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Neurology

FA complete review part 2 Physiology/Anatomy

QuestionAnswer
List of Vagal nuclei: 1. Nucleus Solitarius 2. Nucleus Ambiguus 3. Dorsal motor nucleus
What is the function of the Nucleus solitarius? Visceral sensory information (taste, baroreceptors, gut distension)
Which cranial nerves associated with the Vagal Nucleus solitarius? VII, IX, and X
Motor innervation of pharynx, larynx, and upper esophagus. Which vagal nuclei is described? Nucleus ambiguus
What actions are performed or regulated by Nucleus ambiguus? Swallowing and palate elevation
CNs involved in the nucleus ambiguus IX, X, and XI
Which is the only cranial nerve involved with the Dorsal motor nucleus? X
What is the function of the Dorsal motor nucleus? Sends autonomic (parasympathetic) fibers to heart, lungs, and upper GI.
What are some common cranial nerve reflexes? Corneal, Lacrimation, Jaw jerk, Pupillary, and gag reflexes.
Afferent corneal reflex is done by which nerve? V1 Ophthalmic (nasociliar y branch)
Which CN gives rise to the efferent Corneal reflex? Bilateral VII (temporal branch: orbicularis oculi)
Which reflex is checked by testing Bilateral VII (temporal branch)? Efferent Corneal reflex
Which cranial nerve reflexes are regulated by the CN V1? Afferent Corneal and Afferent Lacrimation reflexes
Does the loss of the afferent lacrimation reflex does not ---> Preclude emotional tears
Which CN must be tested in order to check for Efferent lacrimation reflex? VII
CN V3 cranial afferent reflex? Jaw jerk
Cranial nerve reflex: Sensory-muscle spindle form masserter Afferent Jaw jerk reflex due to V3 stimulation
Efferent Jaw jerk cranial reflex: V3 (motor -masseter)
Which muscle is involved in both efferent and afferent Jaw jerk cranial nerve reflex? Masseter
Which CN is involved in the efferent part of the Pupillary cranial reflex? CN III
What is the cranial nerve involved in the afferent part of the Pupillary reflex? CN II
Which reflex is checked by testing CN II? Afferent Pupillary reflex
A damaged CN III, will cause loss of what part of the pupillary reflex? Efferent Pupillary reflex
CN _____ is involved in afferent gag reflex. IX
Which CN is involved in the efferent part of the gag reflex? X
Damaged CN X will cause a deficit in which cranial nerve reflex? Efferent Gag reflex
How many (number) muscles close the jaw? 3
How many (number) muscles are needed to open the jaw? 1
Which muscles are used to close the jaw? Masseter, Temporalis, and Medial pterygoid
Which muscle is used to open the jaw? Lateral pterygoid
All mastication muscles ar innervated by which cranial nerve? CN V3
Which subdivision of the Trigeminal nerve is in charge to innervate all opening and closing jaw muscles? V3
Which Pterygoid muscle is used to open the jaw, lateral or medial? Lateral
The Medial pterygoid muscle _______________ the jaw. Closes
Masseter, Temporalis, and Medial pterygoid. Mastication muscles that close the jaw
Total number of pairs of spinal nerves 31
How are all 31 pairs of spinal nerves categorized? - 8 cervical pairs - 12 thoracic pairs - 5 lumbar pairs -5 sacral pais - 1 coccygeal pair
How many Cervical Spinal nerve pairs exist? 8
Which subdivision has the most spinal nerve pairs? Thoracic with 12 pairs
Which spinal nerves have each 5 pairs? Lumbar and Sacral
How many coccygeal spinal nerve pairs exist? 1
Which spinal nerves exit above the corresponding vertebra? Nerves C1-C7
What is anatomically important about Spinal nerves C1-C7? Exit ABOVE the corresponding vertebra
Do spinal nerves form C1-C7 exit above or below, the corresponding vertebrae? Above
Which is the only spinal nerve that exits above and below the corresponding vertebra? C8 spinal nerve
C8 spinal nerve exits ---> Below C7 and above T1
C8 spinal nerve exits above the _________. T1
C8 spinal nerve exits below the ________. C7
Nerves below the C8 exit ____________ corresponding vertebra. Below
Where would C3 spinal nerve exit the vertebrae? Above the 3rd cervical vertebra
Where would L2 spinal nerve exits the vertebra? Below the 2nd lumbar vertebra
What is a Vertebral Disc herniation? Nucleus pulposus herniates through annulus fibrosus
MC location anatomically for Vertebral disc herniation Posterolaterally at L4-L5 or L5-S1
In a vertebral disc herniation, which nerve is usually affected? Nerve below the level of herniation
Absent ankle reflex is due to compression of which spinal nerve root? S1
Compression of S1 nerve root ----> Absent ankle reflex
In a vertebral disc herniation of L3-L4, which nerve is affected and which would be spared? L3 would be spared, while L4 is affected
What is the soft central disc of vertebrae also known as? Nucleus pulposus
Another way to refer to the outer ring by which a vertebral disc herniation goes through? Annulus fibrosus
How far does an adult lower spinal cord normally extend to? L1-L2 vertebrae
The subarachnoid space extends how far in healthy adults? Lower border of S2 vertebra
Most common and best locations for a Lumbar puncture? L3-L4 or L4-L5
Why is an LP (lumbar puncture) usually performed in L3-L5 area? Level of Cauda Equina
What is the most likely location of the cauda equina in a healthy adult? L3-L5 vertebrae
What is the ultimate goal of a Lumbar puncture (LP)? Obtain sample of CSF without damaging spinal cord
What are the two DESCENDING spinal cord tracts? 1. Lateral Corticospinal tract 2. Anterior Corticospinal tract
What are the divisions of the Lateral corticospinal tracts? Sacral and Cervical tracts
What is controlled or regulated by the Descending tracts of the Spinal cord? Voluntary motor
List of all ASCENDING spinal tracts: 1. Dorsal column (Fasciculus gracilis, and Fasciculus Cuneatus) 2. Lateral spinothalamic tract 3. Anterior spinothalamic tract
What type of sensory information is controlled or sensed by the Dorsal column? Pressure, vibration, fine touch, and proprioception.
What are the divisions of the Dorsal column?? 1. Fasciculus gracilis 2. Fasciculus cuneatus
Fasciculus gracilis controls which part of the body? Lower body, legs
Fasciculus cuneatus provides sensory information to which part of the body? Upper body, arms
An injury to the F. cuneatus will cause deficits in sensation in the ______________. Upper body and arms
What spinal tract sense pressure, vibration, fine touch, and proprioception? Dorsal column
What is sense the Lateral Spinothalamic tract? Pain and temperature
What is sense by the Anterior Spinothalamic tract? Crude touch, and pressure
Which parts of the dorsal column are the most medial in respect of the spinal cord? Sacral an lumbar
Damage to the Lateral spinothalamic tract will cause Deficit in sensing pain and temperature
Ascending or Descending. Lateral Spinothalamic tract: Ascending
Ascending or Descending: Anterior Spinothalamic tract: Ascending
The Dorsal Column is ascending or Descending tract? Ascending
Ascending and Descending. Fasciculus gracilis? Ascending
Fasciculus Cuneatus is it descending or ascending? Ascending
Ascending or Descending. Lateral corticospinal tract? Descending
Ascending or Descending. Anterior Corticospinal tract? Descending
Name of the anterior descending spinal cord tract: Anterior Corticospinal tract
Key. If the name of the of the spinal tract has the cord "Cortico-" is ascending or descending? Descending
The spinothalamic tracts are both ____________________________. Ascending
Pain and temperature are sensed by which spinal cord tract? Lateral Spinothalamic tract
Crude touch and pressure are sensed or relayed by which cord tract? Anterior Spinothalamic tract
Complete sentence. "Ascending tracts ________________........" Synapse and then cross
Which tracts synapse and then cross? Ascending tracts
1st-Orden Neuron of Dorsal column: Sensory nerve ending --> bypass pseudounipolar cell body in dorsal root ganglion --> enter spinal cord --> ascend ipsilaterally in dorsal column
Where is the Synapse 1 of Dorsal column? Nucleus gracilis, nucleus cuneatus (ipsilateral medulla)
Decussates in medulla and then ascends contralaterally as the medial lemniscus. 2nd-order neuron in Dorsal column tract
Where is the Synapse 2 of the Dorsal column? VPL of the Thalamus (sensory cortex)
What are the two division of the Spinothalamic tract? Lateral and Anterior
Describe the mechanism of the 1st order neuron in the Spinothalamic tract: Sensory nerve ending --> bypass pseudounipolar cell body in dorsal root ganglion and finally entering the spinal cord
Where is the Synapse 1 of the Spinothalamic tract? Ipsilateral gray matter (in spinal cord)
2nd-order Neuron of the Spinothalamic tract: Decussates in spinal cord as the anterior white commissure and then ascends contralaterally
The dorsal column 2nd-order neuron decussates in the ___________________ to tehn ascend contralaterally. Medulla
Which important structure provides the ascend of the second order neuron of the Dorsal column? Medial lemniscus
What can be found to travel up alongside the second order neuron of the dorsal columns? Medial lemniscus
Where is the Synapse 2 of the spinothalamic tract? VPL of the Thalamus (sensory cortex)
If the Synapse 2 is the VPL of the thalamus, which are the two possible tracts? Dorsal columns and Spinothalamic tracts
Crossing the spinal cord at the white commissure is seen in which ascending tract? Spinothalamic tract
Which tract has function for Voluntary movement of contralateral limbs? Lateral corticospinal tract
What is the 1st-order neuron function of the Lateral corticospinal tract? UMN: cell body in primary motor cortex --> descends ipsilateral, and most fibers decussate at the caudal medulla
At what point the first-order neuron of the lateral corticospinal tract decussatus? Caudal medulla
The decussation of the first-order neuron of the lateral corticospinal tract is known as: Pyramidal decussation
Which gtract is known to "descend contralaterally"? Lateral corticospinal tract
Which is the 1st-order neuron of the lateral corticospinal tract, UMN or LMN? UMN
Where does the Synapse 1 of the Lateral corticospinal tract occurs? Cell body of anterior horn of the spinal cord
What is the most likely referred tract, if the synapse 1 happens that the cell body of anterior horn of spinal cord? Lateral corticospinal tract
LMN of the Lateral corticospinal tract is the ----> Second-order neuron pathway
Where is the synapse 2 of the lateral corticospinal tract? Neuromuscular junction (NMJ) ---> muscle fibers
What are the 4 main clinical reflexes? 1. Achilles reflex 2. Patellar reflex 3. Biceps and brachioradialis reflexes 4. Triceps reflex
Nerve roots of the Achilles reflex S1 and S2
Which is the main nerve root of the Achilles reflex? S1
A damage to the S1, S2 nerve roots will cause --> Weak or absent Achilles reflex
Damage to nerve roots L3 , L4 causes: Weak or absent Patellar reflex
What are the nerve roots of the Patellar reflex? L3 and L4
Which is the main nerve root for the Patellar reflex? L4
Which reflex is tested by checking L3/L4 nerve roots? Patellar reflex
The Biceps and Brachioradialis reflexes are tested by checking which nerve roots? C5 and C6
Which is the main nerve root for the Biceps and Brachioradialis reflexes? C5
Which important clinical reflex is tested by the C5 and C6 nerve roots? Biceps and Brachioradialis reflexes
S1, S2 nerve roots ------> reflex? Achilles
L3, L4 nerve roots -----> reflex? Patellar
C5, C6 nerve roots ------> reflex? Biceps and Brachioradialis
Which are the nerve roots involved in the Triceps reflex? C7 and C8
Which is the main nerve root in the Triceps reflex? C7
C7, C8 nerve roots -----> reflex? Triceps
To check the Triceps reflex, the clinician must stimulate which nerve roots? C7 and C8
A injury to the C7 or C8 nerve roots will cause: Weak or absent Triceps reflex
Damage to the C5 or C6 nerve roots will cause: Weak or absent Biceps and Brachioradialis reflexes
"testicles move" reflex. Cremasteric reflex
Which clinical reflex is directed to the testicles? Cremasteric reflex
Which are the nerve roots involved in the Cremasteric reflex? L1 and L2
Damage to L1 or L2 nerve roots will probable cause abnormal __________ reflex. Cremasteric reflex
The phrase "winks galore" is used to describe or indicate which clinical reflex? Anal wink reflex
Which are the nerve roots involved in the Anal wink reflex? S3 and S4
Damage to the S3 or S4 nerve roots result in ----> Weak or absent anal wink reflex
CNS reflexes that are present in a healthy infant, but are absent in a neurologically intact adult Primitive reflexes
What are Primitive reflexes? CNS reflexes that are present in a healthy infant, but are absent in a neurologically intact adult
By when are Primitive reflexes normally gone? 1st year of life
What part of the brain is inhibit the primitive reflexes? Frontal lobe
What is a possible consequence of a frontal lobe lesion? Loss of inhibition (reemergence) of primitive reflexes
Description of the Moro reflex: "Hang on for life" reflex - abduct/extend arms when startled, and the draw together
The abduction/extension of arms when a baby is startled, and then draw back them together. Moro reflex
What is the rooting (primitive) reflex? Movement of head toward one side if cheek or moth is stroked
What is a common way to refer to the rooting reflex? Nipple seeking
The movement of an infant's head toward the side side of cheek or mouth that is stroked. Rooting reflex
What is the description of the Sucking reflex? Sucking response wehn roof of mouth is touch
Placing a finger in an infant roof of mouth should elicit what refeed in a healthy baby? Sucking reflex
What is the Palmar (primitive) reflex? Curling of fingers if palm is stroked
Curling of fingers as the palm of an infant is stroked. Palmar reflex
Definition of the Plantar reflex Dorsiflexion of large toe and fanning of other toes with plantar stimulation
What is the Babinski sign? Presence of Plantar reflex in an adult
A (+) Babinski sign indicates: UMN lesion
What reflex is seen with UMN lesion? (+) Babinski sign
What is the Galant reflex? Stroking alongside of the spine while newborn is in ventral suspension causes lateral flexion of lower body toward stimulated side
A physician places baby laying on its stomach and then gently strokes along side the right side of the spine. What is the reflex been tested? Galant reflex
What is the possible age of a healthy human with (+) plantar, Moro, and Rooting reflexes? Less than one year
What is the expected result or reaction of the Gallant reflex? Lateral flexion of lower body toward the stimulated side
If the galant reflex test is done on the left side, toward which side is the lower body flexion expected to occur? Left side
Dermatome C2 distribution Posterior half of skull
What dermatome is distributed or covers the posterior half of the skull? C2
Which dermatome distribution is described as "high turtle neck"? C3
What dermatomes are the ones that refer diaphragm and gallbladder pain to the right shoulder? C3, C4, and C5
Referred pain to the right shoulder is done via which nerve? Phrenic nerve
Low-collar shift dermatome distribution C4
What is the distribution of the C4 dermatome? Low-collar shirt
Which digits are included in C6 dermatome distribution? Thumbs
What is a Dermatome? An area of the skin supplied by nerves from a single spinal root.
An area of the skin supplied by nerves from a single spinal root Dermatome
By which dermatome are thumbs covered or prove skin nerve sensation? C6
Which dermatome location is described by "At the nipple"? T4
Which dermatome covers the nipple? T4
T4 dermatome distribution is at the ______________. Nipple
Which dermatome covers the Xiphoid process? T7
What part of body is covered by T7 dermatome? Xiphoid process
Which dermatome is located or distributed at the umbilicus? T10
Damage to spinal root T10 will cause lack of skin sensation tow which part of body (dermatome)? Umbilicus
T10 is a point referred with pain in which condition? Appendicitis
A patient will have pain at which dermatome ? T10
L1 dermatome distribution: At the Inguinal Ligament
What dermatome covers the Inguinal ligament? L1
L4 includes what part of the lower extremities? Kneecaps
Kneecap dermatome coverage is done by which spinal nerve root? L4
Dermatomes S2, S3, and S4 provide skin sensation to: Penile and anal zones
What areas of body would experience decreased or absent skin sensation case of S2-S4 dermatome damage? Penile and anal zones
Sensation of penile and anal zones is done by which dermatomes? S2, S3, and S4
What actions and/or functions are controlled by the Temporal lobe? 1. Language comprehension 2. Behavior 3. Memory 4. Hearing 5. Emotions
Which lobe has the area of the brain in charge of language comprehension? Temporal lobe
A person with changes in behavior, hearing, and memorey, as well with deficits in language comprehension, most likely suffered from an injury to which brain lobe? Temporal lobe
What functions and roles are controlled by the Pituitary gland? - Hormones - Growth - Fertility
Damage to the pituitary gland may represent damage into which overall characteristics: Hormonal activity, growth, and fertility
What physiological features are controlled by the Brain stem? 1. Breathing 2. Blood pressure 3. Heartbeat 4. Swallowing
Breathing, swallowing, BP, and HR are controlled all by which area of the CNS? Brain stem
What is coordinated by the actions of the Cerebellum? Balance, coordination, and Fine muscle control
A deficit in balance and coordination may represent damage to the ______________________. Cerebellum
Occipital lobe has which physiological feature under its control? Vision
Which brain lobe houses the vision control and ability? Occipital lobe
What are the roles/functions coordinated or controlled by the Parietal lobe? 1. Telling right from left 2. Calculations 3. Sensations 4. Reading 5. Writing
A person unable to distinguish "right" from "left" may present with damage to: Parietal lobe
A person that prior to a severe car accident was a math teacher, but after that was unable to read, write, or do mathematical calculations, may have injured which part of the brain? Parietal lobe
Reading is controlled by which lobe? Parietal lobe
Writing is controlled by which brain lobe? Parietal lobe
Acalculia is due to damage or injury to the _____________ lobe. Parietal lobe
List of actions controlled or managed by the Frontal lobe of the brain: 1. Movement 2. Reasoning 3. Behavior 4. Memory 5. Personality 6. Planning 7. Decision making 8. Judgement 9. Initiative 10. Inhibition 11. Mood
Which actions are controlled or coordinated by the Frontal and Temporal lobes of the brain? Behavior and memory
A person with movement deficits may have suffered an brain injury involving which lobe? Frontal lobe
Personality changes, may be due to injuries to the _____________ lobe. Frontal lobe
Unable to make decisions, as well as bad judgement calls, may represent an injury to which brain lobe? Frontal lobe
Which brain area or lobe has more actions or roles under its control? Frontal lobe
What is the sensory information conveyed by the Parietal lobe? Taste, smell, touch, sight, hearing, temperature, and pain
Which lobe of the brain is in charge of coordinating Spatial relationships? Parietal lobe
What are the Spatial relationships? - Hand-eye coordination - Recognizing body position - Judging distances - Moving between objects
Understanding what you see Sight
Sight is controlled by which brain lobe? Occipital lobe
Executive functions are controlled by which lobe? Frontal lobe
What are (list) of Executive functions? Planning, organizing, problem solving, decision-making, reasoning
Broca's area in frontal lobe is in charge of: Speaking fluently and with meaning
Wernicke's area in the Temporal lobe is in charge of: Understanding language and speech
Created by: rakomi
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