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PHTH 527: Applied Neurosciences I > Exam 1 Prep > Flashcards

Exam 1 Prep Flashcards

1
Q

What are the principle roles of the nervous system?

A

-Cognitive functions
-Sensory-motor functions
-Motivation and emotion
-Regulatory function and homeostasis (autonomic NS)

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2
Q

What is the soma?

A

Cell body of the neuron

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3
Q

What is the axon hillock?

A

The initial segment of the axon

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4
Q

What is the axon?

A

Where the action potential travels through

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5
Q

What are the nodes of ranvier?

A

Where there is a gap in the myelin sheath surrounding the axon which allows the action potential to travel down the neuron

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6
Q

What is a dendrite?

A

A branch off of the cell body and is the site of synapses

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7
Q

What are the different types of neurons?

A

-Bipolar
-Motor neuron (multipolar)
-Sensory neuron (unipolar)
-Interneuron (multipolar)

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8
Q

What is white matter?

A

Groups of myelinated axons

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9
Q

What is gray matter?

A

Groups of cell bodies

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10
Q

What are fasciculi?

A

White matter pathways or tracts

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11
Q

What is a nucleus?

A

A group of functionally related nerve cells

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12
Q

What is a ganglia?

A

Group of multiple nerve cells

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13
Q

What are columns/tracts?

A

Occurs in the cerebral cortex and spinal cord and is a group of nerve cell bodies and their axons that are related in function

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14
Q

What comprises the central nervous system?

A

-Brain
-Spinal cord

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15
Q

What comprises the peripheral nervous system?

A

-Autonomic nervous system
-Peripheral nerves
-Cranial nerves

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16
Q

What are the components of the autonomic nervous system?

A

-Parasympathetic (“rest and digest”)
-Sympathetic (“fight or flight”)

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17
Q

What is the posterior root ganglion?

A

A group of nerve cell bodies lying in a peripheral nerve root

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18
Q

What is a root/ramus?

A

A peripheral structure with parallel axons

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19
Q

What part of the nervous system does the polio virus attack?

A

The polio virus attacks the anterior horn cell

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20
Q

Is the anterior horn cell considered to be apart of the PNS or CNS?

A

PNS

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21
Q

What nerve roots are associated with the parasympathetic nervous system?

A

-Cranial nerves
-Sacral nerves

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22
Q

What nerve roots are associated with the sympathetic nervous system?

A

-Thoracic nerves
-Lumbar nerves

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23
Q

How does the parasympathetic system effect the body?

A

-Constricts pupils
-Stimulates saliva
-Slows heartbeat
-Constricts airways
-Stimulates activity of stomach
-Inhibits release of glucose
-Stimulates bladder
-Stimulates activity of intestines
-Promotes erection of genitals

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24
Q

How does the sympathetic system effect the body?

A

-Dilates pupils
-Inhibits salivation
-Increases heartbeat
-Relaxes airways
-Inhibits activity of stomach
-Stimulates release of glucose
-Inhibits gallbladder
-Inhibits activity of intestines
-Relaxes bladder
-Release of epinephrine and norepinephrine
-Promotes ejaculation and vaginal contraction

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25
Q

What are the four types of brain/glial cells?

A

-Astrocytes
-Oligodendrocytes
-Ependymal cells
-Microglial cells

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26
Q

What are astrocytes?

A

-“star”
-Direct role in signaling
-Provides nutrition for neurons
-Involved in memory
-Release neurotransmitters (glutamate)
-Make up 30-65% of glial cells

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27
Q

What are oligodendrocytes?

A

They provide myelin in the CNS

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28
Q

What are ependymal cells?

A

-Cells that produce cerebrospinal fluid
-Provide waste clearance

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29
Q

What are microglial cells?

A

-Function as the immune cells in the NS
-Activated in nervous system diseases, infection, or injury
-Dying neurons secrete proteins that attract microglia

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30
Q

What cells are activated by neuroinflammation?

A

Microglia and astrocytes

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31
Q

What diseases is abnormal glial activity seen in? What happens to the microglia?

A

-Alzheimer’s
-Multiple sclerosis
-Parkinson’s disease
-Head injury
-Microglia lose their protective control and stimulate cellular breakdown

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32
Q

What are Schwann cells?

A

-Surround axons in PNS
-Responsible for myelination in PNS
-Participate in repair process after injury

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33
Q

What are satellite cells?

A

-Surround neuron cell bodies in ganglia
-Regulate O2, CO2, nutrient, and neurotransmitter levels around neurons in ganglia

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34
Q

What occurs during multiple sclerosis?

A

-The microglia attack the oligodendrocytes in the CNS
-This causes destruction of myelin which results in plaques (neuronal death)

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35
Q

What type of exercise helps the microglia to regenerate oligodendrocytes and myelin? What are the recommended amounts?

A

-Aerobic exercise
-20-40 min. 3X a week at 70-80% of training heart rate (THR)

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36
Q

What occurs during Alzheimer’s disease?

A

-Microglia cause abnormal increases in neuro inflammation, which leads to the release of cytokines and free radicals
-The neuro inflammation leads to β-amyloid plaques
-The good type of microglia helps to reduce the inflammation

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37
Q

What are the two different types of microglia and what are their functions?

A

-M1 microglia induces inflammation and is the “bad” microglia that attacks the myelin in MS and causes inflammation in Alzheimer’s
-M2 microglia is the non-inflammatory, “good” microglia that helps to regenerate myelin

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38
Q

How many layers is the motor cortex split into?

A

The motor cortex is split into 6 layers/lamina

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39
Q

What are Betz cells and where do they originate from?

A

-A type of pyramidal neuron that connects the axon and descend the spinal cord via the corticospinal tract, which synapses directly with the anterior horn cells
-Over 50% of the Betz cells originate in the primary motor cortex

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40
Q

What is the pathway for motor impulses?

A

-Primary motor cortex
-Through the brain
-To the brainstem
-Midbrain
-Pons
-Medulla
-Through the spinal cord

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41
Q

What are the two corticospinal tracts? Where do they cross?

A

-Lateral corticospinal tract
-Crosses at cervicomedullary junction
-Anterior corticospinal tract
-Stays unilaterally and crosses over at spinal cord level to innervate bilateral sides

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42
Q

What is the anterior corticospinal tract? What motor tracts does it contain? What muscles does it innervate?

A

-One long axon from the precentral gyrus to medial motor nuclei
-Contains motor tracts for cevical and upper thoracic cord (trunk)
-Primarily innervates bilateral axial and shoulder girdle muscles

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43
Q

What is an upper motor neuron?

A

One long axon from the primary motor cortex to the anterior horn cell (CNS)

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44
Q

What are upper motor neuron lesions?

A

Trauma, diseases, or infections occurring in an upper motor neuron that is in the brain or spinal cord

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45
Q

What are lower motor neurons?

A

They involve the anterior horn cell and the peripheral nerves

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46
Q

What are lower motor neuron lesions?

A

Injuries, diseases, or infections associated with the lower motor neurons

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47
Q

Do all neurons in the lateral corticospinal tract travel contralaterally?

A

No, 10% of neurons in the lateral CST travel ipsilaterally and terminate in the ipsilateral spinal cord

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48
Q

What is the order that the motor system is activated in?

A

-Posterior sensory cortex sends goals
-Prefrontal cortex plans
-Premotor cortex sequences
-Motor cortex executes the actions

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49
Q

What are the 5 steps of voluntary motor activation?

A
  1. Decision made in the frontal lobe
  2. Motor planning areas and command centers activate (Pre-motor and vision)
  3. Motor tract delivers signals to alpha motor neurons
  4. AMNs transmit signals directly to skeletal muscles
  5. Correction/feedback of motor activity in cerebellum and the sensory cortex, regulating the activity in descending motor tracts
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50
Q

What are the methods of nervous system muscle activation?

A

-Motor neuron pools
-Systematic method of increasing activation: Henneman’s Size Principle
-Increase the rate of stimulation

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51
Q

What is a motor neuron pool?

A

-Groups of muscles that cluster into discrete neurons (AHCs) with a common target
-Link across several spinal nerves
-Receive sensory feedback (proprioceptive) from muscle spindles
-Coordinate with patterns of muscles by segments, sensory and cortical input
-The more motor pools recruited, the more strength there will be

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52
Q

What is Henneman’s Size Principle?

A

Arrangement of motor unit activation
-Smallest motor units activated first
-Medium motor units activated second
-Largest motor units activated last
-Motor units receive common neural input and are recruited according to their sizes

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53
Q

What are the three types of alpha motor neurons? What is their relative excitabilities?

A

-S type (slow): small and highly excitable
-FR type (fatigue resistant): big and average excitability
-FF type (fatiguable): biggest and low excitability

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54
Q

What is the neural activation size principle?

A

-Type I motor units have a low activation threshold with lower force production
-Type II motor units have a high activation threshold but have high force production

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55
Q

What does the corpus callosum do?

A

It connects the 2 hemispheres of the brain and allows them to communicate

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56
Q

What are gyri?

A

The ridges of the brain that contain cell bodies of the neurons, dendrites, and synapses

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57
Q

What are sulci?

A

The grooves of the brain, the deeper the grooves, the more cortical brain depth

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58
Q

What is the thalamus?

A

The “relay center” of the brain, it sends info to the rest of the brain from the body

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59
Q

What does the premotor cortex do?

A

It arranges activation patterns of our movements/plans our movements

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60
Q

What does the parietal association cortex do?

A

It is the setup for sensory

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61
Q

Does the sensory or motor cortex have more plasticity?

A

Sensory cortex

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62
Q

What is the somatosensory cortex responsible for? Where is it located?

A

-Responsible for receiving and processing sensory information from across the body, such as touch, temperature, and pain
-Located posterior to the Central Sulcus

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63
Q

What is the parietal lobe vital for?

A

-Vital for sensory perception and integration, including the management of taste, hearing, sight, touch, and smell
-It houses the brains primary somatosensory cortex

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64
Q

What structure in the brain has dopaminergic neurons?

A

Substantia nigra

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65
Q

What happens when someone loses their sense of smell?

A

It affects their memory, since memory is associated with smells

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66
Q

What are the purpose of the ventricles?

A

To make and circulate cerebrospinal fluid

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67
Q

Where does CSF travel through?

A

CSF travels through the ventricles, spinal cord, central canal, and subarachnoid space

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68
Q

Where is CSF released into?

A

It is released into the venous blood in the arachnoid granulations in the superior sagittal sinus at the top of the falx cerebri

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69
Q

Where can blood potentially leak into in the brain?

A

Into the CSF

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70
Q

What is hydrocephaly? When does it most commonly happen?

A

-Too much CSF in the brain which causes swelling and puts pressure on the brain
-It most commonly occurs in babies and TBI patients

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71
Q

What are arachnoid granulations?

A

Out-pouchings of the arachnoid membrane into the dural venous sinuses

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72
Q

Where is CSF produced?

A

In the choroid plexus in the 3rd, 4th, and lateral ventricles

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73
Q

What is the composition of CSF?

A

The composition is similar to plasma, but low in protein and gets produced at a steady rate

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74
Q

What is the order of CSF circulation?

A

-Originates in the choroid plexus
-Lateral ventricles
-Foramen of Monroe to III ventricle
-Through cerebral aqueduct
-To IV ventricle
-Through Foramina of Luschka (lateral) and Magendie (medial)
-To subarachnoid space
-Through arachnoid granulations to the dural venous sinus

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75
Q

When do skull fractures occur?

A

In concussions and traumatic head injuries

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76
Q

What is the foramen magnum?

A

The foramen where the spinal cord travels through

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77
Q

Does the brain have sensation?

A

No, but dura mater does

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78
Q

What is dura mater?

A

-Layer of connective tissue that separates and surrounds the two hemispheres of the brain
-Provides autoimmunity to the brain

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79
Q

What are meninges?

A

-Layers of protection for the brain
-Dura mater (outer most layer)
-Arachnoid mater (middle layer)
-Pia mater (inner most layer)

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80
Q

What happens if there is a tear to the dura mater?

A

It is extremely painful

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81
Q

Where do headaches usually originate from?

A

-Dura
-Blood vessels
-Muscles

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82
Q

What happens if there is a bleed in the subarachnoid space? What are the symptoms?

A

-A bleed in the subarachnoid space is deadly
-Someone might describe it as the worst headache of their life
-If this is the case call 911 IMMEDIATELY

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83
Q

What is the falx cerebri? What is its purpose?

A

-Part of the dura mater
-It separates the two hemispheres of the brain
-It helps to protect the brain and keep viruses from spreading from one hemisphere of the brain to the other

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84
Q

What is the tentorium cerebelli?

A

-Part of the dura mater
-“Tent”
-It separates the cerebellum from the rest of the brain to protect against infections or viruses from spreading to it

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85
Q

What do the primary motor cortex and premotor cortex have in common?

A

Both project directly to the spinal cord and are capable of some direct control of movement

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86
Q

What is the purpose of the supplementary motor area (SMA)?

A

-Internally generates plan of movement
-Planning of sequences of movement
-Coordination of the two sides of the body such as bi-manual coordination

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87
Q

Where does the lateral corticospinal tract decussate?

A

At the cervico-medullary junction in the lower medulla

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88
Q

Where does the anterior corticospinal tract decussate?

A

At the spinal cord level

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89
Q

Where does the anterior corticospinal tract end? Why does it end there?

A

-It ends at the mid thoracic area
-Because it primarily innervates the bilateral axial and shoulder girdle muscles

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90
Q

What is the purpose of somatosensation and proprioception?

A

-Explore
-Identify
-Increase feedback
-Prevent injury

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91
Q

What sensory information comes from the cutaneous layer?

A

-Tactile
-Superficial (touch)
-Vibration/proprioception/
kinesthesia
-Pain
-Nerve
-Skin
-Visceral
-Muscle, tendons, ligaments, CT
-Temperature

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92
Q

What sensory information comes from the muscle, connective tissue, and joints?

A

-Stretching
-Static and dynamic force
-Skin

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93
Q

What is proprioception?

A

Awareness of static joint position

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94
Q

What is kinesthesia?

A

Awareness of dynamic joint positions

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95
Q

What does sensory information promote?

A

-Adaptations in posture and movement
-Sent from peripheral nerves

96
Q

What is sensory perception? How does it help us?

A

-Awareness of stimuli
-It interprets sensory info into meaningful forms
-It is an active and ongoing process and involves acting within the environment

97
Q

What are the categories of cutaneous sensory receptors?

A

-Mechanoreceptors
-Pressure
-Discriminative touch
-Vibration
-Proprioception
-Thermoreceptors
-Nociceptors

98
Q

What tissues/parts of the body have specialized receptors?

A

-Vessels
-Connective tissue
-Ligaments
-Tendons
-Viscera

99
Q

What is a Meissner corpuscle?

A

-Found in fingertips mostly
-Discriminative touch
-Low frequency vibrations
-Velocity sensitive (2-40mm/s)
-Small receptive field (2-4mm)

100
Q

How do children learn discriminative touch?

A

They learn over time by playing w/ different objects

101
Q

What is a Pacinian corpuscle?

A

-High frequency vibration
-Sudden stimuli
-Mostly in fingertips
-Deep pressure over large surface
-Large receptive fields (>4mm)

102
Q

What are Ruffini’s corpuscles?

A

-Skin stretch direction & force
-Subcutaneous skin
-Large receptive fields (>4mm)

103
Q

What are Merkel’s disks?

A

-Surface pressure
-Static touch
-Touch & form (shapes & edges)
-Mostly in fingertips
-Dermis & hair follicles
-Small receptive fields (2-4mm)

104
Q

What are free nerve endings?

A

-Unmyelinated
-Pain
-Heat
-Cold

105
Q

Is a slow or rapid stimulus required to stimulate Meissner’s corpuscles?

A

Fast

106
Q

Is a slow or rapid stimulus required to stimulate Pacinian corpuscles?

A

Fast

107
Q

Is a slow or rapid stimulus required to stimulate Merkel cells?

A

Slow

108
Q

Is a slow or rapid stimulus required to stimulate Ruffini endings?

A

Slow

109
Q

Where are free nerve endings found?

A

-Throughout the skin and viscera
-Epidermis

110
Q

What happens to free nerve endings after they are damaged? What can this cause?

A

-Free nerve endings can grow back and grow larger
-This can cause an abnormal increase in pain response

111
Q

How do pain stimuli translate? What types of stimuli can stimulate free nerve endings?

A

-They translate potentially damaging stimuli into electrochemical signals
-Mechanical, thermal, or chemical

112
Q

What are the two different types of pain?

A

-Nociceptive: activation of pain receptors
-Neuropathic: direct injury to neural tissue

113
Q

What are symptoms of neuropathic pain?

A

-Burning sensation
-Radiating pain following peripheral nerve

114
Q

What are Delta fibers?

A

-Myelinated free nerve endings
-Carry sharp, stabbing, and pricking pain, or cold
-High threshold
-Immediate pain

115
Q

What are C fibers?

A

-Unmyelinated free nerve endings
-Carry dull, achey pains
-Higher activation threshold than delta fibers
-Polymodal pain receptors (Chemical, heat, mechanical, hypoxia)

116
Q

What is the sizes of axons of different nerve types from smallest to largest? How fast does each travel?

A

-C fibers
-Delta fibers
-Beta fibers (corpuscles)
-Alpha motor neurons
-Axon and speed of transmission have a direct relationship, so the larger the axon, the faster the transmission

117
Q

What is the rate of adaptation of free nerve endings?

A

Slow

118
Q

What is the rate of adaptation of Meissner’s corpuscles

A

Fast

119
Q

What is the rate of adaptation of Pacinian corpuscles?

A

Fast

120
Q

What is the rate of adaptation of Merkel’s disks?

A

Slow

121
Q

What is the rate of adaptation of Ruffini’s corpuscles?

A

Slow

122
Q

What is the muscle spindle (MS)?

A

-Sensory proprioceptor in the muscle belly
-Intrafusal muscle fibers (muscle spindle) connects w/ extrafusal muscle fibers
-Efferent info is sent from MS to muscle

123
Q

What sensory receptors are found in the joints?

A

-Ruffini’s
-Pacinian
-Free nerve endings

124
Q

How does the muscle spindle work and communicate?

A

-Transmits information of the length of the muscles as well as the speed of the muscle contraction
-Sends info to the cerebellum
-Unconscious sensation
-Plays a vital role in regulating the contraction of muscle

125
Q

How does the cerebellum help us with coordination?

A

-It estimates joint position and force needed to complete movements or tasks
-The muscle spindle sends info to it, and if we estimated our movements incorrectly, the cerebellum corrects it
-It houses motor memory

126
Q

What type of afferent neuron is the muscle spindle?

A

Type Ia afferent neuron to CNS

127
Q

What reflexes test the integrity of the muscle spindle and why?

A

-Deep tendon reflexes
-Because it causes a quick stretch which makes the muscle contract quickly, which the muscle spindle detects

128
Q

What root does sensory information go into?

A

-Dorsal root ganglion

129
Q

How does the muscle spindle aid in reciprocal inhibition?

A

-The muscle spindle synapses onto two motor neurons
-One synapses directly onto the motor neuron of the agonist muscle
-The other synapses onto an inhibitory interneuron, then the interneuron synapses onto the motor neuron of the antagonist muscle to force it to relax

130
Q

What are the two major sensory pathways?

A

-Anterolateral pathway
-Spinothalamic tract
-Dorsal columns (medial leminiscal pathway)

131
Q

What sensory information goes through the anterolateral pathway?

A

-Pain
-Temperature
-Crude touch

132
Q

Where does the anterolateral pathway decussate?

A

Spinal cord

133
Q

What sensory information goes through the medial leminiscal pathway?

A

-Vibration
-Joint position
-Fine touch

134
Q

Where does the medial leminiscal pathway decussate?

A

Medulla

135
Q

What are the functions of the thalamus?

A

-Sensory relay center
-Sensory integration
-Influences voluntary movements (BG, cerebellum)
-Influences limbic system & memory
-Vision: visual grasp
-Recognition of pain & temperature

136
Q

What does non-noxious mechanical stimuli activate?

A

Beta fibers

137
Q

What does noxious mechanical stimuli activate?

A

Delta fibers

138
Q

What does noxious heat and chemical stimuli activate?

A

C fibers

139
Q

What is the Golgi Tendon Organ (GTO)?

A

-Encapsulated receptor located at musculoskeletal junction
-In series w/ extrafusal muscle fibers
-3-50 GTO per muscle fiber
-Innervated by afferent fiber branches, Ib, by which the distal parts of the tendon-spindle are inneravted
-Detects tension in the tendon

140
Q

How does the GTO work?

A

-Detects small change in muscle force (<1g of force)
-Compensates for fatigue in motor units
-Can shut things down to avoid injury by inhibiting muscle contraction
-Reflex regulation of alpha motor neuron
-Context/task dependent because it helps us estimate how much force we need to perform a task

141
Q

What are gamma motor neurons?

A

Type II motor neurons that reset the muscle spindle after activation

142
Q

What does an Upper Motor Neuron UMN) syndrome involve?

A

-Motor cortex and pathways
-Brainstem
-Cerebellum
-And/or involves the spinal cord and its coordination

143
Q

Where does an UMN injury reside?

A

-Injury resides in several areas of the brain and spinal cord
-Major areas are located in the motor cortex or brainstem
-Also involved motor pathways from the major brain areas and the spinal cord involving motor output

144
Q

Where does and LMN injury reside?

A

-Anterior horn cell
-Peripheral nerve

145
Q

What causes UMN syndrome?

A

The result of the disruption of central motor pathways that arise from the cerebral cortex and pathways in spinal cord

146
Q

What are the main motor tracts?

A

-Corticospinal tracts
-Corticobulbar tracts

147
Q

What are signs of UMN lesions in the brain & brainstem?

A

-Spasticity
-Weakness, loss of selective control (pathologic synergies) which can lead to contractures
-Hyperactivity; increase in deep tendon reflexes, clonus, and rigidity
-Loss of upright control

148
Q

What area of the brain is associated with decreased muscular control in UMN syndrome?

A

Cerebellum

149
Q

What is clonus?

A

Repeated rhythmic contractions of individual muscle groups

150
Q

What is tone? What is it independent of/exclude?

A

-Resistance to passive stretch as a patient is attempting to maintain a relaxed state of muscle activity
-Independent of joint, skeletal, or ligamentous abnormalities

151
Q

What does tone reflect?

A

-Muscle state (relaxation)
-Independent of strength, coordination, or involuntary movement

152
Q

What is the range of muscle tone from least to greatest?

A

-Flaccidity (LMN)
-Hypotonia
-Normal
-Hypertonia (UMN)
-Rigidity

153
Q

What is hypertonia?

A

-Increase in passive muscle tightness
-Abnormally increased resistance to an external force about a joint

154
Q

What are the three classifications/subcategories of hypertonia?

A

-Spasticity
-Rigidity
-Dystonia

155
Q

What is spasticity?

A

-Velocity dependent increase in tonic stretch reflexes w/ exaggerated tendon jerks, resulting from the hyper excitability of the stretch reflex
-At multiple joints

156
Q

What is rigidity?

A

-Significant increase in resistance to multidirectional external force about a joint
-Usually seen in end stage Parkinson’s Disease

157
Q

What is dystonia?

A

-A state of abnormal muscle tone resulting in muscular spasm and abnormal posture, typically due to neurological disease or a side effect of drug therapy
-Usually associated w/ basal ganglia & Huntington’s disease

158
Q

What are common upper limb postures or synergies that are seen in UMN syndrome?

A

-Flexed elbow
-Bent wrist
-Pronated forearm
-Clenched fist
-Thumb in palm

159
Q

What is a common synergy pattern for people that have had strokes?

A

-Upper extremity flexion synergy
-Lower extremity extension synergy

160
Q

What is movement ataxia? What area of the brain is it associated with?

A

-Loss of coordination, tremors, overshooting, loss of velocity
-Associated with cerebellum

161
Q

What is bradykinesia? What part of the brain is it associated with?

A

-Slowness of movement
-Associated with the basal ganglia and Parkinson’s disease

162
Q

What is the grading system for reflexes?

A

-4 Absent
-3 Just elicit able
-2 Low response
-1 Moderately low
0 Normal
+1 Brisk
+2 Very brisk
+3 Exhaustible clonus
+4 Continuous clonus

163
Q

What are associated movements?

A

-Moving one part of the body and another limb moves involuntarily
-Loss of complete selective control

164
Q

What is an advanced brain lesion?

A

-Severe injury in the brain (usually from stroke)
-Causes severe motor disruption “posturing”
-All limbs are “fixed” on a posture w/ limited limb movements
-Associated w/ rigidity (severe increase in tone)
-Flexion and extension synergies

165
Q

What are signs and symptoms of a cerebrovascular accident/stroke?

A

-Initially flacid
-Later develops spasticity
-Reflexes hyperactive
-Synergistic movements
-Clonus
-Sensory loss
-Cranial nerve changes (facial weakness and vision changes)
-Bladder changes

166
Q

What is a John Doe spinal cord injury?

A

-When a whole vertebrae shatters
-The broken pieces irritate the spinal cord
-It doesn’t typically sever the spinal cord
-Mostly from high speed accidents

167
Q

What are different types of incomplete spinal cord injuries?

A

-Central cord
-Brown Sequard
-Anterior cord

168
Q

What is Brown Sequard syndrome?

A

-Lesion on hemisection of spinal cord
-Ipsilateral UMN signs below the level of lesion
-Ipsilateral loss of tactile, vibration, proprioception loss 1-2 levels below lesion
-Contralateral pain and temp. loss below lesion
-Ipsilateral loss of all sensation
-Ipsilateral LMN signs

169
Q

What is a transverse cord lesion?

A

A complete spinal cord injury, which effects all motor & sensation under the level of injury

170
Q

What is lost on the involved side in spinal cord injuries?

A

Vibration & proprioception

171
Q

What is lost on the uninvolved side in spinal cord injuries?

A

Loss of pain & temp.

172
Q

What are signs of lower motor neuron lesions?

A

-Loss of muscle function (weakness/flaccid)
-Loss of sensation
-Tone: hyporeflexia

173
Q

What are other LMN lesion signs?

A

-Fibrillations (muscular twitching)
-Fasciculations (worm-like contraction)
-Hypotonia/atonia

174
Q

Where should you test when examining LMN lesions? Why?

A

-Test above, parallel, & other side of where the lesion is
-Because some peripheral nerve disease spread, like Guillan Barre

175
Q

What is neuropraxia? Can the nerve heal from it?

A

-Loss of myelin
-Leads to weakness
-Typically occurs in M.S.
-Can heal

176
Q

What is axontmesis? What is another name for it? Can it heal?

A

-Loss of axon and myelin
-Also called Wallerian degeneration
-Causes atrophy and sensory loss
-Can heal, but it is hard

177
Q

What is neurotmesis? Can it heal? What syndrome can it cause?

A

-Complete transection of nerve
-Recovery more difficult due to neuroma formation
-Usually does not heal
-Can cause phantom limb syndrome in patients with amputations

178
Q

What are nerve root injuries? How do they occur?

A

-An injury to the nerve right at the nerve root (when it exits the spinal cord)
-Common causes are foraminal stenosis and herniated discs

179
Q

What is Carpel Tunnel Syndrome? What is the clinical presentation?

A

-Injury to the median nerve
-Atrophied thenar eminence
-Weakness or paralysis
-Pain along nerve
-Numbness along nerve
-Sensory loss
-Loss of ROM

180
Q

What are the muscles involved in carpel tunnel syndrome?

A

-Flexor pollicis brevis
-Opponens pollicis
-Abductor pollicis brevis

181
Q

What muscle testing should be done for a peripheral nerve injury?

A

-Test muscles on uninvolved side
-Test muscles on involved side
-Test muscles of adjacent peripheral nerves

182
Q

What sensory testing should be done for a peripheral nerve injury?

A

-Ask about pain
-Test sensation to uninvolved side first, then involved side
-Test sensation in the involved sensory distribution
-Test sensation of adjacent peripheral nerves

183
Q

What are signs and symptoms of injury to the deep fibular nerve/common fibular nerve?

A

-Numbness and tingling
-Shooting pain along the nerve
-Pain w/ nerve tapping
-Pain at rest
-Hyperreflexia
-Muscular weakness
-Sensory loss in common fibular distribution

184
Q

What muscles are involved in common fibular nerve injury?

A

-Fibularis longus & brevis
-Tibialis anterior, EHL, EDL

185
Q

What are signs and symptoms of a C6 nerve root injury?

A

-Sensory loss following the C6 dermatome
-Hyporeflexia
-Decreased DTR
-Weakness
-Pain
-Tingling and numbness following C6 distribution

186
Q

What are the muscles involved in the C6 nerve root injury?

A

-Biceps
-Brachioradialis
-Wrist extensors

187
Q

What is diabetic neuropathy?

A

-Length dependent (distal)
-Blood vessels in distal extremities deteriorate which cuts off the blood supply to the nerves
-Follows a glove and stocking presentation
-Polyneuropathy (many nerves involved)

188
Q

What structures make up the basal ganglia?

A

-Caudate
-Putamen
-Globus pallidus
-Subthalamic nucleus
-Substantia nigra

189
Q

What is the basal ganglia?

A

-The basal ganglia is a collection of gray matter nuclei
-Contains a variety of complex excitatory and inhibitory connections, utilizing different neurotransmitters

190
Q

How is the basal ganglia involved in motor control?

A

-Eye movement (helps us plan where to look)
-Associative function
-Limbic system

191
Q

How are the caudate and putamen separated?

A

-Separated by penetrating fibers of the internal capsule but remain joined by cellular bridges

192
Q

What are the functions of the basal ganglia?

A

-Initiates and integrates behavior and movement
-Removes unwanted and inappropriate movement
-Plans motor activity
-Regulates motor habits
-“Rewards and motivation”
-Associations with attention

193
Q

What influences the basal ganglia and how does it influence other structures?

A

-The cerebral cortex directly influences the basal ganglia
-The basal ganglia influences the cortex via the thalamus
-It also influences the motor system through spinal cord pathways

194
Q

What is the basal ganglia circuitry to the brainstem?

A

-Reticulospinal tract
-Vestibulospinal tract

195
Q

Where do skilled movements arise from in the motor cortex?

A

-Corticospinal tracts
-Brainstem

196
Q

How do we select/initiate motor programs?

A

-Basal ganglia to brainstem
-Basal ganglia to thalamus

197
Q

What motor pathways come from the spinal cord?

A

-Central pattern generation
-Muscle movement
-Reflexes

198
Q

How is the basal ganglia intimately connected to the cortex?

A

Through parallel loops

199
Q

What are the parallel loops subdivided into?

A

-Motor
-Associative (cognition)
-Limbic

200
Q

What can dysfunction of the basal ganglia and its connectivity lead to?

A

-Movement disorders (dyskinesias)
-Akinesia
-Bradykinesia
-Hyperkinesia

201
Q

What are non-motor loop pathologies of the basal ganglia?

A

-Emotional, cognitive, and psychiatric deficits
-OCD
-Tourette’s
-ADHD

202
Q

What does functional data suggest about the basal ganglia?

A

-It is involved in both the preparation and execution of movements, motor control, and learning of motor sequences and habit (implicit learning aka learning yourself)

203
Q

How is the basal ganglia related to turning?

A

-It helps us decide where and when to turn based on perceptual decisions
-BG dysfunction creates gait deficits and can make turning hard for people w/ Parkinson’s

204
Q

How does the basal ganglia help us turn?

A

-Planning of cervical and trunk rotation
-Changes the angles of hip rotation, while anticipating any environmental disruptions

205
Q

What are the two motor loops?

A

-Body movement loop
-Oculomotor loop

206
Q

What are the two non-motor loops?

A

-Prefrontal loop
-Limbic loop

207
Q

Is the direct pathway of the basal ganglia more inhibitive or excitable?

A

More inhibitive

208
Q

Is the indirect pathway of the basal ganglia more inhibitive or excitable?

A

More excitable

209
Q

What does dysfunctions in the direct pathway of the basal ganglia lead to?

A

-Hypokinesia
-Under-stimulation (more inhibition of motor cortex)
-Loss of automatic movements
-PD
-Rigidity
-Bradykinesia

210
Q

What does dysfunctions in the indirect pathway of the basal ganglia lead to?

A

-Over-stimulation (less inhibition of cortex)
-Hyperkinetic
-Chorea
-Huntington’s

211
Q

What is the ranking of basal ganglia movement disorders by movement speed (slowest to fastest)?

A

-Bradykinesia, hypokinesia
-Rigidity
-Dystonia
-Athetosis
-Chorea
-Ballismus
-Tics
-Myoclonus
-Tremor

212
Q

What is ballistic movements?

A

-Flinging with large amplitude
-Hemiballismus: unilateral flinging contralateral to lesion

213
Q

What is a common cause of ballistic movements?

A

Infarct of the subthalamic nucleus

214
Q

What are tics?

A

-Involuntary small jerks or yelling
-Tourette’s syndrome
-4 times more in girls
-Increased in ADHD
-Symptoms come and go

215
Q

What are tremors?

A

-Both agonist and antagonist involved
-Bidirectional movement
-Asymmetrical
-“Pin rolling”
-Resting tremor and intention tremor
-Resting tremor is commonly seen in Parkinson’s

216
Q

What is lead pipe rigidity?

A

-Continous throughout whole movement
-Agonist and antagonist involved

217
Q

What is cogwheel rigidity?

A

-Ratchet like interruptions as the limb is passively moved
-Normal stretch reflexes
-Shoulders and cervical spine first affected
-Prolonged results in contracture

218
Q

What is Parkinson’s disease? What are the signs and symptoms?

A

-Loss of dopaminergic neurons & production in the substantia nigra
-Festinating gait (slow & shuffling, difficult to initiate)
-Difficulty turning corners
-Stooped forward & kyphotic
-Gait impediments coincide with visual, decision making, and motor control deficits
-Freeze with impediments/objects in path
-Resting tremors
-“Reptillian stare”/no expression

219
Q

What symptoms in Parkinson’s disease can present themselves 5 years before the onset of motor symptoms?

A

-Sleep issues/insomnia
-GI issues

220
Q

Where does gait originate from?

A

-Brainstem and descends to spinal cord
-Descending pathways come from mesencephalic locomotor region and lateral hypothalamus
-The MLR project into neurons in the pons and medulla , then project into the spinal cord to activate the CPGs involved in locomotion

221
Q

How does the Mesencephalic Locomotor Region (MLR) and lateral hypothalamus help in gait?

A

It helps us plan and initiate walking

222
Q

What is the Mesencephalic locomotor region (MLR)?

A

Area of the brainstem that is implicated in the control of gait and balance

223
Q

What is the pedunculopontine nucelus (PPN)? How is it related to Parkinson’s disease?

A

-Located in the MLR
-Plays a crucial role in appearance of axial symptoms in PD
-Dysfunction of cholinergic neurons in the PPN is what causes the symptoms in PD

224
Q

How does deep brain stimulation help PD patients?

A

Because it activates the MLR and PPN, which helps to alleviate locomotor symptoms

225
Q

What is labile presentation? What patient population is it commonly seen in?

A

-Awake, but not engaged
-Seen in PD

226
Q

What other additional basal ganglia diseases are there?

A

-Brain anoxia (cerebral palsy, common in babies before 1970)
-Huntington’s disease
-Stroke

227
Q

How is movement carried out?

A

-Preplanning: prefrontal cortex
-Preparation: premotor cortex
-Initiation, selection, memory, emotion: basal ganglia
-Activation: primary motor cortex

228
Q

How much oxygen is used for brain function?

A

20% at all times

229
Q

Where do 80% of strokes occur?

A

Middle cerebral artery

230
Q

What is a Stem stroke?

A

A stroke that occurs in the common cerebral artery, which causes a massive stroke

231
Q

What separates the frontal and parietal lobe?

A

The central sulcus

232
Q

What does the frontal lobe house?

A

-Premotor cortex
-Primary motor cortex
-Supplementary motor area

233
Q

What does the parietal lobe house?

A

-Primary somatosensory cortex
-Parietal association cortex
-Secondary somatosensory area

234
Q

What is decerebrate posturing?

A

Abnormal extension posturing and rigidity

235
Q

What is decorticate posturing?

A

-Abnormal UE flexion rigidity
-Abnormal LE extension rigidity

PHTH 527: Applied Neurosciences I (5 decks)

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