1. Motor neurons AKA _________
2. Where do they transmit signals to and from?
1. Efferent neurons
2. From CNS to PNS (brain to limbs)
1. Sensory neurons AKA
2. Where do they transmit signals to and from?
1. Afferent neurons
2. From PNS to CNS (from tips of toes up to the brain)
Meninges layers
dura mater (outer), arachnoid mater, pia mater (inner)
What is in the subdural space?
Nothing� it is empty
So when there is something in there, it is a problem
Which area contains the CSF?
Subarachnoid space
What is the "bony shelf" between the cerebrum and the cerebellum?
Tentorium
The 3 major areas of the brain are the forebrain, cerebellum, brainstem.
What are the parts of the forebrain?
1. Diencephalon
2. Cerebrum
3. Cerebral cortex
What are the parts of the diencephalon (forebrain)
1. Thalamus (relay station for CNS)
2. Hypothalamus (temperature, intellect)
3. Pituitary gland
What does the cerebrum do?
Intellegence
creativity
memory
-right & left hemispheres
-Lateran ventricles for CSF
-basal ganglia (control complex movement)
The cerebral cortex divides the brain into lobes. What are these lobes?
1. Frontal
2. Parietal
3. Temporal
4. Occipital
What is the frontal lobe responsible for? (8)
-executive function
-personality
-thinking
-planning
-organizing
-problem solving
-behavior
-emotions
The frontal lobe is even further broken down into 3 different areas, what are they?
1. Broca's area (expressive speech)
2. Motor cortex (movement)
3. Sensory cortex (sensations)
What is the parietal lobe responsible for? (4)
Perception
arithmatic
spelling
making sense of the world
What is the occiputil lobe responsible for
Vision
What is the temporal lobe responsible for?
-Processing hearing information
-Wernicke's area- receptive speech
What is receptive speech?
Patient cant follow commands
patient wont answer questions
patient wont understand you, but can speak to you just fine
The cerebral cortex is "contralateral" which means what?
An injury on the right side will display left side effects outwardly
1. Where is the cerebellum located?
2. What is the cerebellum responsible for?
3. This part of the brain is "ipsilateral", explain.
1. Infratentorial (below tentorium)
2. Fine movement
3. Right sided injury= right sided effects
cranial nerves
12 pairs of nerves that carry messages to and from the brain
1. Olfactory- smell
2. Optic- vision
3. Oclumotor- pupil constriction
4. Trochlear- eye movement down and inward
5. Trigeminal- corneal reflex (blinking)
6. Abducens- outward eye movement
7. Fac
What are the 3 parts of the brainstem
1. Midbrain
2. Pons
3. Medulla
Midbrain is responsible for cranial nerve ______ & _____
3. Oclumotor
4. Trochlear
The pons affects
1. Breathing by ____ & _____
2. ______ heart rate
3. Which cranial nerves
1. Rate & pattern
2. Increases
3. 5-6-7-8
The medulla:
1. ____ heart rate
2. Also part of the ______ center
3. Which cranial nerves?
1. Slows
2. Respiratory
3. 9-10-11-12-13
Brain circulation is called ___________.
-it is arterial circulation that brings blood into the brain
-located in subarachnoid space
Circle of Willis
The blood brain barrier is a protective mechanism of the brain.
What can cross the blood brain barrier
1. Oxygen
2. Glucose
3. CO2
4. Water
5. ETOH
6. Anesthetics
What cannot cross the blood brain barrier?
Albumin
antibiotics
chemotherapy (so this is why you need an Ommaya reservior)
CSF
1. Location?
2. Continuous rate of production
3. Purpose
4. Normal color
5. Produced where
1. Subarachnoid space
2. 25ml/hr
3. Cushion spinal cord
4. Clear
5. Choroid plexus
1. A clog in the CSF production or circulation will cause ________.
2. #1 s/s
1. Hydrocephalus
2. Sleepy
**if you have to increase your stimuli to wake a patient up, then that is a change in neuro status
-temporary device used to remove increased CSF, blood, or infection
-closed system to prevent infection
-when pressure gets to a certain point, it triggers the "manometer" to drain it
EVD
external ventricular drain
What is a VP shunt?
Ventricular-peritoneal shunt:
standard procedure for treatment of hydrocephalus
-permanent
-drains excess fluid from brain into the abdomen or into chest
3 pieces:
1. Ventricular catheter
2. Pressure valve
3. Peritoneal catheter
What are the potential problems with a VP shunt?
-Clogged catheter
-faulty valve
-intraabdominal infection
#1 s/s= patient will become sleepy
SPINAL CORD
1. What are the 2 tracts?
2. What is the difference in them?
1. Ascending (sensory) & descending (motor)
2. Ascending tracts begin w/ "spino" & descending tracts end with "spinal"
*if there is an injury to the ascending tract, the pt cant feel the injury but they can move
What are dermotomes?
Areas of sensory (basically a sensory map of the body)
NORMAL neuro AGING CHANGES: (6)
1. Slowed processing time
2. Recent memory loss
3. Decreased touch sensation
4. Pain perception
5. Decreased coordination
6. Circadin rhythm disorders
1. What is it called when you can only see half of a visual field?
2. Loss of same visual field on BOTH eyes
1. Hemiopsia
2. Homonymous hemianopsia
1. Decorticate rigidity
2. Decerebrate rigidity
1. Decorticate rigidity - flexion posturing towards the CORE
2. Decerebrate rigidity - extension posture
-examines cerebral circulation
-iodine based dye
Cerebral angiography
What does a CT discover in the brain or spinal cord?
*NO CONTRAST:
Hemorrhage
edema
hydrocephalus
bone defects
*WITH CONTRAST: (these are the only things that will absorb the dye)
tumor
infection
What test is used to determine brain death areas?
Cerebral perfusion test determines blood flow
What is a lumbar puncture contraindicated with?
Hydrocephalus
Iodine/seafood allergy prep:
Steroids + Benadryl