Ch 24 Neurologic sys Jarvis

Question 1

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.

Answer 1

peripheral nervous system

Question 2

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

Answer 2

frontal lobe

Question 3

has areas responsible for sensation

Answer 3

parietal lobe

Question 4

lobe is responsible for visual reception

Answer 4

occipital

Question 5

lobe is responsible for hearing, taste, and smell

-behind the ear has the primary auditory reception center

Answer 5

temporal

Question 6

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

Answer 6

cerebral cortex

Question 7

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

Answer 7

Myelin

Question 8

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

Answer 8

cerebral cortex

Question 9

Each half of the cerebrum is a ?;

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

Answer 9

hemisphere

Question 10

Each hemisphere is divided into four lobes:

Answer 10

frontal, parietal, temporal, and occipital

Question 11

precentral gyrus of the frontal lobe initiates

Answer 11

voluntary movement

Question 12

parietal lobe’s postcentral gyrus is the primary center for

Answer 12

sensation

Question 13

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

Answer 13

Wernicke’s area

Question 14

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.

Answer 14

Broca’s area

Question 15

cerebral artery becomes occluded

Answer 15

(ischemic stroke)

Question 16

vascular bleeding

Answer 16

(hemorrhagic stroke)

Question 17

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

Answer 17

basal ganglia

Question 18

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).

Answer 18

basal ganglia

Question 19

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.

Answer 19

thalamus

Question 20

(sites of contact between two neurons)

Answer 20

synapses

Question 21

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.

Answer 21

hypothalamus

Question 22

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.

Answer 22

cerebellum

Question 23

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

Answer 23

brainstem

Question 24

Brainstem has 3 areas:

Answer 24

1. Midbrain
2. Pons
3. Medulla

Question 25

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.

Answer 25

Midbrain

Question 26

—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.

Answer 26

Pons

Question 27

—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

Answer 27

Medulla

Question 28

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

Answer 28

spinal cord

Question 29

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.”

Answer 29

spinal cord

Question 30

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).

Answer 30

vertebral canal

Question 31

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

Answer 31

Crossed representation (pathway of CNS)

Question 32

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

Answer 32

anterolateral tract

Question 33

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

Answer 33

Posterior (Dorsal) Columns.

Question 34

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

Answer 34

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

Question 35

—You can feel vibrating objects

Answer 35

Vibration//Posterior (Dorsal) Columns.

Question 36

—Without looking you can identify familiar objects by touch

Answer 36

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

Question 37

Pain originating in the spleen is felt on the

Answer 37

top of the left shoulder.

Question 38

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

Answer 38

Corticospinal fibers (in motor cortex)

Question 39

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

Answer 39

somatotopic organization.

Question 40

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.

Answer 40

Upper motor neurons (UMNs)

Question 41

Examples of UMN diseases are

Answer 41

stroke, cerebral palsy, and multiple sclerosis.

Question 42

maintains muscle tone for gross automatic movements, such as walking

Answer 42

extrapyramidal tract

Question 43

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).

Answer 43

Basal Ganglia.

Question 44

are located mostly in the peripheral nervous system

Answer 44

Lower motor neurons (LMNs)

Question 45

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.

Answer 45

LMN

Question 46

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

Answer 46

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

Question 47

is a bundle of fibers outside the CNS

Answer 47

nerve

Question 48

(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.

Answer 48

3 types of Reflex Arc

Question 49

(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

Answer 49

deep tendon

Question 50

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

Answer 50

Cranial nerves

Question 51

Cranial nerves I and II extend from the

Answer 51

cerebrum

Question 52

cranial nerves III through XII extend from the

Answer 52

midbrain and brainstem.

Question 53

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

Answer 53

Spinal Nerves

Question 54

is the cutaneous distribution of the various spinal nerves.

Answer 54

Dermal segmentation

Question 55

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

Answer 55

dermatome

Question 56

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

Answer 56

C6, C7, and C8

Question 57

axilla is at the level of

Answer 57

T1

Question 58

nipple is at the level of

Answer 58

T4.

Question 59

umbilicus is at the level of

Answer 59

T10

Question 60

groin is in the region of

Answer 60

L1

Question 61

knee is at the level of

Answer 61

L4.

Question 62

peripheral nervous system divided 2

Answer 62

somatic and autonomic

Question 63

innervate the skeletal (voluntary) muscles

Answer 63

somatic fibers

Question 64

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

Answer 64

autonomic fibers (unconscious activity)

Question 65

Motor activity in the newborn is under the control of the

Answer 65

spinal cord and medulla

Question 66

(infants) Movements are directed primarily by

Answer 66

primitive reflexes

Question 67

(infants)cerebral cortex develops during the

Answer 67

first year

Question 68

(infants)process of myelinization follows a

Answer 68

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

Question 69

order in which we observe the infant gaining motor control

Answer 69

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

Question 70

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.

Answer 70

aging process

Question 71

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

Answer 71

aging process

Question 72

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

Answer 72

Concussion

Question 73

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

Answer 73

Syncope

Question 74

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

Answer 74

vertigo

Question 75

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

Answer 75

Seizures

Question 76

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

Answer 76

Aura

Question 77

is a partial or incomplete paralysis.

Answer 77

Paresis

Question 78

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

Answer 78

Paralysis

Question 79

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

Answer 79

Dysmetria

Question 80

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

Answer 80

Paresthesia

Question 81

is difficulty forming words

Answer 81

Dysarthria

Question 82

is difficulty with language com­prehension or expression

Answer 82

dysphasia

Question 83

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

Answer 83

Seizures

Question 84

Tested at 1 year. Chronically elevated lead levels cause

Answer 84

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

Question 85

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

Answer 85

Aging Adult

Question 86

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

Answer 86

Micturition syncope

Question 87

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

Answer 87

Anosmia

Question 88

Unilateral loss of smell in the absence of nasal disease is

Answer 88

neurogenic anosmia

Question 89

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

Answer 89

Tone

Question 90

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

Answer 90

Ptosis (drooping)

Question 91

with increased intracra­nial pressure

Answer 91

Papilledema

Question 92

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

Answer 92

Increasing intracranial pressure

Question 93

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

Answer 93

Nystagmus

Question 94

Slow, clumsy, and sloppy response is termed | - occurs with cerebellar disease.

Answer 94

dysdiadochokinesia

Question 95

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

Answer 95

Dysmetria

Question 96

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

Answer 96

positive Romberg sign

Question 97

is an uncoordinated or unsteady gait

Answer 97

Ataxia

Question 98

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

Answer 98

Homans sign

Question 99

—Decreased pain sensa­tion.

Answer 99

Hypoalgesia

Question 100

—Absent pain sensation.

Answer 100

Analgesia

Question 101

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,

Answer 101

peripheral neu­ropathy

Question 102

, which has a clear zone of deficit for its dermatome

Answer 102

specific nerve lesion

Question 103

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

Answer 103

Astereognosis

Question 104

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

Answer 104

Graphesthesia

Question 105

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

Answer 105

Test the Reflexes

Question 106

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

Answer 106

Clonus

Question 107

, frequent consecutive stimuli are perceived as one strong stimulus.

Answer 107

summation

Question 108

normal response of the triceps reflex is

Answer 108

extension of the forearm

Question 109

normal response of the biceps reflex causes

Answer 109

flexion of the forearm

Question 110

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

Answer 110

Landau reflex