Nervous System: Part 1 Flashcards
How is the nervous system divided?
- CNS
2. PNS
What makes up the CNS?
- brain
- spinal cord
What makes up the PNS?
- ANS
- SNS
What does ANS stand for?
Autonomic NS
What does SNS stand for?
Somatic NS
What does the ANS do?
Communicates with internal organs and glands
What does the SNS do?
Communicates with sense organs and voluntary muscles
What makes up the ANS?
- Sympathetic NS
2 Parasympathetic NS
What does the sympathetic NS do?
Arouse
What does the parasympathetic NS do?
Calm
What makes up the Somatic NS?
- Sensory NS
2. Motor NS
What does the Sensory NS do?
- afferent
- sensory input
What does the Motor NS do?
- efferent
- motor output
What controls the PNS?
The CNS
What are the 8 major neurotransmitters?
Acetylcholine Adrenaline Noradrenaline Dopamine Endorphins GABA Glutamate Serotonin
What is the major function: Adrenaline
Fight or Flight
What is the major function: GABA
Calming
What is the major function: Noradrenaline
Concentration
What is the major function: Acetylcholine
Learning
What is the major function: Dopamine
Pleasure
What is the major function: Glutamate
Learning
What is the major function: Serotonin
mood regulation
What is the major function: Endorphins
Euphoria
Which neurotransmitter: Produced in stressful situations
Adrenaline
Which neurotransmitter: Increases HR and blood flow
Adrenaline
Which neurotransmitter: Results in physical boost and awareness
Adrenaline
Which neurotransmitter: Calms firing nerves in the CNS
GABA
Which neurotransmitter: High levels improves focus
GABA
Which neurotransmitter: Low levels cause anxiety
GABA
Which neurotransmitter: Contributes to motor control and vision
GABA
Which neurotransmitter: Affects attention
Noradrenaline
Which neurotransmitter: Affects responding actions in the brain
Noradrenaline
Which neurotransmitter: Contracts blood vessels
Noradrenaline
Which neurotransmitter: Increases blood flow
Noradrenaline
Which neurotransmitter: Involved in thought, learning and memory
Acetylcholine
Which neurotransmitter: Activates muscle action in body
Acetylcholine
Which neurotransmitter: Associated with attention and wakening
Acetylcholine
Which neurotransmitter: Creates feelings of pleasure
Dopamine
Which neurotransmitter: Creates feelings of addiction
Dopamine
Which neurotransmitter: Creates feelings of movement
Dopamine
Which neurotransmitter: Creates feelings of motivation
Dopamine
Which neurotransmitter: People repeat behaviors that lead to the release of this neurotransmitter
Dopamine
Which neurotransmitter: Most common neurotransmitter
Glutamate
Which neurotransmitter: Involved in learning and memory
Glutamate
Which neurotransmitter: Regulates development and creation of nerve contacts
Glutamate
Which neurotransmitter: Contributes to well being and happiness
Serotonin
Which neurotransmitter: Helps sleep cycle
Serotonin
Which neurotransmitter: Helps digestive regulation
Serotonin
Which neurotransmitter: Affected by exercise
Serotonin
Which neurotransmitter: Affected by sun exposure
Serotonin
Which neurotransmitter: Released during exercise
Endorphins
Which neurotransmitter: Released during sex
Endorphins
Which neurotransmitter: Released during excitement
Endorphins
Which neurotransmitter: Produces well being and euphoria
Endorphins
Which neurotransmitter: Reduces pain
Endorphins
Function of the CNS
- Integration
- Control center
What makes up the PNS
- cranial nerves
- spinal nerves
Function of the PNS
Communication line between the CNS and the rest of the body
What type of nerve fibers make up the Sensory NS?
Somatic and visceral nerve fibers
What type of nerve fibers make up the Motor NS?
Motor nerve fibers
What is the function of the Sensory NS?
Conduct impulses from receptors to the CNS
What is the function of the Motor NS?
Conduct impulses from CNS to effectors
What are the effectors that the motor NS conducts impulses from?
- muscles
- glands
What type of motor impulses does the ANS produce?
- visceral
- involuntary
What type of motor impulses does the SNS produce?
- somatic
- voluntary
Function of the ANS
Conducts impulses from the CNS to cardiac muscles, smooth muscles, and glands
Function of the SNS
Conducts impulses from the CNS to skeletal muscles
What are the brain lobes?
- Frontal Lobe
- Occipital Lobe
- Temporal Lobe
- Parietal Lobe
Which brain lobe?: Abstract versus concrete reasoning
Frontal Lobe
Which brain lobe: Motivation/volition
Frontal Lobe
Which brain lobe: Concentration
Frontal Lobe
Which brain lobe: Decision making
Frontal Lobe
Which brain lobe: Purposeful behavior
Frontal Lobe
Which brain lobe: Memory, sequencing
Frontal Lobe
Which brain lobe: , making meaning of language
Frontal Lobe
Which brain lobe: Speech organization & production
Frontal Lobe
Which brain lobe: Aspects of emotional response
Frontal Lobe
Which brain lobe: Vision
Occipital Lobe
Which brain lobe: Possible information holding area
Occipital Lobe
Which brain lobe: Sensory integration
Parietal Lobe
Which brain lobe: spatial relations
Parietal Lobe
Which brain lobe: Bodily awareness
Parietal Lobe
Which brain lobe: Filtration of background stimuli
Parietal Lobe
Which brain lobe: Personality factors and symptom denial
Parietal Lobe
Which brain lobe: Memory and nonverbal memory
Parietal Lobe
Which brain lobe: Concept formation
Parietal Lobe
Which brain lobe:
Parietal Lobe
Which brain lobe:
Parietal Lobe
Which brain lobe:
Parietal Lobe
Which brain lobe: Visual–spatial recognition
Temporal Lobe
Which brain lobe: Attention
Temporal Lobe
Which brain lobe: Motivation
Temporal Lobe
Which brain lobe: Emotional modulation and interpretation
Temporal Lobe
Which brain lobe: Impulse and aggression control
Temporal Lobe
Which brain lobe: Interpretation and meaning of social contact
Temporal Lobe
Which brain lobe: Aspects of sexual action and meaning
Temporal Lobe
Which brain lobe:
Temporal Lobe
Which brain lobe:
Temporal Lobe
How are TBIs categorized?
- Primary (Direct) Injury
2. Secondary Injury
How is a primary TBI caused?
by an impact
How is a secondary TBI caused?
Results from the subsequent:
- brain swelling
- infection
- cerebral hypoxia
How do primary TBIs present:?
- diffuse axonal injury
- focal lesions of laceration
- contusion
- hemorrhage
How do secondary TBIs present?
-diffuse or multifocal
-concussion
-infection
hypoxic brain injury
How is the brain positioned in the skull
floats freely in CSF
Coup–Contrecoup Injury
- blunt force to head
- accelerates brain within skull/CSF
- brain decelerates abruptly on hitting inner skull surfaces
Coup
Direct contusion of brain at the site of external force
Contrecoup
Rebound injury on opposite side of brain
What is the cerebellar region of the brain responsible for?
balance
What does trauma in a TBI result in?
inflammation
What is a common pathway for brain injury?
Increased ICP
What can be the result of ICP?
- obstruct cerebral blood flow
- destroy brain cells
- displace brain tissue
- damage to delicate brain structures
What is the cranial cavity made up of?
- Blood
- Brain tissue
- CSF
What percentage of the cranial cavity is made up of blood?
10%
What percentage of the cranial cavity is made up of brain tissue?
80%
What percentage of the cranial cavity is made up of CSF?
10%
What is normal ICP?
0-15 mmHg
What is the Monro-Kellie doctrine?
hypothesis of normalization of ICP
What does the Monro-Kellie doctrine hypothesize?
An increase in the volume of any one of the 3 components (brain, blood, CSF) must be at the expense of the other two beyond autoregulation.
Which of the 3 brain components is least compressible?
brain
Which of the 3 brain components is autoregulated?
blood flow
What is CPP
Cerebral Perfusion Pressure
What is normal range for CPP?
When CPP is out of range of 60-160 mmHg
When does autoregulation kick in?
When CPP is out of normal range
What occurs if CPP is decreased?
Decreased Cerebral blood flow
At what pressure does cerebral blood flow decrease?
< 60 mmHg
As a clinician what is important to assess when considering ICP
BP
Why is BP important to assess when considering ICP?
Need high enough BP to perfuse brain (but not too high)
Other than trauma, what else can cause ICP?
Tumors
Teachers pearl about ICP
- Teacher worked in neuro trauma
- open up skull (flap open up)
- allowed swelling to give room in the roof of your head
- allows the brain tissue to swell
- also were giving steroids (and other things) to bring swelling down
What is abnormal posturing?
an involuntary flexion or extension of the arms
What does abnormal posturing indicate?
severe brain injury
What are the two types of abnormal posturing?
- Decorticate
2. Decerebrate
What does Decorticate posturing look like?
flexing to the core
What does Decerebrate posturing look like?
extension from the core
Does abnormal posturing occur on one or both sides of the body?
Can be unilateral or bilateral
is Decorticate posturing serious
Yes, but not as serious as Decerebrate
What is Decorticate posturing a sign of?
Damage to the nerve pathway between the brain and spinal cord
Concussion
- immediate and transient loss of consciousness
- accompanied by a brief period of amnesia
- after a blow to the head
How long does it take to recover from a concussion?
24 hours
Characteristics of concussion symptoms
-can be:
- vague
- subjective
- mild
How long can symptoms of concussion last?
can persist for monthns
- Headache
- Irritability
- Insomnia
- Poor concentration
- Memory
- dizziness
- confusion
- nausea
- difficulty hearing and seeing
Symptoms of concussion
Symptoms of concussion
- Headache
- Irritability
- Insomnia
- Poor concentration
- Memory
- dizziness
- confusion
- nausea
- difficulty hearing and seeing
Patho of concussion
-brain collides with skull
What can concussion result in?
- bruising
- torn tissues
- swelling
Second Impact Syndrome
When a person who is not fully recovered from a concussion suffers a second blow to the head
What can be the result of Second Impact Syndrome?
Death
Patho of Second Impact Syndrome
- massive swelling of brain
- cuts off blood flow to brain
When are concussion symptoms presented
- not always right away
- sometimes delayed
What are the types of brain hematomas?
- Epidural Hematoma
- Subdural Hematoma
- Traumatic Intracerebral Hematomas
What type of bleed causes a Epidural Hematoma?
Arterial
What is usually the cause of a Epidural Hematoma
head injury in which skull is fractured
Where does an Epidural Hematoma develop?
between inner table of bones of skull & dura
What type of bleed causes a Subdural Hematoma ?
Venous
What is usually the cause of a Subdural Hematoma?
- tear in small bridging veins that connect veins
- surface of cortex to Dural sinuses
Where does an Subdural Hematoma develop?
in area between dura & arachnoid
What is the arachnoid
subdural space
How are Subdural Hematomas categorized?
- Acute SDH
- Subacute SDH
- Chronic SDH
Characteristic of Traumatic Intracerebral Hematomas
Can be single or multiple
Where does an Traumatic Intracerebral Hematomas
develop?
- in any lobe of brain
- most common in frontal or temporal lobes
Is a venous or arterial bleed worse?
Arterial is much worse
Why is an arterial bleed worse than a venous bleed?
- quick
- higher pressure
In which type of hematoma will we see changes in the GCS quicker?
Epidural Hematoma
What does GCS assess?
LOC
As a clinician how does GSC effect our work
Effects how we will asses our pt
Teacher pearl regarding brain hematomas
- Only so much space in skull
- If you have an epidural bleed it is going to bleed very quickly and take up a lot of space in the brain
Why can Subdural Hematomas be more dangerous than Epidural Hematomas?
- Take longer to show symptoms (venous)
- Pt can be forgotten
Example 1:
- Pt is in an accident
- Has slight headache for awhile
- Headache slowly increases
- Pt decides to go lie down
What could the pt have?
What can happen to the pt?
- Subdural Hematoma
2. Die
As a clinician, if you have a pt who is walking and talking after a traumatic head injury what should you do?
good close monitoring is important
