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Biomed2 > Nervous 2 > Flashcards

Nervous 2 Flashcards

1
Q

What are the meninges

A

The membranes that surround the brain and spinal cord

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2
Q

What are the three layers of the meninges

A
  1. Dura mater - tough outer for protection & support, attaching to cranium & periosteum & sacrum
  2. Arachnoid mater - collagen & elastic fibres, subdural space filled with interstitial fluid
  3. Pia mater - very thin layer containing blood vessels
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3
Q

What are the bridging veins of the skull

A

Layers of the dura mater of the meninges that creates venous sinuses aka repetitive ‘bridging’ appearance

Allows blood to drain out of the brain into the jugular veins

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4
Q

Where is cerebrospinal fluid found

A

Between the pia mater & arachnoid mater is the sub-arachnoid space is filled with the fluid
Ventricles of the brain & central canal of the spinal cord

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5
Q

What is a subdural haematoma

A

Venous bleed (from venous sinuses damage) - Slowly developing as low pressure system

More likely in alzheimers as shrinkage creates tension

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6
Q

What is a subarachnoid haemorrhage

A

Arterial bleed - rapid onset
“thunderclap headache”

Usually berry anuerysm associated

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7
Q

What is CSF

A

Made from filtered blood & mostly water with ions & glucose (colourless as blood cells are too large to filter through)

Ependymal cells produce at a rate of 500ml/day - brain can only contain about 150ml

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8
Q

Functions of CSF

A
  • supports & protects acting as a shock absorber
  • maintains uniform pressure around the brain
  • moistens
  • circulates nutrients (oxygen, glucose, ions) & wastes
  • optimal chemical environment for nerve signalling ie ions
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9
Q

What are the choroid plexi

A

A cluster of ependymal cells & network of capillaries found in the walls of ventricles
Produce csf & introduce via capillaries nutrients needed

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10
Q

What 2 arteries deliver blood to the brain

A

Vertebral & carotid

Brain uses 20% of bodys oxygen & glucose at rest - neurons die within minutes of being deprived of oxygen

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11
Q

What is the blood brain barrier

A

Protects the brain from toxins, harmful substances & bacteria that enter the bloodstream by Astrocytes maintaining tightness of the capillaries & junctions between cells

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12
Q

What substances can travel through the BBB

A
  • lipid soluble substances cross easily eg alcohol, anaesthetics
  • water soluble, usually just water which hydrates csf
  • glucose crosses by active transport
  • gases diffuse easily eg O2 CO2
  • ions diffuse slowly across
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13
Q

What cant travel through the BBB

A

Larger molecules
Blood cells, proteins, certain drugs

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14
Q

What are the 4 main regions of the brain

A
  1. Brainstem - divided into medulla oblongatta, pons & midbrain
  2. Diancephalon - thalamus, hypothalamus & epithalamus
  3. Cerebrum - sensory, motor outputs
  4. Cerebellum ‘little brain’
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15
Q

What is the foramen magnum

A

Hole that enters cranium, separates spinal cord (a continuation of) into the brainstem

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16
Q

Functions of the medulla oblongata

A

~ Contains respiratory & cardiac centres (regulating heartbeat & breathing)
~ Controls reflexes such as vomiting, sneezing & hicupping
~ contains four cranial nerves (9-12)
~ contains motor tracts (corticospinal)

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17
Q

What is the name of the motor tract found in the brainstem

A

Corticospinal tract - leading down out of brain

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18
Q

Functions of the pons

A

Helps control breathing
Four pairs of cranial nerves (5-8)
Relays motor tracts

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19
Q

Functions of the midbrain of the brainstem

A
  • contains the substantia nigra (contains neuromelanin which causes pigmentation) dopamine releaisng neuronz that help control subconscious muscle activities
  • eye reflexes & tracking
  • 2 cranial nerves (3&4) ^
  • auditory tracts
  • movement of head & neck
  • transfers motor tracts
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20
Q

Functions of thalamus

A

Core of the brain making up 80% of the diencephalon
‘Major relay centre’ to the cerebrum
Integrate sensory & motor info

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21
Q

Functions of the epithalamus

A

Contains pineal gland which secretes melatonin
Connects limbic system to other parts of the hrain

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22
Q

Functions of the hypothalamus

A

Hormone regulation & homeostasis
Receives sensory info (ie viscera & smell)
Controls the ANS
Controls body temp
Regulates emotional & behavioural patterns (limbic) , eating & drinking & regulation of circadian rhythms

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23
Q

Functions of the cerebellum

A

Proprioception
Maintains posture & balance
Coordinates Skilled movements
Correction of errors during movement eg learning bike/instrument
Also thought role in cognition & language
Alters motor behaviour by altering circuits eg muscles

1/2 brains total neuron content - 50 billion

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24
Q

What can impact/damage cerebellum

A

Alcohol
Coeliac disease
Thiamine (vitamin B1) deficiency

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25
Q

What is ataxia

A

Imbalance - lack of muscle coordination
Stumbling, unsteadiness, slurred speech, intention tremor (hand tremor)

Common signs of cerebellar disease

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26
Q

Functions of the cerebrum

A

Sensory perception
Motor control of skeletal muscles

Contains grey matter & white matter
Two hemispheres - left & right

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27
Q

What connects the left & right hemispheres of the cerebrum

A

The corpus callosum

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28
Q

What is the corticospinal tract

A

Motor neuron axons join and the tracts cross over ‘decussates’ in the medulla oblongatta

Hemispheres control opposite sides of the body

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29
Q

Frontal lobe fx

A

Motor skills
Motor cortex

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30
Q

Temporal lobe fx

A

Hearing

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31
Q

Parietal lobe fx

A

Sensory cortex

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32
Q

Occipital lobe fx

A

Vision

Optical nerve has to travel all way to back of brain hence used for observing brain function, if something is damaged

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33
Q

What is the limbic system

A

Formed of interconnected structures including parts of the cerebrum, diancephalon & midbrain + hypothalamus, hippocampus & amygdala

Becomes active when dealing with emotional responses to our environments

34
Q

How much cardiac output does the brain receive

A

20% of body’s cardiac output (around 750ml a minute)

The brain has a very limited ability to store oxygen or glucose, therefore a constant supply is necessary
Thus cardiovasc health important for brain health

35
Q

What is the circle of willis

A

Where the two arterial systems (2 carotid from front & 2 vertebral from back) that supply the brain meet

A common location for aneurysms to develop “berry” = subarachnoid haemorrhage

36
Q

First sensory cranial nerves

A

1 olfactory - unmyelinated
2 optic

37
Q

cranial nerves involved in eyes

A

2 optic - sensory (densely myelinated)
3 oculomotor - 4 out of 6 eye muscles
4 trochlear, rotates eyes
6 abducens, abducts eyeball

38
Q

Trigeminal nerve fx

A

Facial sensations- mastication

3 branches
Opthalmic = over eyes
Maxillary = across cheeks & nose
Mandibular = around jaw

39
Q

Vestibulocochlear cranial nerve fx

A

Hearing & balance in ears

40
Q

Glossopharyngeal nerve fx

A

Taste, swallowing, tongue sensation

41
Q

Vagus nerve fx

A

“Wandering nerve” extensive length, largest nerve

ALL Sensory INFO in chest & abdomen (heart, GI, lungs)
In the Parasympathetic ns
Lowers blood pressure, heart rate
Increase digestive motility

42
Q

Accessory nerve fx

A

Sternocleidomastoid & trapezius movement

43
Q

Hypoglossal nerve fx

A

Tongue movement & speech (underneath)

44
Q

Damage to any optic nerves can cause

A

Strabismus (one eye crossed)
Ptosis (drooping of upper eyelid)
Diplopia (double vision)

45
Q

Injury to vagus nerve can cause

A

Tachycardia, dysphagia
Vaso-vagal (fainting) - syncope = hyperstimulated nerve drops blood pressure

46
Q

What area does the spinal cord begin

A

Foramen magnum

47
Q

What is the cauda equina

A

Consists of spinal nerves that continue beyond the conus where the cord terminates (at L2)

48
Q

Which spinal tracts involve motor impulses

A

Descending tracts, sent out via anterior VENTRAL horn

Involves voluntary & involuntary movement
Coordination, posture, balance

49
Q

What spinal tracts involve sensory info

A

Transmit impulses from skin, tendons, muscles & joints
Touch, vibration, proprioception

Received via posterior DORSAL horn

50
Q

What are the two sensory ascending spinal tracts

A

Both ascending

  1. Dorsal columns = light touch, vibration, proprioception
  2. Spinothalamic tract = pain & temperature
51
Q

What is the corricospinal tract

A

One motor tract of brain, descending
Involved with voluntary movements

52
Q

What is a reflex arc

A

A fast, automatic, unplanned sequence of actiond that occurs in response to a stimulus

53
Q

What are vertebral foramina

A

Holes in the vertebra where spinal nerves exit the vertebral column

54
Q

What is hydrocephalus

A

Excess csf causing brain swelling - raised intracranial pressure

55
Q

What is meningitis

A

Meningeal inflammation causing brain swelling & raised pressure

56
Q

What is encephalitis

A

Inflammation of brain tissue causing brain swelling & raised pressure

57
Q

What is papiloedema

A

Bulging of the optic disc - seen only with opthalmoscopy - sign of raised intracranial pressure

58
Q

Key sign of raised intracranial pressure

A

Vomiting often without nausea prior
Due to medulla being pushed into foramen magnum

59
Q

Most common causes of meningitis

A

Viral (90%) eg herpes simplex
Bacterial
Immuno-compromised eg elderly, HIV
Brain tumour

(Typically lasts 4-72hrs)

60
Q

Photophobia

A

Strong sensitivity to light
Strong sign of meningitis alongside other symptoms

61
Q

Petechiae, non-blanching

A

Small purple/red spots on the skin as a result of tiny haemorrhages
Non-blanching = not disappearing with a finger/glass

Key sign of bacterial meningitis

62
Q

What is kernigs sign

A

Pain & resistance to knee extension when laying with hips fully flexed

Sign of meningitis

63
Q

What is brudzinskis sign

A

Neck flexion upon lying causes flexion of hip & knee

Sign of meningitis

64
Q

What are antipyretics

A

Lowers body temp

Used for meningitis

65
Q

What is a cerebral contusion

A

Bruise
Traumatic brain injury causing bruising of the brain with ruptured vessels & oedema

66
Q

What is a coup

A

Injury to the site of impact of head

67
Q

What is a contracoup

A

Damage to the brain at a site contra-lateral to the site of trauma
The skull acts to stop acceleration of the brain away from the site of impact, causing damage on opposite side

68
Q

What can an absent knee jerk/ankle jerk indicate

A

Either normal or
peripheral nerve damage/compression/sciatica
Disc herniation
Hypothyroidism

69
Q

What is babinskis sign

A

A cutaneous reflex where sole of the foot is stroked upwards
If toes fan out this is positive & indicates corticospinal tract damage such as MS or Motor Neuron Disease
(Normal reaction in infants up to 2yrs)

70
Q

What is a cervicogenic headache

A

Originates from the neck, pain radiates from the back of the head

71
Q

What is a TMJ headache

A

Tempera-mandibular joint headache
Stress-related ie cleched jaw
Grinding teeth can indicate parasitic infection

72
Q

What is a cluster headache

A

Extremely painful caused by facial pain of trigeminal nerve
Aka suicide headache

73
Q

Headache red flags

A

— Uncharacteristic & first onset over 50 yrs
— “Thunderclap” headache
— Non-blanching rash, positive kernig/brudzinski sign = meningitis
— worsening morning headache, uneven pupils, double/tunnel vision, papilloedema, vomiting with no nausea = raised intracranial pressure

74
Q

What is epilepsy

A

Sudden, hyper-excitable & uncontrolled neuronal activity in the brain
Symptom of a disease, most commonly triggered by hypoglycaemia/calcaemia

75
Q

Petit mal epilepsy

A

Non-convulsive
Lasts 10-30 secs “day dreaming child at school”

76
Q

Grand mal epilepsy

A

Convulsive ‘tonic clonic’

Tonic = contraction of all muscles which can cause fall
Clonic = rapid contraction & relaxation of muscles causing convulsions

77
Q

What is spina bifida
‘Occulta’ / ‘cystica’

A

Embryological disease, usually b12 deficient

Incomplete closure of the spinal column around the spinal cord, most common at lumbosacral junction

Either ‘occulta’ = overlying skin intact
‘Cystica’ = visible cystic mass

78
Q

What is the straight leg test indicative of

A

Sciatic/herniated disc

Pain felt up to 45 degrees of raising someones leg whilst lying down

79
Q

What is aspartame

A

An artificial sweetener that is a documented neurotoxic
Can cause weight gain instead of loss
Linked to widespread neurological damage & variety of symptoms/conditions including MS, Parkinsons, balance problems etc

80
Q

What neurological examinations can assess function

A

— signs eg tremor, rigidity
— motor testing
— cranial nerve exam
— dorsal columns test: light touch, vibration, proprioception/balance
— spinothalamic tract: pin prick, temperature
— gait analysis (walking) & rombergs (proprioception)
— cutaneous & deep tendon reflexes

81
Q

What is rombergs test

A

Assesses proprioception

Stand feet together (indicates good cerebellar function if possible)
Upon closing eyes if patient sways indicates positive sign = damage of dorsal columns in spinal cord (often b12 deficient)

Biomed2 (9 decks)

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