8/22 Intro to NBB - Glendinning Flashcards
key questions for neurological problem
history
observations
history
- head trauma
- headache
observations
- level of consciousness
- mental state
- mood
- speech
- perception: dizziness, vision, pain
- movement: muscle weakness or tone, loss of
- coordination or balance (ataxia: loss of coordination)
Neurological Exam steps
- Mental Status (cognition, alertness, language)
- Cranial Nerve exam
- motor fx
- reflexes
- coordination/gait
- sensory fx
concept: localization of function
application of it?
specific brain regions have specific fx → testing diff fx, you test diff parts of brain!
application: functional MRI is based on neural locatization
focal lesion
infection, tumor, injury that develops at a restricted/circumscribed area of neural tissue
produce FOCAL NEURO SIGNS
- loss of pain/temp on half face
- loss of ability to repeat a spoken word
- loss of vision in an eye
what is NOT a focal neuro sign?
headache, tireness, confusion, disorientation (more global problems)
how do we know the brain isn’t hard wired?
- humans able to control prosthetic devices
- psych: cognitive-behavioral therapy as a technique to relearn thinking, make new associations
diffuse/general lesions
more characteristic of neurodegen disease, psych disorder, inflammatory disorder, infection, malnutrition, genetic diorder, compression of brain
dx depends on sx and pattersn of sx!
examples of timecourse
- episodic (migraine/seizure)
- recent onset/episodic (expanding brain tumor)
- relapsing/remitting (multiple sclerosis)
- suddon onset w/ lasting deficit (stroke)
- slow progressive (neurodegen - PD, Alz)
- progressive, short time (expanding tumor, expanding pressure)
distinct regions of neurons
input : usually dendritic tree
integrative : base of axon (initial segment/trigger zone) - rich in voltage gated Na channels
conductive : axon (actively generates AP)
output : terminals to muscles/glands/structures
PNS afferents & efferents
afferents carry sensory info from periphery
efferents carry (usually) motor signals to skeletal/smooth muscle
morphological classification of neurons
psuedo-unipolar (started off bipolar, but body migrated out)
- sensory neurons of DRG
bipolar
- visual/olfactory
multipolar
CNS neurons
interneurons: neurons that form connections within CNS
local interneurons: connect to cells in the immediate region
projection interneurons: project to more distant areas of CNS
- make up tracts which are components of pathways
convergence/divergence
collaterals allow divergence
convergence (integration of inhibitory/excitatory info)
white matter vs grey matter
white : axons
grey : cell bodies/synapses
*in brain: grey outside/white inside
*in spinal cord: grey inside/white outside
cluster types and names
clusters of neuron cell bodies (nuclei) :
- nucleus or ganglia (PNS)
clusters of axons
- tract, nerve, fasciculus, funiculus, commisure (R-L)
glial cells
support cells
- can divide
- roughly equal numbers of glial cells and neurons in brain BUT ratios differ in diff parts
- cortex - 3.72 glia:neuron
- cerebellum - 0.23
- basal ganglia, diencephalon, brainstem - 11.35
