Neuro Patho Flashcards
0
Q
2 types of synaptic transmission
A
Electrical
Chemical
1
Q
Name of chemical messengers
A
Neurotransmitters
2
Q
What is responsible for generating action potentials in electrical transmission?
A
Ion channels on cell membranes
3
Q
Define action potential
A
Impulses that are greater than the membrane threshold which causes rapid change in cell membrane
4
Q
Another term used to describe the resting membrane potential
A
Polarized
5
Q
What is a polarized cell’s charge inside?
A
Negative
6
Q
What is a threshold potential?
A
The membrane’s potential when a cell is optimal for fire
7
Q
Cell’s charge when it is depolarized?
A
Positive inside
8
Q
What is repolarization?
A
When the cell’s polarity of the resting potential is reestablished. Becomes negative again inside of cell
9
Q
What is the absolute refractory period?
A
Period of action potential when membrane cannot respond to anymore stimuli.
10
Q
What is relative refractory period?
A
The end of the absolute refractory period when a stronger than normal stimuli can evoke another action potential
11
Q
When are neurotransmitters used to communicate?
A
Chemical transmission
12
Q
How are neurotransmitters received by the postsynaptic neuron in the synapse?
A
Neurotransmitter binds to receptor sites on postsynaptic neuron
13
Q
Where does biosynthesis of neurotransmitters take place?
A
In cytoplasm of axon terminal
14
Q
Where are neurotransmitters built up and stored?
A
In synaptic vesicle
15
Q
What causes the release of a neurotransmitter?
A
The arrival of an action potential
16
Q
Pathway of neurotransmitter from vesicle to postsynaptic neuron
A
Synaptic vesicle to synaptic cleft to receptor site to postsynaptic neuron
17
Q
2 actions of neurotransmitters
A
Inhibitory or excitatory
18
Q
3 ways to inactivate or remove a neurotransmitter.
A
Diffusion
Enzymatic degradation
Uptake by cells
19
Q
5 small molecule neurotransmitters
A
Acetylcholine (ACh) GABA Catecholamines Dopamine Serotonin
20
Q
Acetylcholine is released from where in sympathetic and parasympathetic divisions in the ANS?
A
Preganglionic neurons
21
Q
Acetylcholine is secreted by the postganglionic neurons in…
A
Parasympathetic nervous system
22
Q
Somatic motor neurons release what into the Neuromuscular junction (NMJ)?
A
Acetylcholine
23
Q
Acetylcholine can be excitatory or inhibitory depending on…
A
The receptors it attaches to
24
What kind of receptors does acetylcholine bind to?
Cholinergic receptors
25
What will inactivate acetylcholine?
Acetylcholinestrase
26
2 functions of acetylcholine
Assists in memory storage
| Promotes coordinated muscle movements along with dopamine
27
What kind of neurotransmitter is GABA (gamma aminobutyric acid)
Inhibitory
28
Where can you find GABA?
Only In the brain
29
What does GABA do?
Keeps neurons in the brain from becoming overly excited
| Decreases seizure potential
30
2 examples of catecholamines
Norepinephrine and epinephrine
31
What inactivated catecholamines?
Enzyme degradation and re-uptake
32
Where is catecholamines released from?
Adrenal medulla and at postsynaptic neurons of SNS
33
5 roles that catecholamines play
```
Arousal
Attention
Concentration
Energy
Alertness
```
34
What kind of receptors do catecholamines bind to?
Adrenergic receptors
35
Are Catecholamines inhibitory or excitatory?
Can be both, depending on the receptor. But mainly it is excitatory
36
2 places where dopamine is produced
In basal ganglia in brain and
| Midbrain-Substantia Nigra.
37
When is dopamine activated? 3
During emotional response, addictive behaviors, and pleasurable activities.
38
4 jobs of dopamine
Muscle tone
Muscle coordination
Integration of thoughts
Enhances judgements
39
Dopamine is excitatory or inhibitory?
Generally excitatory
40
3 Jobs of seratonin
Stabilizes mood
Influences sleep
Influences appetite
41
Is serotonin excitatory or inhibitory?
Inhibitory
42
```
3 neuropeptides (opioid neurotrans)
(Not small molecule neurotransmitters)
```
Enkephalins
Endorphins
Substance P
43
Are neuropeptides excitatory or inhibitory?
Either, depending on the receptors
44
2 functions of enkephalins
Potent analgesic effect (200x stronger than morphine)
| Inhibits substance P
45
6 functions of Endorphins
```
Natural pain killer
Improves memory
Improves learning
Promotes feelings of pleasure
Promotes euphoria
Inhibits Substance P
```
46
2 functions of substance P
Enhances pain sensation
| May be helpful in nerve regeneration
47
What releases substance P?
Neurons that transmit pain signals
48
What is the "vitals" center of the brain
Medulla oblongata
49
Where is the medulla oblongata located
Most inferior portion of brain stem (lowest part)
50
What is found in the medulla oblongata?
90% of descending motor tracts (corticospinal tract)
51
3 functions of the medulla oblongata
CV center
Respiratory center
Reflexes (sneezing, coughing, hiccuping, vomiting, deglutition)
52
The CN originate from the medulla oblongata? (5 of them)
CN 8,9,10,11,12
53
2 functions of the pons
Bridge for communication
| Respiratory rate and rhythm
54
Pons is bridge for communication between what structures?
Cerebellum to brainstem
| Between the 2 hemispheres of the brain
55
What CN originate in the Pons? (4 of them)
CN 5,6,7,8
56
Where is the Pons located?
Above medulla ablongata
57
Where is the midbrain located?
Above the Pons
58
What does the midbrain contain?
Cerebral aqueduct
| Part of Substancia Nigra (dopamine prod)
59
3 reflexes controlled by midbrain
Tracking moving objects
Positioning head to improve hearing
Startle reflex
60
CN that originate in midbrain
CN 3,4
61
What is the Reticular formation
Netlike formation of grey and white matter interspersed throughout from brainstem and diencephalon
62
What does the ascending tract (sensory) stimulate?
RAS-reticular activating system
63
4 functions of the RAS (reticular activating system)
Keeps you conscious, alert, aware, and oriented
Sensory input from eyes and ears (not nose)
Prevents sensory overload
Used in tonic contractions of skeletal muscle
64
What happens if the RAS is damaged?
Coma-from light to deep stages
65
Parts of brainstem
Medulla oblongata
Pons
Midbrain
Reticular formation
66
2 functions of the cerebellum
Feedback loop between motor cortex, cerebrum, and thalamus
| Regulates posture, tone, and proprioception. This helps with making smooth and coordinating movements.
67
Damage to cerebellum causes what?
Inability to coordinate muscle movements including speech.
68
4parts of the diencephalon
Thalamus
Hypothalamus
Epithalamus
Limbic system
69
3 functions of the thalamus
Major relay station for most sensory input to different areas of cerebrum.
Transmits info from cerebellum/basal nuclei to primary motor cortex.
Connects emotions to stimuli.
70
Why can someone in a coma remember what people had said at the bedside?
Thalamus can interpret high emotional auditory stimuli.
71
What does the hypothalamus contain?
The pituitary gland
72
What is the major homeostasis regulator?
Hypothalamus
73
9 things that are regulated by the hypothalamus
```
Homeostasis (thru ANS)
Hormone production
Feeding center
Satiety center
Thirst center
Temp control
Circadian rhythm
LOC
Sleep wake cycles
```
74
What does the epithalamus contain?
Pineal land
75
Function of pineal gland
Secretes melatonin
76
2 functions of the epithalamus
Promotes sleep
| Sets the biological clock
77
What does the limbic system surround?
The corpus collossum
78
2 parts of the limbic system
Hippocampus and Amygdala
79
6 functions of the limbic system
```
Consolidation of new memories
Primitive behavioral/emotional responses
Visceral reaction to emotion
Navigation
Spacial orientation
Olfactory bulbs
```
80
4 structures of the cerebrum
Gyri and sulci
| Fissures and hemispheres
81
Where is grey matter found in the cerebrum?
Cerebral cortex
82
Where is white matter found in the cerebrum?
Corpus collosum
83
3 areas of the frontal lobe
Prefrontal cortex
Primary motor cortex
Broca's area
84
4 functions of the prefrontal cortex
Anticipation/prediction of consequences
Goal oriented behaviors
Short/long term recall
Judgement. Impulse/limbic system inhibition control
85
Primary motor cortex functions (2)
Voluntary muscle control
| Axons from this area form corticospinal tract
86
Where is the Broca's area located?
Inferior margin of precentral gyrus
87
What hemisphere does the Broca's area reside?
97% of it is in left hemisphere
88
Function of Broca's area
Motor aspects of speech
89
What problem arises having to do with Broca's area after a CVA?
Non-fluent speech
90
3 areas of the parietal lobe
Primary somatosensory cortex
Somatosensory association cortex
Primary gustatory sense
91
What purpose does the primary somatosensory cortex have?
Pinpoints incoming somatic info
92
What does the somatosensory association cortex do?
Meaningfulness to sensory input
93
Where is the primary gustatory sense located?
Superior to lateral sulcus
94
Purpose of the primary gustatory sense
Taste perception and discrimination
95
What 5 areas of the brain are included in the temporal lobe
```
Long term memory
Primary auditory cortex
Auditory association area
Wernicke's area
Olfactory area
```
96
What happens if you damage the long term memory portion of brain?
Vivid hallucinations of past events from a long time ago
97
Purpose of auditory association area
Recognizes and gives meaning to sound patterns
98
Where is Wernicke's area located?
Broad region in left temporal and parietal lobes
99
Purpose of Wernicke's area?
Interprets the meaning of speech by recognizing the spoken word
100
CVA in what area will cause fluent aphasia?
Wernicke's area
101
What is fluent aphasia
Can speak, but cannot arrange words to make sense.
102
Function of olfactory area
Smell perception
103
2 areas found in occipital lobe
Primary visual cortex
| Visual association area
104
Purpose of the primary visual cortex
Visual perception
105
Purpose of the visual association area
Attaches meaning to images
106
4 functions of the basal ganglia
Connects diencephalon and midbrain
Contains Substancia Negra (dopamine production)
Provides input to cerebral cortex
Sends output to motor parts of cortex
107
6 ways basal ganglia provide input and output to cortex
Helps regulate initiation/termination of movements
Coordinates muscle tone/eye and body movements
Controls subconscious movements
Initiates/terminates some cognitive processes
Works with limbic system to regulate emotions
Makes up extrapyramidal system
108
3 examples of cognitive processes initiated/terminated by basal ganglia
Attention
Memory
Planning
109
Length of spinal cord in
1. Adults
2. Newborns
1. Medulla to L2
| 2. Medulla to L3-L4
110
Name of end of cord
Conus medullaris
111
Bundle of spinal nerves that extend down from the spinal cord to the coccyx
Cauda equine
112
Purpose of spinal roots
Connect spinal cord to spinal nerves
113
Another name for the posterior root
Dorsal horns
114
Purpose of the dorsal root of the spinal cord?
Sensory axon input from skin, muscles, and internal organs (afferent)
115
Where does the sensory input go?
To CNS
116
Where is grey matter in the spinal cord?
Inside part (H or butterfly shaped)
117
Purpose of lateral gray horn
Cell bodies of autonomic motor neurons (cardiac, smooth, glands)
118
Where is the lateral horn found?
Thoracic and upper lumbar only
119
How are gray matter cells bodies arranged?
Longitudinally in collumns
120
Function of gray matter portion of spinal cord
Receives and integrates incoming and outgoing info
121
White matter of spinal cord contains
Longitudinal myelinated nerve tracts
122
3 neurons involved in sensory pathways
Periphery to spinal cord (long)
Cord to thalamus (short)
Thalamus to cerebral cortex (short)
123
3 sensory dorsal pathways
Dorsal discriminative pathway
Anterolateral pathway
Spinocerebellar
124
Where does the dorsal discriminative pathway go to?
Travels to medulla then decussates at thalamus
125
What does the dorsal discriminative pathway do?
Conveys discriminative touch, light touch, vibration and conscious proprioception
126
Anterolateral pathway to brain
Originates in the dorsal horn, travels to the correct vertebral segment of dorsal horn, crosses over the commissure to the opposite side and travels up to the brain via the spinalthalamic tract (white matter).
127
Purpose of the spinocerebellar tract
Proprioception (goes to cerebellum)
128
2 neurons involved in somatic motor pathways
UMN(upper motor neurons)- brain to spinal cord
| LMN(lower motor neurons)-spinal cord to muscle effectors
129
Where do upper motor neurons originate (have their cell bodies) and go to...
Originate in the cerebral cortex or the brain stem and end at the spinal cord
130
What kind of activity is necessary in cerebral cortex for voluntary muscle movements?
Upper motor neuron activity
131
Upper motor neuron injuries result in...
Loss of connection between brain and spinal cord leading to weakness/paralysis with partial recovery
132
Disuse of upper motor neurons due to injury leads to...
Atrophy
133
Why are hyper reflexes and spacicity signs of upper motor neuron injury?
Connection broken resulting in lower motor neurons below area of injury acting without upper motor neuron control
134
Another name for lower motor neurons
Somatic motor neurons
135
Where are LMN cell bodies located?
Brain stem and ventral horn of spinal cord
136
What is included in one motor unit?
Single motor neuron and all the muscle groups it innervates
137
What happens when an action potential develops?
All fibers in the motor units contracts simultaneously
138
Where are the motor neurons supplying the motor units located and what is another name for them?
Located in the Ventral horn
| Aka: lower Motor neuron LMN
139
Function of LMN
Provide output from CNS to skeletal muscles
140
LMN injuries refer to injury of the...
Spinal roots or motor neurons connecting to the muscle
141
What does a LMN injury cause?
Permanent weakness or paralysis
142
Denervation of a LMN leads to...
Atrophy
143
2 signs of LMN injury (spinal cord injury)
```
Hypo reflex and
Flaccid paralysis (d/t no nerve to muscle connection)
```
144
Direct pathways- pyramidal tracts provide...
Voluntary somatic muscle control
145
2 neurons that direct pathways use
One from cerebral cortex (UMN) to a spinal or cranial nerve (LMN)
146
3 direct pathway tracts
Anterior corticospinal
Lateral corticospinal
Corticobulbar
147
Where does the anterior corticospinal tract cross (decussate)
At the medulla in order to control the proximal upper limbs and trunk
148
Lateral corticospinal crosses where? And what does it control?
It crosses at the spinal cord to control distal parts of the upper extremities
149
What does the corticobulbar tract control?
Skeletal muscles of the face, tongue, and eyes
150
Extrapyramidal tracts are...
Indirect motor pathways
151
Are indirect pathways UMN pathways or LMN?
They are all UMN pathways but have an effect on LMN output
152
How many LMN pathways do indirect pathways separate into at the brainstem?
5 different pathways
153
2 functions of the indirect pathways
1. Indirectly effects motor movement by providing input to the basal ganglia, cerebellum, thalamus, and brainstem
2. Involuntary muscle movements: shiver, breathe, posture, balance
154
How many subdivisions are there in the spinal cord?
3 layers
155
Inner layer of the spinal cord is called
Archilayer
156
Middle layer of spinal cord called
Paleolayer
157
Outer layer of spinal cord is called
Neolayer
158
What layer of the spinal cord is the most developed at birth?
Archilayer, it is the slowest communication
159
What does the inner layer of the spinal cord contain?
Reticular formation enlargements
160
Spinal cords inner layer function in utero and after birth
Quickening reflex at 5 months in utero
| Provides basic unconscious reflexes (responsible for some reflexes seen in a coma state)
161
What layer of the spinal cord has fairly fast communication?
Paleolayer-middle layer
162
What does the middle layer if the spine contain?
Most tract fibers for sensation and movement via the spinothalamic tract
163
What 2 functions is the middle spinal layer responsible for?
1. Auditory startle reflex ((turning head toward sound, dilating pupils, increase HR, etc)
2. Swallowing
164
What is the outer layer of the spinal cord called?
Neolayer-last layer to develop
165
What layer of the spinal cord is the most vulnerable to injury?
Neolayer
166
Which spinal cord layer has the fastest communication?
Neolayer
167
What layer of the spinal cord provides reflex type movements?
Inner layer
168
What layer of the spinal cord provides many primaries movements?
Middle layer
169
What layer of the spinal cord contains many pathways for highly coordinated skills (ex: corticospinal tract)
Outer layer
170
3 pathways/functions of the neolayer
Descending corticospinal layer
Pathway for bladder training
Pathway for fine motor manipulation (finger coordination for using tools, toe movements for acrobats)
171
What two layers of the spinal cord have collateral branches?
Archilayer and the paleolayer to bypass the local damage
172
Benefits of collateral communication
Injury can be followed by rehab and a slow return of function in inner and middle layers.
173
Consequences of injury to neolayer of spinal cord.
Delicate and fine motor function is lost. Basic function may remain
174
How does the spinal cord promote homeostasis
It is an integrating center for some reflexes
175
What are the meninges?
Connective tissue sheath that protects the brain, spinal cord, and segmental nerves
176
What are the 3 layers of the meninges?
Pia mater
Arachnoid layer
Dura layer
177
Location and consistency of the pia mater
Gentle layer that covers the brain
178
Consistency and location of the arachnoid layer
Spongy, weblike, nonvascular, waterproof.
| Contains subarachnoid space which contains CSF
179
Consistency and location of dura mater
Tough, strong. Has Two layers
180
What does the outer layer of the dura mater do?
It lines the skull as the periosteum
181
What does the inner layer of the dura mater do?
Separates the internal brain structures
182
What are 2 portions of the inner layer of the dura mater and what parts of the brain do they cover/separate.
Flax cerebri: dips between two cerebral hemispheres
| Tentorium cerebelli: separates cerebrum from the cerebellum
183
Where is the subdural space and what does it contain?
Lies between arachnoid and dura.
| Contains small bridging veins
184
Where is the epidural space and what does it contain?
Lies between the skull and the dura
| Contains arteries that supply the meninges. (Like the middle meningeal artery)
185
At what vertebrae does the spinal cord end?
L2
186
At what vertebrae does the meninges end?
S2
187
Spinal tap puncture done at what level?
L3-L4 or L4-L5 into subarachnoid space
188
What are 4 reasons to do a spinal tap?
Withdraw CSF
Admin of meds
Contrast
Anesthesia
189
3 protective measures of CNS
CSF
Meninges
BBB blood brain barrier
190
What is CSF? And what does it look like?
Ultra filtrated plasma, 99% water
| Clear
191
What does CSF carry?
0xygen, glucose, other chemicals needed by neurons/neuroglia.
Waste products-urea, lactic acid.
192
Where does CSF circulate?
Thru ventricles, spinal cord, and subarachnoid space
193
How much CSF circulates at one time?
80-150mL in adults
194
How much CSF is produced daily?
600mL.
| CSF is made at the same rate it is reabsorped back into the blood
195
3 functions of the CSF
Mechanical protection
Homeostasis
Circulation of nutrients/waste products
196
How does CSF function as a mechanical protectant?
Shock absorber by adding buoyancy and floating the brain
197
How does CSF function in homeostasis?
pH of CSF affects pulmonary ventilation and cerebral blood flow
198
Formation of CSF
Capillaries of the choroid plexus passes blood by the ependymal cells in ventricles which filter the blood to make and secrete CSF forming the blood brain barrier
199
Where is CSF added?
3rd/4th ventricle
200
Look at the circulation of CSF
Look at the circulation of CSF
201
Where is CSF reabsorbed back into blood stream?
Arachnoid villi
202
How fast is CSF made/reabsorbed?
20mLs an hour
203
B/c CSF is rapidly made and reabsorbed, what is maintained?
Appropriate CSF pressures
204
Any kind of lesion, blockage, or inflammation that interferes with circulation, production, or drainage of CSF results in...
Increased intracranial pressure or hydrocephalus
205
How do branches of the internal carotid arteries enter the cranium?
Thru the cavernous sinus
206
What feeds the frontal, parietal, temporal, basal ganglia, and part of diencephalon
Anterior circulation from internal carotid arteries
207
Branches of the internal carotid arteries include
Middle cerebral artery
| Anterior cerebral artery
208
What is the result of an emboli lodging in the middle cerebral branches
Loss of fine motor manipulation and expressive aphasia results
209
Vertebral arteries branch from subclavian arteries and enter the cranium thru
The foramen magnum
210
Vertebral arteries supply what portion of the brain
Posterior circulation
| Including brain stem, diencephalon, cerebellum, and temporal lobes.
211
What diverges to form the posterior vertebral arteries?
A Basilar artery
212
Where does a basilar artery form from?
2 vertebral arteries unite
213
What forms the circle of Willis (cerebral arterial circle)
Distal branches of internal carotid and vertebral arteries verge at the base of the brain
214
The cross connection of the circle of Willis provides...
Collateral circulation in case blood flow is disrupted in one of the main arteries
215
What does the anterior communicating artery provide?
Connection of R and L anterior cerebral arteries
216
What is the benefit of the anterior communicating artery?
Blood from one carotid can cross over and feed the opposite side of the brain
217
What does the posterior communicating arteries do?
Connects posterior and middle cerebral arteries
218
Benefit of having the posterior communicating arteries
Blood from basilar can run forward and supply front of the brain
219
How does blood flow out of brain?
Thru the dural sinuses to middle of the 2 dural layers where the internal jugular vein
220
2 ways cerebral blood flow is auto-regulated
Local adjustments of blood flow to meet metabolic needs inspire of arterial blow flow
Collateral circulation to compensate for diminished flow
221
3 examples of local adjustments that meet metabolic needs of brain
1. Change in blood vessel diameter
2. CO2 is a potent vasodilator
3. Low oxygen/lactic acid increases cerebral blood flow
222
4ways atherosclerosis impairs flow and auto regulatory abilities
1. Narrowing
2. Turbulence
3. Plaque/possible thrombosis
4. Ischemia
223
What does inter cranial pressure do to blood flow?
Compresses vessels and reduces blood flow
224
What are nerves?
Bundles of axons with neuroglia attached, wrapped then in connective tissue
225
What connects the PNS to the CNS?
Nerves
226
Spinal nerves are mixed nerves with 2 pathways of axons.
1. Dorsolateral: afferent pathway to brain
| 2. Ventrolateral: efferent pathway to periphery
227
Cerebral Blood Flow
amount of blood in mL passing through 100g of brain tissue in 1 minute. *usually matches the local metabolic needs of the brain.
228
Cerebral perfusion pressure (CPP)
* the pressure needed perfuse the cells of the brain
| * calculated: mean arterial blood pressure-intracranial pressure CPP= MABP-ICP
229
When is ischemia seen? ( hint: < what amount of pressure)
<40 mmHg
230
Cerebral Blood Volume (CBB)
The amount of blood in the intracranial vault at any given time.
231
Cerebral Perfusion Pressure <__ mmHg is incompatible with life
30
232
What is CN 1?
Where does it originate?
Is it motor or sensory?
Olfactory
Originates in nose, travels to temporal lobe
Sensory
233
What is CN 2?
Where does it go?
Is it sensory or motor?
Optic
Originates in the eye travels to occipital lobe
Sensory
234
What is CN 3?
Where does it originate?
Is it sensory or motor?
Occulomotor
Originates from midbrain
Motor-ANS innervation (pupil changes, lens accommodation, eye muscles, upper eyelid)
235
CN 4, where from, sensory or motor?
Trochlear
Originates from midbrain
Motor, eye rolling
236
CN 5, where from, sensory or motor?
Trigeminal
Originates from pons, face, dura
Ophthalmic, maxillary, mandibular
Sensory(touch, pain, thermal) and motor(chewing)
237
CN 6, where it originates, and sensory or motor?
Abducens
Originates from pons
Motor-abduction of the eyes
238
CN7, where it originates, sensory or motor?
Facial- originates in pons and face
Sensory-taste, inner ear canal, touch pain thermal facial proprioception
Motor- ear, facial expressions, scalp, neck muscles.
ANS-lacrimal, nasal, and salivary glands
239
CN8, where it originates, sensory or motor?
Vestibulochoclear
Originates in ear, goes to pons
Sensory-hearing, equilibrium
240
CN9, originates where and goes to, sensory or motor?
Glossopharangeal
Originates in medulla, goes to throat
Sensory-taste, carotid baro/chemoreceptors, external ear, touch pain, thermal
Motor-oropharynx, swallowing, gagging
241
CN10, originates where and goes to, sensory/motor.
Vagus
Originates in medulla, goes to neck, thorax, and abd
Sensory-skin external ear, taste in pharynx/epiglottis, proprioception, baro/chemoreceptors in carotid and aorta
Motor-pharynx muscles, swallowing, vocalize toon, coughing
242
ANS innervation of vagus nerve
Lungs, heart, glands, GI tract, peristalsis, glandular secretions, bronchiole constriction, decreases HR
243
CN11, where it originates and where does it go?
| Sensory or motor?
Accessory
Originates in medulla and spinal cord, goes to neck and back
Motor-shoulder raising and lowering, shrugging, turning head
244
CN 12, where it originates and goes, sensory or motor?
Hypoglossal
Originates in medulla, goes to tongue
Motor- tongue, speech, and swallowing
