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92 Cards in this Set
- Front
- Back
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cervical C1-C8
thoracic T1-T12 lumbar L1-L5 Sacral S1-S5 |
The segments of the spinal cord are broken down into three regions:
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dorsal/descending
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Fibers entering the ____ portion of the spinal cord carry sensory information from the body to the brain
______ fibers exit the ventral portion of the spinal cord carry motor info to the muscles |
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dura mater
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Just inside the brain, in various places, closely attached to the skull, separates the two hemispheres of the brain
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arachnoid mater
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a thinner and more delicate membrane separated from the dura by the subdural space through which passes a series of veins
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pia meter
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the most delicate and highly vascular membrane, follows the contours of the brain
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cerebrum
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contains the four major lobes: frontal, temporal, parietal, and occipital
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frontal lobe
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largest of the four lobes, considered the seat of higher cortical and cognitive functioning
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primary motor cortex
(directly anterior to the central sulcus) |
crucial in the initiation of motor movements and isolated muscle groups are specifically represented along the surface of the gyrus
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premotor cortex
(directly anterior to the primary cortex) |
initiation and execution of limb movements in conjunction with input from other cortical regions
location of mirror neurons |
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prefrontal and orbitofrontal regions
(anterior to the primary motor cortex) |
associated with higher-level functions also known as the executive fxs, which includes: reasoning, planning, and judgement
inhibitory control |
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interior lateral region
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left frontal lobe, known as Broca's area --> Broca's (Expressive) Aphasia
fluent production of oral and written language |
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temporal lobes
(inferior to the lateral sulcus) |
divided into the superior, middle, and inferior gyri
primary auditory processing where conscious perception of sound takes place (tonotopic) |
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auditory association cortex
(adjacent and posterior to the primary auditory cortex |
Wernicke's area, COMPREHENSION of language
Wernicke's (receptive) aphasia |
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parietal lobes
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include the site of primary somatosensory processing on the postcentral gyrus. Processes visual information along dorsal and ventral pathways from occipital lobe to help coordinate movements and behaviors with the environment
also, detection of touch, pressure, pain,and temperature |
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occipital lobes
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Primarily dedicated to visual processing, Phototopic in nature, receiving its stimuli from the retina and optic nerve by way of the lateral geniculate nucleus of the thalamus
parietal regions for processing the object location, and ventral stream to temporal regions for object indenitification |
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Hippocampus
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Part of the limbic system, critical for memory function such as the transfer of memories to LTM stores
(HM) |
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amygdala
(anterior of the hippocampus) |
processing olfactory stimuli. Most associated with processing emotions
flight or fight response |
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thalamus
(superior and contiguous with b stem) |
this structure performs the critical relay functions between the cortex and the brain stem
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basal ganglia
(comprised of the caudate nucleus, putamen, globus pallidus, subthalamic nucleus, and substantia nigra*) |
Cerebral cortex provides most of the input here. primary outputs are sent to the thalamus. Involved with the coordination and rhythm of movement (extrapyramidal syndromes). Movement disorders such as Parkinson's disease (PD) and Huntington's disease result from abnormal activity in this region
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brain stem
(comprised of the medulla, pons, and midbrain) |
forms the the core of the brain; involved in the control and regulation of autonomic fx and maintaining the body's homeostasis, including breathing, hr, temp regulations, and blood pressure.
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Reticular Formation (RAS)
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alertness, consciousness, and pain. Plays important roles in regulating the respiratory and cardiovascular systems
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cerebellum
(posterior to b stem) |
most often associated with the regulation of movement, including automatic and rhythmic movements, coordination of limbs, and postural control. Also, learning and attention.
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cell body;
dendrites; axons; |
building block of the nervous system, the neuron consists of a ______ (containing the nucleus), ________(short processed emerging from the cell body which receive inputs from other neurons) and _______(long processes that carry output away from the cell body.
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axon, dendrites
speeds up transmission Firing is all or nothing!! (fires once exicitation reaches minimum threshold) |
The ____ from one neuron communicates with _____ of another neuron.
What is the fx of the myelin sheath? |
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Biogenic amines
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What are ACh and SER classified as?
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Catecholamines
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What are DA, NE, and epinephrine classified as?
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Amino Acids (neurotransmitters)
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GABA and glutamate (smaller molecule messengers)
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neuropeptides
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vasopressin, oxytocin, and substance P
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NE
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formed in locus coeruleus, it is found in the sympathetic nervous system and CNS. It regulates mood, memory, alertness, hormones, and the ability to feel pressure. Elevated levels lead to ANX, whereas lower levels may cause DEP. Also underlies the flight or fight response and is released into the blood as a hormone by the adrenal gland in re: to stress. Primarily and excitatory nt
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DA
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both excitatory and inhibitory; Majority of these type of neurons found in the substantia nigra. Affects frontal lobe, basal ganglia, and hypthalamus. Overactivity of nt in ft leads to schizophrenia and the loss of this nt producing neurons in the basal ganglia is cause of PD. Underactivity of this nt implicated in ADHD. Plays a role in emotions, movements, endocrine fx, as well as attention, socialability, motivation, desire, pleasure, and reward-driven learning***
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SER/5-HT
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Biogenc amine, primarily inhibitory. Widely dist. throughout brain. Levels are associated with the regulation of mood, anger, aggression, anxiety, appetite, learning, sleep, sexual fx , levels of consciousness, and pain. Low levels are associated with depression, obsessive-compulsive disorder, and ANX disorders
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ACh
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biogenic amine, plays a major role in the parasympathetic and autonomic nervous system. Primary nt at the neuromuscular jt and it deals with movement. Degeneration of this nt in the brain is associated with the movement disorder of Hunt. disease. Also plays a major role in activating the brain through the RAS and regulates alertness and attention. (Can also affect hippocampus; attention, learning, and memory)
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GABA
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amino acid; the major inhibitory nt of the CNS***. It is associated with emotion, balance, and sleep patterns. Low levels are associated with high ANX and agitation, and higher levels are associated with a reduction in ANX. Deficiencies in this nt are also implicated in epilepsy
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Glutamate
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amino acid; the brain's primary excitatory nt. Widely seen throughout the CNS. Building blocks of PRO and plays an important role in learning and memory. Excessive levels associated with cell death, often seen in TBI's and stroke.
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1) disrupt the of action of the nt at the synapse
2) inhibiting the enzymes that break down nts at the synaptic cleft 3) changing the sensitivity of the postsynaptic neurons to nts or increasing the amount of nt produced and available at the synapse. |
Name three ways psychotropic medications can work:
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agonist
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a chemical that binds to the a receptor site and mimics the activity if a nt, thus causing the downstream effects as that nt and boosting the overall system
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antagonist
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blocks or reverses the fx of the agonists or inverse agaonists (do not have any fx when on their own)
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pharmacodynamics
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describes the biomedical and physiological fx of the drugs on the body/
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pharmacokinetics
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describes how the body handles the drug through absorption, dist., metabolism, and elimiation.
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elimination half-life
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the time it takes for a drug concentration to decrease by half due to excretion and metabolic change
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therapeutic index
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defined by the range of a drug dose that can result in desired clinical efficacy without resulting in unsafe side fx
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anxiolytics
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used to treat ANX disorders. Can be classified into benzodiazepines and nonbenzos.
common ex's: Xanax, Klonapin nonbenzo--> Buspar Act through the CNS and can cause muscle relaxation as well as sedatice, anti-anx, and anticonvulsant fx. They enhance the action of GABA |
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Tricyclic Antidepressants
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Block the reuptake od 5HT and NE, thus, increasing the activity of these nts systems by making them more available for binding to postsynaptic neurons
side fx: cardiac/autonomic, anticholinergic. and neurobehavioral. ex's: Elavil |
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MAOI's antidepressants
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Rarely used to day because of dangerous food/drug interactions. Block the reuptake of 5HT, NE, and DA by blocking their respective monamine transporters
When taken with tyramine, can cause a hypertensive crisis*** |
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SSRIs (antidepressants)
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block the re-uptake of 5HT (SER) by selective binding. They are esp. effective for the treatment of DEP with agitation or comorbid ANX. Examples include fluoxetine (Prozac), paroxetine (Paxil) and Zoloft. Side fx include GI issues, headache, sexual dys., insomnia, psychomotor agitation, and occasional extrapyramidal rx
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NE-DA re-uptake inhibitors (anti dep)
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Relatively new, they work by blocking the reuptake of NE and DA. Wellbutrin
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SER-NE re-uptake inhibitors
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Block the reuptake of SER and NE. Effexor
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Antipsychotics
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Primarily used to treat schizophrenia, schizophreniform disorder, shizoaffective disorder, brief psychotic dx, BP, and agitation. All traditional, or 1st generation ____ block DA receptors, whereas ____ also block SER receptors
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Conventional antipsychotics
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May cause extrapyramidal symptoms, including parkinsonism (tremors, slowed movements, rigidity), acute dystonia (muscles spams of the face), akathasia (extreme restlessness, and tardive diskinesia (abnormal/involuntary movements of the face, tongue, trunk, and extremities, sometimes irreversible), results from long-term use. Neuroleptic malignant syndrome (NMS)
Haldol, Thorazine |
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Atypical antipsychotics (second generation)
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Block DA and SER receptors in the CNS. May be just as affective as ___ generation, however, these produce milder extrapyramidal symptoms then the ___ generation, however, they may also cause dangerous metabolic fx such as weight gain, diabetes, and dislipidemia.
ex's: quetiapine (Seroquel), aripiprazole (Abilify), clozapine ** (Clozaril), and risperidone (Risperdal)** FDA approved for autism and disruptive behavior disroders. |
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Mood Stabilizers
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Lithium- first FDA drug for acute mania and hyopmania. Effective in preventing relapse in BPdx. Suspected to involve NE and SER. Common side fx include nauseau, diarh., excessive thirst and urination, weight gain, and hand tremor. Narrow therapeutic index.
Some antipsychotics and anticonvulsant rx can aslo be used (zyprexa and abilify) anti-convulsant- depakote |
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opiates (narcotic anelgesics)
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Natural (morphine) or semi-synthetic (percodan, oxy) or full syn; used to relieve intense pain and the anxiety that goes along with it. Can also induce sleep and relieve severe diarrhea or coughs. Changes nerve cells, high potential for abuse, can be abused for euphoric fx
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Psychostimulants
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increase prefrontal cortex levels of NE and DA and primarily used to treat ADHD. amphetamine (Adderall). Somme antiDEPS can be used, except for SSRIs. Side fx may include insominia, headache, tics, exacerbation, nervousness, irritability, overstimulation, tremor, dizziness, weight loss, abdominal pain, possible stunted growth in children, and blurred vision.
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Computerized Topography (CT)
(Structural Imaging) |
Uses X-rays to look at slices of brain, providing info on the density of brain tissue. Different views from different angles. Data are then reconstructed.
hyperdense- dense/bone/white hypodense- less dense/dark/air isodense- intermediate density ER/neoplasms/tumors **URGENT** can use intravenous contrast fluid to show abnormalities |
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Magnetic Resonance Imaging (MRI)
(Structural Imaging) |
provides high-contrast, high resolution imaging, with good anatomical data. Preferred method for detecting small lesions such as those in MS, subtle tumor, or chronic hemorrage. **NON-URGENT **
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Neuroangiography
(Structural Imaging) |
Used to visualize lesions of blood vessels throughout the use of radiographs and injection of contrast material into the vasculature. Gold standard for evaluating vascular diseases.
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Wada Test
(structural imaging) |
Example of a neuroangiography that is helpful in localizing language fx and aiding in presurgical planning, part. in patients with epilepsy who are undergoing brain resection.
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Electroencephalography
(fx neuroimaging) |
Considered original method for measurement of brain activity. Reads electrical impulses from the brain. It is useful in detecting widespread abnormality in the brain fx in a variety of contexts (sleep, coma)
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Functional Magnetic Resonance Imagin (fMRI)
(fx neuroimaging) |
Developed directly from MRI and can detect fxlly induced changes from blood oxygenation. Can be used to measure the brain's real-time response to motor activities or neuropsychological tests.
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Positron Emission Tomography (PET)
(fx neuroimaging) |
Uses small amounts of injected radioactive material to measure regional cerebral blood flow via glucose metobolism or oxygen consumption.
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Aphasia
fluent= speech is okay, comprehension not nonfluent= good comprehension, bad language pure= select aspects of language are affected, such as writing and reading |
Refers to an acquired disorder of the language
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Wernicke's (sensory) Aphasia
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Primary deficit is the inability to understand language. Speech is fluent but meaningless; poor insight, damage in left temporal lobe
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Broca's (expressive) Aphasia
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Nonfluent aphasia in which the person speaks in a slow, halting manner, with poor grammar and limited prosody.
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Conduction aphasia
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Understand, cannot repeat disorder
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Anomic Aphasia
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focal deficit in naming objects
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Global Aphasia
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All aspects of language are impaired
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Alexia
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Inability to read, can usually write (usually stroke disconnecting the visual centers)
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Agraphia
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Acquired disorder of writing
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Apraxia
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An acquired disorder of skilled, purposeful movement that is not due to a primary motor or sensory impairment such as paresis or paralysis
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Neurocogntive Disorder
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Dementia is NOT a normal process of aging. The term dementia has been replaced by _________ _________ in the DSM-5
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beta-amylod plaques & neurofibrilliary tangles
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The primary pathological changes in AD are _________ and ________ which can be found throughout the cortex, although primarily in the limbic cortex region, (e.g. hippo.) and memory. DEP and mood changes common.
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Cholinesterase inhibitors (galantamine, Exelon)
memantine (Namenda) |
AD Rx; ________ inhibitors prevent the breakdown of ACh. Another drug __________ works by regulating glutamate, which, in excess can lead to cell death (slow the progression of AD)
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Age
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The greatest risk factor for AD
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(1-3 years) Mild impairments in memory, trouble learning new skills and retention of new memories, frustration
(inter. stage, 2-10 years) increased impairments in memory, visuspatial skills and language presents. Emergence of apraxia, aphasia, agnosia (later stages; 8-12 years) IQ severly impaired, minimal verbal output, probs in gait and motor control |
Stage of AD
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Pick's disease
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Rare form of cortical dementia that is caused by degeneration of the frontal and temporal lobes of the brain. (FTD) personality change common, memory later
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Cerebrovascular disease, also known as vascular dementia
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___________ is the second leading cause of acquired dementia following AD and is caused by multiple infarcts, or strokes in either large vessels or small that penetrate deeper in brain
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Parkinson's Disease (PD)
L-DOPA and deep brain stimulation |
A progressive neurodegenerative condition that is characterized by tremor, rigidity, bradykinesia, and psotural instability. Considered a movement disorder and caused by the degeneration of the substantia nigra in the basal ganglia and loss of DA. Dementia occurs in 20-60% of pts. Deficits in exec fx and slow thinking. DEP also common
(not enough DA) symptoms are broken down into + and - symptoms txs= |
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Huntington's disease
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Movement disorder caused by a degenerative loss of neurons in the basal ganglia, part. in the caudate nucleus. NTs such as GABA and NE, which normally inhibit the DA pathways, die during the course of the disease, thus creating a hyperactive DA system.
(too much DA) it is an autosomal dominant genetic disorder, offspring have a 50% chance of getting it behavior changes, abnormal movements, and dementia are prevalent. |
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Psuedodementia
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Used to describe a dementia-type presentation in a variety of psychiatric illnesses, although DEP tends to be the most common. Cognitive symptoms may occur with onset of stressors in life or emo upset. Sub Impairments are usually greater then when tested or overestimated
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1) Cortical signs such as aphasia, apraxia, and agnosia are typically absent in DEP
2) DEP pts may exhibit psychomotor slowing and inconsistent effort or attention during neuropsychological testing, rather than primary problems with retentive memory or visuospatial fxing |
How to differentiate dementia from DEP (2)
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Mild Cognitive Impairment (MCI)
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The state in which at least one cog domain, usually memory, is impaired to a greater extent anticipated for someone's age, although the pt doesn't meet criteria for dementia (neurocognitive dx) and doesn't have any impairments in daily fxing. Higher rate of developing dementia, with amnestic having the highest rates
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Delirium
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Defined as a disturbance in consciousness accompanied by a change in cognition that cannot be better accounted for by dementia process. Development is typically abrupt, developing over the course of hours or days. Often fluctuates and is reversible. Can be caused by medical condition, sub use and is common in the hospital setting and the elderly. The hallmark feature is impairment in the ability to focus or sustain attention.
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Concussion
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A form of mild brain injury, the result of direct trauma to the brain. Loss of consc may occur but not necessary for dx. All dx require trauma to the head, some alteration to the consciousness, posttraumatic amnesia or some focal neurological deficit. few hours-several days after injury
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Seizure
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An episode of abnormal electrical firing of neurons resulting in abnormal behavior or experience in the individual
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generalized seizure
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both sides of the brain are affected, resulting in loss of consciousness, falls, or muscle spasms
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tonic-clonic
(generalized) |
individual typically loses consciousness and exhibits stiffening of the body and repetitive jerking of the arms and or legs.
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absence seizure
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the person may appear to be staring into space
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focal seizures (partial)
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Only affect one side of the brain
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simple partial seizure
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individual does not lose consc.; may experience sudden and unexplained joy or anger or may hear, smell, or see things that are not real
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complex partial seizure
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the person experiences an alteration or loss of consciousness; they may display repetitive movements or behaviors, such as blinks, twitches, mouth movements, or complicated actions
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temporal lobe epilepsy
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most common type of recurring focal seizures, may be associated with memory problems (hippo.) May experience aura or warning sign
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Diagnosed with EEG monitoring, brain scans, blood tests, neurological or behavioral tests, and a thorough check of medical history
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How is epilepsy dx?
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