Test 1- Neuroanatomy, Motor Dev/Sensory tests, Pharmacology, Imaging Flashcards
1
Q
CNS consists of
A
Brain, spinal cord, brain stem, and cerebellum
2
Q
PNS consists of:
A
Everything else outside the brain/spinal cord
3
Q
Peripheral sensations are transmitted ___ the _NS via sensory tracts, processed in the ___ and transmitted back to the periphery via ____ tracts.
A
To the CNS via sensory tracts
Processed in brain
Back to periphery via Motor tracts
4
Q
A group of nerve fibers that are similar in origin, destination, and function
A
Tract
5
Q
Two basic types of nerve cells:
A
Neurons and Neuroglia
6
Q
Neurons or Neuroglia?
Specialized for communication through their ability to generate rapid electrochemical signals.
A
Neurons
7
Q
Neurons or Neuroglia?
Diverse support cells that facilitate neuron function and survival
A
Neuroglia
8
Q
Types of neurons and what they do:
A
Afferent (sensory)-Project toward a structure/relay to CNS; arrive
Efferent (motor)- Project away from a structure/convey output from CNS to muscles; exit
Interneurons- Relay signals between two neurons
9
Q
What neurons make up the corticospinal tract, even though they do not innervate muscles?
A
Upper motor neurons
10
Q
4 Types of Neuroglia in CNS:
A
Astrocytes, Oligodendrocytes, Microglia, and Ependymal cells
11
Q
2 Types of Neuroglia in PNS:
Which is most abundant?
A
Satellite cells and Schwann cells
Schwann most abundant -contact vasculature and participate in ion buffering; terminal Schwann cells help maintain the neuromuscular junction
*satellite cells buffer extracellular ion concentrations around neuronal cell bodies
12
Q
Type of Neuroglia in CNS that is responsible for maintaining the capillary endothelium and as such provide a vascular link to neurons. They also contribute to the metabolism of the CNS, regulate extracellular concentrations of ions and neurotransmitters, and proliferate after an injury to create a glial scar.
A
Astrocytes
13
Q
Type of Neuroglia in CNS that wrap myelin sheaths around axons, forming the white matter of the CNS
A
Oligodendrocytes
14
Q
Type of neuroglia in CNS that Is known as the Phagocytes of the CNS. They engulf and digest pathogens and assist with nervous system repair after injury.
A
Microglia
15
Q
Type of Neuroglia in CNS that line the ventricular system and produce and circulate cerebrospinal fluid.
A
Ependymal cells
16
Q
Which neurotransmitter influences motor activity, motivation, general arousal, and cognition?
A
Dopamine
*Parkinson’s, schizophrenia
17
Q
Which neurotransmitter plays a role in mood, behavior, and inhibits pain?
A
Serotonin
*Depression, migraines, ADD
18
Q
Neurotransmitter used by the sympathetic nervous system and produces the “fight or flight”response
A
Norepinephrine
19
Q
The neurotransmitter, Acetylcholine, is associated with what disease?
A
Alzheimer’s
20
Q
The neurotransmitter GABA is associated with what disease?
A
Epilepsy
21
Q
Groupings of cell bodies and dendrites fibers with specialized functions
Gray or white matter?
A
Gray matter
22
Q
Myelinated axons
Gray or white matter?
A
White matter
23
Q
A bundle of myelinated axons the travel together is called a ___ throughout the body.
Called a ____ in the spinal cord
Called a ____ between the cerebellum and brainstem
Called a ___ in the brainstem
Called a ___ in the brain
A
Tract throughout body Column in SC Peduncle between cerebellum & brainstem Leminscus in brainstem Capsule in brain
24
Q
Tracts are named by their ____ and their ____
A
Origin and destination
25
What is the primary motor tract for voluntary movement?
Corticospinal tract
26
The corticospinal tract originates in the ___ and terminates in the ____ ____.
Cortex ; spinal cord
27
The lateral spinothalamic tract (sensory tract) begins in ___ matter of spinal cord and ascends in lateral cord to terminate in the ____.
Gray matter of SC ; thalamus
28
Sensory feedback from what sensory tract includes vibration, 2 point discrimination, proprioception, and graphesthesia?
Dorsal column (fasciculus cunneatus and fasciculus gracillis)
29
Sensory feedback from what sensory tract includes light touch and pressure?
Spinothalamic (Anterior)
30
Sensory feedback from what sensory tract includes pain and temperature?
Spinothalamic (Lateral)
31
Order of meninges from outermost to innermost:
Dura mater
Arachnoid
Pia mater
32
What lobe of the brain is the primary motor cortex and is responsible for judgment, attention, abstract thinking, mood, aggression, and contains Broca’s area? (L hemisphere movements of mouth to produce speech, R hemisphere non-verbal commun.)
Frontal lobe
33
Which lobe of the brain is the primary sensory cortex in that it attaches meaning and context to the sensory input (is it painful?) and contains the sensory homunculus and stores short-term memory :
Parietal lobe
34
Which lobe of the brain is the primary auditory cortex and has Wernicke’s area (which interprets all sensory systems including hearing in comprehending spoken language), allows visual perception, musical discrimination, long-term memory, and facial recognition?
Temporal lobe
35
Which lobe of the brain is the primary visual cortex?
Occipital lobe
36
Left Brain or Right Brain?
Language, sequential/organized, understanding language, analytical, controlled, logical, rational, math calculations
Left Brain
37
Left or right brain?
Nonverbal processing, process info in holistic manner, artistic, general concept comprehension, eye-hand coordination, spatial relationships, kinesthetic awareness, music, math reasoning body image awareness
Right Brain
38
What structure is located deep within white matter of the cerebrum and its functions are voluntary movement, posture, and muscle tone?
Basal Ganglia
39
A dysfunction in what structure of the brain causes Parkinson’s disease?
Basal ganglia
40
Deep brain structures:
Function- Primitive emotional reactions (fear, rage, pain, pleasure, affection, sorrow, hunger, thirst, sexual behavior, sleep)
Limbic System (hypothalamus and parts of thalamus, frontal, and temporal lobes)
41
Deep Brain structures:
Function- Stores new memories and retrieves memories as needed
Hippocampus (located in temporal lobe)
42
Deep brain structures:
Function- Emotional and social processing
Amygdala (located in temporal lobe)
43
Deep Brain Structures:
Function- Central relay station for sensory info from periphery and parts of brain to cerebrum
Thalamus
44
Deep Brain Structures:
Function- Maintains homeostasis, assists in regulating hormones, regulates body temperature
Hypothalamus (deep at base of brain)
45
What makes up the Brain Stem?
Midbrain, Pons, Medulla
46
What part of the brain is the relay station between the cerebrum and the spinal cord or cerebellum?
Midbrain
| Part of brain stem
47
What part of the brain controls rate of breathing and orientation of the head in response to visual & auditory output?
Pons
| Part of brain stem
48
What part of the brain controls respiration, heart rate, vomiting, sneezing, and swallowing?
Medulla (part of brain stem)
49
Located in the ____, the reticular activating system controls levels of ___ and ____ cycles.
In the brain stem
| Levels of arousal, sleep wake cycles
50
What structure of the brain controls balance and complex muscular movement? Major site of motor learning. It learns to carry out anticipatory movements that shift our balance during voluntary movements.
Cerebellum
51
What might you see in someone with cerebellum lesion?
Gait instability, intention tremor, uncoordinated movements, slurred speech, and difficulty with smooth eye movements
52
Spinal cord is a continuation of the brain stem and extends to approx the level of the intervertebral disc between the ________vertebrae.
First two lumbar vertebrae
53
Two primary functions of spinal cord:
Coordination of movement patterns and communication of sensory information
54
A positive Babinski sign in an adult suggests damage to what?
*Stroking of heel to ball of foot and Great toe extends while others splay out
Damage to corticospinal tract
55
What would you see in a pt. with a brain stem lesion?
Coordination and movement challenges, speech and swallowing difficulties, sleep issues (sleep apnea)
56
Muscle spindles are encapsulated ____ receptors that inform the ___ about changes in muscle length.
Sensory receptors
| Inform the brain
57
Anterior horn cells contains neurons that innervate _____ to cause ___.
Skeletal muscle to cause movement
58
PNS is further divided into the ___ and ____.
Somatic and Autonomic Nervous System
59
ANS is divided into the ___ and ___ nervous systems
Sympathetic- fight or flight
Parasympathetic- rest and digest
60
How many pairs of Cranial nerves?
| Spinal nerves?
12 cranial
| 31 spinal
61
Def: Region of skin innervated by sensory fibers of spinal nerve
Dermatome
62
Def: A group of muscles innervated by spinal nerve
Myotomes
63
UMN or LMN disorder?
Damage to descending corticospinal motor tracts in cerebral cortex, brain stem, and spinal cord. INCREASED deep tendon reflexes (DTR), muscle weakness, +Babinski, INCREASED muscle tone/spasticity, possible clonus.
Examples: Cerebral palsy, ALS, CVA, MS, TBI, brain tumors
Upper Motor Neuron disorder
64
UMN or LMN disorder?
Damage to anterior horn cell of brain stem, spinal root or spinal nerve.
DECREASED deep tendon reflexes (DTRs), marked muscle atrophy, DECREASED muscle tone/flaccidity, muscle fiber fasciculations (twitching).
Examples: Poliomyelitis, ALS, spinal cord tumors, Bell’s Palsy, carpal tunnel syndrome, MD
Lower Motor Neuron disorder (LMN)
65
CNS or PNS injury response?
Obstruction of blood flow, death of neurons, unable to regenerate. Neurons don’t come back.
CNS injury
66
CNS or PNS injury response?
Compression, laceration, traction, disease, chemical toxicity
Symptoms: Paresthesias “___ & ___”, sensory loss, muscle weakness. Wallerian degeneration if cell body destroyed. Axon damage-regeneration possible.
PNS injury
67
What artery supplies 80% (the majority) of blood supply to cerebrum?
Carotid arteries
68
External or Internal Carotid?
Supplies the face
External Carotid
69
Anterior cerebral artery:
What artery bifurcates to become the Ant. AND middle cerebral arteries?
What areas does the Anterior cerebral artery supply?
The Internal Carotid arteries bifurcate to become Anterior and Middle cerebral arteries.
Anterior cerebral artery supplies the SUPERIOR border of the FRONTAL and PARIETAL lobes
70
Middle Cerebral Artery:
What’s special about it/what occurs most often in it?
What areas does it supply?
It’s the LARGEST of the cerebral arteries and is most often occluded.
It supplies the LATERAL surface of the brain with blood and also the DEEP PORTIONS OF FRONTAL and PARIETAL lobes.
71
Posterior Cerebral artery:
Comes off of which artery?
Supplies what structures and lobes?
Comes off of Basilar artery
Supplies the structures of the Midbrain, Occipital lobe, and Temporal lobes
72
The anterior and posterior communicating arteries, which are branches of the ___, are interconnected at the base of the brain and form the __________.
Branches of carotid
Form Circle of Willis
*Failure or occlusion of one cerebral artery does not critically decrease blood flow to that region. Consequently, the occlusion can be circumvented or bypassed to meet the nutritional and metabolic needs of cerebral tissue.
73
What CN?
Smell
CN I - Olfactory
74
What CN?
Vision
CN II - Optic
75
What CN?
Moves eye up, down, medially, raises upper eyelid, constricts pupil, adjusts shape of the lens of the eye
CN III - Oculomotor
*Oculomotor Opens eyelid
76
What CN?
Moves eye medially and down
CN IV - Trochlear
77
What CN?
Facial sensation, chewing, sensation from temporomandibular joint
CN V - Trigeminal
78
What CN?
Moves eye laterally (abducts eye)
CN VI - Abducens
79
What CN?
Facial expression, closes eye, tears, salivation, TASTE
CN VII - Facial
80
What CN?
Sensation of head position relative to gravity and head movement; HEARING
CN VIII - Vestibulocochlear
81
What CN?
Swallowing, Salivation; taste
CN IX- Glossopharyngeal
82
What CN?
*Regulates viscera, swallowing, speech, taste
CN X - Vagus
83
What CN?
Elevates shoulders, turns head
CN XI - Accessory
84
What CN?
Moves tongue
CN XII - Hypoglossal
85
Cervical Plexus is C_ - C_
What important nerve of this plexus innervates the diaphragm ?
C1-C4
Phrenic nerve
86
Brachial Plexus C_-T_
What are the primary nerves of the Brachial Plexus?
C5-T1
Axillary, Musculocutaneous, Median, Radial, Ulnar nerves
87
Lumbosacral Plexus L_-S_
Major nerves (7)
L1-S3
Obturator, Femoral, Inferior gluteal, Superior gluteal, Common Peroneal, Tibial, and Sciatic
*Common Peroneal and Tibial form Sciatic nerve and separate just above the knee
88
Def: All motor changes that occur throughout life (occurs over days to weeks to months and continues for a lifetime)
Motor Development
89
Def: The ability to maintain and change posture and movement (occurs in fractions of seconds)
Motor Control
90
Def: The process that brings about permanent change in motor performance as a result of practice or experience
Motor Learning
91
The interaction of the ____, the _____, and the ____ produces movement/motor control.
The Task, the Individual, and the Environment (T.I.E)
92
Reflex and Hierarchic Theory of Motor Control:
4 stages of motor control-
1.
2.
3.
4.
1. Mobility -initial random movements
2. Stability- Maintenance of a posture
3. Controlled mobility- Movement within a posture
4. Skill- Movement from one posture to another posture
93
Systems Model of Motor Control
*most recent
The neural component of movement is distributed to various areas of the nervous system based on the complexity of the task.
_____ is essential to determine if the movement was successful.
_____ (readiness to move) as well as movement are important and referred to as “_____ _____”
This model accounts for the adaptability of motor functions in a variety of situations.
Feedback
Posture ; “postural control”
94
Components of Postural control:
| *keep ___ within ___
COM within BOS
```
Sensory organization,
eye-head stabilization,
motor coordination,
predictive central set,
musculoskeletal system,
environmental adaptation,
limits of stability
```
*Balance is maintained by controlling posture
95
Nashar’s Model of Postural Response:
3 components in quiet standing-
Ankle strategy
Hip strategy
Stepping strategy
96
Motor learning, development, or control?
Involves complex processes that occur in the CNS in response to practice or experience to develop a new motor skill. Often involves improving the smoothness and accuracy of movements
Motor Learning
97
Stages of Motor LEARNING:
-
-
-
Attention -
Cognitive: Mental picture, conscious thought, lacks fluency, trial and error learning, extrinsic feedback
Practice-
Associative: practice stage, fluency increases knowledge of results, knowledge of performance
Repetition-
Autonomous: Accurate, grooved, fluent, efficient, little thought, intrinsic feedback (kinaesthesis)
98
Types of practice:
Repeated, predictable, effective when first learning a skill
Blocked practice
99
Types of practice:
| Non-predictable and nonrepeating; better once a skill has been learned and adding variability
Random Practice
100
Types of practice:
_____ Practice- tasks such as walking, stair climbing are better taught in this practice vs. ____ Practice- breaking down a task in the parts, such as teaching a sliding board transfer
Whole vs. Part practice
101
These two types practice are better when combined.
One involves sufficiently challenging practice which leads to brain changes the underlie learning and the other is a cognitive rehearsal of a skill in the absence of physical performance
Physical vs. Mental Practice
102
Intrinsic or extrinsic feedback?
Internal; what the patient feels; results from movement or augmented input
Intrinsic
103
Intrinsic or extrinsic feedback? External Sensory cues
Extrinsic
| *Withdraw extrinsic feedback as skills improve
104
Def: The ability of the nervous system to change.
Neural Plasticity
105
How does sensation contribute to motor control and motor learning?
Sensation is used in motor control as a means of feedback and as a way to prepare the body’s posture in anticipation of movement. Sensation is needed to learn a new motor skill.
106
Without appropriate motor ____, motor _____ does not proceed normally.
Motor Control,
| Motor Development
107
What two systems contribute the most to postural control?
Musculoskeletal and neurologic systems
108
What is hypotonicity?
Low muscle tone/tension
109
What area in brain is responsible for the PRODUCTION of speech?
What lobe is it in?
Broca’s area
| Frontal lobe
110
Wernicke’s area is responsible for the ______ of speech. Located in ____ lobe.
Comprehension of speech
Temporal lobe
111
What is stereognosis?
Being able to identify an object placed in one’s hands with their eyes closed
112
Commonly referred to as an x-ray, what is this form of imaging properly called?
What are some advantages and disadvantages of this form of imaging?
Plain film radiographs
Advantages include diagnosis of bone and joint pathologies, noninvasive procedure, low-dose radiation, less cost
Disadvantages: quality of images vary, cannot image structures filled with air or behind bone
113
What form of imaging is used to identify disorders of blood flow, multiple sclerosis, neoplasm, or infection of the brain or spinal cord and also evaluating intracranial hemorrhage?
What are some advantages and disadvantages?
Computed Tomography (CT)
Advantages: quick results in emergent situation’s, images of multiple structures at the same time, more detail than a radiograph (3D)
Disadvantages: higher dose of radiation, performed in small space (claustrophobia)
114
Form of imaging that uses a magnetic field and radio waves to create cross-sectional images of the body.
What are some advantages and disadvantages?
Magnetic resonance imaging (MRI)
Advantages: imaging of soft tissues such as, muscle, menisci, ligaments, tumors, internal organs; excellent contrast detail; no radiation
Disadvantages: cannot be used if there is metal in the body, interferes with function of pacemaker, cochlear implants, artificial heart valves or ventilators, costs more than some other imaging tests
115
This form of Imaging provides functional data related to Cerebral activation during any given task; assesses cerebral oxygenation
Functional Magnetic Resonance imaging (fMRI)
116
Type of Imaging that uses radiography and an injected radionuclide To determine the metabolic activity of an organ or disuse. Often used in oncology to identify malignant tumors.
Advantages and disadvantages?
Positive Emission Tomography (PET)
Advantages: looks at function of an organ vs. the anatomy, detects pathological changes at cellular level, identifies onset of diagnosis before other imaging techniques, low dose radiation
Disadvantages: invasive procedure, patient must lie still for long periods of time, small space
117
What type of Imaging used to determine the extent of nerve damage by measuring the speed of electrical impulse through the nerve?
Advantages and disadvantages?
Nerve Conduction Velocity Test (NCV)
Advantages: diagnosis of nerve related pathology, non-invasive, quick results.
*test for carpal tunnel
Disadvantages: precautions with pacemakers
118
Type of imaging that records electrical activity in response to a nerve stimulation of the muscle. Used to detect neuromuscular abnormalities such as muscular dystrophy, peripheral neuropathy‘s, ALS, nerve root disorders
Advantages and disadvantages?
Electromyography (EMG)
Advantages: diagnosis of neuropathies, radiculopathy, myopathies, muscular dystrophies
Disadvantages: uncomfortable, pacemakers, invasive
119
Type of Imaging that records electrical activity of the brain. Used to help diagnose epilepsy, narcolepsy, sleep disorders
Advantages and disadvantages?
Electroencephalography (EEG)
Advantages: non-invasive, cost, detects changes over milliseconds as opposed to seconds or minutes
Disadvantages: what’s effective in detecting exact location of the pathology, must lie still
120
Test that records activity of auditory nerve an auditory pathways in the brain stem and CN VIII
Brainstem Auditory Evoked Potentials (BAEP)
Advantages: evaluate hearing loss in infants, children, comatose person
121
An invasive procedure to collect cerebrospinal fluid from the subarachnoid space in the lumbar spine to diagnose problems such as encephalitis, meningitis, Guillain barre syndrome
Advantages and disadvantages?
Lumbar puncture
Advantages: diagnosis of brain and spinal cord pathologies
Disadvantages: invasive, patient must remain in active after procedure
122
Test that uses x-ray and injected contrast dye to visualize blood vessels. Used to identify arteriosclerosis, aneurysm, vascular malformation, tumors, blockages
Advantages and disadvantages?
Arteriogram
Advantages: diagnosing vascular abnormalities
Disadvantages: invasive, contrast dye could cause allergic reaction
123
Therapeutic classification or pharmacological classification?
Based on what a drug does clinically (anticoagulant, antihypertensive, antidepressant, antibiotic)
Therapeutic Classification
124
Therapeutic or pharmacological classification?
Based on the drug’s mechanism of action in the body (diuretics, Vasodilators, CNS stimulants, hypnotic and sedative drugs, beta blockers
Pharmacological classification
125
What are the different names given to drugs?
Chemical name, Generic name, Brand/Trade name
126
```
Heroin, ecstasy, LSD are schedule _
Methadone and cocaine are schedule _
Codeine with Tylenol and Vicodin are schedule _
Valium and Xanax are schedule _
OTC meds are schedule _
```
```
1
2
3
4
5
```
127
Methods of drug administration
PO =
Oral
| *Tablet, pill, liquid
128
Methods of drug administration
SL =
Sublingual
| *Dissolves under tongue
129
Methods of drug administration:
A patch is an example of this method
Transdermal
130
Methods of drug administration:
sub Q =
Subcutaneous
| *Heparin, insulin injection in posterior arm, abdomen, thigh
131
Methods of drug administration:
IM =
Intramuscular
| *Injection into muscle; deltoid, buttocks
132
Methods of drug administration:
IV =
Intravenous
| *Meds and fluids directly into bloodstream
133
Definition: how drugs move in the body
Pharmacokinetics
134
What specific processes are involved in pharmacokinetics? (4)
Absorption- How drug moves from site of administration to site of action
Distribution- Journey of the drug through the bloodstream to various tissues
Metabolism- How the drug is made more or less active (liver mainly does this)
Excretion- How we get rid of what we don’t need
135
Abbreviations for times of administration:
AC =
Bid =
tid =
qid =
q =
qh =
18h =
PRN =
STAT =
AC- Before meals
Bid, tid, qid- Two times a day, three times a day, four times a day
q- every
qh- every hour
18h- every 18hours
PRN- as needed
STAT- Immediately
136
Drug therapy in pediatrics:
Children have an immature ___ ____ ___- Increased distribution into CNS until two years old
Children have an increased percentage of body ___
Immature blood brain barrier
Body water
137
Pain, temperature, light touch, and pressure are _____ sensations. These occur in the _____ tract.
Superficial sensations
Spinothalamic tract
138
Position since and vibration are examples of ____ sensations.
This occurs where?
Deep sensations
Dorsal column
139
Stereognosis, two point discrimination, and graphesthesia are examples of _____ sensation.
Occurs where?
Cortical sensations
Dorsal column
140
Reflex arcs can be ___synaptic or ___synaptic.
Types of reflexes = Superficial and Deep reflexes
Monosynaptic (only 2 neurons) Example: Patellar reflex and Achilles reflex
or
Polysynaptic (multiple interneurons)
Example: Touching hot surface and withdrawing hand
141
Injury to the spinothalamic tract will produce impaired ___, ____, ____, and pressure. This sensory loss will be [contralateral or ipsilateral?]
Pain, temperature, touch
Contralateral
142
CNS and muscles that control extra ocular movements:
SO ‘4’ LR ‘6’ All the rest ‘3’
Superior oblique- CN 4 (trochlear)
Lateral rectus- CN 6 (abducens)
Superior rectus, Medial rectus, Inferior rectus, Inferior oblique- CN 3 (Oculomotor)
*Obliques move eye in opposite direction
SO-down and in
IO-up and in
143
When the eyelid on one side covers more of the iris compared with the other eye this is known as ____.
What CN involved?
Ptosis
CN III
144
What happens if you have a palsy of CN III? How will the patient present?
Eye presents down and out, droopy eyelid
145
How will a patient present with a palsy of CN VI ?
Eye will be medial
146
What is anosmia?
Loss of smell, often temporary resulting from injury, infection, trauma, virus, etc.
147
Brainstem and cerebellum get most blood from what 2 arteries?
Basilar and Vertebral
148
Central Pattern Generator for motor control of gait is the:
Spinal cord
