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Board Study > Neuro > Flashcards

Neuro Flashcards

1
Q

Astrocytes

A
  • Most abundant glial cell
  • regulate metabolic environment
  • repair neuron after neuronal injury
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2
Q

Ependymal cells

A

Concentrated in roof of 3rd and 4th ventricles & spinal cord

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3
Q

Oligodendrocytes

A

Form myelin sheath in the CNS

Schwann cells form myelin sheath in PNS

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4
Q

Microglia

A

Macrophages - phagocytize neuronal debris

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5
Q

Frontal lobe

A

motor cortex

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6
Q

Parietal lobe

A

somatic sensory

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7
Q

Occipital lobe

A

vision cortex

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8
Q

Temporal lobe

A

auditory

Wernicke’s area - understanding speech
Broca’s area = motor control of speech

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9
Q

Cerebral cortex

A

cognition, sensation, movement

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10
Q

Hippocampus

A

memory and learning

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11
Q

Amygdala

A

emotion, appetite, responds to pain & stressors

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12
Q

Basal ganglia

A

fine control of movement

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13
Q

Diencephalon

A

thalamus & hypothalamus

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14
Q

Thalamus

A

relay station that directs info to cortical structures

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15
Q

Hypothalamus

A

primary neurohumoral organ

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16
Q

Brainstem

A
  • midbrain
  • pons
  • medulla
  • reticular activating system
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17
Q

Midbrain

A

auditory and visual tracts

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18
Q

Pons

A

autonomic integration

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19
Q

Medulla

A

autonomic integration

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20
Q

Reticular Activating System

A

controls consciousness, arousal, and sleep

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21
Q

Cerebellum

A
  • Archiocerebellum
  • Paleocerebellum
  • Neocerebellum
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22
Q

Archeocerebellum

A

maintains equilibrium

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23
Q

Paleocerebellum

A

regulates muscle tone

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24
Q

Neocerebellum

A

coordinates voluntary muscle movement

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25
Q

All cranial nerves are part of the Peripheral Nervous System except…

A

Optic n.

- only CN surrounded by dura

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26
Q

Bell’s palsy results from an injury to which nerve

A

Facial (CN VII)

- ipsilateral facial paralysis

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27
Q

Tic douloureux

A 
Trigeminal neuralgia (CN V)
- excruciating pain in the face
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28
Q

Eye movement is controlled by which cranial nerves?

A

CN III, IV, VI

29
Q

Parasympathetic output is carried out by which cranial nerves?

A

CN III, VII, IX, and X

- vagus is responsible for 75% of all ParaSNS activity

30
Q

Where is CSF located?

A
  • Ventricles ( L lateral, R lateral, 3rd and 4th)
  • Cisterns around the brain
  • Subarachnoid space in the brain and spinal cord
31
Q

Blood Brain Barrier is not present at…

A
  • chemoreceptor trigger zone
  • posterior pituitary gland
  • choroid plexus
  • parts of the hypothalamus
32
Q

CSF volume?

A

150 ml

33
Q

Specific gracvity?

A

1.002-1.009

34
Q

What cells is CSF produced by and at what rate?

A
  • ependymal cells of choroid plexus

- rate of 30 ml/hr

35
Q

Choroid plexus is located in what cerebral ventricles?

A

All 4

36
Q

CSF pressure?

A

5-15 mmHg

37
Q

How is CSF reabsorbed into the venous circulation?

A

via arachnoid villia in the superior sagittal sinus

38
Q

Global cerebral blood flow

A

45-55 mL/100g tissue/min

- 15% of CO

39
Q

Cortical cerebral blood flow

A

75-80 mL/100g tissue/min

40
Q

Subcortical cerebral blood flow

A

20 mL/100g tissue/min

41
Q

Cerebral Perfusion Pressure autoregulation is abolished by?

A
  • intracranial tumor
  • head trauma
  • volatile anesthetics
42
Q

5 determinants of cerebral blood flow

A
  • cerebral metabolic rate for oxygen
  • cerebral perfusion pressure
  • venous pressure
  • PaCO2
  • PaO2
43
Q

Conditions that impair cerebral venous drainage

A
  • jugular compression r/t improper head position
  • inc. intrathoracic pressure r/t coughing or PEEP
  • vena cava thrombosis
  • vena cava syndrome
44
Q

For every 1 mmHg inc or dec in PaCO2, CBF will inc or dec by what?

A

1-2 mL/100g brain tissue/min

45
Q

Cerebral max vasodilation and vasoconstriction occur at what PaCO2 levels?

A

vasodilation: PaCO2 = 80-100 mmHg
vasoconstriction: PaCO2 = 25 mmHg

46
Q

Does metabolic acidosis affect CBF?

A

No - because H+ does not pass through the BBB

  • only respiratory acidosis affects CBF
47
Q

How does PaO2 affect CBF?

A
  • PaO2 < 50-60mmHg causes vasodilation and inc CBF

- PaO2 > 60mmHg does NOT affect CBF

48
Q

Grey Matter

A
  • contains neuronal bodies

- processes afferent signals from periphery

49
Q

Laminae I-VI

A
  • dorsal grey matter

- sensory

50
Q

Laminae VII-IX

A
  • ventral grey matter

- motor

51
Q

Grey matter is larger in two regions of the spinal cord

A
  • C5-C7 (houses cell bodies for neurons that supply upper extremities)
  • L3-S2 (houses cell bodies for neurons that supply lower extremities)
52
Q

White Matter

A
  • contains axons of ascending and descending tracts

- divided in dorsal, later, ventral columns

53
Q

Tracts

A

group of fibers inside white matter in the CNS that relay information up or down the spinal cord

54
Q

Dorsal column - medial lemniscal system

A
  • transmits mechanoreceptive sensations - fine touch, proprioception, vibration, pressure (fine degree of intensity)
  • transmits sensory info faster than anterolateral system
  • ascends spinal cord on ipsilateral side
  • crosses contralateral side in the medulla and ascends towards thalamus (via medial lemniscus)
  • ends in cerebral cortex (postcentral gyrus - parietal lobe)
55
Q

Anterolateral system - spinothalmic tract

A
  • transmits pain, temp, crude touch, tickle, itch, sexual sensation
  • may ascend 1-3 levels on ipsilateral side via lissauer tract
  • pain neurons synapse in substantia gelatinosa (laminae I and II)
  • crosses contralateral side and ascends via anterior spinothalmic tract and lateral spinothalmic tract
  • most tactile signals are relayed to the thalamus and advance towards somatosensory cortex in the postcentral gyrus - parietal lobe
  • most pain fibers synapse in the RAS and are then connected to the thalamus
56
Q

Corticospinal tract

A

“pyramidal tract” - pyramids are formed by neurons as they run through the medulla
- motor neurons exit precentral gyrus of frontal lobe

57
Q

Lateral Corticospinal Tract

A
  • fibers innervate limbs
  • cross to contralateral side in medulla
  • descend via spinal cord via lateral corticospinal tract
58
Q

Ventral Corticospinal Tract

A
  • fibers innervate axial muscles
  • remain on ipsilateral side as they descend via ventral corticospinal tract
  • most fibers crossover to contralateral side of spinal cord when they reach the cervical or upper thoracic area
59
Q

Upper Motor Neuron

A
  • begin in cerebral cortex and end in the ventral horn
60
Q

Lower Motor Neuron

A
  • begin in ventral horn and end at NMJ
61
Q

Upper Motor Neuron Injury

A
  • injury above level of decussation in the medulla, paralysis will be on opposite side
  • injury below level of decussation in the medulla, paralysis will be on the same side
  • manifests as hyperreflexia and spastic paralysis
  • Ex upper motor neuron dz: cerebal palsy, ALS
62
Q

Babinski Sign

A
  • tests integrity of corticospinal tract
  • Normal response: firm stimulus to underside of foot produces downward motion of all toes
  • Damage: upward extension of big toe and fanning of others
63
Q

Lower Motor Neuron Injury

A
  • peripheral motor fibers link spinal cord to a muscle
  • injury results in paralysis on the same side as injury
  • manifests as impaired reflexes and flaccid paralysis
  • Babinski sign is absent in lower motor neuron injury
64
Q

Neurogenic Shock

A
  • hypotension, bradycardia, hypothermia
  • pink, warm extremities
  • can last 1-3 wks
65
Q

Autonomic Hyperreflexia

A
  • 85% of pts w/injury above T6
  • presentation: HTN and bradycardia
  • profound vasoconstriction below level of injury
  • activates baroreceptor in carotid bodies & dec HR
  • body attempts to dec afterload w/vasodilation above the injury
66
Q

Amyotrophic Lateral Sclerosis

A
  • progressive degeneration of motor neurons in corcticospinal tract
  • affects upper & lower motor neurons
67
Q

ALS Signs and Symptoms

A
  • upper neuron involvement: spasticity, hyperreflexia, loss of coordination
  • begins in hands and spreads to rest of body
  • ocular muscles not affects
  • sensation remains intact
  • resp failure = most common cause of death
  • autonomic dysfxn = orthostatic hypotension & resting tachycardia
68
Q

ALS Management

A
  • Succs can cause lethal hyperkalemia (lower motor neuron dysfxn is associated w/proliferation of postjunctional nicotinic receptors)
  • Inc. sensitivity to NDNMB
  • bulbar muscle dysfxn and inc. risk pulm aspiration
  • chest weakness dec. vital capacity and max min. ventilation
  • consider post-op ventilation

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