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147 Cards in this Set
- Front
- Back
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PNS- all nerve f_____ outside brain and spinal cord
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fibers
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cerebral cortex looks like gray matter because it lacks m_____
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myelin
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Myelin is the white insulation on the axon that increases the conduction velocity of nerve -_____
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impulses
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Crossed representation- the left side of cortex receives sensory info from and controls motor function on the _____ side of the body.
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right
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Sensation travels in the a_____ fibers in the peripheral _____ then thru the posterior or dorsal root into the s+++++ cord.
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afferent
nerve spinal |
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Frontal lobe- personality behavior e______. and intellectual function
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emotions
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The parietal lobe's postcentral gyrus is the primary center for s________
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sensation
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The occipital lobe is the primary visual r_____ center
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receptor
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The temporal lobe behind the e_____ has the primary auditory re________center with the functions of hearing, taste, and s)))))_)))
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ear
reception smell |
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Wernicke's Area in the te_______ lobe is associated with language comprehension. Wnen damaged in the person's dominant hemisphere, receptive ap_______ results. The person hears sound, but it has no m_______, like hearing a foreign language.
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temporal
aphasia meaning |
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Broca's area- in the frontal lobe mediates m+++++ speech. When injured in the dominant hemisphere, receptive ap______ results. The person can understand language, and knows what he or she wants to s))))))) but can produce only a garbled sound.
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motor
aphasia say |
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Basal Ganglia- Large bands of g______ matter buried deep with the 2 cerebral h_______that form the s______ associated m_______ system (the e---------) system.
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gray
hemispheres subcortical motor extrapyramidal |
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Thalamus is the main r_____ station where the sensory pathways of the spinal cord, cerebellum, and brain_____ form synapses (sites of contact between 2 neurons) on their way to their cerebral c_______.
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relay
brainstem cortex |
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The hypothalamus is a major respiratory center with basic vital functions; temperature, appetite, s_____ drive, h_____ rate, and b______ pressure, sleep center, anterior and posterior p_________ gland regulator, and coordinator of A______ system activity and s_______ response.
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sex
heart blood pituitary ANS stress |
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Cerebellum is structure located under the occipital lobe concerned with coordination of v________ movement, equilibrium, and muscle tone. Does not initiate movement but c_________ and smoothes complex and quick coordination of many muscles. the auto))))))) pilot
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voluntary
coordinates automatic pilot |
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Left HEMISPHERE is dominant in 95% of the population, even those who are left-handed.
When BROCA’S AREA is injured in the dominant hemisphere, expressive aphasia results meaning the person cannot talk. If WERNICKE’S AREA is damaged in the dominant hemisphere, receptive aphasia occurs and cannot understand what they are listening to. Almost like hearing someone speak in another language! Damage to any of these areas results in loss of f_______. Damage can occur with lack of blood supply (such as with an is______ episode) or when vascular bleeding or vaso_____: A sudden cons______ of a blood ve_____ that reduces the blood flow. |
function
ischemic vasospasm constriction vessel |
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Brain stem
1. Mid______ Contains neurons & tracts 2. Pons Ascending & desc_____ fiber tracts 3. Medulla Connects brain & ______ cord Vital autonomic centers Pyramidal decus_______ |
midbrain
descending spinal pryamidal decussation at medulla |
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Spinal cord
Long cylin______ structure of nervous tissue Upper two th_____ of vertebral canal From medulla to lumbar vertebrae L1- L_____ Highway for asc_____ & descending fiber tracts Mediates refl______ |
cylindrical
2/3 L2 ascending reflexes |
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The midbrain is the most anterior part of the brain_____ that still has the most basic tubular structure of spinal cord.
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brainstem
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Cranial nerves III through XII originate from the nuclei in the br_______
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brainstem
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P____ is the enlarged area containing the ascending sensory and des______ mo+++++++ tracts . It has 2 respiratory centers (pneumotaxic and a_______) that coordinate with the main respiratory center in the m______.
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descending
motor apneustic medulla |
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Crossed representation
Notable feature of nerve tracts Left cerebral cortex gets sensory info from & controls motor function to r______ side of the body Right cerebral cortex interacts with left side of the body |
right
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Medulla is the continuation of the spinal c______ in the brain that contains all of the ascen_____ and descending fiber tracts. It has vital au______ centers (respiration, heart, gastro______ function).
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spinal cord
ascending autonomic gastrointestinal |
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Spinal Cord- upper 2/3 of the v_______ canal from the m_______ to lumbar vertebrae L1-L2. Its white matter axons of m__________ axons form the main highway for the ascending and descending fiber tracts that connect the brain to the s______ nerves.
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vertebral
medulla myelinated spinal |
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Spinal cord- mediates reflexes of p_______ control, urination, and pain r_______. Its nerve cell bodies or gray matter are arranged in a b________ shape with anterior and p+++++++ horns.
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posture
response butterfly posterior |
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Sensory pathways
Receptors in skin, muc_____ membranes, muscles, tendons, & viscera Sensation travels in afferent fibers to per______ nerves, through posterior r_____, & to spinal cord |
mucous
peripheral root |
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Two routes of sensory information into spinal c))))))) the spi++++++++ tract or the pos+++++++ dor_______ columns.
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spinal cord
spinothalamic tract posterior dorsal |
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Spinothalamic tract
Sensory fibers of p____, temperature, & crude or light t++++( not precisely localized) Posterior (Dorsal) column Pos______, vib______, & finely localized touch |
pain
touch position vibration |
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Spinothalamic tract- the fibers enter the dor++++ root of the spinal cord and synapse with a second s++++++neuron. The second order neuron fibers cross to the opposite side and ascend up to the spinal____ tract to the thalamus.
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dorsal
sensory spinalthalamic |
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Spinothalamic tract-Fibers carrying pain and t_______ sensations of p++++++, v+++++++, ascend the l______ spinalthalamic tract whereas those of c_____ touch form the a_______ spinalthalamic tract.
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temperature
pain vibration lateral crude anterior |
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Spinothalamic tract- At the t_______, the fibers synapse with a third s______ neuron, which carries the message to the sensory cortex for full int_________.
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thalamus
sensory interpretation |
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Motor pathways
Corticospinal or Py_________ Tract Originates in pyramidal-shaped cells in mo_____ cortex Mediate voluntary movement Skilled, purp______ movement (writing) Newer, higher motor system |
pyramidal
motor purposeful |
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Extrapyramidal Tracts
Motor nerve fibers originating in motor cortex, basal ganglia, brain stem, & spinal cord Older, lower, more prim_____ motor system Maintain muscle to____, controls gro____ body movements (walking) |
primitive
tone gross |
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Extrapyramidal Tracts
Motor nerve fibers originating in mot____ cortex, basal gan____, brain _____, & spinal cord Older, lower, more primitive motor system Maintain muscle tone, controls gr______ body movements (walking) |
motor
ganglia brain stem gross |
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Posterior Dorsal Columns- conduct sensations of pos_____, v________, and finely localized t________. Finely localized touch is stereognosis. These fibers enter the dorsal r_____ and up the same side of the spinal cord to the b______. At the m+++++, they synapse again and proceed to the sensory cortex which localizes the sensation and makes a full discrimination.
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position
vibration touch root brainstem |
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The sensory cortex is arranged in specific pattern forming a corresponding m+++++. Pain in the heart is felt in the shoulder, chest, and a_____. Pain in the spleen is felt on top of the left shoulder.
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map
arm |
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Cerebellar System
Coordinates mov______ Maintains equilib_____ Helps maintains pos______ Receives info on position of muscles & joints Occurs on subconscious level |
movment
equilibrium posture |
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The pyramidal tract has been so named because it originates in py_______ shaped cells in the m_____ cortex.
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pyramidal
motor |
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Upper motor neurons
Des_______ motor fibers Influence & modify l______ motor neurons Convey impulses from cerebral cor_____ to lower motor neurons |
descending
lower cortex |
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Lower motor neurons
Located in per______ nervous system “Final com______ pathway” Funnels many signals, provides direct contact with mus_____ |
peripheral
common muscle |
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Motor nerve fibers originate in the motor cor____ and travel to the brain_____ where they cross to opposite or contra______ side (pyr_____ decussation) and then pass down in the lateral column of the spinal cord.
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cortex
brainstem contralateral pyramidal |
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At each cord level, they synapse with a lower motor cord neuron, contained in the ant_____ horn of the spinal cord. Ten percent of the corticospinal fibers do not cr+++++ and these des_____ in the anterior col_____ of the spinal cord.
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anterior
cross descend column |
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Corticospinal fibers mediate voluntary movements particularly very skilled discrete, and purp+++++ movements such as writing.
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purposeful
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The corticospinal tract is a newer higher motor system that permits humans to have very skilled and purposeful movement. The tract's origin in the motor cortex is arranged in a specific pattern of som_________ organization.
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Somatotropic
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Somatotropic organization is another body map, this one of a person or h________ hanging upside down.
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homunculus
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On the Homunculus, body parts are equally rep_____
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represented
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The extrapyramidal tracts include all the motor nerve fibers from the motor cortex, basal g______, brain______, and spinal cord that are outside the py______ tracts.
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basal ganglia
brainstem pyramidal |
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The pyramidal system is an older system and is sub_____ maintaining muscle tone and gr_____ movement.
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subcortical
gross |
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PNS
Nerve - bundle of f_____ outside of CNS Carry input to CNS via sensory afferent fibers Deliver output from CNS via ef______ fibers Reflex Arc- Defense mechanism of nervous system Involuntary, operate below L_____ control Quick reaction to potential danger Four types: 1) deep tendon, 2) su_________, 3) visceral, 4) pathologic |
fibers
efferent LOC superficial |
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Corticospinal, Corticobulbar, and extra_______ tracts are examples of upper motor n_______
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extrapyramidal
neurons |
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PNS
Cranial Nerves 12 pairs Supply head & neck, except vagus I & II stem from cerebrum III through XII from diencephalon & brain stem Spinal Nerves 31 pairs from length of spinal cord Supply rest of body ___ cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal |
8
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Nerves carry fibers that divide functionally into 2 parts:
Somatic Innervate skeletal (voluntary) muscle Autonomic Innervate smooth (involuntary) muscles, cardiac muscle, & glands Mediates unconscious activity Maintains hom_________ |
homeostasis
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Deep tendon reflexes myostatic are the patellar or knee j_____. Superficial reflexes are the co_______ reflex and the abdominal reflex. The visceral or organic reflex is the pu_______ reflex or response to light. Pathologic reflexes are the ba______ or extensor p______ reflex.
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jerk
corneal pupillary babinski plantar |
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The fibers that mediate the reflex are carried by a specific s______ nerve. In the simplest reflex, tapping the tendon stretches the muscle s______ in the muscle which activates the sensory af_______ nerve.
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spinal
spindles afferent |
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The sensory aff______ fibers carry the message from the r+++++ and travel through the dorsal root into the sp+++++ cord. They synapse directly in the cord with the motor neuron in the anterior h______
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afferent
receptor spinal horn |
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Parts of the deep tendon reflex: 1. an intact sensory or afferent nerve 2. a functional sy______ in the cord 3. an intact motor nerve fiber efferent and 4. the neuromuscular j_______ 5. a competent muscle
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synapse
neuromuscular junction |
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Olfactory CN1 sensory nerve
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smell
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Optic CN11 Sensory
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Vision
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Oculomotor CNIII Mixed
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Motor most EOM, opening of eyelids
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CN IV Trochlear Motor
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Down and inward movement of the eye
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CN V Trigeminal Mixed
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Mastication and Sensation-face, scalp, mucous membranes of mouth and nose, cornea,
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CN VI Abducens Motor
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Lateral movement of eye
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CN VII Facial- Mixed
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motor- facial muscles; speech; close mouth
sensory- taste on anterior 2/3 of tongue |
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CN VIII Acoustic - Sensory
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Hearing and equilibrium
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CN IX Glossopharyngeal Mixed
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Motor- Pharynx- pronation and swallowing
Sensory- taste on posterior 1/3 of tongue; pharynx- gag reflex |
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CN X Vagus- Mixed Motor- pharnx and larynx
Sensory- general sensation from carotid body; carotid sinus; pharynx, and viscera |
talking and swallowing
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CN XI Spinal- Motor Movement of trapezius and
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Sternomastoid muscles
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CN XII Hypoglossal- motor-
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Movement of tongue
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Nerves exit the spinal cord orderly fashion. Each nerve innervates a particular section of the body. Dermal segmentation is the cut______ distribution of the various spinal nerves.
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cutaneous
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Subjective Data: Incoordination
Numbness or tingling Difficulty swallowing Difficulty speaking Significant past history Environmental/occu_____ hazards. |
environmental/occupational hazards
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III, IV, VI Oculomotor, Trochlear, Abducens:
Palpebral fissures, (Palpebral fissure is the anatomic name for the separation between the upper and lower eyelids) In the adult this measures about 10mm...ptosis, (Dro_____ of the upper eyelid due to paralysis or disease, or as a congenital condition) extraocular movements (6 cardinal positions of gaze), nystagmus- abnormal movment of the eye |
drooping
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Trigeminal: motor function (mastication/mass____ muscles, clench teeth), sensory (opthalmic, max____, mandibular), corneal reflex (cotton wisp touch cornea)
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massater
maxillary |
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Headache
Head injury Dizziness / vertigo Seizures Tremors we_______ |
weakness
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VII Facial: mobility & facial symmetry (smile, frown, close eyes, lift eyebr_____, show teeth)
Test sen_____ only if suspect nerve injury |
eyebrows
sensory |
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VIII Acoustic: hearing acuity
IX, X Glossopharyngeal, Vagus: Motor (depress tongue, say ahh, g____ reflex), sensory (too difficult to test) |
gag
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Compare muscle size for symmetry from left to right & for normal limits for age. Test muscle strength and groups in extremities, neck, & trunk. Tone is the normal degree of ten____ in a relaxed muscle. There should be no invol_____ muscle movements.
ROMBERG TEST - ask person to stand with feet together, arms at side, & close eyes. Should be able to hold position with only a little swaying without vi______orientation. |
tension
involuntary visual |
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Assess the Sensory System
Spinothalamic Tract Pain, temp, light touch Posterior Column Tract Vibration, position, fine touch, stereogenesis Grapesthesia, _____point discrimination Extinction, point location |
2
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Thumb middle finger and fifth finger all in C6, C7, and
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C8
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Syncope is a sudden loss of strength or temporary loss of c______ due to lack of cerebral blood flow.
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consciousness
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Vertigo is rotational spinning caused by neurologic disease in the vestibular apparatus in the ear or ves______ nuclei in the brainstem
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vestibular
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aura subjective sensation that precedes a
Could be visual, auditory, or |
seizure
motor |
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Tremor- is an involuntary shaking vibrating or tre______
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trembling
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Pareis is a partial or incomplete
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paralysis
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Paralysis is a loss of motor f______ due to a lesion in the neurologic or muscular system or loss of sensory i______
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function
innervation |
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Dysmetria is the inability to control the distance, power, and speed of a m_______ action
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muscular
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Paresthesia is an abnormal sensation like a burning or t_______
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tingling
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Dysarthia is difficulty forming w_______
Dysphasia is difficulty with language comprehension or _______ |
words
expression |
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Micturition syncope is the name given to the human phenomenon of fainting shortly after or during uri______. It is a type of Vasovagal response.
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urination
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anosimia- decrease or loss of smell occurs bilaterally with tobacco smoking, allergic rhi____, and cocaine use.
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rhinitis
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unilateral loss of smell in the absence of nasal disease is neurogenic
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anosimia
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Papilledema occurs with increased intracranial pressure.
Papilledema is |
swelling of the optic disc (where the optic nerve enters the eyeball); usually associated with an increase in intraocular pressure.
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Ptosis occurs with myasthenia gravis and dysfunction of CN111 or H______ syndrome
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Horner
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Horner- increased intrcranial pressure causes a sudden unilateral dilated and nonreactive p++++
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pupil
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Strabismus is deviated g____
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gaze
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Nystamus with the disease of the vestibular system, cerebellum, or b
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brainstem
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Muscle weakness is shown by flattening of the nasolabial fold drooping on one side of the face; lower eyelid sagging; and escape of air from one _____ when pressed in
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cheek
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Loss of movement and asymmetry of movement occur with both CNS lesions that affect the lower face on one side. PNS lesions in Bell's Palsy affect the upper and L_____ face on o____ side
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lower
side |
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Absence or asymmetry of soft palate movment or tonsillar pillar movment after stroke may increase risk for a_______
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aspiration.
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Assymetry in jaw movment due to pain with clenched
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teeth
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With a stroke, sensation of face and body is lost on the opposite side of a
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lesion
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Absence or asymmetry of soft palate movement or tonsillar pillar movement. Following a stroke, dysfunction in sw______ may increase risk for aspiration.
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swallowing
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CN XI Muscle weakness or paralysis occurs with a stroke or following injury to the peripheral
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nerve
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CN XII Tongue deviates to side with lesions of the hypoglossal nerve. Deviation toward paralysed side. Fasiculations_ A brief, spontaneous contr____ affecting muscle fibers, often causing a flicker of movement under the skin.
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contraction
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Atrophy- abnormally small muscle with wasted appearance occurs with disease, injury, and lower motor neuron disease such as polio, diabetic n)))))))))
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neuropathy
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Hypertrophy- increased size and strength occurs with isom______ exercise.
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isometric
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Paresis or weakness is diminished strength. Paralysis or plegia is the ab------ of strength
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absence
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Flaccidity- decreased resistance hypotonia occur with peripheral w______. Hypotonia is Having reduced pressure or t_____, in particular.
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weakness
tone |
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Spasticity and rigidity- types of increased resistance hypotonia occur with peripheral w______
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weakness
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ataxia- uncoordinated or unsteady
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gait
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Ataxia that did not appear with regular gait may appear by widening base to maintain b______
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balance
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Inability to tandem walk is sensitive for an upper motor n_____ lesion
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neuron
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Positive Romberg- loss of balance that occurs when closing the e_____. Positive Romberg- cerebellar ataxia; MS and alcohol intox, and loss of prop+++++ and vestibular function.
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eyes
proprioception |
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RAM rapid alternating movements- lack of co+++++
Slow clumsy response called dysdiadochokinesia. |
coordination
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Dysmetria is a clumsy movment with overshooting the mark and occurs with cer_____ disorders or acute alcohol intoxication. Past pointing is a constant deviation to one side. Intention tremor when reaching for a visually directed object.
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cerebellar
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misses nose- worsening of coordination when the eyes are closed occurs with ce++++++ disease and alcohol intoxication. Heel falls off shin with cerebellar disease.
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cerebellar
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Note if the topographic pattern of sensory loss is distal (over the hands and feet in a glove and stocking fashion) distributed or over a specific d_______
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dermatome
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Hypoalgesia- decreased p_____ sensation
Anesthesia- absent touch sensation Hyperesthesia- increased tough sensation |
pain
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Unable to feel vibration occurs with peripheal neuropathy (diabetes and alco______)
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alcoholism
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Peripheral neuropathy is worse at the feet and gradually improves as you move up the l++++
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leg
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Problems with tactile discrimination occur with lesions of the sensory cortex or posterior c++++
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column
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Astereognosis- inability to identify object correctly. Occurs in sensory cortex l______. Inability to distinguish number occurs with lesion of sensory cortex.
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lesions
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2 point discrimination- increase in the distance it normally takes to identify 2 separate ------
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points
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The ability to recognize only one of the stimuli on one side occurs with sensory cortex lesion. The stimulus is ex______ on the side opposite the cortex lesion.
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extinguished
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With a sensory cortex lesion, the person cannot localize the sensation accurately, even though light touch sensation may be retained. Can't point to where oc))))))
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occurred
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Clonus- is a set of rapid, rhythmic contractions of the same
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muscle
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Hyperreflexia- exaggerated reflex seen when the monosynaptic reflex arc is released from the usually inhibiting influence of cortical levels. Occurs with upper motor n_____ lesions.
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neuron
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Hyporeflexia- the absence of a reflex, is a lower motor neuron problem. Occurs with the interruption of sensory afferents or destruction of motor efferents and anterior horn cells (spinal c_____)
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spinal cord
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Clonus is repeated reflex muscular movements. A hyperactive reflex with sustained clonus (lasting as long as the stretch is held) occurs with upper motor ))))))) disease.
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neuron
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Superficial reflexes are absent with diseases of the pyramidal tract. Absent on the contralateral side with s+++++
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stroke
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Abdominal reflex- superficial reflex. Absent in diseases of the pyramidal tract and on contralateral side in s_____
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stroke
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Plantar reflex- abnormal response is dorsiflexion of big toe and fanning of all _____Called Positive Babinski or upgoing toes. Upper motor neuron disease of the corticospinal or pyramidal tract
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toes
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high pitched cry with CNS damage and weak, groaning cry with resp+++++ distress
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respiratory
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CN V- rooting or sucking
CN IX- gag |
reflex
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Mammary glands
Present in ma___ & females Accessory female reproductive organ Anterior to pectoralis major & serratus anterior muscles Between 2nd & 6th ribs |
males
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Surface Anatomy
Tail of Spence Nipple Areola Surrounds ni_____ Sebaceous glands aka Montgomery’s glands Secrete protective lipid during lactation |
nipple
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Internal Anatomy of BreastGlandular tissue
15 - ____lobes Lobules: alveolar clusters produce milk Fibrous tissue Cooper’s ligaments Adipose tissue |
20
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Lymphatics
Extensive lymphatic drainage system Four groups of axillary nodes; C_____ axillary nodes Pectoral (anterior) Subscapular Lateral |
central axillary nodes
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Embryo: ventral epidermal ridges “milk lines”
Newborn: lac______ ducts w/in nipple Adolescent: estrogen stimulates changes, enlargement, ducts develop Precedes menarche |
lactiferous
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Pregnant female:
Changes occur ____ month Stimulates ductal system expansion & secretory alveoli Colostrum (precursor to milk) 4th month Lactation begins 1 – ___days post partum |
2nd
3 |
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Aging female: after menopause, estrogen/ progesterone both decrease, glandular tissue atrophies
Sm_____ breasts = more prominent inner structures Lumps suddenly palpable! |
smaller
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African American (AA) females begin puberty ~1 to 1.5 yrs earlier than A______
Begin menstruating ~8.5 months earlier |
anglos
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Average (mean) age of breast development:
8.87 yrs for AA _____ yrs for Anglo-American |
10
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Estimated new cases in 2012: 229,060
Female: 226,870 ( 99.04%) Male: 2,190 (0.95%) Estimated deaths 2012: _____ 17.4% of new cases still dying! Female: 39,510 (98.97% or 17.24% new cases) Male: 410 (1.02% or 0.17 % new cases) 15, 540 new cases in Florida 2012 California, FL, NY, & Texas lead nation yearly |
39,000 or 40,000
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Breast
Pain 6. Trauma Lump 7. Hx of disease Discharge 8. Surgery Rash 9. Self care: self exam Swelling & last mammo Axilla Tend_______, lump, or swelling Ra_____ |
tenderness
rash |
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Inspect
General appearance: skin, nipple, lymph dra_____areas (bulging) Inspect & palpate axillae Down chest wall Along anterior axilla Along posterior border Along inner aspect of upper arm |
drainage
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Palpate breasts
Ver_____ strip pattern Spokes-on-a-wheel Concentric circles Lumps: Location, size, shape, consistency Movable, distinctness, nipple, skin over lump Tenderness & lymphadenopathy |
vertical
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Teach breast self-exam (BSE)
Help establish regular schedule Best: right after menstrual cycle or ____ to 7th day during cycle Familiarizes with her own breasts Emphasize absence of lumps Encourage to report unusual findings RIGHT AWAY! |
4th
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