Neurological System Flashcards by Alyssa Donley

frontal lobe is responsible for:

primary motor cortex:
personality
expressive speech (Broca’s area)
judgement & decision-making
abstract thought
concentration
temper

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frontal lobe impairment causes:

contralateral weakness
inattention
apathy
poor inhibition
personality change
Broca’s aphasia (expressive deficits)

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parietal lobe is responsible for:

gross sensation (touch, pressure)
fine sensation (texture, weight, size, shape)
sensory homonculus
language
spatial & visual perception

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parietal lobe impairment causes:

L side: agraphia, alexia, agnosia (language comprehension)
R side: dressing & constructional apraxia, anosognosia (no insight)
contralateral sensory deficits: impaired language, taste & comprehension

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temporal lobe is responsible for:

primary auditory processing & olfaction
behavior
language reception (Wernicke’s area)
understanding
Long term memory
interpret nonverbals of others

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temporal lobe impairment causes:

learning deficit
antisocial/aggressive
Wernicke’s aphasia
difficulty w/ facial recognition, memory & categorizing objects

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occipital lobe is responsible for:

vision & 3D
recognize size, shape & color
judging distance

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occipital lobe impairment causes:

impaired eye muscle movement
visual deficits
decreased color recognition
read/write deficits
homonymous hemianopsia
cortical blindness w/ bilat. lobe involved

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hippocampus location & function

(lower temporal lobe)
learning language
form/store new personal memories
declarative memory
sending memory to appropriate areas of cerebral hemisphere

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basal ganglia function

voluntary movement
regulate autonomic movement, posture & mm tone
(includes caudate, putamen, globus, pallidus, substantia nigra, subthalamic nuclei)

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diseases of dysfunctional basal ganglia

Parkinson’s
Tourette’s
Huntington’s
ADD
OCD
addictions

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amygdala location & function

(in temporal lobe, next to hippocampus)
Emotional and social processing
Fear/pleasure response, arousal, memory processing, form emotional memories

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hypothalamus function

receive/integrate info from autonomic NS
hormone regulation
controls hunger, thirst, sex, sleep
regulate body temp, adrenal glands, pituitary glands

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subthalamus location & function

between thalamus & hypothalamus
regulates movement from skeletal muscle

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epithalamus/pineal gland function

secretes melatonin for circadian rhythm
regulates some motor pathways & emotions

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cerebellum function

balance, posture & complex muscle movements
integration, coordination & execution of multi-joint movements
regulates mm contractions (initiation, timing, sequencing, force)

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pons function

helps regulate respiration rate
associated w/ head orientation to visual/auditory stimuli
includes CN 5-8 origins

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medulla oblongata function & wht/gry matter distribution

influence autonomic activity (RR & HR)
reflex center for vomiting, coughing, sneezing
outer white matter, inner gray matter

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What is responsible for exchanging nutrients between the CNS & vascular system?

blood/brain barrier

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3 Meninges Layers & 3 spaces between

[skull]
-epidural space
dura mater (outer)
-subdural space
arachnoid mater (middle)
-subarachnoid space w/ CSF
pia mater (inner)

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PNS: how many cranial nerves?
how many spinal nerves? (cervical, thoracic, lumbar, sacral, coccygeal)

12 CN
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal

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sympathetic NS: hormone, affect on BP, HR & blood flow

norepinephrine
inc. HR, BP & blood flow to skeletal mm

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parasympathetic NS: hormone & affect on HR, BP & digestion; which CN affected (4 total)

acetylcholine
dec/normalized HR, BP & digestion
oculomotor (3), facial & glossopharangeal (7, 9, taste) & vagus

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Name 3 early embryo layers

ectoderm: brain components
mesoderm: vertebrae/skull, dermis, skeletal mm
endoderm: organ development

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upper motor neurons: cell body origin/termination where do they cross? where do they synapse w/ LMN?

origin: cerebral cortex termination: brainstem/spinal cord cross: medulla LMN synapse: anterior horn of SC

UMN Lesions = which diseases?

MS SCI Parkinsons CVA/stroke TBI/head trauma ALS

UMN lesion characteristics

spastic weakness loss of autonomic control clonus paralysis hyperreflexia

lower motor neurons: cell body origin of cranial nerves & spinal nerves

CN: brainstem spinal nerves: anterior horn of S.C.

LMN lesions = what diseases?

muscular dystrophy polio myasthenia graves ALS, Guillan Barre peripheral nerve injury

LMN lesion characteristics

hypotonia hyporeflexia paralysis atrophy loss of coordination

temporary nerve damage due to pressure

neuropraxia

prolonged nerve pressure causes muscle atrophy & axon degeneration (can be permanent)

axonotmesis

nerve axon/sheath damaged; can require surgery

neurotmesis

when peripheral nerve is cut & parts of axon distal to transaction point are disconnected from central neuron

Wallerian degeneration

PT tx: reduce return of primitive reflex patterns of movement (post CVA) -stimulate return of normal tone/posture

Brunnstrom approach

PT tx: focusing on normal movement without compensations (often w/ UMN lesions)

neurodevelopmental therapy (NDT)/ Bobath technique

progressive degenerative organic brain syndrome that destroys neurons of cerebral cortex (frontal lobe first) w/ plaques

Alzheimer's Disease

s/s: memory & behavioral deficits (no cure)

Alzheimer's Disease

Name 4 types of Non-Alzheimer's dementia

Lewy body dementia vascular dementia head trauma dementia substance-induced dementia

inflammation of meninges (acute or chronic that affects different layers) -which of the 2 is more fatal?

meningitis bacterial: (fatal) disrupted blood-brain barrier viral: more common

s/s: high fever ,chills, photophobia, severe HA, vomit, neck stiffness, drowsy, stupor, seizures, coma

meningitis

inflammation of parenchyma of brain tissue due to viral invasion

encephalitis

brain damage due to ischemia (embolus blockage) or hemorrhage stroke (aneurysm)

cerebrovascular accident, CVA

s/s: HA, weakness on 1 side of face/body, slurred speech, blurred vision, sudden flaccidity, spasticity in 2-3 days

CVA

group of rare, prion degenerative neuro disorders w/ rapid progressive dementia

Creutzfeldt-Jacob Disease

numerous neurons in brain fire at the same time, leading to large burst of electrical energy (Types: absence/petit mal, atonic, myoclonic, tonic clonic/grand mal)

epilepsy/seizure disorders

hereditary progressive, degenerative disease affecting 4th chromosome

Huntington's Disease

s/s: mm rigidity, tremors, slow movement, myoclonus, chorea (involuntary jerky/uncoordinated, hallucinations)

Huntingon's Disease

autoimmune, demyelinating neuro disorder of UMNs in CNS b/c plaques/lesions in brain

multiple sclerosis

s/s: blurred vision, numb/tingling, cognitive deficits, heat sensitivity, mm weakness, fatigue, unsteady gait

multiple sclerosis

UMN disease affecting basal ganglia (voluntary movement) d/t deficient dopamine & excess ACH

Parkinson's Disease

s/s: tremors, posture changes, masklike facial expression, slow/soft speech, rigidity, difficulty initiating movement, shuffling gait, bradykinesia, cognitive impairment, mm atrophy, fatigue

Parkinson's Disease

LMN disorder w/ autoimmune response which motor neurons spared during original poliomyelitis infection become overused/overstressed

Post-Polio syndrome

PT tx: reduce excess physical activity w/ low-impact aerobics & strengthening (don't fatigue mm); energy conservation

Post-polio syndrome

UMN disorder causing partial/complete paralysis (usually d/t trauma)

Spinal Cord Injury

s/s: lesion to C4/C6- quad/tetraplegia, T6- paraplegia, L1- paraplegia autonomic dysreflexia

spinal cord injury

external injury to head that damages brain tissue (usually a fall or MVA); UMN lesion

traumatic brain injury

s/s: loss of consciousness, dec. memory, HA, dizzy, behavior changes, mood swing, nausea/vomit, seizures, coma

TBI

2 measurement scales for TBI

Glasgow Coma Scale: for acute injury, rate consciousness level Rancho Los Amigos Scale: determine prognosis

collection of blood between skull & dura mater; large, arterial & develops fast

epidural hematoma

collection of blood between dura mater & arachnoid mater; slow developing, venous

subdural hematoma

temporary, unilateral facial paralysis d/t trauma (affects CN 7- facial)

Bell's Palsy

s/s: asymmetrical facial appearance w/ dropping eyelid/mouth

Bell's Palsy

peripheral nerve disease affecting motor, sensory & autonomic systems causes: diabetes mellitus, guillian-barre, alcoholism, autoimmune disease

neuropathy

immune system attacks & demyelinates peripheral nerves; triggered by infection of trauma (LMN disease)

Guillian Barre Syndrome

s/s: LE mm weakness that spreads to UE; no DTRs, flaccidity; greatest weakness at 3 wks

Guillian Barre syndrome

intense attacks of pain along nerve distribution of CN V- trigeminal; caused by viral infection

trigeminal neuralgia /tic douloureux

progressive, degenerative disease of UMN & LMN; unknown cause & intact sensory system

Amyotrophic Lateral Sclerosis (ALS)/ Lou Gehrig's

s/s: gradual onset but progressive mm weakness (cachexia), spasticity, involuntary movement, hyperreflexia, fatigue, dysarthria

ALS/Lou Gehrig's

neural tube defect that prevents brain formation

Anencephaly

rare developmental deficit where cerebellum protrudes through foramen magnum & puts pressure on S.C., cerebellum & cerebrum

Arnold-Chiari Malformation

wide range of developmental disorders causing impaired social interaction, delayed speech development, repetitive behaviors, sensitivities to stimuli

Autism Spectrum Disorder

any injury to infant brain by congenital abnormalities before/during/immediately after birth ex: hypoxia, mechanical trauma etc

Cerebral Palsy

s/s: physical, musculoskeletal, behavioral and cognitive disorders: small jaw/eyes, cleft palate, flat nasal bridge, microencephaly, mental/growth retardation, poor attention & social skills, hyperactivity, etc

fetal alcohol spectrum disorder

developmental defect in forebrain of embryo/fetus

holoprosencephaly

dorsal column region: proprioception of UEs, trunk & neck; detect vibration, 2 point discrim., graphesthesia

fasciculous cuneatus; outer region

dorsal column region: proprioception of LEs and trunk

fasciculous gracilits; medial region

dorsal column: which direction, where crosses, detects what

ascending sensory tract crosses in pons deep sensation: proprioception, kinesthesia, vibration, combined deep sensation

spinothalamic tract: which direction, where crosses, detects what

ascending sensory tract crosses 2-4 levels above S.C. superficial sensation: light touch/pressure, pain, temperature

corticospinal tract: which direction, where crosses; movement per lateral & medial tracts

descending motor tract crossses in brainstem lateral: contralateral voluntary fine movement medial: contralateral voluntary discrete/skilled movement

Name 3 other ascending/sensory tracts

spinoreticular tract spinotectal tract spinocerebellar tract

Name 4 other descending /motor tracts

tectospinal tract vestibulospinal tract reticulospinal tract rubrospinal tract

lesion of hemisection of SC ipsilateral paralysis of corticospinal tract ipsilateral sensory loss at dorsal column contralateral sensory loss at spinothalamic

Brown-Sequard Syndrome

loss of motor function (corticospinal) below lesion loss of superficial sensation below lesion (dosal columns preserved)

Anterior Cord Syndrome

spinal cord syndrome: occur from hyperextension injury to cervical or degenerative narrowing of spinal canal affect UE more than LE

Central Cord Syndrome

compression of posterior spinal artery loss of dorsal column function motor function preserved

Posterior Cord Syndrome

spinal cord syndrome: a LMN injury w/ areflexic bowel/bladder, saddle anesthesia & variable LE paralysis

Cauda Equina Injury

spinal cord syndrome: (T12-L2 injury) UMN & LMN deficits w/ loss of bowel/bladder, saddle anesthesia & LE motor weakness

Conus medullaris injury

s/s: high BP, low HR, diaphoresis, anxiety, stimuli sensitivity

autonomic dysreflexia `

place where the anterior and posterior circulation systems of the brain converge to provide collateral blood flow

Circle of Willis

2 diseases that use lumbar puncture to diagnosis

Meningitis Encephalitis

PT tx for which disease? strength, stretch, aerobic ex, low temp aquatic therapy, functional e-stim, balance, coordination

multiple sclerosis

PT tx for which disease? limited physical activity, energy conservation, low-impact aerobics/strength, use AD, (no fatiguing mm)

Post-polio syndrome