Exam 1 Neuro 1 Flashcards
1
Q
The somatic NS includes?
A
Cranial & spinal nerves & sensory/motor neurons
2
Q
The autonomic NS is divided into?
A
Sympathetic and parasympathetic NS
3
Q
Cranial nerves XI & XII are?
A
Accessory & Hypoglossal nerves
4
Q
`Which cranial nerves are sensory only?
A
I, II, VIII (Olfactory, Optic, Vestibulochochlear)
5
Q
What is the function of cranial nerves XI & XII?
A
Shoulder shrug & swallowing, speech
6
Q
What is the function of cranial nerves VII & VIII?
A
Facial expression, taste & hearing, balance
7
Q
What is the function of cranial nerves III & IV?
A
Eye movement & moves eyes to look at the nose
8
Q
What is the function of cranial nerves V & VI?
A
Face sensation, mastication & abduction of the eye
9
Q
The cerebrum is for?
A
Higher functions
10
Q
The cerebellum is there for?
A
Balance, posture & coordination
11
Q
The frontal lobe controls what?
A
Personality, behavior, speech self-awareness
12
Q
The Parietal lobe controls what?
A
Language, words, sense of touch, spatial perception (left & right)
13
Q
The occipital lobe controls what?
A
Interpretation of visual stimuli
14
Q
The temporal lobe controls what?
A
Understanding of language, memory, hearing
15
Q
What are the brain folds called?
A
Gyri & Sulci
16
Q
What is contained in Grey matter?
A
Neuron bodies
17
Q
What is contained in White matter?
A
Axons that travel deeper into the brain to communicate with other areas
18
Q
What are the 6 Glial cells called?
A
- Microglia
- Oligodendrocytes,
- Ependymal cells,
- Astrocytes,
- Schwann cells,
- Satellite cells
19
Q
Most synaptic transmission is via?
A
Chemical transmission
20
Q
When are neurotransmitters released?
A
When calcium enters the axon terminal in response to an action potential
21
Q
Where is Ach synthesized?
A
In the presynaptic terminal
22
Q
Ach has what actions on the CNS?
A
Attention, memory, arousal
23
Q
Ach has what effects on the CV system?
A
Regulates heart contraction, decreases HR & BP
24
Q
Ach is usually ____ in action.
A
Excitatory
25
What are some cholinergic side effects?
Salivation Lacrimation Urination Diaphoresis Gastrointestinal upset Emesis (SLUDGE)
26
What are some AchE drugs?
Rivastigmine, Donepezil, Galantamine
26
What do anticholinergic drugs do?
Block the action of Ach
27
What does Scopolamine do in the CNS?
Prevents communication between the nerves of the vestibule and the vomiting center in the brain
28
What is the major excitatory neurotransmitter in the brain & spinal cord?
Glutamate
29
What are 3 actions of glutamate?
Learning/memory,
cognition,
mood regulation
30
Too much glutamate can lead to?
Parkinson’s,
Huntington’s,
Alzheimer’s
31
Dopamine derives from ____ & generally has ____ effects.
Phenylalanine & inhibitory
32
Dopaminergic neurons are located between the ___ & ___, in the ___, ___, & ___.
**Substantia nigra** & **caudate nucleus/putamen,**
in the **limbic system**,
**retina** & **olfactory system**
33
What are the functions of dopamine outside the CNS?
Inhibits NE release,
increases sodium excretion,
reduces insulin secretion
34
How does Levadopa work & why is Carbidopa given in conjunction?
It passes into the brain & converts into dopamine.
Carbidopa prevents early conversion of Levadopa into dopamine as dopamine cannot cross the BBB.
35
Adderall works by.
Increasing dopamine & epinephrine in the brain
36
Wellbutrin works by.
Increasing dopamine & NE
37
What drug is avoided in someone with Parkinson’s?
Reglan as it is a dopamine antagonist
38
Where in the brain is Epi produced?
Medulla oblongata & pons
39
Where in the brain is NE produced?
Locus Coeruleus
40
The Locus coeruleus is located within the?
PONS
41
Where in the PNS are Epi & NE found?
Sympathetic ganglia,
postganglionic sympathetic neurons
42
Serotonin is synthesized from and where?
Tryptophan & 90% in the GI tract’s enterochromaffin cells
43
Where in the brain is Serotonin present?
Pons & medulla
44
What type of blood cell stores serotonin?
Platelets
45
In pathologic states serotonin causes?
Vasoconstriction (Pathologic state= HTN, atherosclerosis)
46
In physiologic states serotonin causes?
Vasodilation (Releases NO)
47
Where is GABA located in the pancreas & what does it do?
In beta cells & inhibits glucagon secretion
48
Which anti-seizure medication works with GABA?
Valproic acid
49
Which muscle relaxer works with GABA?
Baclofen (Lioresal)
50
Where are endorphins released from?
Hypothalamus & pituitary
51
How do endorphins work?
Bind to mu receptors in the brain, block GABA to increase dopamine
52
The common carotid arteries bifurcate into?
The anterior & middle cerebral arteries
53
The vertebral arteries form the _____, which then divides into the ___?
Basilar artery & posterior cerebral arteries
54
Which arteries merge to form the circle of Willis?
Anterior, middle & posterior cerebral arteries
55
What arteries run along the surface of the brain?
Pial arteries
56
The pial arteries branch into the ____?
Penetrating arteries
57
What perfuses deeper brain tissue?
Intracerebral arterioles
58
The circle of Willis includes?
- Anterior communicating artery,
- L & R anterior cerebral arteries,
- L & R posterior communicating arteries,
- Distal tip of L & R internal carotids,
- L & R posterior cerebral arteries
59
The superficial & deep cerebral venous systems meet in the ___?
Confluence of Sinuses
60
The most prominent superficial dural venous sinus is the ____?
Superior sagittal sinus
61
The deep veins in the brain join ___ to form the ___, which drains into the ____ & then into the ____?
- Behind the midbrain &
- Great Cerebral Vein (Vein of Galen),
- inferior sagittal sinus,
- straight sinus
62
The Confluence of Sinus drain into the ____?
Internal jugular veins
63
The brain receives ___% of cardiac output.
15 – 20%
64
The brain receives ___ mL of blood for each ___ gram of tissue per ___.
50 – 60mL / 100gr / per min
65
Average adult CBF is around?
750 – 900mL/min
66
At what CBF is cerebral impairment seen?
20 – 30 mL/100g/min (280 – 420 mL/min)
67
At what CBF is an isoelectric EEG seen?
15 – 20 mL/100g/min (210 – 280 mL/min)
68
At what CBF does irreversible brain damage occur?
10 mL/100g/min (140 mL/min)
69
What 3 main factors affect CBF?
Myogenic, Neurogenic, Metabolic
70
A MAP of __ - ___ relates to stable cerebral blood flow.
60 – 140 mmHg
71
Myogenic control of CBF relates to?
Cerebral vasculature smooth muscle in arterioles
72
Neurogenic CBF control relates to?
SNS innervation of large brain arteries (superior cervical ganglia)
73
Metabolic CBF control is affected by these 4 things?
CO₂/H⁺ concentration, O₂ concentration, Astrocytes & CMRO₂
74
What is a normal CMRO₂ at rest?
~3 mL/100g/min (~40 – 50 mL/min)
75
What hypoxic states cause cerebral vasodilation?
PaO₂ <60 mmHg & SpO₂ <90%; or decreased CaO₂ d/t hemodilution
76
What non-pharmacologic factors affect CMR?
Hypothermia, hypoglycemia, hyperthermia
77
How does hypothermia affect CMRO₂?
Each 1℃ reduction → 6 – 7% decrease in CMRO₂
78
How does hyperthermia affect CMRO₂?
Increases CMRO₂ up to 42℃
79
How does hypoglycemia affect CMRO₂?
Increased CBF & CMRO₂
80
What is the relationship between CBF & PaCO₂?
Blood flow is directly proportional to PaCO₂ (higher PaCO₂ = higher CBF)
81
What is the primary function of astrocytes?
- Provide support and nutrition to neurons.
- Help regulate neuroinflammation.
- Antioxidant response. Release Nitric Oxide
82
What is astrocyte-mediated vasodilation?
Glutamate stimulates astrocytes, which leads to increased calcium in foot projections leading to vasodilation of nearby arterioles/capillaries. They also release NO
83
How does nitrous affect CBF/CRMO₂?
Minor increase in CMRO₂ & CBF (synergistic with volatiles)
84
How does ketamine affect CBF/CRMO₂?
Increased CBF & CMRO₂
85
How do barbiturates affect CBF/CMRO₂?
Decreased CMRO₂ (-tal drugs, Thiopental, etc)
86
How does etomidate, propofol, and opioids affect CMRO₂/CBF?
Reduce CMRO₂ & CBF in parallel
87
What is the Robinhood effect?
Barbiturates decrease cerebrovascular response to CO2, vasoconstrict healthy parts of the brain and allow for preferential perfusion to ischemic areas
88
How do VA’s affect CBF/CRMO2?
- Minimal effect <1MAC.
- >1MAC potent cerebral vasodilation, increase in CBF (healthy & ischemic areas)
89
What is the spinal cord blood supply?
1 anterior spinal artery & 2 posterior spinal arteries
90
The anterior spinal artery runs from ___ to ___.
Foramen magnum to Filum terminale
91
The anterior spinal artery originates from the ___?
Vertebral artery
92
The anterior spinal artery supplies what?
Anterior 2/3 of the spinal cord
93
What does the posterior spinal arteries supply?
Posterior 1/3 of the spinal cord
94
What feeds the posterior spinal arteries?
Radicular & medullary arteries at each spinal level.
95
How is the artery of Adamkiewicz recognized on an angiogram?
Due to its hairpin turn
96
The artery of Adamkiewicz usually arises from where?
Left side of the aorta by T9 – T12
97
What is the largest anterior medullary segmental artery?
Artery of Adamkiewicz
98
What does the Artery of Adamkiewicz supply?
The anterior thoracolumbar spinal cord
99
What could be seen if the Artery of Adamkiewicz is damaged?
- Impaired motor function to the legs;
- paralysis,
- urine/bowel incontinence.
- Sensory is usually intact.
100
What is tethered cord syndrome?
Spinal cord tissue attached to spinal column
