Final Review Flashcards
what are NTs of the AVS
acetycholine (efferent)
glutamate aspartate - excite AVS
gaba glycine - inhibit in AVS
what is a NT of the neuromuscular
acetycholine
Explain the process of stimulus all the way to synapsing of neurons
Neuron is sitting at resting membrane potential with all ion channels closed and inner voltage resting at -70 mV.
Outside trigger (like a spider brushing up against a knee, or a finger touching the hand) causes the mechanically gated ion channels (sodium channel) to open and sodium rushes in the membrane causing the cell to become depolarized
RP stays local where the stimulus was
RP are graded (amplitude modulated) signals with the amount of depolarization representing the strength of the signal.
Stimulus is strong enough to cause a threshold reach of the RP (about -55 mV)
AP (all or none, NO degradation, forward propagating, saltatory conduction)
at the axon hillock, Voltage-gated ion channels open at the first node of Ranvier and sodium rushes in, depolarizing that spot. Then the next (forward) node is stimulated and sodium rushes in so the AP propagates forward by saltatory conduction.
AP propagates down a neuron, activating sodium and potassium channels in a wave, it eventually reaches the presynaptic terminal
Reaching this terminal activates the voltage-gated calcium channels (Ca2+) to open and release calcium into the neuron’s cytoplasm (inside terminal bouton)
The flow of positively charged calcium ions causes the tiny synaptic vesicles (w/ NT) to fuse with the cell membrane and release those chemical messengers
these NT’s diffuse across the synaptic gap and bind to receptor sites on the postsynaptic neuron
Depending which NT binds to which receptor, the post neuron can either be excited or inhibited
correct order that they would occur during sensory transduction for a receptor in the skin and neuron of the ascending sensory pathway
Cell is at rest with a resting membrane potential of -65mV
2. Stimulus triggers a receptor potential
3. depolarization during the receptor potential initiates the action potential
4. Action potential reaches the terminal bouton and triggers synaptic transmission.
5. neurotransmitter is released into the synaptic cleft
purpose of the sodium potassium pump
for every two potassium ions that come in from the extracellular fluid ot the cytoplasm inside the membrane (pumps in), 3 sodium ions are pumped out
what cells create myelin in PNS & CNS
PNS - schwann cells, one axon per cell
CNS - oligodendrocytes, many axons
How does an AP encode intensity of a stimulus?
frequency modulation
a weak stimulus tends to trigger less frequency AP’s (like picking up an egg)
an intense stimulus increases the frequency of APs (like crushing a can)
explain 4 things of an AP
all or none, NO degradation, forward propagating, saltatory conduction)
Action potentials can be conducted along neurons quickly due the presence of myelin and saltatory conduction.
The AP can carry information over relatively long distances without degrading (without getting weaker) so it does not degenerate or lose information on its way to or from the brain
an action potential is all or none
Action potentials carry information about the stimulus as a frequency modulated signal with faster firing rates for stronger stimuli.
period when it cannot respond to any other stimulus no matter how strong (helps prevent signals from traveling in both directions down the axon at once)
absolute refractory period
where is A1
A1 is located on the transverse gyri of the superior temporal gyrus of the temporal lobe, inside the lateral fissure.
Describe Spiral ganglia and Scarpa’s ganglia
Scarpa’s -
The cell bodies of the bipolar afferent vestibular CN VIII fibers located in the internal auditory canal
Spiral ganglia - cochlea nuclei
what does ectoderm form
outer ear (skin) and inner ear (sense organs), membranous labyrinth
what does mesoderm form
ossicles, temporal bone and bony labyrinth
what does endoderm form
middle ear epithelial lining, aerated mastoid cavities, & ET
first sign outside of embryo that inner ear is forming?
otic cyst that invaginated from ectoderm and became inner ear
all 3 germ layers contribute
ME cavity - primordial structure that becomes middle ear
tubotympanic recess - tubo becomes ET, tympanic is the middle ear cavity
Which arches contribute to Ossicles?
1&2
how is outer ear/pinna formed
6 hillocks at 6 weeks that form this shape
how is the canal formed
form bw 1 & 2 arches
only opens later in development because it has meatal plug
how does the TM develop its 3 layers
from all 3 germ layers
ecto outside, meso in middle, endo in middle ear
During embryologic development, six hillocks of tissue form around both sides of the first branchial groove. What do these hillocks eventually become?
pinna of external ear
During embryological development of the central nervous system, which secondary vesicle of the neural tube becomes the pons, cerebellum and a portion of the fourth ventricle?
metencephalon
Which branchial arches play a major role in development of ear structures?
1&2
Embryologically, the central nervous system (including the brain and spinal cord), sense organs such as the cochlear and vestibular hair cells, and the skin are derived from which of the germ layers?
ectoderm
What is the generic term that describes defects of the spinal cord, during embryologic development when the caudal neuropore does not properly close?
spina bifida
With respect to neuroembryology, the term gastrulation refers to
Formation of the three primary germ layers
During embryologic development, which germ layer gives rise to the skeletal structures, circulation structures, meninges, and cartilage (including the ossicles and temporal bone)?
mesoderm
Embryologically, development of the inner ear begins with formation of…
The otic placodes which are thickenings of ectoderm
Embryologically, what structures are derived from the neural tube and its tissues?
Central nervous system structures including structures such as the cerebrum, brainstem, cerebellum, ventricles and spinal cord
During embryologic development, what does the tubotympanic recess eventually become?
middle ear space and ET
In the embryo, which flexure of the developing neural tube marks the location where the future brainstem meets the future spinal cord, and this bend straightens out over time during development?
cephalic flexure
Which branchial arches play a major role in development of ear/auditory structures?
1&2
where is regeneration more likely to happen in our body? PNS or CNS?
PNS
How does regeneration occur?
scwann tube of myelin is in tact and nerve regenerated, new sprout can find the path
attracted to muscle with loss of nerve innervation, grow extra achetecholine receptors and attach
schwann tube to guide the regrowth and attracted to acetecholine on receptors on the muscle to get regrowing nerve back to it causing successful regeneration in PNS
Which type of degeneration involves the distal portion of the axon that has been severed from the cell body and leaves Schwann tubes that may aid in regeneration?
orthograde degeneration
type of degeneration involving the distal portion of the axon that has been severed from the cell body and leaves Schwann tubes that may aid in regeneration
Orthograde degeneration
axonal degeneration occurs proximal to the site of injury -
retrograde degeneration
Loss of neurotrophic factors coming from the axon to the cell body
retrograde axoplasmic flow
nerve is cut and nerve degenerates, so now cell body creates more production and creates a growth cone and sends out sprouts., if it finds the schwann tube, it gets all the nutrients and regrows and reinnervates the muscle and the other sprouts dont go anywhere
regeneration
Main motor area located on the precentral gyrus with direct cortical control over motor neurons
M1
aids in preparation for motor movements through facilitating specific sets of primary motor neuronstate specific sets of neurons
PREMOTOR area
facilitates coordination of complex movements and is not needed for simple repetitive tasks
supplemental motor area
set of nuclei at base of cerebral hemispheres
basal ganglia
what makes up the basal ganglia
Putamen, caudate nucleus, globus pallidus, nucleus accumbens, and diencephalic subthalamic nuclei and substantia nigra
what is a group of BN called
striatum
what is the whole edge of putamen and GP called
lenticular nucleus
forms loop resulting in involvement in most cortical functions (movment, cognition, emotion)
feedback loop because it gets involved in many things
basal ganglia
spasms, involuntary movements of limbs or facial muscles, with possible hypotonia (loss of muscle tone)
chorea
characterized by excessive movement
hyperkinetic
characterized by diminished or slow movement
hypokinetic
“without position”; slow writhing movements (pronounced in hands and fingers); patient may have difficulty holding a limb in a fixed position
athetosis
“jumping about”; wild flailing movements of one arm and leg
ballismus
increased or abnormal tone in muscles or tissue resulting in a somewhat fixed posture
dystonia
loss of muscle tone
hypotonia
tone increase in flexors & extensors
rigidity
decreased or slow movements
bradykinesia
something new that showed up, something added that didn’t use to be there (tremor for ex)
positive signs
taking something away, used to be able to do something and now they cannot
negative signs
What is Huntingdon’s disease
movements that resembled “dancing” - chorea
Neuronal degeneration that is severe in the striatum and especially the caudate nucleus
autosomal dominant inherited disease
what is parkinson’s disease?
hypokinetic disorder
Biochemical disease of basal ganglia (evident in substantia nigra pigmented cells that should produce dopamine and transport it to the striatum)
more rigid and slow, non moving
have a tremor but if they pick up a coffee can and when they are moving the tremor goes away but when they are just sitting at rest, they have a tremor
what would be a positive and negative sign for Parkinson’s?
+ is rigidity
- is bradykinesia
major portion of inferior cerebellar peduncle (“ropelike”) with fibers from spinal cord and brainstem
restiform body
additional fibers of the ICP (inferior cerebellar peduncle) connecting cerebellum and vestibular nuclei
juxtarestiform body
largest peduncle and it emerges from the basal pons
middle cerebellar
peduncle that has many decussations and mainly efferent pathways from cerebellum to red nucleus and thalamus
superior cerebellar
Involved in equilibrium, control of muscle tone, posture and coordination of voluntary movements
cerebellum
what creates the dendritic tree seen in the cerebellar cortex
purkinje cells
difficulty with rapid alternating movements
dysdiadochokinesia
what would we see in damage to a child’s 4th ventricle?
Damage to flocculonodular lobe
Loss of equilibrium, sway side to side, staggering, wide-based gait, falling over, problems with eye movements, can also have noncommunicating hydrocephalus
what could we see with damage to cerebellum?
Can have changes in muscle tone (hypotonia), reflexes (hyporeflexia) and coordination of voluntary movements ipsi to side of lesion
Broad-based stagger, general incoordination or ataxia (“lack of order”), often in leg movements
Problems stopping or changing direction of movement (overshoot or undershoot of targets
dysmetria
Thin watery fluid anterior to the lens, between the lens and cornea
contains nutrients for cornea and lens
aqueous humor
does the cornea and lens have blood supply?
no, lacks this
aqueous humor provides nutrients for it
Thick, jelly-like semifluid found posterior to the lens, between the lens and the retina
Important for maintaining the shape of the eye/orbit
vitreous humor
white part of eye
sclera
clear portion of eye
nonadjustable “lens” of the eye
cornea
contains the blood vessels and nerves for the eye
choroid
pigmented portion and consists of smooth muscles for constricting and dilating the pupil
iris
Pupillary constriction is mediated by the parasympathetic component of
CN III
Dilation is mediated by sympathetic neurons from
spinal cord segments T1 and T2
suspended behind the iris by zonula fiber (thin guide ropes) that are anchored in the ciliary body
lens
contains involuntary muscles that vary the tension exerted on the lens by the zonula fibers
ciliary body
Adjusting the shape of the lens to make it more rounded is called
accomodation
what does accomodation of the eye help us do
Enables us to focus on near and far objects
light-sensing portion of the eye
retina
extension of the diencephalon
retina
are there multiple types of cells in teh retina?
yes, including bipolar
describe the retinogeniculostriate pathway
Retinal ganglion cells (getting information for receptors known as rods and cones)
CN II
Optic chiasm
Optic tract
Lateral geniculate nucleus of the thalamus
Internal capsule as thalamocortical projections
Optic radiations
Primary visual cortex (V1, Brodmann’s area 17, aka Striate cortex) either above or below the calcarine sulcus, in the cuneus or lingual gyrus respectively
represented in the occipital lobe in the left hemisphere
right visual field
represented in the occipital lobe in the right hemisphere.
left visual field
represented inferior to the calcarine sulcus (in the lingual gyrus)
upper visual field
represented superior to the calcarine (in the cuneus).
lower visual field
what does convergence of the eye help us do?
help both eyes look at the same object and focus
describe the light reflex
ganglion cells in retina pick light up, signal carried down CN 2 (optic), crosses the optic chiasm and optic tract to the lateral geniculate, then the superior colliculus stimulating the ciliary ganglion cells of CN 111 (occulomotor) to cause pupil constriction
do we need the cortex for light reflex?
NO
do we need the cortex for the acoustic reflex
no
is there cortical involvement for the accommodation convergences reflex
yes
how is the lens for distance vision
flattened
describe the accomodation convergence reflex
Adjustments of the lens by activation of the ciliary body to bring close objects into focus
There is cortical involvement
After stimulus info reaches the visual cortex, impulses descend from V1 to the superior colliculus to activate the preganglionic parasympathetic neurons of the Edinger-Westphal nucleus
Activation of the ciliary ganglion follows
To cause smooth muscles of the ciliary body to round the lens for near vision
Free nerve endings
Detecting stimuli that caused damage to tissue or that may cause damage
Nociceptors
What happens at the site of tissue damage
chemicals are released that cause dilation of arterioles—redness, leakage of plasma from venules—swelling, and attraction of phagocytes—cleaning up debris
inability to sweat and feel pain
CPA
if you are under stress, which part of ANS is active and what would it control
sympathetic, send harder pumping from heart to big muscles for ff response, reducing digestion and widening of eyes and stimulating sweat glands
Protective mechanism that is normal
Signaling tissue damage
Localized to the site of tissue damage
acute pain
Caused by inflammation, arthritis, nerve entrapment, gun shot wounds, surgery, migraine, cancer, spinal cord injury, stroke, tumors and more
chronic pain
pain located inside of our organs
ex: from gallstons, kidney stones, ulcers, etc.
visceral pain
Superficial pain is pain that arises from the skin (cutaneous receptors)
somatic pain
type of pain described by someone feeling pain in the chest wall or left arm when the stimulation is from the heart due to myocardial ischemia (a heart attack)
referred pain
pain that is projected to areas that are innervated by nerves that are compressed or damaged
With a shoulder injury, the pain may be projected to the wrist or elbow
projected pain
spontaneous pain that occurs in waves or sudden attacks following a noxious stimulus that has acted on the sensory neurons for a long period of time
Generally restricted to the regions supplied by the affected nerve or nerve root
neuralgia
what is trigeminal neuralgia
intractable facial pain along one or more branches of CN V
Maladaptive
from damage to nervous system that changes CNS connections
neuropathic/intractable pain
what kind of pain is phantom pain categorized as
neuropathic/intractable pain
direct stimulation of nociceptors
pain from pinpricks, cuts, minor burns etc
physiological pain (nociceptive)
what are the results of physiological pain
reflexive withdrawal away from the stimulus
Pain that is intensified by peripheral and central mechanisms helps to modify behavior to protect the affected areas during healing (like limping with a sprained ankle)
what is the gate theory
Developed in 1965 by Melzack and Wall
suggested there is a sort of “gate” in the dorsal horn of the spinal cord (specifically, in Rexed’s lamina II, the substantia gelatinosa) that either allows or does not allow pain transmission from afferents to the spinothalamic tract
can either enhance pain by fear and emotional status or we can inhibit this pain through our emotional status
Hitting the thumb with a hammer causes initial and delayed pain
Rubbing the thumb stimulates non-nociceptive cutaneous receptors and their afferents and helps to reduce the pain that is felt
gate theory
what is involved cortically with pain
Limbic system - These regions are thought to play a role in the affective response to painful stimuli
emotional response to pain - will we cry, will we get mad, what are we going to feel with that pain
cortex and frontal lobe also play a role in the affective response to pain - Evaluation of painful input in terms of past experience is also important in determining the response to painful input
lines the heart
endocardium
outermost layer of the heart
epicardium
middle muscular layer of heart
myocardium
what is endocarditis
an infection of the inner lining of the heart usually involving the heart valves
occurs when bacteria, fungi or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in heart.
has 3 leaflets, flow from left ventricle to the aorta and then to the body
prevents backflow
aortic semilunar valve
has 2 leaflets between left ventricle and atrium, flow from lungs into left atrium and then to left ventricle
between L atrium and L ventricle
mitral valve
has 3 leaflets, flow from right ventricle to pulmonary artery
pulmonary semilunar valve
3 leaflets, allows flow from right atrium to right ventricle,
tricuspid valve
what are arteries
blood vessels that carry blood away from the heart to other parts of the body
Primarily oxygenated blood, higher pressure
thicker and stronger than veins
what are veins
blood vessels that carry blood toward the heart from other parts of the body
Carries blood that is low in oxygen, lower pressure
less elastic than arteries
contain valves
superficial vein of the neck that drains blood from the parotid gland, most of the scalp, side of the face, Takes blood back to the heart.
It assists more with drainage if internal jugular is compressed/compromised
external jugular vein
how many laters are in arteries and veins
3
blood vessel cavity (opening)
lumen
junction of blood vessels (forming a group or connections, circle of willis)
anastomosis
smaller arteries attach to capillaries
arterioles
gas nutrient and waste exchange
Any of the fine branching blood vessels that form a network between the arterioles and venules
Smallest blood vessels of the body
Sites of the transfer of oxygen and other nutrients from the bloodstream to other tissues in the body; they also collect carbon dioxide waste
capillaries
Where do muscles of mastication receive vascular supply?
maxillary artery and facial artery
where does the facial artery also supply?
muscles of facial expression
what supplies the temporal muscle?
superficial temporal artery
What supplies the sternocleidomastoid, trapezius, and deep muscles of the back?
occipital artery
an arrangement of interconnected vascular channels that ensure that the (oxygenated) blood flow to the brain continues unimpeded, in case any of the principal suppliers are obstructed by injury, physical pressure or disease.
circle of willis
what are erythrocytes
Red blood cells- makes up 95% of the blood cells) - predominant part of the blood cells
bioconcave disks
no nucleus
contains hemoglobin & iron (appears bright red when carrying O2 and appears darker red when carrying CO2)
what is blood made of
erythrocytes leukocytes and thrombocytes
the protein contained in red blood cells that is responsible for delivery of O2 to the tissues
hemoglobin
what are leukocytes
White blood cells) - to do stuff for immune system like phagocytize (pac man to dead tissue and chomping it up), these are all immune system responses
what is another name for platelets
thrombocytes
What do thrombocytes do
help produce coagulation/blood clotting and prevent from blood loss continuing
what are the types of leukocytes
granular (phagocytes, antihistamin heparin, histamine and serotonin producers)
agranular (phagocytes, T&B cells)
monocytes and lymphocytes
agranular
neutrophils
eosinphils
basophils
granular
what are the basics of blood clotting
cut and ruptured blood vessel attracts thrombocytes
chemicals and processes happen to get fibrin & platelets component of thrombocytes to produce a clot of red blood cells and fibrin to plug up the hole with a netlike pattern and this is a scab
attached connected clot to opening of lumen, unwanted clotting
thrombosis
floating around the blood vessels, circulating blood clot
embolus
Tissues killed as a result of loss of blood supply, area that wont get blood through it and tissue will be killed due to loss of blood, dead area
infarction
foreign body (blood clot) that travels within the body and can constrict blood flow (could be detached thrombus)
embolus
a blood clot, a lesion attached to the inner vessel wall, can block partially or fully the flow of blood. (attached)
thrombus
what is albumin
prominent plasma protein
helps with osmotic pressure and water balance
happens to be protein which chemicals (drugs/hormones) will bind to it in the plasma to get carried around in our system and bounce off so they can transfer across the cell membrane to the tissues
immune function or transportation
globulin
for clotting
fibrinogen
what is the function of blood
Transports: O2, CO2, nutrients, waste, hormones
Regulates: body pH, body temperature
Clotting mechanism
Protection against foreign microbes and toxins
Osmosis - moving fluids between tissues
what is osmosis
movement of fluids between tissues
where are all blood cells produced
red bone marrow
Lymphocytes and monocytes produced by
Lymph nodes, spleen, tonsils
what do blood cells develop from
stem cells (undifferentiated mesenchymal cells)
production of blood cells
hematopoiesis
what is the clumping of RBCs and occurs when blood groups are mismatched
usually a transfusion reaction
agglutination
what are the blood types
A+
O+
B+
AB+
A-
O-
B-
AB-
What blood type is the universal blood donor
O-
what blood type can receive from anyone
AB+
What is RH
protein on the RBCs
inherited through genes
what can happen during pregnancy if you are RH- and the baby is RH+
blood from your baby can cross into your bloodstream, especially during delivery. If you’re Rh-negative and your baby is Rh-positive, your body will react to the baby’s blood as a foreign substance. It will create antibodies (proteins) against the baby’s blood. These antibodies usually don’t cause problems during a first pregnancy.
But Rh incompatibility may cause problems in later pregnancies, if the baby is Rh-positive. This is because the antibodies stay in your body once they have formed. The antibodies can cross the placenta and attack the baby’s red blood cells. The baby could get Rh disease, a serious condition that can cause a serious type of anemia.
The period of time that begins with contraction of the atria and ends with ventricular relaxation is known as
cardiac cycle
What is the difference between systole and diastole?
Systole is the contraction phase of the ventricles in a cardiac cycle and the systolic number in blood pressures measures is the top number.
Diastole is the relaxation phase of the ventricles in a cardiac cycle. The diastolic number is the bottom number in blood pressure measures.
have thicker and stronger layers to account for increased pressure
ARTERIES
Arteries carry (oxygenated / deoxygenated) blood away from the heart and to the body.
oxygenated
Veins carry (oxygenated / deoxygenated) blood toward the heart from the body.
deoxygenated
What are the exceptions to arteries carrying oxygenated and veins carrying deoxygenated?
THE PULMONARY ARTERIES ARE CARRYING DEOXY. BLOOD AWAY FROM HEART AND TO THE LUNGS
THE PULMONARY VEINS ARE CARRYING OXY. BLOOD AWAY FROM LUNGS AND BACK TO THE HEART
What is the purpose of the valves in the heart?
TO PREVENT BACKFLOW – BLOOD ONLY FLOWS IN ONE DIRECTION BETWEEN STRUCTURES
when blood is being pumped to the other location, we want the valves to open to allow it through and then to close so it doesn’t go back in that area
Briefly describe the flow of blood in and out of the heart.
Deoxygenated blood returns from body to right atrium through superior and inferior vena cava (bring used blood in)
Sent to right ventricle, which pumps blood to lungs—through pulmonary trunk and right and left pulmonary arteries
Oxygenated blood returns to left atrium through 4 pulmonary veins
Sent to left ventricle from the left atrium
Left ventricle sends blood to the body via the ascending aorta arches up and sends stuff up and down for upper and lower body
r atrium to r ventricle, to lungs, to l atrium to send to l ventricle and that sends it out to the upper and lower body
What is a thrombocyte and what does it do
PLATELETS HELP FORM BLOOD CLOTS
Thrombocytes (platelet - clotting factor) or platelets
Disk-shaped cellular fragments with a nucleus
Prevent fluid loss when blood vessels are damaged by forming a mesh/net, catching platelets and forming a barrier/clot
after stopped flow, clot needs to be dissolved so it doesn’t stay there forever or become an embolism that doesn’t float within the blood stream
2 components found in the plasma and their functions
Plasma proteins: 7%
Albumin (osmotic pressure and water balance), globulin (immune function or transportation, fibrinogen (for clotting)
Plasma solutes: 2%
Ions, nutrients, waste products, gases, enzymes, hormones
What are the 4 blood types and 2 Rh factors?
A AND A-
B AND B-
AB AND AB-
O AND O-
What types of complaints might necessitate that a patient undergo a tilt table exam?
LIGHT HEADEDEDNESS
SYNCOPE
HEAVY LEGS
how to people get BP measured normally?
sitting
reported dizzy when laying to standing, measure bp in those positions?
20 or more for top
10 or more for bottom
what is the name when BP drops when going from one position to another
orthostatic hypotension
One complete cardiac cycle
Atria contract / ventricles relax
Ventricles contract / atria relax
contraction phase, pumps blood out
systole
relaxation phase after contraction
diastole
abnormal sound/noise from heart/blood flow when listening
bruit
what portions of the body gets the most blood flow from the arteries?
brain, skeletal muscle, kidneys and GI system and spleen
what is involved in pulsatile tinnitus?
cardiovascular
this disorder has heart condition in kids who also have HL and if we know this they can treat it
JLNS
dietary and environmental and multifactoral, sugar levels of intake, dietary or medication treatment
type 2 diabetes
diagnosed in children, more severe, insulin dependent
type 1 diabetes
what are heart conditions that can lead to lowe blood pressure
extremely low heart rate (bradycardia), heart valve problems, heart attack and heart failure
slow heart rate
bradycardiaf
fast heart rate
tachycardia
why are we concerned of HL in arterial sclerosis
more likely to have tiny arteries clogged and are not able to get blood through like to the cochlea and can have HL or vestibular loss
should audiologists ask about cardiovascular issues in case history?
yes, whole person, whole body health, know it plays a role in vestibular and hearing
what part of the body is first to be affected by heart disease
inner ear
what conditions might we see in audiology or how does cardiovascular relate to audiology?
JLNS
POTS
Orthostatic hypotension
Pulsatile tinnitus
set of organs that allows a person to breathe and/or exchange oxygen and carbon dioxide throughout the body.
respiratory system
what is included in the respiratory system
includes the nasal passages, pharynx, larynx, trachea, bronchial tubes, and lungs.
Diaphragm and intercostal muscles contract and pulls downward - opening the cavity to make more space so the pressure in the air is higher and is being pulled into the lungs
inhalation
Pressure decreases in lungs: air rushes in
ribcage rises
draws gases into the lungs
inhalation
Diaphragm and intercostal muscles relax - moves back up to arched position, narrower cavity and squeezing lungs so it pushes the air out
exhalation
Pressure increases in lungs: air rushes out
forces gases out of the lungs
exhalation
what is the function of the respiratory system
Supply the body with oxygen and dispose of carbon dioxide
2. Filter inspired air (air breathed in)
3. Help produce sound (vocalization)
4. Aid in smell (contains receptors for smell)
5. Rids the body of some excess water and heat
6. Helps regulate blood pH
what is the respiration process
external exchange of Oxygen and Carbon Dioxide with the external environment; and internal exchange of the gasses between the lungs and internal tissues at the capillaries
what is the importance of the nose
Filters out dust; warm and moisturize air, smell, speech tone
connects nasal passages to rest of respiratory system
nasopharynx
connection to mouth
oropharynx
connects with esophagus and larynx
laryngopharynx
contains the pharyngeal tonsils (adenoids) which aid in the body’s immune defense.
nasopharynx
back portion of the mouth that contains the palatine tonsils which aid in the body’s immune defense
oropharynx
what is the larynx function
Prevents swallowed materials from entering the
lower respiratory tract.
Conducts air into the lower respiratory tract.
Produces sounds.
Supported by a framework of nine pieces of cartilage
what is the epiglottis
put air and food in the right places so they go down the right tubes
where is the trachea in realtion to the esophagus
anteriorly
where is the esophagus in relation to the trachea
posteriorly
flexible tube aka windpipe
trachea
divided into 2 lobes by oblique fissure
left lung
accomodates the heart (for the L Lung)
cardiac notch
divided into 3 lobes by oblique and horizontal fissure
– located more superiorly in the body due to liver on this side
right lung
where does gas exchange occur
in alveoli at the end of bronchioles
soft tissue around the organ itself
visceral pleura
everything else the lung touches is lined with
parietal plura
why do we need the pleura around the lungs
lubrication to ensure minimal friction during breathing
pleuritis with too much fluid
pleural effusion
between pleura, prevents friction
pleural cavity
what is COPD
Umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma.
Characterized by breathlessness.
Where may we encounter COPD
nursing home, hospital care setting, elderly, history of chronic smoking, occupational exposure (pesiticides, aspestis, etc.)
how is COPD categorized
4 stages based on severity (1-4 mild to severe)
what is the most common cause of emphysema
cigarette smoking
involves damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise
emphysema
is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness.
bronchitis
A hereditary disease that affects the lungs and digestive system.
The body produces thick and sticky mucus that can clog the lungs and obstruct the pancreas.
can be life-threatening, and people with the condition tend to have a shorter-than-normal life span.
cystic fibrosis
an infection that inflames the air sacs in one or both lungs.
The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing.
A variety of organisms, including bacteria, viruses and fungi can cause it
pneumonia
Build-up of excess fluid between the layers of the pleura outside the lungs.
pleural effusion
“water on the lungs”
pleural effusion
where is there info crossing over for visual and auditory pathway for where optic info goes?
temporal lobe
what might we see with a lesion in the temporal lobe?
can have both auditory and visual symptoms with lesion in this area
due to crossing over of visual and auditory pathways
what visual info lands in the cuneus (above calcarine)
lower visual field
what visual info lands in the lingual (below calcarine)
upper visual field
describe accomodation and convergence
same as retinogeniculate
once at thalamus or pretectal area, some info goes out from optic nerve fibers in thalamus and go into the top of BS to pretectal area (superior/inferior coll) and control our natural eye responses (convergence and accommodation and pupil constriction), leaves thalamus and pre tectal to CN III to control medial rectus (go toward nose) and pupillary constrictors in orange that go to the cilliary muscles to constrict pupil
the left temporal hemiretina and the right nasal hemiretina go to which hemisphere in the brain?
left brain
the right temporal hemiretina and the left nasal hemiretina go to which hemisphere in the brain?
right brain
the right visual field hits where and lands where?
hits the right nasal hemiretina and left temporal hemiretina
lands on the left brain
the left visual field hits where and lands where?
hits the left nasal hemiretina and right temporal hemiretina
lands on the right brain
normal spherical-shaped eye
emmetropia
elongated eyeball
myopia
near sightedness (cannot see far away)
flattened eyeball shape
hyperopia
far sightedness (cannot see up close)
If the cornea gradually thins at the center and protrudes, becoming cone-shaped this results in
keratoconus
A type of spherical aberration
Affects the ability of the eye to focus
The cornea has various radii of curvature
astigmatism
loss of accommodation (near vision) due to aging
presbyopia
causes blood vessels of the retina (and other parts of the body) to become leaky. Protein escapes into the normally clear aqueous humor, making it cloudy and causing light to defract, blurring vision. In advanced stages, blindness results.
diabetic retinopathy
film/clogging of the eye
opacity (cornea looks milky)
can occur with aging or sped up with genetics
cataract
front chamber is filled with aqueous and too much of this causes excess pressure on the eye, has to be absorbed through canal of schlem and go out to be absorbed and if it doens’t this occurs
pressure builds up and pushes lens back
puff of air at the eye doctor is checking for this
glaucoma
vascular lesion, deposit of pigment in the retina, etc.
dancing light in the eye
think migraine with light
scotoma
could have damage from injury or genetics and retina falls off of the globe and falls forward in the fluid when it should be firmly attached
think of curtain closing in from the sides after a theater show
can lead to permanent blindness if not treated right away
detached retina
An age-related eye disease affecting the small part of the retina responsible for sharp, straight-ahead vision that is needed for driving and reading small print. This disorder usually occurs in people 65 years of age or older.
macular degeneration
What part of the nervous system mediates the slow phase?
vestibular
What part of the nervous system mediates the fast phase?
CNS
rhythmic eye movements, know which left or right beating
nystagmus
eye tracking
Following a moving object
smooth pursuit
Directing the gaze from one target to another (point A to point B)
saccades
aka railroad nystagmus
eyes track until out of site and then dart back to the middle and repeat and looks just like nystagmus that we would have with a disease
OPK
can compensation in CNS occur with spontaneous nystagmus?
yes if the lesion is to a peripheral vestibular organ and the other side is intact.
Brainstem lesions causing nystagmus do not show compensation
true
How does the body know we are not moving?
the paired vestibular system
how does it know I am moving?
one side of vestibular system is inhibited and the other stimulated
why do I not see spontaneous nystagmus with a PT that comes in? How can we override this?
can have spontaneous nystagmus that you cannot see in a well lit room with some visual stimulus to fixate on so the vision will override the spontaneous nystagmus
when you take this away, the spontaneous nystagmus can show up when they cannot focus on something
when do we see gaze nystagmus?
when hold signal is not able to remain in place on an object, the eyes drift back to center and a new saccade is initiated to bring the eye back to the target
objects/world spinning
objective vertigo
self spinning
subjective vertigo
what is opthalmoplegia
disturbance of eye muscles
sitting and looking at something, muscles work equally, medial pulls stronger and eye deviates towards the nose with lesion to VI
results in a “lazy eye”
nuclear lesion opthalmoplegia
lesion in nuclei of CN’s
nuclear opthalmoplegia
bw nuclei, MLF (Fiber tract), lesion in MLF
multiple sclerosis - depends where lesion is impacted on how the eye movement would be
disoriented/deranged eye movements
internuclear opthalmoplegia
above the eye, in cerebral cortex
still have reflexes intact (because below the cortex) but voluntary saccades are interrupted (look at this, look at this - cannot do it)
supranuclear opthalmoplegia
Reflexive movement of the eyes in response to vestibular stimulation
VOR
Normally the VOR produces conjugate eye movement in the direction opposite the movement of the head
TRUE
right turn of the head, the eyes go to the left the same degree as the head turn
VOR
Blood supply to visual fibers and visual cortex
choroid
posterior cerebral artery
what can trigger free nerve endings?
intense mechanical stimulation, intense heat or cold, or various chemicals released by or in response to tissue damage
if you are under stress, which part of ANS is active and what it would control
sympathetic, send harder pumping from heart to big muscles for ff response, reducing digestion and widening of eyes and stimulating sweat glands
what are examples of effector organs?
muscle, heart, other things, nerves innervate to control automatically
if in sitting down to rest and relaxing what happens to the body
parasympathetic, decreased heart rate, increased digestion, pupillary constriction, no effect on sweat glands
preparation for strenuous or stressful situation when we need energy, increased heart rate, more blood to skeletal muscle
Activates adrenal medulla to secrete chemical messengers which can provide widespread and relatively long-lasting effects
sympathetic system
energy storage or decrease in activity, decreased cardiac output and blood pressure, more gut activity for digestion, pupillary constriction (ready to rest)
parasympathetic
what is HPA axis and what does it do
hypothalamus releases a hormone (corticotropin-releasing) that activates the sympathetic nervous system (increases heart rate, sweating, etc.). This also tells the pituitary gland to start releasing its hormone (adrenocorticotropic) into the bloodstream. Through the blood, this hormone makes its way to the adrenal glands in the abdomen binding to them. The adrenal glands then start producing cortisol
what is cortisol
Cortisol is a steroid hormone that regulates a range of vital processes throughout the body, like metabolism and immune response. It also helps the body respond to stress by sending more blood to muscles, increasing amount of glucose in the blood and increasing blood pressure and turns off the functions in our body that doesn’t help in stressful situations
Discuss Tinnitus and involvement of the ANS and limbic system
connections and vicious cycle of sound tying in limbic for emotions and responds
become hypersensitive, more emotional, more stressed, more tuned into it and keeps going
how many layers does the cortex have
6 (1 superficial, 6 deep)
what cells are the most abundant in the cerebral cortex?
pyramidal cells
what are EE fibers in columns of cortex
excited by stimuli in both ears
what are EI fibers in columns of cortex
excited by stimuli in one ear and inhibited by stimuli in the other ear
favored for the development of speech and language
left hemisphere
usually plays a role in happy feelings
left pre frontal cortex
aiding in negative feelings
right pre frontal cortex
speech dominant
L brain
creative dominant
R brain
why do we have functions in specific areas of the brain rather than having it on both sides?
efficiency of the space and can process and do more because it is compartmentalized allowing for more cognitive functions
damage to left frontal cortex
depression and crying
damage to right frontal cortex
no negative feelings lack of concern about symptoms, pathological laughing, burst of euphoria
what are commissural/interhemispheric fibers and give examples
from contralateral hemisphere, connects the hemispheres
CC, anterior commissure, posterior commissure, interthalamic adhesion
what are association fibers and give an example
other regions within same hemisphere
arcuate fasciculus
In the BS where do we find the most crossing over of fibers?
decussations in BS are in pyramids in front of the medulla
inability to recognize an object or interpret sensory stimuli
agnosia
interference with planning and performing skilled and complex movements
apraxia
spoken and written words have no meaning
wernicke’s aphasia
normal comprehensive but production of speech is impaired
broca’s aphasia
disturbance of language function
aphasia
periods of abnormal hyperactive and synchronized neuronal firing in the cortex
seizures
causes of seizures
Many causes, related to cortical damage
Temporary: Concussion, hypoglycemia, meningitis, encephalitis
Sustained: brain tumors, abscesses, intracranial vascular lesions, metabolic disease
Taking drugs or withdrawal form drugs
what lesion in cortex is a better prognosis for recovery?
supratentorial
Slow and stepwise progression
supratentorial lesion
Dramatic symptoms associated with cranial nerves
Vertigo, nausea and projectile vomiting (vegitative symptoms), deafness, facial paralysis
infratentorial lesion
