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Neurology
FA complete review part 2 Physiology/Anatomy
| Question | Answer |
|---|---|
| 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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