Week 1 - Prunuske Flashcards
What is the general function of the forebrain?
- Motor control
- Somatosensory
- Processing
- Emotion
- Thoughts
- Planning
- Memory
- “Executive Functions”
What is the general function of the brainstem?
- Homeostasis
- Life-sustaining functions
- Cranial nerve nuclei
What is the general function of the cerebellum?
-Coordination of movements that use more than one joint
-Coordination of visually guided movements
-Learning complex new movements
(Damage leads to ataxia)
What is the general function of the spinal cord?
- Ventral (motor) nerve roots
- Dorsal (sensory) nerve roots
- Ascending and descending pathways
- Proprioception
- Spinal reflexes
- Sympathetic nervous system
What is Dr. Prunuske’s definition of CNS?
Everything inside of the dura.
Define consciousness.
- Wakefulness (open eyes, motor arousal)
- Awareness (experience thoughs, memories, & emotions)
- Philisophical enigma
In a coma, what areas of the CNS are damaged?
Damage to BOTH cerebral hemispheres, brainstem, or thalamus
In vegetative state, what areas of the CNS are damaged?
- Damage to cortex and/or thalamus
- Intact brainstem
In locked-in syndrome, what areas of the CNS are damaged?
Brainstem lesion to bilateral ventral pons
What are the clinical hallmarks of a coma?
- Not awake
- Unaware
- Unresponsive to internal or external stimuli (may have preserved spinal reflexes)
- Unarousable
- No spontaneous eye opening
What are the clinical hallmarks of vegetative state?
- Unresponsive wakefulness
- Not aware of self or others
- Will open eyes for sleep-wake cycles
- Unresponsive to internal/external stimuli
- No thoughts, memories, emotions, or intentions (may smile/grimace/grip hand due to reflexes)
What are the clinical hallmarks of vegetative state?
- Incomplete awareness
- Some sleep-wake cycles
- Can have high/low (+/-) behavioral responses
What are the clinical hallmarks of locked-in syndrome?
- Intact awareness
- Sleep-wake cycles
- Conscious, but unable to interact with external world
- Quadriplegia, sensory loss, anarthria (may be able to blink or look up/down)
What is Brown-Sequard Syndrome? What are the symptoms?
Brown-Sequard syndrome is caused by a lesion in the spinal cord which results in weakness or paralysis (hemiparaplegia) on one side of the body and a loss of sensation (hemianesthesia) on the opposite side.
What is the function of the Basal Ganglia?
Coordinates choice of mutually exclusive skeletal muscle actions.
What is the first step in solving a clinical problem?
Anatomical localization
What is the “window” to the patient’s brain?
Neurological exam
What is the first system considered as a descending motor system in the videos?
Corticospinal tract
When do axons from the motor cortex cross to the opposite side?
Spinomedullary junction
What information does the Spinothalamic tract relay to the brain?
Pain and temperature
What information does the Dorsal Column - Medial Lemniscus System relay to the brain?
Discrimatory touch and position sense
When do the spinothalamic tracts cross to the opposite side?
Almost immediately upon entering the spinal cord
When do the Dorsal Column tracts cross to the opposite side?
Not until they reach the level of the medulla
What does the Mental status exam let us “see”?
Supratentorial structures of the cerebral hemispheres
What does the motor exam examine?
Corticospinal tract and Lower motor neuron nerve and muscle
How many pathological gaits are there to look for on neuro exam?
7 basic gaits
