Patho Unit 2 Flashcards
the part of the nervous system made up of the brain and the spinal cord
Central Nervous System (CNS)
system in charge of rapid functions and activities
nervous system
part of the nervous system that is made up of somatic NS, the autonomic NS and the Enteric
Peripheral Nervous System (PNS)
another name for a nerve cell
neuron
neurons that carry information from the environment and the body to the CNS
Sensory Neurons
neurons that carry information away from the CNS to the body
motor neurons
name of the pathway for the motor neurons
descending (efferent) pathway
neurons that connect other neurons to each other
associational neurons
a group of neuron cell bodies outside of the CNS
ganglion
neuron cell bodies inside of the CNS that are grouped closely together and are responsible for one function
nuclei
neurons can not undergo _____
mitosis
rerouting of brain functions to remaining areas after damage
neuroplasticity
cell body of a neuron
soma
the location of a neuron’s destination where it meets up with another cell
synapse
chemicals released by the axon at the destination
neurotransmitters
extension away from the soma (cell body) with or without a covering
axon
insulating covering of some axons
myelin sheath
the swelling at the end of an axon that contains the neurotransmitters
synaptic knob (terminal buttons)
larger and faster axons, due to the insulating properties
myelinated axons
axons with slower conduction
non-myelinated axons
nodes along the axon where there is no myelin
nodes of Ranvier
cells that produce the myelin to cover the neurons and help their function
Schwann cells
star shaped cells that provide physical and nutritional support for neurons (supporting cell)
astrocyte (astroglia)
supporting cells that digest dead neurons
microglia
supporting cells that provide myelin to neurons in the CNS
oligodendroglia
supporting cells that are a physical support for neurons in the PNS
satellite cells
stored energy in the neuron cell body
resting potential
the cell is ______ inside and ______ outside
negative inside & positive outside
electrical polarity in a neuron is created by the _____
sodium potassium pump (Na-K pump)
chemicals synthesized in the soma of a neuron and stored at the end of an axon at the synaptic terminal
neurotransmitters
space between the axon and the receptor cell
synaptic cleft
what is the main inhibitory NT in the brain
gamma amino butyric acid (GABA)
what is the main excitatory NT in the brain
glutamate (glutamic acid)
NT that uses G-protein receptors called cholinergic
acetylcholine (ACh)
type of NT that is implicated in the pathogenesis of depression, narcolepsy, psychosis, and ADHD
monoamines
type of monoamine that affects regions of the pons and brainstem to regulate sleep induction, mood and anxiety
serotonin
what percentage of the body’s cardiac output is recieved by the brain and spinal cord (CNS)
20%
three main divisions of the brain
forebrain
midbrain (mesencephalon)
hindbrain
what is the clinical term for the part of the brain that is made up of the midbrain and the hindbrain
brainstem
another name for midbrain
mesencephalon
another name for the cerebellum and pons (in hindbrain)
metencephalon
another name for the medulla (in hindbrain)
myelencephalon
usual substrate for energy production in cerebral metabolism
glucose
how long does it take for a loss of blood flow due to lack of oxygen for aerobic respiration to cause a coma
5 to 10 seconds
name of the two anterior vessels that supply the brain with blood
carotid arteries
name the two posterior vessels supplying the brain with blood
basilar arteries
lack of blood flow in a specific artery
thrombosis
leaking of blood from a vessel
hemorrhage
________ encompasses a circle around the base of the brain that connects the carotid and basilar arteries
Circle of Willis
blockage of blood supply to the brain could be on or more of what four things
tumor
thrombosis
bleeding
injury
arterial blockage would cause _______
ischemia (lack of blood to the brain)
venous blockage would cause
increase cranial pressure
fluid of the spinal cord
cerebrospinal fluid (CSF)
what makes up the blood brain barrier (BBB)
neuroglia
tight junctions
3 areas of the brain not affected by the BBB
pineal gland
pituitary gland
hypothalamus
why does the BBB not apply to those 3 areas?
the brain has sample the body’s internal environment for body functions controlled by those parts of the brain
3 things can easily cross the BBB
water
lipid soluble substances
gases (O2 CO2)
things that have difficult entry across the BBB
proteins
electrolytes
larger molecules (including certain therapeutic drugs)
nerves that come out of the bottom of the spinal cord
cauda equina (horse’s tail)
white matter of the spinal cord
axons (myelin)
area of the spinal cord that contains the CSF
central canal
gray matter of the cord
soma (neuron cell bodies)
know anatomical position and terms
anterior posterior superior inferior ventral dorsal proximal distal medial lateral midline
bulging areas of the spinal cord where the peripheral nerves attach
“horns”
bundles of axons traveling together and serving the same function (pathways transmitting a certain type of information)
tracts
when a nerve tract crosses over from one side of the body to another at some point in the cord
decussation
membranes with spaces above and below the brain and membranes that contain structures or fluid
meninges
potential space above first layer of meninges which has a negative sub-atmospheric pressure
epidural space
first layer of meninge, including both the periosteum and the inner dura
dura matter
space below the dura matter containing blood vessels
subdural space
second layer of meninge
arachnoid membrane
space that forms the internal cavities of the brain (ventricles) that contains the CSF
subarachnoid space
last meninge layer that contains the choroid plexuses that make CSF
pia matter
PNS neurotransmitters (NTs) that release peripherally at sites of injury and inflammation, stimulated by histamine
neuropeptides (amino acid chains)
when sensory symptoms are in the body area that corresponds to any destructive processes in vertebrae or the spinal cord at that level of the spinal cord
radiculopathy
where a neuron synapses with skeletal muscle
neuromuscular junction
receptor on the skeletal muscle that accepts ACh from a neuron
nicotinic
first neuron that leaves the spinal cord
pre-synaptic neuron
second neuron that leaves the spinal cord that sends its axon to the destination or “end organ”
post-synaptic neuron
division of the motor nervous system that controls voluntary movements
somatic nervous system
division of the motor nervous system that controls involuntary responses
autonomic nervous system
two divisions of the autonomic nervous system
sympathetic
parasympathetic
which division of the ANS is “fight or flight”
sympathetic division
which division of the ANS is the “rest or digest” division
parasympathetic
cranial nerve that affects many visceral organs (parasympathetic)
vagus (vagal)
what is another term for adrenaline
epinephrine
NT released by most sympathetic post-synaptic neurons
catecholamines
catacholamine receptor that is on the lung and relaxes smooth muscle of the bronchioles to bronchodilate them and improve ventilation
beta-2 receptor
receptor on the heart that increases heart rate and force of ventricular contraction (BP)
beta-1 receptor
receptors on peripheral blood vessels for vasoconstriction of peripheral blood vessels and on genitourinary smooth muscle for smooth muscle contraction
alpha-1 receptors
receptors on fat cells that cause lypolysis and on smooth muscle of the bladder
beta-3 receptors
12 large nerves that enter the base of the brain
cranial nerves
name the 12 cranial nerves
1: olfactory
2: optic
3: oculomotor
4: trochlear
5: trigeminal
6: abducent
7: facial
8: vestibulocochlear
9: glossopharyngeal
10: vagus
11: accessory
12: hypoglossal
what is the main inhibitory NT in the brain
gamma amino butyric acid (GABA)
what is the main excitatory NT in the brain
glutamate (glutamic acid)
NT that uses G-protein receptors called cholinergic
acetylcholine (ACh)
type of NT that is implicated in the pathogenesis of depression, narcolepsy, psychosis, and ADHD
monoamines
type of monoamine that affects regions of the pons and brainstem to regulate sleep induction, mood and anxiety
serotonin
what percentage of the body’s cardiac output is recieved by the brain and spinal cord (CNS)
20%
three main divisions of the brain
forebrain
midbrain (mesencephalon)
hindbrain
what is the clinical term for the part of the brain that is made up of the midbrain and the hindbrain
brainstem
another name for midbrain
mesencephalon
another name for the cerebellum and pons (in hindbrain)
metencephalon
another name for the medulla (in hindbrain)
myelencephalon
usual substrate for energy production in cerebral metabolism
glucose
how long does it take for a loss of blood flow due to lack of oxygen for aerobic respiration to cause a coma
5 to 10 seconds
name of the two anterior vessels that supply the brain with blood
carotid arteries
name the two posterior vessels supplying the brain with blood
basilar arteries
lack of blood flow in a specific artery
thrombosis
leaking of blood from a vessel
hemorrhage
________ encompasses a circle around the base of the brain that connects the carotid and basilar arteries
Circle of Willis
blockage of blood supply to the brain could be on or more of what four things
tumor
thrombosis
bleeding
injury
arterial blockage would cause _______
ischemia (lack of blood to the brain)
venous blockage would cause
increase cranial pressure
fluid of the spinal cord
cerebrospinal fluid (CSF)
what makes up the blood brain barrier (BBB)
neuroglia
tight junctions
3 areas of the brain not affected by the BBB
pineal gland
pituitary gland
hypothalamus
why does the BBB not apply to those 3 areas?
the brain has sample the body’s internal environment for body functions controlled by those parts of the brain
3 things can easily cross the BBB
water
lipid soluble substances
gases (O2 CO2)
things that have difficult entry across the BBB
proteins
electrolytes
larger molecules (including certain therapeutic drugs)
nerves that come out of the bottom of the spinal cord
cauda equina (horse’s tail)
white matter of the spinal cord
axons (myelin)
area of the spinal cord that contains the CSF
central canal
gray matter of the cord
soma (neuron cell bodies)
know anatomical position and terms
anterior posterior superior inferior ventral dorsal proximal distal medial lateral midline
bulging areas of the spinal cord where the peripheral nerves attach
“horns”
bundles of axons traveling together and serving the same function (pathways transmitting a certain type of information)
tracts
when a nerve tract crosses over from one side of the body to another at some point in the cord
decussation
membranes with spaces above and below the brain and membranes that contain structures or fluid
meninges
potential space above first layer of meninges which has a negative sub-atmospheric pressure
epidural space
first layer of meninge, including both the periosteum and the inner dura
dura matter
space below the dura matter containing blood vessels
subdural space
second layer of meninge
arachnoid membrane
space that forms the internal cavities of the brain (ventricles) that contains the CSF
subarachnoid space
last meninge layer that contains the choroid plexuses that make CSF
pia matter
PNS neurotransmitters (NTs) that release peripherally at sites of injury and inflammation, stimulated by histamine
neuropeptides (amino acid chains)
when sensory symptoms are in the body area that corresponds to any destructive processes in vertebrae or the spinal cord at that level of the spinal cord
radiculopathy
where a neuron synapses with skeletal muscle
neuromuscular junction
what is the main inhibitory NT in the brain
gamma amino butyric acid (GABA)
what is the main excitatory NT in the brain
glutamate (glutamic acid)
NT that uses G-protein receptors called cholinergic
acetylcholine (ACh)
type of NT that is implicated in the pathogenesis of depression, narcolepsy, psychosis, and ADHD
monoamines
type of monoamine that affects regions of the pons and brainstem to regulate sleep induction, mood and anxiety
serotonin
what percentage of the body’s cardiac output is recieved by the brain and spinal cord (CNS)
20%
three main divisions of the brain
forebrain
midbrain (mesencephalon)
hindbrain
what is the clinical term for the part of the brain that is made up of the midbrain and the hindbrain
brainstem
another name for midbrain
mesencephalon
another name for the cerebellum and pons (in hindbrain)
metencephalon
another name for the medulla (in hindbrain)
myelencephalon
usual substrate for energy production in cerebral metabolism
glucose
how long does it take for a loss of blood flow due to lack of oxygen for aerobic respiration to cause a coma
5 to 10 seconds
name of the two anterior vessels that supply the brain with blood
carotid arteries
name the two posterior vessels supplying the brain with blood
basilar arteries
lack of blood flow in a specific artery
thrombosis
leaking of blood from a vessel
hemorrhage
________ encompasses a circle around the base of the brain that connects the carotid and basilar arteries
Circle of Willis
blockage of blood supply to the brain could be on or more of what four things
tumor
thrombosis
bleeding
injury
arterial blockage would cause _______
ischemia (lack of blood to the brain)
venous blockage would cause
increase cranial pressure
fluid of the spinal cord
cerebrospinal fluid (CSF)
what makes up the blood brain barrier (BBB)
neuroglia
tight junctions
3 areas of the brain not affected by the BBB
pineal gland
pituitary gland
hypothalamus
why does the BBB not apply to those 3 areas?
the brain has sample the body’s internal environment for body functions controlled by those parts of the brain
3 things can easily cross the BBB
water
lipid soluble substances
gases (O2 CO2)
things that have difficult entry across the BBB
proteins
electrolytes
larger molecules (including certain therapeutic drugs)
nerves that come out of the bottom of the spinal cord
cauda equina (horse’s tail)
white matter of the spinal cord
axons (myelin)
area of the spinal cord that contains the CSF
central canal
gray matter of the cord
soma (neuron cell bodies)
know anatomical position and terms
anterior posterior superior inferior ventral dorsal proximal distal medial lateral midline
bulging areas of the spinal cord where the peripheral nerves attach
“horns”
bundles of axons traveling together and serving the same function (pathways transmitting a certain type of information)
tracts
when a nerve tract crosses over from one side of the body to another at some point in the cord
decussation
membranes with spaces above and below the brain and membranes that contain structures or fluid
meninges
potential space above first layer of meninges which has a negative sub-atmospheric pressure
epidural space
first layer of meninge, including both the periosteum and the inner dura
dura matter
space below the dura matter containing blood vessels
subdural space
second layer of meninge
arachnoid membrane
space that forms the internal cavities of the brain (ventricles) that contains the CSF
subarachnoid space
last meninge layer that contains the choroid plexuses that make CSF
pia matter
PNS neurotransmitters (NTs) that release peripherally at sites of injury and inflammation, stimulated by histamine
neuropeptides (amino acid chains)
when sensory symptoms are in the body area that corresponds to any destructive processes in vertebrae or the spinal cord at that level of the spinal cord
radiculopathy
where a neuron synapses with skeletal muscle
neuromuscular junction
what is the main inhibitory NT in the brain
gamma amino butyric acid (GABA)
what is the main excitatory NT in the brain
glutamate (glutamic acid)
NT that uses G-protein receptors called cholinergic
acetylcholine (ACh)
type of NT that is implicated in the pathogenesis of depression, narcolepsy, psychosis, and ADHD
monoamines
type of monoamine that affects regions of the pons and brainstem to regulate sleep induction, mood and anxiety
serotonin
what percentage of the body’s cardiac output is recieved by the brain and spinal cord (CNS)
20%
three main divisions of the brain
forebrain
midbrain (mesencephalon)
hindbrain
what is the clinical term for the part of the brain that is made up of the midbrain and the hindbrain
brainstem
another name for midbrain
mesencephalon
another name for the cerebellum and pons (in hindbrain)
metencephalon
another name for the medulla (in hindbrain)
myelencephalon
usual substrate for energy production in cerebral metabolism
glucose
how long does it take for a loss of blood flow due to lack of oxygen for aerobic respiration to cause a coma
5 to 10 seconds
name of the two anterior vessels that supply the brain with blood
carotid arteries
name the two posterior vessels supplying the brain with blood
basilar arteries
lack of blood flow in a specific artery
thrombosis
leaking of blood from a vessel
hemorrhage
________ encompasses a circle around the base of the brain that connects the carotid and basilar arteries
Circle of Willis
blockage of blood supply to the brain could be on or more of what four things
tumor
thrombosis
bleeding
injury
arterial blockage would cause _______
ischemia (lack of blood to the brain)
venous blockage would cause
increase cranial pressure
fluid of the spinal cord
cerebrospinal fluid (CSF)
what makes up the blood brain barrier (BBB)
neuroglia
tight junctions
3 areas of the brain not affected by the BBB
pineal gland
pituitary gland
hypothalamus
why does the BBB not apply to those 3 areas?
the brain has sample the body’s internal environment for body functions controlled by those parts of the brain
3 things can easily cross the BBB
water
lipid soluble substances
gases (O2 CO2)
things that have difficult entry across the BBB
proteins
electrolytes
larger molecules (including certain therapeutic drugs)
nerves that come out of the bottom of the spinal cord
cauda equina (horse’s tail)
white matter of the spinal cord
axons (myelin)
area of the spinal cord that contains the CSF
central canal
gray matter of the cord
soma (neuron cell bodies)
know anatomical position and terms
anterior posterior superior inferior ventral dorsal proximal distal medial lateral midline
bulging areas of the spinal cord where the peripheral nerves attach
“horns”
bundles of axons traveling together and serving the same function (pathways transmitting a certain type of information)
tracts
when a nerve tract crosses over from one side of the body to another at some point in the cord
decussation
membranes with spaces above and below the brain and membranes that contain structures or fluid
meninges
potential space above first layer of meninges which has a negative sub-atmospheric pressure
epidural space
first layer of meninge, including both the periosteum and the inner dura
dura matter
space below the dura matter containing blood vessels
subdural space
second layer of meninge
arachnoid membrane
space that forms the internal cavities of the brain (ventricles) that contains the CSF
subarachnoid space
last meninge layer that contains the choroid plexuses that make CSF
pia matter
PNS neurotransmitters (NTs) that release peripherally at sites of injury and inflammation, stimulated by histamine
neuropeptides (amino acid chains)
when sensory symptoms are in the body area that corresponds to any destructive processes in vertebrae or the spinal cord at that level of the spinal cord
radiculopathy
where a neuron synapses with skeletal muscle
neuromuscular junction
5 examples of spinal reflexes (primative) that neonates possess
sucking palmar grasp moro stepping rooting
pain that is limited in duration and alerts us to a problem
acute pain
pain that lasts longer than normal persisting beyond resolution of an underlying disorder or healing of injury
chronic pain
dull, poorly localized pain occurring in bone, ligaments, tendons, muscle, and fascia
somatic pain
aching, difficult to lacalize, referred pain that occurs in the body’s internal organs but is localized to another area of the body
visceral
injury to skin or the skin strutures
cutaneous injury
injury to the nerves, spinal cord, or brain
neuropathic pain
fifth vital sign
pain rating
ABCDE of pain assessment and management
Ask about pain regularly
Believe report of pain and relief agents from patient
Choose pain control options appropriately
Deliver interventions
Empower patients as much as possible
some examples of pain indications include:
grimacing guarding, protective behavior of a certain area vocalizations body movements pallor diaphoresis pupil dilation decreased attention span confusion
what is the most common pain scale for adults
numeric pain scale (from 1 to 10)
what is the most popular pain scale for children
Wong-Baker Faces
who must have pain assessed by a checklist of non-verbal indicators
neonates critical care (can't respond)
part of the brain that controls the internal environment
hypothalamus
type of sleep where the sleeper’s eyes can be seen moving beneath partially closed eyelids
rapid eye movement (REM)
type of sleep where vitals, muscle tone, reflexes, and cerebral blood flow are decreased
non-REM (NREM)
map of sleep pattern
EEG (electroencephalogram)
what sleep stages does slow wave sleep (SWS) take place in
stages 3 and 4
what mental activity occurs during slow wave sleep (SWS)
memory consolidation
what stage of sleep comprises about 20-25% of total sleep and occurs every 90 minutes after the first 1-2 hours of sleep
REM
physiological changes occur during REM sleep
sexual excitement
loss of voluntary tongue/larynx musculature
hour much time per day to newborns typically sleep
16-17 hours (mostly REM)
group of primary sleep disorders that is a change in normal sleep patterns
dyssomnias
group of sleep disorders that is something happening during sleep and disrupting it (walking, nightmares…)
parasomnia
sleep study:
polysomnography
sudden loss of muscle tone and stability (drop attacks)
cataplexy
sleep disorder characterized by recurrent sleep attacks that are 10-20 minutes long, with cataplaxy, hallucinations, and sleep paralysis
narcolepsy
breathing related sleep syndromes
sleep apnea syndromes
blockage of upper airway during sleep, mostly in the obese
obstructive sleep apnea
three types of circadian rhythm sleep disorders
jet lag
shift work
delayed sleep phase (night owls)
three types of childhood parasomnias
nightmare disorder
sleep terror disorder
somnabulism
sleep disorder where one is awakened from sleep by nightmares, and they are fully awake on arousal
nightmare disorder
sleep disorder where one is awakened screaming from stage 3 or 4 NREM sleep and they are disoriented and don’t remember why they are screaming
sleep terror disorder
sleepwalking usually during stage 3 or 4 NREM sleep
somnabulism
“crib death” possibly due to central or destructive apnea, position during sleep, or immature hindbrain where the brain doesn’t realize that there is elevated CO2
Sudden Infant Death Syndrome (SIDS)
main assessment scale that exists to evaluate the depth of a coma
Glasgow Coma Scale
disorder characterized by severe and pervasive impairment in thinking, feeling, language, and the ability to relate to others
Autism Spectrum Disorder (ASD)
seizure disorder
epilepsy
recording of electrical activity from the brain
electro-encephalogram (EEG)
two common types of seizures
generalized
partial
type of seizure that has widespread electrical discharge that affects both sides on the brain (often genetic)
generalized
type of seizure that has abnormal electrical discharge in only one part of the brain, and can be due to a variety of different causes
partial
progressive loss of memory and learning with associated behavioral and adaptive deterioration resulting in early death
dementia
ABC’s of dementia (3 domains of disability)
Activity
Behavior
Cognition (memory, language, learning, perception, abstract thinking, judgement )
type of dementia that is the most common in the USA: age related, gradual symptoms over time, neurofibrillary tangles, amyloid plaque deposition, loss of cholinergic neurons producing ACh)
Alzheimer’s
rapidly progressive dementia that is seen alone or with other pathologies
Lewy-body dementia
dementia usually caused by the same risk factors as in any cardiovascular disease (high bp, high cholesterol, smoking)
vascular dementia
autosomal dominant genetic illness where a DNA mutation causes a gene to expand more than it is supposed to which ultimately leads to death of neurons and an imbalance in the basal ganglia with overactive dopaminergic pathways
Huntington’s Disease
familial cause of brain degeneration and coordination difficulties with a resting tremor. (bradykinesia, soft speech, postural instability, abnormal gait, progressive rigidity)
Parkinson’s Disease
any physiological disruption of brain function that is traumatically induced. involves LOC, retrograde or anterograde amnesia and altered mental state at time of diagnosis
traumatic brain injury
type of traumatic brain injury that is a brainstem contusion caused by a shaking type injury or trauma involving rotational stresses (shaken baby syndrome, car accident)
diffuse axonal injury
type of child abuse that is also called acute head trauma that includes any kind of head injury inflicted on a child
shaken baby syndrome
most common type of stroke in adults that is caused by a blood clot (thrombotic)
ischemic
type of stroke that is caused by a inter-cranial bleed
hemorrhagic
what does the stroke acronym “FAST” stand for?
Face (uneven or droopy?)
Arm (one hanging down?)
Speech (slurred?)
Time (call 911 NOW)
autoimmune attack against the acetylcholine receptors on the skeletal muscle with presentations including affected bulbar muscles, slack facial muscles and neck weakness
Myasthenia Gravis
most common demylinating disease where a loss of myelin around CNS neurons causes a loss of neurological function and often there is loss of vision in one eye
Multiple Sclerosis
disease caused by the over-accumulation of the neurotransmitter glutamate in the CNS, causing excito-toxicity of anterior horn cells in the spinal cord. neurons die and there is a loss of lower motor function, and muscle paresis. eventually loses ability to speak, swallow and breath
Amyotrophic Lateral Sclerosis (ALS) (aka Lou Gehrig’s Disease)
