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1054 Cards in this Set
- Front
- Back
|
why does the hypothalamus lack a blood-brain barrier?
|
because it requires a 'truthful' read of what is going on in the body in order to regulate the body
|
|
The nervous system is divided into what two systems?
|
Central
peripheral |
|
what does the endoneurium surround?
|
individual nerve fibers/cells
|
|
subclavius
|
O: costal cartilage of rib 1
I: inferior middle third of the clavicle A: stabilizes and depresses the clavicle |
|
what surrounds nerve fascicles?
|
perimeurium
|
|
what does the epineurium surround?
|
the entire nerve
|
|
why is a nerve considered an organ?
|
because it contains more than one type of tissue
|
|
the peripheral nervous system is divided into what two systems?
|
somatic nervous system
autonomic nervous system |
|
which general areas of nerves are the most vulnerable?
|
those at PNS/CNS junctions
superficial nerves |
|
external intercostals
|
O: inferior border of rib above
I: superior border of inferior rib A: elevate inferior rib |
|
how much of the body's mass is nerves?
|
2%
|
|
how much (%) of oxygen consumed is used by the nervous system?
|
20%
|
|
what makes up the central nervous system?
|
brain
spinal cord |
|
the neuronal membrane is more permeable to which ion?
|
potassium
|
|
which gates of the membrane open as a result of changes in membrane potential?
|
electrical
|
|
internal intercostals
|
O: superior border of rib below
I: inferior border of rib directly above A: depression of ribs / exhalation |
|
a reduction in membrane potential is also known as?
|
depolarization
|
|
both the somatic and the autonomic nervous systems subdivide into what two categories?
|
sensory
motor |
|
an increase in membrane potential is also known as?
|
hyperpolarization
|
|
what is neuronal threshold?
|
the minimal membrane potential required to initiate an action potential
|
|
where does an action potential usually occur/begin?
|
the axon hillock
|
|
transversus thoracis
|
O: xiphoid process, inferior aspect of sternum
I: costal cartilage of ribs 2 - 6 A: depress the ribs |
|
what is the conduction rate of a large diameter neuron?
|
fast
|
|
what is the conduction rate of a intermediate diameter neuron?
|
middle between large and small
|
|
which division of the peripheral nervous system is voluntary?
|
somatic
|
|
what is the conduction rate of a small diameter neuron?
|
slow
|
|
the motor division of the autonomic nervous system further divides into which two systems?
|
parasympathetic
sympathetic |
|
describe the myelination of small, intermediate and large diameter nerve fibers
|
large - myelinated
intermediate - lightly small - unmyelinated |
|
external oblique
|
O: external surface of ribs 5 - 12
I: linea alba, pubic tubercle, anterior half of iliac crest A: trunk flexion, contralateral rotation N: L1 : ilioinguinal, iliohypogastric ; intercostal nerves |
|
what is the function of large diameter nerve fibres?
|
somatic (sensory and motor)
|
|
Rest and digest is related to which nervous system division?
|
parasympathetic
|
|
what is the function of intermediate diameter nerve fibres?
|
autonomic
somatic - pain and touch |
|
which division of the peripheral nervous system is involuntary?
|
autonomic
|
|
what is the function of small diameter nerve fibres?
|
autonomic
somatic - pain and touch |
|
fight or flight is related to which nervous system division?
|
sympathetic
|
|
what are the three ways to classify synapses?
|
type of substance released
structural interneuron connections site of inhibition |
|
internal oblique
|
O: thoracolumbar fascia, anterior 2/3 of iliac crest, inguinal ligament
I: inferior aspect of ribs 10 - 12, linea alba, pubis A: trunk flexion, ipsilateral rotation N: L1 : ilioinguinal, iliohypogastric ; intercostal nerves |
|
what is the location of a graded potential?
|
dendrites
cell body |
|
what determines the intensity of the effect at the post synaptic membrane?
|
the number of APs reaching the terminal and the resulting amount of NTs released
|
|
which ion is responsible of excitation?
|
sodium
|
|
Which ions are responsible for inhibition?
|
chloride
potassium |
|
transversus abdominis
|
O: costal cartilages of ribs 7 - 12, thoracolumbar fascia, iliac crest, inguinal ligament
I: linea alba, pubic crest A: supports abdominal viscera, compresses abdominal contents N: L1 - ilioinguinal, iliohypogastric ; intercostal muscles |
|
what causes synaptic delay?
|
release of NTs
diffusion binding |
|
what are the four types of supporting cells in the CNS?
|
astrocytes
microglia ependymal cells oligodendrocytes |
|
what is synaptic potentiation?
|
continuous use of neuronal pathway leads to greater than expected APs
|
|
which pathway is related to the sensory divisions of the peripheral nervous system?
|
afferent
|
|
what is the speed of directly linked synaptic transmission?
|
fast
|
|
what do astrocytes do?
|
control the chemical environment of the CNS
exchange of materials |
|
what is directly linked synaptic transmission?
|
NTs bind to post synaptic membrane which causes ion channels to open
|
|
vastus intermedius
|
O: anterolateral shaft of femur
I: tibial tuberosity via patellar tendon A: knee extension N: L2 - L4 : femoral nerve |
|
describe indirect synaptic transmission
|
NT activates receptors on PSM
these receptors do not directly open channels a cascade of molecular events lead to ion channels opening and closing |
|
what is the speed of indirect synaptic transmission?
|
relatively slow
|
|
which pathway is related to the motor divisions of the peripheral nervous system?
|
efferent
|
|
what does the ectoderm form?
|
epithelia
epidermis nervous tissue |
|
what CNS cells would you find lining the cavities in the brain and spinal cord?
|
ependymal
|
|
what does the mesoderm form?
|
muscle
CT proper bone cartilage blood dermis endothelium of BVs synovial membranes |
|
common carotid pulse
|
between SCM and the thyroid cartilage
at the level of C6 |
|
what does the endoderm form?
|
mucosal epithelia (digestive, respiratory, urogenital)
|
|
what do ependymal cells do?
|
circulate cerebrospinal fluid
|
|
how many embryo segments form the brain and cranial nerves?
|
12
|
|
how many embryo segments form the spinal cord and spinal nerves?
|
31
|
|
what do oligodendrocytes do?
|
form protective myelin sheaths around axons in the CNS
|
|
what type of matter makes up the horns of the spinal cord?
|
grey matter
|
|
external carotid pulse
|
anterior to SCM
level of the angle of the madible |
|
what happens to white matter as you get closer to the brain?
|
the amount of it increases
|
|
longitudinal tracts are made up of what type of matter?
|
white
|
|
where do ascending tracts originate?
|
in the dorsal horn
|
|
where do descending tracts originate?
|
motor cortex (pyramidal cells)
|
|
proximal brachial pulse
|
medial brachial region
just posterior to coracobrachialis |
|
where do the descending tracts synapse?
|
on LMNs in the ventral horn
|
|
what are neuronal pools?
|
groups of association neurons in the CNS
|
|
what do neuronal pools do?
|
organize incoming and outgoing messages
facilitate responses to stimuli |
|
which zone of a neuronal pool is the zone that will always reach threshold?
|
discharge zone
|
|
distal brachial pulse
|
medial side of bicipital tendon
medial cubital fossa |
|
where do the fasciculus cuneatus and fasciculus gracilis decussate?
|
medulla
|
|
what is the control center of the neuron cell body?
|
the nucleus
|
|
which cells are the function units in the nervous system?
|
neurons
|
|
where to the spinocerebellar tracts decussate?
|
they don't decussate
|
|
what are Nissel bodies?
|
rough endoplasmic reticulum in neuron cell bodies
|
|
where do the fasciculus cuneatus and fasciculus gracilis originate?
|
brain stem
|
|
radial pulse
|
lateral to flexor carpi radialis tendon
also palpated in anatomical snuff box |
|
where do the spinothalamic tracts originate?
|
dorsal horn
|
|
what do Nissel bodies do?
|
the contain ribosomes that make proteins and enzymes
|
|
where to the spinocerebellar tracts originate?
|
dorsal horn
|
|
which cells are the supporting cells in the nervous system?
|
neuroglia
|
|
which tract handles contralateral proprioception and discriminate touch to the upper limbs, upper trunk and neck?
|
fasciculus cuneatus
|
|
what type of information is handled by the fasciulus gracilis?
|
contralateral proprioception and discriminate touch to the lower limbs and inferior trunk?
|
|
ulnar pulse
|
lateral to flexor carpi ulnaris tendon at wrist
|
|
which tract handles contralateral pain and temperature?
|
lateral spinothalamic
|
|
in the CNS what is a bunch of cell bodies together called?
|
nucleus
|
|
what type of information is handled by the anterior spinothalamic tract?
|
contralateral crude touch and pressure
|
|
which tracts handle ipselateral sensations?
|
spinocerebellar
|
|
in the PNS what is a bunch of cell bodies together called?
|
ganglion
|
|
which tracts deal with ipselateral trunk and lower limb proprioception?
|
posterior spinocerebellar
anterior spinocerebellar |
|
femoral pulse
|
midway along inguinal ligament
in femoral triangle |
|
detail the synapsing locations of the fasciculus cuneatus
|
1st order: medulla
2nd order: thalamus 3rd order: cerebral cortex |
|
what are the two types of processes extending from the neuron cell body?
|
dendrites
axons |
|
detail the synapsing locations of the fasciculus gracilis
|
1st order: medulla
2nd order: thalamus 3rd order: cerebral cortex |
|
detail the synapsing locations of the lateral spinothalamic tract
|
1rst order: dorsal horn
2nd order: thalamus 3rd order: cerebral cortex |
|
describe the shape and location of the axon hillock
|
cone shaped
cell body end |
|
describe the synapsing locations of the spinothalamic tracts
|
1rst order: dorsal horn
2nd order: thalamus 3rd order: cerebral cortex |
|
popliteal pulse
|
deep in popliteal fossa
may be slightly off to medial side |
|
describe the synapsing locations of the spinocerebellar tracts
|
1rst order: spinal cord
2nd order: cerebellum |
|
what are telodendria?
|
branching ends of axons
|
|
what would you find in the periphery a neuronal pool?
|
facilitated zone
|
|
which CNS neuroglia are macrophages?
|
microglia
|
|
what state are the neurons of the facilitated zone in?
|
potentiated
they can reach threshold more readily when stimulated by other neurons |
|
what is a (neuronal) circuit?
|
a collection of neurons and the synapses connecting them
|
|
posterior tibial pulse
|
posterior to flexor digitorum tendon
posterior to medial malleolus |
|
what is the purpose of neuronal circuits?
|
they transmit signals along a predictable path
|
|
what is released at the axon terminal?
|
neurotransmitter
|
|
what are the four types of nueronal circuits?
|
diverging
converging reverberating parallel-after discharge |
|
describe a diverging circuit
|
one presynaptic fibre synapses on several post synaptic neurons
|
|
what are bondles of CNS axons called?
|
tracts
|
|
what type of circuit will help to amplify the signal?
|
diverging in the same pathway
|
|
dorsalis pedis pulse
|
between tendons of extensor hallucis longus and extensor digitorum longus
|
|
what is the purpose of a diverging circuit that diverges into multiple pathways?
|
sends signal to more than one location
|
|
what are bondles of PNS axons called?
|
nerves
|
|
describe a converging circuit
|
several presynaptic neurons synapse on one post synaptic neuron
|
|
what are the two methods by which a converging circuit can stimulate the post synaptic membrane leading to an AP?
|
temporal summation
spatial summation |
|
what is the purpose of a reverberating circuit?
|
to prolong a signal
|
|
suboccipital lymph nodes
|
lateral to inion
superior to superior nuchal line |
|
describe a single neuron reverberating circuit?
|
axon synapses on its own dendrite
|
|
what is grey matter?
|
a collection of unmyelinated axons in the CNS
|
|
where are reverberating circuits commonly found?
|
reflexive pathways such as breathing
|
|
describe a parallel-after discharge circuit
|
a single axon branches, discharging on several neurons, which then activates a single output neuron
|
|
what is myelin?
|
a fatty substance that protects and insulates axons
|
|
which type of circuit is believed to be associated with complex mental activities?
|
parallel-after discharge
|
|
post auricular lymph nodes
|
superior portion of mastoid process
directly posterior to external auditory meatus |
|
what is the purpose of serial neuronal processing?
|
to transmit a signal from point A to point B
single pathway |
|
what does myelin do for nerve transmission?
|
speeds it up
|
|
what are some examples of serial neuronal processing?
|
spinal reflexes
|
|
where would you find Schwann cells and satellite cells?
|
in the peripheral nervous system
|
|
which type of neuronal processing is sequential, linear and predictable?
|
serial
|
|
what are Nodes of Ranvier?
|
narrow spaces between two Schwann cells
|
|
what is the point of parallel neuronal processing?
|
to deliver a signal to several destinations
|
|
pre auricular lymph nodes
|
immediately anterior to external auditory meatus
|
|
describe the mechanism of parallel neuronal processing
|
different circuits may be activated along a pathway simultaneously
|
|
associative thinking is an example of what type of neuronal processing?
|
parallel
|
|
what is the role of schwann cells?
|
phagocytic and repair
|
|
list three ways that neurons and the nervous system can synaptically adapt
|
1. number of active receptors on post synaptic membrane
2. rate of NT synthesis 3. changes in number of Ca channels on pre-synaptic membrane |
|
what forms the neurilemma?
|
layer of Schwann cells forming myelin sheaths
|
|
are axodendritic links fast or slow?
|
fast
|
|
sub mandibular lymph nodes
|
under the body of the mandible
begins where facial artery crosses the mandible (anterior to masseter attachment) |
|
what is the role of axodendritic links?
|
usually excitatory
can be inhibitory |
|
what do Nodes of Ranvier do?
|
allow for quick exchange of ions as impulses jump from node to node
|
|
what is the role of axoaxonic links?
|
they enhance or decrease the release of NTs
|
|
what PNS cells control the chemical environment of neurons?
|
satellite cells
|
|
How to axoaxonic links do their job?
|
they affect calcium channels and control the influx of Ca into the cytoplasm
|
|
in which nervous system would you find the neurilemma?
|
the PNS
|
|
if the level of calcium in the neuronal cytoplasm changes, what effect does that have?
|
it affects exocytosis of NTs
|
|
sub mental lymph nodes
|
posterior to mental protuberance
inferior surface of anterior bellies of digastric muscles |
|
what direction does Chloride move in order to hyperpolarize a cell?
|
into the cell
|
|
what direction does potassium move in order to hyperpolarize a cell
|
out of the cell
|
|
which part of the neuron is the metabolic center?
|
the cell body
|
|
changes in the synthesis and release of NTs and / or the reuptake of NTs is what type of neuromodulation?
|
pre-synaptic neuromodulation
|
|
what types of changes occur with post synaptic neuromodulation?
|
increase in receptor sensitivity
degradation of NTs |
|
deep cervical chain lymph nodes
|
deep to the SCM
superior and inferior ends are the only palpable region |
|
what is somaesthesia?
|
awareness of the various sensations we experience
|
|
what are the two major types of sensory receptors?
|
cutaneous
proprioceptors |
|
what type of receptor provides somaesthetic input?
|
cutaneous
|
|
what types of neurons are sensory neurons?
|
unipolar
|
|
superficial cervical chain lymph nodes
|
along posterior-superior border of the SCM
near apex of posterior cervical triangle |
|
where would you find the cell bodies of sensory neurons?
|
dorsal root ganglia
posterolateral to the spine |
|
what do first order neurons link?
|
sensory receptor with segmental reflex circuits or association neurons in the SC
|
|
where would you find the cell bodies of second order neurons?
|
within SC segments
|
|
where would you find the cell bodies of third order neurons?
|
in the thalamus
|
|
infra clavicular lymph nodes
|
along inferior mid portion of the clavicle
|
|
third order neurons provide communication between which areas of the brain?
|
thalamus and cerebral cortex
thalamus and limbic system |
|
second order neurons relay information to which areas?
|
LMN (reflex)
SC higher segments RAS thalamus |
|
which area of the brain facilitates skilled voluntary movement?
|
cerebellum
|
|
what does the somatosensory cortex do?
|
integrates and interprets sensory information
conscious awareness of sensation |
|
central axillary lymph nodes
|
in apex of axilla
travels with deep blood vessels entering the arm |
|
what are the two components of the epithalamus?
|
pineal gland
choroid plexus |
|
which area of the diencephalon is found under the thalamus?
|
hypothalamus
|
|
what part of the neuron cell body is the internal transport system that carries substances from cell body down the axon?
|
neurofilaments
|
|
what is the general function of the hypothalamus?
|
autonomic function
endocrine function |
|
what is the basic pathway of sensory neurons?
|
PNS to CNS
|
|
what are the five functional groupings of the thalamus?
|
sensory
motor limbic multimodal intra-laminar and reticular |
|
anterior / pectoral axillary lymph nodes
|
just posterior to anterior pectoral fold
along posterior lateral edge of pec major |
|
which area of the thalamus relays signals to the somatosensory cortex?
|
sensory
|
|
what is the basic pathway of association neurons?
|
within the CNS
|
|
what arrives at the motor area of the thalamus?
|
signals from the cerebellum and basal nuclei
|
|
where do motor signals from the thalamus go?
|
pre-motor cortex
|
|
what is the basic pathway of motor neurons?
|
CNS to effectors
|
|
which area of the thalamus receives signals from the olfactory cortex and the amygdala?
|
limbic
|
|
posterior / subscapular lymph nodes
|
anterior aspect of posterior axillary fold
anterior surface of lat dorsi and teres major |
|
where do signals from the limbic area of the thalamus end up?
|
pre-frontal cortex
hypothalamus |
|
what comprises the CNS?
|
brain
spinal cord |
|
which area of the brain would you find under the parietal bones and behind the frontal?
|
cerebral hemispheres
|
|
which area of the human brain is the 'newest'
|
cerebral hemispheres
|
|
what are the components of the PNS?
|
cranial nerve
spinal nerve |
|
which brain cortex spans all four lobes?
|
cerebral cortex
|
|
lateral axillary lymph nodes
|
along medial aspect of the proximal shaft of the humerus
|
|
what makes up the cerebral cortex?
|
grey matter (cell bodies, dendrites, glial cells etc)
|
|
which area of the brain is responsible for spatial discrimination?
|
primary somatosensory cortex
|
|
what does the somatosensory association area do?
|
it takes sensory information and makes sense of it and forms a comprehensive picture
|
|
what are the two divisions of the PNS?
|
sensory
motor |
|
what goes on in the pre-frontal cortex?
|
higher mental functions
intellect complex learning abstraction synthesis judgment problem solving |
|
epi-trochlear / superficial cubital lymph nodes
|
proximal to medial epicondyle
along length of the basilic vein |
|
lesions in the pre-frontal cortex lead to what?
|
personality disorders
apathy lack of social discrimination |
|
which hemisphere contains the general interpretation area?
|
the left hemisphere
|
|
what are the three levels of perception in the ascending pathway
|
receptor
circuit perceptual |
|
what do ruffini corpuscles sense and how do the adapt?
|
continuous pressure
adapt slowly |
|
horizontal inguinal lymph nodes
|
along inferior edge of inguinal ligament
running from mid point |
|
what do paccinian corpuscles sense and how do the adapt?
|
deep pressure
adapt rapidly |
|
what are the two sub-divisions of the motor division of the PNS?
|
somatic
autonomic |
|
how quickly to nociceptors adapt?
|
slowly
|
|
what is the function of the tectospinal tract?
|
contralateral head and eye movements
|
|
the motor division of the PNS carries what two types of signals?
|
somatic
visceral |
|
which tract is responsible for ipselateral tone of limb and trunk extensors and head muscles (balance)?
|
vestibulospinal
|
|
popliteal lymph nodes
|
deep in popliteal fossa
travel with the deep vessels |
|
what is the function of the rubrospinal tract?
|
contralateral limb flexor tone
|
|
which tract is responsible for muscle tone, visceral motor function and unskilled movements?
|
reticulospinal
|
|
what would you find at the end of the telodendria?
|
axon terminals
|
|
where do the descending tracts terminate?
|
ventral horn of the spinal cord
|
|
how many pairs of cranial nerves are there?
|
12
|
|
what is the function of the circuit level of perception?
|
mediate simple and complex reflexes
transmit impulses to higher brain levels |
|
fibularis brevis
|
O: distal shaft of fibula
I: base of fifth metatarsal A: plantar flexion, eversion |
|
spinothalamic fibres can synapse in various regions of the thalamus and where else?
|
the reticular area (RAS)
|
|
what does the discriminative pathway allow?
|
localization of feeling
feeling intensity of sensory information |
|
which pathway is the only pathway that transmits kinaesthetic and proprioceptive input?
|
discriminative pathway
|
|
how many pairs of spinal nerves are there?
|
31
|
|
what is the final impulse destination of the discriminative pathway?
|
primary sensory cortex
|
|
tibialis posterior
|
O: tibia, fibula, interosseous membrane
I: navicular, cuboid, cuneiform, base of 2nd to 4th metatarsals A: plantar flexion, inversion |
|
what does the non-specific sensory pathway allow for?
|
broad, general impressions of sensory input
|
|
how many cervical spinal nerves are there?
|
8
|
|
what is the purpose of the perceptual level of integration?
|
volition
|
|
which area of the brain is associated with the perceptual level and what does it allow?
|
somatosensory cortex
allows for full appreciation of quality and source of stimuli |
|
how many thoracic spinal nerves are there?
|
12
|
|
what are some of the properties detected by perceptual integration?
|
magnitude estimation
spatial discrimination feature abstraction quality discrimination pattern recognition |
|
adductor longus
|
O: pubis
I: middle third of linea aspera A: adduction, flexion N: obturator nerve |
|
which cranial nerves are associated with the frontal eye field (voluntary eye movement)?
|
III
IV VI |
|
how many lumbar spinal nerves are there?
|
5
|
|
what form pyramidal tracts / corticospinal tracts?
|
myelinated axons of upper motor neurons
|
|
why do the axons of upper motor neurons project into the brain stem?
|
provide synapses for cranial nerves
|
|
how many sacral spinal nerves are there?
|
5
|
|
damage to the right or left side of the primary motor cortex will result in?
|
hemiplegia (contralateral side)
|
|
adductor magnus
|
O: pubis, ischium, ischial tuberosity
I: gluteal tuberosity, linea aspera, medial supracondylar line, adductor tubercle A: adduction, flexion, extension N: obturator nerve (adductor), sciatic nerve (hamstring) |
|
damage to the posterior aspect of the primary motor cortex will cause what?
|
weakness of distal flexor muscle groups and loss of fine motor control (contralateral)
|
|
damage to which area of the primary motor cortex will cause weakness of larger limb and girdle muscles?
|
anterior
|
|
what is white matter?
|
a collection of myelinated axons in the CNS
|
|
where do most neurons of the premotor cortex synapse?
|
on the primary motor cortex
|
|
what is the function of the premotor cortex?
|
coordinates movement of several muscles groups simultaneously and/sequentially
i.e skills requiring high motor coordination |
|
piriformis
|
O: anterior surface of the sacrum
I: greater trochanter of the femur A: external rotation of hip, abduction of flexed thigh, stabilizes hip N: S1 - S2 piriformis nerve |
|
damage to the premotor cortex results in what?
|
loss of programmed motor skills
ability to perform movements is present, but speed is lost |
|
if someone has damage to the premotor cortex what happens in their brain/spinal cord that allows them to regain the motor skill lost to the damage?
|
neural plasticity
an alternate neuronal pathway is found/made |
|
what structures links neuronal circuits to the premotor and primary motor cortex and thalamus?
|
basal nuclei
|
|
what is the function of the basal nuclei?
|
graceful movement
repetitive motion patterns |
|
vastus medialis
|
O: medial lip of linea aspera, intertrochanteric line
I: tibial tuberosity via patellar tendon A: knee extension N: L2 - L4 : femoral nerve |
|
what type of matter makes up the cerebellum?
|
grey matter with a white matter core
|
|
information traveling along the efferent pathway exits where in the spine?
|
the ventral horn
|
|
what is the function of the cerebellum?
|
skilled voluntary movement
equillibrium and balance muscle tone constant adjustment of muscle contraction required for highly skilled movement |
|
what body areas provide most of the sensory input to the cerebellum?
|
proprioceptors
ears eyes |
|
what is the function of first order neurons?
|
transmit external and interal signals to the CNS
|
|
what is ataxia and damage to what area causes it?
|
lack of coordination
damage to the cerebellum |
|
fibularis longus
|
O: head and proximal fibula
I: medial cuneiform, base of first metatarsal A: plantar flexion, eversion N: L5, S1, S2 superficial fibular |
|
what is dysmetria and damage to what area causes it?
|
'overshooting' a movement
damage to the cerebellum |
|
what is the rebound phenomenon and damage to what area causes it?
|
lost of agonist/antagonist coordination
damage to the cerebellum |
|
define a motor unit
|
one neuron and all the myofibres it innervates
|
|
which tracts are also known as the pyramidal direct tracts?
|
corticospinal tracts
|
|
soleus
|
O: proximal tibia, fibular head, soleal line
I: calcaneus A: plantar flexion, steadies leg on foot N: S1, S2 tibial nerve |
|
why are they called 'direct' pyramidal tracts?
|
because the axons of the pyramidal neurons synapse directly on association neurons and LMNs
|
|
where do the lateral corticospinal tracts decussate?
|
medulla
|
|
where do the anterior corticospinal tracts decussate?
|
in the spinal cord segments
|
|
list the extra pyramidal tracts
|
vestibulospinal
reticulospinal rubrospinal tectospinal |
|
flexor digitorum longus (foot)
|
O: middle, posterior surface of tibia
I: base of distal phalanx of digits 2 - 5 A: toe flexion, plantar flexion N: S2, S3 Tibial nerve |
|
what type of LMN innervates skeletal muscle fibres directly?
|
alpha motor neurons
|
|
a single alpha motor neuron will innervate how many muscle fibres?
|
it will branch and innervate a large number of myofibres
|
|
where would you find Nodes of Ranvier?
|
in the PNS
|
|
describe the pathway of the stretch reflex
|
afferent to efferent
no interneurons involved monosynaptic |
|
second order neurons transmit signals to which locations?
|
reflex circuits in the spinal column
up the spine to the brain |
|
describe the pathway of the tendon reflex
|
multi-synaptic
|
|
flexor hallucis longus
|
O: fibula and interosseus membrane
I: base of distal phalanx of first digit A: hallux flexion, plantar flexion N: S2, S3 tibial nerve |
|
what activates the primary sensory nerve fibres of the muscle spindle?
|
the rate and degree of stretch on extrafusal fibres
|
|
second order neurons traveling to the brain will arrive which locations?
|
thalamus
cerebellum |
|
what activates the secondary sensory nerve fibres of the muscle spindle?
|
the degree of stretch on the extrafusal fibres
|
|
what innervates the contractile ends of the muscle spindle?
|
gamma motor neurons
|
|
second order neurons traveling to the thalamus follow which tract?
|
spinothalamic tract
|
|
what are the steps leading to gamma motor neuron firing in order to maintain muscle tone?
|
1. CNS sensory information from muscle spindle is reduced due to contraction of EFF
2. cerebellum desires to prevent damage and so it increases firing to gamma motor neurons 3. the contractile ends of the IFF shorten |
|
sartorius
|
O: ASIS
I: medial tibial condyle A: flexes, externally rotates, abducts hip ; flexes knee N: L2 - L4 : Femoral |
|
what is hypotonia?
|
reduced excitability of the stretch reflex leading to less muscle contraction
|
|
second order neurons traveling to the cerebellum follow which tract?
|
spinocerebellar tract
|
|
what is hypertonia?
|
increased excitability of motor pathways
|
|
what makes up segmental motor integration?
|
spinal cord segments
|
|
what makes up the projection level of motor integration?
|
pyramidal and extrapyramidal tracts
|
|
semitendinosus
|
O: ischial tuberosity
I: medial, proximal tibia (pes anserine) A: hip extension, knee flexion, medial rotation (at tibia-femoral jt) N: tibial nerve |
|
what makes up the precommand level of motor integration?
|
cerebellum
basal nuclei |
|
what triggers motor stimulation?
|
sensory input at the cortical level
|
|
what is the function of the precommand level of motor integration?
|
start and stop movements
monitor muscle tone |
|
what do pyramidal tracts synapse on?
|
segmental interneurons
lower motor neurons |
|
semimembranous
|
O: ischial tuberosity
I: posterior-superior-medial tibial condyle A: hip extension, knee flexion, medial rotation N: tibial nerve |
|
what do central pattern generators control?
|
neuronal circuits controlling locomotion
|
|
what types of neuronal circuits are associated with CPGs?
|
reverberating
|
|
describe a unipolar neuron
|
1 process
axon extends in two directions |
|
list the four mechanisms of injury (cellular)
|
interference with membrane function
interference with energy production interference with protein synthesis alteration of genetic material |
|
what are two ways that neuronal function can be restored after damage?
|
axonal regeneration
nueral plasticity |
|
extensor digitorum longus (toes)
|
O: lateral tibial condyle, proximal tibia, fibula and interosseous membrane
I: middle and distal phalanges of digits 2-5 A: dorsiflexion, toe extension N: peroneal nerve |
|
what is Wallerian degeneration?
|
disintegration of the axon and its myelin sheath distal to the site of injury
|
|
what is the function of the ANS?
|
regulation of body functions
|
|
describe Wallerian degeneration
|
- injured area is sealed off
- the distal end is deprived of nutrients and begins to disintegrate - cellular debris is cleared via phagocytosis |
|
where would you find unipolar neurons?
|
PNS sensory neurons
|
|
after neuronal damage nerve growth factors lead to what?
|
reproduction of schwann cells at the injury site
|
|
what is a regeneration tube?
|
schwann cells lined up forming a corridor for the ends of the damage axon to meet within
|
|
masseter
|
O: zygomatic arch
I: ramus of the mandible (superficial) coronoid process (deep) A: superficial - elevation, protrusion deep: elevation, retrusion |
|
during axon regeneration what is the cell body doing?
|
- maintains functional and structural integrity of the neuron
- produces proteins and lipids required for restructuring |
|
what is paresis?
|
muscle weakness
|
|
what type of neuron has 2 cell processes extending from the cell with a long dendrite and a long axon?
|
bipolar
|
|
what are the three effects of nerve degeneration?
|
sensory loss
motor loss trophic disturbances |
|
what is responsible for the failure of neuronal regeneration in the CNS?
|
glial scars
oligodendrocytes die and astrocytes replace them forming a scar which is both a mechanical barrier and also secretes inhibitory factors |
|
temporalis
|
O: temporal fossa
I: coronoid process and ramus of the mandible A: elevates the mandible |
|
what is neuroplasticity?
|
formation of new neural pathways in the face of injury
|
|
what effect does the release of norepinephrine have on the body?
|
increase heart rate
increase breathing decrease GI function |
|
what condition is a demyelination disorder of the PNS?
|
Guillain-Barre syndrome
|
|
where do you find bipolar neurons?
|
in special sense organs
|
|
what condition is a demyelination disorder of the CNS?
|
Multiple Sclerosis
|
|
what are the two components of the dura mater?
|
periosteal
meningeal |
|
extensor carpi radialis brevis
|
O: common extensor tendon (lateral epicondule of the humerus)
I: base of the 3rd metacarpal A: acts with extensor carpi radialis longus to do extension and radial deviation of the hand |
|
which mater forms part of the choroid plexus?
|
pia mater
|
|
where would find the falx cerebri?
|
mid sagittal
between cerebral hemispheres |
|
describe a multipolar neuron
|
1 long or short axon
many short dendrites |
|
what does the falx cerebri attach to?
|
crista galli of the ethmoid bone
|
|
where would you find the falx cerebelli?
|
running along the vermis of the cerebellum
|
|
extensor pollicis longus
|
O: posterior surface of the ulna and interosseous membrane
I: base of the distal phalanx of the thumb A: extends the IP and MCP joints of the thumb |
|
which tough fold of the brain runs transverse and tents the cerebellum?
|
tentorium cerebelli
|
|
define a reflex
|
rapid, involuntary responses to stimuli
|
|
the meninges create spaces within the brain known as what?
|
sinuses
|
|
what types of neurons are typically multipolar?
|
association neurons
motor neurons |
|
name the sinuses in the brain
|
dural
subdural subarachnoid |
|
what are the three types of reflex arcs?
|
segmental
inter-segmental supra-segmental |
|
which ventricle of the brain is paired?
|
lateral
|
|
supinator
|
O: lateral epicondyl, radial collateral and annular ligaments, proximal ulna (supinator fossa and supinator crest)
I: posterior, lateral and anterior surfaces of the proximal radius A: primary supinator of the forearm |
|
which ventricle separates the two halves of the diencephalon?
|
the third ventricle
|
|
what connects ventricles three and four in the brain?
|
cerebral aqueduct
|
|
what is the structure of sensory neurons?
|
unipolar
bipolar |
|
what does the fourth ventricle in the brain allow to happen?
|
opens to the subarachnoid space allowing outflow of CSF
|
|
how much total blood volume goes to the brain?
|
about 20%
|
|
what is the structure of association neurons?
|
multipolar
|
|
the vertebral arteries emerge from which arteries?
|
subclavian
|
|
describe an inter-segmental reflex arc
|
moderately complex
involves more than one spinal segment |
|
which areas of the brain are supplied by the vertebral arteries?
|
brain stem
crebellum occipital lobe parts of the thalamus |
|
flexor pollicis longus
|
O: radius, interosseous membrane
I: base of the distal phalanx of the thumb A: flexes proximal phalanx, flexes 1st metacarpal N: C8-T1 : anterior interosseous nerve (median nerve) |
|
how do the internal carotid arteries enter the brain?
|
through the carotid canal
|
|
what forms the Circle of Willis?
|
anastomoses of anterior and posterior cerebral arteries
|
|
what is the structure of motor neurons?
|
multipolar
|
|
what are some physiological factors affecting blood flow in the brain?
|
carotid sinus pressure
oxygen pressure in the blood carbon dioxide pressure in the blood CSF pressure |
|
what are the three spinal reflexes?
|
stretch reflex
golgi tendon reflex withdraw reflex |
|
what are some pathological factors that might lead to decreased blood flow to the brain?
|
tumours
arterial obstructive disease drugs |
|
quadratus lumborum
|
O: inferior border of 12 rib, TVPs L1-L4
I: internal lip of Iliac crest, iliolumbar ligament A: maintain posture, lateral flexion, extension, fixes rib 12 during inhalation |
|
what affect do anaemia and hyperthyroidism have on blood flow to the brain?
|
increase flow
|
|
what affect do polycythemia and hypothyroidism have on blood flow to the brain?
|
decrease flow
|
|
when blood drains from the brain where does it go?
|
to the dural sinuses and then to the internal jugular vein
|
|
describe the stretch reflex
|
muscle contracts when too much stretch is sensed
|
|
what forms CSF?
|
choroid plexus
ependymal cells |
|
gluteus minimus
|
O: external ilium between anterior/inferior gluteal lines
I: greater trochanter A: abduction, internal rotation N: L4 - S1 superior gluteal nerve |
|
where would you find the choroid plexus?
|
enclosed in the ependymal lining of ventricles and in the ventricle spaces
|
|
the cells of the ependymal lining are linked by what kinds of junctions? Why?
|
tight junctions
renders lining impermeable and pumps maintain constant composition of the CSF |
|
how much CSF is formed daily?
|
about 800 ml
|
|
what are golgi tendon organs sensing?
|
tension
force of muscle contraction |
|
CSF is made from which fluid in the body?
|
blood plasma
|
|
biceps femoris
|
O: long head - ischial tuberosity ; short head - shaft of femur, lateral lip of linea aspera
I: head of fibula A: hip extension, knee flexion, lateral rotation (at tibia-femoral jt) N: tibial nerve (long head), common peroneal nerve (short head) |
|
what is the purpose of CSF?
|
- support and cushioning
- provides a constant chemical environment for nutrients and oxygen to circulate and bathe the brain |
|
what do somatic reflexes activate?
|
skeletal muscle
|
|
what forms the blood / brain barrier?
|
tight junction linked endothelial cells in cerebral capillaries
|
|
which substances cross the blood / brain barrier via facilitated diffusion?
|
glucose
essential amino acids |
|
what do visceral reflexes activate?
|
smooth muscle
cardiac muscle glands |
|
what is transported across the blood / brain barrier via active transport?
|
non essential amino acids
potassium ions (pumped out) |
|
gluteus medius
|
O: lateral surface of the ilium (between anterior and posterior gluteal line)
I: greater trochanter of the femur A: strong abductor, internal rotation N: L4 - S1 superior gluteal nerve |
|
what types of substances freely cross the blood/brain barrier?
|
fatty substances
|
|
what is areflexia?
|
reflexes absent
|
|
what areas of the brain are not protected by the blood/brain barrier?
|
vomiting center
hypothalamus |
|
brain function can be changed through alteration to what two internal factors?
|
reduced blood flow (ischemia)
cerebral volumes (changes to ICP) |
|
what is hyporeflexia?
|
diminished reflexes
|
|
what happens to cerebral blood supply when cardiac output changes or when blood pressure changes?
|
nothing, it remains constant
|
|
vastus lateralis
|
O: lateral lip of linea aspera, greater trochanter
I: tibial tuberosity via the patellar tendon A: knee extension N: L2 - L4 : femoral nerve |
|
what happens to blood flow to the brain when carbon dioxide pressure in the brain increases?
|
blood flow increases in order to facilitate waste removal
|
|
what is hypereflexia?
|
exaggerated reflexes
|
|
what happens to blood flow to the brain when hydrogen pressure in the brain increases?
|
blood flow increases
|
|
what is perfusion?
|
local blood supply
|
|
what is hypoxic hypoxia?
|
loss of oxygen despite adequate blood supply
|
|
tensor fascia lata
|
O: ASIS, anterior iliac crest
I: lateral condyle of the tibia via the ITB A: abducts, medially rotates and flexes the hip ; tightens ITB to steady trunk N: L4 - S1 : Superior gluteal nerve |
|
what is ischemic hypoxia?
|
loss of oxygen due to reduce blood flow / supply
|
|
what do joint kinaesthetic receptors monitor?
|
stretch in articular capsules or synovial joints
|
|
why is hypoxia fairly well tolerated by the brain?
|
because neurons are capable of anaerobic metabolism
|
|
what is the main role of the CNS?
|
sort and interpret signals
formulate a response |
|
what leads to acidosis cell injury?
|
reduced blood flow results in inadequate waste removal
|
|
what is cytotoxic edema?
|
cell body swelling in the grey matter of the brain
|
|
Gluteus maximus
|
O: dorsal surface of ilium, sacrum, coccyx
I: gluteal tuberosity and lateral condyle of tibia via ITB A: hip extension, steadies the thigh, lateral rotation, assists in raising up from seated N: L5 - S2 Inferior gluteal nerve |
|
Which types of neurons are most sensitive to effects of ischemia?
|
interneurons
|
|
what do muscle spindles detect?
|
degree of muscle stretch
|
|
what two substances contribute to intercranial pressure and in what percentages?
|
10% blood
80% brain tissue 5-10% CSF |
|
what three things may increase ICP?
|
edema
increased brain tissue (eg tumour) bleeding |
|
what is vasogenic edema?
|
increase in EC fluid fluid around the brain cells due to leaky capillaries
|
|
extensor hallucis longus
|
O: middle third of fibula, interosseous membrane
I: base of distal phalanx of first digit A: dorsiflexion, extends first digit N: L4, L5 deep fibular nerve |
|
what is interstitial edema?
|
increase in sodium and water in IF
|
|
what is a brain herniation?
|
displacement of brain tissue
|
|
which PNS division is the afferent division?
|
sensory
|
|
where might you find brain herniations?
|
1. under the dural fold of the falx cerebri
2. through the notch of the tentorium cerebelli |
|
what do golgi tendon organs detect?
|
tension in tendons
|
|
what are the two types of nervous system lesions?
|
anatomical
physiological |
|
gastrocnemius
|
O: medial and lateral femoral
I: calcaneus A: plantar flexion, knee flexion N: S1, S2 Tibial nerve |
|
describe a negative neurological manifestation
|
loss of function
|
|
what information do golgi tendon organs send to the CNS?
|
information regarding the effective force of muscle contraction
|
|
describe a positive neurological manifestation
|
over stimulation of neurons
eg seizures, spasticity |
|
which PNS division is the efferent division?
|
motor
|
|
damage to grey matter which leads to muscle weakness is also know as what?
|
negative phenomenon
|
|
damage to grey matter which leads to fasiculations is also know as what?
|
positive phenomenon
|
|
tibialis anterior
|
O: lateral condyle, proximal tibia
I: medial cuneiform, base of first metatarsal A: dorsiflexion, inversion N: deep fibular nerve |
|
what are some causes of NS destruction syndromes?
|
chronic neuronal degeneration
necrosis (d/t cerebral haemorrhage) axon degeneration from trauma myelin degeneration |
|
what are some causes of NS compression syndromes?
|
edema
subdural haematomas thombus tumours |
|
brain damage due to impact is what type of damage?
|
primary
|
|
brain damage due to ischemia, increased ICP etc is what type of damage?
|
secondary
|
|
rectus femoris
|
O: AIIS, illium superior to acetabulum
I: tibial tuberosity via patellar ligament A: hip flexion, knee extension N: L2 - L4 : Femoral nerve |
|
describe the characteristics of a severe contusion in the brain
|
tearing or shearing of tissue
intra cranial bleeding cognitive defects |
|
define haematoma
|
accumulation of blood in a tissue, organ or space
|
|
what four words can describe reflexes?
|
specific
predictable purposeful adaptive |
|
Latissimus dorsi
|
O: thoracolumbar fascia, iliac crest, SPs of T6-T12 and inferior 3-4 ribs
I: floor of intertubecular groove of humerus A: extends, adducts and internally rotates the humerus ; raises the body towards arms during climbing N: C6-C8 Thoracodorsal nerve |
|
what is another name for the muscle fibers of skeletal muscle?
|
extrafusal fibres
|
|
what physical space connects the PNS and the CNS?
|
synapse
|
|
what do alpha motor neurons innervate?
|
extrafusal fibers
|
|
abductor pollicis longus
|
O: posterior surface of the radius, ulna and interosseous membrane
I: base of the first metacarpal A: abducts the thumb, assists in extension of the wrist and thumb |
|
describe the relationship of muscle spindles and muscle function
|
the more fine the movement the muscle does, the more muscle spindles are present
|
|
how many pairs of cranial nerves are there?
|
12
|
|
do postural back muscles have a small or large amount of muscle spindles?
|
large
|
|
pronator quadratus
|
O: distal quarter of the ulna
I: distal quarter of the radius A: pronation of the forearm N: C8 - T1 : anterior interosseous nerve (median nerve) |
|
what components make up a muscle spindle?
|
intrafusal fibers
nerve fibers (sensory and motor) |
|
what structures do the cranial nerves supply?
|
face
neck |
|
flexor carpi ulnaris
|
O: humeral medial epicondyle, olecranon, posterior border of the ulna
I:pisiform, hook of hamate, base of 5th metacarpal A: wrist flexion, ulnar deviation (powerful), weak elbow flexor N: C8 - T1 : ulnar nerve |
|
what are the two types of sensory neurons found in the muscle spindle?
|
primary / Type Ia
secondary / Type II |
|
describe the type Ia neurons in the muscle spindle
|
spiral around middle of nuclear bag and nuclear chain fibers
|
|
flexor digitorum superficialis
|
O: common flexor tendon, coronoid process of ulna, shaft of radius
I: by four tendons into the middle phalanges of digits 2 to 5 A: wrist flexion, flexion of MCP, flexion of PIP, weak elbow flexor N: C5 - C7 median nerve |
|
describe the role of Type II neurons in the muscle spindle
|
innervate the contractile ends of the intrafusal fibers
|
|
flexor digitorum profundus
|
O: coronoid process, interosseous membrane
I: by four tendons into the DIPs of fingers 2 through 5 A: flexion of MCP, PIP and DIP joints, weak wrist flexion N: medial half - C8 - T1 : ulnar nerve lateral half: C5 - C7 : median nerve |
|
how many thoracic spinal nerves are there?
|
12
|
|
what are pyramidal cells?
|
cell bodies of large upper motor neurons in the frontal lobe of both sides of the brain
|
|
Brachialis
|
O: distal half of the anterior surface of the humerus
I: coronoid process and ulnar tuberosity A: elbow flexion N: C5 - C7 : musculocutaneous nerve |
|
what does the white matter of pyramidal cells form?
|
corticospinal tracts
|
|
what is the function of upper motor neurons?
|
carry impulses from the motor cortex to the spinal cord or lower brain areas
|
|
Coracobrachialis
|
O: coracoid process of scapula
I: middle third of the medial aspect of the humerus A: adduction, shoulder flexion N: C5 - C7 : musculocutaneous |
|
what and where do the upper motor neurons synapse onto?
|
lower motor neurons at the ventral horn of the spinal cord
|
|
Triceps brachii
|
O: long head - infraglenoid tubercle
lateral head - posterior humerus medial head - posterior humerus I: olecranon process and forearm fascia A: elbow extension, shoulder extension N: C6, C7, C8 : radial nerve |
|
what and where do the lower motor neurons synapse onto?
|
myofibres at the neuromuscular junction
|
|
how many coccygeal spinal nerves are there?
|
1
|
|
Biceps brachii
|
O: long head - supraglenoid tubercle of the scapula
short head - coracoid process I: radial tuberosity and fascia of the forearm via bicipital aponeurosis A: elbow flexion, shoulder flexion, supination N: C5 - C7 : musculocutaneous |
|
where does the dorsal spinal root enter and what type of information does it carry?
|
the dorsal horn
carrying sensory information |
|
Rhomboid minor
|
O: nuchal ligament and SPs of C7-T1
I: medial border of scapula from level of spine to inferior angle A: retracts and elevates the scapula N: C5 dorsal scapular nerve |
|
where in the spine does information from the afferent pathway arrive?
|
the dorsal horn
|
|
iliacus
|
O: iliac fossa, sacral ala, SI ligaments
I: lesser trochanter of the femur A: hip flexion and stabilization N: L2 - L4: femoral |
|
where does the ventral spinal nerve root travel and what kind of information does it carry?
|
exits the ventral horn
carrying motor signals |
|
psoas major
|
O: TVPs of T12 - L5
I: lesser trochanter of femur A: thigh flexion N: L2 - L4: femoral |
|
what are the two components of the autonomic nervous system motor unit?
|
pre-ganglionic motor neuron
post-ganglionic motor neuron |
|
describe the cell body and axon of the pre-ganglionic motor neuron
|
cell body in the ventral horn
axon extends out of the spinal column to a ganglion |
|
Levator scapula
|
O: TVPs of C1-C4
I: superior angle of the scapula A: scapular elevation, inferior rotation of scapula N: C4-C5 dorsal scapular nerve |
|
describe the pathway of the post-ganglionic motor neuron
|
runs from the ganglion to the efffector organ
|
|
supraspinatus
|
O: supraspinous fossa
I: superior aspect of the greater tubercle of the humerus A: abduction of the humerus N: C6 - C6 Suprascapular nerve |
|
what happens if there is strong stimuli at the receptor level?
|
threshold is exceeded and there is a rapid firing of action potential
|
|
which order of neurons begin at sensory receptors?
|
first order
|
|
what happens of the receptor level stimuli is weak?
|
axon fires at a slower rate
|
|
teres minor
|
O: lateral border of the scapula
I: inferior facet of the greater tubercle of the humerus A: external rotation N: C5 - C6 axillary nerve |
|
what happens of the receptor level stimuli is inadequate?
|
does not result in generation of an action potential
|
|
where do first order neurons end?
|
at the dorsal horn of the spinal column
|
|
what is going on at the receptor level of sensory integration?
|
change in the environment is noted and translated into electrical nerve impulses
|
|
subscapularis
|
O: subscapular fossa
I: lesser tubercle of the humerus A: adduction, internal rotation of the humerus N: C5, C6, C7 Upper and lower subscapular nerves |
|
where would you find the cell bodies of motor neurons?
|
the ventral horn of the spinal column
|
|
what are the two functions of the circuit level of the nervous system?
|
prevents over/under reaction
transmission of signals to higher brain centers |
|
teres major
|
O: dorsal surface of the inferior angle of the scapula
I: medial lip of the intertubecular sulcus A: adduction, internal rotation, extension of humerus N: C5 - C6 Lower subscapular nerve |
|
Pectoralis minor
|
O: ribs 3 - 5 (anterior medial surface)
I: coracoid process of the scapula A: protracts and stabilizes the scapula ** if scapula is fixed it draws the ribcage up N: Medial pectoral nerve |
|
what types of signals travel along the ascending tract of the CNS?
|
sensory signals
|
|
what does productive motor function depend on?
|
muscle contraction
coordinated movement |
|
extensor carpi radialis longus
|
O: laterial supracondylar ridge (inferior to brachioradialis)
I: base of the 2nd metacarpal A: extension and radial deviation N: C6, C7 Radial nerve |
|
what types of signals travel along the descending tract of the CNS?
|
motor signals
|
|
extensor carpi ulnaris
|
O: common extensor tendon
I: base of the fifth metacarpal A: wrist extension and ulnar deviation N: C7, C8 Radial nerve |
|
what are the two types of signals or message carriers in the body?
|
chemical
electrical |
|
neurotransmitters are an example of what kind of signal?
|
chemical
|
|
pectoralis major
|
O: clavicular head: anterior medial half of the clavical
sternal head: anterior surface of the sternum costal head: ribs 1 - 6, external oblique muscle I: lateral lip of the intertubecular sulcus A: adduction, internal rotation, draws scapula anterior-inferior N: lateral and medial pectoral nerves |
|
does the nervous system use chemical or electrical signals?
|
both
|
|
deltoid
|
O: lateral 1/3 of clavicle, acromion, spine of the scapula
I: deltoid tuberosity of humerus A: abduction, flexion, internal rotation, extension, external rotation N: C5 - C6 axillary nerve |
|
what is current?
|
a flow of electrical charges from point A to point B
|
|
what is resistance?
|
measure of ease or difficulty of the flow of electrical charge
|
|
Posterior scalene
|
O: TVPS of C4 - C6
I: 2nd rib A: lateral flexion of the neck ; primary role in respiration ; elevate ribs N: C3 - C8 |
|
what is used to describe the relationship between voltage, current and resistance?
|
ohms law
|
|
pronator teres
|
O: medial epicondyle, coronoid process of the ulna
I: lateral radius midshaft A: elbow flexion, pronation N: C5 - C7: median nerve |
|
state ohms law
|
I = V / R
current is equal to voltage over resistance |
|
what order of neurons travel along the spinothalamic tract?
|
second
|
|
what order of neurons travel along the spinocerebellar tract?
|
second
|
|
what happens to the signals initiated in the muscle spindle?
|
travels to the spinal cord
|
|
Palmaris longus
|
O: common flexor tendon
I: palmar aponeurosis, skin and fascia of palm A: tenses skin and fascia of the hand, weak wrist and elbow flexion N: C7 - C8 : median nerve |
|
what order of neurons transmit information between the thalamus and the cerebral cortex?
|
third
|
|
what is another name for extrafusal fibers?
|
myofibers
|
|
middle scalene
|
O: TVPs of C2 - C7
I: 1st rib A: lateral flexion of the neck ; primary role in respiration ; elevate ribs N: C3 - C8 |
|
what are the two components of the muscle spindle?
|
nerve
interfusal fibers |
|
what order of neurons transmit information between the cerebellum and the cerebral cortex?
|
third
|
|
what do neuron types Ia in the muscle spindle detect?
|
stretch and rate
|
|
anterior scalene
|
O: TVPs of C3 - C6
I: scalene tubercle of the 1st rib A: primary role in respiration; elevate ribs; flexion; ipsilateral lateral flexion N: C3 - C8 |
|
what do neuron types II in the muscle spindle detect?
|
stretch
|
|
which branch of the nervous system contains the autonomic nervous system?
|
PNS
|
|
sternocleidomastoid
|
O: manibrium lateral to jugular notch, superior aspect of the medial 1/3 of the clavicle
I: mastoid process and lateral superior nuchal line A: contralateral rotation; ipsilateral side bending; flexion; assists in forceful inhalation N: C2 - C3, CN XI / accessory nerve B: superior thyroid artery |
|
what do alpha motor neurons activate?
|
extrafusal fibers of agonist
|
|
what do motor neurons inhibit?
|
antagonist
|
|
splenius capitis
|
O: ligamentum nuchae, SP C7-T4
I: mastoid process and lateral 1/3 of superior nuchal line A: lateral c/s flexion and rotation ; head/neck extension N: C3 - C4 |
|
what do gamma motor neurons activate?
|
interfusal fibers of the muscle spindle
|
|
trapezius
|
O: medial 1/3 of superior nuchal line, inion, ligamentum nuchae, SPs of C7-T12
I: lateral 1/3 of clavicle, spine of scapula, acromion A: elevation, retraction and superior rotation of scapula N: C3-C4 ; CN XI (Accessory) |
|
where does the sympathetic nervous system originate?
|
thoracic
upper lumber region |
|
describe the afferent pathway of the muscle spindle reflex arc
|
1. receptors of muscle spindle initiate AP
2. sensory neurons propagate AP to spinal cord |
|
where does the parasympathetic nervous division originate?
|
cranial
sacral |
|
rectus abdominus
|
O: pubic symphasis, pubic crest
I: xiphoid process costal cartilage of ribs 5 - 7 A: trunk flexion N: T7 - T12 : thoraco-abdominal nerve ; intercostal nerves |
|
Is the inside or outside surface of a cell more negatively charged?
|
inside
|
|
which autonomic division releases norepinephrine?
|
sympathetic
|
|
infraspinatus
|
O: infraspinous fossa
I: middle facet of the greater tubercle of the humerus A: external rotation of the humerus N: C5, C6 suprascapular nerve |
|
what characteristic of the cell enables it to generate a potential?
|
the selective permeability of the membrane
|
|
brachioradialis
|
O: proximal 2/3 of the lateral supracondylar ridge
I: lateral aspect of distal radius A: flex the forearm at the elbow N: C5, C6, C7 radial nerve |
|
define resting membrane potential
|
the electrical potential (voltage) across the plasma membrane during the resting state of an excitable cell
|
|
what part of the brain is the outer highly folded area of the brain?
|
cerebral cortex
|
|
flexor carpi radialis
|
O: medial epicondyle
I: base of 2nd metacarpal A: wrist flexion, radial deviation, weak elbow flexion N: C6 - C7 : median nerve |
|
what do open channels / ion pores allow cells to do?
|
selective diffusion
|
|
where do first order neurons synapse onto second order neurons?
|
the dorsal horn
|
|
what do gated channels in cells allow the cell to do?
|
control the influx and efflux of ions in and out of the cell
|
|
Rhomboid major
|
O: SPs of T2-T5
I: medial border of scapula from level of spine to inferior angle A: retracts and elevates the scapula N: C5 Dorsal scapular nerve |
|
what are the four types of stimuli associated with gated channels?
|
chemical
electrical barometric / mechanical thermal |
|
where do second order neurons synapse onto third order neurons?
|
in the thalamus and cerebellum
|
|
ulnar collateral ligament
|
Anterior:
P: medial epicondyle D: coronoid process Posterior: P: medial epicondyle (posterior) D: medial olecranon S: valgus stress |
|
what does repolarization mean in terms of membrane potential?
|
restoration of the resting membrane potential
|
|
what is the first step (at the cellular level) in initiating an action potential?
|
depolarization
|
|
fibular collateral ligament
|
P: lateral femoral condyle
D: fibular head S: varus stress |
|
Nuchal ligament
|
P: inion, medial nuchal line
D: spinous process of C7 S: cervical flexion |
|
after repolarization, which cellular mechanism restores the resting membrane potential?
|
the ATPase pump
|
|
what type of reflex arc is proprioception?
|
supra-segmental
|
|
what are the two types of cell membrane currents?
|
inward / outward
flow of ions along the surface |
|
glenohumeral ligament
|
P: labrum of GH joint at the supraglenoid tubercle
D: blends with capsule at anatomical neck of humerus S: adduction |
|
which reflex arc only involves one spinal segment level?
|
segmental
|
|
patellar ligament
|
P: patellar apex
D: tibial tuberosity S: knee flexion |
|
describe a graded potential
|
brief and local change in membrane potential
|
|
what does an excitatory gradedpotential do?
|
moves the membrane closer to threshold
|
|
deltoid ligament
|
P: medial maleolus of tibia
D: navicular tubercle, sustenaculum tali of calcaneous, talus S: eversion |
|
what does an inhibatory graded potential do?
|
moves the membrane farther away from threshold
|
|
which spinal reflex arc is the most complex and involves the spinal cord and brain structures?
|
supra-segmental
|
|
anterior talofibular ligament
|
P: fibular (lateral) maleolus
D: lateral articular facet of talus S: inversion |
|
sacrotuberous ligament
|
P: sacrum (medially)
D: ischial tuberosity S: hip flexion |
|
what does the polarized state of the membrane provide?
|
resting membrane potential
the ability to do electrical work |
|
what receptor is responsible for the stretch reflex?
|
muscle spindle
|
|
inguinal ligament
|
P: ASIS
D: Pubic tubercle S: |
|
what are the two key membrane protein needed for neurotransmission?
|
peripheral proteins - binding sites
integral (trans membranous) proteins - channels |
|
extensor retinaculaum
|
L: fibular maleolus
M: tibial maleolus S: resisted dorsiflexion |
|
what are the three types of structural synapses?
|
axo-dendritic
axo-somatic axo-axonic |
|
which receptor is responsible for the tendon reflex?
|
golgi tendon organs
|
|
what do axo-dendritic synapses link?
|
pre-synaptic axons and post-synaptic dendrites
|
|
coracoacromial ligament
|
P: acromion process
D: coracoid process S: superior upward force (leaning) |
|
what do axo-somatic synapses link?
|
axon of pre-synaptic neuron and the cell body of post synaptic neuron
|
|
supraspinous ligament
|
P: spinous process of C7
D: sacrum S: forward flexion |
|
what do axo-axonic synapses link?
|
axons of two neurons
|
|
linea alba
|
P: xyphoid process
D: pubic symphasis S: trunk extension |
|
what are the two types of functional synapses?
|
chemical
electrical |
|
tibial collateral ligament
|
P: medial femoral condyle
D: medial tibial condyle S: valgus stress |
|
iliotibial band
|
P: anterolateral iliac crest
D: lateral tibial condyle S: adduction |
|
what do both chemical and electrical synapses mediate?
|
transmission of signals between neurons
|
|
what types of receptors are joint kinaesthetic receptors?
|
free dendritic / non-encapsulated
|
|
In a neuron, where does depolarization occur?
|
at the axon terminal
|
|
which receptors provide the brain centers with information about joint position and motion?
|
joint kinaesthetic receptors
|
|
how does Calcium enter the axon terminal?
|
via voltage gated calcium channels
|
|
what does the increase in Calcium concentration at the axon terminal allow?
|
fusion of synaptic vesicles with the membrane
|
|
where would you find the muscle spindle?
|
embedded in skeletal muscles
|
|
where would you find golgi tendon organs?
|
embedded in musculotendinous units
|
|
what happens when NTs bind to the post synaptic membrane?
|
the conformational change opens the gated channels formed by the transmembranous proteins and post synaptic potentials are initiated
|
|
what are the two types of post synaptic potentials?
|
excitatory (EPSP)
inhibitory (IPSP) |
|
which reflex circuits mediate volitional activity?
|
voluntary
|
|
which body structures or involved in the voluntary reflex circuit?
|
higher brain centers
spinal cord skeletal muscle |
|
which reflex circuit mediates reflex activity and regulates muscle tone?
|
involuntary
|
|
which body structures or involved in the involuntary reflex circuit?
|
muscle spindles
spinal cord segments cerebellum |
|
what is the conduction distance of an AP?
|
long distance nerve signal
|
|
what types of motor neurons innervate intrafusal fibers?
|
gamma motor neurons
|
|
what is the conduction distance of an EPSP?
|
graded, local
|
|
what is the conduction distance of an IPSP?
|
graded, local
|
|
where would you find upper motor neurons?
|
the CNS - brain and spinal cord
|
|
where do upper motor neurons originate?
|
primary motor cortex
|
|
does an EPSP have a refractory period?
|
no
|
|
describe the refractory period of an IPSP
|
there isn't one
|
|
what are the two types of summation (neurons)?
|
temporal
spatial |
|
where do lower motor neurons originate?
|
ventral horn of the spinal cord
|
|
describe temporal summation
|
rapid stimulation of post synaptic membranes in quick succession by one or more neurons
|
|
describe spatial summation
|
stimulation of membranes by a large number of NT molecules released by many axon terminals at the same time
|
|
which nervous system division promotes storage (e.g. glycogen and fat)?
|
parasympathetic
|
|
what do inhibitory neurons do?
|
reduce release of NT molecules from the pre-synaptic membrane
|
|
which nervous system division stimulates function of the GI tract?
|
parasympathetic
|
|
what are possible results due to damage of lower motor neurons?
|
atrophy
muscle weakness paralysis areflexia |
|
which nervous system division promotes glandular secretion?
|
parasympathetic
|
|
which nervous system division increases blood sugar levels?
|
sympathetic
|
|
which nervous system division promotes blood flow to skeletal muscles and brain?
|
sympathetic
|
|
which nervous system division stimulates air flow?
|
sympathetic
|
|
describe a neuronal dysfunction in terms of structures affected
|
nerve dysfunction leads to muscular dysfunction
|
|
which nervous system division inhibits GI function and blood flow to the GI tract and the skin?
|
sympathetic
|
|
describe a muscular dysfunction in terms of structures affected
|
nerves are intact
there is a pathology of the muscle itself |
|
what is saltatory conduction?
|
current jumping or skipping from one node to the next along a myelinated axon
|
|
what is multiple sclerosis?
|
a demyelination disorder of CNS neurons
|
|
what is the main function of the autonomic nervous system?
|
maintain homeostasis
|
|
what is the etiology of MS?
|
idiopathetc
perhaps autoimmune triggered by viral infection |
|
what is the early clinical presentation of MS?
|
paresthesia - facial extremities
muscle weakness visual disturbances |
|
what are the later clinical presentations of MS?
|
hyperreflexia
ataxia muscle wasting incontinence emotional instability |
|
what order of neuron are involved at the receptor level?
|
first order
|
|
what is the main function of the perceptual level of sensory integration?
|
choosing how to respond to stimuli based on past experience and the current situation
|
|
what is ALS?
|
degenerative disease of motor neurons in anterior horn and corticospinal tracts
|
|
which area of the brain is the center of perception?
|
cerebral cortex
|
|
what is the etiology of ALS?
|
idiopathic
|
|
what makes up the ascending pathway of the nervous system?
|
receptors
first order neurons second order neurons third order neurons |
|
describe the pathogenesis of ALS
|
degeneration of motor neurons
denervation atrophy sclerosis of SC tissue |
|
what makes up the descending pathway in the nervous system?
|
upper motor neurons
lower motor neurons muscles |
|
what is the eventual cause of death due to ALS?
|
respiratory and cranial nerve dysfunctions
|
|
what type of signal travels along nerve fibers carrying messages?
|
electrical
|
|
what is voltage?
|
electrical potential energy or potential difference
|
|
what is the cause of myasthenia gravis?
|
autoimmune
presence of anti-ACh receptors |
|
describe the pathogenesis of myasthenia gravis
|
circulating antibodies bind to motor end plate blocking NT binding and destroying the binding sites
|
|
what is ptosis and what disorder is it associated with?
|
drooping eyelids
myasthenia gravis |
|
what is used to describe the relationship between voltage, current and resistance?
|
ohms law
|
|
what type of receptor is formed by muscle spindles - free nerve ending or encapsulated?
|
encapsulated
|
|
what is the response formulated to information from the muscle spindle
|
muscle contraction
|
|
what happens during myasthenic crisis?
|
respiratory distress
severe fatigue fever dysphagia |
|
is muscular dystrophy a nervous system problem?
|
no
|
|
describe the pathogenesis of muscular dystrophy
|
skeletal muscle deterioration
necrosis of myofibers replacement of muscle with fibrous tissue |
|
what two reflex arcs are activated by sensory information from muscle spindles?
|
alpha motor neuron arc
gamma motor neuron arc |
|
what are early signs and symptoms of muscular dystrophy?
|
clumsiness
muscle weakness bilaterally |
|
what two things do muscle spindles and their reflex arcs ensure?
|
adequate muscle tone
injury protection |
|
describe the afferent pathway of the muscle spindle reflex arc
|
1. receptors of muscle spindle initiate AP
2. sensory neurons propagate AP to spinal cord |
|
what is the histological difference between Duchenne and Becker's muscular dystrophy?
|
dystophin in absent in DMD
|
|
describe the efferent pathway of the muscle spindle reflex arc
|
1. monosynaptic junction transmits signals to alpha motor neuron
2. new AP transmitted across neuromuscular junction 3. skeletal muscle innervated by alpha motor neuron contract |
|
what are the two causes of inflammatory myopathies?
|
autoimmune
parasitic |
|
what is polymyositis and what disease process is it associated with?
|
inflammation of a number of voluntary muscles
it is a type of inflammatory myopathy |
|
what makes the inside surface of the cell more negative than the outside?
|
anionic proteins inside the cell
slightly more permeable to K+ (leakage) impermeable to sodium |
|
what is dermatomyositis?
|
chronic inflamed muscles with a rash on the face and edema around the eyes
|
|
which cell structure/mechanism is integral to maintaining the resting membrane potential?
|
sodium / potassium pump
|
|
is myasthenia gravis a neurological disorder?
|
no
|
|
what is the resting membrane potential of neurons?
|
-70 mV
|
|
what is an internal stretch?
|
slackening of muscles
|
|
what is an external stretch?
|
stretch mediated by load
|
|
what is the internal/external ionic balance of a depolarized cell?
|
cell membrane is less negative on the inside surface
|
|
how many neurons are involved in the alpha motor neuron arc that inhibits muscles?
|
3
|
|
name the three neurons mediating the alpha motor neuron arc that inhibits muscles
|
sensory - Ia
interneuron alpha motor neuron to the antagonist |
|
what is the function of the alpha motor neuron arc?
|
to prevent injury due to over stretch
maintain muscle tone |
|
which channels and ions are responsible for depolarization?
|
Sodium channels
level of sodium inside the cell increases making it more positive |
|
which channels and ions are responsible for repolarization?
|
potassium
|
|
during the GTO reflex arc, what happens to the antagonist muscle(s)?
|
they contract
|
|
what is the definition of muscle tone (Porth)?
|
resistance to passive movement around a joint
|
|
what type of stimulus results in a graded potential?
|
less than threshold stimulus
|
|
what are the two types of hyertonia?
|
spasticity
tetany |
|
what type of stimulus generates an action potential?
|
threshold or greater
|
|
what clinical tool is an example of the deep tendon reflex?
|
the patellar / knee jerk test
|
|
what type of graded potential results in hyperpolarization?
|
inhibatory graded potential
|
|
what is the ion distribution across the cell membrane in the resting state?
|
Sodium outside
Potassium inside |
|
what is another name for the flexor reflex?
|
pain reflex
withdrawal reflex |
|
how is the flexor reflex similar to the stretch reflex?
|
both involve a flexion / contraction away from a source of pain
|
|
where is a receptor graded potential generated?
|
on receptors of sensory neurons
|
|
what is being excited and inhibited in the flexor reflex?
|
excited: flexors
inhibited: antagonists / extensors |
|
what type of potential results from a hyperpolarized membrane?
|
Inhibitory Post-Synaptic Potential
|
|
describe the crossed extensor reflex
|
ipselateral flexor
contralateral extensor reflex |
|
what type of potential results from a depolarized membrane?
|
Excitatory Post Synaptic Potential
|
|
what is happening during the after-discharge portion of the withrawal reflex?
|
agonists remain contracted while the CNS decides on further action
|
|
list two superficial reflexes / test
|
plantar reflex
abdominal reflex |
|
what is the usual role of axo-dendritic synapses?
|
excitatory
|
|
what is the usual role of axo-somatic synapses?
|
usually inhibatory
|
|
what is the Babinski's sign?
|
abnormal response to plantar simulation where the big toe dorsiflexes and the other digits fan out
|
|
what is the usual role of axo-axonic synapses?
|
modulate the release of NT molecules by post synaptic neuron
|
|
the Babinski's sign is considered normal up to what age?
|
one year
|
|
where would you find chemical synapses?
|
neuromuscular junction
neuroglandular junctions |
|
hypertension and Raynaud's syndrome are examples of imbalances in which nervous system?
|
autonomic
|
|
what is the role of chemical synapses?
|
carry NT molecules from pre-synaptic membrane to post synaptic
convert electrical signals to chemical signals |
|
where would you find electrical synapses?
|
cardiac muscle
single unit smooth muscle |
|
which type of synapse is the structural basis of functional syncytia?
|
electrical synapses
|
|
what four things help to protect the brain?
|
the skull
meninges CSF blood brain barrier |
|
what are the four functions of the meninges?
|
separate brain from other structures
protect blood vessels hold CSF partition the brain |
|
list the layers of CT of the brain from superficial to deep
|
dura mater
arachnoid mater pia mater |
|
which ions enter the axon terminal at depolarization?
|
calcium
|
|
describe the arachnoid mater
|
fine elastic membrane
it fills the nooks and crannies |
|
where do NTs bind to on the post synaptic membrane?
|
to protein receptors
|
|
what is found in the narrow subdural space?
|
serous fluid
|
|
what is found in he wide subarachnoid space?
|
CSP
large blood vessels |
|
which ion is involved in excitatory post synaptic potentials?
|
calcium
|
|
what does the arachnoid villi do?
|
anchors the arachnoid to the dura mater with projections
|
|
which ion is involved in inhibitory post synaptic potentials?
|
potassium
|
|
what is the relationship between neurotransmitters and the intensity of stimulation?
|
more NTs = higher intensity of stimulation
|
|
what are the functions of CSF?
|
buoyancy for the brain
protection nourishment (brain cells) |
|
what three ways can neurotransmission be terminated?
|
1. enzymatic degradation
2. reuptake of NTs by pre-synaptic neuron 3. diffusion away from the synaptic cleft |
|
does the composition of CSF change?
|
no, it remains constant via ion pumps
|
|
what is the threshold value of most neurons?
|
-55 mV
|
|
what is the choroid plexus?
|
capillaries encased in a special layer of cells
|
|
what is the site of initiation of an Action Potential?
|
pre-synaptic neuron
|
|
what are the two cell layers of the choroid plexus?
|
capillary endothelial cells
ependymal cells |
|
what is the site of initiation of an EPSP?
|
post synaptic neuronal membrane
|
|
what is the site of initiation of an IPSP?
|
post synaptic neuronal membrane
|
|
what is the speed of neurotransmission along the axon?
|
very rapid
|
|
what is the rate of diffusion of neurotransmitters?
|
relatively slow
|
|
what stimulus opens the gates for an AP?
|
electrical, change in ion concentration
|
|
what stimulus opens the gates for an EPSP?
|
chemical / NT
|
|
what stimulus opens the gates for an IPSP?
|
chemical / NT
|
|
what is the result of summation in an EPSP?
|
depolarization
|
|
what is the result of summation in an IPSP?
|
hyperpolarization
|
|
what are the boundaries of the lateral sulcus?
|
temporal / frontal - parietal
|
|
what are possible results due to damage of lower motor neurons?
|
atrophy
muscle weakness paralysis areflexia |
|
where can damage to lower motor neurons occur?
|
ventral horn
ventral root peripheral nerve |
|
what type of dysfunction is seen with upper motor neuron damage?
|
loss of control over voluntary movement
spasticity |
|
where can damage to upper motor neurons occur?
|
brain (motor cortex)
spinal cord |
|
what is the critical function of the basal nuclei?
|
initiation and coordination of voluntary movement
|
|
what structure is being destroyed in MS?
|
myelin
|
|
what is the result of demyelination in someone with MS?
|
the neurons are stimulated but the propogation of the AP is slow and it dies out quickly
|
|
describe the pathogenesis of MS
|
1. inflammation of CNS lymphocytes, T cells, macrophages
2. demyelination in brain, brain stem and SC 3. plaque formation and loss of oligodendrocytes |
|
what is the function of the medula oblongata?
|
signal relay between brain and SC
regulates heartbeat, blood flow, respiration |
|
what does the cerebellum help to coordinate?
|
movement
balance muscle tone (via gamma reflex arc) smooth, coordinated movement |
|
which population is affected most by MS?
|
young and middle aged
15-55 years |
|
how many Brodmann areas are there?
|
52
|
|
what leads to remission in MS?
|
remyelination and restoration of neurotransmission
|
|
what is the outcome of ALS?
|
fatal
2 - 6 years after onset |
|
what is somatotrophy?
|
mapping of regions of the body within a brain area
|
|
what is the sensory nerve involvement in ALS?
|
none
|
|
which population is most affected by ALS?
|
males
40-60 years |
|
what is the ratio of males to females suffering from ALS?
|
2:1
|
|
which structure is 'faulty' in myasthenia gravis?
|
the motor end plate is defective
|
|
what is the clinical definition of consciousness?
|
continuum of responses to environmental stimuli
|
|
what does alert mean?
|
very aware of surroundings
highly responsive |
|
what does drowsy mean?
|
less aware
oxygen uptake remains high |
|
what does stupor mean?
|
responsive only to vigorous stimuli
|
|
what is the sensory nerve involvement in myasthenia gravis?
|
none
|
|
what does coma mean?
|
total unresponsiveness
extended loss of consciousness reduced O2 uptake to brain cells |
|
which population is most affected by myasthenia gravis?
|
females 20 - 30
males > 60 |
|
list the motor areas of the cerebral cortex
|
primary motor cortex
premotor cortex Broca's speech area frontal eye field |
|
what is the ratio of young woman to men that suffer from myasthenia gravis?
|
3:1
|
|
what does the frontal eye field control?
|
voluntary eye movement
|
|
what is the treatment for myasthenia gravis?
|
muscle rehab
drugs to disrupt the fault binding at the motor end plate |
|
what are basal nuclei?
|
islands of grey matter among the white matter of the cerebrum
|
|
what other two disorders are sometimes also associated with myasthenia gravis?
|
Rheumatoid arthritis
systemic lupus |
|
what triggers myasthenic crisis?
|
stress
illness colds pregnancy |
|
why does someone with muscular dystrophy have pseudo-hypertrophy?
|
because muscle mass increases due to the fatty and CT replacement in muscle
|
|
what does the reticular activating system do?
|
it keeps the brain awake by sending a continuous stream of signals to various regions
|
|
the reticular activating system filters out what?
|
background signals
|
|
where is the muscle weakness found in early muscular dystrophy?
|
pelvis and pectoral girdle
|
|
what are the two main structures of the diencephalon?
|
thalamus
hypothalamus |
|
what is the target population for Duchenne muscular dystrophy?
|
children ages 3 - 5
males mostly, females rare |
|
what is the target population for Becker's muscular dystrophy?
|
adults
|
|
how many nuceli make up the thalamus?
|
5
|
|
how much of the diencephalon is the thalamus (%)?
|
80%
|
|
describe alpha waves
|
regular
rhythmic low frequency |
|
what types of fibers are innervated by alpha motor neurons?
|
extrafusal fibers
|
|
where would you find a muscle spindle?
|
between extrafusal fibers in the muscle belly
|
|
describe theta waves
|
irregular
found in children, not wakeful adults |
|
what role does the muscle spindle play in maintaining muscle tone?
|
muscles contract when relaxation (stretch) becomes excessive
|
|
in which stage of sleep does dreaming occur?
|
stage 3
|
|
where do gamma motor neurons synapse?
|
contractile ends of interfusal fibers
|
|
in which stage of sleep are vital signs at their lowest and GI motility increases?
|
stage 4
|
|
what makes up a Golgi Tendon Organ?
|
collagen fiber bundles (tendon)
connective tissue capsule |
|
what happens to skeletal muscles during REM sleep?
|
they are actively inhibited
|
|
how often in the night do young and middle aged adults reach REM?
|
every 90 minutes
|
|
what happens to REM sleep as the night progresses?
|
the REM stages get longer
|
|
what is the stimulus and response involved in the deep tendon reflex?
|
stimulus = stretch on a muscle
response = muscle contraction |
|
what hormones are released during stage 3 and 4 sleep?
|
growth hormone
melatonin |
|
which anatomical structure mediates the deep tendon reflex?
|
muscle spindle
|
|
when the stretch reflex occurs what is excited and what is inhibited?
|
excites: agonist
inhibits:antagonist |
|
how many wake periods do adults experience during sleep?
|
2
|
|
when the GTO reflex occurs what is being excited and what is inhibited?
|
excites: antagonist
inhibits: agonist |
|
how many wake periods do seniors experience during sleep?
|
6
|
|
what is converted to make melatonin?
|
serotonin
|
|
define sleep
|
a state of reduced or partial consciousness from which a person can be aroused
|
|
what is the purpose of the crossed extensor reflex?
|
it aids in balance during withdrawal from the site of danger
|
|
what are the four important functions of sleep
|
tissue restoration
neural activity hormone secretion dreaming |
|
how much (%) of growth hormone is released during stage 3 - 4 sleep?
|
70%
|
|
which SC segments are tested during a plantar reflex test?
|
L4 - S2
|
|
what are the two types of memory?
|
short term
long term |
|
what is the normal response during a plantar reflex test?
|
plantar flexion
|
|
what is fact or declarative memory?
|
conscious thought
articulate what we know studying and remembering details |
|
which spinal segments are tested with the abdominal reflex test?
|
T8 - T12
|
|
what is skill memory?
|
memory learned through repetition and doing
|
|
what is the normal reaction to an abdominal reflex test?
|
umbilicus moves towards source of stimulus (muscles contract)
|
|
how are taste and smell linked?
|
both are specialized epithelia
depend on chemoreceptors |
|
how much of taste is actually related to smell?
|
80%
|
|
what type of reflex / tone regulates normal cardiac and GI function?
|
parasympathetic tone
|
|
which types of (general) functions are controlled by the higher brain centers?
|
thought processes
emotional responses coordination of voluntary motor function |
|
describe the pathway of taste sensations
|
chemical stimulus
tongue cranial nerve pons thalamus cerebral cortex (gustatory region) somatosensory area hypothalamus / limbic system |
|
which types of (general) functions are controlled by the lower brain centers?
|
involuntary somatic motor function
visceral functions |
|
how much of the cerebral cortex is dominated by visual processing?
|
half
|
|
where would you find the dural sinuses and what do they do?
|
in the dura mater
drain venous blood |
|
what is a nerve lesion?
|
a zone of localized dysfunction within the CNS or PNS
|
|
what structure helps to anchor the brain to the skull?
|
the dura mater
|
|
what is an anatomic nerve lesion?
|
structural integrity is compromised
e.g. a nerve is cut |
|
what is a physiological nerve lesion?
|
nerve function is compromised
e.g short term ischemia due to inflammation |
|
which CT layer of the brain brings blood vessels to the surface of the brain?
|
pia mater
|
|
describe a depressed skull fracture
|
bone is splintered and impinges on brain tissue
|
|
what are some secondary effects of skull fractures that might be seen in a few hours after injury?
|
edema
intracranial hematoma infection ischemia hypoxia |
|
where do you find CSF?
|
in the subarachnoid space
ventricular system central canal of the SC |
|
define a concussion
|
momentary interruption of brain function with or without loss of consciousness
|
|
describe a moderate concussion
|
longer period of unconsciousness
associated with neurological damage |
|
contusion in the brain stem area leads to what?
|
coma due to injured reticular formation
|
|
what structures form the blood-brain barrier?
|
choroid plexi
capillary membranes |
|
subdural or arachnoid bleeding is what type of brain injury?
|
hemorrhage
|
|
what is the purpose of the blood brain barrier?
|
maintain constant chemical environment
a selective barrier that excludes harmful substances |
|
inflammation in the brain leads to what?
|
cerebral edema
|
|
which substances diffuse freely across the blood-brain barrier?
|
water
CO2 O2 |
|
which ions are excluded from the brain?
|
sodium
potassium |
|
what substances are barred from the brain?
|
metabolic waste
plasma protein most drugs |
|
what is a transient ischemic attack?
|
brief 5 - 50 second episode of ischemia in the brain
|
|
which parts of the brain form the cerebrum?
|
cerebral cortex
basal nuclei |
|
which parts of the brain from the diencephalon?
|
thalamus
hypothalamus epithalamus |
|
which brain areas from the forebrain?
|
cerebrum
diencephalon |
|
what is a seizure?
|
abnormal neuronal activity
|
|
which structures from the hind brain?
|
pons
mendulla oblongata cerebellum |
|
what are the two classifications of seizures?
|
partial
generalized |
|
which structure allows communication between the right and left brain hemispheres?
|
corpus collosum
|
|
which nerve tract is between the right and left hemispheres of the brain?
|
commissural
|
|
describe an absence seizure
|
tonic muscle activity (no convulsion)
change in consciousness sudden stop of activity |
|
which nerve tract is found within each hemisphere of the brain?
|
association
|
|
which nerve tract is between the upper and lower brain?
|
projection
|
|
describe a myoclonic seizure
|
sudden brief contractions
no loss of consciousness patient falls (if lower limbs involved) |
|
what type of brain marking marks larger areas such as those between the right and left hemispheres?
|
deep fissures
|
|
what are the boundaries of the lateral sulcus?
|
temporal / frontal - parietal
|
|
which slightly elevated area of the brain is the site of the primary motor cortex?
|
the pre-central gyrus
|
|
which slightly elevated area of the brain is the site of the primary somatosensory cortex?
|
the post-central gyrus
|
|
what type of matter is the cerebral cortex?
|
grey matter
|
|
what type of work does the cerebral cortex do?
|
perception
memory emotional activity voluntary motor activity sense perception and interpretation |
|
what type of matter is the corpus collosum?
|
white matter
|
|
what type of matter is the basal nuclei?
|
grey
|
|
which structure does the basal nuclei wrap around?
|
the thalamus
|
|
what is the role of the thalamus?
|
relay centre of sensory information
processes information from all brain centres and the spinal cord |
|
what is the main function of the hypothalamus?
|
integrates and regulates autonomic functions
|
|
what types of body functions are regulated by the hypothalamus (5)?
|
body temperature
appetite water balance ciradian rhythms pituitary gland secretion |
|
which gland coordinates endocrine function and where would you find it?
|
pituitary gland
base of hypothalamus |
|
which gland is found in the epithalamus?
|
pineal gland
|
|
what is the main function of the epithalamus and the pineal gland?
|
circadian rhythms
melatonin |
|
which part of the brain relays sight and sound signals?
|
midbrain
|
|
which hemisphere of the brain is logical?
|
left
|
|
which hemisphere of the brain is emotional?
|
right
|
|
where would you find the somatosensory association area?
|
behind the somatosensory cortex
|
|
what is the main function of the somatosensory association area?
|
it is the first stage in formulating an appropriate response to environmental change
|
|
which brain area is involved in learning, cognition and emotive expression?
|
prefrontal cortex
|
|
which area of the brain is involved in complex memory patterns associated with sensation?
|
general interpretation
|
|
which area of the brain is the 'speech area'?
|
Wernicke's area
|
|
which two areas of the brain work together to form a narrative of our experiences?
|
prefrontal cortex
general interpretation areas |
|
what role does the basal nuclei play in movement?
|
starting, stopping, monitoring movement
regulating intensity of movement inhibiting antagonistic movements |
|
which 'area' of the brain is known as the emotional brain?
|
the limbic system
|
|
which area of the brain is responsible for cortical alertness?
|
reticular formation
|
|
which area of the brain contains the olfactory bulb and what phenomenon does it explain?
|
the limbic system
explains emotional reaction/memory attached to smell |
|
where would you find the reticular activating system?
|
spanning the length of the brain stem
|
|
which area of the diencephalon is the major relay centre for sensory and motor signals?
|
thalamus
|
|
which area of the diencephalon is the major integration center for autonomic function?
|
hypothalamus
|
|
which area of the diencephalon is related to learning and memory?
|
thalamus
|
|
where is the hypothalamus located?
|
inferior to the thalamus
|
|
which gland is linked to the hypothalamus?
|
pituitary
|
|
what types of brain waves are less regular, and of higher frequency than alpha waves?
|
beta
|
|
what types of waves are high amplitude waves that indicate brain damage if seen in wakeful adults?
|
delta
|
|
what mental state is associated with beta waves?
|
mental alertness
active thinking |
|
what types of waves are found in stage 1 sleep?
|
alpha
|
|
what types of waves are found in stage 3 sleep?
|
theta
delta |
|
what types of waves are found in stage four of sleep?
|
delta
|
|
which stage of sleep is considered to be 'quality' sleep?
|
REM sleep
|
|
which population experiences the least restful sleep?
|
the elderly
|
|
how many wake periods do children experience during sleep?
|
1
|
|
how many wake periods do adults experience during sleep?
|
2
|
|
what regulates circadian rhythm?
|
hypothalamic pacemakers and the pineal gland
|
|
which body structure produces melatonin?
|
pineal gland
|
|
which brain areas are related to learning and memory processing?
|
limbic system
thalamus / hypothalamus prefrontal cortex |
|
neuronal excitement, repetition, and connecting old and new information facilitates what?
|
retention
|
|
where are gustatory buds located?
|
tongue
soft palate |
|
which cranial nerves carry taste sensations?
|
CN VII
CN IX |
|
which of the special senses is the dominant sense?
|
sight
|
|
Which CN carries signals from the eye to the cerebral cortex?
|
CNII - optic nerve
|
|
which CN innervate the muscles of the eye?
|
CN III
CN IV CN VI |
|
where would you find a basilar skull fracture?
|
at the base of the skull
|
|
which are the two most serious types of skull fractures?
|
depressed
basilar |
|
what are some secondary effects of skull fractures that might be seen in a few hours after injury?
|
edema
intracranial hematoma infection ischemia hypoxia |
|
which classification of concussion leads to momentary loss of consciousness with no lasting neurological damage?
|
mile
|
|
which classification of concussion results in serious damage to brain structures and may result in paralysis or death?
|
severe
|
|
blocked arteries, tumous and intracranial pressure can all lead to what?
|
cerebrovascular accident
|
|
what type of motor dysfunction is seen with a stroke?
|
often unilateral
muscle weakness to paralysis loss of fine digital motor control |
|
what is the treatment for TIAs?
|
asprin
blood thinners Calcium blockers |
|
why do upper motor neuron lesions cause spastic paralysis?
|
because UMNs are responsible for initiation of voluntary movement and control over LMNs. So movement is uncoordinated
|
|
what type of seizure is characterized by behaviour changes, hallucinations or sensory illusions?
|
partial - complex
|
|
which type of seizure has a sudden onset of unconsciousness with convulsions of the extremities?
|
tonic-clonic
|
|
paralysis that affects one side of the body and can be spastic or flaccid
|
hemiplegia
|
|
what is monoplegia
|
paralysis of one limb
|
|
paralysis that affects both legs
|
paraplegia
|
|
what is quadriplegia?
|
paralysis of both legs and both arms
|
|
which area of the brain controls gross and discrete movement?
|
primary motor corext
|
|
which area of the brain controls simultaneous or sequential movement and programmed skills?
|
pre-motor cortex
|
|
what loss causes spasticity in UMNLs?
|
loss of communication from higher brain centers
|
|
does an UMNL affect inhibition or excitation of muscles?
|
both
|
|
describe the reflexes of someone with an UMNL
|
hyperreflexia
abnormal superficial reflexes (abdominal or plantar) |
|
UMNLs affect which upper limb muscles the most?
|
rotator cuff
elbow flexors supinators finger flexors |
|
which lower limb muscles are most affected with an UMNL?
|
hip adductors
hip extensors knee extensors |
|
what are the two classifications of spinal cord injuries?
|
incomplete
complete |
|
describe a complete spinal cord injury
|
total loss of function distal to site of injury
|
|
describe an incomplete spinal cord injury
|
partial loss of function distal to site of injury
|
|
what are the four levels of herniation from least to most severe?
|
protrusion
prolapse extrusion sequestration |
|
describe protrusion herniation
|
posterior bulge
no disc rupture |
|
bulging of the nucleus through the annulus fibrosis with no rupture of the annulus fibrosis suggests what?
|
prolapse herniation
|
|
describe extrusion herniation
|
annulus fibrosis is perforated
nucleus pulposus extrudes into epidural space |
|
if both the nucleus and the annular fibrosis are extruded, what does that suggest?
|
sequestration herniation
|
|
what is spondylolisthesis?
|
anterior slippage of one vertebrae over another
|
|
damage between C1 and C7 results in what type of paralysis?
|
quadriplegia
|
|
where must a spinal cord injury occur to affect sympathetic function or vasomotor activity?
|
above T6
|
|
what are some autonomic dysfunctions that might be present due to spinal cord injury?
|
orthostatic hypotension
thermoregulation DVT bowel/bladder/sexual |
|
what are the autonomic manifestations of spinal shock?
|
vasovagal response
bradycardia impaired circulatory regulation reduced BV tone hypothermia hypotension |
|
what is autonomic dysreflexia?
|
a medical emergency due to exaggerated sympathetic reflex response due to decreased control from higher brain centres
|
|
what are the systemic manifestations of autonomic dysreflexia?
|
severe hypertension
bradycardia headaches nasal congestion anxiety |
|
in someone with autonomic dysreflexia would vasospasm, skin pallor and piloerector response be found above or below the site of injury?
|
below
|
|
in someone suffering from autonomic dysreflexia what symptoms would you expect to find above the site of injury?
|
sympathetic vasomotor response: vasodilation, flushed skin, profuse sweating
|
|
what are some causes of primary seizures?
|
idiopathic
CNS lesion |
|
what are some causes of secondary seizures?
|
high fever in children
tumour scar tissue due to trauma progressive neuro diseases |
|
what are some physiological mechanisms that account for sudden convulsions?
|
changes in cell permeability
changes in ion distribution inhibition of cortical or thalamic activity glial scarring (shift to hyper excitability) NT imbalances |
|
describe a simple partial seizure
|
jerky movement
hearing and visual disturbances strange sensations stomach discomfort |
|
describe a complex partial seizure
|
impaired consciousness
confusion, disorientation purposeless behaviour momentary amnesia |
|
list the four types of complex seizures
|
absence
atonic myoclonic tonic clonic |
|
what type of seizure manifests in 5-15 second lapse in consciousness, staring into space and eyes rolling upward?
|
absence
|
|
describe an atonic seizure
|
very brief loss of muscle tone
loose jaw slack limbs falling if affects weight bearing limbs |
|
what are the two types of myoclonic seizures?
|
tonic
clonic |
|
what is the difference between a tonic seizure and a clonic seizure?
|
tonic - no limb movement - rigidity
clonic - contraction / relaxation |
|
describe a tonic-clonic seizure
|
has a tonic phase followed by a clonic phase
|
|
in cerebral palsy damage to the motor cortex results in what?
|
spasticity
|
|
athetoid cerebral palsy is a result of damage to what area of the brain?
|
basal ganglia / nuclei
|
|
damage to the cerebellum with cerebral palsy results in what?
|
ataxia
|
|
what is the greatest cause of cerebral palsy?
|
prenatal causes such a premature birth, genetic factors, cerebral malfunctions
|
|
what causes of cerebral palsy may be encountered in early childhood?
|
meningitis
brain injury toxins |
|
chemical changes in the body can lead to what type of PNS nerve lesion?
|
systemic
|
|
systemic PNS lesions present with...
|
spontaneous muscle firing or inhibition
aberrant sensations motor weakness trembling |
|
local nerve compression syndromes manifest with...
|
abnormal sensations
muscle dysfunction distal trophic skin changes |
|
damage to a dorsal nerve root results in what kind of symptoms?
|
sensory
paresthesia |
|
damage to a ventral nerve root results in what kind of symptoms?
|
pareisis
paralysis |
|
what are some causes of mononeuropathies?
|
fractures
laceration tight banding / cast too tight infection (eg. herpes) |
|
what types of things can lead to polyneuropathies?
|
usually systemic
immune response toxic agents metabolic diseases |
|
what is different about the loss of sensation or motor function in a polyneuropathy in comparison to a mononeuropathy?
|
it can be symmetrical / bilateral
|
|
where does the anterior longitudinal ligament attach?
|
periosteum of vertebrae and the IVD
|
|
where does the posterior longitudinal ligament attach?
|
IVDs
posterior edges of vertebral bodies |
|
what is osteoarthritis?
|
a degenerative disease characterized by progressive loss of articular cartilage
|
|
what is the role of articular cartilage?
|
provides smooth joint surface
distributes load |
|
where is spondylolisthesis most common?
|
L5/S1
|
|
what is spondylosis?
|
displacement of the vertebral column without forward slippage accompanied by joint immobility
|
|
what is anklylosing spondylitis?
|
arthritis of the spine accompanied with fusion of the vertebrae
|
|
what is degenerative disc disease?
|
deterioration of the annulus fibrosis of the IVDs
|
|
what causes Degenerative Disc Disease?
|
repetitive microtrauma in the CS or LS leading to reduction of the disc space or disc herniation
|
|
what is the result of DDD?
|
narrowing of intervertebral foramina leading to possible nerve root compression
|
|
what movement can lead to a cervical spine disc herniation?
|
sudden hyperflexion
|
|
what movement can lead to a lumbar spine disc herniation?
|
combination of flexion and rotation
|
|
describe the onset and pain symptoms of a disc herniation
|
sudden onset
pain radiates pain on flexion |
|
what type of nerve lesion is a compartment syndrome and what causes it?
|
peripheral
caused by compression |
|
how much intercompartmental pressure is considered normal?
|
6 mm Hg
|
|
how much intercompartmental pressure is considered severe?
|
30-40 mm Hg
|
|
30 minutes of compartment compression results in...
|
paraesthesia
|
|
2 - 4 hours of compartment compression results in...
|
muscle dysfunction
|
|
12-24 hours of compartment compression results in...
|
irreversible loss of function
|
|
what two states can lead to compartment syndromes?
|
anything that decreases compartment size of increases compartment mass / volume
|
|
describe scalene anterior syndrome
|
compression of the brachial plexus between the anterior and middle scalenes
|
|
describe pectoralis minor syndrome
|
compression of the neurovascular bundle passing between the tendon of pec minor and the coracoid process
|
|
describe costoclavicular syndrome
|
the neurovascular bundle is tractioned between the clavicle and the first rib
|
|
the edema in anterior scalene syndrome is causes by what?
|
impaired subclavian blood flow
|
|
what are the common signs and symptoms for all TOSs?
|
paraesthesia in arm, forearm, hand and fingers
|
|
what is neuralgia?
|
sudden, severe, sharp pain along the course of a nerve with not detecable structural change
|
|
what are some common neuralgias?
|
trigeminal
intercostal |
|
what is neuritis?
|
inflammation of a nerve or nerves with pain
|
|
what are some causes of neuritis?
|
mechanical
infections toxins metabolic vascular |
|
what is polyneuritis?
|
inflammatory condition affecting a number of peripheral nerves
|
|
describe the onset and presentation of polyneuritis
|
sudden onset
severe pain lower limb weakness eventually affects whole body: DTRs, sensory and autonomic |
|
what is reflex sympathetic dystrophy?
|
acute, unrelenting burning pain of a distal limb
|
|
what causes reflex sympathetic dystrophy?
|
sudden deformation of a peripheral nerve
|
|
what are signs and symptoms of RSD?
|
hyperalgesia
hyperaestheais swelling that doesn't follow innervation pattern affected area kept immobile |
|
which population is most affected by RSD?
|
the elderly
|
|
what are the spinal segments associated with the musculocutaneous nerve?
|
C5-C6
|
|
what are the spinal segments associated with the median nerve?
|
C5 - T1
|
|
what are the spinal segments associated with the ulnar nerve?
|
C8 - T1
|
|
what are the spinal segments associated with the radial nerve?
|
C5 - T1
|
|
what are the spinal segments associated with the axillary nerve?
|
C5 - C6
|
|
what is Bell's Palsy?
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unilateral facial paralysis involving swelling of tissues around Cranial Nerve VII (Facial)
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Cranial Nerve VII mostly innervates what?
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muscles of fascial expression
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where does CN VII originate?
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pons / medulla
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what visceral functions are affected with Bells Palsy?
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salivation
tears (lacrimal) |
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where is sensory loss noted with Bells Palsy?
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external ear canal
soft palate |
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what is hyperacusis and what pathology is it associated with?
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acute hearing
Bells Palsy |
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what is the treatment for Bell's Palsy?
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eye care
drug therapy surgery |
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What is Erb's Palsy?
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traction injury to C5-C6 nerve root
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What is Klumpke's paralysis?
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traction injury to C8 - T1 nerve root
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Erb's palsy can lead which deformities?
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waiter's tip
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Klumpke's paralysis can lead which deformities?
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claw hand
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what is the main difference between Klumpke's paralysis and Erb's Palsy?
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Klumpke's paralysis has ANS involvement
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describe the ANS involvement with Klumpke's paralysis
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miosis
ptosis Horner's syndrom |
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what is miosis?
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dilation of the pupil
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what is Horner's Syndrome?
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loss of sweating of the face and neck
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wrist drop is caused by paralysis of...
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the radial nerve
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describe wrist drop
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slight pronation
weak adduction weak thumb adduction elbow / wrist / finger flexion |
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what are some possible areas of injury leading to radial nerve paralysis?
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axilla
humerus elbow wrist |
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radial nerve lesions lead to anaesthesia in which area of exclusive innervation?
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dorsal web space (thenar)
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which area of the hand will NOT have sensory loss with a radial nerve lesion?
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medial 1/3 of the hand
distal fingers |
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which nerve entrapment syndrome leads to ape hand?
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median nerve
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describe ape hand
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wasting of the thenar eminance
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where does entrapment occur with pronator syndrome?
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at the elbow
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what is the most disabling aspect of median nerve entrapment syndromes?
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loss of thumb opposition
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does median nerve entrapment lead to ANS dysfunction?
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yes
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which nerve entrapment syndrome leads to Bishop's Hand?
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ulnar nerve
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which movements will be paralyzed with an ulnar nerve lesion?
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finger abduction
finger adduction thumb adduction 5th finger opposition |
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which nerve lesion leads to claw hand?
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combined medial and ulnar lesion
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describe carpal tunnel syndrome
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compression of the median nerve between the transverse carpal ligament and the flexor tendons of the wrist/hand
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what can cause carpal tunnel syndrome?
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occupational
increased pressure (external and internal) narrowing of the tunnel |
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what should be avoided when you have carpal tunnel syndrome?
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excessive flexion/extension
prolonged or forceful gripping wrist hyperextension |
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what is a polyneuropathy?
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pathology that affects multiple nerve sites
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is a polyneuropathy unilateral or bilateral?
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usually bilateral
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where do symptoms usually begin with a polyneuropathy?
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distal segments of the limb
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what can cause polyneuropathy?
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autoimmune reaction
toxic agents metabolic diseases |
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describe the pathogenesis of Guillain Barre Syndrome
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- mononuclear WBCs infiltrate around peripheral nerve capillaries
- edema of endoneurial compartments - demyelination of ventral spinal roots |
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what is the ANS involvement with GBS?
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postural hypotension
arrhythmia abnormal sweating urinary retention impaired circulation respiratory failure |
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describe treatment of pain
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an interim measure controlling pain levels until the cause is dealt with
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describe pain management
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learning to live with or minimize the pain felt due to an underlying cause that can't be removed
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what is chronic pain?
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pain the persists beyond the time expected for the healing of an injury
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what is intractable pain?
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persistent chronic pain that defies treatment and has not demonstrable disease process of cause
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what is allodynia?
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pain resulting from a normally innocuous stimulus
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what is analgesia?
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absence of normal sense of pain
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what is analgesic?
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pain relieving factor
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what is anesthesia?
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loss of sensation without loss of consciousness
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what is causalgia?
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a severe burning pain
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what are endorphins and enkephalins?
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endogenous opiate like substances produced by the brain
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what is a narcotic analgesic?
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opioids modifying pain sensations
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what is nociception?
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perception of pain
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describe the structure of nociceptors
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free dendritic
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where would you find nociceptors?
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dermis
subcutaneous (CT) visceral organs skeletal muscle joint capsules |
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at what level does nociceptive stimuli occur?
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at or close to intensities that cause tissue damage
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do nociceptors always transmit only pain signals?
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yes
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which nerve fibers transmit signals to extrafusal fibers?
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A-Alpha
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what type of stimulus is conducted by A-Beta nerve fibers?
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tactile
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which nerve fibers transmit signals to the contractile ends of muscle spindles?
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A-Gamma
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what type of stimulus is conducted by A-Delta nerve fibers?
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tactile
pain |
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which nerve fibers transmit tactile, pain and temperature signals?
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C fibers
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which two nerve fibers are responsible for pain sensations?
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A-Delta
C |
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what are the two interneurons responsible for pain impulse transmission?
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projection cells
inhibitory internuncial cells |
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which spinal tract carries pain impulse transmission?
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lateral spinothalamic
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where do first order pain impulses synapse onto second order neurons?
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at the dorsal root
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where does the lateral spinothalamic tract cross over?
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the medial lemniscus / pons
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what nerve fiber type are inhibitory (pain) neurons?
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A-Beta
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are C type nerve fibers myelinated?
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no
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what is the clinical application of both A-Beta and C fibers with regards to pain transmission?
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the larger, faster A-Beta fibers (tactile) can sometimes override the pain transmission from the smaller, slower moving C fibers (pain)
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which nerve fibers form the 'gate' in the pain gate theory?
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substantia gelatinosum
projection cells |
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impulses coming from where inhibit projection cells?
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substantia gelatinosum
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which fibers activate the substantia gelatinosum?
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A-Delta
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what are the two major pathways for pain transmission?
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spinothalamic
spinoreticulothalamic |
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which pain pathway/tract is responsible for spatiotemporal pain localization?
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spinothalamic
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what type of information does the spinoreticulothalamic deal with?
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emotional and avoidance responses
non localized |
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describe the pathway of the spinoreticulothalamic system
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ascending tract
reticular system in brain stem hypothalamus thalamus somatosensory cortex |
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which is an objective measure: pain threshold or pain tolerance?
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pain threshold
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what is pain tolerance?
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a subjective measure of an individual's ability to withstand pain
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what types of structures release algogenic serotonin?
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platelets
mast cells (GI tracts) cancer cells |
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where is pain inhibiting serotonin released from?
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the periaquaductal grey matter in the midbrain
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what types of membrane channels are involved with analgesic serotonin?
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potassium
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what types of membrane channels are associated with algogenic serotonin?
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sodium channels
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besides seratonin, what is the PAG's role in pain reduction?
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it contains receptors that bind endogenous opiates
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the serotonin released by the PAG activates receptors on which structure?
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the raphe nucleus
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describe the raphe nucleus's role in the pain gate theory
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raphe nucleus transmits signals from the brain on descending fibres terminating in the dorsal horn. These signals inhibit pain (close the gate)
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endorphins and encephalins modulate pain at what level of the body?
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the spinal cord
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describe the characterization of cutaneous pain
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sharp
burning easily localized |
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describe the character of deep somatic pain
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diffuse
radiates achy, dull, throbbing |
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describe the character of visceral pain
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severe
sharp or dull/achy diffuse, not easily localized |
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what is the source of pshychogenic pain?
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undefined
unknown cause |
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which nerve fibres are responsible for fast pain?
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A-delta
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describe the characteristics of fast pain
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short
bright/sharp localized abrupt onset subsides quickly when stimulus removed |
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which nerve fibres are responsible for slow pain?
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C fibres
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describe slow pain
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throbbing
burning aching |
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which nerve fibre types have chemoreceptor characteristics that respond to algogenic substances released in response to tissue damage?
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C fibres
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