CNS Part 1 Flashcards
Somatic responsible for
Voluntary muscle movement
Autonomic responsible for
Involuntary muscle movement. Mildly influenced by conscious thought
Sympathetic
Fight or flight
Parasympathetic
Rest and digest
Afferrent
Info coming back into brain.
Efferent
Info leaving brain to get a response
General functions CNS 3
Sensory perception
Info processing, integration, storage
Motor and behavior
White matter
What concentration of myelin
General number of neurons
High, few. Highly vascular
Gray matter
High density of __ and ___. __ also present. Requires a lot of ___ and very ___
Neurons, dendrites, axons. ATP. Vascular
Nucleus: a cluster of neurons ___ CNS
In
Ganglion: cluster of ___ ___ the CNS
Neurons outside
Cortex is ___ layers of ___
Dense, neurons
Tract: ___ within CNS traveling as a ___
Example
Axons, group
Spine cerebellum
Pathway
Similar to a ___ however it relates more to ___ connected neurons performing a ____
Tract, synaptically, function
___ matter more metabolically active than ___ matter. Also more vascularized
Gray, white
1st order neurons
2nd order neurons
Third order neurons
Dorsal root ganglion
Spinal cord
Thalamus
Associated nerves with spinal cord: __ and __ __
Primary functions 3
Dorsal and ventral roots
Sensory input, reflex circuits, somatic and autonomic motor output
The brain stem is composed of 3
Medulla, pons, midbrain
The brain stem
Associated nerves
12 cranial nerves
The brain stem primary functions:
Sensation and motor control of the __, __, and __
Input of special senses 3
Head, neck, and face
Taste, hearing, balance
Brain stem primary functions
Mediate functions such as decreases __ and __, increased __ in gut, and pupillary ___
CO and BP
Peristalsis
Constriction
Brain stem functions: a conduit of __ and __ pathways that carry __ and __ info to other areas in the __
Ascending and descending
Sensory and motor
CNS
Reticular formation is part of __ __. Functions to __ __, exclude __ __, and regulate __
Brain stem
Filter info
Irrelevant stimuli
Arousal
Medulla associated nerves: __-__
Functions: subconscious __ and __ control. Early relay nuclei in __, __, __, and __/__ input
___ reflexes
8-12
CV, respiratory
Balance, auditory, gestation, head/neck
Brain stem
Pons:
Nerves __-__
Functions: __ control, __ control, motor control of the __
5-8
Respiratory, urinary, eye
Pons functions:
Sensation and motor control of the ___
Ventral: __ nuclei relay movement and sensation info from __ to __
Dorsal: __ and __
Face
Pontine, cortex to cerebellum
Taste and sleep
Midbrain
Nerves __-__
Functions: __ relay and mapping. ___ movement, __ and __ reflexes
3-4
Acoustic, eye, lens and pupillary
Midbrain functions
__ modulation
Contains nuclei and relay pathways __ for __ coordination (ex in __ __)
Pain
Critical, motor, substantia Nigra
Cerebellum
Associated nerve:
Functions: __&__ (___ input from __ __, __ __, vestibular organs of __ __)
VIII
Coordination and equilibrium
Somatosensory, spinal cord, cerebral cortex, inner ear
Cerebellum functions
___ learning, __ association/___
Motor, sensory/language
Thalamus Assoc nerve: Functions: Sensory and motor relay between \_\_ \_\_ and \_\_ \_\_ regions \_\_ modulation and gating
II
Cerebral hemispheres, lower CNS
Sensory
Thalamus functions
Regulation of __ activation (__ and __)
__ input
Cortical, attention, consciousness
Visual
Hypothalamus functions
__/__ control
__ nucleus: ___ rhythms
__ behavior: __ centers
Autonomic/endocrine
Superchiasmatic: circadian
Motivated: reward
Basal ganglia functions:
Shapes patterns of __ motor __
Control of __ motor movements
Thalamocortical, inhibition
Fine
Amygdala primary functions:
__ behavior and expression of __
Social, emotion
Hippocampus function
Memory
Cerebral cortex
Associated nerve:
Dependent on __ brain regions for __
I
Lower, wakefulness
Cerebral cortex functions
- __ __ lower brain functions
- sensory ____
- __ and __
Fine tunes
Perception
Cognition and learning
Cerebral cortex functions
Large ___ storehouse
__ planning and __ movement
____
Memory
Motor, voluntary
Language
Grooves that allow brain to have more surface area
4 major lobes
Sulci
Frontal, parietal, occipital, temporal
Frontal lobe:
-planning and carrying out __ behavior. __motor, ___ motor, and __ motor areas. __ __ field
Motor, pre, cingulate, supplementary, frontal eye
Frontal lobe:
__ (__ area), from ___ frontal __ of dominant hemisphere
__ and __ behavior (__ frontal lobe)
Speech, brocas, inferior, gyrus
Personality and emotional, rostral
Parietal lobe:
-sensory __ and __ (__ cortex and __ __ cortex)
Perception and processing, somatosensory and parietal association
Parietal lobe:
Projections to __ lobe carrying somatosensory info modulates __ __ behavior
Parietal assoc cortex process ___ info from the __ lobe and sends projections to the __ lobe which influences motor behavior
Frontal, voluntary motor
Visual, occipital, frontal
Parietal lobe
__hemisphere sends somatosensory to ___ area
Establishment of __ context in __ hemisphere
Dominant, wernicke’s
Spatial, nondominant
Occipital lobe
__ perception and processing
Projections to __ eye fields influence __ behavior of eyes
Projection to the midbrain modulates __ eye movements, pupillary __, and ___
Visual
Frontal, motor
Convergent, constriction, accommodation
Temporal lobe
Processing and perception of __ and __ info
__ __ visual processing (__ recognition)
Sound and vestibular
Higher order, facial
Temporal lobe
__ __ transverse here
A portion of ___ area (in __ region)
__ behavior in __ region of lobe, __ system
Optic pathways
Wernicke’s, posterior
Emotional, medial, limbic
Temporal lobe
__ optic info from one region to another
__ __ system regulation in __ region of lobe
__ and __ from __
Transports
Autonomic nervous, medial
Learning and memory from hippocampus
More __ side is where their wernicke’s area will be more dominant
Dominant
2 __ __ and 2 _ _ come into circle of Willis
Internal carotid arteries, vertebral arteries
Stroke in __ __ artery has more severe consequences because less __ __
Middle cerebral, collaterals flow
__ artery is a small artery
Smaller vessels have higher __ __ _
Pial
Cerebral vascular resistance
Atrocytes more important than just support. Take up __, protect neurons from __, influence __
Glutamate, cytotoxicity, tone
__ has good collaterals and won’t suffer from BP drop as much as __ region of spinal cord
Cervical, lumbar
Artery of adamkiewicz supplies blood to __ __ of spinal cord. Comes off of __ at variable levels. Paraplegia can be caused if we don’t know where this is when aorta __
Lower 2/3, aorta, clamped
1 __ artery supplies most of all of function that cord mediates except for __. More vulnerable than __ because less __ __
Anterior. Touch. Posterior, collaterals flow
Posterior cord supplied by __ __ __. Has __ control
2 spinal arteries, sensory
CBF vs cerebral blood vol
Parallel but not __ relationship
CBV: __-__ ml/100g brain tissue
We care about flow because it influences total __ __ __
1:1
3-5
Cerebral blood volume
CBF vs CBV
Consider not only arterial flow and __ but also ___
Obstruction to outflow can occur by __, __ vent with high __
Tone, venous
Position, PP, PIP
ICP Normal \_\_-\_\_mmHg Rigid cranial vault \_\_ volume Brain (\_\_ and \_\_) \_\_% Blood (arterial and venous) \_\_% CSF \_\_%
8-12 Fixed Cellular and ICF, 80 12 8
Herniation risk when __ reduced and __ increased. May occurs from __ compensation mechanisms reaching __
CPP, ICP. Volume, exhaustion
If someone has high ICP need high __ to overcome pressure in brain
MAP
Intracranial elastance
Determined by change in __ after a change in __
Compensatory mechanisms:
1. Initial displacement of CSF from __ to __ compartment
2. __ CSF absorption
3. Decreased CSF ___
4. Decreased ___ (primarily __)
ICP, intracranial volume 1. Cranial to spinal 2. Increased 3. Production CBV, venous
Cerebral perfusion pressure
__-__ (or __ whichever is greater)
Normal is __-__
__ to actually find
MAP- ICP (CVP)
80-100
Rare
Cerebral blood flow
Normal adult __ml/100g/min.= __ml/mi
Blood flow closely linked with ___
50, 750
Metabolism
Cerebral blood flow
Factors affecting CBF during anesthesia
__ agents, level of __, __ by products, blood __, ___, concentration of __ and __ ions, __
Anesthetic, arousal, metabolism, viscosity, temp, co2 and h, o2
Neuronal activity and local CBF
__-__ coupling
Metabolic by products from __,__,__
Flow metabolism
Glial, neuronal, vascular
Neuronal activity and CBF
CBF to __ brain regions change up to __-__% within __ in response to neuronal __ changes (__ input)
Localized, 100-150, seconds, activity, sensory
Co2 + h20= __ __
__ __ disassociates into __
H ions cause almost proportional ___ of cerebral vessels
Other acidic metabolic substance can also __ CBF (__ and __ acid)
Carbonic acid
Carbonic acid, h+
Vasodilation
Increases, lactic, pyruvic
Each 1 mmHg change in paco2 leads to CBF change __-__ml/100g/min
1-2
Each 1 mmHg change paco2 CBV changes __ml/100g brain tissue.
__ml difference for 15 mmHg change
0.5
10
Effect of increased paco2 lasts __ hours and then will return to normal despite maintenance of altered co2 levels due to __ transport
6, bicarb
Increased paco2 useful for anesthesia in short periods with __. Critical to see if a pt with ICP alterations has been hyperventilated for extended Period because of
VA
Low o2 can cause ischemia
Brain metabolism
- __% of body mass and __-__% of metabolism and cardiac output
- cerebral metabolic rate (cmro2)= __-__ml/100g/min= __ml/min of o2
- peds cmro2= __ml/100g/min, mean age of __
2, 15-20
3-3.8, 50
5.2, 6
Brain metabolism
Brain not capable of much __ metabolism (high metabolism coupled with low local __ and __ stores)
Brain glucose consumption __mg/100g/min
Anaerobic, glucose, oxygen
5.5
CBF and o2 concentration
-except for cases of intense brain activity o2 use remains within __ range. ___ml 02/100g brain tissue
-if po2 of brain tissue drops below __mmhg (35-45 normal) or pao2 drops below __-__, CBF __
- narrow, 3.5
- 30, 50-60, increases
Auto regulation of CSF and arterial BP
- CBF auto regulated between map of __-__ mmHg
- cerebral vasculature adjusts to changes in CBV/MAP in __-__ min
- htn will shift to auto regulatory range to __ minimum values and maximums of __-__
70-150
1-3
180-200
Cerebral circulation has strong __ innervation especially in __ vessels
Neither transaction of these nerves or mild stim causes much __. The auto regulation system __
SNS, larger
Change, overrides
May shift auto reg curve to the ___. SNS __ role unless extreme __ rise (__ prevention). Or __ shock.
Right, minor, BP, stroke, hemorrhagic
CBF changes __-__% per 1 degree C change
Hypothermia __ CBF and cmro2
Hyperthermia has __ effect
Clinical evidence does not ___use of hypothermia
5-7
Decreases
Opposite
Support, 35
Decrease in HCT will __ CBF but __ o2 capacity of blood
Severe ___ can reduce CBF
Increase, decrease
Polycythemia
CSF is CNS __ system and protection from __ __
Lymphatic, mechanical force
Cavity enclosing brain and spinal cord has capacity of __-__ mls.
__ml is CSF (rest brain and spinal cord), __ ml of CSF is in cerebral ventricles
1600-1700
125, 30
CSF formed by __ plexuses at __ml/min
Reabsorbed by __ __ function like __ __ valves
Choroid, 0.35
Arachnoid villi, one way
Fluid flows when CSF pressure is __mmhg __ than venous pressure
1.5, greater
Lumbar CSF: NA, k, Cl
148
2.9
120-130
Lumbar CSF: glucose, protein, pH
50-75, 15-45, 7.3
Blood: Na, k, Cl
135-145, 3.5-5, 100-106
Blood: glucose, protein, pH
70-100, 6.8x10^3, 7.4
Part 1 Flow of CSF: from __ __ passes through __ foramina of __ to the __ ventricle. Additional fluid added and then it flows down along __ of __ to __ ventricle.
Lateral ventricles, intraventricular, Munro, third.
Aqueduct of Sylvius, fourth
Part 2 flow CSF: more fluid added, goes out of fourth ventricle through 3 openings: __ lateral foramina of __ and a __ foramen of __ entering the __ __ which is continuous with __ space
Two, luschka, midline, magendie, cisterna magna, arachnoid
__ __ and __ __ __ are excluded from brain and spinal cord requiring active transport
__ __ between CNS capillary endothelial cells. Fenestrations in brain __ of size in other areas
__ also restrict movement by taking up K ions
Large molecules, high charged ions
Tight junctions, 1/8th
Astrocytes
Blood brain barrier exists in tissue capillary membranes in all areas of brain parenchyma except for __, __, and __ __
Hypothalamus, pituitary, area postrema
Movement across BBB depends on __, __, __ solubility, and degree of __ binding in the blood
Size, charge, lipid, protein
BBB
Permeable: __, __, __, __, and __
Slightly permeable: 5 ions
Impermeable: __ molecules, __ proteins, __ (facilitated diffusion only), non lipid soluble __ organic molecules like __
H20, co2, o2, anesthetics, etoh
Na, Cl, k, ca, mg
Polar, plasma, glucose, large, mannitol