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NPTE exam > Neuro > Flashcards

Neuro Flashcards

1
Q

Frontal lobe

A
  • precentral gyrus (primary motor cortex, voluntary muscle)
  • prefrontal cortex (emotions and judgment)
  • Broca’s area (motor of speech)
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2
Q

Parietal lobe

A
  • postcentral gyrus (primary sensory cortex

- receives touch, proprioception, pain, temp, from opposite side of body

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3
Q

Temporal lobe

A
  • primary auditory cortex (receives/processes auditory)

- Wernicke’s area - language comprehension

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4
Q

Occipital lobe

A

-primary visual cortex (receives/processes vision)

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5
Q

Insula

A
  • deep in lateral sulcus

- visceral functions

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6
Q

Limbic systems

A
  • instincts and emotions for preservation of individual

- feeding, aggression, emotions, sexual response

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7
Q

Basal ganglia parts

A
  • gray matter deep in cerebral hemispheres
  • striatum
  • globus pallidus
  • substantia nigra
  • lenticular nucleus= putamen and globus pallidus
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8
Q

Basal ganglia circuits

A
  • oculomotor circuit, saccadic eye movements
  • Motor loop= scale amplitude and velocity of movements, reinforces selected patterns, suppresses conflicting patterns, preparatory for movement
  • limbic circuit=organize behaviors, executive functions
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9
Q

Thalamus

A
  • sensory nuclei=integrate and relay sensory info from body, face, retina, cochlea, taste to cerebral cortex
  • Motor nuclei= relay motor info from cerebellum and globus pallidus to precentral motor cortex
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10
Q

Subthalamus

A

-several functional pathways for sensory, motor, and reticular function

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11
Q

Hypothalamus

A
  • integrates and controls ANS and neuroendicrine system

- maintains homeostasis

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12
Q

Epithalamus

A
  • integrates olfactory, visceral, and somatic pathways

- pineal gland secrets hormones

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13
Q

Midbrain parts

A
  • connects pons to cerebrum
  • tegmentum
  • Substantia
  • superior colliculus
  • periaqueductal gray
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14
Q

Tegmentum

A
  • contains all ascending and descending tracts

- important for coordination

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15
Q

Substantia nigra

A
  • large motor nucleus, connects basal ganglia and cortex

- important for motor control and muscle tone

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16
Q

Superior/inferior colliculus

A
  • superior= relay station for vision and visual reflexes

- inferior= relay station for hearing and auditory reflexes

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17
Q

Pons

A

-connects medulla oblongata to midbrain for passage of ascending/descending tracts

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18
Q

Medulla oblongata

A
  • connects spinal cord w/ pons
  • corticospinal tracts cross in pyramids
  • control of head movements and gaze stabilization (VOR)
  • contains centers for vital functions (cardiac, respiratory, vasomotor)
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19
Q

Cerebellum

A
  • equilibrium and regulation of muscle tone, coordinates VOR
  • anterior lobe receives input from proprioception, modifies muscle tone and synergistic actions of muscles
  • maintenance of posture and voluntary movements
  • smooth coordination, accurate force, direction, extent of movement
  • motor learning, sequencing
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20
Q

Central gray metter

A

anterior horns = efferent motor neurons

posterior horns = afferent sensory neurons

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21
Q

Dorsal columns/medial lemniscal system

A
  • located posteriorly, UE more lateral, LE medial,

- convey proprioception, vibration, and tactile discrimination

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22
Q

Spinothalamic tracts

A
  • located anterolaterally
  • lateral spinothalamic= pain and temp
  • anterior spinothalamic = crude touch
  • ascend 1-2 levels then cross in SC
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23
Q

Spinocerebellar

A
  • located most laterally

- proprioception from muscle spindles, GTOs and touch receptors to cerebellum for voluntary control of movement

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24
Q

Spinoreticular

A

deep and chronic pain

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25
Q

Corticospinal tract

A
  • cross in pyramidal decussation of medulla
  • voluntary movement control
  • lateral tract = cervical is medial, sacral is lateral
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26
Q

Vestibulospinal tract

A

-control of muscle tone, antigravity muscles and postural reflexes

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27
Q

Rubrospinal tract

A

-sensation especially pain

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28
Q

Tectospinal

A

head turning responses to stimuli

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29
Q

Sympathetic ANS

A
  • thoracolumbar divison T1-L2
  • prepares body for fight of flight
  • increases HR and BP
  • constricts peripheral blood vessels
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30
Q

Parasympathetic ANS

A

craniosacral division, CN 3, 5, 9, 10

  • decreases BP and HR
  • increases peristalsis
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31
Q

Meninges

A
  • dura mater
  • arachnoid mater (delicate vascular membrane
  • pia mater (thin vascular membrane, covers brains surface)
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32
Q

Subarachnoid space

A
  • contains CSF and major arteries

- between arachnoid mater and pia mater

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33
Q

Cerebrospinal fluid

A
  • provides mechanical support (cushion)
  • controls brain excitability
  • aids in exchange of nutrients and waste products
34
Q

Carotid system

A
  • internal carotid arteries arise from common carotids
  • branch to form ACA and MCA
  • supply large area of brain and deep structures
35
Q

Vertebrobasilar system

A
  • vertebral arteries arise from subclavian artery and forms basilar artery
  • this branches into to PCAs
  • supplies brainstem, cerebellum, occipital lobe, parts of thalamus
36
Q

Circle of Willis

A
  • formed by anterior communicating artery

- connects two ACAs and PCA

37
Q

“A” nerve fibers

A
  • large myelinated, fast
  • alpha= proprioception, somatic motor
  • beta= touch, pressure
  • Gamma= motor to m spindles
  • Delta= pain, temperature, touch
38
Q

“B” nerve fibers

A

-small myelinated

39
Q

“C” nerve fibers

A

smallest unmyelinated fibers, slowest conducting

40
Q

CN I Olfactory

A
  • smell

- test sense of smell each nostril

41
Q

CN II Optic

A
  • Vision

- test visual acuity and peripheral vision

42
Q

CN III Oculomotor

A
  • pupillary reflex, accommodation, convergence
  • turns eye up, down, in
  • elevates eyelid
  • shine light in eye,
  • pupils move medially when viewing object close range
43
Q

CN IV Trochlear

A

-turns adducted eye down

44
Q

CN V Trigeminal

A
  • sensory to face and cornea
  • motor to temporal and masseter muscles
  • test pain and light touch to forehead, cheeks, jaw
45
Q

CN VI Abducens

A

-Turns eye out

46
Q

CN VII Facial

A
  • Facial expression (smile, frown, show teeth)

- sensory to anterior 2/3 of tongue

47
Q

CN VIII Vestibulocochlear

A

-vestibular function, VOR, cochlear function

48
Q

CN IX Glossopharyngeal

A
  • sensory to posterior 1/3 tongue taste, pharynx, middle ear
  • phonation
  • swallowing
  • palatal, pharynx control
  • gag reflex
49
Q

CN X Vagus

A
  • Phonation, swallowing

- palatal pharynx control, gag reflex

50
Q

CN XI Accessory

A
  • trapezius innervation

- Sternocleidomastoid innervation

51
Q

CN XII hypoglossal nerve

A

Tongue movements

52
Q

Myotatic stretch reflex

A
  • stimulus= muscle stretch
  • Afferent fibers from muscle spindles to alpha motor neurons then back to muscle
  • maintains muscle tone, agonist contraction, muscle length info
  • DTRs
53
Q

Inverse stretch reflex

A
  • stimulus= muscle contraction
  • afferent fibers from GTOs via inhibitory interneuron
  • agonist inhibition, diminution of agonist force, protection
54
Q

Obtundation LoC

A

pt opens eyes

  • responds slowly and confused
  • decreased alertness and interest in environment
55
Q

Stupor LoC

A
  • aroused from sleep w/ painful stimuli

- returns to unresponsive state w/o stimuli

56
Q

Glasgow Coma Scale scores

A
  • eye opening, motor response, verbal response scores 3-15
  • Severe brain injury 1-8
  • Moderate brain injury 9-12
  • minor brain injury 13-15
57
Q

Mini-Mental State Exam

A
  • brief screening for cognitive dysfunction, orientation, registration, attention, recall, language
  • Max score is 30
  • Mild cognitive impairment 21-24
  • Moderate cognitive impairment 16-20
  • Severe impairment 15 or less
58
Q

Rancho Los Amigos LoC

A
  • No response I
  • decreased response II, III
  • Confused levels IV-VI
  • Appropriate VII, VIII
59
Q

Nonfluent aphasia

A
  • Broca’s motor aphasia, expressive aphasia,

- speech is awkward, restricted, interrupted, requires effort

60
Q

Verbal apraxia

A

impairment of volitional articulatory control

61
Q

Dysarthria

A
  • impairment of speech production

- weakness, paralysis, incoordination of motor speech system

62
Q

Fluent aphasia

A
  • Wernicke’s aphasia, receptive aphasia
  • spontaneous speech is preserved and smooth flowing
  • auditory comprehension is impaired
63
Q

Kernig’s sign

A
  • supine, flex hip and knee to chest then extend knee

- if pain and increased resistance bilaterally, may suggest meningeal irritation

64
Q

Brudzinski’s sign

A
  • supine, flex neck to chest

- if flexion of hips and knees, suggests meningeal irritation

65
Q

Homonymous hemianopsia

A
  • loss of half of visual field in each eye

- contralateral to side of cerebral hemisphere lesion

66
Q

Anosognosia

A

severe denial, neglect, or lack of awareness of severity of condition

67
Q

Figure-ground discrimination

A

have pt pick out object from array of objects

68
Q

Form constancy

A
  • pt pick out object from array of similar object

- large blocks from group of blocks

69
Q

Agnosia

A

-inability to recognize familiar objects w/ one sense while retaining ability to recognize same object with other sense

70
Q

Apraxia

A

inability to perform voluntary learned movements in absence of loss of strength, sensation or others

  • ideomotor apraxia, pt can’t perform task on command but can on own
  • ideational apraxia, pt cant perform task at all
71
Q

When is flaccidity seen?

A
  • LMN lesions

- initially after UMN lesions (spinal/cerebral shock)

72
Q

When is spasticity seen?

A

UMN lesions

73
Q

Babinski response

A
  • DF of great toe w/ fanning of other toes after stroking up lateral side of sole foot
  • indicative of corticospinal tract damage
74
Q

Modified ashworth scale

A

0-4 (w/ 1+)

-measures spasticity

75
Q

Normal CSF

A
  • volume 90-150 mL
  • Pressure 90-180 mm H2O
  • Protein 15-45 mg/dL
76
Q

ACA supplies…

A

anterior 2/3 of medial cerebral cortex

77
Q

MCA supplies…

A
  • lateral cerebral cortex
  • basal ganglia
  • internal capsule
78
Q

PCA supplies…

A
  • temporal lobe
  • posterior 1/3 of cerebral cortex
  • midbrain
  • diencephalon
79
Q

Vertebral artery supplies…

A
  • ventral medulla

- posterior cerebellum

80
Q

Basilar artery supplies …

A

ventral pons

81
Q

Pts with left hemisphere lesions are…

A

slow, cautions, hesitant, insecure

  • develop appropriate communication
  • dont underestimate ability to learn
82
Q

Pts with right hemisphere lesions are

A

impulsive, quick, indifferent

  • poor judgement and safety, overestimate abilities
  • use verbal cues, demos
  • focus on slowing down and safety

NPTE exam (7 decks)

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