Neuro Anatomy & Assessment CE Flashcards
Protective covering of brain and spinal cord is called:
Meninges
Name types of meninges and relative location:
Dura mater (just below skull, tough mother); arachnoid mater; pia mater (comforting mother directly on brain)
falx cerebri
named from its sickle-like form, is a strong, arched fold of dura mater that descends vertically in the longitudinal fissure between the cerebral hemispheres
tentorium cerebelli
an extension of the dura mater that separates the cerebellum from the inferior portion of the occipital lobes
Name the 3 potential neurological spaces
Epidural; subdural; subarachnoid
sulcus (sulci)
depression or fissure in the surface of the brain
gyrus (gyri)
a ridge on the cerebral cortex generally surrounded by one or more sulci (depressions or furrows)
Name the 4 lobes of the brain
frontal; temporal; occipital; parietal
diencephalon responsible for:
autonomic visceral activities
diencephalon made up of:
the thalamus, the subthalamus, the hypothalamus and the epithalamus (and pituitary)
brain stem includes (3 structures):
medulla oblongata (myelencephalon), pons (part of metencephalon), and midbrain (mesencephalon)
brain stem responsible for:
main motor and sensory innervation to the face and neck via the cranial nerves
midbrain responsible for:
vision, hearing, motor control, sleep/wake, arousal (alertness), and temperature regulation
medulla (oblongota) responsible for:
lower half of the brainstem; cardiac, respiratory, vomiting and vasomotor centers and deals with autonomic, involuntary functions, such as breathing, heart rate and blood pressure
pons is latin for:
bridge
pons responsible for:
white matter that includes tracts that conduct signals from the cerebrum down to the cerebellum and medulla, and tracts that carry the sensory signals up into the thalamus
pons location
cranial to the medulla oblongata, caudal to the midbrain, and ventral to the cerebellum
cerebellum latin for:
little brain
cerebellum responsible for:
motor control
How much CSF produced daily
500mL
Standard constant vol of CSF is:
120-150mL
Pressure range of CSF:
75-180 mm/H2O
Abnormal accumulation of CSF is:
hydrocephalus
Most common cause of hydrocephalus:
CSF flow obstruction - hindering the free passage of cerebrospinal fluid through the ventricular system and subarachnoid space
communicating hydrocephalus
impaired cerebrospinal fluid resorption in the absence of any CSF-flow obstruction between the ventricles and subarachnoid space
non-communicating hydrocephalus
CSF-flow obstruction ultimately preventing CSF from flowing into the subarachnoid space (either due to external compression or intraventricular mass lesions)
CSF produced in the:
choroid plexus
CSF absorbed in the:
across the arachnoid villi into the venous circulation
Circle of Willis is:
a circle of arteries that supply blood to the brain (considerable anatomic variation exists)
Circle of Willis significant because:
if one artery blocked, others can feed into the circle and thus the rest of the brain without symptoms
What percentage of cardiac output is directed to cerebral blood flow?
15-20%
Most likely location for aneurysm or subarachnoid bleed:
Circle of Willis
Aphasia is:
inability to communicate
loss of the ability to produce language:
expressive aphasia (Broca’s aphasia)
inability to understand, but able to speak:
receptive aphasia (Wernicke’s or sensory aphasia)
Inability to recognize familiar objects (i.e. visual, auditory, or tactile)
agnosia
Inability to do simple tasks (i.e. brush teeth or hair)
apraxia
loss of intellectual abilities or cognitive function
dementia
Grading motor ability on scale of:
0 to 5
Motor ability grade 0
No movement
Motor ability grade 1
Flicker of contraction
Motor ability grade 2
Movement without gravity
Motor ability grade 3
Movement against gravity
Motor ability grade 4
Movement against resistance
Motor ability grade 5
Full strength movement
dermatome landmark: shoulder
C5
dermatome landmark: thumb
C6
dermatome landmark: little finger
C8/T1
dermatome landmark: nipple line
T4
dermatome landmark: umbilicus
T10
dermatome landmark: groin
T12
dermatome landmark: knee
L3
dermatome landmark: foot
L5
Number and types of vertebrae:
Approx 33 total: C7, T12, L5, S5 (fused), C3-5 (fused)
Move ____ to ____ during neuro exam.
Head to foot.
Brown-Séquard syndrome is:
Loss pain/temp sensation on 1 side body; loss of motor on other side.
Brown-Séquard syndrome (hemiplegia) caused by:
lateral hemisection of spinal cord
anterior cord syndrome is:
loss of mvmt and pain sensation while retaining proprioception and vibratory sensation
proprioception
sense of the relative position of neighbouring parts of the body and strength of effort being employed in movement
exteroception
one perceives the outside world
interoception
one perceives pain, hunger, etc., and the movement of internal organs
Early Signs ICP (name 5)
LOC changes subtly (reassess if GCS dec by 2 or more); Headache (increasing intensity and/or not relieved); Facial Palsy; Pupil changes; Vomiting
Late Signs ICP
Posturing (flexion or extension); Cushing’s Triad (Vital Signs - BP, RR; HR); Abnormal respirations; Pahologic or loss of protective reflexes
Why is INITIAL GCS SUPER IMPORTANT!!?
Influences treatment decisions and guides recovery predictions
Stroke sole of foot and toes spread (normal up to age 2) = ? reflex
Babinski Reflex
Put fingers pt palm -> pt grab fingers
Grab reflex: Not indication of improvement. “Squeeze my hand twice.”
thigh is bent at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance)
Kernig’s Sign (meningitis)
Forced flexion of the neck elicits a reflex flexion of the hips (knees draw up)
Brudzinski’s Sign ( meningitis, subarachnoid haemorrhage and possibly encephalitis)
Level of consciousness triggered by ?
Reticular Activating System (RAS) - responsible for regulating arousal and sleep-wake transitions
Levels of mental alertness (RAS?)
Confusion; Lethargy; Obtundation; Stupor; Coma
Obtundation
less than full mental capacity in pt, typically result of a med condition or trauma. (obtund = dulled or less sharp)
Stupor
lack of critical cognitive function and LOC wherein sufferer almost entirely unresponsive (responds to base stimuli i.e. pain)
Progression of neurological compromise
Lose Reflex, then Sensory, then Motor
Doll’s Eyes also called:
Oculocephalic Reflex or the Vestibulo-ocular Reflex
Doll’s Eyes indicates what?
Intact brain stem
Cold Calorics / Caloric Reflex Test
test of the vestibulo-ocular reflex; can be used to test for brain stem death; cold water in ear and eyes turn toward that ear (conscious pt’s can puke)
