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Question 1
Peripheral nervous system components
ganglia, cranial and spinal nerves autonomic, somatic, enteric nervous system
Question 2
What are the two main divisions of the nervous system?
Central nervous system and peripheral nervous system
Question 3
What are the two main components of the central nervous system?
Brain and spinal cord
Question 4
Spinal cord extension?
Foramen magnum to L1/L2
Question 5
What is the cauda equina and what does it consist of?
lumbosacral nerve roots that travel inferiorly through the vertebral canal
Question 6
What is the function of the white matter in the spinal cord?
Contains myelinated ascending and descending fiber tracts of sensory and motor pathways, respectively.
Question 7
What is the function of the anterior horn in the spinal cord?
Conveys info from the motor cortex to the skeletal muscles voluntary
Question 8
What is the function of the posterior horn in the spinal cord?
Sensory info to the sensory cortex of the brain
Question 9
What type of neurons are located in the lateral horn of the spinal cord?
Preganglionic neurons of the ANS
Question 10
What are the ascending spinal tracts?
Dorsal columnmedial lemincus Spinothalamic Spinocerebellar
Question 11
What does the dorsal solumn-medial lemniscus control?
• vibration • consious priopioception • fine touch
Question 12
What does the spinothalamic tract control?
• crude touch • pressure • pain • temperature
Question 13
What does the spinocerebellar tract control?
position of body parts
Question 14
What are the descending spinal tracts and what do they control?
Direct - voluntary and fine movement
• pyramidal • corticospinal • corticobulbar
Indirect - balance, posture, muscles tone, coordination
• extrapyramidal tract
Question 15
What is a reflex arc?
Involuntary rapid reflex mediated by the spinal cord before stimulating the brain
Question 16
What are the components of a reflex arc?
Receptor + sensory neuron with 1+ synapses to generate quick efferent output (via motor neuron + muscle)
Question 17
What are the functions of the cervical region of the spinal cord?
Controls sensation/movement of the neck and upper body, and autonomic functions like breathing and heart rate.
Question 18
Consequences of a transection at C1-C3 ?
No function below the head and a ventilator is needed.
Question 19
Transection at C4-C5 vs C6-C8?
C4-C5 = quadriplegia C6-C8 = loss of lower limb function but some upper limb may be intact
Question 20
Transection at T1-9
Paraplegia paralysis in lower body and legs but upper limb intact
Question 21
Transection at T10-L3
some dysfunction in lower limbs
Question 22
What are the three layers of the meninges?
Pia mater, arachnoid, and dura mater
Question 23
What is cerebrospinal fluid (CSF)?
CSF is a clear, colorless, and sterile ultrafiltrate of blood.
Question 24
What is the function of arachnoid villi?
one-way valves between the subarachnoid space and the venous system
Question 25
What are the main components of cerebrospinal fluid (CSF)?
Water, ions, glucose, small amounts of proteins, and small number of lymphocytes.
Question 26
What are the functions of cerebrospinal fluid (CSF)?
a) hydromechanical protection b) Providing nutrients, removing waste c) Neuromodulators transport
Question 27
What is the choroid plexus?
A highly vascular tissue that projects into the ventricles and is lined by ependymal cells.
Question 28
What is the main function of the choroid plexus?
To remove water and solutes from the blood and release it as cerebrospinal fluid (CSF).
Question 29
What is the dura mater and what are its layers?
Outermost layer of the brain meninges formed by the periosteal layer + inner meningeal layer
Question 30
What is the subdural space and what does it contain?
The subdural space is a narrow space between the dura mater and the arachnoid. It contains a scarce amount of cerebrospinal fluid (CSF).
Question 31
What is the arachnoid mater?
layer that covers the subarachnoid space surrounds the brain and spinal cord
Question 32
What is the subarachnoid space?
between the arachnoid and pia mater contains CSF, blood vessels, and cranial nerves
Question 33
What space does the CSF use for circulation
subarachnoid space
Question 34
What is the function of the arachnoid villi?
They act as a conduit for CSF to return to the venous circulation.
Question 35
What is the pia mater?
innermost layer connective tissue that covers the brain surface
Question 36
What are the leptomeninges?
The arachnoid mater and pia mater.
Question 37
What is meningitis?
An inflammatory condition that typically affects the leptomeninges.
Question 38
What are the components of the blood brain barrier?
Capillary endothelium with continuous tight junctions, astrocyte end foot, and basement membrane.
Question 39
What is the blood brain barrier and what are its functions?
1. tightly controlling substances that pass from blood to brain 2. protecting neurons/glia from toxins, infectious agents 3. prevents escape of neurotransmitters from site of production to general circulation
Question 40
What are the key factors that determine the permeability of the blood brain barrier?
Nonionized (lipid-soluble) drugs can cross the BBB easier than the ionized (water-soluble) drugs
Question 41
What is meningitis?
An inflammatory condition affecting the leptomeninges.
Question 42
What are the types of meningitis?
Bacterial, viral, and fungal meningitis.
Question 43
Causes of bacterial meningitis?
• Streptococcus pneumoniae (most common) • Neisseria meningitidis (common) • Mycobacterial tuberculosis • S. aureus
Question 44
Causes of viral meningitis
• Enterovirus (coxsackievirus and echovirus) • Herpes simplex virus
Question 45
Causes of fungal meningitis
cryptococcus sp
in immunocompromised patients
Question 46
What are the two main pathways for pathogens to reach the leptomeninges?
Direct and Hematogenous
Question 47
What is the direct pathway for pathogens to reach the leptomeninges?
Through the skin or nose, associated with anatomical defects or skull fractures
Question 48
What is the hematogenous pathway for pathogens to reach the leptomeninges?
Bacteria colonize the nasopharynx by attaching to epithelial cells, then gain access to the bloodstream and reach the choroid plexus
Question 49
Classic symptoms of meningitis?
Fever, headaches, and neck stiffness (nuchal rigidity)
Question 50
What are the protective vaccines mentioned for bacterial meningitis?
Meningococcal vaccines (N. meningitidis) Hib vaccine (H. influenzae B) pneumococcal vaccine (S. pneumoniae)
Question 51
What is the treatment for bacterial meningitis?
Dexamethasone (steroid to prevent leptomeninges injury) prior to antibiotics
Question 52
What are the two main types of stroke?
Ischemic and Haemorrhagic
Question 53
Ischemic stroke subtypes?
Thrombotic Embolic
Question 54
Haemorrhagic stroke subtypes
Subarachnoid Intracerebral
Question 55
Ischemic stroke cause
reduced or complete interruption of blood flow → rapid depletion of ATP stores → neural death
Question 56
What is a thrombotic stroke?
formation of a thrombus inside the cerebral vessels leading to the occlusion of cerebral vessels
Question 57
What are the symptoms of a thrombotic stroke?
Symptoms may include headache, dizziness, confusion, loss of coordination, limb paralysis, and slurred speech. They can be sudden or gradual and often precede TIA.
Question 58
What is an embolic stroke?
Arterial occlusion caused by clot that originates somewhere else in body → ischemia
Question 59
What are the symptoms of an embolic stroke?
Symptoms include difficulty speaking weakness or numbness temporary paralysis blurred vision nausea slurred speech
Question 60
What is systemic hypoperfusion?
Reduced blood flow to brain + organs due to issues in the systemic circulation
Question 61
What causes systemic hypoperfusion?
It can be caused by arrhythmias, reduced cardiac output, or bleeding.
Question 62
What is the term for loss of the ability to understand or express language?
Aphasia
Question 63
What are the two phases of stroke management?
Acute phase and chronic phase
Question 64
Treatment of acute phase of stroke
thrombolysis and endovascular surgery
Question 65
Treatment of chronic phase of stroke
physical therapy to minimize disability pharmacological treatment to prevent recurrence
Question 66
What are the four steps of the F.A.S.T. acronym for recognizing stroke symptoms?
Face drooping, Arm weakness, Speech difficulty, Time to call 9-1-1
Question 67
What is a hemorrhagic stroke?
Bleeding in brain that prevents proper oxygenation → edema and brain damage
Question 68
What is subarachnoid hemorrhage?
Bleeding into subarachnoid space surrounding the brain Cause: rupturing of an arterial aneurysm
Question 69
What are the symptoms of subarachnoid hemorrhage?
Sudden onset of severe headache (thunderclap headache) blurred vision loss of consciousness due to sudden rise in intracranial pressure
Question 70
What is intracerebral hemorrhage (ICH)?
Bleeding directly into brain parenchyma → localized hematoma
Question 71
What are the symptoms of intracerebral hemorrhage?
Rapid onset (minutes to hours) headache, vomiting, decreased level of consciousness, and hemiplegia
Question 72
What is the definition of Transient Ischemic Attack (TIA)?
transient neurologic dysfunction due to a brief ischemic event does not cause MI or tissue injury
Question 73
What are the symptoms of TIA?
Symptoms include weakness or numbness of the tongue, face, arm, or leg, trouble speaking normally, and double vision or trouble seeing in one or both eyes.
Question 74
What is the function of the Peripheral Nervous System (PNS)?
Carries messages to and from the Central Nervous System (CNS)
Question 75
How are cranial nerves functionally divided?
Sensory nerves, Motor nerves, Mixed (sensory & motor; common)
Question 76
What are the two types of spinal nerve roots and what do they carry?
Dorsal root (afferent/sensory) and ventral root (efferent/motor)
Question 77
What is the primary motor cortext of the brain?
Frontal lobe Sends motor output to body parts
Question 78
How does the size of the various parts in the Motor Homunculus relate to the cortical area?
Size of the various parts is proportional to the cortical area devoted to them
Question 79
Why do we have more neurons contributing to the face and hand movement compared to the feet?
This enables fine control for face and hands
Question 80
What are the sources of upper motor neurons?
Cerebral cortex and deep nuclei of the brainstem
Question 81
Where do lower motor neurons originate?
Anterior (ventral) horns of the spinal cord
Question 82
What is the function of descending somatic pathways?
Carry motor signals from the brain to muscles to control voluntary movements
Question 83
What is the function of the corticospinal tract?
Controls muscle movement in the trunk and limbs
Question 84
What is the Parietal Lobe and what does it contain?
Somatosensory cortex, specifically the postcentral gyrus
Question 85
What are Sensory Receptors?
Specialized epithelial cells or neurons that respond to different environmental signals and transduce these signals into neural signals.
Question 86
What are the kinds of sensory receptors
mechanoreceptors photorecptors chemoreceptors nocireceptors
Question 87
What are Mechanoreceptors?
Respond to touch and pressure
Question 88
Ascending sensory tract neuron pathway
1st order: dorsal root ganglia 2nd order: spinal cord 3rd order: thalamus 4th order: cerebral cortex
Question 89
What is the function of the spinothalamic tract?
Transfers sharp pain and heat sensation
Question 90
Where do second order neurons desscusate in the spinothalamic tract
via the anterior white commissure of the spinal cord ascend contralaterally towards thalamus
Question 91
What does 'Taste Sensation' refer to in the context of dental medicine?
A term used to describe the perception of taste in the mouth, often related to dental health and taste disorders.
Question 92
Innervation of taste buds: 2/3 vs 1/3
anterior: facial nerve posterior: glossopharyngeal
Question 93
What are the three major types of papillae on the tongue and what do they detect?
Fungiform: anterior two-thirds, detects salty, sweet, and umami Circumvallate and foliate: posterior third, detects sour and bitter
Question 94
What is the function of microvilli in receptor cells?
To increase the surface area.
Question 95
What role does saliva play in the taste process?
Saliva in the oral cavity acts as a solvent for tastants and helps the chemicals diffuse to the taste receptor.
Question 96
What is the pathway of taste signals from the tongue to the gustatory cortex?
Taste → afferent cranial nerve → medulla → thalamus → gustatory cortex
Question 97
What is the role of neurotransmitter release at the synapse in the activation of taste receptors?
Neurotransmitter release at the synapse activates the activation of taste receptors.
Question 98
What are the five general taste categories?
salt, sweet, sour, bitter, and umami
Question 99
Which taste has the lowest threshold and which has the highest?
Bitter has the lowest threshold, and sweet has the highest
Question 100
What are the cranial nerves involved in taste sensation?
CN VII, IX & X
Question 101
What is taste adaptation?
Within minutes of eating the same food, taste receptors start sending less signals to the brain.
Question 102
How does hunger affect taste sensitivity?
Hunger increases the sensitivity of taste receptors.
Question 103
Disorders of taste
• ageusia: absence of the sense of taste • hypogeusia: diminished taste sensitivity • dysgeusia: unpleasant perception of taste
Question 104
What are the two main categories of pain?
Acute and Chronic
Question 105
What are nociceptors and what do they do?
Sensory receptors that respond to noxious stimuli by triggering pain to protect the host
Question 106
What are the three main types of nociceptors?
Thermal, Mechanical, and Polymodal
Question 107
What is the activation temperature for Thermal nociceptors?
Skin temperatures above 45°C Severe cold (<20°C)
Question 108
What are polymodal nocireceptors
senses combo of thermal/mechanical obnoxious stimuli
Question 109
What does non-adaptive nature of nociceptors lead to?
leads to unresolved causes and continuous pain
Question 110
What are A delta fibers
• thin myelinated fibers • fast conduction speed • fast pain perception • sharp or piercing pain • release glutamate
Question 111
What are C fibers
• unmyelinated axons with smaller diameter • slow conduction velocity. • slow pain perception • dull, intense, diffuse, aching in nature • releases a combination of glutamate and substance P