Mansour Study guide for exam 1 Flashcards

1
Q

How many brain regions are there?

A

There are 5 embryonically derived brain regions

  1. Telencephalon
  2. Diencephalon-3 parts
  3. Mesencephalon
  4. Metencephalon
  5. Myelencephalon
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2
Q

List at least 2 features/structures in each of the following brain
regions

A
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3
Q

The lateral ventricle is part of

A

Telencephalon

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4
Q

Mesencephalon: Structures/Function

A

Tectum

Coropa quadrigemina
- Rostral Colliculi (visual Reflexes)
- Caudal Colliculi (auditory Reflexes)

Mesencephalic Aqueduct

Tegmentum:
- Reticular activating system (RAS)
- red nuclei (UMN

CN III( Oculomotor) and IV (Trochlear)

Crus Cerebri

Cerebral Peduncles
- tegmentum
- substantia nigra
-crus cerebri

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5
Q

What happens when there is a lesion in the midbrain

A

May cause loss of consciousness

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6
Q

Ascending Reticular Activating system (ARAS)

A

The Ascending Reticular Activating System (ARAS), or reticular formation, is a network of anatomically and physiologically distinct nuclei in the brainstem that function to “activate” the cerebral cortex and maintain consciousness

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7
Q

Corpus Callosum

A

Is an example of commissural fibers L and R cerebral Hemispheres.

Association fibers or cortex within same cerebral hemisphere.

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8
Q

Visual input is linked to motor output by

A

Rostral Colliculus
and Lateral geniculate

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9
Q

Lateral geniculate is part______ of the brain

A

Diencephalon

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10
Q

Primary motor cortex Lobe

A

Frontal

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11
Q

Motor and sensory lobe

A

Parietal

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12
Q

Primary visual lobe

A

Occipital

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13
Q

Primary auditory lobe

A

Temporal

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14
Q

Cranial Nerves emerging from the 5 major regions

A

Telencephalon CN I
* Diencephalon CN II
* Mesencephalon CN III CN IV
* Metencephalon CN V
* Myelencephalon CN VI-XII

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15
Q

Of the following cranial nerve which
arises from diencephalon?

A

CN II Optic Nerve

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16
Q

What septum separating cerebral hemispheres

A

Longitudinal Fissure

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17
Q

The_______separates the cerebrum from cerebellum

A

Transverse Fissure

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18
Q

Types of Neuroglia

A

Ependymal Cells
- Neuro-epithelial producing CSF

Oligodendrocytes
- Myelination in CNS

Satellite cells
COME BACK

Astrocytes
- BBB waste/ repair in CNS

Microglia
- Macrophage in CNS

Schwann cells
- Myelination in PNS

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19
Q

Astrocytes

A

Astrocytes project foot processes that envelop the basement membrane of capillaries (BBB), neurons (bodies-perikaryons or soma), and synapses

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20
Q

Where do Astrocytes work

A

Blood vessels
Other Astrocytes
Synapses
Neuron Cell Bodies

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21
Q

Facts about glial cells

A

neuroglia or glial cells are defined as supportive
cells

non-excitable

Fibrous astrocytes are found mainly in the white
matter

Protoplasmic astrocytes are found mainly in the
gray matter

Astrocytes project foot processes that envelop the basement membrane of capillaries, neurons, and synapses

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22
Q

Spinal Cord CHECK THIS

A

Gray matter-cell bodies of LMN (dorsal, lateral and ventral horns)

White matter-axons (descending & ascending UMN neurons)

Ventral horn–> Somatic LMN
Dorsal horn–> Sensory Fibers
Lateral Horn–> Autonomic

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23
Q

Spinal Cord location of LMN

A

Ventral gray matter: motor role, LMN

Dorsal gray matter: sensory role

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24
Q

Dorsal roots are formed by what processes

A

Dorsal roots are formed by processes of the dorsal root ganglia

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25
Q

The white matter of the spinal cord contains all the following except:

A

Schwann Cells, they are in the peripheral nervous system

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26
Q

A large lesion of the ventral horn likely induces

A

Muscle atrophy

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27
Q

Spinal Cord regions

A

Neck ( C1-5)
Thoracic Limb (C6-T2)
Thoracolumbar Region ( T3-L3)
Pelvic Limb (L4- S1)
Pelvis (S1-S3)

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28
Q

Meninges

A

Dura Mater
Arachnoid membrane
Pia Mater

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29
Q

Leptomeninges

A

Arachnoid and Pia mater

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30
Q

Arachnoid membrane

A

Fluid-filled subarachnoid space that contains cerebrospinal fluid (CSF)

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31
Q

CSF Pathway

A

Lateral ventricles through interventricular foramen
Third Ventricle
Cerebral aqueduct
Fourth Ventricle

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32
Q

What does the cerebral aqueduct connect

A

The third ventricle with the fourth ventricle

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33
Q

The major regulators of CSF pressure

A

Arachnoid Villus
(CSF from subarachnoid space passes into the venous circulation)

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34
Q

What Produces CSF

A

Choroid plexus

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35
Q

What is the Epidural space filled with

A

Fat

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36
Q

The Cerebrospinal fluid circulates in which of the following spaces

A

Subarachnoid Space

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37
Q

Lacking in circumventricular organs (CVO)

A

Median eminence
Area postrema
Pineal Gland
Subfornical Organ

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38
Q

3 Key nerves in Micturition

A

Hypogastric nerve
Pelvic Nerve
Pudendal nerve

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39
Q

The types of fibers in each of the nerves in micturition

A

Sympathetic : Hypogastric
Parasympathetic: Pelvic
Somatic Motor: Pudendal

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40
Q

Neurogenic Causes

A

Trauma ( UMN vs LMN)

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41
Q

Neurogenic

A

(Cerebrum/brain stem
[pons] or spinal cord)

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42
Q

Nonneurogenic

A
  • Anatomic
  • Diseases-UTI
  • Drugs
  • Aging
  • Spaying
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43
Q

CNS Centers for Micturition

A

Brainstem/Pons: Micturition center (Integration)
Cerebrum: Voluntary Control
Cerebellum: Inhibitory influence on micturition

44
Q

Bladder Filling

A

Sensory input( pelvic, hypogastric, pudendal)
- pelvic is the major source

Increased sphincter tone ( pudendal, hypogastric)
- makes it tight

Detrusor relaxation (hypogastric)

Decrease parasympathetic tone (pelvic)

Input from higher centers–> voluntary control, integration of sensory input

45
Q

Bladder Emptying

A
  • Sensory input (pelvic, hypogastric, pudendal)
  • Integration by higher centers
  • Decreased sympathetic/ somatic tone (hypogastric pudendal)
  • Decreased sphincter tone (hypogastric, pudendal), Sphincter relaxation
  • Detrusor contraction (pelvic)
46
Q

Summary Of Micturition

A

Micturition depends on the coordinated action between the sympathetic, parasympathetic, somatic nervous systems and central control centers (pontine and cerebrum).

The somatic (pudendal n) and sympathetic (hypogastric n) divisions promote storage (s and s) while the parasympathetic division (pelvic n) promotes voiding (p for peeing)

47
Q

Myasthenia Gravis

A

(deficiency in AChR)

48
Q

Tick Paralysis

A

Interferes with Ca preventing release of
Ach at NMJ

49
Q

Botulism

A

Clostridium botulinum toxin (type c) Cleaves SNARE proteins. This leads to Inhibition of Ca binding to pre-synaptic vesicles and inhibition of the release of Ach into NMJ

50
Q

Typical symptoms seen with LMN dysfunction

A

Noodle-decreased or absent reflexes-atrophy (fast)

51
Q

Typical symptoms seen with UMN dysfunction

A

Stick-Normal or exaggerated reflexes—atrophy (slow)

52
Q

Clinical signs of LMN disease

A
  • LMN= Weakness/inability to support weight (paresis/paralysis (pleg* Short strides (decrease stride length// choppy gait
  • Postural reaction normal (with appropriate support)
  • Hyporeflexia
  • Decreased muscle tone
  • Muscle atrophy
53
Q

Signs of LMN damage

A

If LMNs cause muscle to contract, then…
- When LMNs are damaged, the muscles they innervate don’t contract

Tests/Indicators of muscle contractility
* Muscle strength
* Muscle size
* Muscle tone
* Ability to produce reflex response

54
Q

Functions of the motor system (UMN & LMN)

A
  • Voluntary control of muscles (our interest in skeletal muscles)
  • Enables animals to walk, run, eat, bite and perform complex movement
55
Q

Terms describing clinical conditions

A

Monoparesis (sensory), monoplegia (motor)

Paraparesis (sensory) , paraplegia (motor)

Hemiparesis (sensory), hemiplegia (motor)

Tetraparesis (sensory) , tetraplegia (motor)

56
Q

Monoparesis, monoplegia

A

1 limb affected (fore or hind)

57
Q

Paraparesis, paraplegia

A

Both pelvic limbs affected (lower
limbs)

58
Q

Hemiparesis, hemiplegia

A

Both limbs on same side affected

59
Q

Tetraparesis, tetraplegia

A

All 4 limbs affected

60
Q

LMN components

A

Innervate skeletal muscles-alpha (α fibers)
(involves 36 pair spinal nerves and 9 pairs of CNN (III, IV, V, VI, VII, IX, X, XI, XII)

61
Q

UMN Components

A

(Descending tracts) in cerebral cortex and
brainstem. They influence LMN

62
Q

Know clinical signs of CN V

A

Dropped jaw, atrophy of muscle of mastication

63
Q

Know clinical signs of CN VII

A

Inability to move lid (blinking), ear, lips, dry eye

64
Q

Know clinical signs of CN X

A

Dysphagia, megaesophagus, dysphonia

65
Q

Know clinical signs of CN XII

A

Tongue paralysis—leads to dysphagia

66
Q

Know clinical signs of CN III, IV, VI

A

Strabismus, pupil (CN III)

67
Q

What do LMNs in the brainstem and spinal cord regulate

A

Lowest level of motor hierarchy
Skeletal muscle
including axial muscles for posture

Cerebral Motor cortex–> basal nuclei–> Brain stem ( UMN)–> Spinal cord (LMN)

68
Q

Cell body for LMN locations

A

Midbrain: III & IV
Pons: V
Medulla: VI,VII, IX, X, (XI), XII
Ventral Horn gray from C1 through CD5: all spinal nerves
- Also, intermediate gray from T1-L4, S1-S3)

69
Q

What does the UMN do/ Function

A
  • ‘Tells’ the LMN what to do * Stimulate or inhibit the LMN
  • Initiation of voluntary movement
  • Maintenance of muscle tone and support against gravity
  • Regulation of posture
70
Q

Cell bodies for UMN location

A
  • UMN- Cell bodies are located in
    the cerebrum and brainstem
    (midbrain-pons-Medulla)
  • Entire UMN is confined to CNS
71
Q

How does UMN work

A

Upper Motor Neuron axons
- Some go to cranial motor nuclei (LMNs)
- Most go to spinal cord lateral/ventral horn (LMNs)
- Project long distances
Most synapse on INTERNEURONS
- Inhibitory interneurons
- Excitatory interneurons

72
Q

Cerebral motor cortex motor tracts

A

3 descending motor tracts from the cerebral cortex:

  • Corticopontine tract
  • Corticonuclear tract
    (CNN LMN nuclei)
  • Corticospinal tract
    (Lateral & ventral)
    (LMN-limbs)
73
Q

Basal Ganglia : Part of the cerebrum

A

The “basal nuclei” refers to a group of subcortical nuclei responsible primarily for motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions.

74
Q

Basal Nuclei

A

Caudate, putamen-globus pallidus

Makes movement successful

(regulate movement vigor)

75
Q

Descending spinal motor tracts (from cerebral cortex/brainstem)

A

Lateral funiculus tracts stimulates flexion and inhibits extension

Ventral funiculus tract stimulate extension and inhibits flexion

76
Q

Lateral funiculus tracts

A

Lateral funiculus tracts stimulates flexion and inhibits extension

  • Lateral corticospinal (cerebral cortex)
  • Rubrospinal (red nucleus)
  • Medullary reticulospinal (medullary Reticular Formation)
77
Q

Ventral funiculus tracts

A

Ventral funiculus tract stimulate extension and inhibits flexion

  • Pontine reticulospinal ( Pontine Reticular Formation)
  • Tectospinal ( Rostral Colliculus)
  • Lateral vestibulospinal ( Vestibular nuclei)
    -Medial vestibulospinal ( Vestibular nuclei)
78
Q

LMN clinical relevance of gait, reflex, muscle tone

A

Gait: paresis – paralysis

Reflexes: decreased to absent

Muscle tone: decreased to absent

Atrophy: rapid, severe

79
Q

UMN clinical relevance of gait, reflex, muscle tone

A

Gait: ataxia, paresis – paralysis

Reflexes: Normal – exaggerated

Muscle tone: normal – exaggerated

Atrophy: slow, moderate

80
Q

What Brainstem Motor Control is hypotonia

A

LMN: Hypotonia
flabby-baby bean doll

81
Q

What Brainstem Motor Control is hypertonia

A

UMN: Hypertonia
Rigid

82
Q

Spinal cord reflexes

A

Used clinically to assess neurological
patients

83
Q

Reflex arc:

A
  1. Receptor
  2. Afferent pathway
  3. Integrating center
  4. Efferent pathway : LMN
  5. Effector (visible response)
84
Q

Neurologic exam form

A

Spinal cord reflexes:
Biceps
- Peripheral Nerve: Musculocutaneous
- Spinal Cord Segment: c6-c8
- Vertebral Level:c5-c7

Triceps
- Peripheral Nerve:Radial
- Spinal Cord Segment:C7-T2
- Vertebral Level: c6-T1

Extensor Carpi Radialis
- Peripheral Nerve:Radial
- Spinal Cord Segment: C7-T2
- Vertebral Level: C6-T1

Thoracic limb flexor withdrawal
- Peripheral Nerve:Musculocutaneous, median, ulnar
- Spinal Cord Segment:C6-T2
- Vertebral Level: C5-T1

Patellar
- Peripheral Nerve: Femoral
- Spinal Cord Segment: L4-L6
- Vertebral Level:L3-L4

Cranial Tibial
- Peripheral Nerve: Peroneal
- Spinal Cord Segment: L6-L7
- Vertebral Level:L4

Gastrocnemius
- Peripheral Nerve: Tibial
- Spinal Cord Segment: L7-S1
- Vertebral Level:

Pelvic Limb Flexor Withdrawal
- Peripheral Nerve: Sciatic ( Femoral if include flexion of hip)
- Spinal Cord Segment: L6-S1
- Vertebral Level: L4-L5

** Perineal Reflex
- Peripheral Nerve:Pudendal
- Spinal Cord Segment: S1-S2 (S3)
- Vertebral Level: L5

85
Q

Perineal Reflex

A
  • Peripheral Nerve:Pudendal
  • Spinal Cord Segment: S1-S2 (S3)
  • Vertebral Level: L5
86
Q

What happens if any part of the reflex pathway is damaged

A

If any part of the reflex pathway is damaged, you will see a decreased or absent reflex response
- LMN signs

87
Q

Muscle Spindles

A
  • Found within skeletal muscles
  • Detect muscle : Stretch (rate and degree)
  • Important for maintaining muscle tone
    and posture (antigravity muscles/extensors)
  • Role in myotatic reflexes
88
Q

Difference between spindle afferents

A

Muscle spindle afferents transduce muscle length (STRETCH) , whereas GTO afferents transduce muscle force.

89
Q

What are alpha motor neurons

A

Innervate extrafusal fibers, the highly
contracting fibers that supply the muscle with its power.

90
Q

What are Gamma motor neurons

A

innervate intrafusal fibers, which contract only slightly. … This contraction keeps the spindle taut at all times and maintains its sensitivity to changes in the length of the muscle.

91
Q

Spinal cord reflexes: Crossed Extensor Reflex

A

In a normal standing animal, when a noxious
stimulus is applied to a limb, the opposite limb
will extend (normal crossed extensor reflex)
when the other limb is pulled away from the
stimulus.

In a recumbent animal, when a noxious
stimulus is applied to a limb, the opposite limb
should NOT extend (inhibited by UMNs) when
the stimulated limb is pulled away from the
stimulus.

The presence of a crossed extensor reflex in a
recumbent animal is considered abnormal and
a sign of:UMN disease (loss of input from
higher brain centers).

The crossed extensor reflex is evaluated while
performing the flexor withdrawal reflex,
however, they are separate reflexes.

92
Q

Spinal cord reflexes: Cutaneous trunci reflex

A

Sensory stimulus to the skin along the back results in twitching of the skin via activation of the cutaneous trunci muscle by the: Lateral thoracic artery

  • Used clinically to assist in the location of spinal cord lesions from: C8-T1 through T2-L7.

Cutaneous trunci muscle is supplied
by the lateral thoracic nerve (arises
from C8-T1 spinal cord
segments)

93
Q

Panniculus Reflex

A

Intersegmental reflex

94
Q

What happens to the Cutaneous Trunci reflex with a spinal cord injury

A

With spinal cord injury, the cutaneous trunci reflex may be absent behind the site of the injury pending the severity of the injury

  • Interruption of the sensory component of the reflex arc
95
Q

What happens to the Cutaneous Trunci reflex with a brachial plexus avulsion

A

With brachial plexus avulsion, the cutaneous trunci reflex may be absent on the affected side (C8-T1 nerve roots for lateral thoracic nerve)

Interruption of the: Efferent component of the reflex arc

96
Q

Avulsion of Brachial plexus

A

Findings: Both dorsal & ventral roots are
affected. No cutaneous trunci reflex on left side

Deficits: Ipsilateral (motor and sensory)
LMN-TL, LTN.
Sensory deficit-Dorsal horn affected

97
Q

Lesion at Ventral horn at C6-T1

A

Findings: No ipsilateral cutaneous trunci reflex (left)

Deficit: LMN-TL, LTN
No sensory deficit (dorsal root intact)

98
Q

Large Bilateral Lesion

A

Cutaneous trunci reflex absent caudal to lesion
UMN-PL

99
Q

Left Lateral Funiculus

A

Affect left (ipsilateral) cutaneous trunci reflex
UMN Left PL

100
Q

Lesion Localization

A
101
Q

Lesion affecting C1-C5

A

N or UMN thoracic limb, pelvic limb, organ sphincters

  • All limbs affected
    • Tetra-paresis/plegia
  • UMN signs to limbs/sphincters
  • Normal cutaneous trunci? Yes or No
  • Normal mentation and CNN
102
Q

Lesion affecting T3-L3:

A

N or UMN pelvic limb, pelvic organ sphincters

  • Only PLs affected
    * Para-paresis/plegia
  • UMN signs to PL/sphincters
  • Normal TL
  • Cutaneous trunci? Absent behind the legion
  • Normal mentation and CNN
103
Q

Lesion affecting L4-S1(2)

A

LMN pelvic limb N or UMN pelvic organ sphincters

  • Only PLs affected
  • Para-paresis/plegia
  • LMN signs to PL
  • UMN sphincters
  • Normal TL
  • Cutaneous trunci reflex? Yes or No
  • Normal mentation and CNN
104
Q

Lesion affecting C6-T2

A

LMN thoracic limb N or UMN pelvic limb, organ sphincters

  • All limbs affected
    • Tetra-paresis/plegia
  • LMN to TL & UMN signs to PL/sphincters
  • Cutaneous trunci?: Absent
  • Horner syndrome +/-
  • Normal mentation and CNN
105
Q

Lesion affecting S1-S3

A

LMN pelvic
organ sphincters

106
Q

Paresis

A

Some voluntary movement

107
Q

Plegic

A

No voluntary motor movement (paralysis)