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Biomedicine II CNM (2024) > 14. Nervous System II > Flashcards

14. Nervous System II Flashcards

1
Q

What does the central nervous system consist of?

A

The brain and the spinal cord

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2
Q

What are the connective tissue layers that cover the brain and spinal cord?

(Overall name, and the 3 specific layers)

A

The Meninges

1) Dura Mater - tough fibrous outer later
2) Arachnoid mater - middle layer of collagen and elastic fibres
3) Pia mater - thin inner most layer containing blood vessels

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3
Q

What are the two gaps between the meninges called and where are they located?

A

1) Subdural space between the dura mater and the arachnoid mater.

2) Subarachnoid space between the arachnoid mater and pia mater

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4
Q

What 2 haemorrhages can occur in the spaces between the meninges and how do they differ?

A

Subdural haematoma - as this is venous blood is develops slowly

Subarachnoid haemorrhage - arterial bleed so rapid (feels like being hit in the back of the head - an explosive headache).

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5
Q

What is cerebrospinal fluid (CSF)?

A

A clear liquid that protects the brain and spinal cord from mechanical and immunological trauma.

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6
Q

Where can you find cerebrospinal fluid (CSF)?

A

Subarachnoid space
Ventricles (cavities) of the brain
Central canal of the spinal cord

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7
Q

What cells make cerebrospinal fluid and how much of it?

A

Ependymal cells make 500ml / day

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8
Q

List 4 functions of the cerebrospinal fluid.

A

1) Supports and protects the brain and spinal cord acting as a shock absorber.
2) Maintains uniform pressure around the brain
3) Keeps brain and spinal cord moist
4) Circulates nutrients and waste
5) Provides optimal chemical environment for nerve signalling

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9
Q

What arteries supply blood to the brain?

A

Vertebral & carotid arteries

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10
Q

What is the purpose of the blood brain barrier?

A

To protect the brain from toxins, harmful substances and bacteria that enter the bloodstream.

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11
Q

Describe how the blood brain barrier works.

A

Astrocytes maintains tightness of the capillaries and the junctions between the cells.

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12
Q

What can pass through the blood brain barrier? (4)

A
  • Lipid soluble substances
  • Glucose
  • Gases (eg oxygen and carbon dioxide)
  • Ions
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13
Q

Name the 4 main parts of the brain

A

1) Brain steam
2) Diencephalon
3) Cerebrum
4) Cerebellum

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14
Q

Of the 3 sections of the brainstem, provide:
- their name
- key functions
- the nerves they contain

A

Medulla oblongata
- contains respiratory & cardiac centres
- controls reflexes such as vomiting
- contains 4 cranial nerves (9-12)
- contains motor tracts

Pons
- helps control breathing
- contains 6 cranial nerves (5-8)
- relays motor tracts

Midbrain
- controls subconscious muscle activities
- eye reflexes and tracking
- 2 cranial nerves (3-4)

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15
Q

Of the 3 sections of the diencephalon, provide:
- their name
- key functions

A

Thalamus:
- Major relay centre of sensory information

Epithalamus:
- Connects limbic system to other parts of the brain
- Contains the pineal gland

Hypothalamus:
- Hormone regulation and homeostasis
- Controls ANS
- Controls body temperature
- Regulates emotions and behavioural patterns

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16
Q

Describe the main functions of the cerebellum

A
  • Maintenance of posture and balance
  • Coordinating complex movements
  • Correction of errors during ongoing movement
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17
Q

What can damage the cerebellum?

A
  • Chronic alcohol abuse
  • Coeliac’s disease
  • Thiamine (Vit B1) deficiency
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18
Q

What are the 2 main functions of the cerebrum?

A
  • Sensory perception
  • Motor control of skeletal muscles
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19
Q

What are the 4 areas of the cerebrum and name 1 function for each?

A
  • Frontal lobe - motor skills
  • Temporal lobe - hearing
  • Parietal lobe - sensory interpretation
  • Occipital lobe - vision
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20
Q

What is the limbic system?

A

It’s the area of the brain that is active with different emotions.

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21
Q

Name 3 key structures found in the limbic system.

A

1) Hypothalamus
2) Hippocampus
3) Amygdala

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22
Q

How much of the cardiac output does the brain receive?

A

20% / 750ml per minute

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23
Q

What is the meeting point of the carotid and vertebral arteries called?

A

Circle of Willis

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24
Q

What’s the 1st cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Olfactory nerve
Located in cerebrum
Sense of smell
Sensory

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25
Q

What’s the 2nd cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Optic nerve
Cerebrum
Vision
Sensory

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26
Q

What’s the 3rd cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Oculomotor
Midbrain
Eye movement, eyelids, pupil size
Motor

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27
Q

What’s the 4th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Trochlear
Midbrain
Eye movement
Motor

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28
Q

What’s the 5th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Trigeminal
Pons
Facial Sensations, chewing
Sensory and motor

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29
Q

What’s the 6th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Abducens
Pons
Abducts eyes
Motor

30
Q

What’s the 7th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Facial nerve
Pons
Facial expressions, Taste, salivary glands
Sensory & motor

31
Q

What’s the 8th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Vestibulocochlear
Pons
Hearing, balance
Sensory

32
Q

What’s the 9th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Glossopharyngeal
Medulla
Taste, swallowing, tongue sensations
Sensory & motor

33
Q

What’s the 10th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Vagus
Medulla
Sensory/motor functions in chest/abdomen
Sensory & motor

34
Q

What’s the 11th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Accessory nerve
Medulla
Neck and shoulders
Motor

35
Q

What’s the 12th cranial nerve?
Where is it located?
What is its function?
Is it sensory or motor?

A

Hypoglossal
Medulla
Tongue movement
Motor

36
Q

What spinal nerves continue beyond the conus (end of the spinal cord)?

A

Cauda equina

37
Q

Where does the spinal cord end?

A

L2 at the conus

38
Q

Briefly describe what the spinal cord consists of.

A

White matter around the outside consisting of bundles/tracts of myelinated axons. These tracts make up the motor tracts (descending) and sensory tracts (ascending)

Butterfly shape of grey matter in the middle consisting of cell bodies and dendrites receiving incoming and outgoing information.

39
Q

What are the 3 spinal cord tracts?

A

1) Dorsal columns - ascending tract for light touch, vibration, proprioception.

2) Spinothalamic tract - ascending tract for pain and temperature

3) Corticospinal tract - descending for voluntary movement.

40
Q

What is Raised Intracranial Pressure?

A

An increase in the pressure within the cranial cavity. This compression of blood vessels leads to reduced oxygen to the brain

41
Q

List 3 causes of raised intracranial pressure.

A
  • Tumours
  • Haemorrhage
  • Hydrocephalus
  • Meningitis
42
Q

List 4 signs/symptoms of Raised Intracranial Pressure.

A
  • Headaches (worse on awakening)
  • Vomiting often without nausea
  • Visual disturbance
  • Pupil fixed / dilated in one eye
  • Impaired mental state
43
Q

What is Hydrocephalus?

A

An abnormal accumulation of cerebrospinal fluid occupying the cerebral ventricles and subarachnoid space.

Usually due to impaired absorption but can be due to excessive secretion.

44
Q

Provide 1 cause each for hydrocephalus in small children and adults.

A

Small children:
Infection
Congenital malformation

Older children & adults:
Tumour
Trauma
Meningitis

45
Q

List 3 signs/symptoms of hydrocephalus

A
  • Headaches (worse in the morning)
  • Increase in head circumference in infants
  • Vomiting
  • Blurred vision
  • Impaired motor skills
46
Q

What allopathic treatment is there for hydrocephalus?

A

Shunt
Diuretics
Ventricular drain

47
Q

What is meningitis?

A

Inflammation or infection of the meninges.

48
Q

What can cause meningitis?

A

Viral (most common 90%) - herpes simplex
Bacterial (most severe)
Fungal or parasitic microorganisms.

49
Q

List 4 signs/symptoms of meningitis

A
  • Fever
  • Sudden onset of severe headache
  • Neck stiffness
  • Vomiting
  • Petechiae (skin rach - tiny hemorrhages)
50
Q

How might meningitis be treated allopathically?

A

Antibiotics (if bacteria)
Antivirals (if viral)
Corticosteroids
Intravenous fluids

51
Q

List 3 potential complications of meningitis

A
  • Swelling (and raised intracranial pressure)
  • Septicaelmia (if bacteria)
  • Seizures
52
Q

What is concussion?

A

Temporary loss of neuronal function due to a head injury.

53
Q

List 3 common signs/symptoms of concussion

A
  • Loss of consciousness
  • Memory loss
  • Heachache
  • Disorientation
54
Q

What is a cerebral contusion?

A

A type of traumatic brain injury that causes bruising of the brain with ruptured blood vessels and oedema.

Usually caused by a blunt blow to the head.

55
Q

What is the difference between a coup and a contrecoup injury?

A

Coup = damage on the same side as the trauma

Contrecoup = damage to the brain also appears on the opposite side as the trauma

56
Q

List 5 causes of headaches

A
  • Dehydration
  • Tension headache
  • Congested sinuses
  • Hypoglycaemia
  • Migraines and cluster headaches
  • Medication induced
  • Tumour
  • Haemorrhage
57
Q

What is a migraine?

A

A neurological condition that results in recurrent severe heachaches

58
Q

List 4 causes migraines?

A
  • Cerebral depolarisation causing initial vasoconstriction (aura) and subsequent vasodilation.
  • Low serotonin
  • Food additives
  • Stress
  • Hormonal changes
  • Poor sleep
59
Q

List 4 signs/symptoms of migraines

A
  • Aura
  • Unilateral, pulsating headache
  • Photophobia
  • Phonophobia
  • Nausea and vomiting
60
Q

Provide 2 headache red flags

A
  • First onset over 50yrs
  • Thunderclap headache (subarachnoid haemorrhage)
  • Signs of meningitis - accompanied by neck stiffness, non-blanching rash
  • Signs of raised intracranial pressure - worsening in the morning, uneven pupils, vomiting and no nausea.
61
Q

What is epilepsy?

A

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

(Symptom, not a disease)

62
Q

List 3 causes of epilepsy

A

(Idiopathic)
Brain tumour
Cerebral haemorrhage
Head trauma
CNS infection

63
Q

List 4 common triggers for epilepsy

A

Hypoglycaemia
Fever
Sleep deprivation
Dehydration
Stress
Flickering lights
Drugs and alcohol
Pesticides

64
Q

Briefly describe 2 types of seizures

A

Petit mal seizures: aka an absence seizure
Non-convulsive
Lasts 10-30 seconds
Seen mainly in children

Grand mal seizure:
Convulsive
Lasts around a minute

65
Q

What natural treatment is there for epilepsy?

A

Magnesium
Sleep hygiene
Stress management
Ketogenic diet - increases GABA production which suppresses excess electrical activity

66
Q

What is sciatica?

A

Pain due to the compression or irritation of the sciatic nerve (which is the longest and widest nerve in the body)

67
Q

List 3 signs/symptoms of sciatica

A
  • Pain in the lower back and buttock
  • Pain radiating down the posterior leg
  • Pins and needles and numbness
  • Weak calf
  • Absent ankle jerk reflex
68
Q

What are 2 common causes of sciatica?

A

Disc herniation (L4/5 or L5/S1)
Compression against piriformis muscle

69
Q

What test can be done to help diagnose a disc herniation?

A

Straight leg raise test (SLRT)
Patient lies on their back and you raise one of their legs whilst keeping it straight to about 45 degrees.

A positive result is pain in this initial 45 degrees.

70
Q

What are the dangers of aspartame?

A

It’s a neurotoxin with neuro-excitatory properties.

Linked to widespread neurological damage and a variety of symptoms and conditions, including MS, Parkinson’s, and balance problems.

71
Q

How might you test someone’s proprioception?

A

Romberg’s test:
The patient stands with feet together, then close their eyes. Positive Romberg’s if sways after closing eyes.

72
Q

Name 2 reflex neurological examinations

A

1) Deep Tendon Reflexes - (knee or ankle)
2) Cutanous Reflexes (plantar or abdominal)

Biomedicine II CNM (2024) (6 decks)

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