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72 Cards in this Set
- Front
- Back
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What makes up the Cerebral Cortex?
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-Lobes of the Brain
-Wernicke's Area -Broca's Area |
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Name the parts of the Diencephalon.
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-Basal ganglia
-Thalamus -Hypothalamus |
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What are the parts of the brainstem?
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-Midbrain
-Pons -Medulla |
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Where in the brain is the greatest amount of tissue?
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Cerebral Cortex
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What side of the brain is most dominant and in what percentage of the population does this occur?
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The LEFT in 95%, even those that are left handed
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Where is the gray matter in the brain and what is its function?
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-Outer portion
-For highest human function |
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Where is the white matter of the brain? What does it do?
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-Interior portion
-Neuronal axons (myelin) to allow impulses to move faster |
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What is the frontal lobe responsible for?
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-Personality
-behavior -emotion -intellectual -primary motor cortex |
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What occurs in the parietal lobe?
In the occipital lobe? |
-Parietal: primary sensory cortex
-Occipital: visual reception |
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What does the temporal lobe do?
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-Hearing
-Taste -Smell |
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What is Broca's Area responsible for?
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Motor/Formation of speech
-Damage here= understanding what is said, but not able to verbalize |
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Where in the brains is the comprehension of speech regulated?
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Wernicke's area
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Where should you do a lumbar puncture?
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Below L2 (where the spinal chord ends
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What is the cerebellum aka?
What is its function? |
-"little brain"
-Coordination of voluntary movements --muscle tone -equilibrium -DOES NOT INITIATE MOVEMENT |
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Where do motor fibers cross in the brain?
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Pyramidal decussation
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What is the Basal Ganglia responsible for?
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-automatic/associated movements of the body (swinging arms while walking)
-Parkinson's damages this area |
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Where is the main relay station of the brain?
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The Thalamus
-sensory pathways from spinal/brainstem synapse here |
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What are the functions of the hypothalamus?
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-temperature
-sleep -pituitary regulation -some emotional status |
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What is the function of the medulla?
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-contains lower motor/sensory tracts
-Contains the vital autonomic centers (respiratory center, cardiac center etc) |
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What are the major motor pathways? What direction do they travel?
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-Descending Pathways
-Corticospinal or Pyramidal Tract -Extrapyramidal Tracts -Cerebellar system |
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What types of signals are sent along the corticospinal/pyramidal tract?
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-voluntary movements
-discrete and skilled movement ie writing |
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The extrapyramidal tract is comprised of what brain sections? What is its function?
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-Basal ganglia/ brainstem/ everything outside of the pyramidal
-Responsible for maintaining muscle tone and gross body movements ie WALKING |
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The "descending" cerebellar tract has what function?
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-coordinates movements
-maintains equilibrium -maintains posture -receives information about position of muscle and joints to keep equilibrium |
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What are the major sensory pathways? What direction do they travel?
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Ascending pathways
-Spinothalamic Tract -Posterior (Dorsal) Column Tract |
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Describe the function of the spinothalamic tract
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-transmits pain
-temperature crude/light touch -Goes into posterior route of the spinal chord, synapses and goes up to thalamus -actually a general quality or sensation (the cortex know the fine distinction of what is going on) |
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What is the posterior column tract used for?
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-position (up or down)
-vibrations and fine localized touch (you know what is in your hand without looking) -proprioception |
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What comprises the peripheral NS?
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-Cranial nerves
-spinal nerves -reflex arc |
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What is the Sensory function of the facial nerve?
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Taste
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What is the sensory function of the Vagus nerve?
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Pharynx and Larynx
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Does the vestibulochoclear nerve have a sensory portion?
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Yes, some sensation in the eardrum and ear canal
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What is the breakdown of the spinal nerves?
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-8 cervical
-12 thoracic -5 lumbar -5 sacral -1 coccyx |
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What comprises all spinal nerves?
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All have a motor and a sensory portion
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What are the dermatomes and what can they help diagnose?
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The map of spinal nerves as they correspond to areas of the body.
-Can detect which spinal nerves are damaged during sciatica, herpes zoster etc |
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What must be present for a reflex arc to function?
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-intact sensory nerve
-functioning synapse in the spinal chord -intact motor neuron -intact NMJ -competent muscle |
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What are the levels of consciousness?
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-Alert
-Lethargic -Obtunded -Stuporous -Comatose |
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What are the symptoms of being obtunded?
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-open eyes
-respond slowly -confused -no interest in the environment |
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What is stuporous?
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Only awake with painful stimulation "sternal rub"
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Describe comatose?
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Always un-arousable, even with pain
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What aspect of orientation is the first to leave?
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Time
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What type of memory is a problem for demented patients?
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short term memory
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Describe what takes place in Bell's Palsy?
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-Paralysis of CN7
-Cut of the peripheral nerve -Paralysis of all muscles on the SAME side of the face as cut CN7 -No nasolabial fold -cannot close eye -Eye ball rolls up and the eye stays open -Cannot raise eye or wrinkle forehead |
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How are the symptoms of the stroke different from bells palsy?
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-Cut occurs up in the cortex, not directly on the facial nerve
-Stroke can open/shut eye and wrinkle the forehead -Still paralyzed on half of the face -No nasolabial folds -Have drooping |
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What does it mean to have muscle atrophy?
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-small muscle
-not using the muscles -injury -lower motor neuron disease -muscle disease |
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Describe muscle hypertrophy
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-isometric muscle building,
-toning up |
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What are the 3 types of the muscle tone?
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-Flacid
-spastic -rigid |
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What is flacid muscle tone?
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-Decrease in muscle tone, limp
-limp -signs of polio or an early stroke |
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What is spastic muscle tone?
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-increase resistance to passive lengthening
-The more you move it, the tighter it gets -Late stroke or corticospinal tract injury |
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What is rigid muscle tone?
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-constant state of resistance
-damage to extrapyramidal tract -parkinsons -"cog wheel" rigidity |
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What should you inspect when it comes to the size of the muscle?
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Check that there is symmetry
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What occurs in the hands if you have a compression of cervical spinal column?
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Flattening of the hands
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What is fasciculation?
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Rapid twitching of a flacid muscle
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Describe a tick.
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Repetitive twitching of muscle and inappropriate time
-May be psychiatric |
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What is a benign essential tremor?
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Tremor that can spread all over.
-often runs in families |
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What are the 3 tests for the spinothalamic tract?
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-Pain
-Temperature -Crude touch |
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If a pt is able to detect pain, what can you assess for the spinothalamic tract?
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That it is in tact.
-You do not need to test temperature or crude touch |
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What are the tests of the posterior column tract?
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-Vibration
-Proprioception -Tactile discrimination |
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What is graphesthesia?
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Draw a number in the hand and have them tell you it with eyes closed
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what is stereognosis?
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Place an object in pts hand with eyes closed and have them identify it.
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Describe the 2 point discrimation test?
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use two pins, start far apart and bring them closer together until pt cannot tell there is 2 anymore
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What is the test for extinction?
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Test to see if the pt knows you are touching both of their hands.
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What are the 4 tests for tactile discrimination?
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-Graphesthesia
-Stereognosis -Two-point discrimination -Extinction |
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What tests are used to ***** coordination and skilled movements?
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-Rapid Alternating Movements
-Point-to-point movements |
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What are the tests for rapid alternating movements?
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-Middle finger to thumb
-Paddy Cake -Paddle feet |
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What is dysergia?
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Improper coordinated function of given muscle groups
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Describe dysmetria
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Inability to gauge properly the distance between two points or objects
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What walking function is affected in Parkinson's?
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They cannot spin
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How will a person who has suffered a stroke walk?
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They will swing their hips more
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What is a positive Babinski test? When should this occur?
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-When the toes curl up during a plantar reflex test
-should only occur in children up to 2 years old |
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When can a positive Babinski test be found in an adult?
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-Intoxicated
-drugs -can happen after a seizure |
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What are the ratings for reflexes?
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0= not present
1+ = diminished, "feel but not see 2+ = normal 3+ = brisk foot comes way out (may be normal or disease) 4+ = test for clonis |
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How do you test for clonus?
When do you use this? |
With pt supine, lift the knee and other hand on bottom of the foot
-will see cog wheel rigidity (rhythmic rigidity) -Use this when you get a 4+ on reflexes |
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How should you assess the pts language?
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Is the speech...
-fluent -hesitant -making sense? |
