Final Exam Flashcards
What are the 4 Ventricles of the brain?
- Left Hemisphere
- Right Hemisphere
- Pons
- Medulla
What is hydrocephalus?
Excess volume and pressure of CSF
Types of Hydrocephalus?
- Noncommunicating = Obstruction to CSF Flow
- Communicating = Over secretion or reduced Absorption
In the corticospinal tract, a complication in the upper motor neuron can lead to what?
More spasms and rigidity
In the corticospinal tract, an issue with the lower motor neuron can result in what?
Paralysis and Drooping
Cell bodies of the upper motor neurons are located where?
Primary motor cortex and premotor cortex of the frontal lobe
Signs of upper motor neuron lesions?
- Spastic paralysis
- Hyperreflexia
- Hypertonia
- Positive Babinski Sign
Patients with lower motor neuron lesion show signs of?
- Flaccid paralysis
- Areflexia
- Atonia
- Muscle Atrophy
- Fasiculations
As opposed to 2 neurons in the motor pathway, how many are there in the sensory pathway?
3:
1. Cell body in the dorsal root ganglion synapses and axon heads to spinal cord or brain stem
2. Second neuron decussates and goes to thalamus
3. Third neuron moves from thalamus to somatosensory cortex.
When looking at the spinal cord diagram, the back portion from right to left indicates what?
From head (Right Side) to toe (Left Side) of what part of the sensory pathway is affected.
What are the names of the dorsal columns that an axon in the sensory pathway is sent to?
- Fasciculus gracilis: Sensory information for the lower limb
- Fasciculus Cuneatus: Sensory information for the upper limb
What is affecting with lesions in the sensory pathway for the dorsal column?
- Lesions above the decussation in the brainstem/cortex leads to Contralateral loss of proprioception and sensation
- Lesions below it lead to ipsilateral loss of proprioception and sensation
What is the spinothalamic tract responsible for?
- Pain and temperature sensations
Pathway for Spinothalamic tract?
- Dorsal horn, Decussates, Lateral aspect of brain stem, Ventral Posterolateral Nucleus of thalamus, Cortex
All lesions of the spinothalamic tract lead to?
CONTRALATERAL ONLY; Loss of pain and temperature change below the lesion
Syringomyelia, a central cord lesion, leads to what?
Bilateral loss of pain and temperature
What is Brown-Sequard Syndrome?
An incomplete spinal cord lesion by hemisection of the spinal cord.
What are the results of brown-sequard syndrome?
- Ipsilateral motor paralysis and contralateral pain and temperature sensation deficits
Which cranial nerves are located in the midbrain?
CN 3 and 4 (Occulomotor and Trochlear)
What cranial nerves are located in the pons?
CN 5-8 (Trigeminal, Adducens, Facial, Vestibulocochlear)
Which Cranial Nerves are located in the Medulla?
CN 9 and 10; Glossopharyngeal and Vagus
Lesion of the Cranial nerve nuclei leads to?
Ipsilateral damage
Lesion of the Cranial nerve tracts from the spinal cord leads to?
Contralateral Damage
Diseases of the cerebellum results in improper…
Gait balance
Coordination
Ataxia and poor ability to start and stop movement
Cerebellar lesions are expressed…
Ipsilaterally and results in patient falling on the side of the lesion.
What is the importance of the basal ganglia?
- Starts and stops voluntary motor functions
- Inhibits unwanted movement
What are the pathways for the basal ganglia and what are the effects of each pathway?
- Direct pathway: Increases Cortical excitation, promotes movement
- Indirect Pathway: Decreases cortical excitation, stops movement
What are the effects of dopamine on the basal ganglia pathways?
Dopamine excites the direct pathway and inhibits the indirect pathway
Hyperkinetic disorder is caused by?
Lesion of the indirect pathway of the basal ganglia; leads to an overactive motor cortex
What is the circle of Willis?
A structure composed of arteries that supply the Cerebral cortex
What structures make up the Circle of Willis?
- 2 Internal Carotid Arteries
- Anterior and Posterior Communicating arteries
Similar to the dorsal root ganglion, the homunuclus of the motor and sensory cortex display…
- Upper limbs and head on the most lateral portions
- Lower Limb and pelvis in the medial surface of each hemisphere’s homunculus
Primary language centers like the Broca and Wernicke’s areas are functionally located…
on the opposite hemisphere of the dominant hand
Lesions to the Broca Area lead to…
Motor or expressive aphasia
Lesions in the Wernicke area leads to…
Receptive aphasia (Unable to comprehend language)
Lesion in the area connecting the broca and wernicke’s area leads to…
Conduction Aphasia (Difficult to speak)
CN1’s Name, Function, and effect if lesioned?
-Olfactory
- Smell
- Lesion: Anosmia
CN2’s Name, Function, and effect if lesioned?
- Optic
- To see
- Anopsia
- Only CN to be considered part of the CNS instead of the PNS
CN3’s Name, Function, and effect if lesioned?
- Oculomotor
- Moves Eyeball in all directions, accommodates eye, raises eyelid, constricts pupil, and ADDUCTS the Eye*
- Lesion = Down and Out
- Loss of light reflex with CN2
CN4’s Name, Function, and effect if lesioned?
- Trochlear
- Allows the eye to voluntarily look down and out
- Lesion would lead to individual head tilting to look down at the ground, trouble going down the stairs
CN5 V1’s Name, Function, and effect if lesioned?
- Trigeminal OPTHALMIC
- Sensation of forehead, scalp, cornea
- Lesion leads to loss of blink reflex with CN7 as this detects sensation of the area near eye
CN5 V2’s Name, Function, and effect if lesioned?
- Trigeminal Maxillary
- General sensation of palate, nasal cavity, maxillary, and maxillary teeth
CN5 V3’s Name, Function, and effect if lesioned?
-Trigeminal Mandibular
- Sensation of two thirds of tongue, mandibular face and teeth
- Lesion leads to jaw deviation towards the affected side
CN6’s Name, Function, and effect if lesioned?
- Abducens
- Helps the eyeball abduct
CN7’s Name, Function, and effect if lesioned?
- Facial Nerve
- Mixed Nerve
- Muscles of facial expression, stylohyoid, taste of anterior tongue, salivates, tears, and mucus.
- Lesions lead to mouth droop, can’t close eye, loss of blink reflex with CN5
Difference between Supranuclear lesion and Lower Facial Nerve lesion?
- Supranuclear lesion is located higher up, not on the tract so only the lower half of the face is compromised.
- Lower Facial Nerve lesion affects both the forehead and the lower face.
CN8’s Name, Function, and effect if lesioned?
- Vestibulocochlear
- Hears, Linear Acceleration, and head turning
CN9’s Name, Function, and effect if lesioned?
- Glossopharyngeal
- Senses pharynx and carotid sinus/body, salivates
- Lesion can compromise gag reflex along with CN 10
CN10’s Name, Function, and effect if lesioned?
- Vagus
- Powerful Parasympathetic
- Muscles of palate and pharynx for swallowing, Larynx, Senses Larynx and GI tract, smooth muscle movement in gut
- Also raises eyelid, dilates pupil, sweat glands, constricts blood vessels in head
- Lesion = Nasal speech, dysphagia, gag reflex with CN9, and Cough Reflex
- Lesion = Horner syndrome: Eyelid droop, constricted pupil, and loss of sweating
CN11’s Name, Function, and effect if lesioned?
- Accessory
- Turn head to opposite side using the sternoclidomastoid
- Elevates and rotates scapula
CN12’s Name, Function, and effect if lesioned?
- Hypoglossal
- Moves Tongue
- Lesion results in tongue pointing to affected side
The phrenic nerve is formed from which ventral rami?
- C3, C4, and C5
Significance of the carotid triangle?
- Internal Jugular Vein
- Vagus Nerve
- Common carotid arteries
Most significant artery of the external carotid artery is:
Middle meningeal artery, which supplies the skull and dura
- Lesions would result in a epidural hematoma
What is a epidural hematoma?
Trauma to the lateral aspect of the skull
- Signs include:
1. Momentary loss of consciousness
2. Lucid 48 hour asymptomatic period
3. Intracranial pressure leading to headaches, vomiting, and nausea
All signs lead to death if not intervened.
What is a subarachnoid hemorrhage?
- Rupture of the circle of willis
- Onset of a severe headache leading to projectile vomiting and nausea.
What are the eye examinations you can do to test the CNs?
- Movement of the eyes involved CN 3, 4, and 6
- Blinking involves CN 5 and 7
- Papillary light reflex involves CN 2 and 3
