A&P 1: Lower Brain/Cerebrum/CNs Flashcards

1
Q

What are the 4 parts of the diencephalon?

A

Thalamus
Hypothalamus
Epithalamus
Subthalamus

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2
Q

What supports the largest part of the brain?

A

Diencephalon and brain stem support the cerebrum

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3
Q

What are the two layers of the cranial dura mater?

What makes these layers?

A

External periosteal- formed by periosteum covering the internal surface of the cranium

Internal meningeal- continuous w/ dura mater of the spinal cord

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4
Q

The two layers of the cranial dura mater are fused together except for where?

A

Separate to enclose the dural venous sinuses

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5
Q

What is the function of the dural venous sinuses?

A

Drain blood from brain to the internal jugular vein

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6
Q

What are the 3 extensions of the dura mater?

A

Falx cerbri- cerebrum hemispheres
Falx cerebelli- cerebellum hemispheres
Tentorium cerebelli- cerebrum and cerebellum

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7
Q

Brain consumed __% of the body’s O2 and glucose

A

20%

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8
Q

Neurons synthesize ATP almost exclusively from ____

A

Glucose

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9
Q

What are the parts of the brain that lack the BBB?

A

Pineal gland
Pituitary gland
Medial eminence of hypothalamus

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10
Q

What part of the brain senses toxins in the blood and is responsible for control over vomiting?

A

Area postrema (4th ventricle)

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11
Q

What can pass into the BBB by active transport?

A

Water soluble

Glucose

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12
Q

What crosses the BBB very slowly?
Not at all?
Easily?

A

Slowly: Creatinine, urea, ions
Not: proteins, ABX
Easily: O, CO2, ETOH, anesthetics

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13
Q

What space does CSF circulate through?

A

Subarachnoid space

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14
Q

What separates the lateral ventricles?

A

Septum pellucidum

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15
Q

What surrounds the 3rd ventricle?

A

R/L halves of thalamus

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16
Q

What surrounds the 4th ventricle?

A

Brain stem

Cerebellum

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17
Q

Where is the CSF made and by what type of cells?

A

Produced in choroid plexuses by ependymal cells

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18
Q

How do ependymal cells make CSF?

A

By filtration (some secretion)

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19
Q

What is the sequence of CSF flow from lateral ventricles -> circulation?

A
Lateral ventricles
Interventricular foramina
3rd ventricle
Aqueduct
4th ventricle
Median (1) and lateral (2) apertures
Subarachnoid space
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20
Q

How can hydrocephalus develop in adults?

A

Head trauma
Meningitis
Subarachnoid hemorrhage

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21
Q

Define reticular formation

A

Gray and white matter network that spans throughout brain stem

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22
Q

What processes/reflexes does the medulla oblongata control?

A

Breathing
HR
BP

Cough
Swallow
Vomit

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23
Q

Where does the medulla oblongata start?

A

Foramen magnum

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24
Q

What color matter is found in the medulla oblongata?

A

White w/ ascending and descending tracts

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25
Q

Define pyramids and their functions

A
Bulges of white matter on ANTERIOR
Corticospinal tracts (largest motor tracts from cerebrum->spine)
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26
Q

Define decussation and where it occurs?

A

Axons of L pyramid cross to R side of pyramid

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27
Q

Medullary nuceli are what color matter?

A

Gray

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28
Q

What are the 3 masses in the medullary nuclei

A

Cardiovascular
Medullary rhythmic
Deglutition

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29
Q

What is the function of the cardiovascular center?

A

Heart rate and force

Vessel diameter

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30
Q

What is the function of the medullary rhythmic center?

A

Adjusts basic rhythm of breathing

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31
Q

Function of the inferior olivary nucleus

A

Relay impulses from cortex, red nucleus and spinal proprioceptors to cerebellum

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32
Q

What nucleus’ make up the posterior nuclei?

A

Gracile and cuneate nucleus

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33
Q

What are the functions of gracile and cuneate nucleus

A

Touch
Conscious proprioception
Pressure
Vibration

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34
Q

Where are the first and second order sensory neurons and where do the relay impulses to?

A

First order- bodies in dorsal root of spinal cord
Second order- bodies in correspondingly named posterior nucleus of medulla

First order->posterior columns->Posterior nuclei->second order->medial lemnisus in thalamus

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35
Q

What is the name of the white band in the thalamus?

A

Medial lemniscus

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36
Q

The medial lemniscus extends through what 3 structures?

A

Medulla
Pons
Midbrain

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37
Q

Define posterior column-medial lemniscus pathway?

A

Tracts of posterior columns +

Axons of medial lemniscus

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38
Q

Where do pontine nuclei relays signals to? What type of signals are these?

A

Voluntary muscle movements from cortex->cerebellum

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39
Q

What are the two structures in the pontine that help control breathing?

A

Pneumotaxic center

Apneustic area

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40
Q

What are the components of the respiratory center?

A

Medulla- rhythmic
Pons- pneumotaxic
Pons- apneustic

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41
Q

What are the two parts of the medullary rhythmic area?

A

Inspiratory and expiratory area

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42
Q

What happens when the inspiratory center is active?

A

Generates nerve impulses to: EXTERNAL intercostal muscles

diaphragm

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43
Q

During normal, quiet breathing and in the absence of the inspiratory center, what event occurs?

A

Exhalation, passive recoil of lungs and thoracic wall

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44
Q

What center is inactive during quiet breathing?

A

Expiratory

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45
Q

What happens with the expiratory center during forceful breathing?

A

Expiratory area sends impulses to INTERNAL intercostal and abdominal muscles

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46
Q

What contribution does the pneumotaxic and apneustic area make during respiration?

A

Pneumotaxic- turn inspiratory area off (prevents over expansion)

Apneustic- prolongs inhalation by sending impulses to inspiratory area

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47
Q

CN 8 has nuclei in what two parts of the brain stem?

A

Pons

Medulla

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48
Q

What are the two sensory branches of CN8

A

Vestibular- sensory axon ending in pons

Cochlear- sensory axons ending in medulla

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49
Q

How does the vestibular branch of CN8 enter the cerebellum?

A

Inferior cerebellar peduncle

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50
Q

What are the motor axons of CN*?

A

Project from pons to hair cells in semicircular canals and spiral organ

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51
Q

What is the function of the mesencephalon?

A

Connects the pons to the diencephalon

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52
Q

What types of impulses does the cerebral peduncles conduct?

A

Corticospinal
Corticobulbar
Corticopontine

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53
Q

What does the tectum contain?

A

Two rounded elevations, corpora quadrigemina

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54
Q

The Corpora Quadrigemina comprised of what two structures?

A

Superior colliculi

Inferior colliculi

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55
Q

Function of superior colliculi

A

Extrinsic eye movement during eye tracking

Pupil reflex
Accommodation reflex

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56
Q

Function of the inferior colliculi

A

Relays impulses from inner ear to thalamus

Startle reflex

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57
Q

Function of the Substantia Nigra

A

Releases dopamine

Controls subconscious muscle activities

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58
Q

What structure of the brain is effected by Parkinson’s disease?

A

Substantia Nigra

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59
Q

Function of the Red Nuclei

A

Coordinate muscle movements

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60
Q

Why is the Red Nuclei red?

A

Rich blood supply

Iron containing pigment in neuron cell bodies

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61
Q

Where does the rubropsinal tract originate?

A

Red nucleus

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62
Q

What does the Red Nucleus control?

A

Baby crawling
Arm swings during walking
Upper shoulder/arm muscles

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63
Q

What controls the fine/precise movements of fingers?

A

Corticospinal tract

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64
Q

What is the main function of the Reticular Formation?

A

Main function: regulates muscle tone

RAS: Maintain consciousness, awakening from sleep

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65
Q

What is the vermis and where is it found?

A

Central constricted area of the cerebellum

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66
Q

Define folia and where are they found?

A

Ridges on surface of cerebellum

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67
Q

What are the components of the cerebellar cortex?

A

Gray matter w/ foliar ridges

White matter forming the arbor vitae

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68
Q

Function of the cerebellar peduncles?

A

Conduct impulses between cerebellum and brain

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69
Q

Difference between Cerebral Peduncles and Cerebellar Peduncles?

A

Cerebral: anterior, impulses from cerebrum to spine

Cerebellar: posterior, impulses from cerebellum and brain

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70
Q

Main function of the cerebellum?

A

Evaluate how well movements are carried out
Posture
Balance

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71
Q

Function of the anterior/posterior lobes of cerebellum?

A

Unconscious refinements of skeletal muscle movements

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72
Q

Function of the floculonodule lobe of the cerebellum?

A

Equilibrium and balance

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73
Q

Define ataxia

A

Without order, incoordination

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74
Q

Ataxia is contributed to what issues in the cerebellum?

A

Infection
Injury
Disease
Degeneration

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75
Q

How does alcohol effect the brain and potentially cause death?

A

Inhibits cerebellum

Suppresses medullary rhythmicity

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76
Q

Diencephalon surrounds which brain ventricle?

A

3rd

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77
Q

Where does the deincephalon extend from/to?

A

From brain stem to cerebrum

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78
Q

What makes up most of the diencephalon?

A

Thalamus

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79
Q

What connects the two halves of the thalamus?

A

Intermediate mass

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80
Q

What are the functions of the thalamus?

A

Main relay station for sensory impulses
Autonomic activities
Maintenance of consciousness

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81
Q

What is the function of the Internal Capsule?

A

Band of thick white matter

Separates thalamus and caudate nucleus from lentiform nucleus

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82
Q

Function of the Mammillary bodies?

A

Relay station for olfactory reflexes

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83
Q

What is the main visceral control center of the body?

A

Hypothalamus

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84
Q

Hypothalamus receptors monitor what things?

A

Glucose
Osmotic pressure
Blood temp
Hormones

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85
Q

What are the specific functions of the hypothalamus?

A
ANS
Hormone production
Emotion
Behavior
Eating
Drinking
Body temp
Cardiac rythms
States of consciousness
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86
Q

Parts of the epithalamus and their function?

A

Habenular nuclei- emotional olfactory responses

Pineal gland- melatonin secretion

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87
Q

What does the subthalamus contain?

A

Tracts

Paired subthalamic nuclei

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88
Q

What are the layers of matter in the cerebral cortex?

A

Gray->white->gray nuclei

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89
Q

What is the most prominent fissure?

A

Longitudinal fissure- separates cerebrum into R/L hemispheres

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90
Q

When are gyri and fissures developed?

A

Embryonic development

When gray matter of cortex enlarges faster than the deeper white matter

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91
Q

Define central sulcus

A

Separates the frontal and parietal lobes

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92
Q

Define the lateral cerebral sulcus

A

Separates frontal and temporal lobes

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93
Q

Define parieto-occiptal sulcus

A

Separates the parietal and occipital lobe

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94
Q

Define association tracts

A

Nerve impulses between gyri in same hemisphere

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95
Q

Define Commissural tracts

A

Nerve impulses between gyri across different hemispheres

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96
Q

Define Projection tracts

A

Nerve impulses from cerebrum to lower CNS / lower CNS to cerebrum

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97
Q

What are the important groups of commissural tracts?

A

Corpus callosum

Anterior/posterior commissure

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98
Q

What makes up the basal ganglia?

A

Globus pallidus
Putamen
Caudate nucleus

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99
Q

What makes up the Lentiform nucleus?

A

Globus Pallidus

Putamen

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100
Q

What makes up the Corpus Striatum?

A

Lentiform and Caudate nucleus

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101
Q

Why is the Basal Ganglia a naming exception?

A

Ganglia usually used for collections of nerve cell bodies outside of CNS

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102
Q

What does the basal ganglia help regulate?

A

Initiation and termination of movements
Control conscious contractions of skeletal muscles
Muscle tone

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103
Q

Define inconscient

A

Unconscious

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104
Q

What movement disorders affect the basal ganglia?

A

Parkinsons- melanin-pigmented dopamine producing neurons of basal ganglia degenerate

Huntingtons- damage to corpus striatum

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105
Q

What happens if the basal ganglia is damaged?

A

Tremors
Stiffness
Involuntary movements

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106
Q

Basal ganglia damage has bee linked back to what disorders?

A

OCD and ADHD

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107
Q

What is the Limbic system?

A

Emotional, affective brain

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108
Q

What is the “emotional brain”?

A

Limbic system

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109
Q

What does the Limbic system play a primary role in regulating?

A
Pain
Pleasure
Docility
Affection
Anger
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110
Q

Where does the Limbic system tie into other brain structures?

A

Encircle upper part of brain stem

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111
Q

What are the components of the limbic system?

A
Hippocampus
Amygdala
Limbic lobe
Dentate and Cingulate gyrus
Mammillary bodies
Anterior/medial thalamus nuclei
Olfactory bulbs
Fornix
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112
Q

What is the role of hippocampus?

A

Converting new info->long term memories (autobiographical and factual)
The memory “gateway”

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113
Q

What does the amygdala play roles in?

A

Docile behavior
Rage
Aggression- presence or absence
Restlessness

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114
Q

What do the olfactory bulbs synapse with?

A

Olfactory receptors

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115
Q

What are the olfactory relay stations?

A

Mammillary bodies

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116
Q

What is the location and function of the Cingulate Gyrus?

A

Superior to Corpus Callosum

Sensory input w/ emotions, regulates aggression and mediates emotional response to pain

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117
Q

What is the function and location of the Fornix?

A

Extends from hippocampus to mammillary body of hypothalamus
Forms arch over thalamus
Carries signals hippocampus->hypothalamus
Transfers info mammillary bodies->hippocampus

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118
Q

What happens if the hippocampus is damaged?

A

Anterograde amnesia- inability to generate new memories

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119
Q

What is the “executive suite” of the brain?

A

Cerbral cortex

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120
Q

What are the functions of the Cerebral Cortex?

A
Communicate
Perceive
Remember
Understant
Appreciate
Initiate voluntary movement
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121
Q

What type of matter makes up the Cerebral Cortex?

A
Gray matter only
Neuron bodies, dendrites and unmyelinated axons
Glia 
Vessels 
NO FIBER TRACTS
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122
Q

What is each hemisphere of the brain mainly concerned with?

A

Contralateral sensory and motor functions

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123
Q

Generally, there is _____ of cortical function

A

Lateralization (specialization)

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124
Q

Define association areas

A

Communicate w/ motor cortex and association areas to analyze, recognize and act on sensory inputs

Receive input from primary’s and integrate sensory experiences to generate patterns of recognition/awareness

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125
Q

Define Primary Sensory Areas?

A

Receives impulses from sensory neurons w/out prior filtering/analysis

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126
Q

Define Primary Motor area?

A

Originators of voluntary muscle contractions

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127
Q

What is located in Areas 44/45 of the Frontal Lobe and what function does it have?

A

Broca’s Speech Area
Planning and production of speech
Nerve impulses->premotor regions

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128
Q

What is located in Areas 22, 39/40?

A

Wernicke’s Area

Interprets and recognizes spoken words

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129
Q

Define aphasia

A

Inability to use or comprehend words

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130
Q

What hemisphere contains the language areas?

A

L hemisphere

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131
Q

What occurs if there is damage to Broca’s Area?

A

Non-fluent aphasia- inability to form words (know what to say, can’t say it)

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132
Q

What happens if there is damage to Wernicke’s Area?

A

Fluent aphasia

Produces strings of words w/out combined meaning

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133
Q

People with fluent aphasia may exhibit what two forms?

A

Word deafness- inability to understand spoken words

Word blindness- inability to understand written words

Or, both

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134
Q

What functions are predominantly controlled by the LEFT hemisphere?

A

Language
Math
Logic

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135
Q

What functions are predominantly controlled by the RIGHT hemisphere?

A

Visual-spatial skills
Intuition
Emotion
Art/music appreciation

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136
Q

Define hemispheric lateralization

A

Functional asymmetry between the brain hemispheres

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137
Q

What are the suspected causes of Alzheimers

A

Genetics
Environment
Lifestyle
Aging process

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138
Q

What anatomical changes are found in a brain with Alzheimers upon autopsy?

A

Loss of neurons that release ACh
Destruction of neurons at nucleus basalis
Beta-amyloid plaques
Neurofibrillary tangles

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139
Q

What is the hallmark sign/finding of Alzheimers in a brain?

A

Neuron destruction at nucleus basalis

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140
Q

Define concussion

A

Brain injury w/ loss of consciousness
Vision disturbances
Issue w/ equilibrium
THE MOST COMMON BRAIN INJURY

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141
Q

Define contusion

A

Bruising of the brain due to trauma (concussion)

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142
Q

Define Free Radical

A

Charged molecule w/ unpaired ve-

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143
Q

Define hematoma

A

Localized, clotted pool of blood

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144
Q

Define ischemia

A

Reduction of blood flow

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145
Q

Define laceration

A

Tear of the brain, rupture of large vessels

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146
Q

Define cerebrovascular accident

A

Stroke

Usually caused by intercerebral hemorrhage, emboli or atherosclerosis of cerebral arteries

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147
Q

Define Transient Ischemic Attack

A

Impaired brain blood flow causing episode of temporary cerebral dysfunction

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148
Q

Define agnosia

A

Inability to recognize significance of sensory stimuli (sounds, sights, smells)

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149
Q

Define apraxia

A

Inability to carry out movements in absence of paralysis

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150
Q

Define lethargy

A

Functional sluggishness

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151
Q

Define Reye’s Syndrome

A

Effects brain and liver after viral infection (chicken pox, influenza)
Most often in kids/teens who take aspirin

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152
Q

Define stupor

A

Unresponsiveness that can be aroused for brief moments w/ vigorous stimulation

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153
Q

What are the only two “only” sensory neurons?

A

1 and 2

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154
Q

What are nerves are grouped as the sensory nerves?

A

1 2 8

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155
Q

What nerves are grouped together as motor nerves?

A

3 4 6 11 12

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156
Q

What is the sensory function of the primary motor nerves?

A

Proprioception

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157
Q

What nerves are termed as “mixed” nerves?

A

5 7 9 10

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158
Q

What two CNs only innervate one muscle?

A

4- superior oblique

6- lateral rectus

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159
Q

Which motor neurons also have autonomic axons?

A

3 7 9 10

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160
Q

Motor neurons w/ autonomic nerves are part of what branch of NS?
What do they innervate?

A

Parasympathetic

Innervate glands, smooth muscle and cardiac muscle

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161
Q

What type of neurons are olfactory receptors and optic nerves?

A

Bipolar

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162
Q

How do olfactory axon bundles form olfactory nerves?

A

Extend through cribiform plate of ethmoid bone

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163
Q

Define anosmia

A

Loss of sense of smell

164
Q

CN 2 axones are myelinated or unmyelinated?

A

Myelinated

165
Q

What is the sequence of terms from the retina to the occipital lobe?

A
Rods/cones
Ganglion cells
Retina
Optic nerve
Optic chiasm
Optic tract
166
Q

What extrinsic and intrinsic muscles does CN 3 innervate?

A

Extrinsic eye muscles not innervated by CN 4 and 6

Intrinsic: ciliary muscle and sphincter pupillae (parasympathetic)

167
Q

What muscle does CN 3 innervate in the eye lid?

A

Levator palpebrae superioris

168
Q

What is the smallest and largest CN?

A

Smallest- 4

Largest- 5

169
Q

What is unique about CN 4?

A

Only CN to arise from posterior aspect of brain stem

170
Q

What muscle dos CN 4 innervate?

A

Superior oblique muscle

171
Q

CN4 moves the eye in which directions?

A

Inferior and lateral

172
Q

Having a PT track a finger with their eyes utilizes which CNs?

A

3 4 and 6

173
Q

Where does CN 5 emerge from?

A

Pons, isolated from other CNs

174
Q

What does CN5 provide sensory and motor?

A

Sensory: face, scalp and anterior 2/3 of tongue

Motor: chewing

175
Q

What are the two roots and subsequent branches of CN5?

A
Small root- mastication
Large root- sensation
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Mandibular nerve (V3)
176
Q

What part of the facial nerve is the target for dental procedures?

A

Maxillary nerve

177
Q

What nerve contains the corneal reflex?

A

CN V1

178
Q

What CN is the dermatome for the face and scalp?

A

CN 5

179
Q

What muscle does CN 6 innervate?

What kind of movement does it provide?

A

Lateral rectus

Abduction

180
Q

CN 7 allows for what types of movements, sensory, and autonomic processes?

A
Movement: 
Facial expression
Stylohyoid 
Posterior belly of digastric
Satpedius muscles

Sensory:
taste buds on anterior 2/3 of tongue

Parasym: lacrimal, nasal and salivary glands (sublingual and submandibular)

181
Q

What are the 5 branches of the facial nerve?

A
Temporal
Zygomatic
Buccal
Mandibular
Cervical
182
Q

Function of CN8?

A

Vestibular branch: equilibrium

Cochlear: hearing

183
Q

Function of CN 9?

A

Sensory: posterior 1/3 tongue taste and sensation
Baroreceptors
Chemoreceptors

Motor fibers to parotid gland

184
Q

Where is the carotid sinus and what does it contain?

A

Internal carotid artery

Contains carotid body (chemoreceptors) that react to changes in O, CO2 and H+

185
Q

Having a PT open their mouth, protrude their tongue and saying “AHH” uses which CNs?

A

9 and 10

186
Q

What is the longest CN?

A

10

187
Q

Short function of CN 10?

A
Swallow
Talk
Cardiac
GI tract
Respiration
Taste
188
Q

Where is the Vagus nerve distributed in?

A

Head
Neck
Thorax
Abdomen

189
Q

What are the sensory and motor functions of CN10?

A
Sensory: 
taste
touch
pain
temp
proprioception(epiglottis, pharynx)
BP
O/CO2

Motor:
Swallow
Cough
Voice production

Autonomic:
GI smooth muscles
Slows HR
Secretes digestive fluids

190
Q

What type of procedure can be done to reduce stomach acid secretions/reduce stomach ulcers?

A

Selective vagotomy

191
Q

Why is CN11 sometimes called the spinal accessory?

A

Originates from both brain stem and spinal cord (only CN w/ spinal cord component)

192
Q

Functions CN11 allows?

A

Swallowing
Trapezius
Sternocleidomastoid

193
Q

What CN allows for pharynx, larynx, shoulder and neck muscle movements?

A

CN 11

194
Q

What muscles does CN 12 innervate?

A

All intrinsic and extrinsic muscles of the tongue EXCEPT palatoglossus

195
Q

What muscles are needed for balanced tongue protrusion?

A

Genioglossi muscles

196
Q

Spinal cord is an extension of what part of the brain?

A

Medulla oblongata

197
Q

Where does the spinal cord start and end?

A

Foramen magnum

Conus medullaris @ L1/L2

198
Q

Where does the dura mater start and extend to in the spine?

A

Foramen magnum

S2

199
Q

Where is the epidural space?

What does this space contain?

A

Between dura mater and wall of vertebral canal

Fat and CT

200
Q

Where is the subdural space and what does it contain?

A

Between dura and arachnoid mater

Contains Interstitial fluid

201
Q

What layer of the spinal meninges contains the blood and lymph vessels?

A

Pia

202
Q

What is the subarachnoid space filled with?

A

CSF

203
Q

Define denticulate ligaments

A

Extensions of Pia Mater, fuse w/ arachnoid and inner surface of dura mater

204
Q

What is the function of denticulate ligaments

A

Suspend spinal cord w/in dural sheath and protect it from displacement

205
Q

Define arachnoid trabeculae

A

Strands originating from arachnoid mater connecting arachnoid to pia mater

206
Q

Where does the spinal cord in adults start and end?

A

Medulla oblongata

S2

207
Q

What are the purposes of the cervical and lumbar enlargements

A

Accommodate nerves to/from limbs

208
Q

Where is the conus medullaris?

A

Inferior to lumbar enlargement

Ends at L1/L2

209
Q

Define filum terminale

A

Extension of pia mater that anchors spinal cord to coccyx

210
Q

Define cauda equina

A

Nerves that leave the spinal cord but don’t leave the vertebral column so continue in vertebral canal in strands
Only in L/S/C regions

211
Q

Where is a spinal tap conducted?

A

L3/L4 or L4/L5

212
Q

What are the 6 uses of a spinal tap?

A
Withdraw CSF
ABX
Contrast
Anesthetics
Chemo
Measure CSF pressure
213
Q

__ bundles of axons connect each spinal nerve to a segment of cord

A

2 bundles

214
Q

Each bundle of axons is called a ____ which is composed of smaller units called _____

A

root

rootlet

215
Q

What is the swelling each posterior and anterior root has?

A

Posterior root ganglion

Anterior root and rootlets

216
Q

Posterior root ganglion contain cell bodies of _____

A

Sensory neurons

217
Q

Anterior roots contain axons of ______

A

Motor neurons (CNS to effectors)

218
Q

Gray matter in spine is shaped like a ___

A

H, butterfly

219
Q

What forms the crossbar of the H in the spinal gray matter?

A

Gray commissure

220
Q

What do the anterior horns of the spinal column contain?

A

Cell bodies of somatic neurons
Motor nuclei
Provide impulses for skeletal muscle contractions

221
Q

What do the posterior horns of the spinal column contain?

A

Somatic and autonomic sensory nuclei

222
Q

Where does the central canal of the spinal column start?

A

Continuous w/ 4th ventricle in medulla oblongata

223
Q

Where is the white commissure in relation to the gray commissure?

A

White is anterior to gray

224
Q

What do the lateral gray horns of the spinal column contain?

A

Cell bodies of autonomic motor neurons for regulation of smooth/cardiac muscle and glands

225
Q

Lateral gray horns are only present in what parts of the spine?

A

T1-L3 and S2-S4

226
Q

What is the function of the spinal gray matter?

A

Receives and integrates incoming/outgoing information

227
Q

What parts of the spinal cord does polio attack?

A

Cell bodies of motor neurons in anterior horns

Nuclei of cranial nerves

228
Q

Anterior and posterior gray horns divide white matter into what three columns?

A

Anterior
Posterior
Lateral

229
Q

Define tracts

A

Bundles of myelinated axons with common origin/destination and carry similar info

230
Q

Where does the first cervical pair of nerves emerge from?

A

Between occipital and atlas

231
Q

Cervical nerves are numbered by the vertebrae ____ them, while T/L/S nerves are numbered by the vertebrae ____ them

A

Cervical- below

T/L/S- above

232
Q

Spinal cord elongation stops at what year?

A

4-5 years old

233
Q

Sequence of nerves leaving the spine and rejoining

A

Rootlets->roots->spinal nerves->ramus

Spinal nerve exists only between union of dorsal and ventral roots, subsequent division into rami

234
Q

Define endoneurium

A

Covers individual axons

235
Q

Define Fascicle

A

Groups of axons

236
Q

Define perineurium

A

Wraps around facsicles

237
Q

Define epineurium

A

Covers entire nerves

238
Q

After spinal nerves pass through intervertebral foramen and branch, the branches are called ____

A

Ramus

239
Q

What are the terminal branches of spinal nerves?

A

Rami

240
Q

Function of the Posterior Ramus?

A

Innervate deep muscles and skin of dorsal surface

241
Q

Function of the Anterior Ramus?

A

Muscles and structures of limbs and skin of lateral/ventral trunk surfaces

242
Q

Define meningeal branch of the spinal nerve

A

Reenters vertebral canal to supply vertebrae and asoociated structures

243
Q

Function of rami communicantes

A

Contribute to trunk ganglia of ANS

244
Q

The ____ rami of spinal nerves do not go directly to the body structures they supply

A

Anterior

Form networks of axons called plexus

245
Q

What part of the spine does not have a plexus?

A

Thoracic

246
Q

Anterior rami of which spinal nerves are the intercostal nerves?

A

T2-T12

247
Q

What do the anterior rami supply?

A

Intercostal muscles
Abdominal muscles
Skin over the above muscles

248
Q

Roots arise from ___ ___

A

spinal cord->trunks->division

249
Q

What are the trunks of the brachial plexus?

What are the divisions as a result of branching trunks?

A

Superior, middle, inferior

Ant/Post

250
Q

What does the cervical plexus supply?

A

Skin and muscles of head, neck and superior shoulders, chest and diaphragm

251
Q

Where doe the phrenic nerves arise from?

What do they supply?

A

Cervical plexus

Motor fiber for diaphragm

252
Q

What do the brachial plexus supply?

A

Shoulder

Upper Limbs

253
Q

What does the lumbar plexus supply?

A

Anterolateral abdominal wall
External genitals
Part of lower limb

254
Q

What does the sacral plexus supply?

A

Buttocks
Perineum
Lower limbs

255
Q

What does cutaneous sensation arise from?

A

Tactile sensation
Thermal sensation
Pain

256
Q

What sensations encompass tactile sensation?

A

Touch
Pressure
Vibration
Tickling

257
Q

What are the two types of maps of afferent nerves?

A

Dermatomes

Peripheral nerve fields (cutaneous nerves)

258
Q

What do the different afferent nerve maps differ?

A

Plexuses

259
Q

Define dermatome

A

Area of skin that provides sensory input to CNS via spinal nerves or CN 5

260
Q

Adjacent dermatomes overlap except for where?

A

Axial lines

261
Q

Shingles is caused by what virus?
Where does the virus hide?
How does it leave it’s hidey hole?

A

Herpes zoster virus (chicken pox)
Posterior root ganglion
Sensory neurons of skin by fast axonal transport

262
Q

What are the two principle functions of the spinal cord in maintaining homeostasis?

A

Nerve impulse propagation

Information integration

263
Q

What type of info does the gray and white matter carry?

A

Gray- receives and integrates incoming and outgoing info

White- sensory impulses to brain and motor impulses to effectors

264
Q

Difference between discriminative touch and two-point discrimination?

A

DT= feel what part is being touched

Two point= distinguish between two touches near each other

265
Q

What structure integrate input?

A

Interneurons

266
Q

Cerebral cortex has major function in what movements?

A

Precise, voluntary muscluar

267
Q

Motor output to skeletal muscles travels down the spine in two types?

A

Direct

Indirect

268
Q

Define Direct Pathway

A

Originate in Cerebral Cortex

Precise, voluntary movement

269
Q

Direct pathway comprises what tracts?

A

Anterior Cortico
Lateral Cortico
Corticobulbar tract

270
Q

Define indirect pathways

A

Originate in brain stem or other areas of autonomic movements
Coordinate body movement with visual stimuli, maintain skeletal muscle tone and posture

271
Q

Indirect pathway includes what 5 tracts?

A
Rubrospinal
Tectospinal
Vestibulospinal
Lateral reticulospinal
Medial reticulospinal
272
Q

Define reflex

A

Fast, involuntary, unplanned sequence of actions in response to stimulus

273
Q

What are the two types of reflexes

A

Innate
Learned

Or bases on site of integration:
Spinal- spine gray matter
Cranial- brain stem

274
Q

Reflex arc includes what 5 structural components?

A
Sensory receptor
Sensory neuron
Integrating center
Motor neuron
Effector
275
Q

How does a dendrite or sensory structure response to a stimulus?

A

Produces graded potential called generator/receptor potential

276
Q

What is the integrating center of a reflex arc?

A

CNS gray matter

277
Q

What is the purpose of the Stretch Reflex?

A

Prevents injury from over stretching

278
Q

What type of reflex arc is the stretch reflex?

A

Monosynaptic, ipsilateral arc

279
Q

What is the sequence of events during the stretch reflex?

A

Muscle spindle in muscle signals stretch

Motor neuron activated and muscle contracts

280
Q

What is the stretch receptor?

A

Muscle spindle in muscle

281
Q

What is the reciprocal innervation of the stretch reflex?

A

Polysynaptic neuron

Antagonistic muscle relaxes

282
Q

Define Westphals Sign and

A

Absence or decrease in patellar reflexes

283
Q

What can cause Westphals Sign?

A

Receptor damage
Lesion in motor cortex/pyramid tract/dorsal column
Interruption of femoral nerve

284
Q

Define Tendon Reflex

A

Controls muscle tension by causing muscle relaxation when force becomes too extreme, protects tendon and muscle

285
Q

What kind of reflex arc is the Tendon Reflex?

A

Polysynaptic, ipsilateral reflex

286
Q

What are the tension receptors?

A

Golgi tendon organs located in tendons at musculotendon junction

287
Q

What are the events of the Tendon Reflex?

A

Tendon stretching
Inhibitory neuron stimulated
Motor neuron is hyperpolarized and muscle relaxes

288
Q

What kind of reciprocal innervation does the Tendon Reflex have?

A

Causes contraction of ipsilateral muscle group

289
Q

Define Flexor (withdrawal) Reflex

A

Ipsilateral protective withdrawal reflex to avoid pain

Contraction of flexor muscles

290
Q

What is the Flexor Reflex aka?

A

Nociceptive withdrawal refelx

291
Q

Define Crossed Extensor Reflex?

A

Contralateral, maintains balance during flexor reflex

Extension of one limb and flexion of opposite limb

292
Q

When is Babinski sign normal and why?

A

Less than 18mon due to lack of myelination in the corticospinal tract
Dorsiflexion of great toe

293
Q

What is a normal Babinski’s sign?

A

No Babinski

Curling of toes

294
Q

Define the Clasp Knife Reflex?

A

Stretch reflex
Rapid decrease in resistance when attempting to flex a joint

Caused by tendon reflex of antagonistic muscle

295
Q

What is a positive Clasp Knife Refelex indicative of?

A

Damage to pyramidal tract

Upper motor tract neuron lesion

296
Q

What do hyperactive reflexes indicate?

A

CNS disease

297
Q

What do decreased reflexes suggest?

A

Damage to spine
Muscle disease
Disease at nueromuscular joint
Loss of sensation

298
Q

Define monoplegia
Diplegia
Paraplegia
Hemiplegia

A

One limb paralysis
Two limb paralysis
Both lower limbs
Paralysis one sided

299
Q

Define hemisection

A

Partial transection of spine on R/L side

300
Q

Define areflexia

A

Loss of reflex function

301
Q

Define myelitis

A

Inflammation of spinal cord

302
Q

Define myelography

A

CT/Xray of spine is taken after contract injection to diagnose tumors/herniations

303
Q

Define neuralgia

A

Pain along sensory nerve

304
Q

Define paresthesia

A

Abnormal sensation resulting from disorder of sensory nerves

305
Q

Like the Somatic NS, the autonomic NS operates via ___ ___-

A

Reflex arcs

306
Q

What is the flow of info in and out of the ANS?

A

Sensory->CNS integrating center->motor

307
Q

What are the sub-branches of the PNS?

A

S/E/ANS

308
Q

What are the motor parts of the ANS?

A

Symp and Parasymp

309
Q

Most of the ANS’ interoceptors are ____ or ______

A

Chemoreceptor

Mechanoreceptors

310
Q

How/when are ANS interoceptor consciously perceived?

A

Intense activation may produce conscious sensation

311
Q

How does the ANS regulate visceral activities?

A

Increasing (exciting) or decreasing (inhibiting) activities in effector tissue

312
Q

Unlike skeletal muscles, tissues innervated by the ANS have a _____ function
What does that function mean?

A

Intrinsic

Continued function with damaged/lack of serve supply

313
Q

What are the two motor neurons in series of an ANS motor pathway?

A

Pre-ganglionic: cell body in CNS and is myelinated, extending from CNS to automatic ganglion

Post-ganglion: cell body in ganglion, unmyelinated, extending from ganglion to effector

314
Q

Somatic motor neurons release what neurotransmitter while ANS motor neurons release which ones?

A

Somatic- ACh only

ANS- ACh or NorEpi

315
Q

Preganglionic neuron body is located where?

How does it exit?

A

Brain or spinal cord

Exits CNS as part of CN or spinal nerve

316
Q

What kind of nerve impulse does the preganglionic neuron convey?

A

Impulse from CNS to autonomic ganglia

317
Q

Postganglionic neuron body is where?

A

Cell body and dendrites are in automatic ganglion

318
Q

What kind of nerve impulse does the postganglionic neuron relay?

A

Impulse from autonomic ganglia to visceral effectors

319
Q

Preganglion neurons of Sympathetic division have cell bodies located where?

Post ganglion neurons of the parasympathetic division have cell bodies where?

A

Lateral gray horns of T1-L2

Nuclei of CN 3 7 9 10 and lateral gray horns of S2-S4

320
Q

What are the two major types of sympathetic ganglia?

A

Sympathetic trunk

Prevertebral

321
Q

Sympathetic trunk ganglia are aka

A

Vertebral chain

Paravertebral ganglia

322
Q

Where are sympathetic trunk ganglia located, what are their functions and sizes?

A

Vertical rows along spine
Pre- short
Post- long, innervate organs above diaphragm

323
Q

Where are pre-vertebral ganglia located, what are their functions and sizes?

A

Anterior to spinal column
Pre- short
Post- long, innervate organs below diaphragm

324
Q

What are the 5 major prevertebral ganglia?

A

Celiac
Superior/inferior
Aorticorenal
Renal

325
Q

Where are parasympathetic trunk ganglia located, what are their functions and sizes?

A

Pre synapse w/ post in terminal ganglia which are located close to/within walls of visceral organs
Pre- long
Post- short, non-existant

326
Q

What are the parasympathetic ganglia of the head?

A

Ciliary
Pterygopalatine
Submandibular
Otic

327
Q

Where does the pelvic splanchnic nerves extend to?

A

Colon
Ureters
Bladder
Reproductive organs

328
Q

Sympathetic ganglia connect w/ postganglion neurons by what ways?

A

1- synapse w/ first ganglia it meets
2- a/descend then synapse
3- continue through trunk to prevertebral ganglion
4- continue to chromaffin cells

329
Q

What are the projection patters of the sympathetic branch?

A

Preganglion- many axon collaterals and synapse w/ many postganglion neurons

Postganglion- terminate in several effector after leaving ganglia

330
Q

What phenomenon does the sympathetic branch divergent projection pattern explain?

A

Why sympathetic response affect entire body almost simultaneously

331
Q

What are the projection patters of the parasympathetic branch?

A

Preganglion- few axon collaterals and synapse with limited postganglion neurons in the SAME visceral effector

Postganglion- terminate in the same effector after leaving ganglia

332
Q

Where do autonomic plexuses exist?

A

Thorax
Abdomen
Pelvis
Along major arteries

333
Q

Autonomic plexuses are usually components of autonomic motor pathways, but what can they also contain?

A

Sympathetic ganglia
Axons of autonomic sensory neurons
Visceral afferent fibers

334
Q

What are the plexuses in the thorax?

A

Cardiac

Pulmonary

335
Q

What are the plexuses in the abdomen?

A

Celiac

Inf/Superior messenteric

336
Q

What are the plexuses in the pelvis?

A

Hypogastric

Renal

337
Q

Characteristics of the cardiac plexus?

A

Located at base of heart surrounding the large emerging vessels

Supplied by sympathetic post-ganglion and parasympathetic pre-ganglion

338
Q

Characteristics of Pulmonary plexus?

A

Posterior to each lung
Sympathetic= dilation
Parasymp= constriction and increased secretions

339
Q

Characteristics of the celiac plexus?

A

AKA solar plexus, largest plexus

Surrounds celiac and mesenteric arteries

Located at last thoracic/first lumbar vertebrae

340
Q

What does the superior/inferior mesenteric plexus supply?

A

Superior- small and large intestine

Inferior- large only

341
Q

What does the hypogastric plexus supply?

A

Bladder

Genitals

342
Q

What does the renal plexus supply?

A

Renal arteries

Ureters

343
Q

Sympathetic preganglionic neurons cell bodies are located where?

A

Lateral horns of all thoracic and first three lumbar segments

344
Q

How doe sympathetic preganglionic axons leave the spinal cord and vertebral columns?

A

Spinal cord through anterior root of a spinal nerve

Exit column through intervertebral foramina

345
Q

What preganglionic neurons are myelinated?

A

Sympathetic

346
Q

How/what joins to form a sympathetic trunk?

A

Myelinated axons pass through white ramus to enter adjoining paravertebral ganglion

347
Q

White rami communicantes are only present in what spinal regions?

A

Thoracic

First 2 lumbar

348
Q

Where does the cervical ganglia emerge from?

A

T1-T6

349
Q

What does the cervical ganglia comprise of?

A

Superior/middle/inferior cervical ganglion

350
Q

What do the branches of the cervical ganglia supply?

A

Superior- head and heart

Middle/inferior- heart

351
Q

What spinal region receives most of the sympathetic preganglionic axons?

A

Thoracic ganglia

352
Q

Axons leave the sympathetic trunk in hat 4 ways?

A

Enter spinal nerves
Cephalic periarterial nerves
Sympathetic nerves
Spanchnic nerves

353
Q

How do sympathetic trunk pathways enter a spinal nerve?

A

Postganglionic neurons leave trunk through gray ramus and merge w/ anterior ramus of spinal nerve

354
Q

Wha forms sypathetic chains?

A

Axons collaterals from preganglionic neurons going up or down the sympathetic trunk

355
Q

What type of ganglion axon passes through gray rami communicantes?

A

Unmyelinated postganglion axon

356
Q

What is the function of gray rami communicantes?

A

Connects ganglia of sympathetic trunk to spinal nerves

357
Q

What type of rami is associated with all spinal nerves?

A

Gray

358
Q

What happens to ganglia after synapsing at the cephalic periarterial nerves?

A

Extend to thoracic cavity to the heart (sup, mid, inferior cervical ganglia and 1-4 thoracic ganglia)
Bronchi and lungs

359
Q

Sympathetic preganglia that pass through the trunk without synapsing form splanchnic nerves that extend to where?

A

Prevertebral ganglia

360
Q

What type of ganglia make up the splanchnic nerves?

A

Preganglionic axons that terminate in prevertebral ganglia

361
Q

What does the greater and lesser splanchnic nerve supply?

A

Greater: liver stomach spleen small intestine and kidney

Lesser: Small intestine and colon

362
Q

What does the lumbar splanchnic nerve innervate?

A

Colon
Rectum
Genitals
Bladder

363
Q

Adrenal medulla lack what type of ganglion neurons?

What hormones does it secrete?

A

Postganglionic

Epi
NorEpi
Dopamine

364
Q

Where are parasympathetic preganglion nerve bodie found?

A

Nuclei of brain stem and lateral horns of S2-S4

365
Q

What does the cranial parasympathetic outflow consist of?

A

Myelinated preganglion from brain stem in four CNs

366
Q

What does the sacral parasympathetic outflow consist of?

A

Myelinated preganglion axons in anterior roots of S2-S4

367
Q

Where do parasympathetic preganglion neurons terminate?

A

Terminal ganglia near organs they innervate

368
Q

Make up of the Ciliary Ganglia?

A

Posterior aspect of each eye
Preganglion from CN3
Postganglion innervate eye smooth muscles

369
Q

What makes up the Pterygopalatine Ganglia?

A

Preganglia from CN 7

Post ganglia to nasal, pharynx and lacrimal glands

370
Q

What makes up the Submandibular ganglia?

A

Preganglia form CN7

Postganglia to submandibular salivary glands

371
Q

What makes up the otic ganglia?

A

Inferior to each foramen ovale
Preganglion from CN 9
Postganglia to parotid salivary glands

372
Q

___% of the total craniosacral outflow is carried by vagus nerve

A

80%

373
Q

Autonomic neurons are classified into two groups based off the neurotransmitter released, what are the groups?

A

Cholinergic- release ACh

Adrenergic- release NE

374
Q

Characteristics of cholinergic neurons

A

All para/symp Pregang
All parasymp postgang
Symp postgang sweat glands
Somatic NS motor neurson

375
Q

What are Adrenergic neurons?

A

Symp postgang

376
Q

The only NE neurotransmitter?

A

Sympathetic Second synapse

377
Q

All cholinergic receptors bind ____

A

ACh

378
Q

What are the two types of cholinergic receptors?

A

Nicotinic
Muscarinic
No cross reactivity, both activated by ACh

379
Q

Effects of cholinergic neurons lasts how long?

A

Brief

380
Q

Activation of nicotinic receptors by ACh causes _______

A

Depolarization (excitation) of postgang neuron or skeletal muscle

381
Q

ACh activation of muscarinic receptors causes what reactions?

A

Depolarization or hyperpolarization (inhibition)

GI- relax
Eye- constrict

382
Q

Activation of Muscarinic receptors causes what syndrome?

A
DUMBELS
Defecation
Urination
Miosis
Bronchoconstriction
Emesis
Lacrimation
Salivation
383
Q

All adrenergic receptors bind with ?

A

Both Epi and NE
NE- released by symp postgang

Epi- hormones into blood

384
Q

What are the two types of adrenergic receptors?

A

Alpha 1 2

Beta 1 2 3

385
Q

Activation of A1 or B1=____

Activation of A2 or B2=____

A

excitatory

inhibitory

386
Q

Where is B3 receptors and what heppens when activated?

A

Brown adipose

Thermogenesis

387
Q

How does NE activity end?

A

Reuptake

Enzymatically degraded- COMT or MAO

388
Q

Whta happens with Beta blockers?

A

B1 receptors predominantly in heart

Beta blockers reduce effect of epi allowing heart to not work as hard

389
Q

What happens with Alpha blockers?

A

Located in all blood vessels except heart

Alpha blockers block adrenergic receptors allowing muscles that constrict to relax

390
Q

What happens when A1 receptors are activated?

A

Blood vessels and visceral organs constrict

Pupils dilate

391
Q

Define autonomic tone

What regulates it?

A

Balance between symp and parasymp activity

Hypothalamus

392
Q

What structures only receive sympathetic innervation?

A
Seat
Arrectors
Kidneys
Adrenal glands
Spleen
Vessels
393
Q

Sympathetic NS is called the E division, meaning?

A

Exercise
Excitement
Emergency
Embarassment

394
Q

Parasympathetic NS is called the SLUDD, meaning?

A
Salivation
Lacrimation
Urination
Digestion
Defecation
395
Q

___ _____ are central in regulating conditions of the body

A

Autonomic reflexes

396
Q

What is the distal end of a sensory neuron called?

A

Receptor in an autonomic reflex arc

397
Q

Autonomic sensory receptors are generally ____

A

Interoceptors

398
Q

Where are the cell bodies of visceral sensory neurons located?

A

CNs

Dorsal root ganglia of spine

399
Q

What are the integrating centers for most autonomic reflexes? Some?

A

Most- hypothatlamus and brain stem

Some- spinal cord

400
Q

All pregang neurons are____

All postgang neurons are___

A

Myelinated

Unmyelinated

401
Q

The major control and integration center of the ANS is ______?

A

Hypothalamus

402
Q

Define Raynaud disease

A

Digits become cold after exposure to cold or stress

Due to excessive sympathetic stimulation to arterioles in digits

403
Q

What does Atropine do?

A

Anticholinergic
Blocks parasymp

Suppresses salivation
Suppresses resp secretions
Mydriatic agent
Antidote

404
Q

What does Neostigmine do?

A

Anticholinesterase
Inhibs acetylcholinesterase
Allows ACh to accumulate
Treats myasthnia gravis- skeletal muscle impaired by lack of ACh

405
Q

What do Tricyclic antidepressants do?

A

Prolong NE on postsynaptic membrane

406
Q

Function of Monoamine oxidase

Function of MAO inhibitors

A

Inactivates NE

MAO inhibitors: prolong NE on postsynaptic membrane