Week 2 Flashcards
List the basic structures of a neuron
anatomical components:
Dendrites
Soma (cell body)
node of ranvier (comes before axon hillock in a sensory neuron)
axon hillock (comes before NoR in a motor neuron)
Axon
Axon terminal
Is the strength and connection of the synapse modifiable?
yes
Each neuron makes and receives up to 10,000 synaptic connections with others
Neuroplasticity: its the brain’s ability to adapt and reorganize by forming new neural connections in response to learning, experiences, injuries, or environmental changes. It involves structural changes, such as the growth or remodeling of synapses, and functional adaptations, like shifting tasks from damaged to healthy brain areas. Neuroplasticity is crucial for learning, memory, habit formation, and recovery from injuries like strokes, highlighting the brain’s remarkable capacity to change and adapt throughout life.
Define synapse
a specialized “zone” of contact at which one neuron communicates with another
Information transfers at a synapse
Plays role in all the operations of the nervous system
What is the role of presynaptic and postsynaptic neurons?
Presynaptic neuron
– conducts impulses
toward the synapse
(1 of these can connect to many postsynaptic neurons)
Postsynaptic neuron
– transmits impulses
away from the synapse
What are the types of synapses?
A) electrical synapses (No gap. not as common in humans, ex: SA node): signal transported by current through gap junction
No signal delay
B) chemical synapse (has a gap): signal transported by neurotransmitters in the synaptic cleft to go bind to receptors
what type of synapse is this?
electrical synapse
What type of synapse is this?
chemical synapse: The complex process of synaptic transmission accounts for the delay between an action potential in presynaptic cell and synaptic potential in the post synaptic cells compared to the virtually instantaneous transmission of signals at electrical synapses.
What are the characteristics of an electrical synapses?
- Distance between pre- and post- cell membrane: 3.5 nm
- Cytoplasmic continuity between pre- to post- synaptic cell: YES (physical touch)
- Gap junction (specialized ion channels)
- Agent of transmission: Ion current
- Synaptic delay: virtually absent
- Direction of transmission: bi-directional
What are the characteristics of a chemical synapse?
- Distance between pre- and post- cell membrane: 20-40 nm
- Cytoplasmic continuity between pre- to post- synaptic cell: NO (physical touch)
- Synaptic cleft
- Agent of transmission: Chemical neurotransmitter
- Synaptic delay: at least 0.3 ms, usually ranged from 1-5 ms or longer
- Direction of transmission: uni-directional
What are the advantages of a synapse through neurotransmitter (chemical)?
- The advantage of using neurotransmitter is that the nerve impulse can be given some more specificity
Neurotransmitters can also control the operation of the nervous system by inhibition or excitation
Signal can be modulated (i.e. amplified or degraded) based on a specific type of synaptic connections (ex. Presynaptic inhibition)
- Many drugs that try to cure problems in the nervous system operate at synapses
What are the steps of synaptic transmission?
A.Voltage-gated Ca2+ channels at the active zone open
B.Neurotransmitters released to the synaptic cleft
C.Neurotransmitters bonded to membrane receptors of post-synaptic cells and triggered changes in membrane potentials at post-synaptic sites
Explain these steps
Voltage-gated Ca2+ channels at the active zone open
1) Action potential arrives at the terminal
2) The membrane of pre-synaptic terminal depolarized
3) Voltage-gated Ca2+ channels at the active zone open cause influx of Ca2+
Neurotransmitters released to the synaptic cleft
4) Influx of Ca2+ triggers synaptic vesicles moving toward the release sites
5) Vesicles fuse with the membrane and release neurotransmitters
6) Neurotransmitters then diffuse across the synaptic cleft
Neurotransmitters bind to membrane receptors
7) Neurotransmitters bind to membrane receptors of post-synaptic cells
8) Open ion channels associated with the membrane receptor or activate intracellular messengers
Explain post-synaptic potentials
- Local changes in ion concentration across the postsynaptic membrane
Excitatory post synaptic potential (EPSP) – local depolarization, allowing flow of Na+ or Ca2+ into the neuron (ex. Ach in muscle)
Inhibitory post synaptic potential (IPSP) – local hyperpolarization, allowing flow of Cl- into the cell or K+ out of the cell
What is the state of postsynaptic membrane in EPSP?
Transient postsynaptic membrane
depolarization
What is the state of postsynaptic membrane in IPSP?
Transient postsynaptic membrane
hyperpolarization
Explain the process
Knee jerk:
Sensory muscle spindle
Inhibitory interneuron inhibiting flexor motor neuron (hamstring)
Synapse with alpha motor neuron within spinal cord
Excites motor nerve within quad to activate it
How do multiple inputs combine to determine the output firing pattern of the neuron?
Synaptic Integration - Spatial and temporal summation
Explain neurotransmitters and neuromodulators
both are chemicals that convey information among neurons
1) Neurotransmitters
−released at specific synapses
−act directly on postsynaptic ion channels (iontropic) of a neuron or activate proteins (metabotropic) inside the postsynaptic neuron
Ex: ACh (excitatory neurotransmitter)
2) Neuromodulators
−released into extracellular space
−affect a group of neurons
−manifest more slowly and last longer than neurotransmitters
List types of neurotransmitters
- Acetylcholine
- Glutamate
- Serotonin
- GABA
- Dopamine
- Norepinephrine
- Substance P
describe the function of ACh and what happens when it is disrupted?
- All neurons that synapse with skeletal muscles use Ach to elicit fast-acting effects on muscle membrane
- Excitatory neurotransmitter found in neuromuscular junctions involves in muscle contractions
- Blocking ACh receptors results in paralysis
- In the brain, Ach acts as a slow neuromodulator in control of movement and attention
Disruption:
Alzheimer’s Disease:
* Deterioration of memory, reasoning, and language skills
* Low levels of Ach found in those with Alzheimer’s disease
* Symptoms may be due to loss of ACh neurons
Describe glutamate
- Major fast, excitatory neurotransmitter of CNS (most common in CNS)
- Too much glutamate (and too little GABA) associated with epileptic seizures
- Involve with learning and development
Describe serotonin
- Involved in mood, perception of pain, general arousal level, and can suppress sensory information
- Highest levels occur with alertness and lowest levels are associated with rapid eye movement sleep.
- Low levels involved in depression
– Prozac works by keeping serotonin in the synapse longer, giving it more time to exert an effect (re-uptake inhibitor)
Describe function of GABA and what happens when it is disrupted?
Gamma-aminobutyric acid (GABA)
- Inhibition (slows down) of brain activity and spinal neuronal activity
- Cause neural over-activity (i.e. seizures and unwanted skeletal muscle contractions) and anxiety when in low supply.
- Alcohol mimics GABA
Disruption:
Huntington’s disease involves loss of neurons in striatum that utilize GABA
Symptoms:
* jerky involuntary movements
* mental deterioration
Describe function of dopamine and what happens when it is disrupted?
- Affects motor activity, cognition, and behavior.
- Involved in movement, attention and learning. Also pleasure & rewarding sensations.
- Too much Dopamine involved in schizophrenia.
- Drugs like cocaine and nicotine mimic dopamine, interfering dopamine reuptake into the presynaptic neuron.
Disruption:
* Parkinson’s disease: Loss of dopamine-producing neurons in the substantia nigra
Describe norepinephrine (NE)
- Arousal – increasing attention to sensory information
- “Fight or flight” response (secreted by adrenal gland and autonomic nervous system)
- Excessive levels of NE can produce panic disorder, the abrupt onset of intense terror and hallucination combined with signs of increased sympathetic nervous system activity.
- Post traumatic stress disorder
- Low levels found during sleep and in those with depression.
Describe substance P
- Released in response to pain
- Substance P stimulate nerve ending to transmit pain messages to the brain.
- Involve in pathophysiology of pain syndromes; percieve the normal stimulation as pain
- In CNS, P acts as neuromodulator, producing long-duration excitation of postsynaptic cells.
- Modulate immune system and neuronal activity in times of high stress.
What are synaptic receptors?
- Specific sites where neurotransmitters bonding at
- Are typically named for the neurotransmitter to which they bind
- Most neurotransmitters can bind to several different types of receptors.
- Thus, the effect of a neurotransmitter is based not on the chemical itself, but on the TYPE OF RECEPTOR to which it binds
- Lock and key Analogy:
For binding to occur, the neurotransmitters (keys) and a receptor site (a lock) must have perfectly complementing
What are the types of synaptic receptors?
Ionotropic receptor (opening of a specific receptor):
− Fast synaptic transmission
− Directly activating ion channels
Metabotropic receptor (binds and causes G-protein to move):
− Slow synaptic transmission
− Act through G-proteins
(Secondary messengers are involved)
What type of receptor is this?
metabotropic receptor
What type of receptor is this?
ionotropic receptor
What is this? Give examples of the neurotransmitter
Direct opening Ion Channels: Ligand-gated ion channels (specific channel)
- Act as receptors for the neurotransmitter (NT)
- Also act as ion channels
- Ionotropic receptors
Example:
* Neurotransmitter: Glutamate
* Receptor: a ligand-gated channels
* At rest, channels are closed
* After NT bonding to the receptor, ion channels open
* Influx of Na+ or Ca2+, producing local depolarization
* Ion channels open and close rapidly
what is this?
Indirect opening Ion Channels:
Guanine nucleotide-binding protein (G-protein)
G protein receptor -> G protein activated -> subunits break free and bind to ion channel to open it
Define neuropharmacology, agonists, and antagonists
Neuropharmacology - Effect of drugs on nervous system tissue
Agonists: Mimic actions of naturally occurring neurotransmitters
Antagonists: Impedes the effects of a naturally occurring transmitter such as preventing the release of neurotransmitter or binding to the receptors
What is Lambert - Eaton Syndrome?
disorder of synaptic function
Damage to voltage-gated Ca2+ in the presynaptic terminal (neuromuscular junction)
Blockage of Ca2+ influx into the terminal
Decreased release of neurotransmitter
Decreased excitation of muscle
Lead to muscle weakness
What is Myasthenia Gravis?
disorder of synaptic function
Damage to nicotinic (Ach-binding) postsynaptic receptors on muscle cells (neuromuscular junction)
Normal amount of Ach are released to the cleft, but few receptors are available for binding
Repetitive use of the muscle lead to increased weakness and rapid fatigue of the muscle
Improves after periods of rest
Define sensation and perception
Both by somatosensory system
- Sensations: awareness of stimuli from the sense
− Receptors convert the energy of stimulus into electrical potentials (attached to peripheral nerves, ex: mechanoreceptors)
− Action potentials propagate to specific areas of the brain - Perceptions: the interpretation of sensation into meaningful forms
− Once the brain recognizes a sensation, it interprets it, giving the perception (color, taste, sound, taste) of a stimulus
What are the levels (1, 2, 3)?
1) receptor level: sensory reception and transmission to CNS
2) circuit level: processing in ascending pathways
3) perceptual level: processing in the cortical sensory centers
If someone had a stroke, is perception or sensation affected?
sensation intact, but perception affected
List and explain the order of events starting from the stimulus
stimulus -> receptor -> conduction -> translation
- Stimulus: apply to the receptor triggering a graded membrane potential in the receptor.
- Receptor: converts stimulus energy to impulse (action potential)
- Conduction = of impulse over sensory pathway to CNS
- Translation = region of CNS receives impulse(s) & integrates information; may prepare response.
Define stimulus
- Environmental energy, or energy change, that causes a change in receptor potential in a receptor cell
- Stimulation determines types of receptors that are activated as well as the pattern of signal transmission
Define receptors
- Specialized peripheral element of the sensory neuron where the sensation and perception begin
- Each type of receptor is specialized, responding only to a specific type of stimulus
Label these
specific tracts for specific signals
1-2 (PNS), 3-7 (CNS)
1) receptors
2) afferent neuron (first order neuron)
3) spinal cord or brainstem
4) seconds order neuron
5) thalamus
6) third order neuron
7) cortex
What are these?
A) simple receptors: are neurons with free nerve endings. Usually for pain sensation
B) complex neural receptors: have nerve endings enclosed in connective tissue capsules
C) special senses receptors: are cells that release neurotransmitter onto sensory neurons, initiating an action potential
What are the classifications of sensory receptors?
- General senses: somatic and visceral.
−Somatic- tactile, thermal, pain and proprioceptive sensations.
−Visceral- provide information about conditions within internal organs. - Special senses: smell, taste, vision, hearing and equilibrium or balance.
What are the classifications based on the locations of receptors?
- Exteroceptors:
A) at or near body surface (superficial, cutaneous)
B) Detect external stimuli (light, heat, chemicals, pressure)
- Interoceptors (Visceroceptors):
A) Deep
B) react to stimuli coming from the internal body/organs (blood pressure, plasma osmolality, blood pH)
- Proprioceptors:
A) muscles, tendons, ligaments (position & kinesthetic sense)
What type of stimulus is each receptor for?
- Mechanoreceptors:
react to mechanical stimuli (ex. touch, stretch) - Proprioceptors:
muscles, tendons, ligaments (position & kinesthetic sense) - Chemoreceptors:
react to chemical molecule or substances (ex. smell, taste, substance P) - Thermoreceptors:
Cold & hot - Nociceptors (subcategory):
– sensitive to stimuli that damage or threaten to damage tissue - Photoreceptor: (vision)
What do proprioceptive receptors detect?
body position and movement
What do cutaneous and subcutaneous receptors detect?
light touch and pressure
What do free nerve endings detect?
Temperature and pain
List the proprioceptive receptors based on axon diameter and state their function
List the cutaneous and subcutaneous receptors based on axon diameter and state their function
List the free nerve ending receptors based on axon diameter and state their function
Label these and state what they do
Mechanoreceptors (fine touch, A-beta fiber)
Superficial (small receptive field):
1) Meisner’s corpuscles (light touch and vibration)
2) Merkel’s disks (pressure)
Subcutaneous (large receptive field):
3) Pacinian corpuscle (touch and vibration)
4) Ruffini’s corpuscles (stretch of the skin)
Are big or small receptive field more accurate?
small
What type of receptor is each?
1) Meissner corpuscle
2) Merkel cells
3) Pacinian corpuscle
4) Ruffini endings
1) What is an example of coarse touch? 2) what is pain detected by? 3) what is temperature detected by?
1) Coarse touch (pleasant touch or pressure, sensation of tickle and itch)
2) Pain : damage or threaten tissue (Nociceptors)
3) Cold or warmth within the normal range of temperature (thermal receptors)
Define receptor adaptation
(Both are important for movement control)
- Tonic Receptor: slow adapting (SA) fibers
− Slow or no adaptation to constant stimulation
− detect object pressure and form (static sense) - Phasic Receptor: fast adapting (FA or RA) fibers
− Rapid adaptation to constant stimulation
− detect motion and vibration (rate of changes)
Rapid or slow adapting receptor?
slow
Rapid or slow adapting receptor?
rapid
explain
- Slow adapting fibers
− SA1: encode grip force
− SA2: encode hand posture - Fast adapting fibers
− RA1: encode rate of force application and movement of the hand on the object
− RA2: sense vibrations in the object with each movement at hand contact, lift-off, table contact, and release of grasp
Describe receptive field
- The area of skin innervated by a sensory neuron
- Receptive Fields define the zone of tactile sensitivity
−Smaller receptive area in distal limbs
−Greater density of receptors in distal regions of the body (2/mm2)
−Stimuli can be precisely detected on the fingertip
Describe type I and type II sensory fibers
- Type I sensory fibers: terminate in clusters of small receptors in superficial layers of the skin
- Type II sensory fibers: terminate in single large receptors in the deeper layers of the skin
- Both sensory fibers contain rapid- and slow- adaptive receptors
Explain
threshold detection:
The detection thresholds varied corresponding to characteristics of
receptors and stimulations
− Pacinian corpuscle is most sensitive to vibration at 250 Hz
What are the attributes of sensory information encoding?
- Modality:
− Diverse sensations
− Receptors specialized for particular forms of stimulation - Location:
− Receptor’s receptive field, precise area
− Tracts/pathways connected between receptors and CNS - Intensity:
− The amplitude of receptor potentials
− Total number of receptors activated
− Frequency of activation - Duration:
− The time course of receptor potential
− Total number of receptors activated
Explain the amplitude and duration of stimulus
( a stronger stimulus (deeper stretch) results in higher amplitude and longer duration (overall higher response))
- Amplitude and duration of the stretch determine the receptor potential’s magnitude.
- The receptor potential, if large enough, triggers action potentials at a frequency proportional to the stimulus intensity.
- Action potential frequency, not amplitude, encodes the strength of the stimulus.
- Neurotransmitter release at the synapse reflects the action potential frequency, controlling the strength of the signal sent to the next neuron.
What are the levels of neural integration?
- Receptor level (periphery)
Receptor potential: graded membrane potential in receptors
− Strong receptor potential (depolarization) initiates action potentials and causes release of
neurotransmitters - Circuit level (spinal region)
Transmission of action potentials to CNS within tracts
− Divergence: synapses can spread action potentials to several areas of CNS
− Convergence: synapses can focus action potentials from several sensors on narrow area of CNS - Perceptual level (cortical regions)
Sensory representation (map): sensory nerve tracts carry impulses to
appropriate part of brain
explain processing at circuit level
- Transmission of action potentials to CNS within tracts:
Divergence: synapses can spread action potentials to several areas of CNS
Convergence: synapses can focus action potentials from several sensors on narrow area of CNS
− Converging primary sensory neuronal circuits results in a larger receptive field
Explain A and B
A) Many primary sensory neurons converging onto a single secondary neuron creates a very large receptive field. The two stimuli will be perceived as a single point because both stimuli fall within the same receptive field.
B) When fewer neurons converge, secondary receptive fields are much smaller. The two stimuli activate separate pathways and are perceived as distinct stimuli.
Explain
1) primary neuron response is proportional to stimulus strength
2) pathway closest to the stimulus inhibits neighbors
3) inhibition of lateral neurons enhances perception of stimulus
(Adaptive: through specific stimulus training you can improve a specific pathway and over time an inhibitory effect on other pathways)
explain processing at the perceptual level
- Sensory representation (map): sensory nerve tracts carry impulses to appropriate part of brain
Disproportionally larger areas in the map
− Mouth and tongue
− The tip of the index finger
Why: because they have more areas with 2 point receptive fields leading to high levels of sensory processing and dexterity
Explain processing speed
- Information in the somatosensory system proceeds from the receptor through a series of neurons to the brain.
- Speed of information processing is determined by the following:
Diameter of the axons
Degree of axonal myelination
Number of synapses in the pathway
What does somatosensory information protect against and what is it used to control?
- Somatosensory information protects against injury
- Somatosensory information is essential for accurate control of movement
ADL and IADL (needed for posture, coordinated actions,…)
Balance & coordination
Muscle activation and force control
Reflex & protective reaction
If a diabetes patient has large mylenated fibers are affected. What type of sensation is impacted?
proprioception, body position, movement
What is the purpose of testing somatic sensation? How is it mapped?
- Purpose: evaluate whether sensory impairment is present
the location
type of sensation affected
severity of the deficit. - Patterns can be mapped by:
peripheral nerve distribution
adjacent dermatomes
(Dermatome vs peripheral issue) - Overlap of adjacent dermatomes ensures that if only one SENSORY ROOT is severed, a complete loss of sensation does not occur in any area.
What are the guidelines for somatic sensation testing?
- Six guidelines improve the reliability of sensory testing:
Administer tests in a quiet, distraction-free setting.
Position the patient seated or lying supported by a firm, stable surface to avoid challenging balance.
Explain the purpose of the test.
Demonstrate each test before administering.
Block the patient’s vision during the tests.
Apply stimuli near the center of the dermatomes being tested.
What happens when there is a peripheral nerve lesion?
- Complete severance of a peripheral nerve results in lack of sensation in the distribution of the nerve; pain may occur; sensory changes are accompanied by motor and reflex loss.
- Compression of a nerve affects large myelinated fibers preferentially; the order of sensory loss:
Conscious proprioception and discriminative touch
Cold
Fast pain (sharp, stinging pain)
Heat
Slow pain (aching pain) - When compression is relieved, tingling or prickling sensation occur as the blood supply increases; sensation return in the reverse order
Rank carried sensation from high to low speed
- Conscious proprioception and discriminative touch
- Fast pain (sharp, stinging pain)
- Cold
- Heat
- Slow pain (aching pain)
What type of somatic sensory tests are these?
A) Primary sensation:
location of touch: integrity of medial lemniscus pathway
tactile threshold: inability to sense the 10 g filament indicates loss of protective sensation.
B) Cortical sensation:
1) two-point discrimination: evaluate the function of the primary somatosensory cortex
Cannot be performed when primary touch sensation is abnormal
Which structures have the smallest, and which have the largest receptive fields?
two point discrimination:
fingers (2 mm) (smallest)
Upper lip (5 mm)
Cheek (6 mm)
palm (10 mm)
Big toe (10 mm)
Sole of the foot (20 mm)
Upper arm (45 mm)
thigh (45 mm)
back (40 mm) (Largest)
How do you test electrical activity of nerves? What do they reveal?
- Electrical activity from nerves reveals the location of the pathologic function.
- Two methods of testing function:
Nerve conduction study (NCS) testing measures peripheral nerve function.
Somatosensory-evoked potentials test peripheral nerves and central nervous system (CNS) pathways. - Measurements can be compared with unaffected nerves in the same patient or with published normal values
What are the symptoms, causes, and treatment for Varicella Zoster (shingle or herpes zoster)?
- Symptom:
Painful skin rash with blisters following a dermatome pattern - Causes:
Varicella-zoster virus cause chickenpox and infects the dorsal root ganglion
Virus remains latent in the sensory ganglia for many years
Virus break out of the nerve cells and travel down to the nerve endings causing painful eruptions on the skin - Treatment:
Antiviral drugs within 72 hours of rash onset
List the etiology, pathology, speed of onset, and signs & symptoms for Varicella Zoster infection
List the region affected, demographics, and prognosis for Varicella Zoster infection
How many bones are in the cranial vault?
28 total (there are 6 ear bones, 8 paired, and 6 unpaired)
Label
What type of joints connect each bone of the outer skull together? list them
sutures (fibrous joints)
Sutures typically close by age 2-3 yo
1) coronal suture:
Frontal lobe, parietal lobe
2) squamous suture:
Temporal lobe, parietal lobe
3) lambdoid suture
Parietal lobe, occipital lobe
Label
Label and explain
1) pterion:
Most vulnerable area (thin)
Protects middle meningeal artery
2) metopic:
Forehead related
Label
1) ethmoid bone
2) wings of sphenoid bone
3) sella turcica (has pituitary gland)
4) foramen magnum (largest foramen, has spinal cord)
Label
List the bones and lobes of each cranial fossa
What structure separates anterior/middle and middle/posterior fossa?
1) anterior fossa/middle fossa:
Lesser wing of sphenoid bone
2) middle fossa/posterior fossa:
Petrous ridge of temporal bone
Do all cerebral lobes connect to the fossa?
no (parietal lobe)
The sella Turcica is part of what bone?
sphenoid bone
The frontal bone, Sphenoid bone, Temporal bone and parietal
bone all connect to form what “vulnerable area of the skull”?
Pterion
how do you differentiate between motor, sensory, or both (nerves)?
S (some)
S (say)
M (money)
M (matters)
B (but)
M (my)
B (brother)
S (says)
B (big)
B (brain)
M (matters)
M (most)
List the cranial nerves in order
Oh Once One Take The Anatomy Final Very Good Vacations Are Heavenly
1) olfactory
2) optic
3) oculomotor
4) trochlear
5) trigeminal
6) abducens
7) facial
8) vestibulocochlear
9) glossopharyngeal
10) vagus
11) accessory
12) hypoglossal
Label
Which foramen has CN I (olfactory)?
cribiform foramina in the cribiform plate
Label the structure and list the cranial nerves associated with it
1) optic canal:
CN II (optic nerve)
2) superior orbital fissure:
CN III (oculomotor nerve)
CN IV (trochlear nerve)
CN VI (abducens nerve)
CN V ”1” (trigeminal nerve, opthalamic)
Label the structure and list the cranial nerves or structures associated with it
1) foramen rotundum:
CN V “2” (trigeminal nerve, maxillary)
2) foramen ovale:
CN V “3” (trigeminal nerve, mandibular)
3) foramen lacerum:
Internal carotid artery
4) foramen spinosum:
Middle meningeal artery
Label the structure and list the cranial nerves or structures associated with it
What are the divisions for each cranial nerve?
total 24 nerves (because they are paired)
2,2,4,4
1) Cerebral hemisphere:
I, II
2) Mid brain:
III, IV
3) Pons:
V, VI, VII, VIII
4) Medulla:
IX, X, XI, XII
Label
What is the order of meninges (cranium), superficial to deep?
dura, arachnoid, pia
Describe dura mater
Label and state what does 1 do
1) falx cerebri (seperates R and L hemispheres
2) meningeal layer (dura mater)
3) periosteal layer (dura mater)
Label and states what 2 does
1) falx cerebri
2) tentorium cerebelli (seperates supraentorial and infraentorial)
3) tentorium notch
Describe arachnoid mater
Describe pia mater
Label
1) arachnoid mater
2) pia mater
Label
1) superior sagittal sinus
2) subdural space
3) subarachnoid space
4) falx cerebri
List and describe the spaces of the cranium
(potential: no direct opening, anatomical: true space, natural opening)
Label
1) subarachnoid space
2) subdural space
What is between dura and periosteum?
posterior epidural fat
does the falx cerebri divides the cerebellum from cerebrum?
no (from R & L hemispheres)
What are the CSF functions?
chemical stability/brain growth
Hormone & neuropeptide transport
Buoyancy
Protection
Metabolite removal
Label
What structure makes CSF? Where is it located?
choroid plexus in the lateral ventricles
Label
Describe choroid plexus
What conditions is a lumbar puncture (LP) and neurological Dx used for?
Label the steps of fluid resorption
List the steps of CSF flow
What is the function of the blood brain barrier (BBB)?
selective barrier
Nutrition
Protection
Homeostasis (ions & neurotransmitters)
Where is the BBB found?
List neurological pathologies caused by BBB dysfunction
Label
List the circulation in the circle of willis
What structures do the anterior and posterior circulations (circle of willis) supply?
Which arteries supply the cerebellum?
1) superior cerebellar artery (SCA)
2) anterior inferior cerebellar artery (AICA)
3) posterior inferior cerebellar artery (PICA)
What type of junction does the BBB have?
Tight for protection
Which main artery initiates the rise to the posterior circulation of the brain?
vertebral artery
What are the components of the cranium? Volume?
What are the types of intracranial hemorrhages?
What are the clinical features and mechanism of injury for each intracranial hemorrhage type?
What are the secondary effects of intracranial hemorrhage?
What is the medical management of an intracranial hemorrhage?
What is the difference between a craniotomy and craniectomy?
Epidural (lens)
Intracerebral
Subarachnoid
Subdural
Explain
concussion (coup-countercoup)
Coup: initial side of injury
Countercoup: opposite of impact (rebound of brain against skull)
(Concussion is not visible in an MRI or CT. It need functional MRI “FMRI”)
List signs and symptoms of mild TBI
What is the population most at risk from CTE?
What are the symptoms of post concussive syndrome?
Explain
What is excess CSF within the cranium caused by?
What are the types of hydrocephalus?
What are the signs and symptoms of hydrocephalus?
How does hydrocephalus present in a pediatric patient?
What are the treatments for hydrocephalus?
How does hydrocephalus affect intracranial pressure?
What are the effects of increased intracranial pressure?
Explain brain herniation
List the types of brain herniation and their features
Explain meningitis
What are the types meningitis?
What are the clinical symptoms of meningitis (meningeal irritation)?
What are the tests that can be done to detect meningitis?
