Neuro Exam 2

Front 1

somatosensory info converges in ___ lobes of cortex

Back 1

parietal lobe

Front 2

primary somsethic area

Back 2

(3,1,2); primary sensations

Front 3

secondary somesthetic area

Back 3

(40) bilateral connections - bimanual skills

Front 4

sensory association area

Back 4

(5,7) perceptual interpretive fxn

Front 5

sensory info flow in brain

Back 5

thalamus to primary somatosensory cortex to secondary somatosensory cortex, primary supplementary motor cortex (frontal lobe), posterior parietal cortex sensory association area

Front 6

primary cortical receiving area

Back 6

primary somatosensory cortex SI, includes post central gyrus (BA 312)

Front 7

primary somatosensory cortex (SI) neurons are responsive to

Back 7

somatosensory stimuli almost exclusively- proprioception, pain, tactile perception (texture, shape, size), vibration, thermal sensation, edge detection, stereognosis

Front 8

how is primary somatosensory cortex organized

Back 8

somatotopically organized- sensory homunculus

Front 9

To appreciate the shape, texture, size, weight,and movement of a given object, the somatosensory cortex must integrate theparallel streams of information carried by the

Back 9

medial leminiscal pathway

Front 10

destruction of primary somatosensory cortex

Back 10

severe deficits in discriminative touch and proprioception on contralesional side of body; deficits in ability to accurately localize and recognize objects by shape, texture and size, vibrating/moving stimuli; also deficits in fine motor coordination

Front 11

secondary somatosensory area (SII) location

Back 11

small area in ventral portion of post-central gyrus (40)

Front 12

secondary somatosensory area receives extensive input from

Back 12

primary somatosensory area and thalamus

Front 13

function of secondary somatosensory area

Back 13

shape and texture discrimination and bilateral secondary somatosensory areas strongly linked which could explain involvement in bilateral activities; processing for graphasthesia

Front 14

BA of somatosensory association area

Back 14

5, 7

Front 15

highest degree of convergence of somatosensory info occurs in

Back 15

posterior parietal cortex (receives axons of primary and secondary somatosensory association areas)

Front 16

damage to neurons in somatosensory association area

Back 16

affect ability to recognize objects even though objects can be felt (tactile agnosia)

perceptual deficits: unilateral neglect (non dominant hemisphere lesions), Pusher's syndrome (poor vertical orientation)

Front 17

Pusher's syndrome

Back 17

poor vertical orientation (damage to somatosensory association area)

Front 18

contralateral cortical damage in somatosensory cortex

Back 18

accurate for touch but unable to localize

Front 19

lesions in somatosensory cortex

Back 19

contralateral anesthesia, paresthesia, impaired sensory fxn

Front 20

contralateral parietal lobe damage

Back 20

tactile extinction

Front 21

tactile extinction

Back 21

ability to sense touch separately but not able to identify bilateral simultaneous touch

Front 22

ability to sense specific touch but unable to identify graphing letters on hand or recognize objects on manipulation

Back 22

parietal lobe damage

Front 23

what is usually retained in somatosensory cortical lesions

Back 23

vibration sense

Front 24

loss of ability to sense pain (lesion locations)

Back 24

damage to pain receptors, lateral spinothalamic tract, primary sensory cortex

Front 25

damage to medial pain systems

Back 25

changes in attention to pain modulation of pain sensations and affective response to pain

Front 26

what would indicate that the DC-ML system from peripheral to somatosensory cortex is intact

Back 26

awareness of touch and ability to locate; ability to discriminate 2 simultaneous points of contact

Front 27

parietal lobe damage can result in

Back 27

unilateral neglect, impaired vertical orientation, tactile agnosias

Front 28

somatosensory system

Back 28

elements of PNS and CNS that subserve sensory modalities of touch, vibration, temp, pain, proprioception; sensory info that comes from skin and MSK system

Front 29

flow of somatosensory system (AP if stimulus is strong enough)

Back 29

receptors to afferents to cell body in DRG to posterior horn of SC to ascending tracts to brainstem to thalamus to cortex

Front 30

superficial or cutaneous sensation (exteroceptive)

Back 30

info from skin and subcutaneous tissue

Front 31

types of superficial/cutaneous sensation

Back 31

touch (coarse, discriminative), temp (relative and delta temp), pain (fast and slow)

Front 32

discriminative touch

Back 32

light touch, tactile threshold, superficial vibration/flutter, pressure, skin stretch, form, texture

Front 33

coarse touch

Back 33

crudely localized touch, tickle, itch

Front 34

pain

Back 34

any noxious sensation, sharp, dull, local, diffuse, burning, stabbing; fast or slow

Front 35

deep sensations

Back 35

pain and proprioception; info from MSK system

Front 36

types of deep sensations

Back 36

joint position sense, kinesthesia, vibration

Front 37

proprioception

Back 37

awareness of position and mvm to limbs in relation to each other and the body; knowledge about position of our bodies in space

Front 38

cortical fine touch sensations

Back 38

higher order sensations dependent on intact cutaneous and deep sensory fxn

Front 39

cortical final touch sensations types

Back 39

2 point discrimination, bilateral simultaneous stimulation, graphesthesia, localization of touch

Front 40

2 point discrimination

Back 40

ability to discern that 2 nearby objects touching skin are truly 2 distinct points, not one

Front 41

bilateral simultaneous stimulation

Back 41

ability to determine 2 simultaneous stimulations are being applied to opposite sides of body, prox and distal on same side

Front 42

tactile extinction

Back 42

from unilateral cerebral damage; inability to recognize 2 simultaneous stimuli on opposite sides of body, or proximally and distally, though either one can be sensed alone

Front 43

graphesthesia

Back 43

ability to recognize writing on skin purely by sensation of touch

Front 44

stereognosis

Back 44

ability to recognize form of objects by touch

Front 45

barognosis

Back 45

ability to tell relative weights

Front 46

combined cortical sensations

Back 46

use info from touch and proprioception;

stereognosis and barognosis

Front 47

receptor specificity

Back 47

receptors respond to 1 type of energy and 1 type of stimulus

Front 48

receptive field

Back 48

of sensory neuron is region of space in which presence of stimulus will alter firing of that neuron

Front 49

t/f: distal receptors tend to smaller than proximal + greater density of receptors

Back 49

true

Front 50

tonic receptors

Back 50

respond as long as stimulus is applied- sustained

Front 51

phasic receptors

Back 51

adapt to constant stimulus and stop responding- brief

Front 52

mechanoreceptors

Back 52

respond to mechanical deformation of receptor by touch, pressure, stretch, or vibration; mediate sense of touch, proprioceptive sensations

Front 53

chemoreceptors

Back 53

involved in senses of pain, itch, and respond to chemicals released by cells including damaged cells post-injury ... pain

Front 54

thermoreceptors

Back 54

in skin sense body temp and also changes in temp, temp of ambient air, objects that we touch

Front 55

nociceptors

Back 55

subset of each type of 3 receptors types that are specifically responsive to stimuli that threaten or damage tissue- noxious

Front 56

receptors of touch

Back 56

mechanoreceptors

Front 57

_____ receptors to skin deformation

Back 57

superficial dermis receptors

Front 58

merkel's discs

Back 58

pressure, fine touch

Front 59

meissner's corpuscles

Back 59

respond to skin deformation and are sensitive to light touch and vibration

Front 60

hair follicle receptors

Back 60

respond to hair displacement

Front 61

types of superficial dermis receptors

Back 61

merkel's discs, meissner corpuscles, hair follicle receptors

Front 62

deep dermis/subcutaneous fine touch receptors

Back 62

info about larger surface areas

Front 63

types of deep dermis/subcutaneous fine touch receptors

Back 63

ruffini endings, pacinian corpuscles

Front 64

ruffini endings

Back 64

detect skin stretch; contribution to proprioception

Front 65

pacinian corpuscles

Back 65

info regarding touch and vibration; contribution to proprioception

Front 66

course touch is mediated via ___ throughout skin

Back 66

free nerve endings

Front 67

thermoreception

Back 67

ability to sense relative temp and temp changes but not absolute temp

Front 68

adapt to maintained temp (types of nerves)

Back 68

free nerve endings

Front 69

specific nociceptors

Back 69

free nerve endings which respond to one type of noxious stimulus; respond to high intensity noxious mechanical, thermal, and chemical stimuli; localized pain sensations which are transmitted rapidly via myelinated A-delta fibers- fast sharp pain

Front 70

polymodal nociceptors

Back 70

not specific and respond to any high-intensity mechanical stimuli, chemical stimuli, and thermal stimuli; slow transmission of poorly localized pain occurs via unmyelinated C fibers and pain sensation replaced w/ long lasting burning pain

Front 71

receptors involved in proprioception

Back 71

muscle spindles, GTOs, joint receptors

Front 72

muscle spindles

Back 72

sensory organs of muscles; mechanorecptors buried in skeletal muscle = intrafusal fibers + sensory endings + motor endings

Front 73

respond to lengthening of muscle; muscle activation, rate of change in muscle length

Back 73

muscle spindles

Front 74

muscle spindle has what components

Back 74

2 types muscle fibers: extrafusal and intrafusal

2 types sensory afferents: Ia, IIb

2 types motor efferent fibers: alpha (stimulate extrafusal fibers) and gamma (stimulate intrafusal fibers)

Front 75

intrafusal fibers

Back 75

fusiform, inside fleshy part of skeletal muscle; contractile only at ends; arrangement of nuclei defines 2 types of fibers: nuclear bag and nuclear chain

Front 76

annulospiral sensory endings

Back 76

endings of type Ia afferent neurons wrap around central region of each intrafusal fiber

Front 77

flower spray sensory endings

Back 77

endings of type II afferent neurons end on nuclear chain fibers

Front 78

gamma motor neurons

Back 78

fxn to maintain sensitivity of spindle stretch by firing and causing ends of intrafusal fibers to contract, allowing info to be generated even when muscle is slack

Front 79

when muscle is lengthened and intrafusal fibers stretched

Back 79

activity of Ia and II afferents to spinal cord where they branch

branch 1 = info about motion to higher centers via ascending tracts

branch 2 = interneuron to alpha motor neuron to extrafusal fibers to contract and prevent damage, and to antagonists to relax and allow contraction and to gamma motor neuron back to intrafusal fiber to keep it active and this sending signals continuously

Front 80

GTOs

Back 80

proprioceptive mechanoreceptors in skeletal muscles at musculotendinous jxns and provides info about muscle tension and fxn to inhibit muscle in response to excessive tension

Front 81

GTOs arranged in ___ btw muscle fibers and collagen of tendons

Back 81

series

Front 82

what type of afferents neurons in GTOs

Back 82

Ib afferent

Front 83

GTO records what info

Back 83

change in tension and rate of change of tension and sends to post horn of SC

info to alpha motor... inhibitory to contracting muscle, excitatory to antagonist

Front 84

types of joint receptors

Back 84

ligament receptors

ruffini endings

pacinian corpuscles

free nerve endings

Front 85

joint receptors

Back 85

respond to mechanical deformation of ligs and capsules

Front 86

ligament receptors

Back 86

type Ib afferents respond to tension

Front 87

ruffini endings (jt receptors)

Back 87

in capsule respond to extremes of joint ROM; passive > active

Front 88

pacinian corpuscles (jt receptors)

Back 88

respond to mvmt

Front 89

free nerve endings in jt receptors

Back 89

responds to chemical stimulus in inflammation

Front 90

proprioception especially helpful in detecting

Back 90

size, shape, weight of object

Front 91

all sensory systems convey what 4 basic types of info when stimulated

Back 91

modality, location, intensity, timing

Front 92

sensory neurons

Back 92

afferent neurons; bringing info initiated in receptors in skin, skeletal muscles, tendons, joints; single myelinated or unmyelinated nerve fiber; made up of cell body and bifurcating axons

Front 93

A-beta nerve fibers

Back 93

carry info related to touch and conscious proprioception- large diameter myelinated fast conductors

Front 94

Ia (A alpha) Ib (A beta) , and II (A beta) nerve fibers

Back 94

carry info related to unconscious proprioception- large diameter myelinated fast conductors

Front 95

A-delta nerve fibers

Back 95

carry info related to fast pain and cool temp- medium myelinated rapid fibers

Front 96

C-nerve fibers

Back 96

carry info related to slow pain, warm temp and itch- small unmyelinated slow conductors

Front 97

peripheral neuropathy damage to peripheral nerve

Back 97

glove and stocking distribution

Front 98

diabetic neuropathy

Back 98

microvascular damage; insufficient supply to peripheral nerves

Front 99

chemotoxic neuropathy

Back 99

toxic damage to peripheral nerves

Front 100

alcoholic neuropathy

Back 100

toxic damage to peripheral nerves and nutritional deficits particularly thiamine deficiency

Front 101

damage/trauma/disease to/of spinal nerve

Back 101

sensory loss in dermatome distribution

Front 102

primary/first order neurons

Back 102

all sensory info travels in these neurons from periphery to spinal cord; cell bodies outside SC in DRG; enter SC posteriorally via dorsal roots and rootlets

Front 103

grey matter of SC, dorsal horn

Back 103

dorsal horn; sensory area

Front 104

white matter

Back 104

ascending tracts; sensory info from periphery to brain in dorsal and lateral white matter

Front 105

grey matter in SC arranged in

Back 105

lamina (Rexed lamina)

Front 106

Rexed lamina

Back 106

divisions by fxn and sensory info arrives at specific areas/laminae

Front 107

rexed lamina II

Back 107

substantia gelatinosa; important in modulation of pain sensation

Front 108

rexed lamina III and IV

Back 108

aka nucleus proprius; conscious proprioception and touch

Front 109

unconscious proprioception route

Back 109

spinal nerves entering at T1-L2 to dorsal horn to Clarke's nucleus to posterior spinocerebellar tract to cerebellum

Front 110

t/f: While wefollow the large projection neurons from the periphery to the brain, there aremany interneurons at each level of the spinal cord for intercommunication

Back 110

true

Front 111

Within the CNS a bundle of axons with the sameorigin and a common termination is called a

Back 111

tract

Front 112

projection neurons

Back 112

The tracts (pathways) only describe thoseneurons with long axons connecting distant areas of the body.

Front 113

conscious pathways

Back 113

fine/discriminative touch and proprioception; pain and temp (anterolateral pathways); crude touch and pressure

Front 114

fine/discriminative touch and proprioception pathway

Back 114

dorsal columns to medial leminiscus to thalamus to cortex

Front 115

pain and temp pathway

Back 115

anterolateral pathways

Front 116

fast pain pathway

Back 116

spinothalamic pathway; thalamus and brain

Front 117

slow pain pathway

Back 117

multiple pathways: spinoreticular, spinolimbic, spinomesencephalic pathways to midbrain, reticular formation, amygdala, multiple cerebral cortical areas (divergent relay pathways)

Front 118

crude touch and pressure pathway

Back 118

venterolateral pathway; thalamus and brain

Front 119

unconscious pathways

Back 119

unconscious proprioception via spinocerebellar pathways to cerebellum

Front 120

posterior column- medial leminiscal pathaway involved with

Back 120

conscious proprioception, vibration sense and discriminative touch

Front 121

medial leminiscal pathway

Back 121

first order neurons A-beta to ipsilateral post columns to post column nuclei; medial portion (gracilis fasiculus), lateral portion (cuneatus fasiculus); first order neurons synapse w/ 2nd order neurons in nucleus gracilis and nucleus cuneatus and cross to opposite side; fiber somatotopic representation reverses at entry to brainstem; fibers terminate in ventral posterolateral nucleus of thalamus then to internal capsule and corona radiate then to post central gyrus of cortex, primary sensory cortex, and secondary somatosensory cortex

Front 122

gracile fasiculus

Back 122

medial portion of post column nuclei (medulla); has info from LE and trunk these terminate on nucleus gracilis

Front 123

cuneatus fasiculus

Back 123

lateral portion of post column; has info from upper trunk (approx T6 arms and neck) and terminate in nucleus cuneatus

Front 124

anterolateral pathways

Back 124

several parallel tracts: lateral spinothalamic, spinolimbic, spinoreticular, spinomesencephalic

Front 125

immediate pain- fast and localized: what pathway?

Back 125

lateral pain system via lateral spinothalamic tract

Front 126

lissauer's tracts

Back 126

neurons travel 1 or 2 adjacent levels of SC before entering dorsal horn (in immediate pain)

Front 127

lateral pain system via lateral spinothalamic tract

Back 127

A-delta fibers bring info to post SC; Lissauer's tracts before entering dorsal horn; first order neurons enter dorsal horn synapse w/ interneurons (substantia gelatinosa); second order neurons cross SC in anterior white commissure; go to lateral spinothalamic tract; then to VPL thalamus; then synapse w/ 3rd order neurons to primary and secondary sensory cortex

Front 128

slow pain pathway

Back 128

less localized, more diffuse; medial pain system

Front 129

medial pain system

Back 129

emotional and visceral responses to pain, descending modulation of pain)

Front 130

slow pain transmitted by what type of fibers

Back 130

small unmyelinated C fibers

Front 131

in slow pain, neurons enter posterior horn, synapse and cross midline and project to midbrain, reticular formation, limbic areas via 3 tracts.... what are these tracts?

Back 131

spinomesencephalic, spinoreticular tract, and spinolimbic tract

Front 132

spinomesencephalic tract

Back 132

to midbrain periaqueductal grey; regulates pain and activating descending tracts that control pain; inhibits activation of 2nd order neuron responsible for transmitting pain signal up spinothalamic tract; first order neuron to post horn of SC; second order to PAG in midbrain

Front 133

spinoreticular tract

Back 133

reticular formation; arousal and attention to pain and sleep disruption; neurons from reticular formation project to many areas of the brain, including hypothalamus, thalamus and both directly and indirectly to limbic forebrain and neocortex; influences motor response to pain

Front 134

spinolimbic tract

Back 134

thalamic nuclei; affective response to pain

Front 135

spinocerebellar pathways

Back 135

provides unconscious proprioception and mvmt related info to cerebellum; info from proprioceptors to cerebellum via spinocerebellar tracts- postural and mvmt adjustments, provides smooth coordinated mvmts

Front 136

posterior spinocerebellar pathway

Back 136

infor from legs and lower body; T1-L2; nucleus dorsalis i.e. Clarkes nucleus in thoracic or upper lumbar SC; synapse there w/ 2nd order neurons which form posterior spinocerebellar tract to ipsilateral cerebellar peduncle to cerebellum; from L3-S2 input to dorsal horn to fascicles gracilis to Clarke's nucleus to spinocerebllar tract

Front 137

cuneocerebellar pathway

Back 137

primary afferents from arm and upper body C1-C8 to dorsal columns to lower medulla synapse in lateral cuneate nucleus to second order neurons = cuneocerebellar pathway to ipsilateral cerebellar peduncle to cortex

Front 138

anterior spinocerebellar pathway

Back 138

info from interneurons only and descending motor tracts; crosses on entry, ascends ipsilaterally and sends branches to both cerebellar; info from both legs to both cerebellar hemispheres

Front 139

4 spinocerebellar pathways (unconscious proprioceptive info)

Back 139

posterior spinocerebellar pathway, cuneocerebellar pathway, cuenocerebellar pathway, anterior spinocerebellar, rostro spinocerebellar tracts

Front 140

rostro-spinocerebellar tracts

Back 140

info from cervical SC to ipsilateral cerebellum; automatic coordination of motor activity

Front 141

transection of SC

Back 141

sensory loss in all modalities bilaterally below level of injury

Front 142

hemicord lesions (brown sequard)

Back 142

ipsilateral loss of touch and proprioceptionand conralateral loss of pain and temp

Front 143

anterior cord lesion

Back 143

bilateral loss of pain and temp

Front 144

posterior cord lesion

Back 144

bilateral loss of touch and proprioception

Front 145

central cord lesion

Back 145

more impact on upper than lower extremities

Front 146

first stage of sensory integration and perceptual awareness occurs at level of

Back 146

thalamus

Front 147

thalamocortical projections travel via internal capsule and corona radiata to

Back 147

primary somesthetic area in parietal lobe

Front 148

thalamus (general fxn)

Back 148

gatekeeper to cortex; paired structure located on both sides of 3rd ventricle

Front 149

fxns of thalamus

Back 149

-critical processing station for all sensory info EXCEPT olfactory on its way to cortex

-subcortical structures project to cortex via thalamus (basal ganglia); influence on upper motor neurons

-connect cortical areas to each other influencing and integrating flow of info btw various cortical areas

-info (to and from thalamus to cortex), flows bi-directionally; additional layer of info processing

Front 150

thalamic nuclei

Back 150

medial and lateral, lateral-posterior, thalamic reticular; have bidirectional communication w/ cortex

Front 151

relay nuclei

Back 151

info from periphery to cortex (sensory, motor, and limbic); thalamus decides which info to relay to cortex

Front 152

where is auditory info processed

Back 152

medial geniculate nucleus of thalamus

Front 153

where is visual info processed

Back 153

lateral geniculate nucleus of thalamus

Front 154

motor nuclei

Back 154

receive info from basal ganglia and cerebellum and project to motor cortex and provide FB to BG and cerebellum

Front 155

limbic really nuclei

Back 155

connect to limbic structures; consolidation of memories, motivation, attention to specific stimuli

Front 156

association nuclei

Back 156

connect areas of brain to each other; thalamus gates info traveling from 1 area of cortex to another; involved in exec control and olfactory processing

Front 157

pulvinar

Back 157

extensive reciprocal connections w/ association areas in each of 4 lobes; involved in visual and auditory processing

Front 158

thalamic reticular nucleus

Back 158

gate keeper of gate keeper; contains GABA neurons which can turn down activity of thalamus; selective attention; consciousness

Front 159

hypothalamus

Back 159

anatomically part of diencephalon, functionally part of limbic system; small structure located inferior to thalamus; central regulator of autonomic and endocrine fxn

Front 160

hypothalamus and pituitary gland connected by

Back 160

pituitary stalk/infundibulum

Front 161

input to hypothalamus

Back 161

SC and brainstem (somatosensory, visceral, gustatory info, reticular formation (arousal/wakefulness); limbic system (hippo and amyg); olfactory info; frontal lobe; thalamus; retina

Front 162

output from hypothalamus

Back 162

reciprocal projections back to sources of input; brainstem; sympathetic and parasympathetic nuclei; forebrain

Front 163

what does hypothalamus manage to maintain homeostasis

Back 163

electrolyte and fluid balance, body temp, BP, satiety

Front 164

hypothalamus hormones

Back 164

thyrotropin releasing, gonadotropin releasing, growth hormone releasing, corticotropin releasing, somatostatin; produces oxytocin, ADH

Front 165

oxytocin

Back 165

childbirth, lactation, sexual arousal,mother-infant bonding, in men = ejaculation, conversion of testosterone todihydrotestosterone

Front 166

t/f: hypothalamus regulates visceral fxn

Back 166

true

Front 167

t/f: hypothalamus regulates circadian rhythm and sleep wake cycles

Back 167

true

Front 168

subthalamus

Back 168

-important player in BG fxn in modulating mvmt and muscle tone

-anatomically part of diencephalon

-fxnally works w/ BG

-linked w/ globus pallidus for mvmt

Front 169

damage to subthalamus

Back 169

hemiballismus: random flinging of extremity usually on 1 side

Front 170

epithalamus

Back 170

connects limbic system to other parts of brain; responds to olfactory stimulation and are involved in emotional and visceral response to odors; secretion of melatonin by pineal gland

Front 171

3 meninges

Back 171

dura mater, arachnoid mater, pia mater

Front 172

dura mater

Back 172

strong w/ 2 layers that are generally fused by contain sinuses were they're separated; cerebral blood drains into these venous sinuses and drains into internal jugular; 2 layers = periosteal layer (attaches to skull) and meningeal layer; pain sensitive receiving innervation from branches of trigeminal and vagal cranial nerves; gets blood from meningeal arteries

Front 173

dural reflections

Back 173

contain sinuses; protect anchor and insulate brain to reduce risk of injury

falx cerebri, tentorium cerebelli, falx cerebelli

Front 174

falx cerebri

Back 174

reflection of dura mater extends into longitudinal fissure and partially separates hemispheres

Front 175

tentorium cerebelli

Back 175

reflection of dura mater that extends into transverse fissure and separates cerebrum from cerebellum

Front 176

falx cerebelli

Back 176

separates 2 cerebellar hemispheres

Front 177

epidural space

Back 177

potential space btw skull and periosteal dura mater

Front 178

epidural hematoma

Back 178

arterial bleed from meningeal arteries into epidural space; often caused by trauma/skull fx

Front 179

subdural space

Back 179

potential space btw arachnoid and dura

Front 180

subdural hematoma

Back 180

bleed in subdural space; caused by shearing of veins in shaken baby sx and traumatic injury w/ shearing forces

Front 181

arachnoid mater

Back 181

middle layer of meninges; can project into sinuses via arachnoid granulation/arachnoid villi; connected to pia mater by arachnoid trabeculae

Front 182

arachnoid granulation/arachnoid villi

Back 182

transfer CSF from ventricles back to bloodstream

Front 183

subarachnoid space

Back 183

only real space btw layers of meninges btw arachnoid and pia mater; filled w/ CSF cerebral arteries and veins

Front 184

subarachnoid hemorrhage

Back 184

occurs w/ ruptured aneurysm, fills subarachnoid space

Front 185

pia mater

Back 185

adheres tightly to brain parenchyma; follows ilci and gyri; separates brain tissue from CSF

Front 186

dura mater of SC

Back 186

attached to skull and upper C vertebra but not below that

Front 187

epidural space in SC

Back 187

btw vertebrae and dura; allows caudal analgesia to sacral area

Front 188

arachnoid mater of SC

Back 188

continuous w/ cerebral arachnoid above extends to S2; access can be gained at L2 where spinal cord ends for lumbar puncture (allows pressure of CSF to be measured)

Front 189

whichallows the pressure of the CSF to be measured, the fluid can be withdrawn and analyzed,and spinal anesthetic can be applied, or fluid can be replaced by a contrastmedium for radiography (myelography). During lumbar puncture, a needle is insertedbetween two lumbar vertebrae to remove a sample of cerebrospinal fluid; can help dx meningitis, MS, guillaine barre

Back 189

lumbar puncture

Front 190

pia mater of SC

Back 190

covers spinal cord closely, covers anterior spinal artery, and enters anterior median fissure; laterally denticulate lig penetrates arachnoid and attaches to dura

Front 191

CSF

Back 191

produced from arterial blood by choroid plexuses of lateral and 4th ventricles; small amount produced by ependymal cells

Front 192

2 lateral ventricles

Back 192

telencephalon; span all 4 lobes of brain

Front 193

lateral ventricles connected to third via

Back 193

intraventricular foramen

Front 194

third ventricle

Back 194

diencephalon

Front 195

third ventricle connected to 4th via

Back 195

cerebral aqueduct (aqueduct of sylvius)

Front 196

4th ventricle

Back 196

btw BS and cerebellum

Front 197

CSFfills the ventricles and passes through what three openings to circulate in the sub-arachnoid space of the brain and spinal cord?

Back 197

2 foramina of Luschka and 1 foramen of megendie

Front 198

Absorptionof the CSF into the blood stream takes place in the

Back 198

superior sagittal sinus through structures called arachnoid villi

Front 199

functions of CSF

Back 199

protection, buoyancy, excretion of wast, continuous exchange btw CSF and brain can give us info about brain and useful in admin of drugs, maintain stable intracranial pressure, periventricular neurons secrete NT into CSF for widespread impact

Front 200

draw circle of willis

Back 200

drawing

Front 201

where is brainstem located?

Back 201

posterior cranial fossa; merges w/ diencephalon rostrally and SC caudally

Front 202

brainstem consists of (major players)

Back 202

midbrain, pons, medulla oblongata

Front 203

components of brainstem

Back 203

-nuclei for 9 of 12 CNs (III-X, XII)

-all ascending and descending tracts

-some descending pathways

-respiratory center

Front 204

small lesions in brainstem

Back 204

sig damage w/ deficits in motor, sensory, regulatory systems

Front 205

most rostral aspect of brainstem

Back 205

midbrain

Front 206

periaqueductal gray (PAG)

Back 206

gray matter around cerebral aqueduct that deals w/ pain; control center for pain modulation; has enkephalin-producing cells that suppress pain

Front 207

anterior surface of midbrain

Back 207

cerebral peduncles, CN III, tegmentum, substantia nigra, red nucleus

Front 208

cerebral peduncles

Back 208

peduncle = stem-like connector; prominent bundles of descending motor fibers- most anterior structures of midbrain

Front 209

CN III

Back 209

occulomotor n; emerges btw cerebral peduncles; eye mvmts

Front 210

tegmentum

Back 210

"cover"; all tissue anterior to cerebral aqueduct except for cerebral peduncles; region ventral to ventricular system; extends throughout brainstem; makes up bulk of BS nuclei and reticular formation

Front 211

substantia nigra

Back 211

posterior to cerebral peduncles; deep sub-cortical grey matter; stains black; produces DA for motor circuit of BG

Front 212

red nucleus

Back 212

motor nucleus containing motor neuron cell bodies of motor tract that begins w/ red nucleus = rubrospinal tract

Front 213

posterior surface of midbrain

Back 213

tectum, superior colliculi, inferior colliculi, CN IV (trochlear), sensory tracts

Front 214

tectum

Back 214

all tissue dorsal to cerbral aqueduct; dorsal surface of midbrain and is made up of superior and inferior colliculi

Front 215

superior colliculi

Back 215

top part, controls visual reflexes; receive info from enviro and initiates behavioral response appropriate to current enviro; following baseball flying across stadium

Front 216

inferior colliculi

Back 216

bottom part, controls auditory reflexes like turning your eyes and ears and/or head towards stimulus e.g. when someone slams door e.g. startle reflex

Front 217

CN IV

Back 217

trochlear; eye mvmt emerges caudal to inferior colliculus

Front 218

pons

Back 218

located btw midbrain and MO; ventral part = basilar pons, dorsal part = tegmentum

Front 219

anterior surface of pons (basal pons) contains

Back 219

pontine nuclei, transverse fibers, pontine nuclei, descending motor tracts, ascending afferent tracts

Front 220

pontine nuclei

Back 220

conveying info from motor cortex to cerebellum regarding intended mvmts of contralateral arm and leg

Front 221

transverse fibers

Back 221

pontocerebellar fibers (signals from pons to opposite cerebellum) via middle cerebellar peduncles originate from pontine nuclei

Front 222

pontine nuclei

Back 222

deal w/ sleep, respiration, swallowing, bladder control, hearing, equilibrium, taste, eye mvmt, facial expressions, facial sensation, posture

CN V- trigeminal; CN VI- abducens; CN VII-facial; CN VII- vestibulocochlear

Front 223

cortex to spinal cord and to cortex to brainstem travel through pons

Back 223

descending motor tracts

Front 224

posterior surface of pons

Back 224

floor of midbrain; superior cerebellar peduncles, middle cerebellar peduncles, pneumotaxic center

Front 225

superior cerebellar peduncles

Back 225

arise from cerebellum and enter BS from dorsolateral position at level of rostral pons near inferior colliculus of midbrain; they are the only efferents from cerebellum

Front 226

middle cerebellar peduncles

Back 226

carrying afferent pontocerebellar fibers that come from cortex to pons and to cerebellum

Front 227

pneumotaxic center

Back 227

regulates change from inhalation to exhalation

Front 228

apneustic centers

Back 228

sends signals to dorsal respiratory center in medulla to delay switch off signal of inspiratory ramp provided by pneumotaxic center of pons; controls intensity of breathing

Front 229

medulla oblongata

Back 229

most caudal element of BS; merges w/ SC

Front 230

pyramids

Back 230

anterior medulla; conduit for descending corticospinal tracts; from cortex to internal capsule through midbrain and pons = main motor tracts for voluntary mvmt of limbs; cross at medullary decussation

Front 231

pyramids cross at

Back 231

medullary decussation- signals to opp side of body

Front 232

olives

Back 232

lateral to pyramids in medulla; oval swellings overlying olivary complex- modulates motor activity as major source of input to cerebellum

Front 233

CNs in medulla

Back 233

CN IX- XII except for accessory

Front 234

what lies posterior to pyramids

Back 234

fasiculus gracilis (LE) and cuneatus (UE)

Front 235

respiratory center

Back 235

located in medulla; receives controlling signals of neural, chemical, and hormonal nature and controls rate and depth of respiratory mvmts of diaphragm and other respiratory muscles

Front 236

injury to respiratory center

Back 236

may lead to center respiratory failure, which necessitates mechanical ventilation; poor px

Front 237

inspiratory center

Back 237

located w/in dorsal of medulla and appears to be physiologically most important brainstem center responsible for coordinating respiration

Front 238

pneumotaxic center

Back 238

located in upper portion of pons and primarily acts to raise respiratory rate but reducing inspiratory volume

Front 239

expiratory center

Back 239

located in ventrum of medulla and appears to primarily activate rectus abdominis and other expiratory muscles detailed in breathing biomechanics

Front 240

reticular formation

Back 240

set of interconnected nuclei that are located throughout BS; not anatomically well defined; crucial role in maintain behavioral arousal and consciousness

Front 241

ascending reticular formation/reticular activating system

Back 241

sleep-wake cycle, alertness

Front 242

descending reticular formation

Back 242

involved in posture and equilibrium as well as ANS activity; receives info from hypothalamus; plays role in motor mvmt; gives rise to reticulospinal tract

Front 243

neurotransmitter systems in brainstem

Back 243

neurons using specific NTs that project to widespread areas in CNS and play role in wakefulness, consciousness, play, reward, addiction, motivation, emotion

Front 244

locus coerulus is nucleus

Back 244

in pons; principal site for brain synthesis of NE; important in attention and w/ physiological responses to stress and pain

Front 245

serotonergic system has neurons located in

Back 245

raphe nuclei; regulation of mood, appetite, sleep, wakefulness, aggression, memory/learning

Front 246

SC extends from

Back 246

foramen magnum to L1/L2

Front 247

SC contains cell bodies of ____ nerves that send signals to skeletal muscles (lower motor neurons) and signals to visceral smooth muscle

Back 247

motor

Front 248

3 major fxns of SC

Back 248

-conduit for motor info to periphery

-conduit for sensory info from periphery

-center for coordinating reflexes

Front 249

upper motor neurons

Back 249

do not leave CNS; descending white matter tracts that originate in motor nuclei in motor cortex or BS

Front 250

lower motor neurons

Back 250

tracts carry info to motor nuclei in grey matter of SC; innervate skeletal muscle, smooth muscle, visceral organs

Front 251

central pattern generators (CPGs)

Back 251

neural networks that can produce rhythmic patterned outputs w/o rhythmic sensory or central input; underlie production of most rhythmic motor patterns e.g. locomotion and breathing

Front 252

31 segments of SC

Back 252

8 C, 12 T, 5 L, 5 S, 1 Co

Front 253

in thoracic and upper lumbar regions, difference btw veterbrae and SC level

Back 253

3 segments

Front 254

conus medullaris

Back 254

most distal bulbous part of SC

Front 255

filum terminale

Back 255

pia mater continues as extension, which anchors SC to coccyx

Front 256

anterior median fissure

Back 256

divides anterior SC in 1/2

Front 257

anterior commissure

Back 257

some motor and sensory fibers cross midline

Front 258

posterior median fissure

Back 258

separates post cord into 2 halves

Front 259

posterolateral sulcus

Back 259

marks entry of posterior rootlets carrying sensory info from periphery

Front 260

anterolateral sulcus

Back 260

marks exit of anterior rootlets carrying motor commands

Front 261

anterior (ventral) horn SC

Back 261

motor; contains cell bodies of lower motor neurons + renshaw cells; large in C and L regions since have lower motor neurons for muscles in UE and LE

Front 262

Renshaw cells

Back 262

regulate activity of motor neurons that supply fibers of skeletal muscle

Front 263

cervical enlargement

Back 263

C5-L1

Front 264

lumbar enlargement

Back 264

L1-S3

Front 265

posterior (dorsal) horn SC

Back 265

sensory; gray matter consists of interneurons that are responsible for first level integration of sensory info primarily related to pain

Front 266

rexed laminae

Back 266

info coming into grey matter of SC is arranged in lamina

Front 267

lateral horn of SC

Back 267

visceral motor cells of ANS; only pronounced in T spine

T1-L2 = sympathetic

S2-S4 = para

Front 268

white matter of SC

Back 268

contain tracts which are composed of axons of neurons

Front 269

dorsal columns

Back 269

posterior white matter of SC; afferent sensory info about touch and conscious proprioception

Front 270

fasiculus gracilis

Back 270

carries info from LE

Front 271

fasiculus cuneatus

Back 271

carries info from UE

Front 272

spinothalamic tracts

Back 272

afferent info about pain and temp; lateral white matter of SC

Front 273

lateral corticospinal tract

Back 273

conveys efferent motor command to LMNs; lateral white matter SC

Front 274

spinocerebrellar tracts

Back 274

conveying unconscious proprioceptive info to cerebellum; lateral white matter SC

Front 275

anterior corticospinal tract

Back 275

anterior white matter SC; motor commands

Front 276

ratio of grey and white matter by level in SC

Back 276

upper segments = large amount of white matter

lower segments = less white matter

Front 277

spinal nerve

Back 277

consists of posterior and anterior roots which come together in IV foramen to form spinal nerve; contains sensory and motor and ANS info

Front 278

sensory info enters SC via dorsal rootlets to post horn at

Back 278

posterolateral sulcus

Front 279

cell bodies of all sensory nerves located in

Back 279

dorsal root ganglion

Front 280

motor info leaves SC via ventral rootlets at

Back 280

anterolateral sulcus

Front 281

cauda equina syndrome

Back 281

loss of fxn of lumbar plexus of spinal canal below conus medullaris of SC; lower motor neuron lesion; reveals characteristic pattern of NM and urogenital sx's resulting from simultaneous compression of multiple lumbosacral nerve roots below level of conus medullaris; LBP, sciatica, saddle sensory loss, bladder and bowel dysfxn; LE motor and sensory loss

Front 282

epidural anesthesia

Back 282

applied in epidural space; nerve roots entering or exiting SC have to pass thru this space and can be anesthetized by local anesthetic that blocks Na channels

Front 283

spinal anesthesia

Back 283

drugs admin into subarachnoid space and also block nerve rootlets entering SC

Front 284

limbic system composed of

Back 284

limbic lobe + limbic structures

Front 285

limbic system comprised of neural structures for

Back 285

reward, emotions and memory and learning

Front 286

t/f: most psych conditions involve dysfxn of limbic system

Back 286

true

Front 287

limbic cortex

Back 287

located on medial surface of frontal, parietal, and temporal lobes and consists of cingulate gyrus

Front 288

cingulate gyrus

Back 288

receives info from thalamus and has 3 areas: rostral, middle portion, and posterior portion

Front 289

rostral portion of cingulate gyrus

Back 289

emotions; emotional responses to pain

Front 290

middle portion of cingulate gyrus

Back 290

aspects of mvmt control drive by emotions and reward

Front 291

posterior portion of cingulate gyrus

Back 291

memory

Front 292

what area of cingulate gyrus associated w/ depression is target area of therapeutic brain stimulation?

Back 292

genu

Front 293

parahippocampal gyrus

Back 293

inferior temporal lobe; provides info to hippocampal formation; encodes new memory and recall of visual scenes

Front 294

entorhinal cortex

Back 294

anterior parahippocampal gyrus adjacent to hippocampal formation; delivers sensory and cognitive info from association cortices to hippocampal formation

Front 295

uncus

Back 295

bulge on surface of parahippocampal gyrus; seizures often begin here and brain can herniate here

Front 296

orbitofrontal gyrus

Back 296

central to reward and decision making; receives info from all sensory modalities and from subcortical reward centers (limbic and BG) and integrates them for decision making

Front 297

lesions in orbitofrontal gyrus

Back 297

personality changes like social withdrawal

Front 298

hippocampal formation

Back 298

continuation of parahippocampal gyrus and extends s C shaped structure = fornix; coordinates info from variety of sources and connects to fornix and from there to many areas of brain; long term consolidation of explicit memories (facts and ongoing events), spatial navigation

Front 299

posterior hippocampal formation

Back 299

memory, cognition, spatial memory

Front 300

anterior hippocampal formation

Back 300

stress and emotions

Front 301

output neurons from hippocampal formation collect to form this contact bundle of fibers on surface that project to other subcortical telencephalic (BG and amygdala) and diencephalic structures (thalamic)

Back 301

fornix

Front 302

mammillary bodies

Back 302

terminals of anterior arches of fornix

Front 303

injury to mammillary bodies

Back 303

amnesia, from thiamine deficiency

Front 304

Wernicke korsakoff syndrome

Back 304

impaired memory, thiamine deficiency from alcoholism, damage to mammillary bodies

Front 305

cingulum

Back 305

bundle of axons that runt through cingulate gyrus from cortical association areas to hippocampal formation

Front 306

amygdala

Back 306

emotions and emotional memory and overt behavioral expressions; almond shaped; visceral response to emotional stimuli; fear conditioning; contribute to substance abuse by organizing drug seeking behaviors through reward circuits; olfactory perception

Front 307

damage to amygdala

Back 307

-loss of ability to recognize affective meaning of facial expressions

-loss of ability to recognize emotional content of speech

-decreased emotional regulation particularly in relation to fear

Front 308

insula

Back 308

potion of cerebral cortex folded deep w/in lateral fissure; involved in consciousness and play role in diverse function linked to emotion or regulation of homeostasis; processes info relating to pain perception and contributes to emotional response to pain

Front 309

complex pathways connecting limbic system to what 3 effector organ systems responsible for behavioral expression of emotion?

Back 309

endocrine (hypothalamus), autonomic system (visceral response of emotion), somatic motor (flight/fight)

Front 310

damage to hippocampus/amygdala

Back 310

changes in memory fxn, changes in emotional behavior, seizures

Front 311

3 important circuits of BG

Back 311

mvmt, cognitive, emotional (reward)

Front 312

NT produced in BG

Back 312

DA

Front 313

delivery of blood to brain is fxn of

Back 313

SBP and CO

Front 314

reductions in brain O2 beyond critical minimum results in

Back 314

immediate behavioral changes, lethargy, coma

Front 315

entire brain gets its blood from what 2 paired sets of arteries

Back 315

vertebral arteries (post), internal carotid arteries (anterior)

Front 316

vertebral arteries and internal carotid arteries joint together on inferior surface of brain to form

Back 316

Circle of willis

Front 317

vertebral arteries arise from

Back 317

subclavian arteries that arise from aorta and brachiocephalic trunk; travel in foramen in C transverse processes and enter cranium though foramen magnum; joint to form basilar artery

Front 318

most common site for large vessel occlusion

Back 318

Carotid T-jxn (where internal carotid branches into anterior and middle cerebral arteries)

Front 319

branches from vertebro basilar system

Back 319

anterior spinal a, post inferior cerebellar a, pontine arteries, anterior inferior cerebellar a, superior inferior cerebellar a, posterior cerebral a

Front 320

branches from internal carotid system

Back 320

anterior cerebral a, opthalamic a, middle cerebral a, anterior communicating a, posterior communicating a

Front 321

posterior cerebral artery supplies

Back 321

inferior temporal lobe to occipital mpole

Front 322

anterior cerebral artery supplies

Back 322

medial surface of hemispheres to about level of corpus callosum

Front 323

middle cerebral artery supplies

Back 323

pre-sylvian cortex

Front 324

damage to middle cerebral artery

Back 324

inability to repeat words and phrases; clot came from ICA

Front 325

diencephalon, BG, internal capsule receive blood from

Back 325

internal carotid, 3 cerebral arteries, posterior communicating artery

Front 326

thrombi tend to develop in

Back 326

heart, aorta, just distal to common carotid artery bifurcations, in vertebral arteries just before they join as basilar a, prox half of basilar a, perforating micro vessels of cerebrum and brainstem

Front 327

emboli from heart tend to lodge where

Back 327

bifurcation points (external and internal carotids), or tend to move into largest and least angled branch (e.g. almost always MCA)

Front 328

lacunar infarct

Back 328

when small or penetrating blood vessel develops atheroma, there is poor connection btw various microvasculature networks, and this small infarct develops

Front 329

what structures do vertebrobasilar system perfuse

Back 329

medulla, cerebellum, pons, midbrain, thalamus, occipital cortex

Front 330

t/f: occlusion of large vessels in vertebrobasilar arterial system usually lead to major disability or death

Back 330

true; vetebrobasial stroke = 85% mortality rate

Front 331

what provides primary vascularization of SC?

Back 331

vertebral arteries and ten medullary arteries that arise from segmental branches of aorta

Front 332

ten medullary arteries joint to form

Back 332

anterior and posterior spinal arteries

Front 333

loss of posterior supply to SC results in

Back 333

loss of sensory fxns

Front 334

loss of anterior supply to SC results in

Back 334

impaired motor functions

Front 335

at level of medulla, vertebral arteries give off 10-12 branches that merge to form the anterior spinal artery... what are they called

Back 335

medullary arteries

Front 336

artery of adamkiewicz (aka artery radicularis magna)

Back 336

largest anterior segmental medullary artery; provides major blood supply to lumbar and sacral cord

Front 337

damage to artery of adamkiewicz

Back 337

anterior spinal artery syndrome, w/ loss of urinary and fecal continence and impaired motor fxn of legs; sensory fxn often preserved to a degree

Front 338

Rexed lamina II

Back 338

substantia gelatinosa; important in modulation of pain and sensation

Front 339

Rexed lamina III and IV

Back 339

aka nucleus proprius; conscious proprioception and touch

Front 340

clarke's nucleus involved with

Back 340

unconscious proprioception

Front 341

afferents of fine touch

Back 341

A- beta

Front 342

afferents of course touch

Back 342

A-delta

Front 343

afferents of fast pain

Back 343

A-delta

Front 344

afferents of slow pain

Back 344

C fibers

Front 345

afferents of warm temp

Back 345

C fibers

Front 346

afferents of cold temp

Back 346

A-delta

Front 347

afferents of muscle spindles

Back 347

Ia, II

Front 348

afferents of GTOs

Back 348

Ib

Front 349

afferents of joint receptors

Back 349

A-beta

Front 350

crude touch follows what pathway?

Back 350

ventrolateral pathway (anterior spinothalamic tract)

Front 351

3 projection pathways of slow pain

Back 351

spinomesencephalic (PAG, pain mod), spinoreticular (awareness), spinolimbic (emotional)

Front 352

pain and temp follow what pathways

Back 352

anterolateral systems

Front 353

unconscious proprioception follows what pathway

Back 353

spinocerebellar (LE = post spinocerebellar, UE = cuneocerebellar)