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Mental status > Ch 24 Neurologic sys Jarvis > Flashcards

Ch 24 Neurologic sys Jarvis Flashcards

1
Q

carries sensory (afferent) messages to the CNS from sensory receptors, motor (efferent) messages from the CNS out to muscles and glands, and autonomic messages that govern the internal organs and blood vessels.

A

peripheral nervous system

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2
Q

has areas responsible for personality, behavior, emotions, and intellectual function

A

frontal lobe

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3
Q

has areas responsible for sensation

A

parietal lobe

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4
Q

lobe is responsible for visual reception

A

occipital

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5
Q

lobe is responsible for hearing, taste, and smell

-behind the ear has the primary auditory reception center

A

temporal

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6
Q

is the outer layer of nerve cell bodies; it looks like “gray matter” because it lacks myelin

A

cerebral cortex

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7
Q

is the white insulation on the axon that increases the conduction velocity of nerve impulses.

A

Myelin

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8
Q

is the center for a human’s highest functions, governing thought, memory, reasoning, sensation, and voluntary movement

A

cerebral cortex

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9
Q

Each half of the cerebrum is a ?;

-the left hemisphere is dominant in most (95%) people, including those who are left-handed

A

hemisphere

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10
Q

Each hemisphere is divided into four lobes:

A

frontal, parietal, temporal, and occipital

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11
Q

precentral gyrus of the frontal lobe initiates

A

voluntary movement

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12
Q

parietal lobe’s postcentral gyrus is the primary center for

A

sensation

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13
Q

in the temporal lobe is associated with language comprehension. When damaged in the person’s dominant hemisphere, receptive aphasia results. The person hears sound, but it has no meaning, like hearing a foreign language

A

Wernicke’s area

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14
Q

in the frontal lobe mediates motor speech. When injured in the dominant hemisphere, expressive aphasia results; the person cannot talk. The person can understand language and knows what he or she wants to say but can produce only a garbled sound.

A

Broca’s area

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15
Q

cerebral artery becomes occluded

A

(ischemic stroke)

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16
Q

vascular bleeding

A

(hemorrhagic stroke)

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17
Q

are large bands of gray matter buried deep within the two cerebral hemispheres that form the subcortical-associated motor system (the extrapyramidal system)

A

basal ganglia

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18
Q

help to initiate and coordinate movement and control automatic associated movements of the body (e.g., the arm swing alternating with the legs during walking).

A

basal ganglia

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19
Q

is the main relay station where the sensory pathways of the spinal cord, cerebellum, basal ganglia, and brainstem form synapses (sites of contact between two neurons) on their way to the cerebral cortex. It is an integrating center with connections that are crucial to human emotion and creativity.

A

thalamus

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20
Q

(sites of contact between two neurons)

A

synapses

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21
Q

is a major respiratory center with basic vital functions: temperature, appetite, sex drive, heart rate, and blood pressure (BP) control; sleep center; anterior and posterior pituitary gland regulator; and coordinator of autonomic nervous system activity and stress response.

A

hypothalamus

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22
Q

is a coiled structure located under the occipital lobe that is concerned with motor coordination of voluntary movements, equilibrium (i.e., the postural balance of the body), and muscle tone

  • “automatic pilot” on an airplane in that it adjusts and corrects
  • corrects the voluntary movements but operates entirely below the conscious level.
A

cerebellum

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23
Q

is the central core of the brain consisting of mostly nerve fibers
-Cranial nerves III through XII originate from nuclei in the brainstem

A

brainstem

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24
Q

Brainstem has 3 areas:

A
  1. Midbrain
  2. Pons
  3. Medulla
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25
Q

The most anterior part of the brainstem that still has the basic tubular structure of the spinal cord. It merges into the thalamus and hypothalamus. It contains many motor neurons and tracts.

A

Midbrain

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26
Q

—The enlarged area containing ascending sensory and descending motor tracts. It has two respiratory centers (pneumotaxic and apneustic) that coordinate with the main respiratory center in the medulla.

A

Pons

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27
Q

—The continuation of the spinal cord in the brain that contains all ascending and descending fiber tracts. It has vital autonomic centers (respiration, heart, gastrointestinal function) and nuclei for cranial nerves VIII through XII. Pyramidal decussation (crossing of the motor fibers) occurs here

A

Medulla

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28
Q

is the long, cylindric structure of nervous tissue about as big around as your little finger. It occupies the upper 2/3 of the vertebral canal from the medulla to lumbar vertebrae L1-L2

A

spinal cord

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29
Q

its white matter is bundles of myelinated axons that form the main highway for ascending and descending fiber tracts that connect the brain to the spinal nerves. It mediates reflexes of posture control, urination, and pain response. Its nerve cell bodies, or gray matter, are arranged in a butterfly shape with anterior and posterior “horns.”

A

spinal cord

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30
Q

continues down beyond the spinal cord for several inches. The lumbar cistern is inside this space and is the favored spot to withdraw samples of cerebrospinal fluid (CSF).

A

vertebral canal

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31
Q

is a notable feature of the nerve tracts; the left cerebral cortex receives sensory information from and controls motor function to the right side of the body, whereas the right cerebral cortex likewise interacts with the left side of the body

A

Crossed representation (pathway of CNS)

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32
Q

(formerly spinothalamic) contains sensory fibers that transmit the sensations of pain, temperature, itch, and crude touch
-(i.e., not precisely localized).

A

anterolateral tract

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33
Q

fibers conduct the sensations of position, vibration, and finely localized touch.

A

Posterior (Dorsal) Columns.

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34
Q

—Without looking you know where your body parts are in space and in relation to one another

A

Position (proprioception)//Posterior (Dorsal) Columns.

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35
Q

—You can feel vibrating objects

A

Vibration//Posterior (Dorsal) Columns.

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36
Q

—Without looking you can identify familiar objects by touch

A

Finely localized touch (stereognosis)//Posterior (Dorsal) Columns.

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37
Q

Pain originating in the spleen is felt on the

A

top of the left shoulder.

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38
Q

mediate voluntary movement, particularly very skilled, discrete, purposeful movements such as writing.

A

Corticospinal fibers (in motor cortex)

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39
Q

origin of the tract in the motor cortex is arranged in a specific pattern called

A

somatotopic organization.

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40
Q

are a complex of all the descending motor fibers that can influence or modify the lower motor neurons. They are located completely within the CNS.

A

Upper motor neurons (UMNs)

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41
Q

Examples of UMN diseases are

A

stroke, cerebral palsy, and multiple sclerosis.

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42
Q

maintains muscle tone for gross automatic movements, such as walking

A

extrapyramidal tract

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43
Q

form the subcortical-associated motor system (the extrapyramidal system) They help to initiate and coordinate movement and control automatic associated movements of the body (e.g., the arm swing alternating with the legs during walking).

A

Basal Ganglia.

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44
Q

are located mostly in the peripheral nervous system

A

Lower motor neurons (LMNs)

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45
Q

is the “final common pathway” because it funnels many neural signals here and provides the final direct contact with the muscles. Any movement must be translated into action by LMN fibers.

A

LMN

46
Q

Examples of LMNs are cranial nerves and spinal nerves of the peripheral nervous system. Examples of LMN diseases are

A

Bell palsy in the face (cranial nerve VII), spinal cord lesions, and poliomyelitis.

47
Q

is a bundle of fibers outside the CNS

A

nerve

48
Q

(1) Stretch or/deep tendon reflexes (myotatic), e.g., patellar (or knee jerk)
(2) superficial (cutaneous), e.g., plantar reflex;
(3) visceral (organic), e.g., pupillary response to light and accommodation.

A

3 types of Reflex Arc

49
Q

(myotatic, or stretch) reflex has 5 components: (1) an intact sensory nerve (afferent), (2) a functional synapse in the cord, (3) an intact motor nerve fiber (efferent), (4) the neuromuscular junction, and (5) a competent muscle

A

deep tendon

50
Q

are LMNs that enter and exit the brain rather than the spinal cord

A

Cranial nerves

51
Q

Cranial nerves I and II extend from the

A

cerebrum

52
Q

cranial nerves III through XII extend from the

A

midbrain and brainstem.

53
Q

8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal

A

Spinal Nerves

54
Q

is the cutaneous distribution of the various spinal nerves.

A

Dermal segmentation

55
Q

is a circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve . The dermatomes overlap, which is a form of biologic insurance, i.e., if one nerve is severed, most of the sensations can be transmitted by the one above and the one below

A

dermatome

56
Q

thumb, middle finger, and fifth finger are each in the dermatomes of

A

C6, C7, and C8

57
Q

axilla is at the level of

A

T1

58
Q

nipple is at the level of

A

T4.

59
Q

umbilicus is at the level of

A

T10

60
Q

groin is in the region of

A

L1

61
Q

knee is at the level of

A

L4.

62
Q

peripheral nervous system divided 2

A

somatic and autonomic

63
Q

innervate the skeletal (voluntary) muscles

A

somatic fibers

64
Q

innervate smooth (involuntary) muscles, cardiac muscle, and glands

A

autonomic fibers (unconscious activity)

65
Q

Motor activity in the newborn is under the control of the

A

spinal cord and medulla

66
Q

(infants) Movements are directed primarily by

A

primitive reflexes

67
Q

(infants)cerebral cortex develops during the

A

first year

68
Q

(infants)process of myelinization follows a

A

cephalocaudal and proximodistal order (head, then neck, trunk, and out to extremities)

69
Q

order in which we observe the infant gaining motor control

A

(lifts head, lifts head and shoulders, rolls over, moves whole arm, uses hands, walks)

70
Q

causes a general atrophy with a steady loss of neuron structure in the brain and spinal cord
-touch and pain sensation, taste, and smell may be diminished.

A

aging process

71
Q

Reductions in brain volume are normal in healthy aging, but more increased atrophy occurs with AD
- accompanied by a progressive decrease in cerebral blood flow and oxygen consumption= dizziness

A

aging process

72
Q

comes from a direct blow that causes rotation of the brain inside the skull and shear injury

A

Concussion

73
Q

is a sudden loss of strength, a temporary loss of consciousness (a faint) caused by lack of cerebral blood flow, e.g., low BP.

A

Syncope

74
Q

is rotational spinning caused by neurologic disease in the vestibu­lar apparatus in the ear or the vestibular nuclei in the brainstem.

A

vertigo

75
Q

occur with epilepsy, a par­oxysmal disease characterized by altered or loss of consciousness, involuntary muscle movements, and sensory disturbances.

A

Seizures

76
Q

is a subjective sensation that pre­cedes a seizure; it could be auditory, visual, or motor

A

Aura

77
Q

is a partial or incomplete paralysis.

A

Paresis

78
Q

is a total loss of motor function caused by a lesion in the neurologic or muscular system or loss of sensory inner­vation.

A

Paralysis

79
Q

is the inability to control the distance, power, and speed of a muscular action

A

Dysmetria

80
Q

is an abnormal sensation (e.g., burning, tingling).

A

Paresthesia

81
Q

is difficulty forming words

A

Dysarthria

82
Q

is difficulty with language com­prehension or expression

A

dysphasia

83
Q

may occur with high fever in infants and toddlers. Or they may be a sign of neurologic disease.

A

Seizures

84
Q

Tested at 1 year. Chronically elevated lead levels cause

A

developmental delay or loss of a newly acquired skill or may be asymptomatic.

85
Q

Decreased blood to brain (orthostatic hypotension) increases the risk for falls. Major risks for falls: balance and gait disorder, polypharmacy, history of recent falls. Other risks: older age, female, poor vision, cognitive decline, environmental clutter, and alcohol use

A

Aging Adult

86
Q

get up at night and then feel faint while standing to urinate

A

Micturition syncope

87
Q

—Decrease or loss of smell occurs bilaterally with tobacco smoking, allergic rhinitis, and cocaine use.

A

Anosmia

88
Q

Unilateral loss of smell in the absence of nasal disease is

A

neurogenic anosmia

89
Q

is the normal degree of tension (contraction) in voluntarily relaxed muscles

A

Tone

90
Q

occurs with myas­thenia gravis, dysfunction of cranial nerve III, or Horner syndrome

A

Ptosis (drooping)

91
Q

with increased intracra­nial pressure

A

Papilledema

92
Q

causes a sudden, unilateral, dilated, and nonreactive pupil.

A

Increasing intracranial pressure

93
Q

occurs with disease of the vestibular system, cerebellum, or brainstem.

A

Nystagmus

94
Q

Slow, clumsy, and sloppy response is termed

- occurs with cerebellar disease.

A

dysdiadochokinesia

95
Q

is clumsy movement with overshooting the mark and occurs with cerebellar disorders, alcohol intoxicatio

A

Dysmetria

96
Q

is a loss of balance that is increased by the closing of the eyes.
-occurs with cerebellar ataxia (multiple sclerosis, alcohol intoxi­cation), loss of proprioception, and loss of vestibular function

A

positive Romberg sign

97
Q

is an uncoordinated or unsteady gait

A

Ataxia

98
Q

is used to test the legs for deep-vein thrombosis.

A

Homans sign

99
Q

—Decreased pain sensa­tion.

A

Hypoalgesia

100
Q

—Absent pain sensation.

A

Analgesia

101
Q

Loss of vibra­tion sense occurs with ? (e.g., diabetes and alcoholism). Often this is the first sensation lost.
-worse at the feet and gradually improves as you move up the leg,

A

peripheral neu­ropathy

102
Q

, which has a clear zone of deficit for its dermatome

A

specific nerve lesion

103
Q

—Inability to identify object correctly. Occurs in sensory cortex lesions (e.g., stroke).

A

Astereognosis

104
Q

is the ability to “read” a number by having it traced on the skin
-inability to do it = sensory cortex lesion

A

Graphesthesia

105
Q

4+ Very brisk, hyperactive with clonus, indicative of disease

3+ Brisker than average, may indicate disease, probably normal

2+ Average, normal

1+ Diminished, low normal, or occurs only with reinforcement

0 No response

A

Test the Reflexes

106
Q

is a set of rapid, rhythmic contractions of the same muscle

A

Clonus

107
Q

, frequent consecutive stimuli are perceived as one strong stimulus.

A

summation

108
Q

normal response of the triceps reflex is

A

extension of the forearm

109
Q

normal response of the biceps reflex causes

A

flexion of the forearm

110
Q

3 months of age, the infant raises the head and arches the back as if in a swan dive. This response is the

A

Landau reflex

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