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Neuroscience PTA
PTA neurology final review
| Question | Answer |
|---|---|
| Arachanoid granulation | aka Arachanoid villi. reabsorb CSF back into the blood at a rate equal to formation. |
| CSF | -CSF filled cavities are known as Ventricles -Most CSF forms in the lateral ventricles -Formed by blood filtration. |
| Choroid plexus | name of the network of capillaries that line the walls of ventricles. -Produce the CSF by flitrating/pushing blood plasma |
| 3 ways CSF maintains homeostasis | Mechanical protection-shock absorber Chemical protection-maintains an ionic env for(AP) Circulation-a medium exchange of nutrients and waste products btw blood and nervous tissue. |
| Hydocephalus | blood blocked interfering w drainage of CSF from ventricles. AKA-enlargement of the ventricles kids-bulging of the head. |
| Blood supply of the brain | 20% oxygen 4 mins or more of interruption of blood flow=permanent damage to the brain. -Supply by the Circle of willis -Lysosomes if lack of O2 release enzymes and they destroy neurons. |
| Can the blood brain barrier store glucose? | NO, so blood supply is important!! |
| What are of the Brain stores more O2? | Cerebrum |
| BBB | Blood brain barrier crosses over and interacts with neurons Capillaries of the brain r less permeable bc of their endothelial cells. Astrocytes- stars cells! press against capills and allow specif substances. |
| Circle of Willis | main trunk that supplies brain. if blood is blocked, can still get to brain. -is a point where the blood carried by th 2 internal carotids and basilar systems come 2gether and then redistributed by the ant, mid, and pos cerebral arteries. |
| Falx cerebrix | from the dura mater-separater the hemispheres of the cerebrum. |
| What are the layers of the brain? | protection layers Dura mate-outer Arachanoid-middle Pia mater-inner most |
| What produces CSF and where? | secreted by-Choroid plexuses-located in the 4 ventricles circulates through the brain and enters the superior sagittal sinus. Arachnoid layer-middle |
| What is Sensation? | State of awareness pf external or internal conditions of the body. Info travels via Conscious relay path divergent path and unconscious relay paths. |
| What 3 ways does sensation get to the brain? | Conscious relay path-discriminative touch divergent path-aching pain unconscious relay paths-how I move(cerebellum) |
| Sensation receptor classifications | Exteroceptors-external/superficial env(nose,eyes,touch,sound) Visceroceptors or interoceptors- internal. Proprioceptors- movement-joints ligs,tendons. |
| What is a mechanoreceptor? | sensory recepts, touch, pressure, stretch, |
| Thermoreceptor? | temp warm and cold receptors thermal sensation |
| Nociceptors? | Pain sensation sensitive to chemicals released. |
| Photoreceptors? | eyes |
| Chemoreceptors? | responds to chemical receptors>O2 levels taste. |
| Proprioceptive | aka kinesthetic sense. info regarding movement and positions. joint, hair cells, ms spindles, GTO-ms strength. |
| Sensory intergration | ability of the brain to organize, interpret, and use sensory info. occurs automatically. -ways to teach kids better. |
| Sensory Arousal levels or SAL | Alert Lethargic-drowsy w lessened focus Obtunded-difficulty to arouse, confused when awake. Stupor-responce to painful stimuli only. then back to unconscio. Coma- no arousal by any stimuli |
| Orientation- | pt's awareness of, TIME, PERSON, PLACE pt orientate X3 pt orientate X1 (place) Pt orientate X2 (time and person) Soap note i.e=O+A X3 |
| Labeled line principle | line going from tongue to brain. |
| Receptive field | area of skin innervated by a single afferent neuron(sensory) different types cutaneous, superficial, thermal, ect... More sensory distally! |
| Modality sensation | each sense is a modality sensation. i.e hearing, vision, taste, touch. |
| Superficial fine touch | smaller receptive fields |
| Merkels discs | superficial fine touch receptive field. free nerve endings wraps around base of hair follicle; TOUCH RECEPTOR detects mechanical movement/touch. feel me touch the hair |
| Meissner's corpuscles | in superficial dermis, light pressure. rapidly adapt. RECOGNIZE OF TEXTURE. |
| Pacinian corpuscles | deep dermis, deep pressure and vibration. (circle) |
| Subcutaneous fine touch | larger receptor fields |
| Ruffinis corpuscles | deep dermis, sensitive to stretch of the skin. Assist w joint position sense. |
| Thermal receptors | free nerve endings in dermis, ms, liver. rapidly adapt. Warm rec- respond to temps btw 77-113 degrees Cold recep- respond to temps btw 50-68 degrees F |
| Nociceptors | scatter about free nerve endingd w LARGE receptive fields. found in superficial skin, joint caps, periosteum, around walls of b. vessles, A-fibers-carry fast pain C-fibers-carry slow burning aching pain |
| Periosteum- | fiber connective tissue that wraps around ms spindles. |
| Coarse touch | free nerve endings throughout skin, detect crudely localized touch/pressure/tickle/itch. |
| Deep sensory receptors | in ms, tendons, joints GAMMA motor neurons fiber. |
| Ms spindles | intrafusal fibers parallel to extrafusal fibers. monitor changes in ms length n velocity. motor learning! |
| Golgi tendon organ | in tendons. monitor tension in a ms. Golgi-protective, 2 relax ms w/in a tendon. will inhibit contracting. deep sensory receptors |
| Free nerve endings | w/in fascia of a ms. respond to pain/pressure/vibration |
| Pacinian corpuscles | in tendons/around joints. respond to deep pressure and vibration. circle! |
| Golgi | type nerve ending- receptors in ligs. detect rate of joint movement. |
| Ruffini endings | in joint caps and ligs. joint receptor. respond to direction of joint movement. |
| Dorsal column | sensory axon enter the SC via dorsal horn. Fast conducting fibers. two-point discrimination. Lager fibers. Discriminative touch. skin,joints, |
| Sensory receptors- | are located at the distal end of an afferent nerve fiber. |
| Anterolateral spinothlamic | Anterior-carry info regarding crude touch. Lateral-pain and temp. SMALL conducting fibers. Mechanoreceptors, thermo, and nociceptors. Afferent fibers that slowly conduct. |
| Dyscalculia-define- | difficulty calculating. |
| Barognosis | regcognition of weight |
| Graphethsia | traced figure ID. like letters |
| Stereognosis | id a common object w/out site. key,pen, |
| 2 point discrimination | aesthesoimeter or circular disk measures distance on skin that 2 points are felt. |
| Kinesthesia | PROM. where is joint moving? up or down? |
| Proprioception | move joint then stop. eyes closed. |
| Quantitative | sensory testing |
| Varicella zoster | shingles. infection of senory root cell body. |
| Define Pain | pain is objective. peripheral nociceptors r found through out skin and internal tissues, cept tissue of the brain. |
| Ischemia | deficiency of blood. resulting in deficiency of )2 (hypoxa) |
| Cramp pain | ms's tighten up and squeezing caps. which decrease blood. then pain-stimi chems accumulate. BUT if u apply heat=dialtes blood, increasing blood flow/O2=less pain. |
| a-delta fibers | fast carrying pain info. myelinated axons. |
| C-fibers | slow carrying dull aching pain. on unmyelinated axons. synapse on neurons in dorsal horn. to the limbic system(emotional response) and reticular-wake up! turn towards pain. |
| Somatosensory cortex | pain perception or localization. |
| Gate theory | (non pain)if alpha-beta fibers are stimulated more then the alpha-delta fibers(pain fibers)then the pain is inhibited in the dorsal horn. 'closing the gate' rubbing the pain inhibits the T-cells=stopped the pain! |
| Alpha-beta fibers | non-nociceptors(non pain receptors)carry info from mechnoreceptors |
| What does lower levels of serotonin mean? | increased pain! so increased levels of serotonin and dopamine in brain means = inhibit pain! Neurotransmitter |
| Counterirritant theory | pressure stimulates mechanoreceptor afferent branches, which attivate interneurons that release Enkephalin, which decreases the release of Substance P(chronic pain nt) |
| Antinociception | suppression of pain |
| Neuromodulators | produced in brain. enkephalin, beta-endorphin can inhibit pain |
| Peripheral pain | aspirin can inhibit pain |
| Brainstem descending tacts | become activated, and inhibit pain by increasing the release of serotonin in the dorsal horn, which increases enkephalins. |
| Hormonal system | pituitary gland and adrenal medulla release enkephalin during acute stress. thats y ppl walk away w a broken leg. |
| Cortical | ihibits pain by distraction, placebo, excitement. |
| Pronociception | edema- endogenous chems-sunburn anxiety-can increase pain. increased levels of norepinphrine can increase pain. |
| Multiple ways to shut down pain | Neurotransmitters-increased serotonin Doral horn-TENS Hormonal- stress |
| Types of pain | Acute, referred, Chronic Chronic pain-Nociceptive- continuing stimulation all the time Chronic pain neuropathic- a disease. pain continues after stimi is gone. |
| Chronic pain-Nociceptive | Chronic pain-Nociceptive- continuing stimulation all the time bc of cancer or tumor. takes less stimi to generation AP. |
| Chronic pain neuropathic- | a disease. pain continues after stimi is gone. |
| Symptoms of neuropathic pain | paresthesia-painless. abnorm sensation. Dysethesia-unpleasant. abnorm sensation. burning, shooting pain. Allodynia-norm non-painful touch produces pain. Secondary hyperalgesia-fibromyalgia pain. normal touch feels painful! |
| Secondary hyperalgesia | fibromyalgia pain. normal touch feels mildly painful! |
| Allodynia- | norm non-painful touch produces pain. |
| paresthesia | painless. abnorm sensation. (tickle)lesions |
| Dysethesia- | unpleasant. abnorm sensation. burning, shooting pain. |
| PNS neuropathic pain | injury or disease of peripheral nerve. Ectopic foci- myelin damage make AP w/out stimi. Ectopic develop at nerve stump ends and tapping induces pain AKA Tinels sign! |
| Tinels sign | Ectopic foci- myelin damage produces AP w/out stimi. this develops at stump nerve ends and when tapping=induces pain- TINELS sign. |
| Mononeuropathy | PNS- one nerve median or ulna nerve compression |
| Polyneuropathies | PNS- more than one nerve. like diabetic neuropathy and guillain barre. |
| CNS neuropathic pain | if peripheral sensory info in completely absent.(sensory info coming in) then CNS neurons in the pain pathway become abnormally active! |
| Deafferentation | CNS neuropathic pain avulsion of afferent roots (MVA)(cutting off dorsal roots) causes burning pain in area of sensation loss |
| Phantom limb pain | CNS neuropathic pain |
| Pain matrix malfunction | Antinociception is decreased and pronociception is increasesd. Fibromyalgia, Complex regional pain syndrome. |
| Complex regional pain syndrome | abnormal response to trama leading to limb disuse. excessive sweating, edema, red/pink skin, |
| Chronic pain syndromes | migraine, chronic low back pain-never stops. |
| Simple descriptive pain scale | a line....no pain,mild, moderate, severe,-max pain tolerable |
| VAS-visual analog scale | a line...no pain-max. |
| Pain estimate (scale) | a line---0-100 or 0-10 |
| Face pain scale | faces for kids |
| Mcgill pain questionnaire | 20 categories of descriptive words. pain clinics use this a lot. 1-10 sensory 11-15 affective number 16 evaluative |
| Caregiver checklist | list of demonstrated pain behaviors for pt's who cant communicate. |
| Observe- | gait, posture, skin, ROM, ms strength, sensation. |
| Disorders of Vascular supply | Anerism- dislocation of wall, abnormal widening. TIA-stroke Angedogphy -X-ray pictures of the inside of blood vessels. Hemerage- thin wall vessles |
| What makes up the CNS? | brain and sc |
| PNS | 31 SP-pairs nerves 12 pairs-cranal. Subdivision-ANS |
| CNS-all nervous systems ARE encased in Vertebral column. (brainstem, SC, skull) Neuroglia cell types-Astrocytes, Oligodendrocytes, microglia, ependyma. No Neurolemma-> NO REGENERATE! Oligodendrocytes-myelinate. Mulitple Sclerosis) Has nucleus and PNS | PNS-all nervous systems NOT encased in bone Have ganglia,carry info to and from CNS. Neurolemma AKA Schwann Cells->mylinate -regeneration Guillian-barre Divided into 2 systems- Somatic-voluntary-motor control ability.ANS-involuntary2 subdiv sympath+ |
| PNS-two systems | ANS-sympathic s-fight or flight. and Parasympathic s-restful. Somatic-voluntary. contraction of ms. motor control. |
| Afferent fibers | sensory. info to the CNS. somatic afferent-to CNS-skin, skeleton, joints, |
| Efferent fibers | Motor-leaves CNS Somatic efferent-skeletal ms's. Viseral efferent fibers- heart, smooth ms, glands, to autonomic sys. |
| Neurons | Dendrites receive, Axons conduct. |
| Node of Ranvier | space btw mylein exposed 2 extracelluar fuild. Where the gates open!! |
| Spinal cord-how long and how many nerves? | 31 pairs of nerves runs to medulla-L1/L2 18" Gray matter inside-unmyleinated axon. cell bodies. |
| Sensory coming in from where? | Dorsal roots gangila. Motor coming out-Ventral. |
| Reflex arch? | quick response. |
| Lateral spinothalamic tract | pain/temp |
| Lateral Corico tract* | BIG AIS motor-distal- |
| UMN vs LMN | UMN-synapse w.inhibitory hyper reflexia, hypertonia (babinski) LMN-directly to Ms. Hypotonia. |
| Flaccid- | no resistance, |
| Cranial nerve VIII | Vestibulocochlear balance, auditory sensations from inner ear. |
| Cranial nerve XII | Hypoglossal motor to tongue |
| X cranial nerve | Vagus nerve-only cranial nerve to descend below neck. autonomic. throacic and abdom organs. |
| Cranial nerve IV | Trochlear- motor for chewing |
| area of brain which has cardiac, vasomotor, and respiratory centers. | Medulla |
| Hypothalmus is which part of the brain? | Diencephalon |
| Area of brain which can modify the respiratory phythmicity center and contains 4 nuclei? | PONS |
| Cognitive, problem solving, are functions of what area of the brain? | Parietotemporal ass cortex |
| Crutch palsy is from compression of which nerve? | radial |
| Primary motor area is where? | frontal lobe and is the source of most of the corticospinal tract neurons. |
| Brocas area is | area of the cerebral cortex which provides motor control of the mouth, tongue, and larynx for speech. |
| Wrenicke's are is? | comprehension of spoken language |
| The primary somatosensory area receives info regarding? | touch, pain, temp, proprioception |
| Cerebellum | compares intended movement with actual movement. adjusts UMN activity. helps w balance and coordination |
| Gyri are | Convolutions |
| Sulci are | shallow grooves |
| The longitudinsal fissures separates | the cerebral hemspheres; the transverse. |
| Taste is interpreted in what lobe? | parietal lobe |
| Cerebral cortex | outer 2-5mm of the cerebrum. contains 75% of all neuron cell bodies. |
| Prefrontal association area deals with | executive function and goal oriented behavior |
| Thoracic plexus | is not considered a nerve plexus |
| Commissural (cerebral white fiber) | cross to the opposite cerebral hemisp |
| Association fiber | Stay w in same hemisphere |
| Projection fiber | leave the cerebrum and descend towards spinal cord. |
| LMN | cell bodies in SC or brainstem communicate directly w skeletal ms. Loss of reflexes-LMN Hyperreflexia-LMN Hypertonia-LMN |
| UMN | Cell bodies in the cerebral cortex or brainstem. (rubrospinal tract) UMN can inhibit LMN or modify them. |
| Fasiculation | quick twitches of ms fibers visible under skin. |
| Rigidity | type of hypertonia.. amt of resistance to passive stretch dont matter of velocity |
| Hyperreflexia | ms spindle stretch leads to overactivity of lmn's |
| Clasp-knife | strong resistance to stretch and then sudden give. |
| Basal gangial masses of what kind of matter? | Gray matter can adjust descending tracts activity can provide subconscious control of ms tone and coordination. |
| What neurotransmitter is lacking in Parkinsons? | Domonphine |
| Auto immune disease that kills basal ganglia cells, leading to hyperkinesia? | Huntington's |
| What gland scretes melatonin? | pineal gland |
| Large tract of commissural fibers in brain? | Corpus collum |
| Afferent | toward CNS |
| Efferent | away CNS |
| AP- | refers to a wave of charge that propagates alone axon of neuron til its reaches axon terminal. |
| Microglia cell | a neuroglia cell of the CNS that breaksdown pathogens. |
| Absolute refractory period | the cell cant respond to other stimi at this time. it coincides w the ap and lasts for 1 millisecond. |
| the parasympathic system is responsible for energy conservation | the sympathic sys is responsible for expenditure of energy. |
| how long does the relative refractory period last? | 10-15 millisecs after an AP |
| -90mV | hyperpolarization |
| Acetycholine | is a neurontransmitter is the PNS that is a big conveyor of info and is always excitstory at th neuormuscular juction. |
| Divergence | 1 pre-synptic neuron synapsing w MANY post syn. |
| Sodium potassium pump, pumps sodium | out and potassium into the cell |
| Neuroblastoma is | cancer of neurons |
| Where are the abundant voltage gated Na+ and K+ channels? | at the axon and node of ranvier. |
| Filum terminale | is ct from the end of the sc to the S2 level |
| Which horn houses sensory endings and cell bodies of 2nd order sensory neurons? | dorsal horn dorsal root consists of afferent fibers |
| anterior/ventral roots consists of what fibers? | efferent |
| Decussation pyramids | many sensory or motor tracts cross over here |
| Perineurium | is a ct that wraps around a fascicle of nerve fibers (axons) |
| Tectospinal | controls movements of the head in response to visual/auditory stimi. |
| Spinocerebellar | unconscious proprioception |
| upper truck, neck, vibration, kinesthesia, | Fasiculus cuneatue |
| lateral spinothalamic | pain/temp |
| lateral corticospinal | precise contraction of distasl extremities |
| Rubrospinal | contralateral UE flexors and gross postural tone |
| Vestibulospinal | regulates ms tone in response to head movement, balance. |
| Anterior spinothalamic | crude touch and pressure |
| Circle of willis info | There are some watershed areas in the brain located at the ends of the vascular sys. Problems with blood supply r here, Blockages in the water shed areas can cause transcortical aphasia |
| transcortical aphasia | from lesions outside of Broca's area or Wernicke's area of the cerebral cortex. |
| aphasia | Loss of ability to understand or express speech, caused by brain damage |
| Resting membrane potential? | -70mV |
| Hyperpolerization threshold? | -90mV |
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Nicolercronin11
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