Neuro #2 Flashcards
Duchenne’s Muscular Dystrophy
Sex-linked recessive
Post synaptic (MUSCULAR dystrophy)
Atrophy of muscle (dystROPHY)
Poor prognosis
Myasthenia Gravis
-Auto immune
Post-synaptic
Treat with cholinesterase inhibitors
Rapid, high activity muscles affected first (droopy eyes, failure to swallow)
Multiple Sclerosis
Presynaptic Auto-immune Disruption of myelinated tracts Plaques/hardening of myelin Affects only CNS Noted c exacerbations followed by remission
Gullian-barre
Presynaptic
Hypersensitivity disorder
Follows an infection, vaccination, surgical procedure
Affects anterior and posterior nerve root (sensory and motor involvement)
May resolve with treatment
Partial seizures
Least serious
Unilateral
Loss of attention
Sensory/motor defects
Generalized seizures
Bilateral brain areas affected
Convulsive
Petit Mal-/Grand Mal
“Epileptic”
Secondary Seizures
Secondary to metabolic disturbance
- electrolyte imbalance
- drug withdrawal
- trauma
- Strokes
RAS
Reticular Activating System
Your “Consciousness”
White matter tracts
Use caution when conversing around coma patients, RAS may be active
Supratentorial coma
Damage to white matter tracts from tentorioum of midbrain to cortex
DeCORticate posturing
May recover, as white matter can eventually heal
Infratentorial coma
Damage to brain stem below tentorium
Decerebrate posturing
Alteration in breathing patterns
Very poor prognosis
Transient Ischemic Attacks (TIA’s)
Mild ischemic event/ “Mini-stroke”
Issues resolve in less than one hour
Warning: Impending major stroke
Hemorrhagic stroke
Bleeding into brain tissue
Difficult to manage- hard to stop bleeding
Thromobembolic Stroke
- Air (Central line removal)
- Fat (Broken bones)
- Thombus (Atrial Fibrillation)
- Calcium (Dunno)
- Atheromatous plaque (of the carotid artieries)
Penumbral effect caused by _______
Death of neural cells releasing glutamate.
Glutamate stimulates calcium channels
Toxic levels of intracellular calcium ions result in cellular death
Treatment: Calcium channel blockers/glutamate receptor blockers
Nociceptor
Pain Receptor
Pain tract pathway
- Sensory portion of peripheral nerve
- Cross over and ascend contralaterally
- Anterolateral spinothalamic tract
A-delta
Small, well mylenated, sharp pain tract
C-Fiber
Unmylenated tract- dull, aching pain tract
Pain intensity modulators
Enkephalins
Endorphins
-both produce opiate like analgesic effect
Axons
Conduct action potential AWAY from cell body
Dendrites
Conduct action potential TOWARDS cell body
Sensory nerves
AFFERENT- carry info towards CNS
Motor Nerves
EFFERENT- carry info from CNS toward periphery
All motor nerves cross ________
At medula
Hypocalcemia has what effect on neuron excitability
Increased calcium = increased neural excitability
Acetylcholine (Ach)
Most common transmitter
- Excites “nicotinic” receptors
- Inhibits (Hyperpolarizes) “muscarinic” receptors
Cholinesterase
Destroys Acetylcholine
Norepinipherine
Generally excitable
Sympathetic division of autonomic nervous system
Sympathetic nervous system
Fight or flight function
- increase bp/hr
- Increase blood glucose
- Dilate puplis
- Vasoconstriction
Parasympathetic nervous system
Conservation of energy
- slow HR
- Increases gastrointestinal function
- contracts pupil
Gamma Amino Butyric Acid (BABA)
Inhibitory (Hyperpolarization) neurotransmitter
Reflex Arc
Basic functional unit of human nervous system
“Sensory Arm”: dorsal root ganglion of spinal nerves
“Motor Arm”: anterior horn of gray matter of spinal cord
Integrated within gray matter of the spinal cord
Cerebral Cortex
Outer layer of gray matter
‘conscious’ areas of brain
Longitudinal fissure
Divides cerebrum into hemispheres
Precentral gyrus
Primary voluntary motor area
Postcentral gyrus
- pain
- pressure
- touch
- temperature
Damage to Lower Left precentral gyrus results in symptoms including:
loss of motor function on right side of head/face
Diencephalon
Thalamus
Hypothalamus
Optic Nerve
Thalami
Direct info to and from cord tracts and regions
Hypothalamus
thirst
sleep
temperature regulation
ADH
Cerebellum
Voluntary motor activity
Medulla Oblongata
breathing
vasomotor activity
Anterior horn gray matter
Muscle function
Dorsal Column pathway
QUICK and EXACT
-Kinesthetic sensation
-Refined touch/pressure
Cross at medulla
Lateral Spinalthalamic
-Crude touch/pressure
-Pain
-Sexual sensations
-Many synapses = vague sensations
Cross at medulla
Motor Pathway
1) Precentral Gyrus
2) Synapse at anterior horn gray matter of cord
3) Lower motor neuron exits through anterior horn
4) Supply skeletal muscle effector
Damage to lower motor neuron results in ______ paralysis
Flaccid
Damage to upper motor neuron results in ______
Spastic paralysis, due to reflex arcs still being intact
Sympathetic (Automonic) Dysreflexia (Hyperreflexia)
Cord transsections above T-6
Reflexive systemic vasoconstriction (Dangerously high B/P)
-Stimulated by full bladder/bowel, or other stimulation
