Neuro Function Flashcards
1
Q
What is the function of the nervous system?
A
Receives and reacts to environment stimuli on a physiologic and cognitive level
2
Q
What are the three components of the nervous system?
A
- Brain
- Spinal cord
- Nerves
3
Q
Which parts of the nervous system are a part of the CNS (central nervous system)?
A
Brain and spinal cord
4
Q
Which part of the nervous system is part of the PNS (peripheral nervous system)?
A
Nerves
5
Q
What are the membranes that encase the CNS
A
Meninges
6
Q
This is the outer and toughest layer of meninges
A
Dura mater
7
Q
This is the middle layer of meninges and has a spider web-like vascular system
A
Arachnoid layer
8
Q
This is the innermost layer of the meninges
A
Pia mater
9
Q
Plasma-like liquid that fills the space between the arachnoid and the pia mater layers to provide additional cushion and support
A
Cerebrospinal fluid
10
Q
Interconnected, hollow areas of the brain where CSF is produced, fills, and flows
A
Ventricles
11
Q
Which cells provide support in the brain
A
Neuroglia cells
12
Q
What is the function of neuroglia cells
A
They scaffold neural tissue, isolate, and protect neuron cell membranes, regulate interstitial fluid, defend the neuron against pathogens, and assist with neural repair
13
Q
These cells:
- Generate and transmit bioelectrical impulses
- Do not have the ability to divide
- Losses due to aging or injury cannot be replaced
- Not all cell death results in loss of functioning
- Undamaged cells in the brain will assume functions of damaged cells
- Severed peripheral nerves can regenerate to a point to reestablish connections
A
Neurons
14
Q
What do severed spinal cord nerves result in?
A
Paralysis and loss of sensation below the area of damage
15
Q
These cells require a constant oxygen and glucose supply, making them vulnerable to hypoxia and hypoglycemia
A
Neurons
16
Q
Projections that transmit impulses away from the cell body
A
Axons
17
Q
Projections that transmit impulses toward the cell body
A
Dendrites
18
Q
Tiny bulges at the end of the axon that communicate with neurons, muscle fibers, or glands
A
Terminal boutons
19
Q
Surrounds some axons and increases the rate of impulse transmission
A
Myelin
20
Q
Produce the myelin sheaths
A
Schwann cells
21
Q
Sites of nutrition exchange where myelin is not present
A
Nodes of Ranvier
22
Q
Bundles of myelinated nerves
A
White matter
23
Q
The gap between the neurons
A
Synapse
24
Q
Space between the neurons in the synapse
A
Synaptic cleft
25
Opposite end to the presynaptic terminal
Postsynaptic cell membrane
26
What are neural impulses generated by?
Small ionic changes
27
The ability to create a charge
Action potential
28
Charging at rest
Resting potential
29
Why does the plasma side of the neuron membrane have a slight charge at rest, or resting potential
Because of the sodium ions concentrated on the outside of the cell
30
What is it called when protein gates open and sodium flows into the cell, increasing the charge
Depolarization
31
This is the largest region of the brain and controls the higher thought processes
Cerebrum
32
Folds that increase the surface area
Gyri
33
Grooves between the gyri
Sulci
34
This lobe facilitates voluntary motor activity and plays a role in personality traits
Frontal lobe
35
This lobe receives and interprets sensory input with the exception of smell, hearing, and vision
Parietal lobe
36
This lobe processes visual information
Occipital lobe
37
This lobe is essential for hearing and memory
Temporal lobe
38
This area within and across the lobes stimulates muscle activity
Motor
39
This area within and across the lobes receives sensory information
Sensory
40
This area within and across the lobes integrates information and initiates coordinated responses
Association
41
Receives and relays most of the sensory input, affects mood, and initiates body movements
Thalamus
42
Functions of this in the diencephalon are unclear
Epithalamus
43
The most inferior portion of the diencephalon and regulates many bodily functions
Hypothalamus
44
This collaborates with the hypothalamus to regulate vital activities
Brain stem
45
This area of the brain contains nerves that regulate sleep and breathing
Pons
46
This is the smallest region of the brain and acts as a relay station for auditory and visual information and controls the visual and auditory systems as well as eye movement
Midbrain
47
This area of the brain is a conduction pathway for ascending and descending nerve tracts that coordinates heart rate, peripheral vascular resistance, breathing, swallowing, vomiting, coughing, and sneezing
Medulla
48
Lies deep within the cerebrum, diencephalon, and midbrain and plays a pivotal role in coordination, motor movement, and posture
Basal ganglia
49
This system includes portions of the cerebrum and diencephalon and works in conjunction with the hypothalamus to influence instinctive behavior, emotions, motivation, mood, pain, and pleasure
Limbic system
50
Where does the spinal cord exit from the skull?
Foramen magnum
51
At L2, the spinal cord transitions into individual nerve roots called what?
Cauda equina
52
How many pairs of spinal nerves branch off at regular intervals in the spinal cord?
31 pairs
53
Which fibers in the spinal cord carry sensory information in the form of action potentials from the periphery back to the brain
Ascending fibers, or afferent tracts
54
Which fibers in the spinal cord carry motor impulses in the form of action potentials from the brain to the fibers of the PNS
Descending fibers or efferent tracts
55
Process within the spinal cord that creates an unconscious response to stimuli
Spinal reflex arcs
56
Withdrawal reflex in response to touching an unpleasant stimulus; causes the muscles of a limb to withdraw the limb from the source of the stimulus without any conscious action
Flexor reflex
57
Several nerves intersecting to form an organized collaboration
Plexus
58
This controls smooth muscles and the unconscious response that affects such activities as heart rate, blood pressure, and intestinal motility
Autonomic Nervous System
59
Which two subdivisions of the autonomic nervous system have an antagonistic effect with each other to aid in maintaining homeostasis
Sympathetic and parasympathetic nervous systems
60
This system is responsible for the fight or flight response and is augmented by secretions of the adrenal medulla; stimulates the adrenergic receptors
Sympathetic nervous system
61
This system is responsible for the rest and digest response; stimulates the cholinergic receptors
Parasympathetic nervous system
62
This is caused by localized conditions such as trauma, compression, or infections that affect a single spinal nerve, plexus, or peripheral nerve trunk
For example: fractured bones may lacerate or compress nerves; Excessively tight tourniquets; infections such as herpes zoster may affect a single segmental afferent nerve distribution
Mononeuropathy
63
This involves demyelination or axonal degeneration of multiple peripheral nerves that leads to symmetric sensory, motor, or mixed sensorimotor deficits.
Typically, the longest axons are involved first - symptoms begin in the distal part of the extremities
Polyneuropathy
64
- Common condition of excess CSF accumulation within the skull
- Ventricles dilate and the brain and blood vessels become compressed
- Pressure thins the cortex, causing severe brain damage
Hydrocephalus
65
This cause of hydrocephalus is due to CSF flow disruption
Non-communicating or an obstructive hydrocephalus
66
This cause of hydrocephalus occurs when CSF is not properly absorbed by the bloodstream
Communicating hydrocephalus
67
- Most common neural tube birth defect in the US
- Can vary in severity from mild to debilitating and the cause is unknown
- The posterior spinous processes on the vertebrae fail to fuse, leading the meninges and spinal cord to herniate
- The lumbar area of the vertebrae is most commonly the site
- Most common in Caucasian and Hispanic populations
Spina Bifida
68
- A group of non-progressive disorders that appear in infancy or early childhood and permanently affect motor movement and muscle coordination
- Usually damage to the cerebellum during the prenatal period (often during childbirth) but can occur any time during the first three years of life when the brain is developing
- Can also occur because of brain abnormalities
- More common in males, African Americans, and persons of lower socioeconomic status
Cerebral Palsy
69
- Inflammation of the meninges and subarachnoid space, usually resulting from an infection
- CSF may also become affected
- Causes include bacteria, viruses, tumors, and allergens
- Infection or irritant triggers the inflammatory process, leading to swelling of the meninges and increased ICP
- Risk factors: younger than 25, living in a community setting, pregnancy, working with animals, immunodeficiency
Meningitis
70
This form of meningitis can be difficult to spot and progresses fast, can lead to sepsis which may result in limb loss/death, is diagnosed by a lumbar puncture and treated with antibiotics, and is globally the second biggest infectious killer of children under 5
Bacterial meningitis
71
This form of meningitis has no method of prevention and is more common, does not lead to sepsis, most people recover without needing medical treatment, and can lead to non-visible after effects like depression and headaches
Viral meningitis
72
- Infection of the parenchyma of the brain or spinal cord
- Progressive degeneration of the nerve cell bodies and diffuse brain destruction
- Prominent edema
- Types: bacterial, fungal, viral (Herpes simplex, West Nile Virus)
Encephalitis
73
What are the different types of transmission of encephalitis?
- Ingestion
- Mosquito
- Rabid animal
74
What are the common pathways of brain damage?
- The effects of ischemia
- Excitatory amino acid injury (interruption of excretion in these chemicals)
- Cerebral edema
- Direct injury
- Injury due to increased intracranial pressure (ICP)
75
What are the conditions that cause injury to the brain?
- Trauma
- Tumors
- Stroke
- Metabolic derangements
- Degenerative disorders
76
Which level of consciousness is characterized by activeness and responsive
Alertness (Alert)
77
Which level of consciousness is characterized by sluggish and apathetic
Lethargy (Lethargic)
78
Which level of consciousness is characterized by sleepiness and drowsy
Somnolence (Somnolent)
79
Which level of consciousness is characterized a slows to respond to stimuli and reduced alertness
Obtundation (Obtunded)
80
Which level of consciousness is described as unresponsive and no spontaneous movement
Stupor (Stuporous)
81
This level of consciousness involves being unconscious
Coma (Comatose)
82
What are the earliest signs of deteriorating level of consciousness
Inattention, mild confusion, disorientation, and blunted responsiveness
83
What are the signs of deteriorating level of consciousness that occur with further deterioration
- Person becomes markedly inattentive and variable lethargic or agitated
- Person may progress to become obtunded and may respond only to vigorous or noxious stimuli
84
- This is a common pathway for brain injury
- Can obstruct cerebral blood flow, destroy brain cells, displace brain tissue, and damage delicate brain structures
Intracranial Pressure (ICP)
85
What makes up the cranial cavity?
10% blood, 80% brain tissue, and 10% CSF
86
What is the normal ICP level?
0 to 15 mm Hg
87
This type of posturing that occurs with increased ICP is characterized by the arms shaped like "C" because they move in towards the "cord"
Problems with the cervical spinal tract or cerebral hemisphere occur
Decorticate (Flexor)
88
This type of posturing that occurs with increased ICP is characterized by arms that look like "e"
Problems within midbrain or pons
Decerebrate (Extensor)
89
This is due to increased intracranial pressure and causes hypertension, bradycardia, and diminished respiratory effort
Cushing's Reflex
90
The three primary signs that often indicate an increase in intracranial pressure is known as
Cushing's Triad (increased BP, Decrease in pulse, and Decrease in respiration)
91
This type of brain injury occurs from damage caused by an impact (blunt or penetrating) and includes diffuse axonal injury and the focal lesions of laceration, confusion, and hemorrhage
Primary or Direct Injuries
92
This type of brain injury occurs from damages resulting from the subsequent brain swelling, infection, and cerebral hypoxia.
Often diffuse or multifocal, including concussion, infection, and hypoxic brain injury
Secondary Injuries
93
Direct contusion of the brain at the site of external force
Coup
94
Rebound injury on the opposite side of the brain
Countercoup
95
An immediate and transient loss of consciousness accompanied by a brief period of amnesia after a blow to the head
Concussion
96
This type of hematoma is usually caused by head injury in which the skull is fractured and develops between the inner table of the bones of the skull and the dura - can be arterial or venous
Epidural hematoma
97
This type of hematoma is usually the result of a tear in the small bridging veins that connect veins on the surface of the cortex to dural sinuses and develops in the area between the dura and the arachnoid - often venous
Subdural hematoma
98
This type of hematoma is due to bleeding between arachnoid and pia mater. Can cause sudden "thunder-clap" headache that doesn't feel like normal HA and doesn't improve with normal treatments - often arterial
Subarachnoid hemorrhage
99
- Damage to the neural elements of the spinal cord
- Involve damage to the vertebral column and/or supporting ligaments as well as the spinal cord
- Commonly involve both sensory and motor function
Spinal Cord Injury (SCI)
100
A slight misalignment of the vertebrae, regarded in chiropractic theory as the cause of many health problems (slight dislocation)
Subluxations
101
Which areas are affected by SCI?
- Spinal reflexes
- Ventilation and communication
- Autonomic nervous system
- Temperature regulation
- Edema and deep vein thrombosis
- Sensorimotor function
102
What are the structures supplying blood flow to the brain?
- Two internal carotid arteries anteriorly (Ophthalmic, posterior communicating, anterior choroidal, anterior cerebral, and middle cerebral)
- Vertebral arteries posteriorly
- Internal carotid and vertebral arteries communicate at the base of the brain through the circle of Wilis
103
A temporary episode of cerebral ischemia that results in symptoms of neurologic deficits
Also called mini-strokes because these neurologic deficits mimic a cerebrovascular accident (CVA) or stroke except that these deficits resolve within 24 hours
Transient Ischemic Attack
104
What are the signs of a stroke?
- Balance: loss of balance, headache or dizziness
- Eyes: blurred vision
- Face: one side of the face is drooping
- Arms: arm or leg weakness
- Speech: speech difficulty
- Time: time to call for ambulance immediately
105
Who has a higher risk of stroke?
Women - 1 in 5 women in the US will have a stroke
106
What are some preventions for stroke?
- Keep BP low
- Eat healthy
- Manage diabetes
- Stop smoking
- Lower cholesterol
- Exercise regularly
- Limit alcohol
- Avoid stress
- Maintain a healthy weight
107
This type of stroke is caused by an interruption of blood flow in a cerebral vessel and are the most common type of strokes, accounting for 70% to 80% of all strokes.
Ischemic Strokes
108
This type of stroke is caused by bleeding into brain tissue usually from a blood vessel rupture caused by hypertension, aneurysms, arteriovenous malformations, head injury, or blood dyscrasias
Hemorrhagic Strokes
109
This type of stroke is caused by an interruption of cerebral blood supply - ischemic damage is permanent
Risk factors include:
- Age, sex, race
- Family history
- Hypertension, Hyperlipidemia, Obesity
- Smoking
- Diabetes Mellitus
- Carotid stenosis
- Sickle cell disease
- Atrial fibrillation
Cerebral Vascular Accident (CVA) or Stroke
110
What are the treatments for an ischemic stroke?
Thrombolytic agents, aspirin, angioplasty
111
What are the treatments for an hemorrhagic stroke?
Surgical repair or aneurysm as well as blood removal
112
This component of the nervous system provides an awareness of body sensations as touch, temperature, limb position, and pain
Somatosensory
113
Sense of body movement and position, independent of vision
Proprioception
114
What are the four major modalities of sensory experience?
- Discriminative touch
- Temperature sensation
- Body position
- Nociperception (pain sensation)
115
Pain from non-injurious stimuli to the skin
Allodynia
116
Extreme sensitivity to pain
Hyperalgesia
117
The absence of pain from stimuli that normally would be painful
Analgesia
118
Characterized by brief, severe, often repetitive attacks of lightning-like or throbbing pain
Neuralgia
119
The point at which a stimulus is perceived as painful
Pain threshold
120
The maximum intensity or duration of pain that a person is willing to endure before the person wants something done about the pain
Pain tolerance
121
This type of pain is characterized by sharp, burning pain - origin in skin or subcutaneous tissues
Cutaneous
122
This type of pain is characterized by more diffuse and throbbing pain - origin in body structures
Deep
123
This type of pain is diffuse and poorly defined - results from stretching, distension, or ischemia of tissues
Visceral
124
This type of pain originates at a visceral site but perceived as origination in part of the body wall that is innervated by neurons entering the same segment of the nervous system
Referred
125
What are the four questions associated with pain assessment?
Nature
Severity
Location
Radiation
126
What are the nonpharm interventions for pain?
- Cognitive-behavioral: relaxation, distraction, imagery, biofeedback
- Physical agent: heat and cold
- Stimulus-induced analgesia
- Acupuncture and acupressure
127
What are the pharmacologic treatments for pain?
- Nonnarcotic analgesics: NSAIDs, antiseizure medications, antidepressants
- Opioid analgesics: morphine congeners
128
This is a type of pain that often begins as sensations of tingling, heat and cold, or heaviness, followed by burning, cramping, or shooting pain - type of neurologic pain following amputation; as many as 70% of amputees experience this
Phantom Limb Pain
129
What are the types of headaches?
- Migraine
- Tension-type
- Cluster
- Sinus
- Temporomandibular joint syndrome
130
- Transient physical or behavior alteration that results from an abnormal electrical activity in the brain
- Causes: altered membrane ion channels, altered extracellular electrolytes, and imbalanced excitatory and inhibitory neurotransmitters
- Can occur secondary to trauma, hypoglycemia, electrolyte disorders, acidosis, infection, fever, chemical ingestion, cerebral ischemia, or hypoxia
Seizure
131
Seizure disorder resulting from spontaneous firing of abnormal neurons; characterized by recurrent seizures for which there is no underlying or correctable cause
Epilepsy
132
What are the causes of epilepsy?
- Sudden, recurrent episodes of sensory disturbances
- Alterations in cell membrane permeability or distribution of ions across the neuronal cell membranes
- Decreased inhibition of cortical or thalamic neuronal activity or structural changes that alter the excitability of neurons
- Neurotransmitter imbalances such as an acetylcholine excess or y-aminobutyric acid (GABA, an inhibitory neurotransmitter) deficiency have been proposed as causes
133
This type of seizure is also known as partial seizure, occurs in just one part of the brain, usually lasts for just a few seconds, and some may experience auras
Focal seizures
134
Person remains conscious but experiences unusual feelings or sensations that can take many forms (sudden unexplainable feelings of joy, anger, sadness, nausea, or alterations in senses
Focal Aware Seizure
135
Individual has changes in or loss of consciousness, dream-like experience
Complex focal seizure
136
This type of seizure is characterized by abnormal neuronal activity on both sides of the brain and may cause loss of consciousness, falls, or massive muscle spasms
Generalized seizures
137
Individual may appear to be staring into space and/or have jerking or twitching muscles
Absence seizure
138
Causes stiffening of the body and repeated jerks of the arms and/or legs as well as loss of consciousness
Tonic-clonic (Grand Mal) seizure
139
Just after the seizure, the individual may be confused, fatigued, and fall into a deep sleep
Postictal period
140
What is the treatment for someone experiencing a seizure?
- Position the individual on their side
- Protect head
- Do not force items between teeth
- Do not restrain individual
- Manage airway
- Oxygen therapy
- Muscle relaxants
- Anti-seizure agents
- Allow to sleep after
141
This disorder is characterized by continual seizures, do not stop spontaneously, there are many types, and if untreated or not stopped can lead to death due to respiratory failure
Status Epilepticus
142
This is a demyelinating disease of the CNS
Most common non-traumatic cause of neurologic disability among young and middle-aged adults
Characterized by exacerbations and remissions over many years in several different sites in the CNS
Multiple Sclerosis (MS)
143
- Progressive condition involving the destruction of the substantia nigra in the brain
- Results in a lack of dopamine
- When approximately 80% of the dopamine producing cells are destroyed, movement issues that typically include tremors of the hands and head develop
- Cause unknown
- More common in men and those living in rural areas
Parkinson's Disease
144
What are the manifestations of Parkinson's Disease?
- Slowing or stopping of automatic movements
- Constipation
- Urinary hesitancy and/or urgency
- Dysphagia
- Drooling
- Anosmia
- Mask-like appearance to face
- Myalgia
- Muscle cramps and dystonia
145
What are some of the problems with movement with Parkinson's Disease?
- Difficulty initiating or continuing movement
- Loss of fine hand movements
- Shuffling gait
- Unsteady gait
- Slowed movement
146
What is the treatment for Parkinson's disease?
- No cure
- Medications (levodopa, dopamine agonists, and MAOIs)
- Deep brain stimulation
- Physical and occupational therapies along with assistive devices
- Coping strategies, support, nutrition, and adequate rest can promote and maintain overall good health
147
- Also known as Lou Gehrig's disease, this causes damage to the upper motor neurons of the cerebral cortex and lower motor neurons of the brain stem and spinal cord
- Nerves lose their ability to trigger muscle movement, resulting in muscle weakness, disability, paralysis and eventually death (usually within three years of onset of symptoms)
- Cause unknown - genetics and environment play a role
Amyotrophic Lateral Sclerosis (ALS)
148
What are the manifestations of ALS?
- Progressively worse as more neurons damaged: spastic paralysis and hyperreflexia, eventually leading to flaccid paralysis
- Early manifestations include foot drop, lower extremity weakness, hand weakness, or clumsiness, slurred speech, dysphagia, and muscle cramps and twitching of upper extremities and tongue
- Affects chewing, swallowing, speaking, and breathing
149
Autoimmune condition where acetylcholine receptors are impaired or destroyed by immunoglobulin G autoantibodies
Myasthenia Gravis
150
- Genetic alteration with too many repeated CAG on chromosome 4
- This over-expression of the gene causes atrophy of neurons (more repeats = more severe symptoms at a younger age)
Huntington's Disease
151
- A group of conditions in which cortical function is decreased, impairing cognitive skills and motor coordination
- Causes: vascular disease, infections, toxins, and genetic conditions
Dementia
152
- Most common form of dementia
- Brain tissue degenerates and atrophies, causing a steady decline in memory and mental abilities
- Rates are higher with advanced age and in women, family history
- May last 10-20 years
Alzheimer's Disease
153
What is the pathogenesis of Alzheimer's disease?
- Amyloid plaques form within the brain
- Neurofibrillary tangles found inside neurons
- Connections among neurons responsible for memory are severed
154
Highest prevalence of psychiatric disorders occur among who?
Ages 18-25, women, and of mixed race
155
Mental disorders are due to anatomic, developmental, and functional disorders of the brain
Biologic psychiatry school of thought
156
Mental disorders are due to impaired psychological development, a consequence of poor child rearing or environmental stress
Psychosocial psychiatry school of thought
157
- Chronic debilitating psychotic disorder that involves the disconnection between thought and language
- Affects thinking, feeling, perceiving, behaving, and experiencing the environment
- Onset occurs between 17 and 25 years
- First-degree relatives of a person with this disease have a 10-fold greater prevalence of the illness
Schizophrenia
158
What are the goals of treatment for schizophrenia?
- Reduce agitation and the risk of physical harm
- Induce a remission
- Prevent a recurrence
- Restore behavioral, cognitive, and psychosocial function to premorbid levels
159
A mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity
Depression
160
Characterized by extremely elevated mood, energy, and unusual thought patterns
Mania
161
20% to 40% of adolescents who present with major depression develop which disorder within 5 years?
Bipolar disorder
162
Repeated use of alcohol or other drugs resulting in functional problems
Abuse
163
A combination of craving, compulsive use, and high risk of relapse after withdrawal
Addiction
