Introduction Flashcards
- composed of specialized cells, whose function is to: receive sensory stimuli and to transmit them to effector organs, whether muscular or grandular
nervous sytem
coordinated so that the effector organs work harmoniously together for the well-being of the individual
efferent impluses
- consists of the brain and spinal cord
- brain and spinal cord are the main centers where correlation and integration of nervous information occurs
central nervous system
- consists of the cranial and spinal nerves and their associated ganglia
peripheral nervous sytem
- both the brain and spinal cord are covered with a system of membranes ___ and are suspended in ___
meninges, cerebrospinal fluid
- protected by the bones of the skull and the vertebral column
- protective covering of the spinal cord
meninges
- CNS is composed of large numbers of neurons
- excitable nerve cells
neurons
- processes of neurons are known as
axons or nerve fibers
- neurons are supported by specialized tissue called
neuroglia
- the CNS interior is organized into ___ and ___
gray matter, white matter
- gray in color
- consists of nerve cells embedded in neuroglia
gray matter
- consists of nerve fibers embedded in neuroglia and is white in color because of the presence of lipid material in nerve fiber myelin sheaths
white matter
- In the PNS, the ___ and ___ nerves conduct information to and from the CNS
- unprotected and are commonly damaged by trauma
cranial and spinal nerves
- innervates the body’s involuntary structures such as the heart, smooth muscle, and glands
- distributed throughout the CNS and PNS and is divided into two parts: sympathetic & parasympathetic
autonomic nervous system
- prepare the body for an emergency
sympathetic part of the ANS
- conserving and restoring energy
parasympathetic
- meninges is formed by
- three meninges
dura, arachnoid, and pia matter
- space between the arachnoid and pial membranes
- contains cerebrospinal fluid (CSF)
subarachnoid space
- projects into the dural venous sinuses to drain CSF from the subarachnoid space
- connect the dura mater to the pia mater
arachnoid mater
Central Nervous System
Brain Forebrain Midbrain Hindbrain Spinal cord
Central Nervous System
Forebrain
Cerebrum
Diencephalon (between brain)
Central Nervous System
Hindbrain
medulla oblongata
pons
cerebellum
Central Nervous System
Spinal cord
cervical segments thoracic segments lumbar segments sacral segments coccygeal segments
Peripheral Nervous System
cranial nerves and their ganglia spinal nerves and the ganglia 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
Peripheral Nervous System
12 pairs that exit the skull through the foramina
Cranial nerves and their ganglia
Peripheral Nervous System
31 pairs that exit the vertebral column through the intervertebral foramina
spinal nerves and their ganglia
- situated within the vertebral canal of the vertebral column and is surrounded by three meninges
- roughly cylindrical and begins superiorly at the foramen magnum in the skull where it is continuous with the medulla oblongata of the brain.
spinal cord
- protection of the spinal cord is provided by the ___ which surrounds the spinal cord in the ___
cerebrospinal fluid, subarachnoid space
- 31 pairs of spinal nerves are attached by the ___ and the ___
anterior or motor roots, posterior or sensory roots
- each posterior nerve root possesses a ___,
- the cells of which give rise to peripheral and center nerve fibers
posterior root ganglion
TRUE OR FALSE
the spinal cord is composed of an inner core of gray matter which is surrounded by an outer covering of white matter
true
- seen on cross section as an H-shaped pillar with anterior and posterior gray columns, or horns united by a thin gray commissure containing the small central canal
gray matter
- divided into anterior, lateral, and posterior white columns
white matter
- lies in the cranial cavity and is continuous with the spinal through the foramen magnum
- surrounded by the dura mater, the arachnoid mater, and the pia mater
brain
- divided into three major divisions: the hindbrain, midbrain, and forebrain in ascending order from the spinal cord
brain
- collective term of medulla oblongata, pons, and midbrain
- what remains after the cerebral hemispheres and cerebellum are removed
brain stem
- comprises the medulla oblongata, the pons, and the cerebellum
hindbrain
- conical in shape and connects the pons superiorly to the spinal cord inferiorly
medulla oblongata
- medulla oblongata contains many collections of neurons called
- serves as a conduit for ascending and descending nerve fibers
nuclei
- situated on the anterior surface of the cerebellum, inferior to the midbrain and superior to the medulla oblongata
- large number of transverse fibers on it anterior aspect connecting the two cerebellar hemispheres
pons
- contains many nuclei and ascending and descending nerve fibers
pons
- posterior cranial fossa of the skull
- posterior to the pons and the medulla oblongata
cerebellum
- cerebellum consists of two laterally placed hemispheres connected by a median portion called the
vermis
- the cerebellum is connected to the ___ by the superior cerebellar peduncles, to the ___ by the middle cerebellar peduncles, and to the ___ by the inferior cerebellar peduncles
mid- brain, pons, medulla
- composed of large bundles of nerve fibers connecting the cerebellum to the remainder of the nervous system
peduncles
- the surface layer of each cerebellar hemisphere
- composed of gray matter
cortex
- thrown into folds or folia, separated by closely set transverse fissures
cerebellar cortex
- certain masses of gray matter are found in the interior of the cerebellum, embedded in the white matter
- the largest of these is known as
denate nucleus
- the medulla oblongata, the pons, and the cerebellum surround a cavity filled with CSF, called
fourth ventricle
- fourth ventricle is connected superiorly to the third ventricle by the
- inferiorly it is continuous with the central canal of the spinal cord
cerebral aqueduct
- narrow part of the brain that connects the forebrain to the hindbrain
midbrain
- the narrow cavity of the midbrain
- connects the third and fourth ventricles
cerebral aqueduct
TRUE OR FALSE
the midbrain does not contain a lot of nuclei and bundles of ascending and descending nerve fibers
false, contains a lot
- comprises the diencephalon (between brain)
- central part of the forebrain, and the cerebrum
forebrain
- consists of a dorsal thalamus and a ventral hypothalamus
- between brain
diencephalon
- large, egg-shaped mass of gray matter that lies on either side of the third ventricle
thalamus
- anterior end of the thalamus forms the posterior boundary of the
interventricular foramen
TRUE OR FALSE
the thalamus forms the lower part of the lateral wall and floor of the third ventricle
false, hypothalamus
- largest part of the brain
- consists of two cerebral hemispheres, which are connected by a mass of white matter
cerebrum
- mass of white matter in the cerebrum
corpus callosum
- the hemispheres are separated by a deep cleft called
- into which projects the falx cerebri
longitudinal fissure
- surface layer of each hemisphere
- composed of gray matter
cortex
- the cerebral cortex is thrown into folds called
gyri
- the cerebral cortex is separated by fissures or
sulci
TRUE OR FALSE
this arrangement greatly increases the surface area of the cortex
TRUE
- a number of the large sulci are used to subdivide the surface of each hemisphere into
lobes
- within the hemisphere is a central core of white matter containing several large masses of gray matter
basal nuclei or ganglia
- fan shaped collection of nerve fibers
- passes in the white matter to and from the cerebral cortex to the brainstem
corona radiata
- the corona radiata converges on the basal nuclei and passes between them as the
internal capsule
- the tailed nucleus situated on the medial side of the internal capsule is the
caudate nucleus
- the lens shaped nucleus on the lateral side of the internal capsule is the
lentiform nucleus
- within each cerebral hemisphere is a cavity called
lateral ventricle
- communicate with the third ventricle through the
interventricular foramina
TRUE OR FALSE
during the process of development, the cerebrum becomes enormously enlarged and overhangs the diencephalon, midbrain, and hindbrain
true
- composed of an inner core of white matter, which is surrounded by an outer covering of gray matter
brain
- situated deeply within the white matter
gray matter
- grey cerebellar nuclei in the ___ and the gray thalamic, caudate, and lentiform nuclei in the ___
cerebellum, cerebrum
- made up of bundles of nerve fibers supported by connective tissue
cranial and spinal nerves
- leave the brain and pass through foramina in the skull
12 pairs of cranial nerves
- leave the spinal cord and pass through intervertebral foramina in the vertebral column
31 pairs of spinal nerves
- the spinal nerves are associated with regions of the spinal cord:
8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
- 8 cervical nerves yet only _ cervical vertebrae
7
- 1 coccygeal nerve but _ coccygeal vertebrae
4
- each spinal nerve is connected to the spinal cord by two roots:
anterior root & posterior root
- consists of bundles of nerve fibers carrying nerve impulses away from the CNS - efferent fibers
- their cells of origin lie in the anterior gray horn of the spinal cord
anterior root
efferent fibers that go to skeletal muscles and cause them to contract are
motor fibers
consists of bundles of afferent fibers that carry nervous impulses to the CNS
posterior root
afferent fibers covey information about sensations of touch, pain, temperature, and vibration, they are called
sensory fibers
- the cell bodies of the afferent fibers are situated in a swelling on the posterior root called the
- sensory ganglia of spinal nerves
posterior root ganglion
the spinal nerve roots pass from the spinal cord to the level of their respective intervertebral foramina, where they unite to form a
spinal nerve
TRUE OR FALSE
because of the disproportionate growth in length of the vertebral column during development, compared with that of the spinal cord, the length of the roots increases progressively from above downward
true
- the spinal nerve roots are short and run almost horizontally, but the roots of the lumbar and sacral nerves below the level of the termination of the cord
- consists of the atlas (C1) and the axis (C2)
upper cervical region
- the upper cervical region forms a vertical leash of nerves around the
- a fibrous band that extends from the conus medullaris to the periosteum of the coccyx, and its functions are to fixate, stabilize, and buffer the distal spinal cord from normal and abnormal cephalic and caudal traction.
filum terminale
lower nerve roots of the upper cervical region
cauda equina
- after emerging from the intervertebral foramen, each spinal nerve immediately divides into a large ___ and ___
- each containing both motor and sensory fibers
anterior ramus and posterior ramus
passes posteriorly around the vertebral column to supply the muscles and skin of the back
posterior ramus
continues anteriorly to supply the muscles and skin over the anterolateral body wall and all the muscles and skin of the limbs
anterior ramus
join one another at the root of the libs to form complicated nerve plexuses
anterior rami
found at the root of the upper limbs
cervical and brachial plexuses
found at the root of the lower limbs
lumbar and sacral plexuses
divided into sensory ganglia of spinal nerves (posterior root ganglia) and cranial nerves and autonomic ganglia
ganglia
- fusiform (spindled-shaped) swellings on the posterior root of each spinal nerve just proximal to the root’s junction with a corresponding anterior root
- referred as posterior root ganglia
sensory ganglia
ganglia found along the course of cranial nerves5,6,8,9, & 10
sensory ganglia
- irregular in shape, situated along the course of efferent nerve fibers of the autonomic nervous system
- found in the paravertebral sympathetic chains around the roots of the great visceral arteries in the abdomen and close to or embedded within the walls of various viscera
autonomic ganglia
NERVOUS SYSTEM
- inner most layer
- gives rise to the gastrointestinal tract, the lungs, and liver
entoderm
NERVOUS SYSTEM
- gives rise to the muscle, connective tissues and the vascular system
mesoderm
NERVOUS SYSTEM
- third and outermost layer
- formed of columnar epithelium, gives rise to the entire nervous system
ectoderm
NERVOUS SYSTEM
during the ___ week of development, the ectoderm on the dorsal surface of the embryo between the primitive knot and the buccopharyngeal membrane thickens to form ___
third ,neural plate
NERVOUS SYSTEM
plate which is pear shaped and wider cranially, develops a longitudinal ___
neural groove
NERVOUS SYSTEM
the groove now deepens so that it is bounded on either side by ___
neural folds
NERVOUS SYSTEM
the neural folds fuse, converting the neural groove into a ___
neural tube
NERVOUS SYSTEM
the cavity of the tube remains in communication with the amniotic cavity through the
anterior and posterior neuropores
TRUE OR FALSE
fusion starts at about the midpoint along the groove and extends cranially and caudally so that the cavity remains in communication with the amniotic cavity
true
Which closes first? the anterior neuropore pr posterior neuropore?
anterior, posterior closes 2 days after
how many days does the neural tube closes normally?
28 days
sunk beneath the surface ectoderm after neural tube closure
neural tube
- the ___ will differentiate into the cells of the posterior root ganglia, sensory ganglia of the cranial nerves, autonomic ganglia, cells of the suprarenal medulla, and melanocytes
- give rise to mesenchymal cells in the head and neck
neural crest cells
the ___ at the cephalic end of the neural tube causes it to dilate and form three primary brain vesicles
proliferation of cells
the rest of the tube elongates and remains smaller in diameter; it will form the ___
spinal cord
Primary Division of the Developing Brain
- Primary Division of Forebrain vesicle
prosencephalon (forebrain)
Primary Division of the Developing Brain
- Primary Division of Midbrain vesicle
mesencephalon (midbrain)
Primary Division of the Developing Brain
- Primary Division of hindbrain vesicle
rhombencephalon (hindbrain)
Primary Division of the Developing Brain
- Subdivision of Forebrain vesicle
telencephalon & diencephalon
Primary Division of the Developing Brain
- Subdivision of midbrain vesicle
mesencephalon
Primary Division of the Developing Brain
- Subdivision of hindbrain vesicle
metencephalon & myelencephalon
Primary Division of the Developing Brain
- Adult Structures of forebrain vesicle (telencephalon)
cerebral hemisphere, basal ganglia, hippocampus
Primary Division of the Developing Brain
- Adult structures of forebrain vesicle (diencephalon)
thalamus, hypothamus, pineal body, infundibulum
Primary Division of the Developing Brain
- Adult structures of midbrain vesicle
tectum, tegmentum, crus cerebri
Primary Division of the Developing Brain
- Adult structures of hindbrain vesicle
pons, cerebellum, medulla oblongata
excessive numbers of neurons and neuroglial cells develop, and many will be programmed to die by a process known as
programmed cell death
promote the development and survival of neurons
identification of neurotrophic factors
TRUE OR FALSE
the spinal cord is longer than the vertebral column, the spinal cord segments do not correspond numerically with the vertebrae that lie at the same level
false, shorter
the degree of spinal cord injury at different vertebral levels is determined largely by
anatominal factors
Spinal cord injury
in the ___, dislocation or fracture dislocation is common
cervical region (neck area)
Spinal cord injury
- ceases if the cord is completely severed above the segmental origin of the phrenic nerves (c3-c5)
- intercostal muscles (muscles between your ribs) and the diaphragm are paralyzed resulting in death,
respiration
Relationship of spinal cord segments to vertebral numbers
Vertebrae: cervical vertebrae
Spinal segment: ?
add 1
Relationship of spinal cord segments to vertebral numbers
Vertebrae: upper thoracic vertebrae
Spinal segment: ?
add 2
Relationship of spinal cord segments to vertebral numbers
Vertebrae: lower thoracic vertebrae (7-9)
Spinal segment: ?
add 3
Relationship of spinal cord segments to vertebral numbers
Vertebrae: 10th thoracic vertebra
Spinal segment: ?
L1-L2 cord segments
Relationship of spinal cord segments to vertebral numbers
Vertebrae: 11th thoracic vertebra
Spinal segment: ?
L3-L4 cord segments
Relationship of spinal cord segments to vertebral numbers
Vertebrae: 12th thoracic vertebra
Spinal segment: ?
L5 cord segment
Relationship of spinal cord segments to vertebral numbers
Vertebrae: 1st lumbar vertebra
Spinal segment: ?
sacral and coccygeal cord segments
Relationship of spinal cord segments to vertebral numbers
Vertebrae: ?
Spinal segment: add 1
cervical vertebrae
Relationship of spinal cord segments to vertebral numbers
Vertebrae: ?
Spinal segment: add 2
upper thoracic vertebrae
Relationship of spinal cord segments to vertebral numbers
Vertebrae: ?
Spinal segment: add 3
lower thoracic vertebrae (7-9)
Relationship of spinal cord segments to vertebral numbers
Vertebrae: ?
Spinal segment: L1-L2 cord segments
10th thoracic vertebra
Relationship of spinal cord segments to vertebral numbers
Vertebrae: ?
Spinal segment: L3-L4 cord segments
11th thoracic vertebra
Relationship of spinal cord segments to vertebral numbers
Vertebrae: ?
Spinal segment: L5 cord segments
12th thoracic vertebra
Relationship of spinal cord segments to vertebral numbers
Vertebrae: ?
Spinal segment: sacral and coccygeal cord segments
1st lumbar vertebra
Spinal cord injury
- spinal cord in the adult extends down only as far as the level of the lower border of the 1st lumbar vertebra
- the large size of the vertebral foramen in this region gives the roots of the cauda equina ample room
fracture dislocations of the lumbar region
Spinal cord injury
-partial or complete loss of function at the ___ and partial or complete loss of function of afferent and efferent nerve tracts ___
level of the lesion, below the level of the lesion
Spinal nerve injurues
- transmit the spinal nerves and the small segmental arteries and veins, all of which are embedded in areolar tissue
intervertebral foramina
Spinal nerve injurues
- less comon
- 5th. 6th, and 7th cervical vertebrae
cervical disc herniations
Spinal nerve injurues
- pain if felt near the lower part of the back of the neck and shoulder and along the area in the distribution of the spinal nerve involved
cervical disc herniations
Spinal nerve injurues
- more common
- discs usually affected are those between the 5th lumbar vertebra and the sacrum
lumbar disc herniations
Spinal nerve injurues
- the roots of the cauda equina run posteriorly over a number of intervertebral discs
lumbar region
Spinal nerve injurues
- press on one or two roots and commonly involves the nerve root going to the intervertebral foramen just below
lateral herniation
Spinal nerve injurues
- pain is referred down the leg and foot in the distribution of the affected nerve
lumbar disc herniations
Spinal nerve injurues
- pain is usally felt down the back and lateral side of the leg, radiating to the sole of the foot, a condition known as
sciatica
Spinal nerve injurues
- causes muscle weakness
pressure on the anterior motor roots
performed to withdraw a sample of CSF (Cerebrospinal fluid) for microscopic or bacteriologic examination or to inject drugs to combat infection or induce anesthesia
spinal tap (lumbar puncture)
Spinal Tap
- the lower part of the vertebral canal is thus occupied by the
- interval between the arachnoid membrane and the pia mater.
subarachnoid space
Spinal Tap
- contains the lumbar and sacral nerve roots and the filum terminale
subarachnoid space
TRUE OR FALSE
a neddle inserted into the subarachnoid space in this region usually pushes the nerve roots to one side causing damage
False, without causing damage
Spinal Tap
- the needle will pass through the following anatomical structures before it enters the subarachnoid space: a,b,c,d,e,f,g, h
a - skin b- superficial fascia c - supraspinous ligament d- interspinous ligament e - ligamentum flavum f - areolar tissue containing the internal vertebral venous plexus g - dura matter h - arachnoid matter
Spinal Tap
- measured by attaching a manometer to the needle
- normal pressure is about 60 to 150 mm of water
CSF pressure
Spinal Tap
- the pressure shows oscillations corresponding to the movements of respiration and the arterial pulse
CSF pressure
Caudal Anesthesia
- anesthetic solutions may be injected into the ___ through the sacral hiatus
sacral canal
- obstetricians use this method of nerve block to relieve the pains of the first and second stages of labor because anesthetic administered by this method does not affect the infant
- used in operations in the sacral region, including anorectal surgery
caudal anesthesia
Skull fractures
- in the ___ fractures of the skull are common, but they are less common in the young child
adult
Skull fractures
- the skull bones are more resilient, and they are separated by fibrous sutural ligaments
infants
Skull fractures
- sutural ligaments begin to ossify (harden) during ___
middle age
Skull fractures
- resembles an eggshell, with limited resilience
- a severe localized blow will cause a local indentation, commonly with bone splintering
adult skull
Skull fractures
- resembles a ping-pong ball
- a localized blow produces a depression without splintering
young child’s skull
caused by displacement and distortion of the neural tissues at the moment of impact
brain injuries
brain injuries
- ___ lead to displacement of the brain
- cause severe cerebral damage, stretching and distortion of the brainstem, and stretching and even tearing of brain commissures
blows on the front or back of the head
brain injuries
- cause less cerebral displacement, and the injuries to the brain consequently tend to be less severe
blows to the side of the head
brain injuries
- tough structure and may cause considerable damage to the softer brain tissue in cases of a severe blow to the side of the head
falx cerebri
brain injuries
- the brain is forcibly thrown against the sharp edges of bone within the skull
brain lacerations
brain injuries
- result in damage to the brain at two sites: at the point of impact and at the pole of the brain opposite the point of impact, where the brain is thrown against the skull wall
contercoup injury
Intracranial Hemorrhage
- injuries to the meningeal arteries or veins
- minor blow to the side of the head, resulting in fracture of the skull in the region of the anterior-inferior portion of the parietal bone
epidural hemorrhage
Intracranial Hemorrhage
- bleeding occurs and strips the meningeal layer of dura from the internal surface of the skull
- intercranial pressure (ICP) rises, and the enlarging blood clot exerts local pressure on the underlying precentral motor (motor area)
arterial or venous injury
Intracranial Hemorrhage
- to stop the hemorrhage, the torn artery must be ___ or ___
ligated or plugged
Intracranial Hemorrhage
- tearing of the superior cerebral veins where they enter the superior sagittal sinus
- blow to the front or back of the head resulting in excessive anterposterior displacement of the brain within the skull
subdural hemorrhage
Intracranial Hemorrhage
- caused by a sudden minor blow
meningeal hemorrhage
Intracranial Hemorrhage
- nontraumatic leakage or rupture of a cogenital aneurysm on the cerebral arterial circle
subarachnoid hemorrhage
Intracranial Hemorrhage
- most common in patients with hypertension (high blood pressure)
cerebral hemorrhage, spontaneous intracerebral hemorrhage
Intracranial Hemorrhage
- a branch of the middle artery
lenticulostriate artery
the most common cause of traumatic injury death in infancy
inflicted head injury
- most cases takes place during the first year of life
- usually restricted to infants under 3 years of age
shaken baby syndrome
- the fontanelles (soft spots on an infant’s head where the bony plates that make up the skull have not yet come together) are bulging
- child may have retinal hemorrhages
shaken baby syndrome
- include tumor, hematoma, abscess
- these lesions will add to the normal bulk of the intracranial contents
space occupying or expanding lesions
- first accommodated by the expulsion of CSF from the cranial cavity
expanding lesion
- used for the detection of intracranial lesions
- quick, safe, accurate
CT (computed tomography)
- structures are distinguished from one another by their ability to absorb energy from x-rays
Computed tomography
- uses the magnetic properties of the hydrogen nucleus excited by radio frequency radiation transmitted by a coil surrounding the head
- best imaging method for detecting low-contrast lesions such as brain tumors or small multiple sclerosis plaques
MRI (magnetic resonance imaging)
- used radioactive isotopes that decay with the emission of positively charged electrons to map the biochemical. physiologic, and pharmacologic processes taking place in the brain
- successfully used in evaluation of patients with brain tumors, movement, disorders, seizures, and schizophrenia
Positron Emission Tomography (PET)
comprises the central nervous system and peripheral nervous system
nervous system
consists of the brain and the spinal cord, both of which are surrounded by the meninges and the cerebrospinal fluid
central nervous system
consists of all other nerves in the body
peripheral nervous sytem
concerned with involuntary structures and distributed throughout both CNS and PNS
autonomic nervous system
3 major divisions of the brain
hindbrain, midbrain, forebrain
subdivided into the medulla oblongata, pons, and cerebellum
hindbrain
subdivided into the diencephalon and cerebrum
forebrain
largest component of the brain and consists of two hemispheres, covered by cerebral cortex, which is made up of a series of folds and fissures called gyri and sulci
cerebrum
cylindrical structure continuous with the medulla oblongata of the brainstem
spinal cord
TRUE OR FALSE
27 pairs of spinal nerves are attached
false, 31
connect the spinal nerve to the spinal cord
motor and sensory roots