Neuro final

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Neuro final
2012-08-16 18:14:36

Slides 29-56
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  1. 1st order neurons
    -Cell body lies in the dorsal root ganglion
  2. 2nd order neuron
    -Cell body is in the spinal cord or medulla oblongata
  3. 3rd order neuron
    -  Cell body is in the thalamus
  4. Adiadochokinesia
    Inability to perform rapidly alternating movements
  5. Astereognosis
    Loss of the ability to distinguish between objects through touch and manipulation
  6. Asynergia
    Loss of coordination in performing motor acts
  7. Ataxia
    Loss of proper coordination between muscles
  8. Dysmetria
    Inability to judge distance & stop movement at chosen spot
  9. Ascending Tracts Chart (see chart week 3)
    • Fasciculus Gracilis
    • Fasciculus Cuneatus
    • Anterior Spinothalamic
    • Lateral Spinothalamic
    • Anterior Spinocerebellar
    • Posterior Spinocerebellar
  10. Descending Tracts Chart (see chart week 4)
    • Anterior Corticospinal
    • Lateral Corticospinal
    • Lateral Reticulospinal (medullary)
    • Medial Reticulospinal (pontine)
    • Rubrospinal
  11. Difference between Upper & Lower Motor Neurons
    • Upper Motor Neuron-
    • Form descending tracts

    • Lower Motor Neuron- 
    • Directly innervate skeletal muscle
  12. Pyramidal Signs
    Clinical signs of damage to the upper motor neuron functions of the corticospinal tract only
  13. Upper Motor Neuron Syndromes (5)
    • §Pyramidal Weakness
    • §No wasting of muscles
    • §Spasticity
    • §Hyperreflexia
    • §Positive Babinski reflex
  14. Lower Motor Neuron Syndromes (6)
    • §Weakness (paresis)
    • §Paralysis (plegia)
    • §Atrophy
    • §Hypotonia
    • §Hyporeflexia or Areflexia
    • §Visible spontaneous contractions of motor units
  15. Because of the crossing of the principal motor pathways in the lower brain stems, lesions in the cerebral hemispheresand higher brain stem cause paralysis of the...

    Spinal cord lesions lead to paralysis of the limbs on the...
    § limbs opposite (contralateral) to the side of the lesion

    §limbs on the same side as (ipsilateral to) the lesion
  16. Cerebellum
    External Structures
    §Two lateral (right/left) hemispheres partially separated by a layer of the dura mater called
    falx cerebelli
  17. Cerebellum
    §Structure that connects the hemispheres at the midline
  18. Cerebellum
    • •Operates at unconscious level
    • •Controls the maintenance of equilibrium
    • •Influences posture and muscle tone
    • •Coordinates movement
  19. Dermatome
    A skin area innervated by the sensory fibers of a single nerve root
  20. Myotome
    A group of muscles primarily innervated by the motor fibers of a single nerve root
  21. Cranial Nerves
    • I     Olfactory                       S
    • II   Optic                              S
    • III    Oculomotor                 M
    • IV    Trochlear                     M
    • VI    Trigeminal                   B
    • VI    Abducens                    M
    • VII   Facial                           B
    • VIII Vestibulocochlear        S
    • IX    Glossopharyngeal        B
    • X     Vagus                           B
    • XI    Accessory                    M
    • XII  Hypoglossal                 M
  22. Cranial Nerve- Function? S-M-B?
        I  -  Olfactory
    Sensory – Smell
  23. Cranial Nerve- Function? S-M-B?
       II  -  Optic
    Sensory – Vision
  24. Cranial Nerve- Function? S-M-B?
      III  -  Oculomotor
    Motor    – Muscles that raise eyelids, move eyes, adjust amount of light entering the eye & focus lenses
  25. Cranial Nerve- Function? S-M-B?
      IV  -  Trochlear
    Motor    – Muscles that move one eye
  26. Cranial Nerve- Function? S-M-B?
      V  -  Trigeminal           
    -  Ophthalmic          
    -  Maxillary           
    -  Mandibular
    Sensory – Impulses from the surface of the eyes, tear glands, scalp, forehead & upper eyelids

    Sensory – Impulses from upper teeth, upper gum, upper lip, lining of the palate and skin of face

    Sensory – Impulses from scalp, skin of jaw, lower teeth, lower gum & lower lip

    Motor    - Muscles of mastication and muscles in the floor of the mouth
  27. Cranial Nerve- Function? S-M-B?
      VI  -  Abducens
    Motor   –  Muscles that move one eye
  28. Cranial Nerve- Function? S-M-B?
     VII  -  Facial
    Sensory – Impulses associated with taste receptors of the anterior of the tongue

    Motor  –  Impulses to muscles of facial expression, tear glands & salivary glands
  29. Cranial Nerve- Function? S-M-B?
    VIII  -  Vestibulocochlear            
    - Vestibular            
    - Cochlear
    • Sensory – Impulses associated with equilibrium
    • Sensory – Impulses associated with hearing
  30. Cranial Nerve- Function? S-M-B?
    IX  -  Glossopharyngeal
    Sensory – Impulses from the pharynx, tonsils, posterior tongue and carotid arteries

    Motor    – Impulses to salivary glands and to muscles of pharynx for swallowing
  31. Cranial Nerve- Function? S-M-B?
    X  -  Vagus
    Sensory – Impulses from pharynx, larynx, esophagus & viscera of thorax & abdomen

    • Motor    – Somatic motor impulses to muscles associated with speech and swallowing              
    •              – Autonomic motor impulses to viscera of the thorax & abdomen
  32. Cranial Nerve- Function? S-M-B?
    XI  -  Accessory            
    -  Cranial            
    -  Spinal
    • Motor   –  Impulses to muscles of the soft palate, pharynx and larynx
    • Motor   –  Impulses to muscles of the neck and back; some proprioception input
  33. Cranial Nerve- Function? S-M-B?
      XII  -  Hypoglossal
    Motor   –  Impulses to muscles that move the tongue                
  34. Meninges Function
    Protects brain & spinal cord
  35. Epidural Space
    Space between the dura mater and the periosteum of the bone (skull)
  36. Subdural Space (potential space)
    • Space between the dura mater (meningeal layer and arachnoid)
    • Filled with thin film of fluid (may fill w/blood as with hemorrhage)
  37. Subarachnoid Space
    Space between the arachnoid mater and the pia mater
  38. Cranial Meninges
    • Dura mater
    • Arachnoid Mater
    • Arachnoid Granulations (villi)
    • Pia Mater
  39. Cranial Meninges
    Dura mater
    • Tough, outermost membrane- 
    • Splits into 2 layers forming channels called the dural sinuses   
    • Periosteal Layer – outermost layer 
    • Meningeal Layer – innermost layer
  40. Cranial Meninges
    Arachnoid Mater
    -  Thin, web-like membrane that is located between the dura & pia mater
  41. Cranial Meninges
    Arachnoid Granulations (villi)
    • Small, mushroom shaped protrusions (finger-like    projections) of  arachnoid- 
    • Located in the dural sinuses - 
    • Re-absorb CSF into the venous system
  42. Cranial Meninges
    Pia Mater
    • Very thin, inner layer that clings or attaches to brain surface- 
    • Dips into grooves & contours
  43. Spinal Meninges
    • Dura Mater
    • Arachnoid
    • Pia
    • Filum Terminale
  44. Spinal Meninges
    Dura Mater
    -  Composed of only one meningeal layer
  45. Spinal Meninges
    -  Continuous with the cranial arachnoid
  46. Spinal Meninges
    -  Closely conforms to the spinal cord
  47. Spinal Meninges
    Filum Terminale
    – Pia mater gathers into a very thin, non-nervous filament at the conus medullaris
  48. Cranial Meninges – Dura Mater
    Falx cerebri
    Dura mater dips or folds down into the median longitudinal fissure between (separates) the right & left cerebral hemispheres
  49. Cranial Meninges – Dura Mater
    Tentorium cerebelli
    Tentorium cerebelli Dura also dips or folds down into the space between the cerebellum and the overlying occipital lobes forming a tent-like covering over the cerebellum  (separates occipital lobes of the cerebrum from the cerebellum)
  50. Cranial Meninges – Dura Mater
    Falx cerebelli
    Dura mater dips between (separates) the two cerebellar hemispheres
  51. Meninges of the Spinal Cord
    Filum Terminale
    §  Spinal Pia mater gathers into a very thin, non-nervous filament at the conus medullaris

    §  Extends for approximately 20cm

    §  Attached to the periosteum of the first     coccygeal vertebra§  Helps anchor and stabilize the spinal cord
  52. Meninges of the Spinal Cord
    Pia Mater  
    Dentate Ligaments
    • §Dentate Ligaments
    • §Toothlike extensions
    • §Located on each side of the entire spinal cord
    • §Attached to the arachnoid and dura
    • §Serve to anchor and stabilize the spinal cord
  53. Lateral Ventricles
    • Pair of C-shaped structures with “horns”- 
    • The C-shape allows the ventricles to reach into all lobes of the cerebrum
  54. Interventricular Foramen
    -Connects the lateral and third ventricles
  55. Third Ventricle
    Floor of the third ventricle is formed by the hypothalamus-Walls are formed by right/left thalamus
  56. Cerebral Aqueduct
    Connects the third & fourth ventricle
  57. Fourth Ventricle
    • -  Extends laterally into each cerebellar hemispheres forming recesses
    • -  Fourth ventricle narrows inferiorly and becomes the central canal of the spinal cord
  58. Cerebrospinal Fluid ( CSF)
    Clear lymph-like fluid that is produced by the choroid plexus located in the lateral, third & fourth ventricles 

    • Fills the entire subarachnoid space which surrounds the brain and spinal cord
    • Protective cushioning for brain & spinal cord
  59. Circle of Willis (Cerebral Arterial Circle)
    • -  Right & Left Internal Carotid Arteries
    • -  Right & Left Vertebral Arteries
  60. Right & Left Internal Carotid Arteries
    -Bifurcate into the
    • -Anterior cerebral arteries
    • -Middle cerebral arteries
  61. Anterior Communicating Artery
    Connects the Right & Left Anterior Cerebral Arteries
  62. Middle cerebral arteries
    -    Give rise to the...
     striate arteries
  63. Striate arteries
    • -Frequent site of CVAs
    • -Known as “arteries of stroke”
  64. Posterior Communicating Arteries
    -  Connects the middle cerebral and posterior cerebral arteries
  65. Right and Left Vertebral Arteries -  Gives rise to:
    • Anterior Spinal & Posterior Spinal arteries 
    • Posterior Inferior Cerebellar arteries Basilar artery
    • -Joins together to form Basilar artery
  66. Basilar Artery
    Bifurcates into the..
    Posterior Cerebral Arteries
  67. Anterior Spinal artery (1)
    Posterior Spinal arteries (2)
    • -  Three longitudinal vessels run the length of the spinal cord-  
    • Insufficient to supply the cord below cervical levels
  68. Radicular arteries
    Serial reinforcement or Supplemental arteries for the spinal cord
  69. Superior sagittal sinus
    -Receives blood primarily from the superior cerebral veins and superior anastomotic vein
  70. Inferior sagittal sinus
    -Receives flow of veins from the medial aspect of the hemisphere
  71. Straight Sinus
    -  The Great Cerebral vein runs into the Straight Sinus
  72. Confluence of the Sinuses
    Convergence of the Superior Sagittal and Straight Sinuses
  73. Transverse Sinus
    • Blood flows laterally from the confluence and also receives blood from the cavernous sinus
    • -Continuous with the Sigmoid sinus
  74. Sigmoid Sinus
    • -  Continues from the transverse sinus
    • -  Joins the Internal Jugular vein at the level of the jugular foramen
  75. Diseases / Disorders per handout
    see handouts