Chapter 10 nervous system Flashcards
The nervous system is complex with ____________ nerve cells
10 billion
The NS carries ______ messages
electrical
The NS has _______ and _______ functions
involuntary
voluntary
What are microscopic cells collected together into macroscopic structures that carry electrical messages?
nerves/neurons
Two major NS divisions
CNS and PNS
The CNS is composed of (2)
brain
spinal cord
The PNS is composed of (4)
cranial nerves
spinal nerves
plexuses
Peripheral nerves
______ nerves carry messages towards the brain
sensory
____ nerves carry messages away from the brain
motor
______ nerves carry both sensory and motor fibers
mixed
What carries impulses from the CNS to the organs
ANS
What nerves stimulate the body under stress
sympathetic
What nerves balance the sympathetic system by slowing HR and lowering BP
Parasympathetic
How many pairs of cranial nerves are there
12
how many pairs of spinal nerves are there
31
What is an individual nerve cell with dendrites, cell nucleus, and axon
neuron
What covers around the axon (2)
myelin sheath
neurilemma
What part of the neuron secretes neurotransmitters?
terminal end fibers
neurotransmitters transfer impulse across the _________ (gap at end)
synapse
What are small clusters of nerve cell bodies called?
ganglia
What cells maintain the health of the nervous system and do not transmit impulses?
Glial cells
What are the 4 types of glial cells?
Astrocytes
Microglia
Oligodendroglia
Ependymal Cells
What is the largest section of the brain that manages speech, vision, smell, movement, hearing, and thought?
cerebrum
The surface nerve cells of the cerebrum are called?
cerebral cortex
What part of the brain coordinates voluntary movement and maintains balance?
Cerebellum
What part of the brain integrates and monitors impulses from skin (pain)
thalamus
What part of the brain controls body temp, sleep, appetite, sexual desire, emotions hormones from the pituitary gland, and monitors sympathetic and parasympathetic nervous systems.
Hypothalamus
What are the 3 parts of the brainstem?
Pons, midbrain, medulla oblongata
What are of the brainstem bridges the cerebrum and cerebellum with the rest of the brain
pons
What part of the brainstem houses nerves for face and eyes
pons
What part of the brainstem is the uppermost portion and contains pathways connecting the cerebrum with lower portions of the brain
midbrain
What part of the brainstem connects the spinal cord to the brain and nerve tracts from side to side?
medulla oblongata
What are the 3 things the medulla oblongata regulates?
blood vessels
heart
respiratory
What neurotransmitter chemical is released at ends of nerve cells (starts with letter a)
acetylcholine
What neurons carry messages toward the brain and spinal cord (sensory)
afferent
What is the middle layer of the meninges?
arachnoid mater
What are glial cells that transport water and salts from capillaries
astrocytes
What are nerves that control involuntary body functions of muscles, glands, and internal organs
ANS
What are microscopic fibers that carries nervous impulse along a nerve cell
axon
What is the protective separation between the blood and brain cells the keeps substances (such as anticancer drugs) from penetrating capillary walls and entering the brain
blood brain barrier
What is the posterior portion of the brain that connects that cerebrum with the spinal cord
brainstem
What is the microscopic fiber collection of spinal nerves below the end of the spinal cord that carries the nervous impulse along a nerve sell
cauda equina
What is the part of a nerve cell that contains the nucleus
cell body
The brain and the spinal cord together make up the ________
CNS
What is the posterior part of the brain that coordinates muscle movements and maintains balance
cerebellum
What is the outer region of the cerebrum, that contains sheet of nerve cells; gray matter
cerebral cortex
What fluid circulates through the brain and spinal cord
cerebrospinal fluid
12 pairs; carry messages to and from the brain with regard to the head and neck (except vagus nerve)
cranial nerves
What is the microscopic branching fiber of a nerve cell, the first part to receive the nerve impulse
dendrite
What is the thick outermost layer of the meninges surrounding and protecting the CNS
dura mater
What neuron carries messages away from the CNS (motor)
efferent nerve
What are glial cells that lines the membranes within the CNS and help form CSF
ependymal cell
What is the collection of nerve cell bodies in the PNS
ganglion
What is the supportive and connective nerve cell that does not carry nervous impulses, that can reproduce itself
glial cells
What is the sheet of nerve cells that produces a rounded ridge on the surface of the cerebral cortex, convolution
gyrus
What are the 3 protective membrane layers that surround that brain and spinal cord
meninges
What glial cells of phagocytic and remove wastes from the CNS
microglial cell
What is a glial cell that forms the myelin sheath covering axons
Oligodendrocytes
What are involuntary, autonomic nerves that regulate normal body functions such as HR, breathing, and GI muscles
Parasympathetic nervous
what is the essential, distinguishing tissue of any organ or system
parenchyma
What is the thin delicate inner membrane of the meninges
pia mater
A large interlacing network of nerves
plexus
What is the nerve extending from the base of the spine down the thigh, lower leg, and foot
Sciatic nerve
What are the 31 pairs arising from the spinal cord called
spinal nerves
An agent of change in internal or external environment that evokes a response
Stimulus
what is the connective and supporting tissue of an organ
stroma (stromal tissue)
What is the depression or groove in the surface of the cerebral cortex; fissure
sulcus
What are the autonomic nerves that influence bodily functions involuntary in times of stress
sympathetic nerves
What is the main relay center of teh brain
thalamus
What is the 10th cranial nerve that branchs down into chest and abdomen
vagus nerve
What are the canals in the brain that contain cerebrospinal fluid
ventricles of the brain
What is the abnormal accumulation of CSF fluid in the brain that causes enlarged head and small face
hydrocephalus
What is placed to remove pressure on the brain for hydrocephalus
Ventriculoperitoneal shunt
Hydrocephalus can occur in adults from what 2 things?
infection
tumors
What condition is the incomplete closure of the vertebral column during embryogenesis, resulting in exposure of meninges and spinal cord
spina bifida
What are the 3 types of spina bifida
SB occulta
SB cystica with meningocele
SB cystica with myelomeningocele
What spina bifida is where the posterior vertebrae have not fused, so may see mole, simple, or patch of hair over area
SB occulta
What type of spina bifida has an external protruding sac containing meninges and CSF
SB cystica with meningocele
What type of Spina bifida has an external protruding sac with meninges, CSF, and spinal cord, often associated with paralysis and hydrocephalus
SB cystica with myelomeningocele
What are serious congenital anomalies of the NS, which occur during the first 4 weeks of gestation that result from faulty formation of the _________
neural tube
What is a environmental factor that is strongly associated with neural tube defects
folic acid deficiency
What is a chronic progressive disorder that causes progressive impairment of intellectual function that may compromise language and memory, behavior, and cognition
Alzheimer’s Disease
Alzheimers disease accounts for ______% of all cases of dementia
> 50%
The cause of alzheimers is ______
unknown
Alzheimers can be associated with a symptom of loss of expression also called
masked faces
What is a degenerative disease which affects the upper and lower motor neurons
amyotrophic lateral sclerosis (ALS)
ALS signs and symptoms
Debilitating motor functions
including difficulty walking, swallowing, atrophy
What is an abnormal paroxysmal neuronal discharge in the brain, which may cause a transient disturbance of cerebral function
Seizure
Seizures are classified as ______ or _______
partial or generalized
What seizures are limited to a part of a cerebral hemisphere and can be simple or complex
partial seizure
What are the 4 types of generalized seizures
absence (petit mal)
Febrile
Tonoclonic (grand mal)
Status epilepticus (prolonged and not stopping)
What is the condition of having seizures called?
epilepsy
After seizures (postictal) patients often have _______
weakness
What is contralateral postictal paralysis called
Todds paralysis
What is an inherited disease characterized by dementia and chorea that has a gradual onset and slow progress
Huntingtons disease
Huntington’s disease symptoms typically dont develop until after what age
30
Huntingtons disease is autosomal dominant with a marker on chromosome ________
4
S/S of Huntington’s (theres a million)
chorea
Dysphagia
dysarthria
mind impairment
Excretion incompetance
There is a cure for Huntintons (T/F)
F
What is an inflammatory progressive demyelination of the white matter of the brain and spinal cord resulting in multiple neurological signs and symptoms?
Multiple Sclerosis
The cause of MS is known? (T/F)
F
What are risk factors for MS (4)
<55y/old, western European, possibly familial, immunologic basis
S/S of MS
weaknss
numbness
tingling
unsteadiness
spastic paraparesis
diplopia
disequillibrium
optic neuritis
—– WAX AND WANING
What is used to Dx MS
lesions on MRI
use LP
What is a disorder of the neuromuscular junction resulting in a pure motor syndrome characterized by weakness and fatigue of eyes, face, respiratory ect
myasthenia gravis
Myasthenia gravis is what kind of disorder
autoimmune
In Myasthenia gravis, Ab block the ability of _____ to transmit neural impulse from nerve to muscle cell
Acetylcholine
Myasthenia gravis peaks in what decade:
Females ___
Males ___
3rd
5th
S/S of Myasthenia gravis
ptosis
diplopia
facial weakness
chewing fatigue
dysphagia, phonia, arthria
weakness in limbs, neck, repiratory failure
What is a partial or complete loss of motor function called?
Palsy / paralysis
What palsy involved damage to the cerebrum during gestation/birth
cerebral palsy
What palsy is unilateral facial paralysis secondary to a problem with the facial nerve
Bells palsy
What is a chronic degenerative disease of basal ganglia , characterized by fine slowly spreading tremor, muscle weakness, shuffling gait, and postural instability
parkinsons
What is parkinsons also called
paralysis agitans
What are the causes of parkinsons (3)
unknown
associated dopamine depletion
exposure to toxins
Parkinsons S/S
masked facies
positive myerson sign ( blink from tapping nose)
Pill rolling resting tremor
shuffling gait
bradykinesia
What is a hereditary chronic neuromuscular disorder consisting of various motor and vocal tics
tourette syndrome
Tourettes tics stay the same all the time (T/F)
F
What is a disease usually presenting as a painful unilateral dermatomal eruption
Shingles (herpes Zoster)
Shingles is a reactivation of what dormant virus
Varicella zoster
S/S of shingles
Prodromal phase
-tingling
-itching
-boring knifelike pain
acute phase
- fatigue
-HA
-dermatomal rash
What is inflammation of the membranes of the brain and spinal cord
meningitis
What are causes of meningitis
viral, bacterial, or fungal infections
S/S of meningitis
HA
fever
sensorial disturbances
neck and back stiffness
positive kerning and Brudzinski sign
What Dx meningitis
CBC
blood culture
CXR
LP
—-CT BEFORE LP if space occupying lesion
What is the most common type of brain tumor in adults, and most common cause of new onset seizure in middle age
glioblastoma
What are the two neurologic complications from the human immunodeficiency virus?
HIV encephalopathy and AIDS dementia
HIV complications can occur from HIV itself or other ________
opportunistic infections
Less than ______th glioblastoma patients survive >1 year
1/5
S/S of glioblastoma
hemiparesis
seizures
confusion
obtundation
HA
DX glioblastoma what two ways
CT or MRI
What is a benign brain tumor arising from arachnoid cells
meningiomas
Meningiomas are usually asymptomatic (T/F)
T
Meningiomas usually do not produce bone erosion (T/F)
T
What diagnoses meningiomas (2)
CT
MRI
What is traumatic damage to the brain where the patient has a loss of consciousness >2 minutes
CNS trauma
What injury may cause increased ICP, seizure, cerebral edema, and intracranial hematoma
cerebral injury
What is caused by a tear of the veins between the dura and arachnoid membrane, usually from blunt trauma
Subdural hematoma
Subdural hematoma S/S
change in mental status
Focal neurological signs
unreactive pupils with ophthalmoplegia
possible seizure
What is caused by a tear of the middle meningeal artery or venous sinus, between the skull and dura, after skull fracture
epidural hematoma
Epidural hematomas are lethal if ______
untreated
What is it called with epidural hematomas where there is a recovery followed by a progressive gradual decline until coma (what is the recovery called)
transient
Epidural hematomas show a __________ on CT and MRI
concave blood clot
What is a sudden developing neurological deficit usually related to impaired cerebral blood flow
stroke/ CVA
Stroke is the _______ leading cause of death in the US
3rd
What are causes of strokes
carotid atherosclerosis
hypercoagulable states
oral contraceptive
HTN
drugs
What are the 3 kinds of strokes
thrombotic
embolic
hemorrhagic
Risk factors for stroke include
7/8th decade
HTN
DM
hypercoagulable (smoker)
family Hx
What are neurological deficits caused by ischemia that lasts <24 hrs , usually less than 2 hours and are related to CVA
Transient cerebral ischemia
What are causes of TIA
embolus formation
cardiac causes
hematologic causes
TIA S/S
onset and abrupt
vertebrobasilar ischemia vs carotid artery ischemia
What is a severe reoccurring unilateral vascular headache
migraine
What are the 3 types of migraine
classic
common
basilar
Migraine POUND acronym
pulsatile,
onset abrupt
unilateral
N/V
Duration 4-72 hours
What is a clear colorless fluid formed within the ventricles of the brain
CSF
What produces 70% of CSF
choroid plexus
How much CSF is produced daily
500ml
how much CSF is present in the system at 1 time
90-150 ml
Where does reabsorption of CSF occur
arachnoid villi
Fxns of CSF
shock absorber
regulate ICP
supply nervous tissue nutrients
remove wastes
What is CSF removed with?
LP
What is Xray imaging of arterial blood vessels in the brain
cerebral angiography
Cerebral angiogrpahy injects contrast to Dx these 3 things
hemorrhage
aneurysm
occulsions
CT is better than MRI of the brain for acute hemorrhage and subarachnoid space (T/F)
T
CT is best after trauma for how long
1-3 days
MRI is better than CT for posterior fossa tumors and brain stem glioma (and tumors) (T/F)
T
MRI is the best for imaging the cervical ________
cord
What is a nuclear medicine technique that produces a 3D image of function processes in the body
PET scan
(Positron emission tomography)
PET scans detect pairs of gamma rays emitted indirectly by what?
Positron emitting radioisotope 1qa2az
PET scans get images of what kind of activity?
metabolic
What tests use sound waves to detect blood flow in the carotid and intracranial arteries
Doppler/ultrasound studies
what are the 2 types of doppler studies
duplex carotid ultrasound
transcranial doppler
What test is a measurement of electrical activity produced by the brain as recorded from electrodes placed on the scalp
Electroencephalogram (EEG)
What is a highly precise form of radiation therapy used primarily to treat tumors and other abnormalities of brain
stereotactic Radiosurgery
Stereotactic radiosurgery is actually non _____
surgical
Stereotactic radiosurgery can be used to treat what stroke causer in young people
arteriovenous malformation
