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