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pathophysiology > Exam #5- Neurology Physiology > Flashcards

Exam #5- Neurology Physiology Flashcards

1
Q

neuroglial cells (neuoglia)

A

“nerve glue”

includes:

astrocytess

oligodendroglia (oligodendrocytes)

ependymal cells

microglia

schwann cells

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2
Q

astrocytes

A

fill spaces between neurons and surround CNS blood vessels

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3
Q

oligodendroglia (oligodendrocytes)

A

store mylin in CNS

counterpart of schwann cells

schwann cells form INDIVIDUAL myelin sheaths around axons in the PNS, while oligodendroglia form MULTIPLE myelin sheaths on separate axons in the CNS

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4
Q

ependymal cells

A

line CSF filled cavities of CNS

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5
Q

microglia

A

phagocytosis in CNS (they get rid of debris)

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6
Q

schwann cells (neurolemmocytes)

A

wrap around and cover axons in PNS!!

they form and maintain the MYELIN sheath

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7
Q

what does the neuro system need for fuel?

A

glucose

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8
Q

3 components of a neuron

A

cell body (soma)

dendrites

axons

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9
Q

cell body (soma) of neuron

A

located mainly in CNS

have densely packed cell bodies: CNS=NUCLEI, PNS= GANGLIA/PLEXUSES

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10
Q

dendrites of neuron

A

carry nerve impulses TOWARD cell body

receive messages from other cells

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11
Q

axons of neuron

A

carry nerve impulses AWAY from cell body to other neurons, muscles, or glands

contain: myelin, nodes of ranvier, saltatory conduction

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12
Q

myelin

A

in the axon

insulated layer formed/maintained by the SCHWANN CELLS

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13
Q

nodes of ranvier

A

in the axon

spaced in between schwann cells

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14
Q

saltatory conduction

A

happens in axon

ions flow between myelin segments (instea of the entire length of the axon)

makes the IMPULSE travel FASTER!!!

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15
Q

conduction velocity in an axon depends on what?

A

myelin coating and axon diameter

the larger the axon, the faster the travel

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16
Q

action potential

A

electrical signal traveling down the axon

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17
Q

myelin sheath

A

covers the axon of some neurons and helps speed neural impulses

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18
Q

terminal buttons

A

part of the neuron that forms junction with other cells

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19
Q

sensory neuron

A

AFFERENT

sends impulses from sensory receptors to the CNS

the conduction travels from the dendrites to the cell body and up the axon to an interneuron

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20
Q

associational (interneurons)

A

sends impulses from neuron to neuron

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21
Q

motor neuron

A

EFFERENT

sends impulses from CNS to effector organ

the conduction travels down an axon

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22
Q

the end processes of a neuron form what?

A

NMJ (in skeletal muscle)

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23
Q

what happens when an axon is SEVERED (INURED)?

A

WALLERIAN DEGENERATION= deterioration of nerve fiber that has been separated from its nutritive source (by injury or disease)

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24
Q

what cells play a key role in nerve injury?

A

schwann cells and macrophages

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25
Q

the process of nerve regeneration is limited to what?

A

MYELINATED axons in peripheral nerves

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26
Q

nerve regeneration depends on what?

A

location/type of injury, inflammatory response, and scar tissue formed

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27
Q

nerve regeneration in the axon distal (below) cut

A

myeling sheath shrinks/DISINTEGRATES

axon portion deteriorates and disappears

myelin sheaths reform into schwann cells that line up between the cut and effector organ

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28
Q

nerve regeneration in the proximal to the injury (above) cut

A

similar changes to distal but only as far back as the next node of ranvier (cells increase metabolic activity, protein synthesis, and mitochondrial activity; new terminal sprouts project from the proximal segment 7-14 days after injury)

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29
Q

the CLOSER the cell body of the nerve to the injury…

A

more likely it will DIE and not regenerate

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30
Q

crushing injury to a nerve allows what?

A

recovery more fully than a cut injury

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31
Q

nerve impulse

A

NEURONS make and conduct electrical/chemical impulses by selectively changing the electrical portion of their plasma membranes and influencing other nearby neurons by the release of NEUROTRANSMITTERS

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32
Q

synapses

A

region between adjacent neurons

impulses are transmitted across the synapse via chemical and electrical conduction

neurotransmitters are formed in the neuron

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33
Q

presynaptic neurons (toward)

A

next to synapse

relays impulses TOWARD synapse

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34
Q

postsynaptic neurons (away)

A

farther away from synapse

relays impulses AWAY from synapse

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35
Q

synaptic knobs (boutons)

A

STORE neurotransmitters

neurotransmitters are released across the synaptic cleft (space between neurons) when the AP in the presynaptic neuron causes the synaptic vesicles to release 1 or more NT’s

the NT binds to receptor sites on the plasma membrane of the postsynaptic neuron

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36
Q

neurotransmitters

A

norepi, acetylcholine, histamine, GABA, dopamine, serotonin

have effects on postsynaptic neurons

either excited or inhibited

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37
Q

excited neurotransmitters

A

DEPOLARIZED

acetylcholine, norepi, glutamate

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38
Q

inhibited neurotransmitters

A

HYPERPOLARIZED

dopamine, GABA, glycine, serotonin

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39
Q

reticular formation

A

MAINTAINS WAKEFULNESS

network of connected nuclei that regulate vital reflexes (like heart and lung function)

extends through the central core of the medulla oblongota, pons, and midbrain

intricate system composed of loosely clustered neurons in what is otherwise white matter

visual, auditory, touch, pain, temp

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40
Q

RAS (reticular activating system)

A

reticular formation+cerebral cortex

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41
Q

forebrain

A

anterior part of the brain, including cerebral hemispheres, the thalamus, and hypothalamus

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42
Q

cerebrum

A

includes gray matter and white matter

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43
Q

gray matter (nuclei)

A

part of cerebrum

cell bodies and dendrites of neurons in cerebral cortex

receive, integrate, store, and transmit info

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44
Q

white matter (numerous tracts)

A

part of cerebrum

beneath cerebral cortex

composed of myelinated nerve fibers

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45
Q

frontal lobe

A

verbal and physical function

includes prefrontal, premotor, primary motor, and broca speech area

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46
Q

prefrontal lobe

A

GOAL-ORIENTED BEHAVIOR

ST memory

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47
Q

premotor area

A

part of frontal lobe

programs motor movement

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48
Q

primary motor area

A

part of frontal lobe

primary voluntary motor area

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49
Q

broca speech area

A

part of frontal lobe

motor aspect of speech

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50
Q

parietal lobe

A

somatic SENSORY input

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51
Q

occipital lobe

A

VISUAL cortex

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52
Q

temporal lobe

A

primary AUDITORY cortex

WERNICKE AREA=reception/interpret speech

LT memory

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53
Q

corpus callosum

A

connects 2 cerebral hemispheres (how 2 sides of brain communicate)

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54
Q

limbic system

A

primitive behavioral responses, expression of affect (emotional/behavioral states), consolidation of memory

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55
Q

diancephalon

A

processes incoming sensory data made up of epiTHALAMUS, THALAMUS, hypoTHALAMUS, and subTHALAMUS

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56
Q

midbrain

A

relay center for motor and sensory tracts

center for auditory and visual reflexes

cerebral aqueduct (carries CSF)

57
Q

hindbrain

A

includes cerebellum, pons, medulla oblongata

58
Q

cerebellum

A

part of hindbrain

balance and posture

damage is characterized by ipsilateral loss of equilibrium, balance, motor coordination

59
Q

pons

A

part of hindbrain

controls RR’s

60
Q

medulla oblongata

A

part of hindbrain

controls reflex activities (HR, RR, BP, coughing, sneezing, swallowing, vomiting)

61
Q

cranial nerves

A

project from brain and pass through foramina in skull

12 pairs (sensory, motor, and mixed)

62
Q

mnemonic for nerves

A

on old olympus towering tops a finn and german viewed some hops

olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, acoustic, glossopharyngeal, vagus, spinal accessory, hypoglossal

63
Q

mnemonic for sensory, motor or both

A

some say marry money but my brother says bad business marry money

olfactory- sensory
optic-sensory
oculomotor-motor
trochlear-motor
trigeminal-both
abducens-motor
facial-both
acoustic-sensory
glossopharyngeal-both
vagus- both
spinal accessory- motor
hypoglossal- motor
64
Q

olfactory

A

sensory

smell

“some”

“on”

65
Q

optic

A

sensory

vision

some “say”

on “old”

66
Q

oculomotor

A

motor

pupil reaction, EOM

some say “marry”

on old “olympus”

67
Q

trochlear

A

motor

EOM

superior oblique muscles (rotates laterally and intorts- twists in and out- eye)

some say marry “money”

on old olympus “towering”

68
Q

trigeminal

A

motor and sensory (both)

mastication, face sensation

some say marry money “but”

on old olympus towering “tops”

69
Q

abducens

A

motor

EOM

lateral rectus; abducts the eye

some say marry money but “my”

on old olympus towering tops “a”

70
Q

facial nerve

A

motor and sensory (both)

facial expression

taste on front of tongue

some say marry money but my “brother”

on old olympus towering tops a “finn”

71
Q

vestibulocochlear (acoustic)

A

sensory

hearing

some say marry money but my brother “says”

on old olympus towering tops a finn and

72
Q

glossopharyngeal

A

motor and sensory (both)

motor fibers work on pharynx and salivary glands

tastes on back of tongue

some say marry money but my brother says “bad”

on old olympus towering tops a finn and “german”

73
Q

vagus

A

motor and sensory (both)

motor and sensory for pharynx

parasympathetic motor fiber (supplies smooth muscle of abdominal organs)

some say marry money but my brother says bad “business”

on old olympus towering tops a finn and german “viewed”

74
Q

spinal accessory

A

motor

shrugs your shoulders

some say marry money but my brother says bad business “marry”

on old olympus towering tops a finn and german viewed “some”

75
Q

hypoglossal

A

motor

tongue muscles

some say marry money but my brother says bad business marry “money”

on old olympus towering tops a finn and german viewed some “hops”

76
Q

which cranial nerve would you be most concerned about if you found that the patient was unable to abduct their left eye?

A

abducens nerve

77
Q

where is the spinal cord?

A

in the vertebral canal and protected by vertebral column

78
Q

what does the spinal cord do?

A

connects the brain and body, conducts somatic and autonomic reflexes, provides motor pattern control centers, and modulates sensory and motor function

79
Q

conus medullaris

A

end of spinal cord

80
Q

cauda equina

A

nerve bundle at end of spinal cord

81
Q

gray matter

A

POSTERIOR/DORSAL horn is composed of SENSORY neurons

LATERAL HORN contains cell bodies involved with ANS (INVOLUNTARY)

ANTERIOR/VENTRAL horn contains cell bodies for efferent pathways leaving spinal cord by way of spinal nerves (MOTOR)

82
Q

white matter

A

spinal tracts are named after their beginning and end point (ex: spinothalamic tract)

contain afferent and efferent tracts

83
Q

afferent tracts

A

part of white matter

SENSORY

carry impulses TO CNS and away from organs/receptors

84
Q

efferent tracts

A

part of white matter

MOTOR

carry impulses AWAY from CNS and to organs

85
Q

upper motor neurons

A

disruption of UMN’s leads to INITIAL paralysis which leads to partial recovery

pathways are completely WITHIN CNS

efferent pathways relay info from cerebrum to the brain stem/spinal cord

86
Q

upper motor neurons are located where?

A

in the CNS

87
Q

lower motor neurons

A

destruction of LMN’s leads to PERMANENT paralysis

neurons have DIRECT influence on MUSCLES

cell bodies ORIGINATE in gray matter of spinal cord but their axons EXTEND into PNS!!

88
Q

meninges

A

protective membrane that surrounds brain and spinal cord

composed of DURA MATER, ARACHNOID, and PIA MATER

89
Q

subdural space

A

part of the meninges

CONTAINS CSF

between dura and arachnoid

has bridging veins

90
Q

subarachnoid space

A

part of the meninges

between arachnoid and pia matter

contains CSF!

91
Q

epidural space

A

part of the meninges

between dura and skull

92
Q

arterial supply to the meninges is in which dural space?

A

epidural

93
Q

CO2 regulates what?

A

CNS blood flow!!!

it is a potent vasodilator

increased CO2 will increase ICP

94
Q

ACA blood flow

A

supplies frontal and parietal lobes

95
Q

MCA blood flow

A

supplies frontal, temporal, parietal lobes

96
Q

PCA blood flow

A

supplies occipital lobe

97
Q

blood brain barrier

A

cellular structures that prevent harmful stuff from the blood from entering the interstitial spaces of the brain and CSF

this matters because certain drugs are more likely to cross the BBB

98
Q

functions of the blood brain barrier

A

protects brain from foreign stuff in blood that can cause injury

protects brain from hormones and NT’s secreted by other organs

maintains a constant biochemical environment for the brain

99
Q

things that increase permeability/break down BBB

A

HTN, dilutional hyponatremia, lots of anesthetics, vasodilation, hypercapnia

100
Q

somatic nervous system

A

VOLUNTARY motor control of skeletal muscle

101
Q

autonomic nervous system

A

INVOLUNTARY control of organ systems

located in both CNS and PNS

102
Q

motor neuron component of autonomic nervous system (PNS)

A

preganglionic (myelinated) and postganglionic (unmyelinated)

103
Q

preganglionic (myelinated) motor neuron of autonomic nervous system

A

located in CNS (brain stem/spinal cord)

in PNS the preganglionic (efferent fibers) synapse (passing from one to another) with ganglionic neuron located in PNS

104
Q

postganglionic (unmyelinated) motor neuron of the autonomic nervous system

A

terminates on the effector organ

105
Q

sympathetic nervous system

A

fight or flight

receives innervation from THORACOLUMBAR DIVISION (T1-L2)

releases epi (vasodialtes) and norepi (constricts)

106
Q

effects of lesions interrupting sympathetic fibers

A

blood vessel dilation (skin gets warm/red), lack of seating in involved area, constricted pupil on side of lesion, paralysis of arrector pili muscles so “good bumps” don’t happen when pt is cold

107
Q

what is a lesion in the sympathetic fibers?

A

damage

108
Q

horner’s syndrome

A

injury to preganglionic sympathetic trunk or postganglionic sympathetic neurons of cervical ganglion

with these patients you’ll see ipsilateral pupil constriction (occurring on the same side), sunken Ipsiolateral eyeball, ptosis of ipsilateral eye (droooping), no sweating on ipsilateral side of face

109
Q

neuroreceptors of the sympathetic nervous system

A

a-adrenergic and b-adrenergic receptors (alpha 1 is most common)

110
Q

sympathetic postganglionic nerve fibers release which neurotransmitter?

A

norepinephrine

111
Q

parasympathetic nervous system

A

rest and digest

conserves and restores energy

receives innervation from CRANIOSACRAL DIVISION (cell bodies in CRANIAL NERVE NUCLEI and SACRAL REGION OF SPINAL CORD)

112
Q

cell bodies of the parasympathetic nervous system are located in which region of the spinal cord?

A

cranial and sacral

113
Q

neuroreceptors of the parasympathetic nervous system

A

cholinergic receptors (nicotinic type 1 and muscarinic)

nicotini= muscle contraction at NMJ

can be found on cells of ADRENAL MEDULLA

114
Q

parasaympathetic effect on body parts

A

pupil-constriction

heart- slows heartbeat

airway- constricts the bronchial tubules

liver- stimulates bile release

blood vessels- constriction

digestive system- stimulates activity

uterus- relaxation

urinary system- increases the urinary output

cranial part of spinal cord is responsible for pupil, heart, airways, liver, blood vessels, and digestive system

sacral part of spinal cord is responsible for uterus and urinary system

115
Q

sympathetic effect on body parts

A

pupil- dilates

heart- increases heartbeat

airway- dilates the bronchial tubules

sweat glands- stimulates activation

liver- increases the rate of glycogen to glucose

digestive system- decreases activity

adrenal glands- stimulates the production of adrenaline

uterus- vaginal contraction

urinary system- relaxes bladder

sympathetic ganglion in cervical part of spinal cord- pupil

sympathetic ganglion in thoracic part of spinal cord- heart, airways, sweat glands, liver, digestive system

sympathetic ganglion in lumbar part of spinal cord- adrenal glands, uterus, urinary system

116
Q

parasympathetic nerve roots

A

cranial nerves III, VII, IX, X

sacral nerves 2, 3, 4

117
Q

sympathetic nerve roots

A

thoracic nerves 1-12

lumbar nerves 1 and 2

118
Q

craniosacral division of autonomic nervous system

A

parasympathetic

119
Q

thoracolumbar division of autonomic nervous system

A

sympathetic

120
Q

sensory pathways

A

pain-temp (spinothalamic tract)

proprioception and vibratory sense in posterior column

vague light touch (anterior spinothalamic tract)

121
Q

pathway for PAIN and TEMP

A

enters spinal cord then immediately crosses over cord

then travels to thalamus on opposite side where it enters

122
Q

pathways for PROPRIOCEPTION and VIBRATORY SENSE

A

stays on the same side of the spinal cord until it reaches the BRAINSTEM

123
Q

lesion of SPINOTHALAMIC TRACT

A

loss of PAIN-TEMP CONTRALATERALLY BELOW level of lesion (because of immediate cross over in spinal cord)

124
Q

lesion in POSTERIOR COLUMN

A

ipsilateral loss/decreases in stereogenesis, vibratory sense, proprioception in conscious pts (because there is NO cross over until the level of the brainstem)

posterior=proprioception!!!=iPsilateral

125
Q

LIGHT TOUCH is carried where?

A

in BOTH tracts so it’s SPARED in unilateral spinal cord lesions (because there are alternate routes)

126
Q

somatic-superficial pain

A

comes from connective tissue, muscle, bone, and skin

pain is sharp/well localized with A delta fibers

pain is dull aching, and poorly localized with C fibers

127
Q

visceral-internal pain

A

transmitted via sympathetic afferents

poorly localized, dull

fewer nociceptors

128
Q

referred pain

A

pain is somewhere other than its origin

area of referred pain is supplied by same spinal segment as actual site (ex: MI)

129
Q

chronic pain

A

can be persistent/intermittent and sudden/gradual lasting 3-6 months or more

can lead to behavior/psychological changes(unlike acute)

conditions include myofascial pain syndromes, chronic post op pain, low back pain, chronic pain with cancer

130
Q

neuropathic pain

A

d/t trauma or disease of PNS/CNS

usually chronic

131
Q

chronic neuropathic pain groups

A

peripheral and central

132
Q

peripheral chronic neuropathic pain

A

injured nerves are now hyper excitable

causes are trauma, DM, ETOH, CA, HIV

133
Q

central chronic neuropathic pain

A

d/t lesion or dysfunction in brain/spinal cord

causes are brain/spinal cord trauma, vascular lesions, MS, post-herpetic neuralgia, phantom limb pain, reflex sympathetic dystrophy

134
Q

s/s of neuropathic pain

A

paroxysaml with herpesthesia and paresthesia (pins and needles), burning, shooting, stabbling

“gnawing” and miserable

135
Q

deafferentation

A

neuropathies that are d/t lesions in PNS

136
Q

hemiagnosia

A

paralysis and hypersensitivity on 1 half of body

137
Q

phantom limb

A

pain felt in amputated limb after stump has healed

type of neuropathy

138
Q

complex regional neuropathic pain

A

1-2 weeks

after injury (fracture without an identifiable nerve injury) OR injury to brachial plexus or median, sciatic, or other peripheral nerves

139
Q

radiculopathy

A

a patient presents with a herniated lumbar disc and they are complaining of pain in their right leg

pathophysiology (5 decks)

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