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What is cranial nerve 1, and it's major function?
Olfactory, its major function is smell.
What is the second cranial nerve and it's major function?
Optic, its major function is vision.
What is cranial nerve 3 and it's function?
Oculomotor, its major function is eye movement.
What is the 4th cranial nerve and it's major function?
Trochlear, its major function is eye movement.
What is the 5th cranial nerve and it's major function?
Trigeminal, its major function is chewing. face, mouth, teeth scalp sensation.
What is the 6th cranial nerve and it's function?
Abducens and it turns eyes outward
What is the 7th cranial nerve and it's major function?
Facial and it controls most facial expressions and taste sensation. Tears, mucus and saliva production
What is the 8th cranial nerve and it's major function?
Vestibulocochlear (Acoustic) and its major function is hearing and equilibrium.
What is the 9th cranial nerve and it's major function?
Glossopharyngeal and its major function is the sensations of throat, taste, swallowing movements. Secretion of saliva. Normal voice (Contraction of the pharynx)
What is the 10th cranial nerve and it's major function?
Sensory and motor to larynx, (-) HR, contraction of the eliminatory tube, (+) digestive secretions, Sensory of cardiac, resp. + BP reflexes
What is the 11th cranial nerve, and it's major function?
Accessory (spinal accessory) and its major function is controlling the trapezius & sternocleidomastoid muscles.
What is the 12 cranial nerve and it's major function?
Hypoglossal and its major function controls tongue movements.
What two systems maintain homeostasis of the body?
The Endocrine and the Nervous system.
What are Ganglia?
Bunch of cell body's located outside the CNS
What is an Afferent Neuron?
Afferent are sensory. They send information to the CNS.
What are Efferent Neurons?
Efferent Neurons are Motor Neurons the send information from the CNS to the rest of the body.
What is the organization of the Nervous system?
The Nervous system is Organized into two divisions. The CNS and the PNS
What is the break down of the CNS organization?
- -Spinal cord
What is Gray Matter made up of?
Gray matter is made up of Nerve Cells
What is white matter is made up of?
White matter is made up of militated Sheaths, it is what allows the communication occur
What is the division of the Brain or Functional areas of the Brain?
What is the Broca's area responsible for? and where is it located?
Broca's area is responsible for Motor Expressive speech (getting information out that makes sense. It is located in the frontal lobe.
What is the Wernicke's area responsible for, and where is it located?
The Wernicke's area is responsible for language comprehension. Its located in the Temporal lobe.
Which side of the brain is the dominant side in most people?
The left Hemisphere is the dominant side in most people.
Divisions of the Cerebrum?
Left Hemisphere and the Right Hemisphere
The Left Hemisphere is responsible for what characteristics?
- -Problem solving
- -Logical reasoning
The Right Hemisphere is responsible for what characteristics?
- -Artistic abilities
- -Spatial relations
- -Emotional/Behavioral characteristics
What are the Lobes of the Cerebrum?
- -Frontal Lobe
- -Parietal Lobe
- -Temporal Lobe
- -Occipital Lobe
What does the Frontal lobe do?
- -Voluntary Movements
- -Intellectual function
- -This is where the Broca's area is located
What does the Parietal lobe do?
- -Sensation (touch and pain)
- -This is where the Wernickies area is located
What is the Basal Ganglia/Nuclei
- -Cluster of nerve cells
- -Surrounds the Thalamus
- -Initiating and intergrading movements
What are some associated Diseases with the Basal Ganglia?
Where is the Diencephalon located?
Between the brainstem and the cerebrum
What are the major divisions of the Diencephalon?
What is the responsibility of the Hypothalamus?
- -Control Center for ANS
- -Temperature regulation
What is the Thalamus responsible for?
- -Sorting and relay station
- > Incoming Sensory
- -General body movement
Where is the Limbic system located?
-Portion of cerebrum and diencephalon
What is the Limbic responsible for?
- -Sensation to pain and pleasure
What is the division of the Brainstem?
- - Pons
- - Medulla Oblongata
What is the responsibility of the Medulla Oblongata?
- Vital center & Cranial nerves IX - XII
- -Vasomotor Center
What is the responsibility of the Pons?
- -Relays information
- > Cerebrum to Cerebellum
- -Sleep Center
- -Respiratory Center
- -Cranial nerves V - IIV
- (How well we breathe, sleep)
What is the Reticular Formation, and where is it located?
- -Its part of the Reticular Activating system (RAS)
- -Regulates many involuntary functions
What is the RAS (reticular activating system)
- -Control over the Cerebral Cortex
- >Sleep/wake cycle
- >Arousing and maintaining consciousness
What are the major functions of the Cerebellum?
- -Gross motor Coordination
- -Smooth muscle movement
- > Balance
- > Posture
- -Compares intended movement with actual one
What structures protect the brain?
- > Three Layers
What are the layers of the Meninges? (in order of inferior to superior)
- -Dura Mater
- >Subdural space
- >Dura sinuses
- -Arachnoid mater (not very strong)
- >Subarachnoid Space
- >Arachnoid Villi
- -Pia Mater
What are the Ventricles of the Brain?
- -There are 4 Ventricles
- -Choroid Plexus
- >This is where CSF is produced
What is the Blood Brain Barrier?
- -Protective Mechanism
- -Tight Junction of capillary Endothelial Cells
- >Least permeable capillaries in the entire body
- -Only allows lipid soluble substances
What DOES get through the BBB?
- -Water (There is a difference between water itself and water soluble)
- -Anesthetic Substances
What is the Extrapyramidal System?
-Motor pathway in the CNS
What does the Extrapyramidal System affect?
- Skeletal muscle
- Coordinates movements
What is the Blood supply to the brain?
- -Internal Carotid Arteries
- -Vertebral arteries
- -Circle of Willis
What is the make up of the Internal Carotid Arteries?
- -Anterior cerebral artery
- -Middle cerebral artery
What is the make-up of the Vertebral Arteries?
- -Basil artery
- -Posterior cerebral arteries
How many Cranial nerves are there?
How many spinal nerves are there?
31 - Identified by Letter and Number
What do the Spinal Nerves?
-Conduct impulses between spinal cord and parts of the body not supplied by the cranial nerves
How many nerves are in the Cervical section of the spine?
8 pairs of nerves
How many nerves are in the Thoracic section of the spine?
How many nerves are in the lumbar section of the spine?
How many nerves are in the Sacral section of the spine?
How many nerves are in the Coccyx section of the spine?
Where does the Internal Carotid Artery come from?
Where does the Vertebral arteries come up from?
What areas of the brain does the Internal carotid arteries perfuse?
Look this up in the paramedic book
What areas of the brain does the Vertebral arteries perfuse?
Look this up in the paramedic text book
What is the hole at the bottom of the skull called?
Cranial Nerve 1 is what type of nerve?
Cranial nerve II is what type of nerve?
What type of nerve is Cranial nerve #3?
Motor (Efferent) and Parasympathetic
What type of nerve is Cranial nerve #4?
What type of nerve is Cranial nerve #5?
Combo, Sensory and Motor
What type of nerve is cranial nerve #6?
What type of nerve is cranial nerve #7?
Sensory, Motor and parasympathetic
What type of nerve is cranial nerve #8?
What type of nerve is cranial nerve #9?
Sensory, motor and parasympathetic
What type of nerve is cranial nerve #10?
Sensory, motor and parasympathetic
What type of nerve is cranial nerve #11?
What type of nerve is cranial nerve #12?
What is a reflex arc?
A reflex arc is communication that does not include the intraneuron its like touching something hot. You don't think before you move.
What is a Dermatome?
- A Dermatome is an area on the surface of the skin supplied by a single nerve
- Letters and numbers indicate spinal nerves innervating a given region of the skin
Can neurons regenerate?
- PNS nerves can regenerate
- CNS nerves do not regenerate
What conducts impulses?
- Neurons conduct information (Impulses)
- Glia or Neuroglia do not transmit
What is the 3 parts of a Neuron?
What are the three types of neurons?
What is the purpose of a Interneuron?
- (Also called Central/Connecting Neurons)
- Connects sensory neurons to Motor
What is Myelin?
Myelin is a fatty substance that allows information to be transmit
Where are Schwann Cells located?
Only in the PNS surrounding the Axon
What is the outer layer of the Schwann cells called?
What are the nodes of Ranvier?
- The nodes of Ranvier are the spaces between the Schwann cells.
- Its also a place for nutrients and waste
What is the Saltatory conduction?
Saltatory Conduction is the bunny hoping that information takes down the Axon in the Nodes of Ranvier
What is Repolarization?
Getting back to the place where it receive another impulse
What is Depolarization?
This is where the sodium channels ion and an Electrical impulse goes across the axon
What is the Preganglionic neurotransmitter for the parasympathetic and the sympathetic nervous system?
What happens in the Synapse?
Transmission of signals from the presynaptic neuron to the synaptic neuron.
What actions occur in the in the Synapse, in order.
Denrites receive information (Energy) relay the information to the cell body, down the axon to the Synaptic Knob where the Vesicles are located containing a certain neurotransmitter will be released, then across the Synaptic Cleft to the Plasma membrane where the Receptor sites are located, and the neurotransmitter can only connect to a certain receptor
What is an Action Potential?
What receptor is always inhibitory?
How does the body get rid of neurotransmitters?
- Destroyed by certain enzymes
- Reabsorbed into the synaptic Knob
What kind of neurons is the Autonomic system made up of?
Motor neurons only
What is the enzyme that breaks up Acetylcholine?
What is the Enzyme(s) that break up Norepinephrine?
What are the types of Glia Cells we need to know?
What do Astrocytes do?
Attach to Neurons and Small Blood Vessels
What so the Microglia do?
What do the Oligodendrocytes do?
Produce Fatty Myelin Sheaths (Protection)
Where does the Parasympathetic nerves come from?
The cranial and sacral areas
What is the make up of the Preganglionic Neurons?
- Cell body located in the CNS
- Come from the Brainstem and the sacral region
Where are the Postganglionic Neurons?
- On or near the Visceral Structures
What are the Cranial Preganglionic Neurons nerves?
What are the Cholinergic Receptors?
Stimulation of the Parasympathetic Nervous system results in what?
- Pupillary Constriction
- Secretion of Saliva
- Reduced HR & Negative Inotropic Effects
- Increases Secretion by Digestive glands
- Increased smooth muscle activity along the GI track
- Increased Urine
What is the location of the Preganglionic Neurons in the sympathetic nervous system?
- Cell body located in the CNS
- Comes from the Thoracic + Lumbar regions
What is the location of the sympathetic Postganglionic neurons?
- Come off the Paravertebral Sympathetic Ganglion chain
What are the Adrenergic Receptors?
- 2 - Alpha
- 2 - Beta
What does Alpha 1 do?
- Peripheral vasoconstriction
- Increased Glycogenolysis
- Pupillary Dilation
- There is more Alpha 1 then Alpha 2
What does Alpha 2 do?
- Peripheral vasodilation (Limits release of Norepinephrine)
- Stimulated By Excessive Amounts of Norepinephrine in Synaptic Cleft
What does Beta 1 do?
- + Inotropic
- + Chronotrpic
- + Dronotropic
- Increased Automaticity
What does Beta 2 do?
- Peripheral vasodilation
- Uterine smooth muscle relaxant
- GI smooth muscle relaxant
Stimulation of the sympathetic nervous system does what?
- Dilates Pupils
- Constricts Peripheral Vessels
- Increase Blood to Skeletal Muscles
- Increase Chronotropic and Inotropic effects
- Decrease Digestive Activity
What are some things that are specific to the sympathetic nervous system?
- Sweat Glands Stimulation
- Release of Glucose Stores From the Liver
- Arrector Pili Stimulation
- Adrenal Medulla Stimulation
Are the stimulation of the sweat glands sympathetic or parasympathetic nervous system?
They are parasympathetic in nature but are stimulated by the sympathetic nervous system
What are the 3 Cranial nerves that are Motor, sensory, parasympathetic?
How do we test cranial nerve # 1
How do we test cranial nerve # 2
How do we test cranial nerve # 3
Check pupil size, shape, reactivity to light - Cardinal Gaze
How do we test cranial nerve # 4
Turn eye laterally, up+down
How do we test cranial nerve # 5
- Sensory: Use something thats sharp/dull and put on pt’s face, cheek, chin and ask pt to distinguish
- Motor: Ask pt to clinch teeth while you palpate the temporal, massetar muscle
How do we test cranial nerve # 6
How do we test cranial nerve # 7
- Motor: Smile, frown, raise eye brow
- Sensory: Taste something
- Parasympathetic: Mucus membranes are pink and wet
How do we test cranial nerve # 8
Rombergs/Snapping hearing test
How do we test cranial nerve # 9
- Sensory: Taste/gag reflex
- Motor: Ask patient to swallow and listen for normal voice sounds Parasympathetic: Secretion of saliva
How do we test cranial nerve # 10
- Sensory: Assess patient ability to swallow and produce saliva, rub tummy
- Motor: Produce normal voice sounds
- Parasympathetic: Valsalva maneuver
How do we test cranial nerve # 11
Ask patient to shrug shoulders and look left and right
How do we test cranial nerve # 12
Ask patient to stick out their tongue and move it around
What does the middle cerebral artery perfuse?
- Parietal Lobe
- Temporal Lobe
What does the Anterior Cerebral artery perfuse?
What does the Basil artery perfuse?
- Medulla Oblongata
What does the Posterior Cerebral Arteries perfuse?
What are the 5 components of the neurological assessment?
- Mental Status and speech
- Cranial nerves (Sensory, Motor, Parasympathetic)
- Motor system
- Sensory System
Where is the RAS located?
The RAS is located in the brainstem
What is the definition of Confused?
Bewilderment (Not quite getting it)
What is the definition of Disorientation?
Losing the ability to know where you are
What is the definition of Lethargy?
What is the definition of Obtundant?
A chemical cause to be less conjugate
A state near-unconsciousness or insensibility
Define a Coma.
- A state of deep/superficial unconsciousness that lasts for a prolonged or indefinite period
- Superficial= Deep reflexes are present
- Deep= No reflexes
- A period of prolonged inspiratory hold
- People do this on a regular basis (A deep breath)
What is Normal Breathing called?
What are Cheyne-Stokes?
- A regular irregular breathing pattern
- Usually associated with a Neurological problem, however sow people do normally
- Pattern with periods of apnea
- Looks like torsades de pointes
What is Central Neurogenic Hyperventilation?
Fast, Deep and regular ventilations
What is Expressive Aphasia?
Problems expressing speech
What is Receptive Aphasia?
What is Dysarthria?
Problems getting things out
What is Dysphonia?
- weakness problem getting things out
- (But can still get things out)
What does Anascoria mean?
- Unequal pupils
- Can be normal
What is a Conjugate/Disconjugate gaze?
- Conjugate: Both eyes looking in the same direction
- Disconjugate: Eye's looking in different directions
What is hyperreflexia?
Reflex is extra large
What is Spasticity?
Increase uncle tone to where they are tight
What is Rigidity?
Not moving very stiff (Dead people)
What is Flaccidity?
Floppy, hanging lose or limp
What is the Pronators Drift test?
- This is where you ask the patient to put their arms up in front of them with there palms facing up, if one of the arms fall and turns downward then it is a positive drift pronators drift test, if the arm falls but the hands remain supinated the test is positive arm drift
- Test coordination
How do we test muscle tone?
Have the patient push and pull with their feet and hands
What types of Posturing are there?
- Decorticate: This is where the patients feet extend and the hands flex toward the patients core
- Decerebrate: This is where the patients feet/hands extend out
What is Hemianopia?
Loss of vision
What is the Eye Opening of the GCS?
- 4 - Spontaneous
- 3 - Open to Voice
- 2 - Open to Pain
- 1 - No eye opening
What is the Verbal section of the GCS?
- 5 - Oriented
- 4 - Confused speech
- 3 - Inappropriate words
- 2 - Incomprehensible words
- 1 - No Verbal response
What is the Motor response section of the GCS?
- 6 - Obeys commands
- 5 - Localizes Pain
- 4 - Withdraws from pain
- 3 - Flexion (Decorticate)
- 2 - Extension (Decerebrate)
- 1 - No Motor response