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Nervous Flashcards

1
Q

What are the divisions of the nervous system?

A

CNS and PNS
PNS splits into somatic and autonomic
Autonomic splits into sympathetic and parasympathetic

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2
Q

What is the somatic nervous system?

A

A division of the peripheral nervous system
Voluntary control
Sensory perception

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3
Q

What is the structure of a neuron?

A

Cell body contained nucleus
Dendrites project off cell body and receive signals
Axon is a long projection covered in myelin sheath that carries signal to the synapse

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4
Q

What is the myelin sheath?

A

Fatty covering on axon which insulates to speed up the signal transmission
Gaps in this are nodes of ranvier which help to propagate the signal

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5
Q

What is multiple sclerosis?

A

Immune mediated disease that destroys myelin sheath and the cells that produce it.
Causes slow signal transmission and nerves become prone to damage
SX: reduced strength and motor control, reduced sensation, pain

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6
Q

What are the 3 types of neuron?

A

Sensory (afferent): detects stimulus and sends to CNS
Interneuron: bridges sensory and motor neurons/integrates signals
Motor (efferent): transmit motor signal from CNS to body

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7
Q

What are the 4 functional properties of neurons?

A

Excitability: stimulated to generate signals
Action potentials: neuron membrane depolarises to send signal
Synapse: junctions between neurons
Neurotransmitters: transmit signal across junction

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8
Q

What is the fight/flight NT?

A

Adrenaline

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9
Q

What is the concentration NT?

A

Noradrenaline

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10
Q

What is the pleasure NT?

A

Dopamine

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11
Q

What is the mood NT?

A

Serotonin

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12
Q

What is the calming NT?

A

GABA

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13
Q

What is the learning NT?

A

Acetylcholine

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14
Q

What are the 6 phases of an action potential?

A

Resting state
Stimulus and depolarisation
Threshold and AP
Repolarisation
Hyperpolarisation and Refractory
AP propagation

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15
Q

What is the resting state phase of an AP?

A

The cell is at rest with a stable membrane voltage
Inside cell is more negative than outside

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16
Q

What is the stimulus and depolarisation phase of an AP?

A

A stimulus causes the voltage across the membrane to change
This opens sodium channels (voltage-gated) allowing sodium ions to enter the cell
The cell becomes less negative inside charged than outside = depolarised

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17
Q

What is the threshold and AP phase of an AP?

A

If depolarisation of cell meets the threshold, further sodium channels open rapidly causing a mass depolarisation of the cell (the inside becomes way less negatively charged than outside)
Positive feedback loop allows the AP to travel along the neuron

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18
Q

What is the repolarisation phase of an AP?

A

Sodium channels close and potassium channels. No more sodium can enter the cell but potassium exits allowing the cell to become more negatively charged

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19
Q

What is the hyperpolarisation and refractory phase of an AP?

A

Repolarisation overshoots so inside of cell becomes more negatively charged than it should be at rest.
Therefore the cell cannot fire another AP, ensuring these move in one direction only

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20
Q

What is the AP propagation phase of an AP?

A

AP travels along axon to terminal, triggering release of NTs into synapse

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21
Q

What is a synapse?

A

Junction between cells
Presynaptic cell releases NTs that stimulate receptors of postsynaptic cell
NTs housed in vessicles which fuse with membrane at axon terminal to be released into cleft

Once complete, postsynaptic cell releases the NTs which are reuptaken by presynaptic cell

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22
Q

What is the synapse, NT and receptor of a neuron to muscle connection?

A

Synapse is called neuromuscular junction
NT is acetylcholine
Receptor is nicotinic

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23
Q

What is the foramen magnum?

A

Hole in cranium that allows cord to extend from brain into spinal column

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24
Q

What are meninges?

A

Protective layers of brain
Periosteal Dura Mater (adhered to skull)
Meningeal Dura Mater (adhered to deeper structures)
Subdural space
Arachnoid Mater
Subarachnoid space (CSF)
Pia Mater
Brain

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25
Q

What is CSF?

A

Cerebrospinal fluid
Housed in subarachnoid space
Made by choroid plexus in ventricles of brain
Supply and remove waste from brain/cord to prevent blood borne issues affecting them
‘Floats’ brain/cord to protect

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26
Q

What are the 3 main structures of the brain?

A

Cerebrum (main upper part)
Cerebellum
Brain stem

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27
Q

What is the cerebrum?

A

Main upper region of brain
Two hemispheres connected by corpus callosum
Four lobes divided by sulci - frontal, parietal, temporal, occipital
Many gyri (rises) and sulci (grooves) exist to increase surface area

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28
Q

What is the frontal lobe for?

A

High cognitive functions
Personality
Motor control

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29
Q

What is the parietal lobe for?

A

Processes sensory information
Spatial awareness

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30
Q

What is the occipital lobe for?

A

Visual processing

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31
Q

What is the temporal lobe for?

A

Auditory processing
Language
Memory (hippocampus)

32
Q

What is the cerebellum?

A

Major motor centre!!
Receives multiple information (e.g. posture, balance, motor, vision, muscles) and coordinates it to produce movement
Receives information from all over body; send information mainly to stem/cord
Has extra folds = folia
3 lobes = anterior, posterior and flocculonodular

33
Q

What is the brain stem?

A

Connects brain to cord
Acts as relay station for signals and controls life sustaining functions + reflexes
Has 3 regions: medulla oblongata, pons and midbrain (thalamus at the top)

34
Q

What is grey matter?

A

Composed of neuron cell bodies, dendrites and axons
Makes up outermost brain layer but inner H in spinal cord
Pink/grey colour
Processes information

35
Q

What is white matter?

A

Composed of bundled axons coated in myelin
Connects brain areas
Connection/communication: Carries signals between grey matter and to receiving cells

36
Q

What is the brain blood supply?

A

Left and right internal carotid artery
Left and right vertebral artery
These converge in brain at circle of Willis and then feed into other vessels. This ensures continual supply of O2 and glucose to brain even if one vessel fails.

37
Q

What is cerebral palsy?

A

Damage to brain tissue during development
Result ranges from mild weakness to paralysis

38
Q

What is dementia?

A

Group of disorders affecting cognitive brain function
Multiple causes (inc. Parkinson’s, infection, trauma, HIV, huntingtons)
SX: memory loss, reduced cognition, reduced communication, reduced visual perception, changed mood
Progressively worsens over time
TX: control SX, maintain safety, support

39
Q

What is the spinal cord?

A

Cylindrical bundle of nerve tissue extending from brain through foramen magnum down to L1/2
Relays signals between brain and body
Brain to body = motor
Body to brain = sensory
Inner H grey matter with white matter surrounding it
Same 3 layer meninges
Nerve roots of sensory and motor connect to cord at each vertebral level connecting the PNS to CNS

40
Q

What are the 2 pathways of the somatic nervous system?

A

The afferent pathway is sensory (carries signals away from body to CNS)
The efferent pathway is motor (carries signals away from CNS to body)

41
Q

What is a nociceptor?

A

Senses pain
E.g. skin receptor

42
Q

What is a proprioceptor?

A

Senses position/movement
E.g. tendon receptor

43
Q

What are the 4 stages of pain?

A
  1. Transduction: nociceptor detects and creates an AP
  2. Transmission: AP travels afferent pathway to cord + brain
  3. Modulation: process of modifying/controlling pain
  4. Perception: brain interprets pain signal and creates conscious experience
44
Q

What is substantia gelatinosa modulation?

A

At spinal cord, pain signal may interact with interneuron causing an increase or decrease in the signal

45
Q

What is gate control theory?

A

Cord can open/close gate go pain signals
Will close the gate if stimulus is not ‘painful’
Emotional/cognitive factors can open gate

46
Q

What is descending pain modulation?

A

Brain can send signal down the pain pathway to inhibit signals
Serotonin and endorphins can act as a painkiller

47
Q

What are neuromodulation techniques?

A

Medications, blocks or electrical therapies can interfere with pain signal transmission

48
Q

What are spinal reflexes?

A

Rapid, involuntary response to a specific stimulus
Mediated by spinal cord (no brain input)
Achieved with interneurons - direct connection between sensory and motor

49
Q

What are the 6 PNS nerve groups?

A

Cranial (12 pairs) - head/neck
Spinal (31 pairs) - spine to body
Brachial plexus - low C to high T spine to arms
Sciatic nerve - L/S spine to back of legs
Femoral - L spine to legs
Vagus - PNS innervation to organs

50
Q

What is the stress response?

A

Threat perceived
Signal to hypothalamus activates stress response
Cortisol (increases glucose availability) and adrenaline (immediate physical action) released
Sympathetic nervous system outcomes

Once threat gone, parasympathetic system will restore balance

51
Q

How is the paediatric nervous system different?

A

Skull not fused = brain less protected
Developing brain = trauma more damaging
Mental health presents differently
Undeveloped thermoregulation system = vulnerable to hot/cold
Undeveloped control/coordination = falls
Big head with weak neck muscles = high risk damage

52
Q

How does the nervous system of geriatrics differ?

A

Reduced neural tissue = brain loose in skull
Signal transmission speed reduced = slow movement and reflex
Reduced peripheral sensation = injury risk
Reduced memory and decision making

53
Q

What is a stroke/CVA?

A

Blood supply to part of brain interrupted leading to tissue damage
Can be haemorrhagic or ischemic (80%)
Brain needs constant oxygen and glucose supply
SX: F (facial drop), A (arms can’t raise), S (slurred, confused) E
TX: transport to ED, support

54
Q

What is an ischemic stroke?

A

Blood vessel is blocked or narrowed (artherosceloris)
Thrombolic stroke - blood clot in brain
Embolic stroke - blood clot from elsewhere travels to brain

55
Q

What is a haemorrhagic stroke?

A

Blood vessel ruptures causing bleeding
Intracerebral - weakened vessel or AVM bleeds into brain tissue
Subarachnoid - bleed into space between brain and layers (usually aneurysm)

56
Q

What is a cerebral TIA?

A

Transient ischemic attack
Mini/warning stroke
Temporary disruption to brain blood flow which eventually resolves
SX the same as CVA

57
Q

What is a seizure?

A

Abnormal electrical activity in the brain
Big surge in excitation
Can be focal (partial) or generalised

58
Q

What is a focal/partial seizure?

A

Originates in specific area of one hemisphere
Simple: remain conscious, tingling, flashing lights, jerking
Complex: ALOC, repetitive movement, purposeless actions, emotional change

59
Q

What is a generalised seizure?

A

Both hemispheres are involved and there is often a loss of conscious
6 types
SX: uncontrolled muscle movement, ALOC, staring, weird sensation, no tone, stiffness, confusion, fatigue
TX: transport to ED, remove objects/protect from harm, treat cause of seizure, midazolam

60
Q

What is an absent seizure?

A

Generalised seizure often in children
SX: brief loss of awareness, staring, blinking/lip smacking

61
Q

What is a tonic seizure?

A

Generalised seizure
SX: stiffening usually in arms, legs and back

62
Q

What is a clonic seizure?

A

Generalised seizure
SX: rhythmic jerking of muscles usually in face, neck and arms

63
Q

What is a myoclonic seizure?

A

Generalised seizure
SX: sudden, brief twitches

64
Q

What is an atomic seizure?

A

Generalised seizure
SX: sudden loss of tone causing collapse

65
Q

What is a tonic-clonic/grand mal seizure?

A

Severe generalised seizure
SX: tonic and clonic phases (stiff and rhythmic jerking), ALOC, convulsion, dyspnoea

66
Q

What can cause a seizure?

A

Epilepsy
Fever
Brain injury
Infection
Tumour
Drugs
Metabolic disturbance

67
Q

What is a traumatic brain injury?

A

External mechanical force causing brain tissue damage. Acceleration or deceleration of brain within cranium.

Focal: localised damage e.g. haematoma
Diffuse: widespread e.g. concussion

68
Q

What is a concussion?

A

Temporary TBI
Caused by blow to head or violent shaking
Symptom onset can be immediate or delayed
SX: reduced concentration and memory, balance and coordination issues, headaches, N+V, fatigue, mood change, speech slurred, sleep issues, ALOC, seizure
TX: moderate/severe transport to ED, manage pain, stabilise head/neck, monitor ABC

69
Q

What is a spinal cord injury?

A

Movement/force exceeds structures capacity resulting in damage to cord
Level affected = level of dysfunction
Paraplegia = T, L or S spine; torso/leg dysfunction
Tetraplegia/quadriplegia = all limb dysfunction

70
Q

What are the 6 mechanisms of SCI?

A

Flexion: head/neck bends forward
Compression: cord squeezed together
Hyperflexion: neck bent back
Flexion-rotation: spine twists
Penetration: FB
Distraction: cord stretched apart

71
Q

What is autonomic dysreflexia?

A

Life threatening condition with SCI above T6
Exaggerated response to a stimulus below T6 (usually bladder/bowel related). Signal cannot ascend above spinal cord injury so triggers the sympathetic nervous system
Need urgent medical treatment to correct stimulus

72
Q

What are the SX of SCI?

A

Consider mechanism
Neck/back pain worsens with movement
Reduced sensation/movement in limbs
Respiratory issues
Abnormal positioning
Bladder/bowel incontinence

73
Q

What is meningitis?

A

Inflamed meninges caused by a pathogen
Bacterial is the most aggressive

74
Q

What is meningococcal?

A

Neisseria miningitidus bacteria multiples in the blood damaging vessel walls
Marked by non-blanching rash

75
Q

What are SX of meningitis/meningococcal?

A

Sudden fever/chills
Extreme headache
Stiff neck
Photophobia
Altered mental status
N+V
Non-blanching rash
Fatigue
Cold extremities
Body pain
High RR

76
Q

What are SX of drug overdose?

A

Sedation
Altered mental state
Slurred speech
Reduced RR
Cyanosis
Weak/loss muscle control
N+V
ALOC
Low HR and BP
Pinpoint pupils

Health Status (15 decks)

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