Section 8 (CH 15/16/17)

Describe the main features of the middle ear.

Tympanic cavity. Tiny epithelial lined cavity hollowed out of the temporal bone, containing three auditory ossicles: malleus, incus and stape. hammer, anvil and stirrup).

What is the medical term for the tube?

Tympanotomy Tube

Which cranial nerves transmit impulses that result in hearing? Taste sensations?

VIII - Vestibulocochlear - Specifically, Cochlear (auditory branch) and VII - Facial

Which regions of the body are innervated via the brachial plexus?

shoulder / arm

What is the medical term for ringing in the ear?

tinnitus

Which two muscles are controlled by the spinal accessory nerve?

trapezius and sternocleidomastoid

List the names and numbers of the twelve pairs of cranial nerves.

The cranial nerves are as follows: olfactory I, optic II, oculomotor III, trochlear IV, trigeminal V, abducens VI, facial VII, vestibulocochlear VIII, glossopharyngeal IX, vagus X, accessory XI, hypoglossal XII.

Name the anatomical structures associated with static equilibrium.

Utricle and Saccule. Function needed to sense the position of the head relative to gravity or to sense acceleration or deceleration of the body, such as would occur when seated motionless in a vehicle that was increasing or decreasing in speed.

What is the medical term for the sensation of spinning?

Vertigo

Checking to see if a patient can hear you rub your fingers next to each ear would assess which cranial nerve?

Vestibulocochlear

Perform an ankle jerk on a friend or family member. Which muscle is tested? Which ankle movement is assessed?

achilles reflex and plantar flexion

What is the medical term for a curvature of the cornea or lens?

astigmatism

What are the two primary functions of the vestibulocochlear nerve?

balance / equilibrium and hearing

What is assessed in a corneal reflex?

blinking in response to the cornea being touched.

4. Which cranial nerve was the nurse testing? a. Glossopharyngeal b. Olfactory c. Trigeminal d. Facial

4. D The facial nerve (CN VII) innervates the front two thirds of the tongue, and the taste buds found there. In addition to this sensory function, CN VII also functions in facial expression (thus the name). Although smell (olfaction) and taste are closely related, touching the tongue with the taste stimulus will test the facial nerve alone.

3. What type of receptors are responding to the cologne smell? a. Mechanoreceptors b. Photoreceptors c. Thermoreceptors d. Chemoreceptors

3. D Your sense of smell (and taste too) is actually a sense of chemistry. The olfactory receptors in the nose respond to dissolved odorants (chemicals), which triggers a message to the brain.

Name the three types of sense receptors classified according to location in the body.

3. Exteroceptors, visceroceptors (or interoceptors), and proprioceptors are receptor types classified by location in the body.

4. What condition could the spots indicate? a. Presbyopia b. Glaucoma c. Cataracts d. Myopia

4. C A clouding of the lens is called a cataract. If the clouding is enough to limit vision, the lens may be removed and replaced with an artificial lens.

Name the anatomical structures associated with hearing.

External Ear, Middle Ear and Inner Ear

Name the anatomical structures associated with hearing.

External Ear, Middle Ear and Inner Ear. Hearing sense organ - Organ of Corti.

Differentiate between the sympathetic preganglionic and postganglionic neurons in terms of length.

Sympathetic - Pre (short) / Post (long) Paraympathetic - Pre (long) / Post (short)

Describe the actions of norepinephrine. How are these actions terminated?

Synthesized from tyrosine as a precursor and packed into synaptic vesicles. It performs its actions be being released into the synaptic cleft, where it acts on adrenegic receptors followed by the signal termination, either degradation or by uptake by surrounding cells.

List the special senses.

5. The special senses are olfaction, taste, hearing, equilibrium, and vision.

Which regions of the body are innervated via the lumbar plexus?

abdominal wall

What is the medical term for the cloudy spots that develop in the lens?

cataracts

Which regions of the body are innervated via the coccygeal plexus?

coccyx

Which photoreceptors are used for color vision?

cones

What is the medical term for an eye infection known as pink eye?

conjunctivitis

What is the medical term for the disease in which small hemorrhages block oxygen to the photoreceptors?

diabetic retinopathy

Which regions of the body are innervated via the cervical plexus?

neck

What is the medical term for night blindness?

nyctalopia

Which regions of the body are innervated via the sacral plexus?

quads / thigh / sciatic nerve

What is the medical term for the disease in which the retina falls away from the connective tissue?

retinal detachment

Which photoreceptors are used for white light only vision?

rods

List the five "primary" taste sensations.

9. Sour, sweet, bitter, umami (savory), and salty are the primary taste sensations.

6. Which type of effects did Tim`s body experience? a. Adrenergic b. Dopaminergic c. Cholinergic d. Anaphylactic

A The response that Tim's body had was a result of the sympathetic nervous system. The binding of norepinephrine to alpha receptors has a stimulating effect. Axons that release norepinephrine are known as adrenergic fibers.

Name the anatomical structures associated with dynamic equilibrium.

Crista Ampullaris embedded in a gelatinous flap called the cupula. Function needed to maintain balance when the had or body itself is rotated or suddenly moved.

Checking to see if a patient can move their eyebrows and taste salt or sugar on the tip of their tongue would assess which cranial nerve?

Glosopharyngeal

Which cranial nerves transmit impulses that result in vision? Eye movement?

II - Optic / III Oculomotor and IV Trochlear - Eye Movement.

What canal drains fluid from the anterior chamber of the eye?

Lacrimal Apparatus

Name the four treatments for curing a middle ear infection.

Lancet (mission field) Antibiotics Tube (Tympanotomy Tube) Adjustment

What are the three branches of the trigeminal nerve?

Opthalmic, maxillary and mandibular

Which middle ear bone causes otosclerosis?

Stapes

Describe the phenomenon of the referred pain.

Stimulation of pain receptors in deep structures may be felt as pain in the skin that lies over the affected organ or in area of skin on the body surface far removed from the site of disease or injury. (You have to learn your pain areas.)

What happens to the heart, lungs, digestive system and eye with sympathetic and parasympathetic nervous system innervation?

Sympathetic - HR increases, Respiration increased, digestive decreases and pupils dilate. Parasympathetic - HR decreased, respiration decreases,digestive increases and pupils constrict.

15-1: How many pairs of spinal nerves are there? Can you name them?

There are 31 pairs of spinal nerves: cervical (8 pairs), thoracic (12 pairs), lumbar (5 pairs), sacral (5 pairs), and one pair of coccygeal nerves.

Checking to see if a patient can move their jaw and they feel you touch theri forehead, maxilla and jaw would assess which cranial nerve?

Trigeminal

Checking to see if a patient can move their eyes laterally would access which cranial nerve?

Trochlear

Checking to see if a patient can shrug their shoulders and turn their head would access which cranial nerve?

accessory or spinal

Which photoreceptors require a higher level of light energy for activation?

cones

The Macula Lutea has a high concentration of which photoreceptors?

cones (aka forea centralis)

Name the anatomical structures associated with hearing.

ears

Checking to see if a patient can swallow and talk would assess which cranial nerve?

facial

Checking to see if a patient will gag when touching the back of their throat with a tongue depressor would access which cranial nerve?

facial

What is the medical term for nearsightedness?

myopia

What is the study and practice concerned with pathological conditions of the eye?

opthamology

Perform a plantar test on a friend or family member. Which toe movement is assessed? If this test were performed in an infant, which toe movement is assessed? What is the name of this sign if performed on an infant?

outer sole of foot / great toe / babinski's sign

Perform a knee jerk test on a friend or family member. Which muscle is tested? Which knee movement is assessed?

patella and rectas femoris

What is the medical term for the inability to properly focus the lens as we age?

presbyopia

What is assessed in an abdominal reflex?

umblicus movement in response to stroking the side of the abdomen

Checking to see if a patient's pupil constricts with a bright light would assess which cranial nerve?

Oculomotor

Which nervous system is activated by the vagus nerve?

parasympathetic

1. What could be causing the inability to focus on close objects? a. Myopia b. Presbyopia c. Conjunctivitis d. Scotoma

1. B As we age, the lens in our eye becomes less elastic and unable to constrict or thicken enough to bend light rays reflected off of objects close to us at an angle that will focus them onto the retina. This loss of flexibility is called presbyopia.

1. In one of the tests, Tomasina was asked to stick out her tongue. Which cranial nerve was being tested? a. Glossopharyngeal b. Hypoglossal c. Vagus d. Trigeminal

1. B The hypoglossal cranial nerve (CN XII) controls tongue movement. Damage to this nerve would result in the tongue leaning or deviating to the damaged side. Glossopharyngeal includes the word part "glosso" (meaning tongue). But in this case, the "glosso" refers to tongue sensation.

Classify receptors into six groups based on the type of stimuli that activates them.

1. Mechanoreceptors, chemoreceptors, thermoreceptors, nociceptors, photoreceptors, and osmoreceptors are classifications of receptors based on the type of activating stimuli.

List the three anatomical divisions of the ear.

11. External ear, middle ear, and inner ear are the anatomical divisions of the ear.

Identify the three auditory ossicles.

12. The auditory ossicles are the malleus, incus, and stapes.

Name the specific sense organ responsible for hearing.

14.The ear is the sense organ responsible for hearing.

Name the layers or coats of the eyeball.

15. Sclera, choroids, and retina are the layers of the eyeball.

2. What type of receptors in the ear responded to the receptionist's voice? a. Mechanoreceptors b. Photoreceptors c. Thermoreceptors d. Chemoreceptors

2. A The hair cells in the inner ear are bent by the moving fluid in the cochlea. The hair cells respond to this movement by sending an impulse to the brain; thus they are classified as mechano- (moving) receptors.

2. What triggered Tim`s reaction when he saw the mountain lion? a. Sympathetic stimulation of the heart b. Parasympathetic stimulation of the heart c. Somatic motor stimulation of the heart d. Both sympathetic and parasympathetic stimulation of the heart

2. A The increase in the heart rate was due to a sympathetic stimulation of the heart. Beta receptors in cardiac muscle has a stimulating effect that results in a stronger and faster heartbeat.

2. In a second test, Tomasina's hearing was evaluated. What cranial nerve is involved in the sense of hearing? a. Accessory b. Vagus c. Vestibulocochlear d. Trochlear

2. C The vestibulocochlear nerve (CN VIII) carries sensory information from the ear. The two branches of this nerve are associated with the sense of hearing and the sense of balance or equilibrium.

Distinguish between the special and the general, or somatic senses.

2. The general sense organs consist of microscopic receptors widely distributed throughout the body in the skin, mucosa, connective tissues, muscle tendons, joints, and viscera. The special senses are characterized by receptors grouped closely together or located in specialized organs.

3. Which of the following cranial nerves does not control eye movement? a. Optic b. Oculomotor c. Trochlear d. Abducens

3. A The optic nerve (CN II) is definitely associated with the eye, but it carries sensory information from the eye, not motor commands to the eye. The other three cranial nerves communicate with various muscles around the eye to allow movement.

3. What other effect(s) did Tim likely experience besides a rapid heart rate? (choose all that apply) a. Increased rate of breathing b. Sweating c. Slower pulse d. Twitching of the ears e. Increased digestive activity

3. A, B, and C As a result of sympathetic innervation, breathing rate increases (bronchioles dilate) and sweating increases. Because of the secretion of adrenaline (sympathetic nervous system), muscles that innervate the ear may contract involuntarily. Pulse (heart rate) would increase and digestive activity would be inhibited.

What is a plexus? Name the four major pair of plexuses.

A plexus is a complex network formed by converging and diverging nerves; the major pairs of plexuses are the cervical plexus, brachial plexus, lumbar plexus, and the sacral plexus.

Checking to see if a patient can move their eyes downward and lateral would assess which cranial nerve?

Abducens

Which part of the tongue is innervated by the facial nerve?

Anterior 2/3 rds

What does cholinergic mean?

Axons that release acetylocholine

What does adrenergic mean?

Axons that release norepinephrine

5. Which type of organ was primed for maximum efficiency by Tim`s reactions? a. Synovial joints b. Skeletal muscles c. Smooth muscles d. Kidneys e. Digestive organs

B During sympathetic stimulation, blood vessels are dilated thus increasing the delivery of oxygen and nutrients to skeletal muscles.

1. Which statement is true, given the circumstance in which Tim found himself? a. The racing heart resulted from a day of intense exercise including climbing the bluff. b. Increased heart rate is abnormal, given that Tim was well rested. c. Tim experienced a normal reaction to a threat. d. Tim is hallucinating because there are no mountain lions in the Ozarks. e. Tim experienced the rest-and-repair response.

C Tim's response to the presence of the mountain lion was a result of the sympathetic nervous system's "fight or flight" innervation.

4. Which neurotransmitter produced the effects Tim experienced? a. Serotonin b. Dopamine c. Acetylcholine d. Norepinephrine

D Norepinephrine binds to beta receptors in cardiac muscle resulting in a faster and stronger heartbeat.

What is a dermatome? A myotome?

Dermatomes are skin surface areas supplied by a single spinal nerve. A myotome is a skeletal muscle or group of muscles that receives motor axons from a given spinal nerve.

Describe each of the following mechanoreceptors, chemoreceptors, thermoreceptors, nociceptors and photoreceptors.

Mechanoreceptors - pressure applied to skin or to blood vessels or pressure caused by stretch or pressure in muscle, tendor or lung tissue. Chemoreceptors - activated by either the amount or the changing concentration of certain chemicals. Taste and smell depend on. Thermoreceptors - activated by changes in temperature. Nociceptors - activated by intense stimuli of any type that results in tissue damage. (toxic chemicals) Sensation produced is pain. Photoreceptors - found only in the eye. Osmoreceptors - concentrated in the hypothalamus. senses levels of osmotic pressure in body fluids. osmolarity / changes in concentration of electrolytes / in extracellular fluids and in stimulating the hypothalamic thirst center.

What chronic inner ear disease often results in nerve damage with tinnitus, hearing loss and vertigo?

Meniere Disease

Distinguish between a motor nerve, sensory nerve and mixed nerves.

Motor cranial nerves consist mainly of motor axons. Sensory cranial nerves consist of sensory axons. Mixed cranial nerves contain axons of sensory and motor neurons.

Checking to see if a patient can identify the smell of oranges would assess which cranial nerve?

Olfactory

Identify the primary function of each pair of cranial nerves.

Olfactory: sense of smell. Optic: vision. Oculomotor: eye movements, regulation of pupil size, accommodation, proprioception. Trochlear: eye movements, proprioception. Trigeminal: sensations of head and face, chewing movements, proprioception. Abducens: abduction of eye, proprioception. Facial: facial expressions, secretion of saliva and tears, taste. Vestibulocochlear: balance or equilibrium sense (cochlear branch—hearing). Glossopharyngeal: sensation of tongue, swallowing movements, secretion of saliva, aid in reflex control of blood pressure and respiration. Vagus: sensations and movements of organs supplied (e.g., slows heart, increases peristalsis, and contracts muscles for voice production). Accessory: shoulder movements, turning movements of head, movements of viscera, voice production, proprioception. Hypoglossal: tongue movements, proprioception.

Checking to see if a patient can read letters on the wall would assess which cranial nerve?

Optic

What is the medical term for an infection in the middle ear?

Otitis Media

Can you predict the respiratory consequences of an injury that damages the spinal cord between the third and fifth cervical segments? What specific mechanism would cause these consequences?

Paralyze the phrenic nerve and therefore the diaphragm (R & L). Contraction of the diaphragm permits inspiration and relaxation of the diaphragm permits expiration. Unless artificial respiration of some kind is provided, the patient dies.

What is the medical term for hearing loss due to nerve impairment?

Presbycusis

Define adaption.

Process by which the magnitude of the receptor potential decreased over time in response to a continuous stimulus. (After you get used to it.)

Classification of Somatic Sensory Receptors (Table 17-1)

Root hair plexus - movement of hair. Nociceptor - itch, tickle, toxic Tactile (Merkle) Disk - discriminative Touch Tactile (Meissner) Carpusle - low frequency vibration / touch Bulboid (Krause) carpusle - touch textural sensation Bulbouse Carpuscle - crude and persistant touch Lemellar (Pacinin) deep pressure muscle spindles - muscle length golgi tendon receptors - muscle tension

Names, numbers and functional classification of cranial nerves (Table 15-2)

See Previous Cards

Structure and Function of Cranial Nerves (Table 15-3)

See Previous Cards

List the twelve cranial nerve names, their number and if they are sensory, motor or both.

See previous cards.

Define vertigo. How is vertigo treated?

Sensation of spinning. Medications

What is the medical term for farsightedness?

hyperopia

Checking to see if a patient can stick out their tongue and move it would assess which cranial nerve?

hypoglossal

Which photoreceptors utilize the chemical rhodopsin for activation?

rods

How would you compare and contrast the receptors for vision in dim light and those for vision in bright light?

rods - dim light cones - bright light