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SPA6233 Motor Speech > Week 1 Reading- Ch. 2 > Flashcards

Week 1 Reading- Ch. 2 Flashcards

1
Q

Clinical localization of disease requires knowledge about ____________ and ____________

A

the affected functional system and its location within the nervous system

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2
Q

Function of the bones of the skull

A

non-yielding covering for adult brain, protective function against trauma.

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3
Q

Protection of brain by skull bones is offset somewhat by

A

the inability of the adult brain to expand in response to pressure from certain internal pathologic conditions (hemorrhage, hydrocephalus, tumor), a situation that can produce diffuse neurologic abnormalities due to mass effects and increased intracranial pressure

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4
Q

3 distinct shallow cavities at the base of the skull

A

anterior, middle, posterior fossae

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5
Q

The fossae help define what 2 major levels of the CNS?

A

posterior fossa level, supratentorial level (anterior and middle fossae)

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6
Q

The _______ and _______ fossae contain symmetrically oriented _________ through which the paired cranial nerves exit to innervate peripheral structures, including the speech muscles of the head and neck.

A

posterior and middle; foramina (holes),

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7
Q

The ___________ of the CNS consist of 3 layers: the _____, _______, and _______.

A

meninges (coverings); dura, arachnoid, and pia mater

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8
Q

Dura mater- define

A

Outmermost membrane (meningeal layer)

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9
Q

The dura mater consists of 2 layers of fused tissues that separate in certain regions to form the ___________ .

A

intracranial venous sinuses

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10
Q

Define: intracranial venous sinuses

A

areas where venous blood drains from the brain

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11
Q

The folds of the dura in the cranial cavity form what 2 layers?

A

falx cerebri

tentorium cerebelli

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12
Q

Define- falx cerebri

A

located between the 2 hemispheres

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13
Q

Define: tentorium cerebelli

A

separates the cerebellum from the cerebral hemispheres

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14
Q

Define: arachnoid mater

A

lies beneath the dura and is applied loosely to the surface of the brain

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15
Q

Define: pia mater

A

the thin innermost layer, closely attached to the brain’s surface

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16
Q

The ______ mater and _____ mater are collectively known as the __________.

A

pia and arachnoid; leptomeninges

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17
Q

Define: epidural space

A

located between the inner bone of the skull and the dura

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18
Q

Define: subdural space

A

beneath the dura

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19
Q

Define: subarachnoid space

A

beneath the arachnoid, surrounds the brain and spinal cord and is filled with cerebrospinal fluid

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20
Q

The subarachnoid space is filled with _________

A

cerebrospinal fluid

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21
Q

The subarachnoid space is connected to the interior of the brain through the ___________.

A

ventricular system

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22
Q

Most conditions capable of producing MSD’s that involve the meninges and meningeal spaces stem from what 4 things?

A

infection, venous vascular disorders, hydrocephalus, trauma with associated hemorrhage and edema

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23
Q

Supratentorial level includes what 6 structures?

A

hemispheres, lobes, basal ganglia, thalamus, CNI, CN II

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24
Q

Supratentorial level relationship with what parts of skeleton?

A

Skull- anterior and middle fossa

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25
Q

Supratentorial level- relationship to meninges

A

above tentorium cerebelli

lateral to falx cerebri

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26
Q

Supratentorial level- relationship to ventricular system

A

lateral and third ventricles, subarachnoid space

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27
Q

Supratentorial level- relationship to what 6 parts of vascular system

A

carotid arterial system, ophthalmic arteries, middle cerebral arteries, anterior cerebral arteries, vertebrobasilar system, posterior cerebral arteries

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28
Q

Posterior fossa level- includes what 2 structures?

A

Brainstem (pons, medulla, midbrain), cerebellum, origins of cranial nerves III- XII

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29
Q

Posterior fossa level- relationship to what skeletal structure?

A

skull -posterior fossa

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30
Q

Posterior fossa level- relationship to meninges

A

below falx cerebelli

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31
Q

Posterior fossa level- relationship to ventricular system

A

fourth ventricle, subarachnoid space

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32
Q

Posterior fossa level- relationship to vascular system

A

vertebrobasilar system, vertebral arteries, basilar artery

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33
Q

Posterior fossa level- involves what 5 motor speech disorders if dysfunctional?

A

spastic, unilateral UMN, hyperkinetic, ataxic, flaccid dysarthria

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34
Q

Supratentorial system- involves what 5 motor speech disorders if dysfunctional?

A

apraxia of speech,

spastic, unilateral UMN, hypokinetic, and hyperkinetic dysarthria

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35
Q

Spinal level- relationship to the skeleton

A

vertebral column

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36
Q

Spinal level- relationship to the meninges

A

spinal meninges

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37
Q

Spinal level- relationship to the subarachnoid system

A

spinal, subarachnoid space

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38
Q

Spinal level- relationship to vascular system

A

anterior spinal artery, posterior spinal arteries

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39
Q

Spinal level- involves what motor speech disorder?

A

flaccid dysarthria

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40
Q

Peripheral level- includes?

A

cranial and spinal nerves

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41
Q

Peripheral level- relationship to skeleton?

A

face and skull

non-cranial and non-spinal bones

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42
Q

Peripheral level- relationship to meninges

A

None

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43
Q

Peripheral level- relationship to ventricular system

A

None

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44
Q

Peripheral level- relationship to vascular system

A

Branches of major extremity vessels

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45
Q

Peripheral level- involves what motor speech disorder?

A

Flaccid dysarthria

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46
Q

Explain: supratentorial level

A

a nearly horizontal membrane that forms the upper border of the posterior fossa, covers the upper surface of the cerebellum, and separates the anterior and middle fossae from the posterior fossa

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47
Q

Define: tectum

A

the area of the posterior fossa dorsal to the aqueduct of Sylvius

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48
Q

The tectum includes what 2 structures?

A

the inferior and superior colliculi

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49
Q

The inferior and superior colliculi are known collectively as the __________

A

corpora quadrigemina

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50
Q

Define: inferior colliculi

A

midbrain structure that is a major relay station for the auditory system

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51
Q

Define: superior colliculi

A

midbrain structure that is a major relay station for the visual system

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52
Q

Define: tegmentum

A

the area ventral to the aqueduct of Sylvius and fourth ventrile; contains white matter and many nuclei, including the reticular formation.

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53
Q

The large cerebral and cerebellar pathways in the most ventral region below the tegmentum form the ________________.

A

Base region of the midbrain and pons

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54
Q

The cerebellum lies dorsal to the _________, _______, and ___________.

A

fourth ventricle, pons, and medulla

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55
Q

The cerebellum is comprised of what 3 structures?

A

A right and left hemisphere, and a midline vermis.

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56
Q

Of the 12 paired cranial nerves, ____ of them (All but ____ and _____) have their origin in and emerge from the _______.

A

10, I and II, brainstem

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57
Q

Define: final common pathway

A

the last neural link from the nervous system to the speech muscles

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58
Q

The cranial nerves serving speech are actually part of the ________ nervous system.

A

peripheral

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59
Q

The adult spinal cord begins at the ___________ and terminates at the level of the ___________.

A

foramen magnum, first lumbar vertebra

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60
Q

Define: foramen magnum

A

the large, central opening in the posterior fossa at the lower end of the medulla

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61
Q

The spinal cord is surrounded by the bony __________, which includes _______, ________, and _________.

A

vertebral column; 7 cervical, 12 thoracic, and 5 lumbar vertebrae

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62
Q

_____ pairs of spinal nerves are attached to it via ______ and _______ nerve roots.

A

31; dorsal (posterior) and ventral (anterior)

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63
Q

The dorsal roots are _______ in function; the ventral roots are _______.

A

sensory, motor

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64
Q

Define: major longitudinal systems

A

groups of structures that have specific functions

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65
Q

Why are the systems called longitudinal?

A

for the most part, the activities of the system are evident over the length of the nervous system (i.e. from the supratentorial to the peripheral level)

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66
Q

6 major functional longitudinal systems

A

Internal regulation system (visceral system), cerebrospinal fluid system (ventricular system), vascular system, consciousness system, sensory system, motor system

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67
Q

Define: internal regulation (visceral) system

A

contains afferent and efferent components to maintain a balanced internal environment (homeostasis) through the regulation of visceral glands and organs.

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68
Q

Define: CSF system

A

Primary function- to cushion the CNS against physical trauma and to help maintain a stable environment for neural activity

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69
Q

CSF is produced by ________ located in the ______/

A

choroid plexuses, each ventricle

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70
Q

Each cerebral hemisphere contains a _________ that is connected by the way of the ________ to the midline-located ________.

A

lateral ventricle, foramen of Monro, third ventricle

71
Q

The third ventricle narrows into the _._________, which leads to the ___________ between the brainstem and cerebellum

A

aqueduct of Sylvius, fourth ventricle

72
Q

The __________ and the _________ in the fourth ventricle link the ventricular system to the subarachnoid space.

A

foramen of Luschka, foramen of Magendie

73
Q

__________ and ______________ comprise the CSF system.

A

ventricular system and subarachnoid space

74
Q

CSF circulates throughout the _________ and _________ and is absorbed in the ___________ in the brain or in the __________ in the spinal cord’s subarachnoid space.

A

ventricles and subarachnoid space, arachnoid villi, leptomeninges.

75
Q

CSF can be found in what 3 major anatomic levels of the nervous system?

A

supratentorial, posterior fossa, spinal levels

76
Q

All blood vessels that supply the brainstem and cerebral hemispheres arise from the _________ in the chest.

A

aortic arch

77
Q

Blood enters the brain by way of the __________ and the ___________

A

carotid system, vertebrobasilar system

78
Q

The carotid and vertebrobasilar systems are capable of some communication with each other through connecting channels to the brainstem known as the ______________.

A

circle of Willis

79
Q

Each internal carotid artery separates at the ______________ into what 2 of the 3 major paired cerebral arteries?

A

circle of willis; anterior cerebral arteries, middle cerebral arteries.

80
Q

The anterior cerebral arteries are connected to eachother by the ______________.

A

anterior communicating artery

81
Q

The vertebrobasilar system begins with the paired _______________, which enter the brainstem through the foramen magnum and join at the lower border of the pons to form the ____________.

A

vertebral arteries, basilar artery

82
Q

Consciousness system structures are found only at the ___________ and ____________ levels.

A

supratentorial and posterior fossa

83
Q

Consciousness system includes:

A

reticular formation and its ascending projection pathways, portions of the thalamus, pathways to the widespread areas of the cerebral cortex, and portions of all lobes of the cerebral cortex

84
Q

Consciousness system is crucial to what 4 things?

A

maintaining wakefulness, consciousness, awareness of the environment, and (on a higher level) selective and sustained attention

85
Q

Malfunctions within the consciousness system can cause

A

cognitive deficits (including language and commuication) and the adequacy of motor actions (including speech)

86
Q

The sensory system includes:

A

peripheral receptor organs, afferent fibers in cranial spinal and peripheral nerves, dorsal root ganglia (spinal level), ascending pathways in the spinal cord and brainstem, portions of the thalamus, and thalamocortical connections (primarily to sensory cortex in the temporal, parietal, and occipital lobes).

87
Q

Motor system directly responsible for:

A

all motor activity involving striated muscle

88
Q

Motor system primary function

A

Essential to normal reflexes, to maintaining normal muscle tone and posture, and to the planning, control, and execution of voluntary movement, including speech

89
Q

The nervous system is composed of _______, or _________, and considerably more numerous ________, or _________.

A

neurons, or nerve cells; supporting cells, or glial cells

90
Q

Define: neuron

A

the most important cellular element of the nervous system because its electrochemical activities drive the receipt, transmission, and processing of information.

91
Q

Many diseases affecting neurons result in their _______, _________, or ________, whereas others prevent normal _________ or _________ of neurons

A

malfunction, degeneration, or loss; normal structural or functional development of neurons

92
Q

Neurons in different parts of the nervous system vary in _______ and _______, but they all contain a _______, __________, and _________.

A

size and shape; cell body, dendrites, axon

93
Q

Define: cell body

A

central processing unit responsible for neuronal metabolic functions.

94
Q

Define: dendrite

A

responsible for gathering information transmitted from surrounding neurons.

95
Q

Axon diameter generally varies with its ________

A

length.

96
Q

Define: axon

A

conducts signals away from the cell body to other neurons or to muscles or glands

97
Q

Most communication among neurons, or between muscles and neurons, takes place at regions known as _________. In neuron to neuron communication, the ________ usually communicates with the __________ or __________ of another neuron.

A

synapses; axon, cell body or dendrites

98
Q

In most instances the axon and dendrite (or muscle fibers) are separated by a ______________.

A

synaptic cleft

99
Q

At the tip of the axon are tiny ___________ containing a chemical neurotransmitter that carries the axon’s signal to ________________ that mediate excitatory, inhibitory, or modulatory effects on the receiving cell.

A

synaptic vesicles; neurotransmitter receptors

100
Q

The message carried by a single axon to another neuron is ultimately simple: it either ____ or ______ the neuron receiving it from firing a message of its own.

A

facilitates or inhibits

101
Q

The “decision” of a neuron to fire or not reflects ________________.

A

a summation of the messages it receives from multiple sources.

102
Q

Define: glutamate

A

primary excitatory neurotransmitter for all CNS neurons

103
Q

Define: GABA (gamma-aminobutyric acid)

A

primary inhibitory neurotransmitter in the mature CNS and plays a role in the regulation of muscle tone; important in motor control activities of the basal ganglia and cerebellum

104
Q

Define: dopamine

A

crucial neurotransmitter that originates in the substantia nigra and ventral tegmental area in the midbrain and projects to many areas of the brain.
Role in movement, motivation and reward, cognition and learning, attention, mood, and sleep. Its modulatory actions in the basal ganglia aid the initiation and control of skilled motor acts (including speech)

105
Q

Define: acetylcholine; only neurotransmitter involved in what?

A

only neurotransmitter involved in the PNS control of skeletal muscle functions. excitatory effects, leads to movement by contraction of muscle fibers, modulatory effects in areas relevant to speech motor control and learning

106
Q

Actions of neurotransmitters at any given point in time must _____. Mechanisms that accomplish this depend on the type of neurotransmitter and include _______________(3 things).

A

end/turn off; uptake by astrocytes or presynaptic terminals, enzyme metabolism, or diffusion out of the synaptic cleft.

107
Q

Examples of neurochemical abnormalities leading to motor speech issues

A
  1. dopamine implicated in hypokinetic dysarthria associated with Parkinson’s disease
  2. acetylcholine is implicated in the flaccid dysarthrias associated with myasthenia gravis
  3. GABA is implicated in the spastic dysarthria associated with the spastic cerebral palsy
108
Q

Use of __________ to influence neurochemical systems is crucial to the management of many diseases associated with MSD’s

A

pharmacological agents

109
Q

5 types of supporting (glial) cells

A

oligodendroglia and schwann cells, astrocytes, ependymal cells, microglia, connective tissue

110
Q

Define: blood-brain barrier

A

mechanism that prevents the passage of many metabolytes from the blood into the brain, thereby protecting it from toxic compounds and variations in blood composition

111
Q

Define: astrocytes

A

assist neuronal migration during development; help regulate neuronal metabolism, the chemical microenvironment, and synaptic transmission; contribute to mechanisms of repair in response to injury

112
Q

Define: oligodendroglia

A

source of myelin in the CNS

113
Q

Define: schwann cells

A

source of myelin in the PNS

114
Q

Define: myelin

A

insulation that surrounds axons

115
Q

Define: nodes of Ranvier

A

small gaps between each myelinated segment of peripheral nerve fibers

116
Q

Define: saltatory conduction

A

electrical signals traveling down axons skip from node to node with a resulting increased speed of transmission

117
Q

Define: ependymal cells. Also form the?

A

line ventricular system and form a barrier between ventricular fluid and the neuronal substance (parenchyma) of the brain. also form the choroid plexuses that produce ventricular and cerebrospinal fluid

118
Q

Define: microglia

A

respond to destructive CNS processes by proliferating and transforming into macrophages

119
Q

Define and function: macrophages

A

scavenger cells, ingest pathogens and remove damaged tissue

120
Q

Define: connective tissue

A

make up the meninges . In PNS, form thin layers on myelinated nerve fibers, help bind fibers together within nerves, cover areas at the trunks of nerves. Analogous to meninges that surround CNS.

121
Q

Define: nerve

A

collection of axons (nerve fibers) bound together by connective tissues; groups of fibers that travel together in the PNS

122
Q

Peripheral nerves travel between ______ and ________.

A

CNS (where cell bodies reside) and peripheral end organs

123
Q

Define: peripheral end organs

A

sensory, motor, and visceral structures that nerves innervate

124
Q

Major distinction between PNS nerves and CNS tracts

A

CNS tracts transmit impulses to other neurons, while PNS nerves transmit impulses from nerves to end organs (such as muscle)

125
Q

Fiber tracts in the CNS are organized according to the _____________.

A

areas they connect

126
Q

Define: association tracts

A

connect cortical areas within a hemisphere to one another

127
Q

Define: projection tracts

A

contain afferent and efferent fibers that connect higher and lower centers in the CNS

128
Q

Projection tract names, such as extrinsic muscles, usually reflect ______.

A

the names of the areas they connect

129
Q

Define: ischemia. Reversible?

A

deprivation of oxygen and cessation of oxidative metabolism, as occurs in stroke. Not reversible

130
Q

Within as little as ________ of ischemia, _____, followed by _________ and _________ may occur

A

2-5 minutes; acute swelling of neurons followed by shrinkage and eventual cell loss

131
Q

Define: central chromatolysis/axonal reaction. Reversible?

A

when axons are severely injured, cell bodies may swell and lose some of their internal components; process is reversible

132
Q

Define: wallerian degeneration

A

degeneration of the axon distal to the point of separation

133
Q

Functionally significant regeneration of axons (does, doesn’t) occur in the CNS

A

doesn’t

134
Q

Define: neurofibrillary degeneration

A

characterized by the formation of clumps of neurofibrils in the cytoplasm of CNS neurons. Most common form of dementia associated with clinical dementia (particularly Alzheimer’s disease)

135
Q

Define: Senile plaques

A

related pathologic changes where deposits of a fibrous protein (amyloid) in cell bodies and degenerated nerve processes characterize them

136
Q

Define: inclusion bodies

A

abnormal, discrete deposits in nerve cells. their presence may identify specific diseases (Parkinson’s, Pick’s, certain viral infections)

137
Q

Define: storage cells

A

abnormal accumulations of metabolic products in nerve cells

138
Q

Define: atrophy

A

when lower motor neuron innervation of muscle cells is destroyed, the muscle will waste away

139
Q

Define: diaschisis

A

process in which neurons function abnormally because influences necessary to their normal function have been removed by damage to neurons to which they are connected

140
Q

Define: positron emission tomography (PET)

A

has demonstrated that neuronal cell death in one region of the brain can lead to changes in metabolic functions of adjacent and even distant regions to which the damaged area has important anatomic connections

141
Q

Define: demyelinating disease

A

myelin is attacked by some exogenous agent, broken down, and absorbed

142
Q

The most common demyelinating disease is ____, but demyelinization also occurs in other CNS And PNS diseases, such as _________.

A

multiple sclerosis (MS), Guillain-Barre syndrome

143
Q

The terms _____, ______, and ______ refer to the nonspecific process of astrocytes reacting to many CNS injuries by forming scars in injured neural tissue.

A

gliosis, astrocytosis, astrogliosis

144
Q

Neurologic signs and symptoms generally reflect the ________, not and not necessarily its specific ______.

A

location of a lesion, cause.

145
Q

Disease can often be localized on the basis of _____ and _______.

A

history and clinical examination

146
Q

LDE Chart- degenerative disease

A

Diffuse-focal,
chronic,
progressive

147
Q

LDE Chart- inflammatory disease

A

Diffuse-focal
subacute
progressive- exacerbate or remit

148
Q

LDE Chart- toxic or metabolic disease

A

Diffuse,
acute subacute chronic
progressive- stationary

149
Q

LDE Chart- neoplastic disease

A

Focal
Chronic Subacute
Progressive

150
Q

LDE Chart- traumatic disease

A

Diffuse, multifocal, focal
Acute
Improving, stationary

151
Q

LDE Chart- vascular disease

A

Focal, multifocal, diffuse
Acute
Improving, stationary, transient, progressive

152
Q

3 types of localization

A

Focal, multifocal, diffuse

153
Q

Define- focal

A

involving a single circumscribed area or contiguous group of structures (e.g.left frontal lobe)

154
Q

Define- multifocal

A

involving more than one area or more than one group of contiguous structures (e.g. cerebellar and cerebral hemisphere plaques associated with MS

155
Q

Define- diffuse

A

involving roughly symmetric portions of the nervous system bilaterally (e.g. generalized cerebral atrophy associated with dementia)

156
Q

3 types of development; time span of course for each

A

acute (within minutes), subacute (within days), chronic (within months)

157
Q

5 types of evolution

A

Transient, Improving, Progressive, Exacerbating-remitting, Stationary

158
Q

Define: Development

A

establishing the course or temporal profile of the disease

159
Q

Define: Evolution

A

course of the disease after symptoms have developed

160
Q

Define: transient

A

when symptoms resolve completely after onset

161
Q

Define: improving

A

when severity is reduced but symptoms are not resolved

162
Q

Define: progressive

A

when symptoms continue to progress or new symptoms appear

163
Q

Define: exacerbating-remitting

A

when symptoms develop, then resolve or improve, then recur and worsen, and so on

164
Q

Define: stationary (or chronic)

A

when symptoms remain unchanged for an extended period of time

165
Q

MSD’s can appear at any point during the __________ and _________ of neurologic disease.

A

development and evolution

166
Q

6 broad etiologic categories of MSD’s

A

degenerative, inflammatory, toxic-metabolic, neoplastic, trauma, vascular

167
Q

Degenerative diseases are characterized by what?

A

a gradual decline in neuronal function of unknown cause

168
Q

Neurons may either _______ or _______.

A

atrophy and disappear, endure more specific changes (e.g. neurofibrillary tangles)

169
Q

Define: degenerative diseases

A

genetically determined biochemical disorders that share basic mechanisms that lead to neuronal death.

170
Q

Clinical differences in degenerative diseases reflect the _________ and ________.

A

localization of the affected neurons, order and pace at which degeneration proceeds

171
Q

Degenerative disease are most often _____, _____, and _____, but they sometimes begin with ______.

A

chronic, progressive, and diffuse; focal manifestations

172
Q

Inflammatory diseases: include? Characterized by? Pathologic Hallmark?

A

Include (not limited to) infectious processes
Characterized by: inflammatory response to microorganisms, toxic chemicals, or immunologic reactions.
Pathologic hallmark: outpouring of white blood cells

173
Q

Development of clinical signs and symptoms in degenerative diseases is usually ________.

A

subacute

SPA6233 Motor Speech (5 decks)

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