Chapters 5, 6, & 7 Flashcards
Name the two types of the spinal peripheral nerves
Anterior Root and Posterior Root
(Spinal Peripheral Nerves) Anterior Root are bundles of nerve fibers that transmit impulse in what direction?
Away/efferent
Is Anterior root motor or sensory?
Motor
Where does Anterior Roots originate?
Anterior (Ventral) Horn Cells
(Spinal Peripheral Nerves) POSTERIOR ROOT are bundles of nerve fibers that transmit impulses __in what direction___?
To/Afferent
Is Posterior root motor or sensory?
Sensory
What do the spinal nerves of the dorsal ramus supply?
Branches supply the muscles and the skin of the back
What do the 1st four cervical nerves of the ventral ramus supply?
The muscles and the skin of the front of the neck
What to the last four cervical nerves and part of the ventral ramus of the 1st thoracic nerve form?
Forms the brachial plexus by a series of communicating branches
Gray commissure
Bridge that links the wings of the butterfly
Dorsal/Posterior Horn
They are sensory and they are the two wingtips in the back
Ventral/Anterior Horn
They are motor and the two wingtips in the front
Somatic motor cells
Axons leave via ventral roots and supply the skeletal muscles
Autonomic motor cells
Axons leave via ventral roots to the autonomic ganglia
Transmission Neurons
Rise to ascending projections to the brain and to the connections with other spinal cord levels
Interneurons
connect with other neurons at the same spinal cord levels with sensory and reflex mechanisms
What is a plexus
A group of intersecting nerves.
Name the 7 plexus
Cervical Brachial Lumbar Sacral Celiac Coccygeal Auerbachs
What does C1 control?
Controls the carotid plexus which determines blood pressure
controls blood supply to the brain
What does C2 control?
eyes, ears, and sinuses
What does c3 control?
Face and teeth
What does C4 control?
Pharynx and Larynx
What does c5 control
neck and throat
C 3, 4, and 5 have a long branch called ___ which innervated the ___
Phrenic Nerve, Diaphragm
The cervical plexus communicates with which two nerves?
X vagus and IX Hypoglossal Cranial Nerves
The Brachial Plexus goes to what parts of the body? (4)
Chest, shoulders, arms, and hands
What does T1 control?
trachea, esophagus, esophageal sphincter
What lumbar plexus goes to what parts of the body? (6)
back, abdomen, groin, thighs, knees, and calves
The Sacral Plexus goes to what parts of the body? (6)
pelvis, buttocks, genitalia, thighs, calves, and feet
What is the Celiac plexus in charge of?
Internal organs
What is the Auerbachs Plexus in charge of?
GI Tract
What is segmentation distrubution?
each muscle in the body is supplied by a particular level or segmnt of the Spinal Cord and its corresponding nerve
dermatones
Area of skin supplied by nerve fibers originally from a single dorsal root bands of innervation around the body
What are the 3 major division of the autonomic nervous system?
The Enteric Division
The Sympathetic Division
The Parasympathetic Division
The Enteric Division is formed by
the neuronal plexus of the GI Tract (Auerbach’s)
Sympathetic Division is the body’s “___”
alerting system; fight or flight
The Sympathetic Division is responsible for preparatory measures such as: (4)
Accelerating the heart rate,
causing constriction of the peripheral blood vessels
raising blood pressure
redistributing blood away from skin and intestines to be used in the brain, heart, and skeletal muscles
What is the Parasympathetic Division? (3)
It is the body’s calming effect
it conserves and restores energy
slows heart rate and increases peristalsis (saliva, and secretion of GI Tract)
Name the neurons of the Spinal Cord (4)
Somatic motor cells
Autonomic motor cells
Transmission Neurons
Interneurons
Definition of Proprioception
ability to determine the body’s position in space
What is the definition of Two-point discrimination?
Ability to discriminate the shortest distance between two Tactile points on the body
What is Vibration?
Ability to recognize vibration from touch
What is Stereognosis/Form perception?
The Ability to recognize objects by touch
What are the two Proprioception Pathways?
Spinocerebellar tract and dorsal columns
(Sensory exam) what are two ways to determine light touch?
Test the ability to perceive light stroking of skin with a cotton ball
Determine ability to localize by closing eyes and asking to point where being touched
If the ability to perceive the cotton ball light touch exam is DECREASE what could that mean?
Hypothesia
If the ability to perceive the cotton ball light touch exam is COMPLETELY LOSS, what could that mean?
Anethesia
If the ability to perceive the cotton ball light touch exam is INCREASED, what could that mean?
hyperthesia
If a client has an uniablity to localize the light touch exam where they close their eyes and point to where they were touch, what could that mean?
atopognosis
What could the loss of Two-Point Discrimination mean?
suggests a parietal lobe lesion
What could it mean if the client has double stimulation when doing the two point discrimination exam?
determines lateralized loss
What is testing the two point discrimination important to SLP?
Sensory pathways or cortical sensory loss frequently is seen with lesions that produce cerebral language disorders
How can you do a sensory exam on pain? Explain the possible findings if they are INCREASE, DECREASED, or COMPLETELY LOSS.
Pinprink or deep pressure
INCREASED: Hyperalgesia
Decreased: Hypoalgesia
LOSS: analgesia
How can you do a sensory exam on temperature?
test the ability to identify a tube of warm water and a tube of cold water
What is a propioception sensory exam?
Test by closing your eyes and determine if joints of an arm, hand, or leg is in flexion or extension
What is Astereognosis? how can you exam this?
inability to recognize common objects by touch.
have the client close their eyes, place an object in their hand to identify
What is Tactile Agnosia?
recognition disorder caused by a cortical sensory lesion rather than pathway (can’t name by touching but can by sound)
How do you do a sensory exam for Vibratory?
Test by vibrating a tuning for to a bony prominence vs. non vibrating
How do you do a sensory exam on body sway?
Romberg’s Test (Stand with feet together, observe for swaying)
What are the three great motor subsystems?
Pyramidal, extrapyramidal, cerebellar
What is pyramidal system?
it controls voluntary movement of muscles of speech, all are cortifugal (originate in or away from the cortex)
What are the 3 major tracts of pyramidal system?
Corticospinal tract
Corticobullbar tract
corticopontine tract
Define the FAST perception of pain
sharp, prickly sensation
Involves myelinated axons
Easily located
Define the SLOW perception of pain
Slower onset greater persistence burning sensation Has a general area Unmyelinated
Define the VISCERAL/REFERRED perception of pain
achy feeling
sometimes burning
vaguely localized
What is Upper Motor Neurons?
All neurons of the anterior and lateral CS Tracts
They are the first order neurons and they are long axons
They do not leave the neuraxis
What is a Lower Motor Neuron?
Neurons that send motor axons into peripheral nerves
Second order neurons that start at the brainstem or ventral horn of the SC (The Great Common Pathway-Sherrington)
Define Paralysis
gross limitation of movement
Define Paresis
Incomplete paralysis (weakness)
Define Hemiparalyisis/Hemiplegia
Complete or nearly completely paralysis on one side
What is Bilateral Symmetry
Bilateral innervation for motor nuclei
is the Majority of midline speech muscles
provides a safety valve for speech in CB lesion
What is the MOST AFFECTED area when the cranial nuclei receives unilateral and contralateral innervations instead of bilaterally?
Lower part of face and Trapezious muscles
What is the INTERMEDIATELY AFFECTED area when the cranial nuclei receives unilateral and contralateral innervations instead of bilaterally?
The Tongue
What is the MILDLY AFFECTED area when the cranial nuclei receives unilateral and contralateral innervations instead of bilaterally?
diaphragm ocular upper face jaw pharynx larynx
What is the corticobulbar innervation in the cranial nerve V TRIGEMINAL, IX GLOSSOPHARYNGEAL, X VAGUS?
Bilateral
What is the corticobulbar innervation in the cranial nerve VII FACIAL and XII HYPOGLOSSAL?
Mixed Bilateral/Contralateral
What is the corticobulbar innervation in the cranial nerve XI SPINAL ACCESORY
Contralateral
Rods are associated with?
night vision; shapes
Cones are associated with?
day vision (color; visual acuity)
Define Hemianopia. What are the to types of Hemianopia?
1/2 of visual field is lost
Heteronymous
Homonymous
Define Heteronymous. What are the two types of heteronymous?
loss of 1/2 of the visual field on different sides.
Bitemporal (can’t see temporal side) and Binasal (can’t see nasal side)
Define Homonymous
visual lost in both RVF or LVF
What are for possible results for lesions in the optic chiasm?
Injury to decussating fibers of optic nerve
left eye does not perceive images in left 1/2 of visual field
right eye does not perceive images in right 1/2 of visual field
Bilateral hemianopia
What are 3 possible results for lesions of the Optic Tract?
Loses communication from 1/2 of each retina
right optic tract is destoyed
which means left homonymous hemianopia
What is the result if there is a lesion of the entire visual area of one occipital lobe or all fibers of one optic radiation?
Produces a homonymous hemianopia of the opposite side of visual field
What MOTOR innervation for V Trigeminal? (7)
Masseter Temporalis Lateral and medial pterygoids Tensor Tympani Tensor Veli Palatini Mylohyoid Anterior Belly of Diagastric
What are the 3 sensory innervations of the V Trigeminal Nerve
Opthalamic nerve
Maxillary nerve
Mandibular nerve
Ophthalamic nerve is in charge of: (3)
Sensation to Forehead, eyes, and nose
Maxillary Nerve is in charge of: (6)
Upper lip mucosa maxilla upper teeth cheeks palate maxillary sinus
Mandibular nerve is in charge of:
anterior 2/3 tongue mandible lower teeth lower lop part of cheek and part of external ear
How do you do Trigeminal Nerve Testing of the masseter?
palpate 2 cm above and in front of angle of mandible, bite down/relax
How do you do Trigeminal Nerve Testing of the Temporal?
above ear, chewing, temples can appear shrunken if atrophied
How do you do Trigeminal Nerve Testing of Jaw closure?
Hand on tip of mandible as jaw is held open, other hand on forehead. Ask pt to bite down.
How do you do Trigeminal Nerve Testing of the Lateral pterygoids?
ask pt to open jaw to resistance, watch for top of mandible lining up between upper medial incisors
How do you do Trigeminal Nerve Testing of lateralizing against resistance?
Have pt move jaw to one side and hold it while attempting to push it to center
What are the functions of VII Facial Nerve? (8)
Guard all facial aperatures Wrinkle forehead close eyes tightly close mouth tightly smiling frowning Guards middle ear by innervating the stapeduis muscle to protect from loud noises partially responsible for taste
What are 3 ways to test facial nerve testing?
Observe facial symmetry by having the pt: wrinkle the forehead, close eyes tightly, and smile/pucker
Auditory Nerve Lesions in the Vestibular Nerve can consist of? (4)
Vertigo
Postural deviations
Unsteady walking and standing
Deviations of the eyes
VII Auditory Nerve Lesions in the Acoustic Nerve can cause
Deafness or partial deafness
Ways to do VII Auditory Nerve Testing for Vestibular Nerve (2) and Auditory Nerve (1)
Vestibular: rotating chair to induce nystagmus, and caloric test
Auditory: Tuning Fork
What is the anatomy of the IX glossopharyngeal
origin near the inferior cerebellar penduncles
pathway through the jugular foramen
What is the innervation of IX glossopharyngeal?
Taste buds on the posterior 1/3 of tongue
Upper pharyngeal constrictor muscles
What can result of lesions in the IX glossopharyngeal nerve? (4)
Loss of sensation and taste in the posterior 1/3 of tongue
Unilateral loss of gag reflex
Deviation of uvula to the involved side
Difficulty in the initial phase of swallowing
How can you test IX glossopharyngeal nerve? What could it mean if patient is hyperactive, hyporeflexic, and no reflex?
Elicit gag reflex
Hyperactive: UMN Lesion in the CB tract
Hyporeflexic: unilateral IX damage
No reflex: Bilateral IX damage
What is the function of the X Vagus Nerve? (4)
Visceral motor nerve
With V and XII innervates the palatal muscles
with IX innervates pharyngeal constrictors
Innervates intrinsic muscles of the larynx
Name five results X vagus lesions
Paralysis of the soft palate difficulty swallowing Variety of voice problems (aphonia and roughness) UMN- Spastic Dysphonia LMN- Left branch RLN partial paralysis
5 ways to test X vagus nerve
observe the palate at rest, symmetry of arches
phonate “ah” soft palate should elevate posteriorly
elicit gag reflex
Laryngoscopy for laryngeal fx
Voicing: prolong /ah/ normal 15 secs
What can result in the lesions in the XI spinal accesory? (3)
Inability to turn head away from the side of lesion
General neck weakness
laryngeal dysfunction/voice problems
How can you test for XI spinal accessory lesions? (4)
size and symmetry of the sternocleidomastoids
Turn head to one side and hold it while trying to push to midline
thrust head forward while resisting movement against forehead
shrug shoulders while pushing down
What is the function for XII Hypoglossal Nerve INTRINSIC MUSCLES? (5)
control shortening, concaving, narrowing, elongating, and flattening of the tongue
What is the function for XII Hypoglossal Nerve EXTRINSIC MUSCLES? (3)
genioglossus: tongue protusion
hyoglossus: retraction and depression
Styloglossus: drawing tongue up and back
Concussion
traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches, and problem with concentration, memory, balance, and coordination
Traumatic Brain Injury
a blow or jolt to the head or a penetrating head injury that disrupts the functions of the brain
Primary Brain Trauma Injuries (3)
Acceleration/Deceleration
Discrete Focal Lesions
Diffuse Axonal Injury
Secondary Brain Trauma Injuries (6)
Ischemia Hypoxia Edema Hermorrhage Brainshift Raised intracranial pressure
Define Ischemia
Lack of blood getting to an area
Hypoxia
Lack of oxygen getting to an area
edema
swelling of brain
Hemorrhage
bleeding and bruising of the brain
Cognitive Disorganization include (7)
Attention Perception Memory Learning Organization Problem solving Judgement
Dementia may have an impairment which of the following
Language, Memory, Visuospatial Skills, Emotion, Personality, Cognition
What is the diagnosis of Mild Cognitive Impairment? (4)
Normal general cognition
Normal ADL’s
No diagnosis for the dementia
Deficits in one of cognitive area
What are the four phases of swallowing
oral preparation phase
oral transfer phase
pharyngeal phase
esophageal phase
