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Anatomy And Assessment Flashcards

1
Q

Make up of the central nervous system

A

Brain
Cerebrum
Cerebellum
Brain stem

Spinal Cord

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2
Q

Make up of the peripheral nervous system

A

12 pairs cranial nerves
31 pairs spinal nerves
Somatic nervous system
Autonomic nervous system

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3
Q

What does the somatic nervous system do?

A

Innervates voluntary muscle

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4
Q

What does the autonomic nervous system do?

A

Innervate visceral smooth muscle

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5
Q

What are the cerebral hemispheres?

A

Also called the cortex of cerebellum the hemispheres are:
Frontal
Parietal
Temporal
Occipital

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6
Q

Frontal lobes

A

Personality
IQ
Judgement
Attention Span
Moral/ Ethical Behavior
Long term memory
Voluntary movement
Motor speech
Inhibition

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7
Q

Parietal Lobes

A

Sensory interpretation
Calculation
Right/Left discrimination
Proprioception
Sensory speech

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8
Q

Temporal Lobes

A

Interpretation of sounds
Integration of taste and smell
Short term memory
Seizure focus

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9
Q

Occipital Lobes

A

Primary visual cortex
Visual interpretation

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10
Q

Basal ganglia structures

A

Caudate nucleus
Lentiform nucleus
Subthalmic nucleus
Globus pallidus

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11
Q

Role of the basal ganglia

A

Integration of movement

Sometimes referred to as the extra pyramidal motor system

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12
Q

Anterior pituitary gland hormones

A

Growth stimulating hormones
Adrenocorticotropic hormone
Thyroid stimulating hormone
Follicle stimulating hormone
Leutinizing hormone
Prolactin

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13
Q

Posterior pituitary hormones

A

Anti-diuretic hormone
Oxytocin

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14
Q

What is the optic chiasm part of?

A

Pituitary gland

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15
Q

Functions of the cerebellum

A

Reflexive control of muscle tone
Coordination
Equilibrium

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16
Q

Reticular activating system/ RAS

A

Located between the midbrain and medulla

Controls arousal/wakefulness

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17
Q

List the cranial nerves

A
  1. Olfactory
  2. Optic
  3. Oculomotor
  4. Trochlear
  5. Trigeminal
  6. Abducens
  7. Facial
  8. Acoustic
  9. Glossopharyngeal
  10. Vagus
  11. Accessory
  12. Hypoglossal
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18
Q

Cranial nerves located in the cerebral hemispheres

A

1 and 2

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19
Q

Cranial nerves located in the midbrain

A

3 and 4

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20
Q

Cranial nerves located in the Pons

A

5 through 8

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21
Q

Cranial nerves located in the medulla

A

9 through 12

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22
Q

Most common errors in neuro assessments

A

Inadequate baseline
Failure to recognize cues
Failure to recognize the significance of clues
Failure to go up the chain

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23
Q

Stimulus chain

A

Voice
Shout
Shake
Pain

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24
Q

Level of consciousness

A

Most sensitive indicator of chance
Components include wakefulness (RAS) and awareness (frontal)

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25
Q

Glasgow coma scale

A

Developed for assessment of consciousness in patients with head injury

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26
Q

Critical scores for the Glasgow coma scale

A

8- critical severity
Less than or equal to 8 six hours after injury- 50% mortality rate

9-11 moderate severity

12 and up minor injury

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27
Q

Lethargy

A

Slowness in movement, speech, and thought processes

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28
Q

Obtundation

A

Arousable to stimulation
Appears drowsy, few words, simple commands

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29
Q

Stupor

A

Minimal spontaneous movement
Eye opening or incomprehensible sounds to painful stimuli
No response without stimulation

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30
Q

Motor dysphasia

A

Also called expressive or non-fluent dysphasia

Frontal lobe

Defects in use of spoken word

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31
Q

Sensory dysphasia

A

Also called receptive or fluent dysphasia

Temporal/ Parietal lobes

Defect in understanding written or spoken word

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32
Q

Central pain

A

Used when no response to extremity pain

Trapezius squeeze, supraorbital pressure, or submandibular pressure

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33
Q

Weber

A

Tuning for in middle of head

Conductive hearing loss- lateralization to deaf ear

Sensorineural hearing loss- lateralization to good ear

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34
Q

Rinne

A

Tuning for to mastoid and time until sound no longer heard. Move to ear and time again. Air : Bone

Normal- 2:1

Conductive- bone> air

Sensorineural- air > bone

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35
Q

Assess cranial nerve I

A

Olfactory

Check for mucus, obstruction, or inflammation

One nostril at a time

Use non-irritating stimulants such as coffee or soap

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36
Q

Assess cranial nerve II

A

Optic nerve

Acuity
Visual fields
Pupils

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37
Q

Assess cranial nerve III

A

Oculomotor nerve

Pupil construction
Follow finger with eye
Lids should not dip to top of iris

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38
Q

Assess cranial nerve IV

A

Trochlear

Ability to move eyes down and in

39
Q

Assess cranial nerve V

A

Trigeminal

Sensation on zones of face
Stroke cornea with cotton swab. Eye should close
Masseter and temporal muscle tone with jaw clenched

40
Q

Assess cranial nerve VI

A

Abducens

Ability to move eyes direct laterally (to outward side)

41
Q

Assess cranial nerve VII

A

Facial

Close lid, wrinkle brow, raise eyebrows, wiggle nose, pucker, show teeth, smile, puff out cheeks

42
Q

Assess cranial nerve VIII

A

Acoustic

Balance

Assess hearing by rubbing or tapping fingers by ears
Weber and Rhine tests

43
Q

Assess cranial nerves IX and X

A

Glossopharyngeal/ Vagus

Touch each side of palate and watch for prompt bilateral elevation

Check uvula is midline

Palate generated sounds ex: ”ka”/ “ga”

Ask patient to speak

44
Q

Assess cranial nerve XI

A

Spinal accessory nerve

Turn chin against examiners hand and resist

Elevate both shoulders against examiner’s hands

45
Q

Assess cranial nerve XII

A

Hypoglossal

Ask patient to stick out tongue and note any deviation

Ask pt to push tongue against cheeks against examiners hand

Tongue generated sounds ex: “la”

46
Q

Anatomy of spinal column

A

33 vertebrae
7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccygeal

Intervertebral discs between vertebrae

Connecting ligaments

47
Q

Purpose of the spinal column

A

Provide basic structural support

Protect the spinal cord

48
Q

Spinal nerves locations and root types

A

31 spinal cord segments
8 cervical
12 thoracic
5 lumbar
5 sacral

31 pairs of spinal nerve roots
Ventral/ Anterior root= motor
Dorsal/ Posterior root= sensory

49
Q

Spinal cord basics

A

Begins at the foramen magnum

Comprised to white matter (nerve cell bodies) and gray matter (tracts)

50
Q

Nerve cell bodies of the spinal cord

A

Butterfly shaped gray matter

Ventral/anterior horns are entry point for motor information to CNS

Dorsal/ posterior horns are entry point for sensory information to CNS

51
Q

Spinal tracts

A

Myelin coated white matter

Motor and sensory tracts

52
Q

5 major motor tracts and purpose

A

Corticospinal- voluntary movement medically to lateral=arms to legs

Rubrospinal
Reticulospinal
Vestibulospinal
Tectospinal

All 4 assist with reflexes, posture, and tone

53
Q

4 major sensory tracts and purpose

A

Spinothalmic- pain touch and temperature input immediately cross over

Posterior Columns- proprioceptipn and vibrationipsilateral

Spinocerebellar- unconscious proprioception

Spinoreticular- deep pain

54
Q

Spinal cord blood supply

A

Anterior spinal artery- supplies anterior two thirds

Posterior spinal artery- two of them supply primarily dorsal columns

55
Q

Myotomes

A

Motor fibers or each nerve that supply and receive info in a specific muscle distribution

56
Q

C5 motor fiber muscle and how to assess it

A

Deltoid- pronator drift

57
Q

How to assess motor fiber of L2-3

A

Hip flexion (iliopsoas)

58
Q

Dermatomes

A

Sensory fibers of each nerve that supply and receive in a specific skin distribution

59
Q

Sensory exam

A

Done in the different dermatomes

Superficial pain-pinprick (spinothalmic)

Temp with alcohol pad (spinothalmic)

Proprioception- romberg test and finger tap (posterior columns)

Vibration (posterior columns)

60
Q

Supratentorial compartment

A

Contains the cerebral hemispheres and diencephalon

61
Q

Infratentorial compartment

A

Contains the cerebellum, pons, medulla, and part of the midbrain

62
Q

Tentorium cerebelli

A

Separates the occipital lobes from the cerebellum

Transverse shelf-like membrane that attaches to skull

63
Q

3 meningeal layers

A

Dura/ dura mater
Arachnoid
Pia/ pia mater

64
Q

Dura

A

Thin inelastic inner layer (meningeal) and outer (periosteal) layer lining the inside of the skull and vertebral column forming a continuous membranous sac and separates the CNS and PNS

65
Q

Epidural space

A

Space between the skull and dura

66
Q

Falx cerebri

A

Double layer of dura that separates the left and right hemispheres

67
Q

Falx cerebelli

A

Double layer of dura that separates the left and right cerebellar hemispheres

68
Q

Tentorium cerebelli

A

Double layer of dura that separates the cerebellum from the cortex

69
Q

The arachnoid layer

A

Thin, weblike, non vascular membrane between the dura and pia which is filled with CSF

70
Q

Pia mater

A

Delicate membrane that covers the brain shielding surface vessels and exiting nerves

71
Q

CSF pathway

A

Lateral ventricles

Intraventricular foramen/ foramen of Monroe

Third ventricle

Cerebral aqueduct/ Sylvian aqueduct

Fourth ventricle

Foramen of magendie and foramina of Luschka

72
Q

Function of CSF

A

Provide buoyancy to reduce momentum and acceleration of the brain when the cranium is suddenly displaced

73
Q

Lumbar makeup of CSF

A

Clear and colorless

70-180mm H2O

0-5 cells/ml

Protein: 15-45mg/dL

Glucose 50-75

74
Q

Ventricular make up of CSF

A

Clear and colorless

79-190mm H2O

0-5 cells/ml

Protein: 5-15mg/dL

Nonprotein nitrogen 10-35

75
Q

Production rate of CSF

A

0.357 ml/min

22 ml/hr

500 ml/day

76
Q

Diencephalon

A

Composed of the thalamus and hypothalamus

77
Q

Number 1

A
  1. Anterior cerebral artery
78
Q

Number 2

A
  1. Anterior communicating artery
79
Q

Number 3

A
  1. Middle cerebral artery
80
Q

Number 4

A
  1. Internal carotid artery
81
Q

Number 5

A
  1. Posterior communicating artery
82
Q

Number 6

A
  1. Posterior cerebral artery
83
Q

Number 7

A
  1. Superior cerebellar artery
84
Q

Number 8

A
  1. Basilar artery
85
Q

Number 9

A
  1. Anterior inferior cerebellar artery
86
Q

Number 10

A
  1. Vertebral artery
87
Q

Number 11

A
  1. Posterior inferior cerebellar artery
88
Q

Number 12

A
  1. Anterior spinal artery
89
Q

C5 and 6 muscle group and how to assess

A

Bicep- elbow flexion

90
Q

C6 and 7 muscle group and how to assess it

A

Tricep- elbow extension

91
Q

C8 muscle group and how to assess

A

Fingers - flexion of fingers

92
Q

T1 motor fiber muscle group and how to assess

A

Fingers- finger extension and abduction

93
Q

How to assess muscle fiber group L2-4

A

Hip adduction

94
Q

How to assess muscle fiber group L4-S1

A

Hip abduction

Neurosciences (5 decks)

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