A&P - EXAM 2 Study Guide
Beta-2 receptors
(sympathetic division of ANS) responsible for relaxation or respiratory passage; works to open airway and blood vessels to increase blood flow
Beta-1 receptors
(sympathetic division of ANS) responsible for cardiac muscle stimulation and increased tissue metabolism
Beta-3 receptors
(sympathetic division of ANS) responsible for release of fatty acids from adipose tissue for metabolic use in other tissues
What are some common symptoms of a CSF leak?
*1. photophobia* *2. phonophobia* *3. rhinorrhea* *4. otorrhea* *5. anosmia* 6. positional headaches 7. neck pain/stiffness 8. N/V 9. sense of imbalance 10. sense of drainage down back of throat
Main function of frontal lobe:
cognition
Mamillary bodies
component of hypothalamus that controls *feeding reflexes* (licking and swallowing)
descending tracts of white matter
convey *motor* commands to spinal cord
Inadequate iodine intake can lead to:
cretinism and hypothyroidism, which can then lead to absence of thyroxine production, causing continuous production of TSH, leading to goiter
What is the inferior anterior attachment of the falx cerebri?
crista galli
In regards to tactile receptors (type of mechanoreceptor), ____ touch and ______ receptors provide poor localization and give little info
crude; pressure
CNS visceral motor neurons of the sympathetic division are located in the _________; whereas, those of the parasympathetic division are located in the _________
lateral gray horns; brain stem and spinal segments S2-S4
the dural sinuses ultimately drain into the:
internal jugular vein
What is the inferior posterior attachment of the falx cerebri?
internal occipital crest
Pledget test (definition)
involves placing small cotton pads (called "pledgets") into the nose; *used to confirm the presence of a CSF leak,* although it cannot determine the exact location of the leak
What is Cavernous Sinus Syndrome
it is essentially an internal carotid artery aneurysm leading to a *mixing of arterial and venous blood,* which increases the pressure in the Cavernous Sinus, causing venous blood to not drain from the tributaries
epidural space
located between dura and vertebral canal; contains areolar connective tissue, blood vessels, and protective adipose tissue
Chemoreceptor Trigger Zone (CTZ)
located within area postrema; receives inputs from blood-borne drugs or hormones, and communicates with other structures in the vomiting center *to initiate vomiting*
the length of *post*ganglionic fibers of the sympathetic division are _________ in length than those of the parasympathetic division
longer
Anosmia (definition)
loss of sense of smell
Which component of the thalamus is responsible for relaying *auditory information*?
medial geniculate nucleus
Where are cardiac centers located in the brain?
medulla oblongata *only*
Arachnoid mater
middle meningeal layer that includes subarachnoid space, which contains CSF
Overall effect of resistance phase of the stress response:
mobilization of body's energy reserves while reserving glucose for neural tissues
Regarding portions of the brain, as we go from low to high, functions and capabilities become _____________
more sophisticated
The ventral root ganglia is responsible for ________
motor
If your anterior gray horns were damaged, you would lose:
motor function
Type C fibers
slow pain nociceptors; burning/aching pain; responsible for pain that interrupts sleep due to generalized activation of thalamus
Tentorium cerebelli separates:
cerebrum from cerebellum
Function of the somatic nervous system
(part of PNS; motor division) controls skeletal muscle contractions
Damage to superior colliculi can cause:
changes in vision; vision issues
what type of synapse is the most common?
chemical
Type A fibers
(fast fibers; nociceptors) quickly reach CNS and trigger fast reflexive responses; alter perception (respond to injections, deep cuts)
What happens when parasympathetic division is activated?
"rest and digest:" - decreased HR and BP - decreased metabolic rate - increased salivary and digestive gland secretion - increased digestive tract motility and blood flow (assoc. with sexual arousal) - stimulation of urination and defecation - constriction of pupils
What is the function of ADH?
(also known as AVP) decrease water lost from kidney; vasconstriction released in response to increased solute concentration of blood or decrease in BP
Function of the superior colliculus:
(component of corpora quadrigemina in midbrain) controls reflex movements of eyes, head, and neck in response to *visual inputs*
Function of inferior colliculus
(component of corpora quadrigemina in midbrain) controls reflex movements of head, neck, and trunk in response to *auditory data*
Function of the autonomic nervous system
(part of PNS; motor division) automatic regulation of smooth and cardiac muscles, glands, and adipose tissue
What are some functions of parathyroid hormone?
*increases level of calcium in blood when they are too low* by: 1. mobilizes calcium from bone by inhibiting osteoblasts and increasing osteoclast production 2. enhances reabsorption of Ca2+ by kidneys 3. stimulates release of calcitriol by kidneys
which component of the thalamus receives visual information from the optic tract and relays signals to midbrain and occipital lobe?
*lateral* geniculate nucleus
substantia nigra
- black in color due to melanin pigmentation - center of dopamine production - degeneration of cells in substantia nigra leads to Parkinson's
Effects of lacking sleep on the body:
- decreased tissue repair - decreased cognitive function - increased hunger
What are some clinical features of Cavernous Sinus *Syndrome*?
- edema into upper and lower eyelids - chemosis (edema of conjunctiva) - proptosis - pulsatile exopthalmos - periorbital tissues become edematous - bruit with stethoscope - compression of CN leads to dysmobility - diplopia - external, internal, or total ophthalmoplegia - papillary edema - decreased corneal reflex - hypoesthesia or hyperesthesia
What happens when the sympathetic division is stimulated?
- increased alertness (RAS activated) - feeling of energy - HR, BP, RR increases - general elevation in muscle tone - constriction of urinary bladder and defecation
Features of bipolar neurons
- rare, but occur in *special sense organs* - small in size - two distinct processes (one with branching dendritic process, one axon)
What could be some clinical findings of a patient with uncontrolled diabetes?
1. glucose spilling into urine 2. hyperglycemia 3. frequent urination 4. excessive thirst
What are the 2 hormones that the posterior pituitary gland produces?
1. Antidiuretic (ADH) 2. Oxytocin (OXT)
What are the 3 types of Dural folds?
1. Falx cerebri 2. Tentorium cerebello 3. Falx cerebelli
What are some diagnostic techniques for CSF leak?
1. Physical Exam & History (ex. have pt lean forward to observe if this increases rhinorrhea) 2. CT scan 3. MRI 4. Myelography 5. Cisternogram 6. Pledget test
What arteries make up the Circle of Willis?
1. R/L anterior cerebral arteries 2. R/L internal carotid arteries 3. R/L posterior cerebral arteries 4. anterior communicating artery 5. R/L posterior communicating artery
What are the 7 hormones that the anterior pituitary gland produces?
1. Thyroid-stimulating (TSH) 2. Adrenocorticotropic (ACTH) 3. Follicle-stimulating (FSH) 4. Luteinizing hormone (LH) 5. Growth (GH) 6. Prolactin (PRL) 7. Melanocyte-stimilating (MSH)
What are the neurotransmitters implicated in the control of N/V?
1. acetylcholine 2. dopamine 3. histamine 4. substance P 5. serotonin 6. opioid receptors (involved with N/V caused by opiates)
What are the 3 phases of the stress response (or general adaptation syndrome)
1. alarm phase 2. resistance phase 3. exhaustion phase
What are the four major anatomical classes of neurons?
1. anaxonic 2. bipolar 3. unipolar 4. multipolar
What are the two components of the Dorsal Vagal Complex?
1. area postrema 2. nucleus tractus solitarius
Treatment options for CSF leak:
1. bed rest 2. surgery (for CSF leaks that do not respond to conservative treatments) 3. nasal endoscopy 4. epidural blood patch 5. shunts (leaks caused by high-pressure hydrocephalus)
The 4 functions of oxytocin (OXT) include:
1. childbirth/labor 2. lactation/nursing 3. sexual arousal/orgasm 4. bonding
What are the two most common causes of Toxoplasmosis?
1. contact with cats and their feces 2. contact with raw/undercooked meat
What are the 4 main features (structures) that make up the BBB?
1. continuous capillaries 2. tight junctions 3. basement membrane 4. pericytes
What are the components of the midbrain?
1. corpora quadrigemina 2. Reticular activating system 3. Red nucleus 4. Substantia nigra 5. Cerebral Peduncles
What are the 3 layers of the spinal meninges?
1. dura mater 2. arachnoid mater 3. pia mater
What are the 4 main causes of a CVA?
1. embolism (*most common*) 2. thrombosis 3. hypoperfusion 4. hemorrhage
What are some components/functions of the hypothalamus?
1. feeding reflexes (licking and swallowing) 2. hunger control ; regulates appetite 3. produces ADH 4. secretes oxytocin 5. regulates body temp 6. directs the pineal gland
Changes in the body during resistance phase of the stress response:
1. glycogen stores are depleted in liver 2. gluconeogenesis is increased 3. glycerol and fatty acids in blood increase 4. increased protein catabolism increases amino acids in blood 5. glucose uptake inhibited --> hyperglycemia
What can cause Cavernous Sinus Syndrome / Internal Carotid Artery Aneurysm?
1. head trauma 2. degenerative diseases (atherosclerosis) 3. Ehlers-Danlos Syndrome
Two structural organizations of gray matter:
1. horns 2. gray commissures
What are the 3 categories of reflexes?
1. innate reflexes 2. acquired 3. complexity of circuit
What are the two sets of arteries that supply the brain?
1. internal carotid arteries (ICA) 2. vertebral arteries
Parkinson's Disease is believed to be associated with:
1. lack of dopamine 2. damage to cells/neurons in substantia nigra
Which nerves make up the brachial plexus?
1. median nerve 2. ulnar nerve 3. musculocutaneous 4. radial 5. medial antebrachial cutaneous 6. axillary 7. thoracodorsal 8. subscapular 9. pectoral 10. suprascapular 11. long thoracic 12. dorsal scapular 13. nerve to subclavius
What are the 4 targets for autonomic neurons?
1. organs 2. cardiac muscle 3. smooth muscles 4. reflexes
Possible solutions for emesis
1. prescribe medical anti-emetic on top of opioid 2. pretreat patients prone to emetic response 3. medical marijuana 4. *do not* prescribe drug that inhibits BBB
Roles of kisspeptin:
1. puberty (*gonadotropin pathway*) 2. kidney function 3. tumor suppression
What are two main types of neuroglia of the PNS?
1. schwann cells 2. satellite cells
What are some structures that protect that brain?
1. skull/cranium 2. dural folds 3. BBB 4. CSF
What are the 3 main functions of the BBB?
1. stabilizer 2. protection 3. retainer of neurotransmitters
What are the two components of the corpora quadrigemina?
1. superior colliculus 2. inferior colliculus
The cavernous sinus receives tributaries from:
1. superior ophthalmic vein 2. inferior ophthalmic vein 3. sphenoparietal sinus 4. superficial middle cerebral veins
What are the two main divisions of the autonomic nervous system?
1. sympathetic 2. parasympathetic
What are the components of the diencephalon?
1. thalamus 2. hypothalamus 3. epithalamus
Adult spinal cord dimensions
18 in long, 0.55in (max) wide
Breakdown of Spinal Nerves:
31 total *pairs*: 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
How many hormones does the pituitary gland produce?
9 total (2 posterior, 7 anterior)
Which type of receptor would be responsible for detecting pH?
chemoreceptor
What part of the brain is the only part where the blood brain barrier is not intact?
Area Postrema
Which type of receptor would tell you your bladder is full?
Baroreceptor (mechanoreceptor)
What type of blocker can you give to patients with excessive heart rate/force?
Beta-1 blockers
The preoptic area (located in hypothalamus) is in charge of what?
Body temperature regulation
What is the most common place for aneurysms in the brain?
Circle of Willis
Which *spinal nerves* form the brachial plexus?
C4, C5, C6, C7, C8, T1
What structures travel through the cavernous sinus?
CN III, IV, V, VI, and the internal carotid artery
Which nerves from the cervical plexus innervate the diaphragm?
CN III, IV, V; phrenic nerve
Which CN controls *most* muscles that move the eye(s)?
CN III: oculomotor
What CN nuclei are associated with the Medulla Oblangata?
CN IX - Glossopharyngeal CN X - Vagus CN XI - Accessory CN XII - Hypoglossal
What CN nuclei are associated with the pons?
CN V - Trigeminal
What CN nuclei are associated with the Pontine-Medulla Junction?
CN VI - Abducens CN VII - Facial CN VIII - Vestibulococchlear
Damage to what CN would cause your eye to turn/drift outwards?
CN VI: abducens nerve, innervating lateral rectus muscle
CN XI innervates:
CN XI = accessory nerve 1. skeletal muscles of palata, pharynx, and larynx 2. sternocleidomastoids 3. trapezius muscles
Damage to what cranial nerve would affect speech?
CN XII: hypoglossal
ataxia
Disturbance of muscular coordination from trauma, stroke, or drugs such as alcohol
anti-emetic medications often target the:
chemoreceptor trigger zone (CTZ)
True or False: somatic motor neurons of the spinal cord control facial movements
False, cranial nerves control movements of the head; while somatic motor neurons control locomotion
True or False: CNS neurons have centrioles which allow them to divide and be replaced when injured
False, most CNS neurons lack centrioles and cannot divide; neurons lost to injury or disease are seldom replaced
True or False: pain cannot be localized when it is "prickly"
False, pain cannot be localized when it is *dull &/or achy*
Which reflex accomplishes withdrawal from stimuli
Flexor reflex
A patient presents with a history of CVA and experiences right-sided deficit, preventing them from being able to move their right side. What part of their brain is damaged?
Left precentral gyrus
The *pre*central gyrus is connected to what system?
MOTOR
Important pathology of Blood Brain Barrier in *newborns*
Newborns lack effective BBB and bilirubin is highly neurotoxic. By placing babies under fluorescent lights, bilirubin can be broken down, preventing an accumulation, therefore, preventing neurotoxicity
Which type of glial cell produces myelin in order to help create the myelin sheath in the CNS?
Oligodendrocytes
What are the components of the Peripheral Nervous System?
PNS includes all neural tissue outside the CNS and is broken down into two divisions: motor and sensory
Function of the thalamus
Relay and processing centers for sensory information; acts as a *filter* for sensory, only passing on small portion of sensory info
A patient presents post CVA. They can move all extremities, but they do not have sensation on the left side of their body. What part of the brain was damaged from the stroke?
Right postcentral gyrus
The *post*central gyrus is connected to what system?
SENSORY
Which cell is responsible for creating the myelin sheath in the *peripheral vascular system*?
Schwann cells
Vital life functions originate/are located in what part of the brain?
The low brain
What is the purpose of the sodium-potassium pumps?
These pumps work to counteract the leak channels and maintain the resting membrane potential
What is the function of CN IV
Trochlear nerve: motor nerve that innervates superior oblique muscle
True or False: spinal nerves are both motor and sensory
True
True or False: the hypothalamus lacks blood-brain barrier
True, because it needs to excrete hormones
Which CN are involved with taste (i.e. associated with taste buds)?
VII, IX, and X
What nerve alone provides approx. 75% of all parasympathetic outflow?
Vagus nerve
Main function of occipital lobe:
Visual
When does a CSF leak occur?
When there is a *tear* or hole in the meninges surrounding the brain or spinal cord
too much growth hormone *after* puberty can cause:
acromegaly
What is another name for the anterior lobe of pituitary gland?
adenohypophysis
How should you treat a patient who is now hypoglycemic after receiving too much insulin?
administer glucagon, which breaks down glycogen to release sugar into blood
Epinephrine is released by what gland?
adrenal gland (autonomic nervous system)
Neuroglia
aka glial cells; work to support and protect neurons; *make up half the volume of nervous system*
stimulation to Reticular Activating System makes a person more _____, while damage to RAS causes ______
alert/attentive; unconsciousness
amygdala hijack
an immediate, overwhelming emotional response with a later realization that the response was inappropriately strong given the trigger; stems from *sympathetic NS*
Positioning for lumbar puncture
anywhere below L1 (spinal cord ends at level of L1-L2)
CSF exits subarachnoid space via what?
arachnoid granulations into dural sinuses; helps to prevent excess CSF
Where are most unipolar neurons found?
as sensory neurons of the peripheral nervous system
How many reflexes are required for withdrawal reflex?
at least 2 (1 sensory, 1 motor)
Main function of temporal lobe:
auditory
Blood brain barrier only exists in two places in the body. Where?
brain and testicles
Where are Purkinje cells located?
cerebellar cortex of the cerebellum
Falx cerebelli separates:
cerebellar hemispheres along midsagittal line
Ventricles of the brain are filled with ______________ and are lined with ________ ______
cerebrospinal fluid; ependymal cells
Why can chemotherapeutic drugs be successful in attacking tumors?
capillaries that run through tumors *do not* have astrocytes; therefore, *tumors do not have a BBB,* allowing these drugs to enter and attack tumors
Where are highly significant chemoreceptors located in abundance?
carotid sinus and aortic sinus to regulate/detect pH and prevent build-up of CO2
ascending tracts of white matter
carry *sensory* information toward brain
What is the main difference between cavernous sinus syndrome and cavernous sinus thrombosis?
cavernous sinus thrombosis *does not* present with pulsatile exophthalmos
Where is the insula located?
deep and medial to temporal lobe (medial to lateral sulcus); separates frontal and temporal lobes
What should be your first thought on a patient presenting with mood swings in addition to increased thirst and hunger?
defect in the hypothalamus
What is the affect of peripheral adaptation on response time to stimuli?
delayed response
What is the primary function of the exocrine pancreas?
digestive function (digestive enzymes are main route for absorption)
Otorrhea (definition)
drainage from the ear
Rhinorrhea (definition)
drainage from the nose
Which glial cells assist in producing, circulating, and monitoring CSF?
ependymal cells
Is the pancreas primarily exocrine or endocrine?
exocrine (99%)
In regards to tactile receptors (type of mechanoreceptor), ____ touch and ______ receptors give more detailed information
fine; vibration
Which part of the body has the smallest touch receptor field (think 2-point discrimination test)
finger tips
Function of Purkinje cells
form sensory and motor synapses
Wernicke's area
general interpretive area; comprehension
too much growth hormone *prior* to puberty can cause:
gigantism
Function of astrocytes
glial cell that works to maintain blood barrier and form scar tissue after CNS injury
Alpha cells of the endocrine pancreas secrete ___________, while beta cells secrete _________
glucagon; insulin
What causes Cushing's Disease?
hypersecretion of glucocorticoids
What causes Addison disease?
hyposecretion of corticosteroids, especially glucocorticoids
Cisternogram (definition)
image used to determine if there is abnormal cerebrospinal fluid flow within the brain or spinal canal; *can be used to diagnose CSF leak*
Myelography (definition)
images of the spine, spinal cord and surrounding structures ; *can be used to diagnosed CSF leak*
Function of hippocampus
important role in learning, especially in storage and retrieval of long-term memories
Where are respiratory centers present in the brain?
in *both* the medulla oblongata and the pons
Where is CSF excreted?
in the choroid plexus by ependymal cells
Where does the sciatic nerve originate?
in the sacral plexus
Where are preganglionic cells found?
in the spinal cord and brainstem because they haven't left CNS yet
What can be some negative effects if CSF was blocked and not able to exit subarachnoid space?
increased intracranial pressure, possibly leading to stroke
Function of cortisol:
increases hunger by increasing rate of liver glucose and glycogen formation
Main role/function of aldosterone:
increases renal uptake/reabsorption of sodium and water, while also accelerating renal loss of potassium
Sympathetic innervation of the urinary bladder is by way of the:
inferior mesenteric ganglion
Pia mater
innermost meningral layer that is bound to underlying nervous tissue (bound to spinal cord and brain)
What type of neuron is the most common neuron in the CNS?
multipolar neuron
Damage to CN XI may clinically present with:
muscle atrophy of sternocleidomastoid and trapezius muscles
Hyperkalemia can cause:
muscle weakness and cardiac arrhythmias
What is often a chief complaint of patients receiving chemotherapy?
nausea and vomiting
PNS ganglia are located _________ in the sympathetic division, but are typically located ________ in the parasympathetic division
near vertebral column; intramural
What is the etiology of Cavernous Sinus *Thrombosis* ?
neoplasia or infection
Hypothalamus is the principal link between:
nervous and endocrine systems
What is another name for the posterior lobe of pituitary gland?
neurohypophysis
Dura mater
outermost covering of meninges
Amygdaloid
part of limbic system that links emotions to specific memories
The gray commissures in the spinal cord act as:
passageways for the axon to crossover
Important function of pre-frontal cortex:
performs abstract intellectual functions such as predicting consequences of events or actions
Kisspeptin is highly expressed during:
pregnancy
What is the function of FSH?
promotes ovarian follicle development in females and maturation of sperm in males
What is the function of LH?
promotes secretion of estrogen&progestins, as well as induces ovulation in females; stimulates production of sex hormones (testosterone) in males
What is the function of the dural folds?
provide additional stabilization and support to brain by holding cerebral spheres in place
Glucagon works to _____ blood glucose, while insulin _______ it
raise; lowers
What is the function of MSH?
rarely/barely produced in adults, but work to stimulate melanocytes of skin to increase melanin production
muscarinic receptors
receptors of the parasympathetic division that are found in sweat glands responsible for metabolic effects ; can be interrupted by wild mushrooms
If sodium channels were to be blocked by a toxin, what would happen?
response to acetylcholine would be blocked, therefore, action potential could not be generated
what is the function of the pineal gland?
secrete melatonin
Photophobia (definition)
sensitivity to light
Phonophobia (definition)
sensitivity to sound
The dorsal root ganglia is responsible for ______
sensory
What are the two features of spinal nerves in regards to sensation?
sensory and motor
If you damaged your posterior gray horns, _____ would be affected
sensory detection
preganglionic fibers of the sympathetic division are _______ in length than those of the parasympathetic division
shorter
Arachnoid granulations (aka arachnoid villi)
small protrusions of the arachnoid matter into the outer membrane of the dura matter that *allow CSF to exit subarachnoid space and enter blood stream*
Broca's area
speech/ motor speech area
What is the function of PRL?
stimulates mammary gland development and milk production
What is the function of GH?
stimulates rate of protein synthesis in order to stimulate cell growth/reproduction
What is the function of ACTH?
stimulates release of steroid affecting glucose metabolism from adrenal cortex
What is the function of TSH?
stimulates release of thyroid hormones
What is the function of the diencephalon?
structural and functional link between the cerebral hemispheres and the rest of the CNS
midbrain is the ______ portion of the brainstem
superior
The alarm phase of stress response is stimulation of the:
sympathetic nervous system
What are the two components of the CNS?
the brain and the spinal cord
Through what do the vertebral arteries enter the cranial cavity?
the foramen magnum
What component of the midbrain helps maintain posture while standing, walking, or bending?
the red nucleus
Importance of anterior median fissure
this groove allows for vascular tissue to move down
which nerve condition is also known as the "suicide syndrome?"
trigeminal neuralgia
Function of microglia
type of glial cell that persist as mobile phagocytic cells
Shingles
viral infection of dorsal root ganglia caused by varicella-zoster virus; those who have had chickenpox are more at risk; treat with *NSAIDS and analgesics*
Function of the basal nuclei of the cerebrum:
voluntary motor/muscle movements; help coordinate learned movement patterns (ex. walking)
where is a spinal nerve formed?
where the two roots (dorsal and ventral) meet