or L5/S1
  • Compression against piriformis muscle
  • Tumours in the spinal canal or pelvis
65
Q

Name ONE diagnostic test for sciatica

A

Straight leg raise test

Absent ankle jerk reflex

66
Q

List ONE key side effect of aspartame

A

It is an excitotoxin that is linked to MS and Parkinson’s

CNM BIOMEDICINE II (8 decks)

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