DONE: Pathophysiology of the Central Nervous System Flashcards by Delia Archer

At birth Broca’s Area is in both lobes. As we grow up our Right or Left handedness affects which lobe the Broca’s Area develops in that lobe. This is the Expressive Speech Center. How does the dominant hand affect the Broca’s Area?

If you are RIGHT handed Broca’s Area is located in the LEFT Frontal Lobe.
If you are LEFT handed Broca’s Area is located in the RIGHT Frontal Lobe.

IMPORTANT: Broca’s Area is the Expressive Speech Center. REMEMBER > The brain can create new pathways through treatment so the patient can regain speech if the brain is injured.

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The gray matter is the outermost layer of the _______. This is because the neuron cell bodies are this color so thats what gives the brain this gray appearance.

Cerebral Cortex

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The _______ is essential to brain functioning without it we would not be alive.

skull

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The spinal cord has both descending and ascending pathways.
________ tract carries motor information to the brain > _______ information.
________ tract carries muscle reaction information to the muscles > _______ Information

Ascending > SENSORY
Descending > MOTOR / Muscle Movement

Study Tip: This is IMPORTANT

Example: When you touch something sensory information is sent to the brain. If you touch something HOT the brain will send a motor response through the descending tracts to remove your hand rapidly.

FYI > Spinal cord injury is covered in Block 4

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Which area of the brain controls speech interpretation and active listening?

Wernicke’s Area

Study Tip: IMPORTANT

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There are 150mL of CSF in this space which is formed by the ______ in the ventricles in the brain.

Choroid Plexus

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ASK ARBOGAST?After the Test:
Correct Positioning dependent on the Dye used.
-Ex. Flat HOB or 30 – 45 degree angle depending on the dye used and the orders that are given
These interventions are preformed after what test?

Myelogram

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The _________ is another term for the protective junction between the capillaries that feed the brain with blood and nutrients.

Blood-Brain Barrier

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Which lobe of the brain integrates vision. This lobe is where the processing of sight takes place?

Occipital Lobe

Study Tip: This lobe helps you understand what you are seeing.

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The skull is composed of ____ cranial bones and ____ facial bones.

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_______ are underneath the skull bone and surrounding the spinal cord within the vertebral column.

Meninges

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A stroke occurring in the _______ will affect the Occipital lobe which when damaged this can affect control of the patient’s vision.

Posterior Cerebral Artery

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Ex. Personality, inhibition, and cognitive function. This is an example of an assessment of what lobe of the brain?

Frontal Lobe

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To remember the amount of vertebrae in the trunk area the nurse must remember what helpful tip?

The amount of vertebrae in each section of the trunk correlate with the times of day that you eat.

Study Tip: 7am/12pm/5pm

Cervical Vertebrae = 7

Thoracic Vertebrae = 12

Lumbar Vertebrae = 5

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_______ should be clear and colorless similar in composition to plasma.

Cerebral Spinal Fluid

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Someone with a subarachnoid hemorrhage has a more ______ condition than a subdural hematoma.

SEVERE

Study Tip: This is because this is where the cerebral spinal fluid is located. The cerebral arteries and veins are in this space as well this will increase the amount of bleeding possible and increase pressure on the brain more rapidly.

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The ________ prevents harmful agents and toxins from entering the brain. This is BAD because it can prevent some medications from entering the brain when the nurse is trying to treat infections in the brain. It can be difficult to locate medications that can get into the brain.

Blood-Brain Barrier

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Ex. Memory retention, socialized insight, and voluntary motor movement functions. This is an example of an assessment of what lobe of the brain?

Frontal Lobe

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There are three layers of the meninges which are the protective membranes which surround the brain and spinal cord. What are these layers called?

Pia Mater - Inner
Arachnoid Space - Middle
Dura Mater - Outer

Study Tip: REMEMBER the order because it actually spells PAD - Pia/Arachnoid/Dura in order from innermost to outermost.

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There are ________ of CSF in this space which is formed by the choroid plexus in the ventricles in the brain.

150mL

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The ______ is underneath the arachnoid layer and it hugs all of the folds of the brain. This is the innermost layer of the meninges.

Pia Mater

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Where is the temporal lobe located?

Left & Right of the Frontal Lobe

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Within the ________ is where all of the Cerebral Spinal Fluid is located.

SUB-arachnoid space

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There are ______ ventricles in the brain.

four

Study Tip: The choroid plexus in the ventricles creates CSF.

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As much ______ that is produced in a day an equal amount of must be absorbed so that the body can maintain a constant level of balanced pressure in the brain. This is a protective mechanism to cushion the brain from injury by the skull.

Cerebral Spinal Fluid

ASK ARBOGAST? CSF is re-absorbed by the ______ in the arachnoid?? Or SUB space.

villi

Before the Test: Assess for Allergies to Shellfish or Iodine Increase fluid intake before the procedure to increase hydration > REMEMBER Clear Liquids can be given until the patient is placed on NPO four hours before the procedure. These interventions are preformed before what test?

Myelogram Study Tip: These are very IMPORTANT!

Cerebral Circulation is important in nursing practice because this system receives about 15% of cardiac output at any time which equals ______ of blood per minute going through the brain.

750mL

________ is IMPORTANT to understand because when you have a patient with a stroke you may be told that they have a stroke in a certain artery and each artery supplies a different lobe of the brain which will cause different symptoms in your patient.

Cerebral Circulation

The formation of the CSF is it starts in the _______ and it flows around the brain and spinal cord in the sub arachnoid space. It is reabsorbed at the SAME rate that it is made.

ventricles

These capillaries are regulated by very tight junctions between the cells in this specific type of capillaries. _______ is good because it allows nutrients and gases that the brain needs to live to enter.

Blood-Brain Barrier

ASK ARBOGAST? This part of the brain relays sensory and motor inputs to the cortex and cerebrum. This is also called the Pain Gate. What part of the cerebrum is this? Where is it located in the brain? What does this part of the brain produce? What is an example of a sign that this part of your patients brain is affected?

Thalamus Located: ??? Produces: ??? Ex. ???

The _______ is a delicate area. It is between the Dura Mater and the Pia Mater and it is the middle layer of the meninges?

Arachnoid Study Tip: The arachnoid matter resembles a spider web which is why it has that name. This is where the cerebral spinal fluid is located. The cerebral arteries and veins are in this space as well.

The ______ creates redundancies in cerebral circulation. This is there so that if there is a clot in one of the arteries the blood will circulate through another route to maintain perfusion to the brain.

Circle of Willis

The cerebrum has two ______. The external surface of the cerebrum is called the ________.

Hemispheres | Cerebral Cortex

The outermost layer of the ________ is made up of gray matter this is because it contains billions of neuron cell bodies.

cerebral cortex

The white matter is the innermost layer of the ________. The inner layer is white because that is where the axons of the neuron bodies are located. The axons are myelinated.

Cerebral Cortex Study Tip: Myelin is a fatty tissue so it appears white on imaging tests such as CT Scans and MRIs.

This part of the brain regulates the endocrine and autonomic functions. This houses the Limbic System. What part of the cerebrum is this? Where is it located in the brain? What does this part of the brain produce? What is an example of a sign that this part of your patients brain is affected?

Hypothalamus Located: ??? Produces: ??? Ex. ???

Myelin is a fatty tissue so it appears white on imaging tests such as ______ and ______.

CT Scans | MRIs

Which lobe of the brain controls higher cognitive function?

Frontal Lobe

When the brain exits through the foramen magnum of the skull it becomes the spinal cord. If pressure builds up within the brain because of a subdural hematoma it is surrounded by the cranial bones so the increase in pressure will have nowhere to escape except through the foreman magnum so this will result in increased intracranial pressure. The pressure will NOT have anywhere to go so it will push down and the only way to release the pressure is out through Foramen Magnum but REMEMBER the _______ sits on top of the Foramen Magnum part of the skull which can herniate if compressed. REMEMBER this part of the brain controls ____, _____, ______, and _____ which are important vital signs needed to maintain life.

brain stem HR, RR, BP, and Pulse Study Tip: This is IMPORTANT!

What are the three major parts of the brain?

Cerebrum Brain Stem Cerebellum Study Tip: CBC

How many lobes does the brain have?

4 Lobes per side so 8 Lobes TOTAL. Study Tip: Important

Which lobe of the brain controls the integration of somatic, visual, & auditory data?

Temporal Lobe

The ______ is right next to the skull it is thick and forms the outermost layer of the meninges?

Dura Mater

Ex. Thought, memory, motor, and judgement functions. This is an example of an assessment of what lobe of the brain?

Frontal Lobe

What is one of the most IMPORANT functions of the cerebrum?

The cerebrum can create new pathways after damage occurs to continue functioning effectively.

This part of the brain links the medulla to the higher cortical structures of the brain. This part of the brain controls motor & sensory pathways. What part of the brainstem is this?

Pons Study Tip: This part of the brain is the BRIDGE like structure that links the relay stations between the medulla to higher cortical structures of the brain.

ASK ARBOGAST? Hippocampus? NOT DISCUSSED

In Relation to the temporal lobe

Which lobe of the brain controls word formation and speech?

Broca’s Area/Frontal Lobe Study Tip: IMPORTANT

Which lobe of the brain interprets sensory and spatial information. This also known as the sensory cortex of the brain. This lobe helps our body interpret what we can feel and converts and interprets spatial information?

Parietal Lobe

The blood brain barrier can only be penetrated ONE way because this occurs in the capillaries. The barrier can only be altered by what three adverse conditions?

Trauma to the brain Cerebral edema in the brain Cerebral hypoxemia

This mechanism prevents ischemia to the whole brain. This preserves brain function in case a clot occurs. What is this mechanism called?

Circle of Willis

________ is receiving the sound but what area of the brain is helping you understand the words that are hearing so that your brain can understand it and determine how to respond?

Cranial Nerve 8 - Acoustic Temporal Lobe / Wernicke's Area

The skull and the vertebral column protects the _________ and ________ from trauma and environmental toxins.

Brain and spinal cord

Where is Broca's area located?:

Usually in the Left Frontal Lobe in 90% of patients Study Tip: At birth Broca’s Area is in both lobes. As we grow up our Right or Left handedness effects which lobe the Broca’s Area develops in that lobe. If you are RIGHT handed Broca’s Area is located in the LEFT Frontal Lobe.

A stroke occurring in the ______will affect the Frontal lobe, Parietal lobe, and Temporal lobe. The experienced nurse will know what deficits to expect when this area is affected by a clot.

Middle Cerebral Artery

Ex. Close eyes and move the patient’s finger facing up or down and ask the patient where you moved it? This is an example of an assessment of what lobe of the brain?

Parietal Lobe

Spinal fluid is withdrawn and dye is injected to replace the low fluid level to get a better view of the spinal cord. The dye is injected into the subarachnoid space of the spinal column and then _______, _________, and _________ diagnostic tests are done. Photos of the spinal cord and vertebral column are taken to identify spinal lesions, tumors, infections, spinal tumors, and herniated or ruptured disks. What procedure is this?

X-Rays CT Scan MRI Myelogram

ASK ARBOGAST? Parietal Lobe NOT DISCUSSED?

The Location of the Parietal Lobe of the brain?

The spinal cord is ________ and a part of the ______ and exits through the cranial cavity though the _________.

continuous brain stem Foramen Magnum

The patient can be at risk for having their brain exposed to toxins IF they have a trauma, cerebral edema, or cerebral hypoxemia which is the only way you can penetrate the _________.

Blood-Brain Barrier

_______ allows you to see but what lobe of the brain helps the patient understand what they are looking at?

Cranial Nerve 2 - Optic Occipital Lobe

The vertebral column has how many: Total Vertebrae = ? Cervical Vertebrae = ? Thoracic Vertebrae = ? Lumbar Vertebrae = ? Fused Sacral = ? Fused Coccygeal = ?

``` 22 7 12 5 5 4 ```

Cerebral Circulation is important because this system receives about _____ of cardiac output at any time which equals 750mL of blood per minute going through the brain.

15%

Ex. Sensations of touch and sight. This is an example of an assessment of what lobe of the brain?

Temporal Lobe

Where is Wernicke’s Area located?

The area immediately surrounding the EAR. Temporal Lobe

Ex. This lobe allows a patient to walk with their eyes closed and know which direction is up and down. This lobe is responsible for reading and math. This is an example of an assessment of what lobe of the brain?

Parietal Lobe

Ex. Memories of taste, smell, and sound. This is an example of an assessment of what lobe of the brain?

Temporal Lobe

Ex. When a nurse assesses this lobe of the brain they will poke the patient with the sharp end of a broken swab and poke them with the soft end of the swab and ask them to let you know when they feel something, where the sensation is located on the body, and to let you know whether is it a dull or sharp sensation. This is an example of an assessment of what lobe of the brain?

Parietal Lobe REMEMBER: Do not tell them when you are going to touch them this can create phantom sensations by a patient with neural defects.

Where is the frontal lobe located?

Entire Forehead Area

This part of the brain coordinates voluntary smooth muscle movement to maintain trunk stability and equilibrium. Receives information from the cerebral cortex, muscles, joints, and the inner ear. Controls coordination of posture, equilibrium, and muscle tone. What part of the brain is this? Where is it located in the brain? What does this part of the brain produce? What is an example of a sign that this part of your patients brain is affected?

Cerebellum Located: In the back of the head Produces: ? Ex: ?

Ex. Memories of hallucinations, illusions, and déjà vu. This is an example of an assessment of what lobe of the brain?

Temporal Lobe

Where is the occipital lobe located?

Base of the Skull on the Back of the Head.

What is a Myelogram?

Diagnostic Test: A dye is injected into the spinal cord to make the vertebrae stand out during the imaging process the patient is then rotated to spread the dye to all nerve fibers then the Dr will order a X-Ray, CT Scan, or an MRI of the spinal cord to look for lesions or abnormalities.

This part of the brain is the relay station between the crossing of motor tracts between the spinal cord and the brain. Controls HR, RR, BP, sneezing, swallowing, vomiting, and coughing. What part of the brainstem is this?

Medulla Oblongata IMPORTANT: The pons and the medulla both contain activities related to respiratory control. HR, RR, BP, are housed mostly in the medulla but also located in the Pons. Ex. Increased ICP can herniate the brainstem and kill it which will cause the patient to have the inability to sustain vital signs.

This part of the brain regulates emotional behavior, feeding and sexual behavior. This is an old part of the human brain. What part of the cerebrum is this? Where is it located in the brain? What does this part of the brain produce? What is an example of a sign that this part of your patients brain is affected?

Limbic System Located: ??? Produces: ??? Ex. Primal sexual instincts come from this part of the brain.

_________ damage affects patients with Parkinson ’s disease because this allows the human body to have smooth voluntary movements. These patients do not swing their arms when they walk, shuffling gait, do not blink much (1-2 times per minute), may appear to be staring, and they may be drooling. This occurs because this part of the brain is not releasing enough ________.

Basal Ganglia | Dopamine

The brain stem houses the _______, _______, and ________.

Midbrain, Pons, and Medulla

ASK ARBOGAST? The cell bodies of cranial nerve _____ are ALL located in the brainstem. Why is this important to remember?

3-12

This part of the brain is the nerve pathway of the cerebral hemispheres which allows the two hemispheres to communicate messages. This controls motor coordination, auditory reflex centers, and visual reflex centers. What part of the brainstem is this?

Midbrain

This part of the cerebrum controls and facilitates learned and automatic movements What part of the cerebrum is this? Where is it located in the brain? What does this part of the brain produce? What is an example of a sign that this part of your patients brain is affected?

Basal Ganglia Located: Deep in the brain base Produces: Dopamine Neurotransmitter Ex: Swinging arms while walking, blinking, and swallowing saliva. Study Tip: Basal Ganglia damage affects patients with Parkinson ’s disease because this allows the human body to have smooth voluntary movements. These patients do not swing their arms when they walk, shuffling gait, do not blink much (1-2 times per minute), may appear to be staring, and they may be drooling. This occurs because the basal ganglia is not releasing enough dopamine.

_______ is a fatty tissue so it appears white on imaging tests such as CT Scans and MRIs.

Myelin

This is what is tested during a DUI test. Alcohol crosses the blood-brain barrier. When the _______ is affected by either alcohol or a stroke they will not be able to complete these tasks easily. What are 3 examples of common DUI tests?

Cerebellum Ex. Walking tandem heel to toe. Ex. Closing eyes and touching the fingers to the nose Ex. Rapid alternating movements

Both the _______ and the ______ both contain activities related to respiratory control.

Pons | Medulla

ASK ARBOGAST? After the Test: Patient is on bed rest from 3-24 hours after the procedure. WHY? NOT DISCUSSED Encourage fluid intake to replace the lost CSF and to encourage urinary excretion of the dye. Monitor for CSF leak at the puncture site. These interventions are preformed after what test?

Myelogram

Photos of the spinal cord and vertebral column are taken during a Myelogram to identify what 5 common abnormalities?

``` Spinal lesions Infections Spinal tumors Herniated disks Ruptured disks ```

This is a small part of the brains Respiratory center. What part of the brainstem is this?

Pons

This is a major part of the brains Respiratory center. What part of the brainstem is this?

Medulla Oblongata