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68 Cards in this Set
- Front
- Back
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Many neurological disorders are due to?
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Imbalance in neurotransmitters
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action of acetylcholine
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cholinergic system (PSNS), excitatory action
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action of serotonin
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inhibitory, helps control mood and sleep, inhibits pain pathways
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action of dopamine
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unually inhibitory, affects behavior (attention, emotions, fine motor movement)
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action of norepinnphrine
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SNS, excitatory, affects mood and overall activity
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action of GABA
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excitatory,
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enkephalin, endorphin
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excitatory, pleasure , inhibits pain transmission
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three major areas of the brain
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cerebrum, brain stem, cerebellum
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cerebrum contains
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two hemisphere, thalamus, hypothalamus, basal ganglia, connects CN I, III
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the brain stem contains
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midbrain (audio/visual reflexes), pons (heart, resp, BP reg), medulla, connects CN IV-XII
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the cerebellum is responsible for
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excitatory and inhibitory, controls movement, balance, proprioception, and sensory input
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frontal lobe is responsible for
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concentration, abstract thought, memory, motor function, judgement, speech, personality, inhibitions
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parietal lobe is responsible for
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sensory info, awareness of body in space, spatial relationship
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temporal lobe is responsible for
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interpretation of visual, auditory, somatization, thinking
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occipital lobe is responsible for
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visual interpretation
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corpus callosum
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connects two hemispheres, transmission of information from one side of the brain to the other.
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basal ganglia
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control of fine motor movements
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thalamus
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relay station for all sensations except smell (memory, sensation, pain)
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hypothalamus
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metabolism, stress response, urine production, temp regulation, appetite, sleep, BP, emotion, sexual behav---overall supervisor of autonomic NS
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meninges layers
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dura mater, arachnoid, pia mater
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dura mater
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the outermost layer
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arachnoid
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middle layer, white- no blood supply, contains choroid plexus which produces CSF, arachnoid villi absorb CSF
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How much CSF is produced each day? How much is absorbed each day?
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500 ml produced
150 ml absorbed |
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pia mater
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innermost membrane
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Where is the CSF produced?
How much CSF is contained here? |
Ventricles
150 ml |
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CSF contain a lot or a little or none WBC and RBC?
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minimal WBC and no RBC
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Frequent sites of aneurysms are?
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at the circle of Willis
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How many and what arteries provide the blood supply to the brain?
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2 carotid and 2 vertebral
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Where does the spinal cord start and end?
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extends from the foramen magnum at the base of the skull to the 2nd lumbar space
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Spinal cord has how many spinal nerves?
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31
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Each spinal nerve has a ventral root and a dorsal root. What are these?
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ventral root are motor, somatic or visceral and transmit impulses from the spinal cord to the body.
Dorsal roots are sensory and transmit impulses from specific areas of the body to the dorsal gangalia. |
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afferent nerve
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AKA sensory or receptor neurons, carry nerve impulses from receptors to CNS
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efferent nerve
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AKA motor or effector neuron, carry nerve impulses away from the CNS to muscle or glands
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The autonomic nervous system regulates..
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activites of the internal organs, heart, lungs, blood vessels, digestive organs and glands
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Autonomic nervous system is part of which nervous system?
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peripheral
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Autonomic nervous system consists of two major divisions?
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sympathetic and parasympathetic nervous system
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The autonomic NS is regulated by what three things?
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spinal cord, brain stem, hypothalamus
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sympathetic sydromes
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dilation of pup on same side of penetrating neck wound
temporary paralysis of bowel after fx of lower dorsal or upper lumbar verte with hemorrage into base of mesentary fx of >6 thorasic verte causing pulse rate and rythm variations |
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sympathetic storming
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stim of SNS via hypothalamus following traumatic brain injury-- changed LOC, altered VS, diaphoresis, agitation
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What does the motor cortex do?
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controls voluntary movement of the body
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The two groups of neurons in the voluntary motor system
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Upper motor neurons- descending pathway, brain down CNS
Lower motor neurons- posterior part of cord to peripheral muscle. |
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Upper motor neuron lesions
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stroke, spinal cord injury, paralysis---reflex uninhibited, hyperactive deep tendon reflex, contractors
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Lower motor neuron lesions
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motor nerve is damaged between muscle and spinal cord by trauma, infection, degeneration---muscle paralysis, flaccid, atrophy
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what is the function of the nervous system?
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controls all motor, sensory, autonomic, cognitive and behavioral activites
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What are basic structures of the neurological system?
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CNS- brain, spinal cord
PNS- cranial and spinal nerves, autonomic and somatic systems |
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Neurological health history components:
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pain, seizure, dizziness, vertigo, visural disturbances, muscle weakness, adnormal sensations
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5 components of a neurological assessment:
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cerebral function, cranial nerves, motor system, sensory system, reflexes
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Assessing cerebral functioning includes:
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mental status (Ox3), intellectual fx, thought content, emotional status, perception, motor ability, language, lifestyle
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Assessing cranial nerves:
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I-olfactory, smell in each nostril
II-optic, snellen chart III-oculomotor, ocular rotation IV-trochlear, pupillary reflex V- trigeminal, facial sensation, blink reflex VI-abducens, ocular rotation, pupillary reflex VII-facial, smile, frown VIII-acoustic, whisper IX-glossopharyngeal, taste X-vagus, swallow "ah" XI-spinal accessory, shoulder sshrug XII-hypoglossal, tongue side to side |
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Assessing motor system:
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posture, gait, muscle tone, and strength, coordination and balance (Romberg), 5 strong to 1 severe weakness
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Define ataxia
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incoordination of voluntary muscle action
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Define the Romberg test
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feet together arms at side balance 20-30 secs, then with eyes closed 20-30 secs.
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Assessing the reflexes:
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deep tendon response (0 no response to +4 hyperactive, superficial (corneal, gag, abdominal +/-), Babinski-abn. toes draw back and fan out
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What is clonus?
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Sustained hyperactive reflex, indicating presense of CNS disease
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Assessing the sensory system:
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tactile sensation, superficial pain, vibration, position sense
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CT scan
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Computed tomography (cross sectional views of the brain, then added with contrast)
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PET
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Positive emission tomography (2-d view of various levels of the brain with radioactive substance, able to measure metabolic activity of glucose in brain)
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SPECT
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Single photon emission computed tomography (3-D using radionuclides, shows perfusion of the brain)
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MRI
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Magnetic Resonance Imaging (magnetic field to obtain images of the body, CAN IDENTIFY CEREBRAL ABN EARLIER AND MORE CLEALY THAN OTHER TESTS.
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Cerebral Angiography
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Catheter insertion to inject contrast agent in chosen artery, images obtained. USED BEFORE CRANIOTOMY TO ASSESS CEREBRAL CIRCULATION.
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Myelography
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X-ray of supinal subarachnoid spine after injection of contrast agent. Must remain at 30-45° for 3 hours, lots of fluids
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Noninvasive Carotid Flow Studies
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ultrasound imagery and doppler measurements of arterial blood flow to evaluate stenosis or obstruction
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Transcranial Doppler
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records blood flow velocities of intracranial vessels at temporal and occipital bones
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EEG
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Electroencephalography-electical activity generated in the brain
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EMG
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Electromyography- electrical potential of the muscles and nerves
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Nerve Conduction Studies, Evoked Potential Studies
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Stimulation of peripheral nerves at several points, changes in brain waves
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Lumbar puncture
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Spinal tap- needle is inserted into subarachnoid space and CSF is withdrawn (or antibiodics can be given). Given between L3 or L4 and L5.
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What is normal CSF pressure when a patient is in a lateral recumbent position?
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70-200 mm H2O
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