Neurological System Flashcards
frontal lobe is responsible for:
primary motor cortex:
personality
expressive speech (Broca’s area)
judgement & decision-making
abstract thought
concentration
temper
frontal lobe impairment causes:
contralateral weakness
inattention
apathy
poor inhibition
personality change
Broca’s aphasia (expressive deficits)
parietal lobe is responsible for:
gross sensation (touch, pressure)
fine sensation (texture, weight, size, shape)
sensory homonculus
language
spatial & visual perception
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
temporal lobe is responsible for:
primary auditory processing & olfaction
behavior
language reception (Wernicke’s area)
understanding
Long term memory
interpret nonverbals of others
temporal lobe impairment causes:
learning deficit
antisocial/aggressive
Wernicke’s aphasia
difficulty w/ facial recognition, memory & categorizing objects
occipital lobe is responsible for:
vision & 3D
recognize size, shape & color
judging distance
occipital lobe impairment causes:
impaired eye muscle movement
visual deficits
decreased color recognition
read/write deficits
homonymous hemianopsia
cortical blindness w/ bilat. lobe involved
hippocampus location & function
(lower temporal lobe)
learning language
form/store new personal memories
declarative memory
sending memory to appropriate areas of cerebral hemisphere
basal ganglia function
voluntary movement
regulate autonomic movement, posture & mm tone
(includes caudate, putamen, globus, pallidus, substantia nigra, subthalamic nuclei)
diseases of dysfunctional basal ganglia
Parkinson’s
Tourette’s
Huntington’s
ADD
OCD
addictions
amygdala location & function
(in temporal lobe, next to hippocampus)
Emotional and social processing
Fear/pleasure response, arousal, memory processing, form emotional memories
hypothalamus function
receive/integrate info from autonomic NS
hormone regulation
controls hunger, thirst, sex, sleep
regulate body temp, adrenal glands, pituitary glands
subthalamus location & function
between thalamus & hypothalamus
regulates movement from skeletal muscle
epithalamus/pineal gland function
secretes melatonin for circadian rhythm
regulates some motor pathways & emotions
cerebellum function
balance, posture & complex muscle movements
integration, coordination & execution of multi-joint movements
regulates mm contractions (initiation, timing, sequencing, force)
pons function
helps regulate respiration rate
associated w/ head orientation to visual/auditory stimuli
includes CN 5-8 origins
medulla oblongata function & wht/gry matter distribution
influence autonomic activity (RR & HR)
reflex center for vomiting, coughing, sneezing
outer white matter, inner gray matter
What is responsible for exchanging nutrients between the CNS & vascular system?
blood/brain barrier
3 Meninges Layers & 3 spaces between
[skull]
-epidural space
dura mater (outer)
-subdural space
arachnoid mater (middle)
-subarachnoid space w/ CSF
pia mater (inner)
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
sympathetic NS: hormone, affect on BP, HR & blood flow
norepinephrine
inc. HR, BP & blood flow to skeletal mm
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
Name 3 early embryo layers
ectoderm: brain components
mesoderm: vertebrae/skull, dermis, skeletal mm
endoderm: organ development
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
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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
