Neurological exam 1 Flashcards
What makes up the cerebrum?
- cortex
- basal ganglion
- limbic structures
What part of the brain is responsible for most higher functions?
Cortex
What occurs at the frontal lobe (pre-central gyrus, anterior & pre central gyrus & anterior inferior pre-central gyrus) ?
Pre-central gyrus: simple movements
Anterior & Pre central gyrus: complex motor plans
Ant & inferior to pre central gyrus: motor aspects of speech
What occurs at both frontal & partial lobes?
planning, abstract thinking,social behaviour
What occurs at post-central gyrus?
Parietal lobe:
- Perception of touch, temp, vibration
- Perception of proprioception
What occurs distributed throughout the parietal lobe (3)?
- memory
- Executive functions
- abstract thinking
What occurs at the temporal lobe (3)?
- Hearing, scent, taste
- recognition of speech
- memory (w/ limbic system)
What occurs at the occipital lobe (3)?
- vision
- Association cortex: relate visual stimuli to things
- memories related to what has been seen
What does memory formation require (3)?
- attention (pre-frontal lobe)
- processors (limbic lobe)
- Storage (cortex - close to sensation they associated with)
What makes up the basal ganglion?
- Striatum (caudate & putamen)
- Globus Pallidus
- Subthalmic nuclei
Function of basal ganglion?
coordination of meaningful movement
- encourages intended movements while inhibiting others
Loss of function of basal ganglion is in what diseases (3)?
- Parkinsons
- Huntingtons
- Turets
= remorse, random movements, fiddiculty initiating, vocal utterances, personality changes
What are the limbic structures (2)?
- Amyglada
- Hippocampus
Hippocampus function?
long term memory & retrieval
Amygdala function?
emotional responses
-attaches emotions to memories
-memories related to fear
Thalamus function?
- relay centre for sensory info to cortex
-relays info to help refine motor skill (basal ganglion, cerebellum)
Hypothalamus function (3)?
- Regulates autonomic NS
- controls endocrine system & pituitary gland
- some thalamic nuclei modulate emotion & memory function
Cerebellum function?
- compares info from R about joint proprioception & movement, gravity & eqm
- uses info to adjust movements formulated in prefrontal cortex “error corrects”
NEUROANATOMY: coordination of voluntary movement, posture & balance
Highly folded structure that takes 10% mass of brain?
Cerebellum
What makes up the brainstem?
1.midbrain
2. pons
3. medulla
Brainstem function?
all pathways that bring sensory info into CNS or motor info out of CNS
Do damaged neruons/axons regenerate in CNS? PNS?
CNS: no
PNS: common
What do the components of the white mater of the spinal cord carry?
Dorsal column: proprioception, vibration, fast pain fibers (sensory)
Anterior & lateral column: pain, temp, itch, sensory to pain
Anterior column: motor info to skeletal muscle
What does gray matter of spinal cord have?
Dorsal horns: Sensory/afferent to CNS
Ventral horns: Motor/efferent away from CNS (skeletal m)
*back brain front
What info does lateral and anterior corticospinal tract carry?
Lateral: fine movement of extremities
Anterior: movements of the trunk
Corticospinal tract pathway? (general motor)
Motor plan formed (prefrontal cortex) >
Primary neuron activated in prefrontal lobe >
Axons travel down brainstem & cross over & medullary pyramids >
1 OR 2
1. Activation of primary neuron in ventral horn > stimulate skeletal m. contraction
- Activation of motor neuron in ventral horn > modify reflexes
How does cerebellar modify motor plans (3)?
- Intergrates info from proprioceptors (spinocerebellar tract) & inner ear (vestibulocerebellar tract)
- Compares the motor plan generated by frontal lobe that was relayed by pons
- Adjusts by communicating via thalamus to front lobe
=refines movements relayed by corticopsinal tract
Motor system relies of info from? 2 pathways?
proprioceptors!
- Dorsal column-medial leminsical system:
R > dorsal horn > dorsal column > thalamus > post central gyrus - Spinocerebellar system:
R > dorsal horn > dorsal lateral column > cerebellum
What are reflexes? their function?
- fast involuntary sequence of movements that only require simple neuron connection (no brainstem/spinal cord)
- FNC: protective/ stabilizing
Stretch reflex?
FNC: maintains posture
- muscle stretches & contracts >
stumulates motor neuron in ventral horn
-inhibits antagonist m
Muscle spindle?
proprioceptor that senses muscle stretch
Tendon Reflex?
FUNC: prevents tendon tearing during excessive force
-tendon stretches, agonist muscle contracts > stimulate motor neuron in ventral horn
ex. patellar, triceps
Withdrawl reflex?
-in response to painful stimuli
Plantar reflex?
-in response to an irritating stimuli (lateral side stroke), foot plantar flexes & toes curl
-in response to corticospinal tract
Cerebellar tests (4)?
- Rapid alternating eye movements
- Point-to-point movements
- Heal to shin movements
- Gait
-test cerebellar ability to evaluate body position & provide feedback
What does Romberg sign evalaute & what is the test?
EVALUATES: function of dorsal columns (sensory info from proprioceptors to cerebellum & pareital cortex)
TEST: pt stands with feet together, eyes closed & if looses balance = positive sign
What does pronator drive evaluate & what is the test?
EVALUATES: cortiospinal tract (precentral gyrus & prefrontal cortex)
TEST: pt stands with arm in front supine, eyes closed, if they fit (pronate) = positive test
