Ch 25 Neuro Flashcards
Name the 4 lobes and function of the cerebral cortex
Frontal lobe: personality, behaviour, emotions, intellectual function
Parietal lobe: postcentral gyrus for sensation
Occipital lobe: visual reception
Temporal lobe: auditory reception
Wernicke’s area is located in ____ lobe and associated with ______
temporal lobe
language comprehension
Broca’s area is located in ____ and associated with ____
frontal lobe
motor speech
(damage causes expressive aphasia)
The ______ controls temperature, heart rate, BP, regulates sleep, controls autonomic nervous system and emotional state.
The ______ controls motor coordination of voluntary movement, equilibrium and muscle tone.
The ______ is where sensory pathways of the spinal cord and brain stem synapse.
hypothalamus - control station
cerebellum - motor coordination and equilibrium
thalamus - sensory pathways
Brain stem has 3 areas:
_______ merges into thalamus and hypothalamus, has many motor neurons and tracts
_______ contains ascending and descending fibres
_______ is continuation of spinal cord in brain, has vital autonomic centres and nuclei for CN VIII to XII
Midbrain
Pons
Medulla
Pyramidal decussation of motor fibres occurs at ______
Medulla
_________ contains sensory fibres that transmit sensation of pain, temperature, crude/light touch.
spinothalamic
Fibres carrying pain and temperature sensations ascend ______ spinothalamic tract
Fibres carrying crude touch ascend ______ spinothalamaic tract
lateral
anterior
The ________ column carries fibres conducting proprioception, vibration and fine touch (stereognosis)
posterior (dorsal) column
Motor neurons in pyramidal tract (corticospinal) mediate ________ movement
voluntary movement
- very fine eg writing
- skilled and purposeful
Extrapyramidal tract motor fibres maintain _____ and control _____
maintain muscle tone, control body movements (eg walking)
-more primitive motor system
Upper motor neurons are located _______
eg
completely in CNS
-eg corticospinal, corticobulbar, extrapyramidal tract
eg MS, CVA, cerebral paly
Lower motor neurons are located _______
eg
mostly in PNS
-cell body in anterior spinal cord but nerve fibre extends to muscle
eg cranial nerves, spinal nerves
eg spinal cord lesions, poliomyelitis, ALS
What are the 4 types of reflexes? examples?
- DTR eg patellar
- superficial eg corneal, abdominal
- visceral eg pupillary response to light/accommodation
- pathological eg Babinski
The 12 pairs of CN supply primarily ____ and ____ except vagus nerve which supplies ______
majority head and neck
vagus nerve: heart, resp muscles, stomach, gallbladder (think vagus = vagabond)
Sensory afferent fibres enter spinal cord through ____ roots
Motor efferent fibres exit spinal cord through ____ roots
Sensory afferent: posterior (dorsal)
Motor efferent: anterior (ventral)
Dermatomes
Thumb, middle finger, fifth finger: Axilla: Nipple: Umbilicus: Groin: Knee:
Dermatomes
Thumb, middle finder, fifth finger: C6, 7, 8 Axilla: T1 Nipple: T4 Umbilicus: T10 Groin: L1 Knee: L4
Syncope is sudden _______ caused by _____
sudden loss of strength, temp loss of consciousness
caused by lack of cerebral blood flow
True vertigo is sensation of _____ caused by _______
sensation of rotational spinning
caused by neurological disease in vestibular apparatus in ear or vestibular nuclei in brain stem
Paresis is _____
Paralysis is _____
Paresis: weakness of voluntary movements
Paralysis: loss of motor function due to lesion in neurological/muscular system or loss of sensory innervation
Dysmetria is inability to ______
control ROM of muscles
Dysarthria is difficulty with ______
forming words
aphasia = difficulty with language comprehension/expression
What is the sequence of order for complete neuro exam?
MH cranial nerves motor sensory reflexes
CN II optic nerve is tested by:
visual acuity
visual fields by confrontation
fundoscopy
CN III, IV and VI is tested by:
PERRLA
EOM
nystagmus
CN V trigeminal nerve is tested by:
what are the 3 branches?
Motor: clench teeth, separate jaw
sensory: light touch to 3 areas, corneal reflex
V1: ophthalmic
V2: maxillary
V3: mandibular
Corneal reflex tests ____ and _____
sensory afferent CN V
motor efferent CN VII
CN VII facial nerve is tested by:
motor: make faces - also against resistance
sensory: not routine, taste
CN VIII auditory nerve is tested by:
whisper test
Weber, Rinne
CN IX and X is tested by:
motor: ahhhh, gag reflex
sensory: not routine, taste posterior third
CN XI spinal accessory nerve is tested by:
sternomastoid and trapezius muscle
- rotate against resistance
- shrug shoulders
CN XII hypoglossal nerve is tested by:
- tongue
- light tight dynamite
How do you test posterior column tract?
- vibration
- position
- stereognosis, graphesthesia, two point discrimination for fine tactile touch
What is extinction?
ability to recognize two simultaneous stimuli
-sensory cortex lesion will “extinguish” stimulus on side opposite lesion
Define clonus
Hyperreflexia occurs with ____ motor neuron lesions
Hyporeflexia occurs with ____ motor neuron lesions
-rapid rhythmic contractions of same muscle
Hyperreflexia: upper
Hyporeflexia: lower
Spinal nerves:
- biceps reflex
- triceps reflex
- brachioradialis reflex:
- patellar reflex
- ankle reflex
biceps: C5-6
triceps: C7-8
brachioradialis: C5-6
patellar: L2-L4
ankle: L5 - S2
Superficial cutaneous reflexes are absent with diseases of ____ tract
Abdominal reflexes:
tests spinal nerves _____ (upper) _____ (lower)
cremasteric reflex:
tests spinal nerves ____
plantar reflex:
tests spinal nerves _____
superficial: absent with pyramidal tract
upper: T8-T10
lower: T0-T12
cremasteric: L1-L2 (elevation of ipsilateral testicle)
plantar: L4-S2
Define and give example of cause
- flaccidity
- spasticity
- ridigity
flaccidity: decreased muscle tone, muscle is soft and flabby, weak eg LMN injury
spasticity: increased muscle tone, clasp knife (increased resistance then suddenly gives way) eg UMN injury
rigidity: constant state of resistance (lead pipe) to passive movement in any direction eg extrapyramidal motor tract injury
Intention tremor is ____ with voluntary movement.
Resting tremor ______ with voluntary movement
Intention: worse
Resting: partly/completely disappears
_____ is sudden, rapid, jerky purposeless movement, irregular - accentuated with voluntary movement
____ is slow writhing twisting continuous movement
Chorea
Athetosis
Hemiplegia occurs from damage to ______ tract.
______ motor neuron damage occurs _____ pyramidal decussation so motor impairment is on ____ side
damage to corticospinal tract
- upper motor neuron damage
- above pyramidal decussation
- motor impairment on contralateral side
What function is affected by:
- dysphonia
- dysarthria
- aphasia
dysphonia: voice (articulation intact) - speaking
dysarthria: articulation (language intact) - saying
aphasia: language comprehension and expression - understanding
Broca’s aphasia is _____ aphasia.
Able to ____ but cannot _____
expressive
can understand, cannot express with language
repetition and reading aloud is impaired
listening/reading comprehension intact
Wernicke’s aphasia is _____ aphasia
Able to ____ abut cannot _______
receptive
can speak but cannot relate them to previous experiences
speech is fluent, effortless but doesn’t make sense
repetition, reading, writing impaired
Reflex arc:
Tapping the tendon stretches ______ in muscle to activates _____ nerve —-> signal travels through ____ root into spinal cord.
At the spinal cord, they synapse with motor neuron in ____ horn
Motor efferent fibres leave via ____ root and travel to muscle
muscles spindles
sensory afferent nerve –> dorsal root –> synapse at anterior horn –> motor efferent fibres leave via ventral root –> muscle
