Quiz 1 Flashcards
How do you obtain a thorough history?
Understand neurological complaints, medical history (symptom development, review of systems), family history, social history…
What kinds of general observations should you make?
Make observations about bx, gait, skin, head, neck & spine.
What is a mental status exam?
Gain general info on someone’s mental status. Concerns memory (what were the three words?), language (“no ifs, ands or buts”), visuospatial function (copying shapes) & manipulation of acquired knowledge (count backwards by 7).
What is cranial nerve 1 & what is it responsible for?
Olfactory- responsible for smell & taste
What is cranial nerve 2 & what is it responsible for? Why do we talk about it so much?
Optic- responsible for vision. We know what happens in every part of the visual system!
What happens if there is a cut at the optic nerve? Optic chiasm? Optic tract? Visual cortex?
Blindness in one eye
Bitemporal hemianopia
Homonymous hemianopia
Homonymous hemianopia
What side are those with aphasia most likely to have strokes? What vision would this affect?
Left, affecting right side’s vision.
What is cranial nerve 3 and what is it responsible for? What are some symptoms of dysfunction?
Occulomotor- responsible for upward eye movement. Paresis of eye gaze (not moving), diplopia (double vision), nystagmus, ptosis…
What is cranial nerve 4 and what is it responsible for? What are symptoms of dysfunction?
Trochlear- responsible for downward eye movement. Diplopia (double vision).
What is cranial nerve 5 and what is it responsible for? What are symptoms of damage?
Trigeminal- sensory receptors on skin of face, oral and nasal mucosa, gums, eyeballs… motor innervation for muscles of mastication. Damage results in difficulty opening and closing mandible or sensory problem called Tic Douloureux which is severe facial pain (trigeminal neuralgia).
What is cranial nerve 6 and what is responsible for? Symptoms of damage?
Abducens- outward eye rotation. Horizontal diplopia.
What is cranial nerve 7 and what is it responsible for? Symptoms of damage?
Facial- facial muscles. Unilateral facial weakness!
What is cranial nerve 8 and what is it responsible for? Symptoms of damage?
Vestibulocochlear- hearing, balance, position sense. Sensorineural hearing loss, vertigo.
What is cranial nerve 9 and what is it responsible for? Symptoms of damage?
Glossopharyngeal- constriction of posterior pharynx, gag reflex-sensory. Dysphagia.
What is cranial nerve 10 and what is it responsible for? Symptoms of damage?
Vagus- intrinsic laryngeal muscles, soft palate, and pharyngeal function. Atypical vocal quality, restricted pitch, hypernasality, dysphagia.
What is cranial nerve 11 and what is it responsible for? Symptoms of damage?
Spinal accessory- neck and shoulder muscles. Impaired rotation of head or shrug of shoulders.
What is cranial nerve 12 and what is it responsible for? Symptoms of damage?
Hypoglossal- all tongue muscles except palatoglossus. Impaired tongue mobility.
What is looked at in a motor system exam?
Muscle tone, bulk, strength, range of motion, coordination, reflexes, and involuntary movements.
What are types of paralysis?
Monoplegia (one limb one side), hemiplegia (both limbs one side) due to upper motor neuron damage OR paraplegia (2 limbs on either side of body- 2 legs!), quadriplegia ( 4 limbs) due to damage to the spinal cord.
What are types of reflexes?
Hyperreflexia (upper motor neuron damage= increased reflexes), hyporeflexia (lower motor neuron damage= reduced/absent reflexes), and primitive reflexes (present in infant but typically disappear in adults- if occurs, bilateral upper motor neuron damage).
What are the parts of the sensory system exam?
Primary: pain/temp, light touch, vibration, position
Secondary: two-point discrimination, stereognosis (ID something in hand), graphesthesia (ID charactres written on skin)
What is a dermatome?
Sensory regions of the body. Letters correspond to segments of spinal cord (cervical, thoracic, lumbar, sacral).
What are the signs of sensory involvement?
Pain (tissue damage), numbness (c or p nerve damage), abnormal sensations (parasthesia: tingling, etc. due to nerve damage), and astereognosis (inability to ID objects by touch- nerves)
What is the CNS comprised of? PNS?
Brain & spinal cord
All neural fibers outside of CNS that transport impulses to and from CNS
What are the three meninges?
Dura mater- Outer tough, thick layer
Arachnoid mater- Thin weblike avascular membrane
Pia mater- Delicate thin membrane that fills every bump/groove of surface
Where are spinal nerves? Where does sensory/afferent info come from?
In each of the 31 segments of the spinal cord.
Dorsal root– motor/efferent info goes out on anterior surface
What happens in a reflex reaction?
No higher level function; sensory nerve endings detect muscle lengthening, sent immediately to dorsal side of spinal cord and synapses just one time with motor neuron which has output back to muscle saying go back to normal!
Why are reflexes important to us?
Test integrity of nervous system at different levels.
What are the parts of the brainstem?
Medulla, pons, midbrain, superior and inferior colliculi
What are inferior colliculi? Superior colliculi?
Important for auditory system
Visual system!
What are the three functions of the brainstem?
Serves as conduit for all of input and output to cortex
Cranial nerve function- all but olfactory and optic originate from brainstem
Integrative function- cardiovascular function, consciousness, heart rate, etc.
Cranial mnemonic!
Olfactory Optic Occulomotor Trochlear Trigeminal Abducens Facial Auditory Glossopharyngeal Vagus Accessory Hypoglossal
On old olypus towering tops a finn and german viewed some hops
What is the cerebellum?
Covers most of posterior surface of brain anchored by peduncles (neural fibers) Important for equilibrium, muscle tone, posture, coordination of voluntary movement
What do we need to know about diencephalon?
Contains egg shaped thalamus where neural processing takes place. No sensory info except for olfactory that gets to cortex without first being processed through thalamus.
What is the basal ganglia? What happens if damaged?
Subcortical structures/nuclei that are involved in processing- regulates tone, postural control.
Can result in involuntary extra movement, or too LITTLE movement
What are the components of the basal ganglia? Input? Output?
Amygdala
Caudate nucleus
Putamen (Striatum when together)- receiving area
Globus pallidus- major output
What are the ventricles?
Spaces where CSF is made and circulates.
Lateral 2 follow c shaped course through all lobes
Third is a narrow slit in midline
Fourth is between cerebellum, pons and rostral medulla
What are fiber tracts/pathways?
Groups of fibers that travel together in the CNS
What are the two motor tracts?
Corticospinal tract- voluntary movement of trunk and limbs (opposite side effect)
Corticobulbar tract- volitional movement of head and neck
What are the two sensory tracts?
Spinothalamic tact- pain and temp sensation (hot stove)
Spinocerebellar tract- tactile pressure and proprioception
What are commisural tracts?
Connect different areas of cortex (r and l hemisphere)
Corpus callosum- all 4 lobes connects r and l
Anterior & posterior commissures- anterior connects two temporal lobes and limbic system; posterior who really knows
What are association fiber tracts?
Arcuate fasciculus/superior longitudinal fasciculus goes from posterior inferior frontal lobe to poster superior temporal lobe…?
What are external features of the cerebral cortex?
Gyrus (ridge), sulcus (groove), fissure (deeper groove)
What are the 4 sulci that divide the lobes?
Central sulcus (frontal and parietal)
Lateral sulcus/sylvian fissure (laterally separating temporal lobe from frontal and parietal)
Parieto-occipital sulcus (parietal and occipital)
Calcarine sulcus (location of visual cortex)
What is the function of the frontal lobe?
Attention Prediction Imagination Forethought/judgment Problem solving
…Exec functions!
What is the function of the parietal lobe?
Sensory association area
Visuospatial function
Body awareness
Recognizing object in hand without looking (stereognosis)
What is the function of the temporal lobe?
Processing auditory info to make sense of it/perceiving speech
Auditory comp
Memory
What is the function of the occipital lobe?
Higher order visual processing
What is the insula?
The fifth lobe- tucked into sylvian fissure hidden by operculum. Thought to be important to language.
What is the precentral gyrus/primary motor cortex?
What is the premotor strip/premotor cortex?
Larger areas for larger parts (mouth, hand) and not for foot without much fine motor control.
Motor planning and initiation of speech
What happens if post central gyrus/primary sensory cortex is damaged?
Loss of sensation versus paralysis or weakness in primary motor cortex
What is the supramarginal gyrus?
Implicated in deficits in sentence comprehension
What is the superior temporal gyrus/Heschl’s gyrus?
Primary auditory cortex- cortical deafness if damaged
What is the angular gyrus?
Important in reading and writing
