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Neuro Module > Physiology of Nervous System > Flashcards

Physiology of Nervous System Flashcards

1
Q

How is the metabolism of nervous tissue unique from other body tissues?

A
  • Constant, very high, metabolic rate
  • Depend entirely on glucose
  • Limited or no anaerobic capabilities
  • Don’t store an energy source (glycogen)
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2
Q

Effects of low glucose on neurons

A
  • Neurons malfunction and if prolonged may die
  • Primarily effects higher cortical levels
  • patient “spaced out”, irritable, diaphoretic, blurred vision, coma, seizure
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3
Q

Effects of low oxygen on neurons

A
  • More dramatic than low glucose
  • rapidly induces confusion and coma
  • Neuronal death in 3-4 min
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4
Q

3 major embryologic divisions of the brain

A
  1. forebrain (cerebral cortex, thalamus, hypothalamus, basal ganglia)
  2. midbrain
  3. hindbrain (cerebellum, pons, medulla)
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5
Q

What is the largest portion of the brain and what does it consist of?

A

cerebrum, consisting of cerebral cortex and basal ganglia

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6
Q

grey matter vs white matter in cerebrum

A

grey matter - cell bodies and dendrites

white matter - myelinated nerve fibers beneath cortex

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7
Q

reticular formation

A

Large network of nuclei (grey matter) in brainstem that regulate CV, respiratory rate, and wakefulness/consciousness

reticular formation + cerebral cortex = reticular activating system

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8
Q

General functions of the limbic system

A

emotions (rage, fear), feeding behaviors, bio rhythms, smell

eg. music/smell makes you think of particular memory

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9
Q

General functions of the frontal lobe

A

thought and judgement

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10
Q

Neuroglia

A

cells that support neurons of CNS

50% of brain and spinal cord volume

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11
Q

astrocytes

A
  • Most abundant glial cells
  • Surround BV of CNS and fill space between neurons
  • Provide rapid transport of nutrient and metabolites
  • Essential components of blood brain barrier
  • “scar forming” cells (foci for seizures)
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12
Q

myelinated vs unmyelinated

A

myelinated have myelin sheath and use saltatory conduction

unmyelinated do not have and use continuous conduction

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13
Q

salutatory conduction

A

allows for faster conduction of a nerve impulse because impulses jump from node to node (gaps in myelin)

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14
Q

inhibitory vs excitatory neurotransmitters

A

inhibitory: hyperpolarize; make harder for neuron to reach threshold (GABA)
excitatory: depolarize; make neuron less negative; easier to reach threshold (glutamate)

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15
Q

What produces myelin?

A

Schwann cells in PNS

Oligodendrocytes in CNS

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16
Q

What type cells are damaged by Guillain-Barre? Effects?

A

Antibodies destroys Schwann cells and axonal myelin

prevents nerves from transmitting signals to brain, causing weakness, numbness, or paralysis

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17
Q

GABA

A
  • most common inhibitory neurotransmitter in brain
  • used to treat seizures
  • GABA release is blocked in tetanus
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18
Q

IPSP vs EPSP

A

IPSP: passage of hyperpolarizing ions into cell (chloride)

EPSP: passage of depolarizing ions into cell (Na/K)

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19
Q

ependymal cells

A

neuroglia that line the ventricles and are involved in CSF production

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20
Q

microglia

A

neuroglia that remove debris via phagocytosis in CNS

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21
Q

plasticity

A

CNS capability of changing what a region of the brain does

Capability in children high, but declines with age

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22
Q

substantia gelatinosa

A

part of posterior horn with sensory axons involved in pain transmission

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23
Q

spinothalamic tract

A

pain and temp

crosses at spinal level

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24
Q

medial lemniscus tract

A

touch, pressure, vibration, proprioception

crosses at medulla

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25
Q

tracts that run through anterior horn?

A

MOTOR pathways - corticospinal tract and corticobulbar tract

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26
Q

Where do motor axons cross midline?

A

medullary pyramid

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27
Q

corticobulbar tract specifically controls what?

A
  • muscles of head and face

- motor component of cranial nerves 5, 7, 9-12

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28
Q

spinal reflexes

A

reflexes contained within the spinal cord

afferent neuron (sensory) -> interneuron -> efferent neuron (motor) -> effector muscle or gland

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29
Q

_______ influence and modify reflex spinal arcs.

A

upper motor neurons

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30
Q

What nerves make up the PNS?

A

cranial nerves and spinal nerves

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31
Q

______ pathways carry SENORY impulses _____ the CNS.

_______ pathways carry MOTOR impulses _____ the CNS.

A

afferent; towards

efferent; away from

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32
Q

What do motor impulses target?

A

effector organs - skeletal, cardiac, smooth muscle; glands

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33
Q

What are the divisions of PNS?

A

somatic: motor/sensory of voluntary motor control of skeletal muscle
autonomic: motor/sensory of involuntary muscles (sympathetic & parasympathetic)

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34
Q

Wallerian degeneration

A

Degeneration of peripheral nerve fiber (axon and myelin) that has been severed from its cell body (nutrition center)

Occurs at DISTAL portion of severed axon

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35
Q

Wallerian regeneration

A

PROXIMAL end of injury site sprouts new terminal 1-2 wks after injury, hopefully connecting with Schwann cell pathway and grow approx 1 mm/day

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36
Q

Where is Wallerian regeneration restricted to in nervous system? Why?

A

Regeneration limited to PNS

Very limited in CNS d/t scar formation after injury and different nature of myelin production by oligodendrocytes

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37
Q

intension vs resting tremor

A

intension occurs with movement or following commands

resting occurs at rest when not thinking about it

38
Q

chorea

A

quick, irregular, involuntary, but relatively coordinated movement face, limbs, trunk

39
Q

athetosis

A

distal muscle postural fixation disorder; slower than chorea, writhing, sinuous, abnormal hand posture, slowly fluctuating grimaces

40
Q

ballism

A

proximal muscle postural fixation; wild flinging movement of limbs - usually unilateral

41
Q

agnosia

A
  • inability to recognize and interpret objects, people, sounds, or smells despite intact primary sense organs
  • ex: inability to identify a sound despite intact hearing; inability to identify a coin placed in hand; inability to recognize familiar faces
  • damage to occipital & parietal lobe
42
Q

akinesia

A

paucity of movement

43
Q

allodynia

A

condition in which an ordinarily painless stimulus is experienced as being painful (ex. the pant leg touching the thigh is described as uncomfortable)

44
Q

anosognosia

A

Lack of self-awareness; unaware they have a problem or disability

Ex: schizophrenic who doesn’t take meds because “there is nothing wrong with me” or hemiplegic who finds excuses (other than paralysis) for not using paralyzed arm

45
Q

apnea test

A

part of “brain death exam” where patient taken off the ventilator for a certain amount of time

  • Verifies lack of responsiveness to increased carbon dioxide (paCO2 > 60 mm Hg) in the presence of respiratory acidosis (pH < 7.3)
46
Q

aphasia

A

inability to formulate or understand language

47
Q

expressive vs receptive aphasia

A

expressive: damage to Broca’s; have understanding but can’t produce speech
receptive: damage to Wernicke’s; speak without understanding; “word salad”

48
Q

apraxia

A

impaired planning/sequencing of movement that is not due to weakness, incoordination, or sensory loss. Although the movements cannot be performed for a specific situation, they may be performed under other circumstances (e.g., inability to lift feet off the floor when attempting to walk but preserved ability to perform bicycling movements of the legs while lying in bed)

49
Q

asterixis

A

sudden palmar flapping movement of the hands at the wrists; indicative of hepatic encephalopathy

50
Q

ataxia

A

Lack of coordination of movement usually due to disease of cerebellum or damage to sensory pathways

51
Q

bradykinesia

A

slowed movement typically due to dysfunction of the basal ganglia and related structures

52
Q

Charcot joint

A

progressive destruction and deformity of bone and soft tissue at weight bearing joints due to severe sensory or autonomic neuropathy.

53
Q

Chiari malformation

A

CNS disorder characterized by cerebellar elongation and protrusion through the foramen magnum into cervical spinal cord. Places these individuals at risk with extension of the head on the neck

54
Q

“clasp knife”

A

spring-like resistance to passive extension at elbow or flexion at knee that increases up to a certain length and force before suddenly relaxing as the Golgi tendon organ is activated; sign of spasticity

55
Q

“cogwheeling”

A

ratchet movement due to superimposition of tremor on rigidity

56
Q

dysarthria

A

inability to pronounce or articulate words d/t disorder of vocal apparatus (lips, tongue, larynx)

57
Q

dysesthesia

A

pain or discomfort in response to stimuli (e.g. touch) that would not be expected

58
Q

fasciculation

A

spontaneous firing of axon resulting in visible twitch of all muscle fibers that it controls; indicates denervation

59
Q

hemiparesis

A

weakness on one side of body

60
Q

hemiplegia

A

paralysis on one side of body

61
Q

Horner’s Syndrome

A

ptosis, miosis, and anhidrosis - ipsilateral to damaged sympathetic nerve fibers

62
Q

Kernig’s sign

A

pain in posterior thigh in response to passive flexion of thigh and extension of knee; indicative of meningeal irritation

63
Q

Long-tract signs

A

signs referable to impaired functioning of corticospinal tract, spinothalamic tract, and dorsal columns/medial lemniscus

64
Q

Lower motor neuron lesion

A

neurons located in brainstem or anterior horn

lesions result in flaccid weakness, reflex loss, atrophy, +/- fasciculations

65
Q

meiosis

A

pupillary constriction

66
Q

neuropathy

A

disease of axons; manifested by varying combinations of lower motor neuron weakness or peripheral sensory loss that is typically distal > proximal; often with DTR reflex impairment or loss

67
Q

paresthesia

A

skin sensation such as burning, prickling, itching, or tingling with no apparent physical cause

68
Q

rigidity

A

increased resistance throughout range of motion when passively moving a body part due to co-contraction of agonist and antagonist muscles (“lead pipe”)

69
Q

Romberg test

A

inability to maintain upright posture when feet together and eyes closed; assuming intact vestibular system, indicates impaired proprioception or cerebellar disease

70
Q

simple tic

A

tic involving a limited number of muscles; simple vocal tics are meaningless noises such as grunting or throat clearing; simple motor tics are focal movements such as eye blinking or facial grimacing

71
Q

spasticity

A

abnormal increase in muscle tone and reflexes; indicates upper motor neuron lesion

72
Q

spondylosis

A

degenerative disease of vertebral column that results in spinal cord compression. May include osteoarthritis, osteophytes, and disc disease

73
Q

spondylolisthesis

A

condition where vertebral body, typically in lumbar or sacral, slips forward and has a “step off”
May cause spinal cord compression

74
Q

transient ischemic attack

A

abrupt focal loss of neurologic function caused by reduction in blood flow that persists less than 24 hours and clears without residual disability

75
Q

2-point discrimination

A

an increase in distance in which a patient distinguishes two differing points of stimulation.

An increased distance suggests neuropathy (ex. carpal tunnel)

76
Q

vertigo

A

subjective sense of imbalance usually noted as “room spinning”

77
Q

How are nerve fiber sizes and myelination related to function?

A

Large: myelinated motor fibers
Medium: myelinated sensory (touch, vibrations, proprioception)
Small: thinly myelinated to unmyelinated sensory (pain and temp)
Very small: unmyelinated autonomic fibers (BP, HR, sweating, gut)

78
Q

Signs of UMN lesion

A

weakness
spasticity
increased DTRs
+ Babinski

79
Q

Signs of LMN lesion

A

weakness
fasciculations
decreased/loss of DTRs
atrophy

80
Q

Signs of basal ganglia pathology

A 
akinesia
resting tremor
rigidity
athetosis
chorea
81
Q

Signs of cerebellar pathology

A

errors of rate, range, force, & direction
intension tremor
ataxia

82
Q

central cord syndrome

A
  • incomplete injury to cervical cord resulting in more extensive motor weakness in UE than LE. - occurs from hyperextension injury with pre-existent osteophytic
83
Q

Brown-Sequard syndrome

A

injury to one half of the spinal cord; deficits all on ipsilateral side except pain/temp contralateral

84
Q

Dermatome of posterior leg and lateral foot

A

S1

85
Q

Dermatome of medial foot

A

L4

86
Q

Dermatome of bottom and top of foot

A

L5

87
Q

Dermatome of sphincter

A

S3-S5

88
Q

Rash that follows dermatome

A

shingles

89
Q

Examples of primitive rooting reflexes

A

primitive reflexes exist in infants but should go away in adults

grasp reflex
cheek reflex
Babinski

90
Q

decorticate

A

lesion of the cortical spinal tract superior to brainstem

Neuro Module (13 decks)

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