• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/145

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

145 Cards in this Set

  • Front
  • Back
Anatomy and physiology
-Functions to control various body activities.
-Structures of the nervous system include the central nervous system, peripheral nervous system, and autonomic nervous systems.
-
-
Cells of the nervous system
-Nervous system is made up of two types of cells.
-Neurons: basic unit of the nervous system.
-Neuroglial cells: function is to support neurons.
-
-
Neurons
-Basic unit of the nervous system
-Do not regenerate, but axons can repair to some extent.
-Rarely become primary brain tumors
-Share three characteristics
--Excitability: the ability to generate a nerve impulse
--Conductivity – the ability to transmit an impulse
--Influence – the ability to innervate target tissues
-
-
Excitability
The ability to generate a nerve impulse
-
-
Conductivity
The ability to transmit an impulse
-
-
Influence
The ability to innervate target tissues
-
-
Anatomy of a neuron
Dendrites – receive impulses from surrounding neurons.
Cell body – impulses are transmitted to cell body.
Axon – Impulse continues down axon and across synaptic cleft to adjacent neurons.
Myelin sheath – a white lipid material produced by Schwann cells in the PNS and oligodendroglia in the CNS.
Nodes of Ranvier – gaps in the myelin sheath that allow impulses to travel more quickly over the neuron.
Neurotransmitters – chemical agents acetylcholine, norepinephrine, serotonin, dopamine, glutamate, and histamine.
-
-
Dendrites
Receive impulses from surrounding neurons.
-
-
Cell body
impulses are transmitted to cell body.
-
-
Axon
Impulse continues down axon and across synaptic cleft to adjacent neurons.
-
-
Myelin sheath
A white lipid material produced by Schwann cells in the PNS and oligodendroglia in the CNS.
-
-
Nodes of Ranvier
Gaps in the myelin sheath that allow impulses to travel more quickly over the neuron.
-
-
Neurotransmitters
Chemical agents acetylcholine, norepinephrine, serotonin, dopamine, glutamate, and histamine.
-
-
Neuroglial cells
-Most numerous and function to support neurons.
-Have some ability to regenerate or repair themselves
-Most primary brain tumors are neuroglial
-
-
Central Nervous System
-Brain
-Spinal cord
-
-
Structures of the brain
-Cerebrum
-Diencephalon
-Brainstem
-Cerebellum
-
-
Cerebrum
-Controls high level functioning such as hearing, speech, personality, behavior, intellectual functioning, vision, memory, sensory and motor function

-Divided into two hemispheres
-Left cerebral hemisphere controls language.
-Right cerebral hemisphere controls perception.
-90% of the population is left hemisphere dominant.
-
-
Four Lobes of the Cerebrum
-Frontal
-Parietal
-Occipital
-Temporal
-
-
Frontal
-Concerned with personality, behavior, emotions, and intellectual function.
**Broca’s area controls motor speech.
-
-
Parietal
-Precentral gyrus center for sensation. Pain, temperature, touch, vibration.
-
-
Occipital
-Visual receptor center, interpreter shapes.
-
-
Temporal
-Auditory reception center.
**Wernicke’s area language comprehension
-
-
Diencephalon
Contains:
-The basal ganglia
-Thalamus
-Hypothalamus
-The limbic system
-
-
The basal ganglia
Control voluntary and automatic movement such as arm swinging, swallowing and blinking.
-
-
Thalamus
Serves as a relay station for sensory information from the cerebellum to the cerebral cortex.
-
-
Hypothalamus
Regulates the ANS and endocrine system.
-
-
Limbic system
Controls appetite, sleep, emotional response, sexual response.
-
-
Brain Stem
-Contains the midbrain, pons, and the medulla.
-Contains the vital respiratory cardiovascular and vasomotor centers.
-Contains the reticular formation – center for consciousness.
-Controls sneezing, coughing, hiccupping, vomiting, sucking, and swallowing.
-
-
Reticular Formation
**Center for consciousness
-
-
Cerebellum
-Located under the occipital lobe of the cerebrum
-Coordinates movement
-Maintains trunk stability and gait
-Operates on a subconscious level
-Receives information from muscles, cerebral cortex, and inner ear.
-
-
Examination for Cerebellum Function
-Observe posture and gait
-Finger to nose touch test
-Pronating and supinating hands on thighs
-Shallow knee bends
-Opposition movements of thumb to each finger
-Heel to shin test
-
-
Cerebral spinal fluid
-Contained in the ventricles, subarachnoid space, and spinal canal.
-Ventricles of the brain are four fluid filled cavities that communicate with one another and with the spinal cord.
-Averages 135 ml
-Provides a cushion, nutrients, and allows shifts to occur during times of increased intracranial pressure.
-Formed in the choroid plexus of the lateral ventricles and reabsorbed by the arachnoid villi in the subarachnoid space.
-
-
CSF analysis (Normal Values)
Normal values:
-Specific gravity: 1.007
-pH: 7.35
-Appearance: clear, colorless
-RBC: none
-WBC: 0-8/ ul
-Protein: 15-45 mg/dl
-Glucose: 45-74 mg/dl
-Microorganism: none
-Opening pressure: 60-150 mm H2O
-
-
Lumbar puncture
-Contraindicated in patients with elevated intracranial pressure and infection at the lumbar site.
-Place patient in the lateral recumbent position with the back near the edge of the bed.
--Flex head to chest and knees up to the abdomen.

-Puncture is made between L3 and L4 because there is a pocket of spinal fluid here.
-Straighten patients legs before measuring pressures.
-Post procedure maintain flat in bed for several hours to prevent spinal headache.
-Observe for spinal fluid leaks.
-
-
Cerebral circulation
-Blood supply to the brain is provided by the internal carotid arteries.
-Circle of Willis arises from the basilar artery and the internal carotid arteries.
-This provides protection and collateral flow in case of arterial occlusion.
-
-
-
-
Blood Brain Barrier
-Capillary membranes in the brain are less permeable to outside substances than capillaries in the rest of the body.
-This protects the brain from harmful chemicals and also affects medication absorption by brain tissue.
-
-
Meninges
Three layers of protective membranes that surround the brain and the spinal cord:
-Dura mater (outer)
-Arachnoid (center)
-Pia mater (inner)

Structures:
-Falx cerebri: separates the cerebral hemispheres.
-Tentorium: separates the cerebral hemispheres from the brainstem and cerebellum.
-
-
Dura mater
Outer most layer
-
-
Arachnoid
-Center layer
-Arteries and veins reside here
-
-
Pia mater
Inner layer
-
-
Spinal Cord
-Continuous with the brainstem
-Exits the cranial cavity at the foramen magnum
-Grey matter arranged in an H shape surrounded by white matter
-
-
Grey matter of Spinal Cord
Contains cell bodies of voluntary motor neurons, autonomic motor neurons, and cell bodies of association neurons
-
-
White matter of Spinal Cord
-Contains axons of the ascending sensory tracks and descending motor fibers.
-Myelin sheath gives the white matter its color
-
-
Pathways of the CNS
-Spinocerebellar track
-Spinothalamic track
-Posterior column (also known as....fasc...
-
-
Spinocerebellar track
Major sensory track which transmits information about muscle tension and body position to the cerebellum for coordination of movement
-
-
Spinothalamic track
Carries pain and temperature sensation and crude touch
-
-
Posterior column
-also known as...
-carries sensation of vibration, position, light touch and manipulation of digits.
-
-
Stereogenosis
– ability to identify a familiar object without looking
-
-
Graphesthesia
– ability to identify a letter drawn in your hand
-
-
Sensory Receptors
-Mechanoreceptors sense mechanical deformity
-Thermoreceptors sense temperature
-Electromagnetic receptors detect light on the retina
-Chemoreceptors detect taste, smell, oxygen levels, osmolality , and CO2 levels
-Itch and tickle receptors
-
-
Sensory Testing
Light touch – wisp of cotton
Pain and temperature – sharp and dull
Vibration sense – tuning fork to bony prominences
Position sense – move the finger up or down, Rhomberg test
Two point discrimination
Graphesthesia
Stereognosis
-
-
Motor Tracks
-Corticospinal tracks carry impulses from the cerebral cortex to cranial and peripheral nerves

-Upper motor neuron: cell bodies in the cerebral cortex.
--Dysfunction causes weakness and paralysis, disuse atrophy, hyperreflexia, spasticity.

-Lower motor neurons: Cranial nerves or spinal nerves which carry impulses to the end organ.
--Dysfunction causes weakness and paralysis, atrophy, hyporeflexia, flaccid muscle tone.
-
-
Assessing Motor Function
-Assess bulk tone, and strength of major muscle groups of the body.

-Passively move limbs through their normal range of motion.

-Lack of tone = flaccid
-Increased tone = spasticity
-
-
Peripheral nervous system
-Spinal nerves
-Cranial nerves
-
-
Spinal Nerves
-There are 31 pairs of spinal nerves

-They all exit the spinal cord at a given level and influence a specific body region.

-There are:
8 cervical,
12 thoracic,
5 lumbar,
5 sacral, and
1 coccygeal.

-They are labeled by number

-Sensory dorsal root fibers each serve a specific part of the body, a dermatome.
-
-
Spinal nerves and dermatomes
See pictures in lecture notes
-
-
Cranial Nerves
-12 pairs
-Emerge from the brain or brainstem
-Have sensory and motor function
-
-
Cranial Nerve I
Olfactory

-Olfactory nerve: sensory for smell.
--Dysfunction can result from tumor in the olfactory bulb or basilar skull fracture.

-History of sinusitis can effect the test

-Testing: Have the patient identify a familiar smell such as coffee, chocolate with eyes closed.
Test each nostril separately.
-
-
Cranial Nerve II
Optic

-Sensory for sight: dysfunction may result from lesions to the optic nerve, optic chiasm or optic tract through the temporal, parietal or occipital lobe.

-Testing: assess visual acuity with the Snellen chart visual fields
-– The patient and examiner sit opposite each other at the same level.
--The patient and examiner block one eye. An object is brought slowly into the visual field from each of four positions. The patient indicates when they can see the object.
-
-
Cranial Nerves III, IV, VI
-III: Oculomotor
-IV: Trochlear
-VI: Abducen nerve

-Motor neurons which control movement of eye balls, elevation of eye lids, and pupillary constriction

-Testing: assess eye muscle movement with 6 cardinal positions of gaze.
--Ask the patient to move their eyes up and down
--Check pupillary response to light direct and consensual.
-
-
Cranial Nerve V
Trigeminal

-Motor for chewing

-Palpate muscles of the jaw, ask client to resist attempts to open jaw

-Sensory to cornea, mucosa of the mouth, nose, skin of the face and forehead.
--Important in perceiving touch, temperature, pain

-Only test corneal reflex in unconscious pt
-
-
Cranial Nerve VII
Facial

-Motor to facial muscles

-Sensory to taste on the anterior 2/3 of tongue

-Inspect face for symmetry when patient looks up. Wrinkle forehead frown, puff out cheeks, raise eyebrows. Close eyes and squeeze them shut

-Test taste on anterior 2/3 of tongue for sweet
-
-
Cranial Nerve VIII
Acoustic

-Sensory for hearing in the cochlear division

-Vestibular division controls balance

-Cochlear division is tested with hearing test

-Vestibular division is tested with ice caloric in unconscious patient, examiner irrigates the ear with ice water. Nystagmus and nausea normal.

-Weber test: tuning fork to forehead

-Rinne test: tuning fork to mastoid
-
-
Cranial Nerve IX
Glossopharyngeal nerve

-Sensory for taste on the posterior 1/3 of the tongue

-Motor innervates the pharynx, controls swallowing gagging and salivation

-Test taste on the posterior portion of the tongue with sweet or salty. Test swallowing by having patient drink
-
-
Cranial nerve X
Vagus nerve

-Sensory for external ear and pharynx. Motor to soft palate, larynx and esophagus.

-Parasympathetic control to smooth muscle, cardiac muscle, and abdominal organs

-Inspect the soft palate for symmetry, identify the uvula and record deviations from midline. Ask the client to say AH with tongue protruding observe uvula. Check for clear speech
-
-
Cranial Nerve XI
Spinal accessory nerve

-Motor to the sternocleidomastoid and trapezius muscles

-Evaluate for size symmetry and strength

-Ask the client to turn their head to one side against your hand while you palpate the sternocleidomastoid.

-Ask client to shrug shoulders against resistance
-
-
Cranial Nerve XII
Hypoglossal

-Motor to the tongue for speech and swallowing

-Ask the client to stick out their tongue. Inspect for size and symmetry

-Push their tongue into their cheek against resistance
-
-
Reflexes
-Biceps reflex
-Triceps reflex
-Brachioradialis reflex
-Patellar reflex
-Ankle reflex
-
-
Superficial reflexes
-Reflexes that can be elicited by stroking the skin or muscles .

-Abdominal, cremasteric, and plantar reflex
-
-
Abdominal reflex
-Test spinal nerves at level T8 through t12.
-Stroke the skin of the abdomen with a blunt object up and away from the umbilicus and down and away from the umbilicus.
-The umbilicus will move toward the stimulus.
-
-
Cremasteric and plantar reflex
-Cremasteric: In males when the inner thigh is stroked the testicle on the same side moves.

-Plantar reflex: Stroking the plantar surface of the sole of the foot stimulates plantar flexion of the toes.

-Bibinski reflex: In a positive Babinski test the toes of the foot go up and fan out to plantar stimulation.
-
-
Babinski's sign
Dorsiflexion of the great toe and fanning of the other toes
Elicitation of the plantar reflex
-A hard object is applied to the lateral surface of the sole, starting at the heel and going over the ball of the foot, ending beneath the great toe.

-Normal response to plantar stimulation: flexion of all toes