Praxis Study Guide (Part 2) Flashcards
What are axons bound together by connective tissue? They are a group of fibers outside the CNS. Spinal nerves contain fibers of sensory and motor neurons.
Nerves
What are individual cells in the brain? Examples include dendrites, axons, and cell bodies.
Neurons
What are the group of fibers inside the CNS? The spinal tracts carry information up/down the spinal cord, to and from the brain.
Tracts
What are the motor nerves where the brain sends signals down to the nerve to innervate a muscle? (Exits)
Efferent
What are the sensory nerves where the signal comes up from the sensory organ via a nerve to the brain? (Arrives)
Afferent
What are the tracts that carry fibers to the spinal cord/brainstem? They originate in the cerebral cortex and have voluntary control of the body and face muscles.
Pyramidal Tracts
What are the tracts that carry fibers to the spinal cord that originate in the brainstem? They have involuntary and automatic control (tone, balance, posture, etc.)
Extrapyramidal Tracts
What neurons are found in the cerebral cortex/brainstem and transmit nerve impulses from the brain to the lower motor neurons?
Upper Motor Neurons
What neurons are found in the brainstem/spinal cord and transmit nerve impulses from the upper motor neurons to muscles?
Lower Motor Neurons
What tract has synapses that terminate in the spinal cord? It controls movements in the limbs and trunk.
Corticospinal
What tract has synapses that terminate in the brainstem? It controls the muscles of the face, head, and neck.
Corticobulbar
One side innervating
Unilateral
Both sides innervating
Bilateral
Same side of body
Ipsilateral
Opposite side of body
Contralateral
Near given position
Proximal
Away from given position
Distal
In front of
Anterior
Behind
Posterior
Above
Superior
Below
Inferior
Front, towards the nose
Rsotral
Back, towards the tail
Caudal
What system is made up of the brain and spinal cord?
Central Nervous System (CNS)
What system is made up of all other nerves except for the brain and spinal cord? For example, it includes the cranial nerves and the spinal nerves.
Peripheral Nervous System (PNS)
What are the involuntary muscle systems? It makes up cardiac and smooth muscles and glands.
Autonomic
What are the voluntary muscle systems? It includes the skeletal muscles.
Somatic
What division provides the “fight or flight” response? It is part of the Automatic portion of the PNS.
Sympathetic Division
What division controls the body’s functions at rest? It is part of the Automatic portion of the PNS.
Parasympathetic Division
What division of the brain processes sensory information, reasons/problem-solves, and controls automatic motor functions? It is the largest brain division and has 2 subdivisions.
Telencephalon = Cerebral cortex that is divided into 4 major lobes (Frontal, Parietal, Temporal, and Occipital)
Diencephalon = Connects endocrine with nervous system (Thalamus, Hypothalamus, Pineal Gland)
Forebrain
What division of the brain regulates movement and processes auditory and visual information? It connects the forebrain to the hindbrain and has 2 main parts (Tectum and Paired Cerebral Peduncles).
Midbrain
What division of the brain regulates autonomic functions, balance, equilibrium, and relay of sensory information? It has 2 subdivisions: Metencephalon and Myelencephalon.
Metencephalon = Pons & cerebellum
Myelencephalon = Medula oblongata
Hindbrain
Location: front area of skull, composed of two hemispheres (left/right)
Function: “thinking portion” of brain; most complex cognitive functions
Cerebrum
Location: base of brain-cerebrum juncture + spinal cord; midbrain, pons & medulla
Function: automatic reflexes/vegetative functions (e.g., breathing, heart rate, etc.)
Brainstem
Location: hangs off the back of the brainstem under the occipital lobe
Function: voluntary movements; balance, coordination, posture, attention
Cerebellum
Location: lower portion of brainstem, below pons
Function: regulates respiration, heart rate + reflexes such as vomiting, swallowing
Medulla
Location: middle portion of the brainstem
Function: attachment between cerebellum and rest of CNS
Pons
Location: upper (superior) most part of the brainstem
Function: houses substantial nigra (production of neurotransmitter - dopamine)
Midbrain
Location: deep within cerebral hemispheres (either side of the thalamus); telencephalon
Function: fine-tunes voluntary body movements, motor coordination, posture
Basal Ganglia
Location: housed within the bony vertebral column, PNS begins here
Function: allows afferent impulses to transmit to the brain + efferent from brain-body
Spinal Cord
Location: top of brainstem; core of diencephalon
Function: relay center for sensory signals; and also motor
Thalamus
Location: below thalamus; posterior to the optic chiasm
Function: homeostasis, regulates hunger/thirst, pain/pleasure, anger/aggression
Hypothalamus
Location: within the inferior and medial section of the temporal lobe
Function: responsible for new memories, emotions, spatial navigation
Hippocampus
Location: nuclei located within temporal lobes
Function: responsible for emotions, arousal, motivation
Amygdala
Location: Brodmann area 41
Function: auditory processing/sensory hearing area
Heschl’s Gyrus
Location: area 39
Function: involved in semantic processing, language, and cognition / complex language-related functions
Angular Gyrus
Location: area 44
Function: motor speech area; speech production
Broca’s Area
Location: area 22
Function: language comprehension area; processing
Wernicke’s Area
Location: area 17
Function: visual processing area
Primary Visual Area
Location: area 1, 2, 3
Function: somatic sensations processing area
Primary Sensory Area
Location: area 4
Function: planning + execution of movements
Primary Motor Area
Which hemisphere is language dominant? Damage to this hemisphere leads to aphasia.
Left Hemisphere
Which hemisphere is the supporting language hemisphere? Damage to this hemisphere will lead to higher-order language and perceptual damage
Right Hemisphere
Which lobe of the brain is the primary motor area and controls executive function and motor movements? It controls Broca’s area (speech production), memory, attention, and motivation. It also controls language production, cognitive functions, and voluntary movement.
Frontal Lobe
Which lobe of the brain functions in auditory processing, language comprehension, and memory? It contains Wernicke’s area (language comprehension/processing) and helps with memory.
Temporal Lobe
Which lobe of the brain contains the sensory-motor area? It functions in spatial reasoning, math, reading, sensation, hearing, smell, taste, and touch.
Parietal Lobe
Which lobe of the brain contains the visual area? It receives visual cues from the opposite visual fields and functions in color identification, vision, and visual processing.
Occipital Lobe
What connects the internal carotid and vertebral/basilar system? It contains the Middle Cerebral Artery, the Anterior Cerebral Artery, and the Posterior Cerebral Artery.
Circle of Willis
What artery extends upward and forward from the internal carotid artery? It provides blood supply to the frontal and parietal lobes, basal ganglia, and corpus callosum. A stroke in this area will lead to opposite leg weakness!
Anterior Cerebral Artery
What artery is the largest branch of the internal carotid? It supplies blood to Broca’s and Wernicke’s area, the temporal lobe, and the primary motor cortex. This is the artery that is most often occluded in a stroke.
Middle Cerebral Artery
Which artery is the stem from the basilar artery (in most people)? It supplies blood to the occipital lobes, the cerebellum, and the inferior temporal.
Posterior Cerebral Artery
What matter has 3 primary types in the CNS (Association, Commissural, and Projection Fibers)?
White Matter
What fibers are interhemispheric and connect the right and left hemispheres? They interconnect identical and corresponding areas of 2 cerebral hemispheres.
Commissural Fibers
What fibers are Intra hemispheric and have connections within the same hemisphere? They connect different regions of the cerebral cortex within the same hemisphere.
Association Fibers
What fibers leave cerebral white matter? They connect the cerebral cortex to the brainstem and below.
Projection Fibers
This cranial nerve has both sensory and motor involvement and it originates in the Pons. It provides somatic sensation to the face, lips, and jaw, helps control the position of the bolus in the mouth/cheeks, and oral mucosa, teeth, and gum sensation. It also controls the muscles of mastication, and assists in the elevation of the hyoid and larynx. This cranial nerve is CN V.
Trigeminal
This cranial nerve has both sensory and motor involvement and it originates in the Pons. It allows for lip (shape, motion, and seal), tone/movement of the cheeks, elevation of the hyoid, and facial movement and expression. It also facilitates taste for the anterior 2/3 of the tongue, stimulates the salivary glands, and gives sensation to the face/oral cavity/soft palate. This cranial nerve is CN VII.
Facial
This cranial nerve has both sensory and motor involvement and it originates in the Medulla. It controls the larynx, pharynx, abdominal viscera, and velum movement. This cranial nerve is CN XI.
Vagus
This cranial nerve has motor involvement and it originates in the Medulla. It innervates all intrinsic muscles of the tongue but 1 extrinsic muscle and it controls tongue motion, bolus preparation, removing food particles, and mixing the bolus with saliva. It functions in transporting the bolus to the pharynx and is CN XII.
Hypoglossal
This cranial nerve has motor involvement and it originates in the Medulla/Spinal Cord. It controls the shoulder and neck muscles (sternocleidomastoid, temporalis muscles), velopharyngeal closure, head-turning, should shrug, and also assists with vagus nerve movement. It is CN XI.
Accessory
This cranial nerve has both sensory and motor involvement and it originates in the Medulla. It controls larynx/pharynx elevation (superior portion), stylopharyngeus muscle, and pharyngeal constriction/shortening. It also allows for taste (posterior 1/3 of the tongue) and stimulates the parotid gland (saliva) and the gag reflex. It is CN IX.
Glossopharyngeal
Motor:
–open/close jaw
–open jaw against resistance
–move jaw side to side
–clench teeth
Sensory
–sensation of cheeks/forehead/chin (patient closes eyes and identifies where he/she feels clinician tough on face)
Assessment of Trigeminal Nerve
Motor
–assess facial symmetry
–elevate/depress eyebrows
–protrude/retract lips
–shut eyes tight
Sensory
–taste for sweet, sour, etc. on anterior 2/3 of tongue
Assessment of Facial Nerve
Motor
–Assess CN IX with CN X
–soft palate at rest
–soft palate during movement (say “ah”)
–lip and VP seal (listen for nasal emission)
Sensory
–taste for sweet, sour, etc. on posterior 1/3 of tongue
Assessment of Glossopharyngeal and Vagus Nerves
Motor
–head turn
–head turn against resistance
–shoulder shrug (assess symmetry and movement)
Assessment of Accessory Nerve
Motor
–assess tongue at rest and symmetry
–tongue lateralization (left/right)
–tongue strength: against resistance
Assessment of Hypoglossal Nerve
What muscle of mastication connects the mandible and the cheekbone? It elevates the mandible and closes the mouth.
Masseter Muscle
What muscle of mastication is a large, fan-shaped muscle? It retracts and elevates the mandible and allows for side-to-side movement.
Temporalis Muscle
What muscle of mastication connects the mandible with the maxilla, sphenoid, and palatine bones? It elevates the mandible and protrudes the tongue.
Medial Pterygoid
What muscle of mastication is a two-headed muscle located in the infratemporal fossa of the skull? It depresses and protrudes the mandible to open the mouth.
Lateral Pterygoid
What is the process of inspiration and expiration where gas is exchanged (CO2 out and O2 in)
Respiration
What is the porous, spongy organ of breathing located in the thoracic cavity?
Lungs
What is the vertebral Column? It contains 7 cervical (neck), 12 thoracic (chest), 5 lumbar (abdomen), 5 sacral fused (lower back), and 3-4 coccygeal fused (lower back).
Skeletal Structure
What is the type of breathing in which the goal of life is sustenance? It is automatic and consistent.
Vegetative Breathing
What is the type of breathing in which expiration is more important than inspiration because we speak on exhalation?
Speech Breathing
What is the process of inspiration and expiration?
Ventilation
During this process, air enters the lungs after the contraction of the inspiratory muscles. The diaphragm contracts and pulls downward, the external intercostal muscles contract, the thoracic cavity expands, and air rushes into the lungs.
Process of Inspiration
During this process, air exits the lungs after the relaxation of the inspiratory muscles. The diaphragm relaxes and rises, the internal intercostal muscles relax, the thoracic cavity collapses, and air rushes out of the lungs.
Process of Exhalation
What is the organ at the top of the neck that is involved in breathing, sound production, and aspiration prevention?
Larynx
What is the area above the vocal folds?
Supraglottis
What is the area below the vocal folds?
Subglottis
What is the most inferior cartilage? It is ring-shaped.
Cricoid
What is the only paired major cartilage?
Arytenoid
What do the suprahyoid and the stylopharyngeus do?
Elevate the Larynx
What does the posterior cricoarytenoid do?
Vocal Fold Abduction
What is the largest cartilage? It is also called Adam’s apple.
Thyroid
What attaches to the apex of the arytenoid cartilages?
Corniculate
What does the infrahyoid do?
Depress the Larynx
What do the lateral cricoarytenoid, transverse arytenoid, oblique arytenoid, cricothyroid, and thyroarytenoid do?
Vocal Fold Adduction
What is the leaf-shaped structure that protects the airway?
Epiglottis
What cartilage does not attach to any other cartilages?
Cuneiform
What structures modulate the flow of air being expelled from the lungs during phonation? There are 3 pairs; the true vocal folds, the aryepiglottic folds, and the ventricular (false) folds).
Vocal Folds
- vocal folds are adducted, and air pressure builds up below them
- as air pressure rises, the bottom of folds are forced apart
- pressure then forces folds apart at the middle, then at the top, until air freely flows
- pressure decreases
- as pressure decreases, the folds move toward the midline (bottom first and top last)
Vocal Fold Vibration
What separtes the larygneal vestibule from the pharynx? It goes from the tips of the arytenoids to the larynx.
Aryepiglottic Folds
What is caused by contraction of the palatoglossus, tensor veli palatini, and levator veli palatini
Velopharyngeal Closure
What causes the change in pressures that pull the vocal folds together? The speed of air increases and “sucks” the vocal folds toward one another which leads to the closure of the vocal folds.
Bernoulli Effect
What is the wave-like motion of the vocal fold cover? It is necessary for vibration and phonation.
Mucosal Wave
What is the mobile flap of soft tissue that elevates during the swallow to parent food from entering the nasopharynx?
Soft Palate
What is the part of the digestive and respiratory systems that connects the nose, mouth, and throat?
Pharynx
What is the upper part of the pharynx that connects the nasal cavity and the throat?
Nasopharynx
What is the middle part of the pharynx that starts at the soft palate and goes down to the base of the tongue?
Oropharynx
What is the lower part of the pharynx that is above the larynx and below the oropharynx?
Laryngopharynx
