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Physio Test 2 > CNS II Bowman > Flashcards

CNS II Bowman Flashcards

1
Q

What is sensory function in CNS dependent on?

A

intact afferent cellular circuits

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2
Q

Sensory nerve =

A

afferent, dorsal root

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3
Q

Motor nerve=

A

efferent, ventral root

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4
Q

General outlay of dermatomes of body?

A
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5
Q

What is exteroceptive information?

A

Interaction of skin with the environment

  • Fine discriminatory touch
  • Pain and temperature
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6
Q

What is proprioceptive information

A

Body and limb position informing movement

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7
Q

What is enteroceptive information

A

Internal status of the body

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8
Q

What are some type of sensory transductions we have?

A
  • Mechnical (mechanoreceptor)
  • Chemical (chemoreceptor)
  • Thermal (thermoreceptors)
  • Pain (nociceptors)
  • Electromagnetic (detect photons)
    • When dark, gate is open, passing ions
    • When light hits, gate closes
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9
Q

What is common thread with all receptors?

A

Changing permeability of ions in some way (with gate opening, distort membrane to open gate, standard ligand etc)

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10
Q

What are receptor potentials?

A

Need enough stimulus to get enough ion flow, to get to threshold, get to first node of ranvier, then we get action potential

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11
Q

What are tactible fibers fast (FA)

A

From onset of stimulus, quick adaptation to stimulus and action potentials stop

(i.,e. shoe on foot)

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12
Q

What are slow adaptation fibers?

A

From onset of stimulus, continuous action potentials fire (rock in shoe)

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13
Q

What are type I fibers for fine discriminatory touch?

A

High density= better two point discrimination (tip of finger)

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14
Q

What are type II fibers?

A

Large receptive field (i.e. back)

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15
Q

What type of receptors are meissner’s corpuscles?

A

FA1

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16
Q

What type of receptors are pacinian corpuscles?

A

FA2

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17
Q

What type are merkel’s discs?

A

SA1

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18
Q

What typeare ruffini receptors?

A

SA2

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19
Q

What does the amplitud of stimulus intensity look like?

A

Rapid change in amplitude with stimulus strength increase, levels out at higher levels

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20
Q

What are some coding of action potentials from stimuli?

A
  • Modality
    • touch, pressure, flutter
    • taste, smell etc
  • spatial location
  • stimulus intensity
  • stimulus frequency
  • stimulus duration
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21
Q

What makes up dorsal column- medial lemniscal pathway?

A
  • Highly localized touch
  • touch sensation (fine gradation of intensity)
  • phasic sensation (vibratory)
  • skin contact
  • joint position
  • pressure sensation

Largers myelinated fibers

More spatial orientation

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22
Q

What is anterolateral pathway?

A

Type of somatosensory pathway (spinothalamic)

  • Pain
  • Thermal sensation
  • crude touch/pressure
  • tickle and itch
  • sexual sensation

Composed of smaller myelinated fibers and slower (40m/sec)

Less spatial orientation

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23
Q

Pathway of dorsal column medial lemniscal pathway?

A

SOMATOSENSORY PATHWAY (more fine, localized touch)

Transmits signal upward toward medulla via dorsal column

  • Synpases in dorsal column nuclei (in medulla)
  • 2nd order crosses over in medulla and then go thalamus (3rd order)
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24
Q

General pathway of anterolateral system (spinothalamic tract)

A
  • SOMATOSENSORY PATHWAY
  • Enters S.C. form dorsal spinal nerve roots, immediately sypases in dorsal horn
  • Cross to contralateral cord
  • travel up through anterior and lateral white column
  • tract terminate at all levels of lower brain
  • note, there is flame at the toe. this is major pain pathway
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25
Q

What is spinocerebellar proprioceptive pathway?

A

​PRIOPRIOCEPTIVE PATHWAY

  • Perception of position, conscious awareness of body movementa nd local reflexes
  • cutaneous and proprioceptive info to cerebellum and cortex
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26
Q

What are the central pain pathways?

A

Spinothalamic

Spinoreticular

SPinomesencephalic

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27
Q

What is motor function dependent on ?

A

Intact efferent cellular circuits

28
Q

Where do motor neurons contorlling somatic musculature form a column of cells?

A

Ventral horn of spinal cord

29
Q

Where are interneurons for distal muscles?

A

Intermediate/lateral ventral horn

30
Q

WHere are interneurons for proximal muscles?

A

Medial ventral horn

31
Q

What is corticospinal tract pathway?

A
  • Major motor tract that controls trunk and proximal limbs
  • EXTREMELY FAST motor signals (70m/sec)
  • some fibers come down and end up in ventral portion (trunk muscles)
  • some cross over and end up in lateral (control limbs)
32
Q

4 majors vessels supplying blood to brain

A

2 vertebral arteries

2 carotids

33
Q

Which area of the spinal cord has poor callateral blood supply?

A

Anterior portion

34
Q

What is purpose of CSF?

A
  • CNS “lymphatic” system
  • protection from mechanical force
35
Q

What is volume capacity of brian and spinal cord?

A

1600-1700 mL

36
Q

What amount of volume is CSF and CSF in cerebral ventricles?

A

CSF- 125 mL

About 30 mL in cerebral ventricles

37
Q

What is rate of CSF production in chroid plexuses?

A

0.35 mL/min

38
Q

What reabosrbs CSF?

A

Arachnoid villi

if fluid flows into arachnoid villi when CSF is 1.5 mmHg>venous pressure

39
Q

What constiuents appear in CSF at higher level than blood concentration?

A
  • Sodium (148 IN CSF (slightly higher))
  • Chloride (120-130 in CSF)
    *
40
Q

What constituents of CSF is found at a lower concentration than blood?

A
  • Potassium (2.5 in CSF)
  • Glucose (50-75 in CSF)
  • Protein (15-45 in csf MUCH LOWER THAN BLOOD (6.8x10^3 in blood)
41
Q

Pathway of CSF through brain?

A
  • Fluid from lateral ventricle passes through intraventricular foramina (of Munro)
  • goes to 3rd ventricle (additional fluid added there)
  • Flow downard toward aqueduct of Sylvius into 4th ventricle
    • more fluid added here
  • Passes out of 4th ventricle through 3 small openings
    • 2 lateral foramina of luschka
    • midline foramen of magendie
  • Enters cisterna magna (large fluid space behind medulla nd benath cerebellum
    • This space is continuous with subarachnoid space surrounding the spinal cord
42
Q

What is the BBB?

A
  • Large molecules and highly charged ions are excluded from brain and spinal cord requiring active transport mechanisms
  • tight junctions between CNS capillary endothelial cells
    • fenestrations in brian 1/8th size of fenestrations in other areas
  • Astrocytes also restrict movmeent (take up K ions)
43
Q

Where does BBB exist?

A
  • In tissue capillary membranes in all areas of the brain EXCEPT
    • Hypothalamus
    • pituitary
    • area postrema (involved in vomiting)
44
Q

What does movement across BBB depend on?

A

Molecule size (smaller= more likely to ross)

Charge

Lipid solubility

Protein binding

45
Q

What is permeable across membrane?

A

H2O, CO2, O2, lipid soluble substances (anesthetics, alcohol)

46
Q

What is slightly permeable across BBB?

A

Na, K, Mg, Cl, Ca

47
Q

What is impermeable across membrane?

A

Polar molecules, plasma proteins, glucose (FD only), non-lipid soluble large organic molecules (mannitol)

48
Q

What is ICP normal pressure?

A

8-12mmHg

49
Q

What is inside the rigid cranial vauld? percent?

A
  • Brain (cellular and ICF)= 80%
  • Blood (arterial and venous)= 12%
  • CSF= 8%
50
Q

CPP?

A

Cerebral perfusion pressure = MAP- ICP (or CVP, whichever is greater)

Normal 80-100mmHg . In trouble if <50

51
Q

What is volume compensation

A

ICP can compesnate for increased volume until a point, and then shoots up very quickly

52
Q

What is amount of cerebral blood flow?

A

50mL/100g/min= 750 mL/min

53
Q

What factors affect CBF?

A
  • Level of arousal/neural metabolism
  • temperature
  • concnetration of co2 and h ions
  • O2 (only when extremely low)
  • blood viscosity
    • decrease HCT increase CBF but decrease O2 carrying capacity
    • Severe polycythemia can reduce CBF
54
Q

Relationship between neuronal activity and local CBF?

A
  • “Flow metabolism coupling”
  • CBF to localized brain regions can change up to 100-150% withins econds in resposne to local neuronal activity changes (sensory input/arousal)
55
Q

Relationship between CBF and PaCO2?

A
  • co2+ h2o= carbonic acid
  • Carbonic acid disassociates into H
  • H cause “almost proportional” vasodilation of cerebral vessels
  • Each 1 mmHg change in PaCO2
    • CBF changes 1-2 mL/100g/min
    • CBV changes 0.05 mL/100g brain tissue
      • 10 mL change for 15 mmHg change in Paco2
  • Effects last about 6 hours and then it will return to normal due to excretion of bicarb
56
Q

Brains % mass and % total body metabolism?

A

Brain 2% total body mass

15-20% of total body metabolism and cardiac output

57
Q

What is normal cerebral metabolic rate in adult, ped?

A

CMRO2 adults 3-3.8 mL/100g/min= 50mL/min of o2

Ped= 5.2mL/100g/min (2 x as much!)

58
Q

What is rate of brains glucose consumption?

A

5.5mg/100g/min

needs constant supply of blood, o2

59
Q

What is percent used by brain for cellular homeostasis?

A

60%

60
Q

What percent energy of brain is required for electrophysiologic activity?

A

40%

61
Q

What do anesthetics due to CMRO?

A

Reduce down to 60%. Removes electrophysiologic activity but cannot remove cellular homeostasis requirement

62
Q

Relationship between CBF and o2 concentration?

A
  • Except for cases of intense brain activity, o2 utilization by brain remains in narrow range
    • 3.5 mLO2/100g brain tissue
  • If po2 drops below 30 mmHg, or pAo2 drops below 50-60mmHg, CBF increases
63
Q

What does CBF like to keep MAP at?

A

70-150

Adjust to changes after 1-3 minutes

HTN will cause shift in autoregulatory ranges to higher minimum values

64
Q

Relationship of Sympathetic nervous system and CBF?

A
  • Cerebral circulation strong SNS inntervation (vasoconstrictive)
    • especially in larger vessels
  • Neither transection of nerves or mild to mod stimulation causes much change- the auto regulation mechanism overrides
  • May shift auto regulation curve to the Right
    • sns minor role unless EXTREME BP rise (stroke prevention, hemorrphagic shock)

SNS only accounts for acute change to protect brain from high pressure. Not as important as autoregulation

65
Q

Relationship between temperature and CBF?

A
  • CBF changed 5-7% per 1 degree C change
  • hypothermia decreases CBF and CRMO
    • only way to decrease cellular function requirement to be <60%
  • HYPERTHERMIA IS OPPOSTIE EFFECT
66
Q

Where is cell body in sensory pathway?

A

in dorsal root ganglion ( it is a psuedounipolar neuron)

67
Q
A

Physio Test 2 (10 decks)

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