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NPTE > Nervous system stuff > Flashcards

Nervous system stuff Flashcards

1
Q

Frontal lobe - 3 areas

A

Precentral gyrus
prefrontal cortex
broca’s area

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2
Q

Precentral gyrus

A

(frontal lobe)

primary motor cortex for voluntary muscle activation

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3
Q

prefrontal cortex

A

(frontal lobe)

controls emotions and judgments

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4
Q

Broca’s area

A

(frontal lobe)

controls motor aspects of speech

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5
Q

Parietal lobe - area and function

A

Postcentral gyrus - primary sensory cortex for integration of sensation

-receives fibers conveying touch, proprioceptive, pain and temperature sensations from opposite side of body

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6
Q

Temporal lobe - 3 areas

A

Primary auditory cortex
Associative auditory cortex
wernicke’s area

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7
Q

Primary auditory cortex

A

(temporal lobe)

receives/processes auditory stimuli

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8
Q

associative auditory cortex

A

(temporal lobe)

processes auditory stimuli

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9
Q

wernicke’s area

A

(temporal lobe)

language comprehension

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10
Q

occipital lobe - 2 area

A

primary visual cortex

visual association cortex

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11
Q

primary visual cortex

A

occipital lobe

-receives/processes visual stimuli

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12
Q

visual association cortex

A

occipital lobe

-processes visual stimuli

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13
Q

insula brain function

A

-associated with visceral functions

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14
Q

limbic system

A

-limbic lobe, hippocampal formation, amygdaloid nucleus, hypothalamus and anterior nucleus of thalamus.

  • concerned with instincts and emotions
  • basic functions include feeding, aggression, emotions, and endocrine aspects of sexual response.
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15
Q

White matter

A

myelinated nerve fibers located centrally

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16
Q

basal ganglia (BG)

A

-masses of gray matter. (striatum, GPi, GPe, sub thalamic nucleus and substantial nigra)

circuits:
oculomotor (caudate loop)= functions with saccadic eye movements

motor loop (putamen loop) = reinforces selected pattern, suppresses conflicting patterns. prep for movement

limbic circuit = organize behavior (executive function, problem solving, motivation) and procedural learning

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17
Q

diencephalon includes

A

thalamus, subthalamus, hypothalamus, and epithalamus

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18
Q

Thalamus - sensory nuclei

A

(has sensory/motor/other nuclei)
sensory - integrate and relay sensory info from body, face, retina, cochlea, and taste receptors to cerebral cortex and subcortical regions ; smell is exception**

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19
Q

Thalamus - motor nuclei

A

(has sensory/motor/other nuclei)

motor - relay motor info from cerebellum and globes plaids to percentile motor cortex.

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20
Q

Thalamus - other nuclei

A

(has sensory/motor/other nuclei)

other - assist in integration of visceral and somatic func

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21
Q

Subthalamus

A
  • involved in control of several functional pathways for sensory, motor, and reticular function
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22
Q

Hypothalamus

A
  • integrates and controls fun of ANS and the neuroendocrine system
  • maintains body homeostasis (body temp, eating, water balance, anterior pituitary function/sexual behavior, and emotion)
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23
Q

Epithalamus - habenular nuclei and pineal gland

A

habenular nuclei = integrate olfactory, visceral, and somatic afferent pathways

pineal gland = secretes hormones that influence pituitary gland and several other organs; influences circadian rhythm

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24
Q

Brainstem - midbrain, pons, medulla oblongata

A

midbrain - connects pons to cerebrum; superior peduncle connects midbrain to cerebellum

pons - connects medulla oblongata to midbrain, allowing passage of important ascending and descending tracts

  • medulla oblongata - connects spinal cord with pons
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25
Q

Cerebellum

A

(“little brain”)
located behind dorsal pons and medulla in posterior fossa

  • archicerebellum = equilibrium, regulation of muscle tone, helps VOR
  • paleocerebellum = modifying muscle tone and synergistic actions of muscles. maintenance of posture and voluntary movement control
  • neocerebellum = smooth coordination of voluntary movements; ensure accurate force, direction, and extent. Important for motor learning, sequencing of mvmt, and visually triggered movement
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26
Q

Autonomic nervous system - ANA

A

sympathetic - fight or flight, emergency response.

parasympathetic - rest and digest

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27
Q

A fibers (4 types)

A

large, myelinated, fast-conducting

alpha= proprioception, somatic motor
beta = touch, pressure
gamma = motor to muscle spindles
delta = pain, temperature, touch
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28
Q

B fibers

A

small, myelinated, conduct less rapidly

-preganglionic autonomic

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29
Q

C fibers

A

smallest, unmyelinated, slowest conducting

dorsal root = pain, reflex responses
sympathetic = postganglionic sympathetics

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30
Q

Nonfluent aphasia

A

Expressive.
*Broca’s motor aphasia, expressive aphasia

  • central language disorder in which speech is typically awkward, restricted, interrupted, and produced with effort.
  • lesion involving the third frontal convolution of the left hemisphere (Broca’s area)
31
Q

Verbal apraxia

A

Expressive.

-impairment of volitional articulatory control secondary to a cortical, dominant hemisphere lesion

32
Q

Dysarthria

A

Expressive.

  • impairment of speech production resulting from damage to the central or peripheral nervous system;
  • causes weakness, paralysis or incoordination of the motor-speech system (respiration, articulation, phonation, and movements of jaw and tongue)
33
Q

Fluent aphasia

A

Receptive.

  • Wernicke’s aphasia, receptive aphasia
  • spontaneous speech is preserved and flows smoothly, while auditory comprehension is impaired.
  • lesion in the posterior frist temporal gyrus of the left hemisphere (Wernicke’s area)
34
Q

Global aphasia

A

receptive and expressive.

-severe aphasia. marked impairments in comprehension and production of language.

35
Q

HR, BP and exercises.

A

normal for HR to increase in direct proportion to intensity

SBP increases, while DBP remains the same or decreases moderately

36
Q

Cheyne-Stokes respiration

A

period of apnea lasting 10-60 seconds followed by gradually increasing depth and frequency of respirations

-depression of frontal lobe and diencephalic dysfunction

37
Q

Apneustic breathing

A

abnormal respiration marked by prolonged inspiration.

-damage to upper pons

38
Q

Testing of sensation - order

A

Test superficial sensations (pain, temperature, touch)

Test proprioceptie (Deep) sensations - Joint position, kinesthesia/movement sense, and vibration sense (pallesthesia)

Lastly, test combined cortical sensation - stereognosis, tactile localization, 2 point discrimination, barognosis (weight), graphesthesia, bilateral simultaneous stimulation.

39
Q

homonymous hemianopsia

A

loss of half of visual field in each eye.

-contralateral to the side of a cerebral hemisphere lesion

40
Q

Decerebrate rigidity/posturing

A
  • comatose patients with brainstem lesions

- all limbs; trunk/neck in rigid extension

41
Q

Decorticate rigidity/posturing

A

-comatose patients with lesions above superior colliculus

  • upper limbs in flexion
  • Lower limbs in extension

*in “cort” praying not to go to jail.

42
Q

opisthotonos

A

-prolonged severe spasm of muscles, causing head, back, and heels to arch backward; arms and hands are held rigidly flexed.

43
Q

Extrapyramidal disorders, basal ganglia dysfunction

A
  • tics
  • chorea (dancing movements)
  • athetosis (slow, irregular, twisting)
  • tremor (resting tremors)
  • myoclonus (single, quick jerk)
44
Q

Cerebellar disorders cause?

A

intention tremor when voluntary movement is attempted

45
Q

cortical disorders

A

epileptic seizures, tonic/clonic convulsive movements

46
Q

Fibrillation vs fasciculations

A

Fib = fake. cannot see twitch. spontaneous independent contraction of individual muscle fibers

Fasciculation = spontaneous contractions of all or most of the fibers in a motor unit. *can see or palpate twitch (present with LMN disorders and denervation)

47
Q

Stages of recovery after stroke

A

6 stages

stage 1 = flaccidity
stage 2 = emergence of spasticity, hyperreflexia, synergies
stage 3 = voluntary movement possible only in synergies, spasticity strong
stage 4 = decline in spasticity and synergies
stage 5 = increased voluntary control out of synergy
stage 6 = control and coordination near normal

48
Q

naming SPI levels

A

lesion level indicates most distal uninvolved nerve root segment with normal function; muscles must have a grade of at least 3+/5 or fair+ function

49
Q

Complete vs incomplete SPI

A

complete = no sensory or motor function below level of lesion

incomplete = preservation of sensory or motor function below level of injury; spotty sensation, some muscle function (at least 3+/5)

50
Q

ASIA impairment scale.

A

A = complete: no motor or sensory preserved in sacral segments S4-5

B = incomplete: sensory preserved below level and includes sacral S4-5. no motor

c = incomplete: motor preserved below the level, and most key muscles have a grade of less than 3

D = incomplete: motor preserved below level. most key muscles below have a grade of 3 or more

E = normal: motor and sensory normal

51
Q

Central Cord syndrome: characteristics

A

UMN lesion
cavitation of central cord in cervical section. Typically due to cervical hyperextension

  • loss of spinothalammic tracts with bilateral loss of pain and temperature
  • loss of ventral horn with bilateral loss of motor function: Primarily UE
  • preservation of proprioception and discriminatory sensation
52
Q

Brown-Sequard syndrome - characteristics

A

UMN lesion
Hemisection of spinal cord (loss one half) due to penetration wounds (gunshot/knife)

  • ipsilateral loss of dorsal columns with loss of tactile discrimination, pressure, vibration, and proprioception
  • ipsilateral loss of corticospinal tracts with loss of motor function and spastic paralysis below level of lesion
  • contralateral loss of spinothalamic tract with loss of pain and temp below level of lesion; at lesion level, bilateral loss of pain and temp.
53
Q

Anterior cord syndrome - characteristics

A

UMN lesion
loss of anterior cord (motor) typically flexion injuries of C-spine

  • loss of lateral corticospinal tracts with bilateral loss of motor function, spastic paralysis below level of lesion
  • loss of spinothalamic tracts with bilateral loss of pain and temp
  • preservation of dorsal columns: proprioception, kinesthesia, and vibratory sense.
54
Q

Posterior cord syndrome - characteristics

A

UMN lesion - extremely rare
loss of dorsal columns bilaterally (sensory)

  • bilateral loss of proprioception, vibration, pressure, and epicritic sensations (stereognosis, 2 point discrimination)
  • preservation of motor function, pain, and light touch
55
Q

Cauda equina injury - characteristics

A

LMN lesion
loss of long nerve roots at or below L1

variable nerve root damage (motor and sensory signs); incomplete lesions common

  • flaccid paralysis with no spinal reflex activity
  • flaccid paralysis of bladder and bowel
  • potential for nerve regeneration; regeneration often incomplete, slows and stops after about 1 year.
56
Q

Autonomic dysreflexia

A

emergency situation.
- noxious stimulus precipitates a pathological autonomic reflex.

-elevate head, check and empty catheter first. Medical emergency.

57
Q

Heterotopic bone formation (ectopic bone)

A

abnormal bone growth in soft tissue

58
Q

Multiple sclerosis (MS)

A

a chronic, progressive, demyelinating disease of the CNS affecting mostly young adults

59
Q

4 types of Multiple sclerosis

A

Relapsing-remitting (RRMS) - periods of recovery

Primary-progressive (PPMS) - disease progression from onset without plateaus or remissions, or with occasional plateaus and temporary minor improvements

Secondary-progressive (SPMS) - initial relapsing-remitting course, followed by progression at a variable rate. May also include occasional relapse or minor remission

Progressive-relapsing (PRMS) - progressive disease from onset but without clear, acute relapses that may or may not have some recovery or remission. Commonly seen with onset after 40 years old.

60
Q

Parkinson’s disease

A

basal ganglia

chronic, progressive disease of the CNS with degeneration of dopaminergic substantial nigra neurons and nigrostriatal pathways.

-classic symptoms = (TRAP)
Tremor (resting), rigidity, akinesia (no or slow movements), postural reflexes (impaired)

61
Q

Hoehn and Yahr classification stages of parkinson’s

A

I = minimal or absent disability, unilateral symptoms

II = minimal bilateral or midline involvement, no balance involvement

III = impaired balance, some restrictions in activity

IV = all symptoms present and severe; stands and walks only with assistance

V = confinement to bed or w/c

62
Q

Myasthenia gravis

A

neuromuscular junction disorder characterized by progressive muscular weakness and fatiguability on exertion.

autoimmune attack on acetylcholine receptors on postsynaptic junction

**fatigability is characteristic. Repeated muscle use results in rapid weakness.

63
Q

Myasthenic crisis

A

myasthenia graves with respiratory failure

= medical emergency.

64
Q

Tonic-clonic seizure

A

Grand mal
General seizure

  • dramatic loss of consciousness, with a cry, fall, and tonic-clonic convulsions of all extremities.
  • often have tongue biting and arrested breathing, urinary and fecal incontinence
  • lasts 2-5 mins
  • patient is confused, drowsy, and amnesiac about the event
  • full recovery may take several hours
  • some attacks are preceded by a brief aura
65
Q

Absence seizures

A

petit mal
general seizure

  • brief, almost imperceptible lapse of consciousness followed by immediate and full return to consciousness
  • posture is maintained
  • no convulsive muscle contrations
  • may occur up to 100x/day
66
Q

simple partial seizure

A

partial seizure

focal, begin locally, limited to a portion of the body

  • consciousness preserved
  • usually an identifiable structural cause
67
Q

focal motor

A

partial seizure

-clonic activity involving a specific area of the body

68
Q

focal motor with march (Jacksonian)

A

partial seizure

-orderly spread or march of clonic movements from initial muscles to involve adjacent muscles, with spread to the entire side

69
Q

temporal lobe seizure

A

partial seizure

  • characterized by episodic changes in behavior, with complex hallucinations
  • automatisms (lip smacking, chewing, pulling on clothing…)
  • altered cognitive and emotional function (sexual arousal, depression, violent behaviors)
  • preceded by an aura
70
Q

Complex partial seizure

A

simple partial seizure (focal, begin locally, limited to a portion of the body) followed by impairment of consciousness.

71
Q

Cerebellar disorders - characteristics

A

tend to produce ipsilateral signs and symptoms

-balance and coordination issues. Intention tremors

72
Q

Vestibular neuronitis, labyrinthitis

A

unilateral vestibular disorders (UVD)

acute infection with prolonged attack of symptoms, persisting for several days or several weeks.

caused by viral or bacterial infection

73
Q

Meniere’s disease

A

recurrent and usually progressive vestibular disease

  • episodic attacks may last mins to several hours
  • usually associated with tinnitus, deafness, sensation of pressure/fullness within ear

etiology unknown, edema of membranous labyrinth is a consistent finding

NPTE (7 decks)

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