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173 Cards in this Set

  • Front
  • Back
Telencephalon Components
frontal lobe
parietal lobe
temporal lobe
occipital lobe
limbic lobe
basal ganglia
internal capsule
lateral ventricles
Diencephalon Components
epithalamus
thalamus
hypothalamus
subthalamus
third ventricle
Five Stages of Nervous System Embryology
neurulation
cell proliferation
migration
axon/dendrite formation
synaptogenesis
When does differentiation of the nervous system 1st occur? What induces differentiation?
21 days
notochord initiates diff...no notochord = embryo does not survive
What is the neural tube? How does it form?
-tube develops into the CNS
-neural plate margins elevate forming a groove, which then closes off forming neural tube
What is the neural crest?
-neural crest develops into the PNS
-it is a differentiation of cells at the lateral edge of folds during tube formation
What results from defects in neurulation?
-posterior neuropore = spina bifida, 4 categories
-anterior neuropore = non-viable fetus
Spina Bifida Occulta
-bony defect, no neural involvement
-may lead to LBP later in life
Spina Bifida Meningocele
-sac protruding from spinal cord containing meninges
Spina Bifida Myelocele
-spinal cord protrusion
Spina Bifida Myelomeningocele
-sac containing meninges and cord
How does cell proliferation begin within the neural tube?
-sulcus limitans divides into the dorsal alar plate (sensory) and ventral basal plate (motor)
What 3 layers are formed as new cells proliferate?
-germinal
-intermediate or mantle
-marginal
What does the germinal layer develop into?
-lining of central canal and ventricles
-its the inner layer
-ciliated for CSF mvmt
What does the intermediate layer develop into?
-gray matter of spinal cord
What does the marginal layer develop into?
-white matter of the SC
How does growth of the nervous system occur? (not cell division)
-dendrite growth
-axon growth
-vascularization
-myelination
-synapse development
What are the two forms of post-mitotic cell migration?
-radial migration
-tangential migration
How and where does radial migration occur?
-radial glial cells allow neuroblast cells to climb using chemotaxic adhesion molecules
-occurs from spinal cord thru telencephalon
How and where does tangential migration occur?
-uses existing axons in addition to radial glial cells to reach destination
-occurs mostly in brainstem
What are 4 consequences of migration defects?
-dyslexia
-lissencephaly
-microencephaly
-macrogyria
How does cell differentiation occur?
-genetic material intrinsic to the cell is triggered by local extracellular chemicals stimulating growth of axon/dendrites
-dendrites usually grow after axon has reached its destination
What is the fetus' first motor response?
-oral primitive avoidance reflex
-mouth stimulated fetus turns head and squints eyes
What is the order of cranial nerve development?
5, 7, 9, 11, 10, 12, 2, 3, 4, 6, 7, 1
How does synaptogenesis occur? Why is it important?
-at NM jxn, growth cone develops vesicles for neurotransmitter, then pre/postsynaptic membrane thicken and specialize for release/reception
-important with information transfer=> PERMANENT LEARNING
What structure separates the right and left hemispheres? Hemispheres from cerebellum?
-R/L=> falx cerebri
-H/Cerebellum=> tentorium cerebelli
What foramen connects the lateral ventricles to the third ventricle?
-interventricular foramen or foramen of munro
What foramen connects the third and fourth ventricles?
-cerebral aquaduct
How does CSF leave the tent-shaped fourth ventricle?
-lateral = foramen of von luschka
-medial = foramen of magendie
-inferior = central canal
What are three ways hydrocephalus can occur?
-CSF blockage
-excess CSF production
-insufficient CSF reabsorption
What is the confluence of sinuses? How does blood exit the brain?
-site where superior sagittal, inferior sagittal and straight sinuses converge
-confluence -> sigmoid -> internal jugular vein
What is the significance of the cavernous sinus?
-sits on the sella turcica and surrounds the pituitary and CN 3,4,5,6, and the internal carotid artery
-blockage can affect any of above structures
How is the blood-brain/CSF barrier maintained?
-tight jxns of capillary endothelium/choroid plexus which prevents macromolecules from entering
-lipid soluble molecules can cross
Name 4 substances that have higher uptake into the brain.
-tetracyclines
-atropine
-glucose
-L-DOPA
Name 3 substances that have low uptake in the brain.
-norepinephrine
-dopamine
-penicillin
What are the subdivisions of the diencephalon?
-epithalamus
-thalamus
-hypothalamus
-subthalamus
-internal capsule
What are the functions of the thalamus?
-integration and relay of sensory info (-olfac)
-integration and relay of motor control info from cerebellum & basal ganglia to motor cortex
-sensory/motor info gate
-consciousness state brainstem to cortex
What is the function of the ventral posteromedial nucleus?
-SENSORY input from FACE & HEAD
What is the function of the ventral posterolateral nucleus?
-SENSORY input from the BODY
What is the function of the ventral anterior and ventral lateral nuclei?
-MOTOR CONTROL integration and relay
What is the function of the lateral geniculate nucleus?
-integration and relay of VISUAL info
What is the function of the medial geniculate nucleus?
-integration and relay of AUDITORY info
What is the function of the lateral dorsal nucleus?
-association TOUCH info to LIMBIC LOBE
What is the function of the lateral posterior nucleus?
-association relaying PAIN
What is the function of the pulvinar nucleus?
-integration and relay of MOVEMENT & PROPRIOCEPTION
What is the function of the reticular nucleus?
-integrates and relays STATE of CONSCIOUSNESS info
What is the internal capsule?
-white matter that funnels corticospinal, corticobulbar, corticothalamic, & thalamocortical fibers to their destinations
What is the corona radiata?
-ascending fibers RADIATING OUT from the INTERNAL CAPSULE
What processes does the hypothalamus regulate?
-ANS
-CV
-temperature
-energy metabolism
-fluid balance
-sleep cycle
What are the components of the epithalamus?
-habenular nuclei
-pineal gland
-posterior commissure
What is the function of the habenular nuclei?
-NOSTALGIC SMELLS; receive input from olfactory and limbic systems and transmit to ANS
What is the function of the pineal gland?
-delays the onset of puberty
-calcifies in adulthood and acts as an imaging landmark
What condition can occur with lesion to the subthalamic motor nuclei?
-hemiballismus =>rapid flailing movements unilaterally
What are the major sulci and fissures of the cerebrum?
-longitudinal cerebral fissure
-lateral sulcus
-central sulcus
-parieto-occipital sulcus
-calcarine sulcus
What information does the frontal lobe monitor?
-personality
-behavior
-higher intellect
-primary voluntary motor
What information does the parietal lobe monitor?
-general sensation perception
-spatial perceptions and inter-relationships
-interacts w/ motor area
What information does the occipital lobe monitor?
-visual stimuli
What information does the temporal lobe monitor?
-integrates memory
-hearing, taste and smell
-deep lobe visual fibers
What information does the limbic lobe monitor?
-short term memory
-emotions
What is the function of the Basal Ganglia?
-motor learning
-help initiate and support successful execution of movement
What components make up the Basal Ganglia?
-caudate nucleus
-putamen
-globus pallidus internus
-globus pallidus externus
Name 3 types of white matter fibers.
-projection fibers
-commissural fibers
-association fibers
What is the function of projection fibers?
-connect cortical areas to subcortical areas
ex: internal capsule/corona radiata
What is the function of commissural fibers?
-allow communication b/n hemispheres
ex: corpus callosum, anterior and posterior commissures
What is the function of association fibers?
-connect cortical regions w/in the same hemisphere
What artery supplies the caudate, putamen and internal capsule?
-middle cerebral
What artery supplies the thalamus?
-posterior cerebral
What arteries supply the pons?
-basilar
-AICA
-superior cerebellar
What arteries supply the medulla?
-vertebral
-anterior spinal
-posterior spinal
-PICA
-basilar
What arteries supply the midbrain?
-posterior cerebral
-superior cerebellar
-basilar
What arteries supply the cerebellum?
-superior cerebellar
-AICA
-PICA
Define Infarct.
-coagulation necrosis due to local ischemia commonly caused by thrombus/embolus
What is a Transient Ischemic Attack?
-arterial blood vessel changes briefly that causes noticeable neurologic changes: vision loss, numbness in distal extremities. Complete recovery w/ no permanent damage. Sroke warning sign
What is aphasia?
-loss of language (left hemi)
What is apraxia?
-difficulty performing learned movements w/out loss of power, sensation or coordination
What is agnosia?
-loss of ability to recognize importance of sensory stimuli
Ex: tactile agnosia = inability to recognize objects by touch
According to the rule of 2's, the brain:
-makes up 2% bodyweight
-uses 20% oxygen intake
-uses 25% glucose intake
-15% cardiac output goes to the brain
What symptoms are common w/ anterior cerebral artery occlusion?
-severe hemiplegia of contra LE
-some sensory loss to contra LE
-personality change
-urinary incontinence
-apraxia
What symptoms are common w/ middle cerebral artery occlusion?
MOST COMMON
-contra hemiplegia/paresis/paresthesis to UE and face most severely
-homonymous hemianopsia
-tract involvement
What symptoms are more likely to be seen w/ L sided MCA occlusion?
-motor and sensory speech
What symptoms are more likely to be seen w/ R sided MCA occlusion?
-dyspraxia/apraxia
-neglect syndromes
What symptoms are common w/ posterior cerebral artery occlusion?
-visual and perceptual deficits
-thalamic syndrome: contra hemianesthesia, hemichorea, and central px. Px is deep lancinating.
-high suicide rate among PCA occlusion pts
Lesions to what basal ganglia structure leads to Parkinson's Disease?
-substantia nigra
-80% degeneration/impact occurs before symptoms (tremor/bradykinesia) evident
List the components of the Midbrain
-medial lemniscus
-medial longitudinal fasciculus
-red nucleus
-CN III, IV nuclei
-reticular formation
-periaquaductal grey
-substantia nigra
-superior & inferior colliculi
What is the Medial Longitudinal Fasciculus?
-tract allowing brainstem nuclei to communicate with one another
What is the function of the Red Nucleus?
-relays cerebellar info and initiates rubrospinal pathway
What is the function of the Medial Lemniscus?
-sensory tract up to thalamus
What is the function of the Reticular Formation?
-increase or decrease level of consciousness
What is the function of the Periaquaductal Grey Area?
-plays a role in pain regulation
List the components of the Pons
-medial lemniscus
-medial longitudinal fasciculus
-reticular formation
-CN V, VI, VII, VIII nuclei
-middle cerebellar peduncle
List the components of the Open Medulla
-pyramids
-inferior olivary nucleus
-medial lemniscus
-medial longitudinal fasciculus
-reticular formation
-CN IX, X, XI, XII nuclei
-floor of 4th ventricle
List the components of the Closed Medulla
-gracile fasciculus and tubercle
-cuneate fasciculus and tubercle
-central canal
-pyramidal decussation
What is the function of the Cuneate Fasciculus/Tubercle?
-carries ascending sensory info from the UE
What is the function of the Gracile Fasciculus/Tubercle?
-carries ascending sensory info from the LE
What is the function of the cerebellum?
-sequence muscle contractions during complex rapid mvmts
-compares intended mvmt with actual
-plays role in motor learning
What is the importance of the Flocculonodular Lobe?
-involved in balance
Where is the olfactory cortex?
-amygdala/hippocampus
What is anosmia?
-inability to smell
What CNs pass through the superior orbital fissure?
-trochlear n
-trigeminal n (opthalmic, V1)
-oculomotor n
-abducens n
What Structures pass through foramen rotundum?
trigeminal n (maxillary, V2)
What structures pass through the optic canal?
-optic n
-opthalmic a
What structures pass through foramen ovale?
-trigeminal n (mandibular, V3)
What structures pass through foramen spinosum?
-middle meningeal a & v
What structures pass through the jugular foramen?
-glossopharyngeal n
-vagus n
-spinal accessory n
-transverse sinus
What structures pass through the foramen magnum?
-medulla & meninges
-spinal accessory n
-vertebral a
-anterior spinal a
-posterior spinal a
What is the pathway of the optic nerve?
-nasal retinal fields->cross at chiasm->lateral geniculate body->contra visual cortex
-temporal retinal fields->do not cross at chiasm->lateral geniculate body->ipsi visual cortex
*some fibers to pretectal nucleus & superior colliculus for light reflex
What is the pathway of the oculomotor nerve?
-oculomotor nucleus->cavernous sinus->SOF->eye muscles
What is the pathway of the Pupillary Reflex?
-optic nerve->pretectal nucleus
-pretectal->edinger-westphal & other pretectal via posterior commissure
-CN III parasympathetic (from E-W)->ciliary ganglion
-ganglion->ciliary muscles causing pupil constriction
What are the direct and consensual responses of the pupillary reflex?
-direct = ipsi constriction
-consensual = contra constriction due to crossover in posterior commissure
What does the accomodation & convergence reflex allow?
-accomodation = change lens shape and constrict pupil
-convergence = move eyes medially to focus on near objects
What is the accomodation/convergence reflex pathway?
-CN II->lat geniculate-> visual cortex->superior colliculus->
1)EW->ciliary ganglion-> pupil constriction & lens thickens
2)oculomotor nucleus-> medial rectus -> eye moves medially
What is the pathway of the trochlear nerve?
-trochlear nuclei (periaquaductal grey @ inf colliculus)->cavernous sinus-> SOF->superior oblique muscle-> eye moves down/lateral
What is the pathway of the abducens nerve?
-nuclei in pons near facial colliculus-> cavernous sinus -> SOF -> lateral rectus muscle -> eye moves laterally
What are the four nuclei of the trigeminal nerve? Where are they located?
-motor nucleus
-principle sensory nucleus
-spinal nucleus
-mesencephalic nucleus
all found in the pons
What are the 3 sensory divisions of the trigeminal nerve? Where do they exit the skull? What portions of the face do they innervate?
-opthalmic -> SOF -> forehead/anterior scalp
-maxillary -> rotundum -> temple/upper cheek
-mandibular -> ovale -> mandible/lower cheek/chin
Where does the motor portion of the trigeminal nerve leave the skull and what does it innervate?
-exits through ovale; innervates muscles of mastication
What is the pathway of the corneal reflex?
-cotton touched to cornea -> opthalmic (V1) -> spinal nucleus -> medial longitudinal fasciculus -> VII motor nucleus -> orbicularis oculi causing blink
What is trigeminal neuralgia? What are common pain descriptions? Possible causes?
-px in CN V distribution, usually V2/V3
-usually intense burning/stabbing px
-nerve irritation, tumor or MS
What are the three nuclei of the facial nerve? Where are they found?
-motor
-superior salivatory (PS)
-solitary (sensory)
-pons
What muscles are innervated by the motor nucleus of the facial nerve?
-muscles of facial expression
-eyelid closing
-stapes control
What structures are innervated by the superior salivatory nucleus of the facial nerve?
-submandibular and sublingual saliva glands
-lacrimal glands
-glands of oral and nasal cavities
What symptoms are possibly seen with lesion to the facial nerve?
What is Bell's Palsy?
-loss of taste to anterior tongue
-decreased corneal reflex
-face muscle weakness
-drooping of ipsilateral side of the face caused by damage to CN VII
What are the three nuclei of the glossopharyngeal nerve? Where are they located?
-nucleus ambiguus
-inferior salivatory nucleus (PS)
-solitary nucleus (sensory)
-medulla
What structures do each of the 3 nuclei from CN IX innervate?
-motor -> stylopharyngeus m. for swallowing
-solitary -> posterior tongue for taste, pharynx mucus membrane
-inf salivatory -> parotid gland
What may occur with lesion to the glossopharyngeal nerve?
-loss of taste to posterior tongue
-loss of gag/swallowing reflexes
-dysphagia
What are the three nuclei of the vagus nerve? Where are they found?
-motor
-solitary (sensory)
-parasympathetic
-some contribution from nucleus ambiguus
-medulla
What are the functions of each vagal nuclei?
-solitary -> taste to palate/epiglottis
-motor -> muscles of larynx, pharynx & upper esophagus for speaking & swallowing
-parasympathetic -> afferent/efferent info from heart, lungs, esophagus, and GI tract
What muscles are innervated by the spinal accessory nerve? Where is the nucleus found?
-SCOM, upper trapezius and muscles that elevate the larynx during swallowing
-nucleus found in the cervical spinal cord
What structures does the hypoglossal nerve control? Where is the nucleus found?
-muscles of the ipsilateral tongue
-medulla
How will lesions to the hypoglossal nerve manifest?
-weakness of the tongue showing ipsilateral deviation
-dysarthria (speech disorder)
-dysphagia
What cranial nerves and major vessels are found in the cavernous sinus? How could enlargement of blood vessels manifest?
-III, IV, V1, VI, internal carotid a.
-problems w/ eye mvmt
What are the four categories of neurons in the spinal cord?
-sensory
-interneuron
-motor
-preganglionic
What is the function of the marginal zone?
-receives sensory input such as pain and temp and transmits it to the contra spinothalamic tract
What is the function of the substantia gelatinosa? Where is it located?
-synapse with cells in rest of dorsal horn that form ascending pathways for px and temp
-apex of dorsal horn
What is the function of the nucleus proprius? Where is it located?
-receive input from dorsal afferents and descending tracts
-cross midline to form contra spinothalamic tract
-between substantia gelatinosa and nucleus dorsalis
*largest nucleus of dorsal horn
What is the function of the nucleus dorsalis? Where is it located?
-provides info about unconscious proprioception
-receive input from spindle & GTO
-anteromedial to nucleus proprius in dorsal horn
What is the function of the visceral afferent nucleus? Where is it located?
-interneurons receiving input from visceral sensory info
-just lateral to nucleus dorsalis
What comprises the lateral horn? What levels of the spinal cord is it found in?
-small visceral preganglionic motor neurons for ANS
-found between T1-L2, S2-S4
What does the ventral horn consist of? How is it organized? How many columns does it have?
-alpha MN, gamma MN, inhibitory interneurons called Renshaw cells
-somatotopic organization
-2 columns: ventromedial and dorsolateral
What do the cells of the ventromedial column innervate?
-neck and trunk muscles
What do the cells of the dorsolateral column innervate? Where is it prominent? How are the cells organized?
-UE and LE
-cervical and lumbar spine
-somatotopic organization with nuclei for proximal muscles = medial; nuclei for distal muscles = lateral
What are the boundaries of the white matter dorsal column?
-medial = dorsal median sulcus
-lateral = entry of dorsal roots
What are the boundaries of the white matter lateral column?
-between dorsal and ventral roots
What are the boundaries of the white matter ventral column?
-between ventral roots and ventral median fissure
What tracts comprise the white matter dorsal column? Are they ascending or descending?
-fasciculus gracilis
-fasciculus cuneatus
-ascending
What tracts comprise the white matter lateral column? Are they ascending or descending?
ASCENDING: dorsal spinocerebellar, ventral spinocerebellar, lateral spinothalamic, spinotectal
DESCENDING: lateral corticospinal, rubrospinal, reticulospinal, lateral vestibulospinal
What tracts comprise the white matter ventral column? Are they ascending or descending?
ASCENDING: ventral spinothalamic
DESCENDING: anterior corticospinal, medial vestibulospinal, reticulospinal, tectospinal, medial longitudinal fasciculus
What info is carried by the fasciulus gracilis? Fasciculus cuneatus? What column are they found in?
FG: LE sensory
FC: UE sensory
-dorsal column
What info does the dorsal spinocerebellar tract carry? Where is it found?
-unconscious proprioception
-lateral column
What info does the ventral spinocerebellar tract carry? Where is it found?
-unconscious proprioception
-lateral column
What info does the lateral spinothalamic tract carry? Where is it found?
-px and temp
-lateral column
What info does the spinotectal tract carry? Where is it found?
-orient vision and hearing to the body
-lateral column
What info does the lateral corticospinal tract carry? Where is it found?
-voluntary motor control
-lateral column
What info does the rubrospinal tract carry? Where is it found?
-fine motor control (hand)
-lateral column
What info does the reticulospinal (medullary) tract carry? Where is it found?
-changes in muscle tone in response to consciousness
-lateral column
What info does the lateral vestibulospinal tract carry? Where is it found?
-increases extensor muscle tone
-lateral column
What info does the ventral spinothalamic tract carry? Where is it found?
-itch and tickle path
-ventral column
What info does the anterior corticospinal tract carry? Where is it found?
-uncrossed voluntary motor control
-ventral column
What info does the medial vestibulospinal tract carry? Where is it found?
-affects muscle tone
-ventral column
What info does the reticulospinal (pontine) tract carry? Where is it found?
-affects muscle tone
-ventral column
What info does the tectospinal tract carry? Where is it found?
-vision or hearing direct head and neck mvmt
-ventral column
What info does the medial longitudinal fasciculus tract carry? Where is it found?
-intercommunication for CNs
-ventral column
What is the function of the ventral white commissure?
-transverse fibers allow info to cross midline of the SC
What is the fasciculus proprius? What is its function?
-thin band of white matter surrounding the gray matter of the spinal cord
-connects spinal segments to allow intersegmental reflexes
What are the characteristics of a lower motor neuron lesion?
-muscle atrophy
-diminished/absent reflexes
-flaccid muscles
What is polyneuropathy? What are some potential causes?
-impairment of many peripheral nerves at the same time
-Guillan Barre, vitamin deficiency, heavy metal poisoning
Rank classification of nerve injuries from mild to severe.
1)neuropraxia
2)axonotmesis
3)neurotmesis
What are the characteristics of neuropraxia? What neurons are typically involved? What is the prognosis?
-mildest injury
-result of blunt blow, mild compression, or electric shock
-occurs in motor>sensory
-good prognosis
What are the characteristics of axonotmesis? What neurons are typically involved? What is the prognosis?
-some integrity lost, connective tissue still intact
-more severe crush/contusion
-usually involves motor and sensory
-recovery can occur
What are the characteristics of neurotmesis? What neurons are typically involved? What is the prognosis?
-most severe
-caused by severe stretch, contusion or laceration
-axon and CT are disrupted
-complete loss of motor, sensory and autonomic function
What is Wallerian degeneration? Orthograde degeneration? Retrograde degeneration?
-dying of an axon distal to the site of injury
-neurons communicating with the axon of the injured nerve degenerate
-neurons communicating with the body of the injured nerve degenerate
What changes does a muscle encounter when it is denervated?
=fasciculation -> fibrillation -> atrophy
What order are functions & sensations restored in regenerating nerve?
-px -> hot/cold differentiation -> light touch -> tactile discrimination -> voluntary motor