aka Arachanoid villi.
reabsorb CSF back into the blood at a rate equal to formation.
-CSF filled cavities are known as Ventricles
-Most CSF forms in the lateral ventricles
-Formed by blood filtration.
name of the network of capillaries that line the walls of ventricles.
-Produce the CSF by flitrating/pushing blood plasma
|3 ways CSF maintains homeostasis||
Mechanical protection-shock absorber
Chemical protection-maintains an ionic env for(AP)
Circulation-a medium exchange of nutrients and waste products btw blood and nervous tissue.
blood blocked interfering w drainage of CSF from ventricles.
AKA-enlargement of the ventricles
kids-bulging of the head.
|Blood supply of the brain||
4 mins or more of interruption of blood flow=permanent damage to the brain.
-Supply by the Circle of willis
-Lysosomes if lack of O2 release enzymes and they destroy neurons.
|Can the blood brain barrier store glucose?||
NO, so blood supply is important!!
|What are of the Brain stores more O2?||
Blood brain barrier
crosses over and interacts with neurons
Capillaries of the brain r less permeable bc of their endothelial cells.
Astrocytes- stars cells! press against capills and allow specif substances.
|Circle of Willis||
main trunk that supplies brain. if blood is blocked, can still get to brain.
-is a point where the blood carried by th 2 internal carotids and basilar systems come 2gether and then redistributed by the ant, mid, and pos cerebral arteries.
from the dura mater-separater the hemispheres of the cerebrum.
|What are the layers of the brain?||
Pia mater-inner most
|What produces CSF and where?||
secreted by-Choroid plexuses-located in the 4 ventricles
circulates through the brain and enters the superior sagittal sinus.
|What is Sensation?||
State of awareness pf external or internal conditions of the body.
Info travels via
Conscious relay path
and unconscious relay paths.
|What 3 ways does sensation get to the brain?||
Conscious relay path-discriminative touch
divergent path-aching pain
unconscious relay paths-how I move(cerebellum)
|Sensation receptor classifications||
Visceroceptors or interoceptors- internal.
Proprioceptors- movement-joints ligs,tendons.
|What is a mechanoreceptor?||
sensory recepts, touch, pressure, stretch,
temp warm and cold receptors
sensitive to chemicals released.
responds to chemical receptors>O2 levels
aka kinesthetic sense.
info regarding movement and positions.
joint, hair cells, ms spindles, GTO-ms strength.
ability of the brain to organize, interpret, and use sensory info. occurs automatically.
-ways to teach kids better.
|Sensory Arousal levels or SAL||
Lethargic-drowsy w lessened focus
Obtunded-difficulty to arouse, confused when awake.
Stupor-responce to painful stimuli only. then back to unconscio.
Coma- no arousal by any stimuli
pt's awareness of, TIME, PERSON, PLACE
pt orientate X3
pt orientate X1 (place)
Pt orientate X2 (time and person)
Soap note i.e=O+A X3
|Labeled line principle||
line going from tongue to brain.
area of skin innervated by a single afferent neuron(sensory)
different types cutaneous, superficial, thermal, ect...
More sensory distally!
each sense is a modality sensation.
i.e hearing, vision, taste, touch.
|Superficial fine touch||
smaller receptive fields
superficial fine touch receptive field.
free nerve endings wraps around base of hair follicle; TOUCH RECEPTOR
detects mechanical movement/touch.
feel me touch the hair
in superficial dermis, light pressure. rapidly adapt. RECOGNIZE OF TEXTURE.
deep dermis, deep pressure and vibration.
|Subcutaneous fine touch||
larger receptor fields
deep dermis, sensitive to stretch of the skin.
Assist w joint position sense.
free nerve endings in dermis, ms, liver.
Warm rec- respond to temps btw 77-113 degrees
Cold recep- respond to temps btw 50-68 degrees F
free nerve endingd w LARGE receptive fields. found in superficial skin, joint caps, periosteum, around walls of b. vessles,
A-fibers-carry fast pain
C-fibers-carry slow burning aching pain
fiber connective tissue that wraps around ms spindles.
free nerve endings throughout skin,
detect crudely localized touch/pressure/tickle/itch.
|Deep sensory receptors||
in ms, tendons, joints
GAMMA motor neurons fiber.
intrafusal fibers parallel to extrafusal fibers.
monitor changes in ms length n velocity.
|Golgi tendon organ||
in tendons. monitor tension in a ms.
Golgi-protective, 2 relax ms w/in a tendon.
will inhibit contracting.
deep sensory receptors
|Free nerve endings||
w/in fascia of a ms. respond to pain/pressure/vibration
in tendons/around joints. respond to deep pressure and vibration. circle!
type nerve ending- receptors in ligs. detect rate of joint movement.
in joint caps and ligs.
joint receptor. respond to direction of joint movement.
sensory axon enter the SC via dorsal horn.
Fast conducting fibers.
two-point discrimination. Lager fibers.
are located at the distal end of an afferent nerve fiber.
Anterior-carry info regarding crude touch.
Lateral-pain and temp.
SMALL conducting fibers.
Mechanoreceptors, thermo, and nociceptors. Afferent fibers that slowly conduct.
regcognition of weight
traced figure ID.
id a common object w/out site.
|2 point discrimination||
aesthesoimeter or circular disk measures distance on skin that 2 points are felt.
PROM. where is joint moving? up or down?
move joint then stop. eyes closed.
infection of senory root cell body.
pain is objective.
peripheral nociceptors r found through out skin and internal tissues, cept tissue of the brain.
deficiency of blood. resulting in deficiency of )2 (hypoxa)
ms's tighten up and squeezing caps. which decrease blood. then pain-stimi chems accumulate. BUT if u apply heat=dialtes blood, increasing blood flow/O2=less pain.
fast carrying pain info. myelinated axons.
slow carrying dull aching pain. on unmyelinated axons. synapse on neurons in dorsal horn.
to the limbic system(emotional response) and reticular-wake up! turn towards pain.
pain perception or localization.
(non pain)if alpha-beta fibers are stimulated more then the alpha-delta fibers(pain fibers)then the pain is inhibited in the dorsal horn. 'closing the gate'
rubbing the pain inhibits the T-cells=stopped the pain!
non-nociceptors(non pain receptors)carry info from mechnoreceptors
|What does lower levels of serotonin mean?||
so increased levels of serotonin and dopamine in brain means = inhibit pain!
pressure stimulates mechanoreceptor afferent branches, which attivate interneurons that release Enkephalin, which decreases the release of Substance P(chronic pain nt)
suppression of pain
produced in brain. enkephalin, beta-endorphin
can inhibit pain
aspirin can inhibit pain
|Brainstem descending tacts||
become activated, and inhibit pain by increasing the release of serotonin in the dorsal horn, which increases enkephalins.
pituitary gland and adrenal medulla release enkephalin during acute stress.
thats y ppl walk away w a broken leg.
ihibits pain by distraction, placebo, excitement.
edema- endogenous chems-sunburn
anxiety-can increase pain. increased levels of norepinphrine can increase pain.
|Multiple ways to shut down pain||
|Types of pain||
Acute, referred, Chronic
Chronic pain-Nociceptive- continuing stimulation all the time
Chronic pain neuropathic- a disease. pain continues after stimi is gone.
Chronic pain-Nociceptive- continuing stimulation all the time bc of cancer or tumor. takes less stimi to generation AP.
|Chronic pain neuropathic-||
a disease. pain continues after stimi is gone.
|Symptoms of neuropathic pain||
paresthesia-painless. abnorm sensation.
Dysethesia-unpleasant. abnorm sensation. burning, shooting pain.
Allodynia-norm non-painful touch produces pain.
Secondary hyperalgesia-fibromyalgia pain. normal touch feels painful!
fibromyalgia pain. normal touch feels mildly painful!
norm non-painful touch produces pain.
painless. abnorm sensation. (tickle)lesions
unpleasant. abnorm sensation. burning, shooting pain.
|PNS neuropathic pain||
injury or disease of peripheral nerve.
Ectopic foci- myelin damage make AP w/out stimi. Ectopic develop at nerve stump ends and tapping induces pain AKA Tinels sign!
Ectopic foci- myelin damage produces AP w/out stimi. this develops at stump nerve ends and when tapping=induces pain- TINELS sign.
PNS- one nerve
median or ulna nerve compression
PNS- more than one nerve. like diabetic neuropathy and guillain barre.
|CNS neuropathic pain||
if peripheral sensory info in completely absent.(sensory info coming in) then CNS neurons in the pain pathway become abnormally active!
CNS neuropathic pain
avulsion of afferent roots (MVA)(cutting off dorsal roots)
causes burning pain in area of sensation loss
|Phantom limb pain||
CNS neuropathic pain
|Pain matrix malfunction||
Antinociception is decreased and pronociception is increasesd.
Fibromyalgia, Complex regional pain syndrome.
|Complex regional pain syndrome||
abnormal response to trama leading to limb disuse. excessive sweating, edema, red/pink skin,
|Chronic pain syndromes||
migraine, chronic low back pain-never stops.
|Simple descriptive pain scale||
a line....no pain,mild, moderate, severe,-max pain tolerable
|VAS-visual analog scale||
a line...no pain-max.
|Pain estimate (scale)||
a line---0-100 or 0-10
|Face pain scale||
faces for kids
|Mcgill pain questionnaire||
20 categories of descriptive words.
pain clinics use this a lot.
number 16 evaluative
list of demonstrated pain behaviors for pt's who cant communicate.
gait, posture, skin, ROM, ms strength, sensation.
|Disorders of Vascular supply||
Anerism- dislocation of wall, abnormal widening.
Angedogphy -X-ray pictures of the inside of blood vessels.
Hemerage- thin wall vessles
|What makes up the CNS?||
brain and sc
31 SP-pairs nerves
CNS-all nervous systems ARE encased in Vertebral column. (brainstem, SC, skull)
Neuroglia cell types-Astrocytes, Oligodendrocytes, microglia, ependyma.
No Neurolemma-> NO REGENERATE!
Has nucleus and PNS
PNS-all nervous systems NOT encased in bone
Have ganglia,carry info to and from CNS.
Neurolemma AKA Schwann Cells->mylinate -regeneration
Divided into 2 systems- Somatic-voluntary-motor control ability.ANS-involuntary2 subdiv
ANS-sympathic s-fight or flight. and Parasympathic s-restful.
Somatic-voluntary. contraction of ms. motor control.
sensory. info to the CNS.
somatic afferent-to CNS-skin, skeleton, joints,
Somatic efferent-skeletal ms's.
Viseral efferent fibers- heart, smooth ms, glands, to autonomic sys.
Dendrites receive, Axons conduct.
|Node of Ranvier||
space btw mylein
exposed 2 extracelluar fuild.
Where the gates open!!
|Spinal cord-how long and how many nerves?||
31 pairs of nerves
runs to medulla-L1/L2
Gray matter inside-unmyleinated axon. cell bodies.
|Sensory coming in from where?||
Dorsal roots gangila.
Motor coming out-Ventral.
|Lateral spinothalamic tract||
|Lateral Corico tract*||
BIG AIS motor-distal-
|UMN vs LMN||
hyper reflexia, hypertonia (babinski)
LMN-directly to Ms. Hypotonia.
|Cranial nerve VIII||
balance, auditory sensations from inner ear.
|Cranial nerve XII||
motor to tongue
|X cranial nerve||
Vagus nerve-only cranial nerve to descend below neck. autonomic. throacic and abdom organs.
|Cranial nerve IV||
Trochlear- motor for chewing
|area of brain which has cardiac, vasomotor, and respiratory centers.||
|Hypothalmus is which part of the brain?||
|Area of brain which can modify the respiratory phythmicity center and contains 4 nuclei?||
|Cognitive, problem solving, are functions of what area of the brain?||
Parietotemporal ass cortex
|Crutch palsy is from compression of which nerve?||
|Primary motor area is where?||
frontal lobe and is the source of most of the corticospinal tract neurons.
|Brocas area is||
area of the cerebral cortex which provides motor control of the mouth, tongue, and larynx for speech.
|Wrenicke's are is?||
comprehension of spoken language
|The primary somatosensory area receives info regarding?||
touch, pain, temp, proprioception
compares intended movement with actual movement.
adjusts UMN activity.
helps w balance and coordination
|The longitudinsal fissures separates||
the cerebral hemspheres; the transverse.
|Taste is interpreted in what lobe?||
outer 2-5mm of the cerebrum. contains 75% of all neuron cell bodies.
|Prefrontal association area deals with||
executive function and goal oriented behavior
is not considered a nerve plexus
|Commissural (cerebral white fiber)||
cross to the opposite cerebral hemisp
Stay w in same hemisphere
leave the cerebrum and descend towards spinal cord.
cell bodies in SC or brainstem
communicate directly w skeletal ms.
Loss of reflexes-LMN
Cell bodies in the cerebral cortex or brainstem. (rubrospinal tract)
UMN can inhibit LMN or modify them.
quick twitches of ms fibers visible under skin.
type of hypertonia..
amt of resistance to passive stretch dont matter of velocity
ms spindle stretch leads to overactivity of lmn's
strong resistance to stretch and then sudden give.
|Basal gangial masses of what kind of matter?||
can adjust descending tracts activity
can provide subconscious control of ms tone and coordination.
|What neurotransmitter is lacking in Parkinsons?||
|Auto immune disease that kills basal ganglia cells, leading to hyperkinesia?||
|What gland scretes melatonin?||
|Large tract of commissural fibers in brain?||
refers to a wave of charge that propagates alone axon of neuron til its reaches axon terminal.
a neuroglia cell of the CNS that breaksdown pathogens.
|Absolute refractory period||
the cell cant respond to other stimi at this time.
it coincides w the ap and lasts for 1 millisecond.
|the parasympathic system is responsible for energy conservation||
the sympathic sys is responsible for expenditure of energy.
|how long does the relative refractory period last?||
10-15 millisecs after an AP
is a neurontransmitter is the PNS that is a big conveyor of info and is always excitstory at th neuormuscular juction.
1 pre-synptic neuron synapsing w MANY post syn.
|Sodium potassium pump, pumps sodium||
out and potassium into the cell
cancer of neurons
|Where are the abundant voltage gated Na+ and K+ channels?||
at the axon and node of ranvier.
is ct from the end of the sc to the S2 level
|Which horn houses sensory endings and cell bodies of 2nd order sensory neurons?||
dorsal root consists of afferent fibers
|anterior/ventral roots consists of what fibers?||
many sensory or motor tracts cross over here
is a ct that wraps around a fascicle of nerve fibers (axons)
controls movements of the head in response to visual/auditory stimi.
|upper truck, neck, vibration, kinesthesia,||
precise contraction of distasl extremities
contralateral UE flexors and gross postural tone
regulates ms tone in response to head movement, balance.
crude touch and pressure
|Circle of willis info||
There are some watershed areas in the brain located at the ends of the vascular sys. Problems with blood supply r here,
Blockages in the water shed areas can cause transcortical aphasia
from lesions outside of Broca's area or Wernicke's area of the cerebral cortex.
Loss of ability to understand or express speech, caused by brain damage
|Resting membrane potential?||