Neuro Flashcards
1
Q
what does the nervous system consist of?
A
brain, spinal cord, and peripheral nerves
2
Q
major sensory organs
A
eyes and ears
3
Q
what is the nervous system divided into
A
cns and pns
4
Q
pns consists of what
A
12 cranial nerves, 31 pairs of spinal nerves, and the autonomic nervous system
5
Q
basic cell of the nervous system
A
neuron
6
Q
short, branch-like extensions on the cell body that carry impulses to the cell body from other cells
A
dendrites
7
Q
controls the function of the neuron
A
cell body
8
Q
single, long projection that carries impulses away from the cell body
A
axon
9
Q
white fatty substance that protects the axon
A
myelin sheath
10
Q
nerves with a myelin sheath
A
myelinated (white nerve fibers)
11
Q
nerves w/o myelin sheaths
A
unmyelinated (gray nerve fibers)
12
Q
impulses move from one neuron to another across a ____
A
synapse
13
Q
a chemical ____ such as acetylcholine either helps or stops the impulse from crossing the synapse
A
neurotransmitter
14
Q
_____ neurons carry impulses from the skin and muscles to the CNS
A
sensory (afferent)
15
Q
____ neurons carry impulses from the CNS to the muscles for contraction or glands for secretion
A
motor (efferent)
16
Q
what is the control center of the nervous system
A
brain
17
Q
what is the brain protected by
A
bony skull and membranes
18
Q
the outer layer of the meninges
A
dura mater
19
Q
the middle layer of the meninges
A
arachnoid
20
Q
the inner layer of the meninges (directly attached to the brain)
A
pia mater
21
Q
where are arterial blood vessels located
A
epidural space (b/t skull and dura mater)
22
Q
where is csf found
A
Subarachnoid space (b/t arachnoid and pia mater)
23
Q
4 major regions of the brain
A
cerebrum, diencephalon, brainstem, cerebellum
24
Q
largest area of the brain that is separated into the right and left hemispheres
A
cerebrum
25
deep grooves in the cerebrum
fissures
26
what connects the hemispheres and allows for communication
corpus callosum
27
left hemi is responsible for what
speech, problem solving, reasoning, and calculations
28
right hemi is responsible for what
visual-spatial info, art, music, and surrounding physical environment
29
the ____ contains gray matter, while the rest of the cerebrum is made up of white matter
cerebral cortex
30
each hemi is divided into 4 lobes
frontal, parietal, temporal, occipital
31
____ contains the thalamus and hypothalamus
diencephalon
32
what does the hypothalamus regulate
temp, fluid balance, thirst, appetite, emotions, and the sleep-wake cycle
33
what does the brain stem consist of
midbrain, pons, medulla oblongata
34
___ is the center for auditory and visual reflexes
midbrain
35
___ controls respiration
pons
36
___ controls hr, bp, resp, coughing, swallowing, and vomiting
medulla oblongata
37
___ is connected to the brain stem and has two hemispheres, and coordinates involuntary muscle activity and fine motor movements as well as balance and posture
cerebellum
38
a clear, colorless liquid that protects the brain and spinal cord from trauma. It also provides a place for nutrient exchange an waste removal
csf (cerebrospinal fluid)
39
daily production of csf (mL)
125-150 mL
40
what is in csf
high glucose, few wbc, and no rbc
41
how much blood does the brain get per/min
750mL/min (20% od cardiac output)
42
what is the brain's only source of energy
glucose (cannot store O2 or glucose, so needs constant supply)
43
two arterial systems that supply the brain
internal carotid (cerebrum) and vertebral arteries (cerebellum and brainstem)
44
the major arterial supplies of the brain are connected by smaller arteries forming a ring called ____
circle of Willis (alternative routes when artery is blocked)
45
cerebral veins drain venous blood into the ____
jugular veins
46
composed of astrocytes that are joined by tight junctions which decreases permeability so that harmful substances in the blood cannot enter the brain
blood-brain barrier
47
what can pass through the bbb
lipids, glucose, some amino acids, CO2, O2, and water
48
what cannot pass the bbb
urea, creatinine, some toxins, and most antibiotics
49
where does the spinal cord exit the skull
foramen magnum
50
what protects the spinal cord
vertebral column
51
vertebral column consists of what
C 7, T 12, L 5, S 5, 4 fused coccyx
52
the ventral horn consists of ___ neurons
motor
53
the dorsal horn consists of ___ neurons
sensory
54
the lateral horn consists of ___ neurons
sympathetic
55
____ matter forms ascending and descending pathways known as spinal tracts
white
56
these carry messages to and from the brain: ascending sensory pathways and descending motor pathways
spinal tracts
57
the pns is divided into ____ and ____
sensory and autonomic nervous systems
58
connects the skin and muscles to the cns
sensory ns
59
controls visceral organs and some glands
autonomic ns
60
31 pairs of spinal nerves
C8, T12, L5, S5
61
sensory fibers are in the ___ root
dorsal
62
motor fibers are in the ___ root
ventral
63
an area of skin supplied by a single spinal nerve is called
dermatome (useful for locating pain and neurologic lesions)
64
which cranial nerves just control sensory function
I, II, VIII
65
how many pairs of cranial nerves
12
66
a part of the PNS that is responsible for maintaining the body's internal homeostasis
ANS
67
the ANS regulates what
respiration, HR, digestion, urinary excretion, body temp, and sexual function
68
two divisions of the ANS
sympathetic and parasympathetic
69
prepares for the body to handle stress "fight or flight"
sns
70
operates during non-stressful events to conserve the body's energy "rest and digest"
psns
71
pneumonic for the cranial nerves and their function
oh oh oh to touch and feel very good vagina ah ha
some say marry money but my brother says big brains matter more
72
protect the eyeballs
eyelids and eyelashes
73
thin mucous membrane that lines the inner surface of the eyelid
conjunctiva
74
secretes and drains tears to cleanse and moisten the eye's surface
lacrimal apparatus
75
tears are produced by what
lacrimal gland
76
where do tears drain
lacrimal ducts (then into nose)
77
when the cornea is touched the eyelids blink and tears are secreted
corneal reflex
78
colored part of the eye, regulates light entering the eye by controlling the size of the pupil
iris
79
a transparent structure behind the pupil that can change shape to focus light onto the retina
lens
80
vascular layer of the eyeball
choroid
81
the innermost lining of the eyeball and contains millions of light receptors called rods and cones
retina
82
light sensitive and allows us to see in dim light
rods
83
allow us to see color and provide a sharper image
cones
84
the area where light passing through the pupil and lens focuses on the retina
macula
85
the center of the macula that allows for detailed color vision
fovea centralis
86
the optic nerve enters the eye at
optic disk
87
the eye has two interior cavities
posterior and anterior cavity
88
posterior cavity behind the lens contains clear gelatinous ___
vitreous body
89
anterior cavity is divided further into ___ and ____
anterior (b/t cornea and iris) and posterior (b/t iris and lens) chamber
90
the anterior cavity is filled with ___
aqueous humor (constantly formed and drained to maintain relative pressure within the eye)
91
___ at the junction of the sclera and the cornea (limbus) allows aqueous humor to flow b/t the anterior and posterior chambers
canal of Schlemm
92
to change the point of focus from far to near, the lens changes shape, the pupil constricts, and the eyes converge
accommodation
93
where do the optic and the cranial nerves meet
optic chiasma
94
impulses generated in the retina travel to the ____ in the occipital lobe of the brain
visual cortex
95
the visual fields of each eye overlap considerably and each eye sees a slightly different view allowing for ___
depth perception
96
2 primary functions of the ear
hearing and maintaining balance
97
3 areas of the ear
external, middle, and inner
98
glands in the auditory canal secrete what
cerumen (traps debris, protecting the tympanic membrane)
99
the auditory ossicles (bones) in the middle ear
malleus, incus, stapes
100
middle ear is filled with air and opens into the ___, which connects it with the nasopharynx (increased likelihood for middle ear infections)
eustachian tube (help equalize pressure with atmospheric pressure)
101
3 regions of the labyrinth (inner ear)
vestibule, semilunar canals, cochlea
102
receptors in the ___ respond to changes in gravity and head position, helping maintain balance
vestibule
103
the cochlea contains the ____, the receptor for hearing
organ of Corti (sensory hair cells)
104
ringing in the ears
tinnitus
105
drooping of the eyelids
ptosis
106
involuntary eye movement
nystagmus
107
difficulty swallowing
dysphagia
108
decreased muscle tone
flaccidity
109
increased muscle tone
spasticity
110
lack of coordination or unbalanced gait
ataxia
111
what chart to assess distant vision with
Snellen
112
what chart to assess near vision with
Rosenbaum
113
what tests to test hearing
whisper, Rinne (place on bone then move to front of ear), Weber (on top of head and should be heard equally)
114
the lens becomes less elastic with aging, affecting near vision
presbyopia
115
eyelid muscles lose tone, causing the lower lid to turn out
ectropion
116
eyelid margin may turn inward causing lashes to irritate the eye
entropion
117
older people cannot hear ____ frequency sounds due to the degeneration in the cochlea or loss of small hairs in the ears
high
118
csf contains ___ mg/dL of glucose
50-70 mg/dL
119
inability to express or receive and understand speech as a result of brain damage
aphasia
120
2 categories of CVA (stroke)
ischemic and hemorrhagic
121
if the brain experiences ____ for more than 10min, irreversible brain damage occurs
anoxia (lack of O2 to the brain)
122
minimally perfused cells whose survival depends on timely return of adequate circulation
penumbra
123
smaller blood vessels develop to supply blood to areas with reduced blood flow
collateral circulation
124
cannot identify familiar objects
agnosia
125
in a CVA there is usually a ___ deficit
contralateral (opposite side)
126
weakness on one half of the body
hemiparesis
127
paralysis of one half of the body
hemiplegia
128
if Broca's area is damaged someone may have ___
expressive aphasia
129
if Wernicke's area is damaged someone may have ___
receptive aphasia
130
difficulty speaking caused by paralysis of the muscles that control speech
dysarthria
131
seeing double
diplopia
132
awareness of body's position
proprioception
133
loss of vision in half of the eye
homonymous hemianopia
134
inability to carry out a familiar routine/coordinate a movement
apraxia
135
identifies the size and location of a CVA
CT scan
136
what is the earliest sign of IICP
change in LOC
137
what standardized chart assesses LOC
Glasgow Coma Scale
138
3 categories of the GCS
eye opening, verbal response, and motor response
139
min and max score of GCS
min 3 and max 15
140
when is the patient in a coma and unable to maintain their own airway on the GCS
8 (at 8 intibate)
141
inflammation of the eyelid, may be caused by an infection or dermatitis. Eyelid is irritated and itchy, margins are red, crusted, and scaly
blepharitis
142
infection of the sebaceous glands of the eyelid, usually caused by staph (red and painful)
hordeolum (stye)
143
painless cyst or nodule of the eyelid
chalazion
144
inflammation of the conjunctiva, usually caused by bacteria or virus (staph or adenovirus). Spread by direct contact
conjunctivitis (pink eye)
145
scratch on the cornea
corneal abrasion
146
what eye injury is often caused by sports
blunt eye trauma
147
what test can help identify the presence of foreign bodies and abrasions
fluorescein stain
148
nearsightedness
myopia
149
farsightedness
hyperopia
150
irregularities in the curvature of the cornea and lens. Light rays are imperfectly focused on the retina
astigmatism
151
clouding of the lens of the eye that impairs vision
cataract
152
what is a cataract that only affects a portion of the lens
immature
153
cataract that affects the entire lens
mature
154
what reflex is lost with cataracts
red reflex
155
how are cataracts corrected
surgery with implantation of an intraocular lens
156
disease characterized by increased intraocular pressure and gradual loss of vision
glaucoma
157
what vision is lost first in glaucoma
peripheral
158
what is aqueous humor produced by
ciliary body
159
aqueous humor drainage through the trabecular meshwork and canal of schelmm is slowed, with a gradual increase in IOP
POAG (primary open angle glaucoma)
160
the angle between the cornea and the iris closes, completely blocking drainage from aqueous humor from the eye, with an abrupt increase in IOP
angle-closure glaucoma
161
which glaucoma is a medical emergency b/c w/o prompt treatment the affected eye will become blind
angle-closure glaucoma
162
we want to avoid eye ___ in someone that has had episodes of angle-closure glaucoma
dilation
163
what is the type of medication that dilates the eye and should be AVOIDED in pts with angle-closure glaucoma
mydriatic (this has a "d" and so does "d"ilate)
164
what test measures IOP
tonometry (start screening at 40yrs)
165
what osmotic diuretic is used in ACG
mannitol
166
what medication constricts the pupil and is given to help open the angle in ACG
miOtic (they cOnstrict)
167
in glaucoma ___ and ___ are also seen in an ophthalmology exam
fundus pallor and optic disk cupping (examine through funduscopy)
168
name a miotic
pilocarpine
169
name a mdriatic
atropine
170
example of a carbonic anhydrase inhibitor (reduce aqueous humor production, lowing IOP)
acetazolamide
171
what test measures the depth of the anterior chamber and helps differentiate b/t open and closed angled glaucoma
gonioscopy
172
what test is used to identify if there is peripheral vision loss
visual field testing
173
beta blockers can also be given to decrease IOP, what vital sign will we watch to see if there was systemic effects
BP
174
swimmer's ear
external otitis
175
when a pt presents with a foreign body such as a bean, do not do what
irrigate (may cause the object to swell)
176
what temp of water to use when irrigating the ear and why
body temp (too cold could induce seizure activity)
177
inflammation or infection of the middle ear
otitis media
178
the eustachian tube connects to what
nasopharynx (organisms can enter the ear through the nose and throat)
179
when the eustachian tube is obstructed for a long time. Air in the middle ear is gradually absorbed, causing negative pressure in the middle ear
serous otitis media
180
acute otitis media usually follows a ___
URI
181
a sensation of whirling or movement when there is none, key symptom of inner ear disorders
vertigo
182
anything that affects sound transmission from the external opening of the ear to the inner ear
conductive hearing loss
183
disorders that affect the inner ear or the auditory pathways of the brain may cause
sensorineural hearing loss
184
with aging, the hair cells of the cochlea degenerate, causing progressive hearing loss
presbycusis
185
what consonants can people suffering from hear loss not understand
t, p, or s
186
most common type of vascular headache (exact causes unknown)
migraine
187
normal IOP
15-22 (orange 10-20)
188
normal ICP
7-12 (orange 5-15)
189
a brief disruption of brain function caused by abnormal electrical activity in the nerve cells of the brain
seizure
190
involuntary muscle contraction and relaxation, which involves the entire body
convulsion
191
seizures occurring in a chronic pattern
epilepsy (seizure disorder)
192
a group of abnormal firing neurons that start a seizure
epileptogenic focus
193
what can trigger seizure activity
hypoglycemia, high fever, hypoxia
194
seizures are classified as ____ or ____
partial or generalized
195
seizures that start in one area of the cerebral cortex
partial seizures
196
uncontrolled jerking movements of a finger, hand, foot, leg, or the face
simple partial seizure
197
when a simple partial seizure spreads to other body areas and is known as ____
Jacksonian march
198
known as psychomotor seizures, usually begin in the temporal lobe and manifestations include automatisms
complex partial seizures
199
repetitive non-purposeful actions (lip smacking, aimless walking, or picking at clothing
automatisms
200
a warning sign that something is going to happen
aura
201
seizures that involve both hemispheres of the brain and result in loss of consciousness
generalized seizures
202
characterized by a brief change in consciousness such as a blank stare (more frequent in chlidren)
absence seizures
203
can develop suddenly and is the most common type of seizure with risk for potential injury
tonic-clonic seizures
204
what is the typical pattern for tonic-clonic seizures
aura, tonic phase, clonic phase, postictal phase
205
muscles are rigid with the arms and legs extended and jaw clenched. Pupils become fixed and dilated. Breathing stops and cyanosis develops
tonic contractions
206
movements are jerky as the muscles alternately relax and contract. The eyes roll back; tongue and cheek biting, as well as frothing from the mouth. Urinary and bowel incontinence are common
clonic contractions
207
post seizure the patient is unconscious for up to 30min
postictal
208
a continuous period of tonic-clonic seizures usually lasting 5min or more in which the patient does not regain consciousness *life threatening medical emergency*
status epilepticus
209
what test can determine the type of seizure and locate the seizure focus
EEG (electroencephalogram)
210
what class of drug is given to quickly stop status epilepticus
Benzodiazepines (antidote: flumazenil)
211
meds for seizures
clonazepam
carbamazepine (4-12)
gabapentin
phenobarbital (15-40)
phenytoin (10-20)
valproic acid
212
a flexion posturing
decorticate (into the core)
213
an extension posturing
decerebrate
214
rescue med for migraines
ketorolac
215
form of vascular headache that typically begins 2 to 3 hours after the person falls asleep. Usually the same side of the head is involved each time
cluster headache
216
headache that often results from prolonged muscle contraction of the head and neck, due to abnormal posture (viselike feeling)
tension headache
217
a slow progressive neurodegenerative movement disorder, resulting from a loss of dopamine
Parkinson disease (PD)
218
an inhibitory neurotransmitter
dopamine
219
an excitatory neurotransmitter
acetylcholine
220
3 cardinal signs of PD
tremor, rigidity, bradykinesia
221
slowed voluntary movements and speech
bradykinesia
222
the classic tremor in PD that occurs with the thumb and fingers
pill rolling
223
muscle rigidity makes active and passive movement difficult, the extremity may move but it does so in a jerky movement called ____
cogwheel rigidity
224
a ___ scan may show decreased levels of levodopa (precursor to dopamine)
PET
225
most common procedure for PD
deep brain stimulation (DBS)
226
two other procedures done in PD that destroy certain areas in the brain to decrease tremors
thalamotomy and pallidotomy
227
progressive, inherited neurologic disease and involves a lack of neurotransmitter GABA (which causes acetylcholine lvls to drop and dopamine lvls to rise)
Huntington disease (HD)
228
what 3 things does HD affects
personality, intellectual function, and movement
229
constant, jerky, uncontrolled movements of the body that is a characteristic manifestation of HD
chorea
230
death from HD is usually due to what
aspiration pneumonia
231
an acute, progressive inflammation of the peripheral nervous system and often follows a recent viral or bacterial infection
guillain-barre syndrome (GBS)
232
where do the manifestations of GBS
in the lower extremities
233
what are the cataracts that occur from aging
senile cataracts
234
Sense of smell
I, olfactory
235
Vision
II, optic
236
Eye movements
Extraocular muscles
Pupillary control (pupillary constriction)
III, oculomotor
237
Down and inward movement of eye
IV, trochlear
238
Sensations of face, scalp, and teeth
Chewing movements
V, trigeminal
239
Outward movement of eye
VI, abducens
240
Sense of taste on anterior two-thirds of tongue
Contraction of muscles of facial expression
VII, facial
241
Hearing
Sense of balance (equilibrium)
VIII, vestibulocochlear
242
Sensations of throat, taste, swallowing movements, gag reflex
Sense of taste on posterior one third of tongue
Secretion of saliva
IX, glossopharyngeal
243
Sensations of throat, larynx, and thoracic and abdominal organs
Swallowing
Voice production
Slowing of heartbeat
Acceleration of peristalsis
X, vagus
244
Shoulder movements (trapezius muscle)
Turning movements of head (sternocleidomastoid muscles)
XI, accessory
245
Tongue movements
XII, hypoglossal
