15 mcq.

5 short answer QUIZ 1

1. Spinal cord
2. Peripheral nerve,spinal nerve 445,cervical c1 to c8
3. What nerve control heart vagus
4. What nerve control diaphragm phrenic
5. What nerve control stomach
6. Brain chapter 14 tortora
7. Brachial plexus,radial and median coming from all root
8. Reflex roots
9. Areas of brain and function
10. Cranial nerve-3 questions
11. Hypothalamus
12. Sacral plexus
13. Parkinson midbrain is affected substantia nigra is affected
14. Myelin,diameter,temperature, increases speed
15. Motor cortex of brain is responsible for motor function,pass
through thalamus, through mid brain and cross over happens in
medulla and then to lateral horn then anterior corticospinal tract
16. Area in midbrain-red nucleus pons,medulla,rubrospinal
pathway,anterior horn
17. Left side of brain damage cause paralysis in right side
18. Cauda equina start at? End at?L2 toCO 1
19. Sensory dorsal motoe ventral
20. Third order to mortata cortex
21. Long thoracic nerve c5 c6 c7..winged scapulls
22.
Motor cortex-corticospinal pathway: lateral pathway distal muscle
Anterior corticospinal tract
Enteric nervous system = brain of the Gut
Imp points
Autonomic nervous system
 Sympathetic and para sympathetic nervous system
Sympathetic nervous system(flight or fight) arise from thoracic
and lumbar spine
Sympathetic: dilate pupil, increase glucose, heart rate ,respiration
rate, decrease digestion, urine out put, inhibit salvation, relax
bladder.
Celiac and inferior mesenteric ganglion supply abdominal area of
the body
Parasympathetic: start from brain stem and sacrum . increase
gut motility Vagus nerve is main parasympathetic affecting organs
and tissues and abdominals. Constrict air ways, stimulates
digestion ,dilates intestinal blood flow, constrict bladder
Cranial dura mater has two layers :The two dural layers are called
the periosteal layer (which is external)and the meningeal laye; the
spinal dura mater has only one.
Medulla oblongata: axons in the pyramid cross to other side, This crossing is
called the decussation of pyramids and explains why each side of the brain controls
voluntary movements on the opposite side of the body. cardiovascular center
regulates the rate and force of the heartbeat and the diameter of blood vessels. The
medullary respiratory center adjusts the basic rhythm of breathing control reflexes
for vomiting, swallowing, sneezing, coughing, and hiccupping.CNVIII-CNXII
The midbrain includes the leftand right substantia nigra that produces
dopamine.CNIII and CNIV emerge from midbrain
reticular activating system (RAS), the most important function ofthe RAS is
consciousness, a state of wakefulness in which an individual is fully alert, aware,
and oriented. Visual and auditory stimuli and mental activities can stimulate the
RAS to help maintain consciousness. The RAS is also active during arousal, or
awakening from sleep. Another function of the RAS is to help maintain attention
(concentrating on a single object or thought).smell cannot activate RAS.
Inactivation of this system cause coma and sleep
Cerebellum: coordination of skilled movements, the cerebellum is the
main brain region that regulates posture and balance. Damage cause
Ataxia .controls upper motor neuron

The diencephalon extends from the brain stem to the cerebrum and
includes the thalamus, hypothalamus, and epithalamus. Projecting from
the hypothalamus is the hypophysis, or pituitary
gland.HYPOTHALAMUS : Production of hormones, hypothalamic
hormones known as releasing hormones and inhibiting hormonesThe
bloodstream carries these hormones directly to the anterior lobe of the
pituitary, where they stimulate or inhibit secretion of anterior pituitary
hormones. second(oxytocin or antidiuretic hormone). transport the
hormones to the posterior pituitary. Regulation of eating and drinking,
Control of body temperature, Regulation of circadian rhythms and
states of consciousness. Regulation of emotional and behavioral
patterns (with limbic system)Expression of rage, aggression, pain,
pleasure, sexual arousal (the behaviors related)
epithalamus a small region superior and posterior to the thalamus,
consists of the pineal gland(melatonin) and habenular nuclei(olfaction).
The cerebrum is the “seat of intelligence.” It provides us with the
ability to read, write, and speak; to make calculations. The cerebral
cortex is a region of gray matter that forms the outer rim of the
cerebrum. longitudinal fissure, separates the cerebrum into right and
left halves called cerebral hemispheres. The cerebral hemispheres are
connected internally by the corpus callosum, abroad band of white
matte. The central sulcus separates the frontal lobe from the parietal
lobe. A major gyrus, the precentral gyrus—located immediately
anterior to the central sulcus—contains the primary motor area of
the cerebral cortex. Another major gyrus, the postcentral gyrus,
which is located immediately posterior to the central sulcus,
contains the primary somatosensory area of the cerebral cortex. The
lateral cerebral sulcus (fissure) separates the frontal lobe from the
temporallobe. The parieto-occipital sulcus separates the parietallobe
from the occipital lobe.
The limbic system is sometimes called the “emotional brain ”because it
plays a primary role in a range of emotions, including pain, pleasure,
docility, affection, and anger. It also is involved in, olfaction (smell) and
memory
Injury to the glossopharyngeal (IX) nerve causes dysphagia, or difficulty in
swallowing; aptyalia, or reduced secretion of saliva; loss of sensation in the throat;
and ageusia (a-GOO-se¯-a), or loss of taste sensation

Olfactory (I) Special sensory Olfaction (smell).

Optic (II) Special sensory Vision (sight).
Oculomotor (III) Motor
Somatic Movement of eyeballs and upper eyelid.
Motor (autonomic) Adjusts lens for near vision (accommodation).
Constriction of pupil.
Trochlear (IV) Motor
Somatic Movement of eyeballs.
Trigeminal (V) Mixed
Sensory Touch, pain, and thermal sensations from scalp, face, and oral cavity (including teeth
and anterior two-thirds of tongue).
Motor (branchial) Chewing and controls middle ear muscle.
Abducens (VI) Motor
Somatic Movement of eyeballs.
Facial (VII) Mixed
Sensory Taste from anterior two-thirds of tongue.
Touch, pain, and thermal sensations from skin in external ear canal.
Motor (branchial) Control of muscles of facial expression and middle ear muscle.
Motor (autonomic) Secretion of tears and saliva.
Vestibulocochlear (VIII) Special sensory Hearing and equilibrium.
Glossopharyngeal (IX) Mixed
Sensory Taste from posterior one-third of tongue.
Proprioception in some swallowing muscles.
Monitors blood pressure and oxygen and carbon dioxide levels in blood.
Touch, pain, and thermal sensations from skin of external ear and upper pharynx.
Motor (branchial) Assists in swallowing.
Motor (autonomic) Secretion of saliva.
Vagus (X) Mixed
Sensory Taste from epiglottis.
Proprioception from throat and voice box muscles.
Monitors blood pressure and oxygen and carbon dioxide levels in blood.
Touch, pain, and thermal sensations from skin of external ear.
Sensations from thoracic and abdominal organs.
Motor (branchial) Swallowing, vocalization, and coughing.
Motor (autonomic) Motility and secretion of gastrointestinal organs.
Constriction of respiratory passageways.
Decreases heart rate.
Accessory (XI) Motor
Branchial Movement of head and pectoral girdle.
Hypoglossal (XII) Motor
Somatic Speech, manipulation of food, and swallowing.

Thermoreceptors are free nerve Cold receptors(more) are located in the stratum basale
of the epidermis and are attached to medium-diameter, myelinated
. Warm receptors(less)are located in the dermis

QUIZ 2
1. First order neuron is in brain,second order neuron and third order
neuron page 558
Touch: first order neuron, goes to medulla, synapse with second
order neuron decussates and reaches thalamus, synapse with third
order neuron and reaches somatosensory cortex
Pain and temperature:first order neuron synapse with second
order neuron at spinal cord decussates and goes directly to
thalamus, synapse with third order neuron goes to cerebral cortex.
dont feel touch in same side below level of injury,do
dermarome,they wont feel sensation but feel pain and temp on
same side.
2. Page 562 Motor pathway 2 neuron pathwayy:cortex(motor cortex-
movt is initiated…cortex to brain stem(upper motor neuron) same
side,goes to other side at medulla ,goes down to spinal cord synapse
with lower motor neuron.upper motor neuron inhibits lower motor
neuron.longest upper motor neuron.receptor sends signal to spinal
cord tells lower motor neuron to stop
Damage to upper motor neuron,lower motor is intact:muscle mass
decrease,hyperreflexia,hypertonicity,spasticity,on opposite side
Lower motor neuron damaged:mass loss more than upper,more
power loss,hyporeflexia,flaccidity/hypotonicity on same side

Fracture above c3 also affect phrenic nerve,any injury above will

affect the lower also
Upper motor neuron:from cerebral cortex, down axon to lower motor
neuron that tells skeletal muscle to contract. corticospinal tract…
collection of axons in cns they cross in medulla and reach spinal
cord.right side brain affected then left side affected
For cranial nerves head and neck muscle…corticobulbar tract..cortex to
brain stem, upper motor neuron:hyperreflexia.Lower motor
hyporeflexia, without upper motor neuron lower motor super
excited….clonus repeated contraction of antagonist muscle,cause is
hyperreflexia is upper motor sign (lesion)
Hypereflexia,clonnus,hypertonia,extensor plantar response all are upper
motor lesion sign.

3.flacid no signal ,hypertonicity

4.tortora,acupuncture569 type of pain ,treat pain, activate sensory
neuron to decrease pain by causing release of neurotransmitter such
as endorphin, enkephalins and dynorphins ,pain killers (use needles
with electricals)
5.type of pain 552 fast and slow pain
6.upper motor neuron 560
Upper motor neurons. Both local circuit neurons and lowermotor neurons receive input from
upper motor neurons(UMNs). Most upper motor neurons synapse with local circuit
neurons, which in turn synapse with lower motor neurons. (Afew upper motor neurons synapse
directly with lower motor neurons.) UMNs from the cerebral cortex are essential for the
execution of voluntary movements of the body. UMNs from the brain stem regulate muscle tone,
control postural muscles, and help maintain balance and orientation of the head and body.
7.sympathetic and parasympathetic fig 15.2 ,sympathetic
thoracolumbar.one is increasing, diagram coming. parasympathetic
craniosacral ,salivary, heart….
In the sympathetic division, the preganglionic neurons have their cell bodies in the lateral horns
of the gray matter in the 12 thoracic segments and the first two (and sometimes three) lumbar
segmentsof the spinal cord (Figure 15.2). For this reason, the sympatheticdivision is also called
the thoracolumbar division
Cell bodies of preganglionic neurons of the parasympathetic division are located in the nuclei of
four cranial nerves in the brain stem (III, VII, IX, and X) and in the lateral gray matter of
the second through fourth sacral segments of the spinal cord(Figure 15.3). Hence, the
parasympathetic division is also known as the craniosacral division
8.ear diagram, sound comes to tympanic membrane ,they vibrate
9.taste buds..100 to 300taste bud in each vallate papilla
10 tongue diagram, taste buds are located in tongue, pharynx,
epiglottis ,soft palate fig 17.3 CN x vagus, glossopharyngeal CNix and
facial CNVii
The facial (VII) nerve serves taste buds in the anterior two-thirds of the tongue; the
glossopharyngeal (IX) nerve serves taste buds in the posteriorone-third of the tongue; and the
vagus (X) nerve serves taste buds in the throat and epiglottis
11olfactory page 574 different cells…supporting cells physical support .
3 types of cells: olfactory sensory neurons, supporting epithelial cells,
and basal epithelial cells
Supporting cells are columnar epithelial cells of the mucous
membrane lining the nose. They provide physical support, nourishment,
and electrical insulation for the olfactory receptor cells
and help detoxify chemicals that come in contact with the olfactory
epithelium. Basal cells are stem cells located between the
bases of the supporting cells. They continually undergo cell division
to produce new olfactory receptor cells

12 brain
13 cerebellum: Cerebellum: coordination of skilled movements, the
cerebellum is the main brain region that regulates posture and balance.
Damage cause Ataxia. Cerebellum controls movement, from upper
motor neuron
14trigeminal thalamic pathway diagram 16.7 page 557
15receptors type, classes(microscopic, origin and location, type of
stimulus)
16cerebral cortex, receive sensory signal and to upper and lower motor
neuron
17 limbic system
18. page 452 fracture on c2 then everything below affected,respiration
affected, phrenic nerve affected
The phrenic nerves originate from C3, C4, and C5 and supply
the diaphragm. Complete severing of the spinal cord above
the origin of the phrenic nerves (C3, C4, and C5) causes respiratory
arrest. In injuries to the phrenic nerves, breathing stops
19. page 469 monoplegia, diplegia, paraplegia, quadriplegia
Monoplegia blow or strike) is paralysis of one limb only. Diplegia is paralysis
of both upper limbs or both lower limbs. Paraplegia (para- _ beyond)
is paralysis of both lower limbs. Hemiplegia is
paralysis of the upper limb, trunk, and lower limb on one side of the
body, and quadriplegia (quad- _ four) is paralysis of all four limbs.

20.How brain receive blood supply page 477 internal carotid and
vertebral artery,vein… internal jugular veinBlood flows to the brain mainly via the
internal carotid and vertebral
arteries (see Figure 21.19); the dural venous sinuses drain
into the internal jugular veins to return blood from the head to the
heart (see Figure 21.24).

21.cranial nerve injury page 503 trigeminal neuralgia (tic douloureux).

Thisis a sharp cutting or tearing pain, Bell’s
palsy (paralysis of the facial muscles),
loss of taste, decreased salivation, and
loss of ability to close the eyes, even
during sleep. The nerve can also be
damaged by trauma, tumors, and
stroke. •flacidity
Injury to the glossopharyngeal (IX) nerve causes dysphagia (dis-FA¯-ge¯-a), or difficulty in
swallowing;
Injury to the vagus (X) nerve due to conditions
such as trauma or lesions causes vagal neuropathy, or interruptions of
sensations from many organs in the thoracic and abdominal cavities; dysphagia or difficulty in
swallowing; and tachycardia or increased heart rate. Affects liver too
23.Remember the ganglions of sympathetic and parassumpathetic
Superior,inferior,middle cervical ganglion,ciliac gangleoon affect liver and
stomach, superior messentric,renal ganglion ,aortic ganglion
24.Page 541 autonomic dysreflexia spinal cord injury at or above level of T6
all organs below will be affected
25. Phantom limb sensation who have amputation ,feel their hand is still there
26.Trigeminothalamic tract diagram
27.ALS page 563 Amyotrophic lateral sclerosis (ALS is a progressive degenerative disease
that attacks motor areas of the cerebral cortex, axons of upper motor neurons in the lateral white
columns(corticospinal and rubrospinal tracts), and lower motor neuron cell
bodies. It causes progressive muscle weakness and atrophy. ALS often begins in sections of the
spinal cord that serve the hands and arms but rapidly spreads to involve the whole body and face,
without affecting intellect or sensations. Death typically occurs in 2 to 5 years.
ALS is commonly known as Lou Gehrig’s disease.NO MEMORY LOSS,distal muscle
n upper extremity affected,weakness and atrophy of muscle

28.parkinson disease: Disorders of the basal nuclei can affect body movements,
cognition, and behavior. Uncontrollable shaking (tremor) and
muscle rigidity (stiffness) are hallmark signs of Parkinson’s disease
(PD) (see Disorders: Homeostatic Imbalances at the end of this chapter).
In this disorder, dopamine-releasing neurons that extend from the substantia
nigra to the putamen and caudate nucleus degenerate.

Condition:
1. Shingles, blister
474 is an acute infection of the peripheral nervous system caused by herpes zoster the virus that
also causes chickenpox .The result is pain, discoloration of the skin, and a characteristic line of
skin blisters.The line of blisters marks the distribution (dermatome) of the
particular cutaneous sensory nerve belonging to the infected posterior root ganglion.
2. Headache /migraine
3. Bells palsy 512
4. Spinal cord injury 473
5. Narcolepsy 571
Narcolepsy :a condition in which REM sleep cannot be inhibited during waking
periods. As a result, involuntary periods of sleep that last about 15 minutes
occur throughout the day
6.Huntington disease:
genetic,neurons in brain to waste away and die, loss of neurons
is an inherited disorder in which the degenerate, with loss of neurons that
normally release GABA or acetylcholine. A key sign of HD is chorea, in which
rapid, jerky movements occur involuntarily
and without purpose. Progressive mental deterioration also
7.Diabetic neuropathy

8.Parkinson disease: page 565..progressive,trmour,rigidity

Disorders of the basal nuclei can affect body movements,cognition,andbehavior.
Uncontrollable shaking (tremor) and muscle rigidity (stiffness) are hallmark signs
of Parkinson’s diseasedopamine-releasing neurons that extend from the substantia
nigra to the putamen and caudate nucleus degenerate.

9ALS..(amyotrophic lateral sclerosis)page 563

is a progressive degenerative disease that attacks motor areas of the cerebral
cortex, axons of upper motor neurons in the lateral white columns
(corticospinal and rubrospinal tracts), and lower motor neuron cell
bodies. It causes progressive muscle weakness and atrophy. ALS often
begins in sections of the spinal cord that serve the hands and arms
but rapidly spreads to involve the whole body and face, without affecting
intellect or sensations. Death typically occurs in 2 to 5 years.
ALS is commonly known as Lou Gehrig’s disease.NO MEMORY LOSS,distal muscle n upper
extremity affected,weakness and atrophy of muscle.
10.Paralysis
Damage or disease of lower motor neurons produces flaccid
paralysis of muscles on the same side of
the body. There is neither voluntary nor reflex action of the
innervated muscle fibers, muscle tone is decreased or lost, and the
muscle remains limp or flaccid. Injury or disease of upper motor neurons
in the cerebral cortex removes inhibitory influences that some of
these neurons have on lower motor neurons, which causes spastic
paralysis of muscles on the opposite side of the body. In this condition
muscle tone is increased, reflexes are exaggerated, and pathological
reflexes such as the Babinski sign appear.
11.Autonomic dysreflexia: spinal cord injury at or above level of T6 all
organs below will be affected

12.Stroke(CVA)
13.Restless leg syndrome
Pain in legs symptoms get more when people rest
14.Mononeuropathy-(example)CTS or sciatica and polyneuropathy-
(example) TOS+CTS;TOS +pronator teres compartment syndrome;
Sciatica + common fibular nerve lesion
15.central sleep apnea :highest risk of mortality. breathing stops more
than 10 sec

Sympathetic nervous system diagram explained

The celiac (solar) plexus is thelargest autonomic plexus and surrounds the celiac trunk. It
contains two large celiac ganglia, two aorticorenal ganglia, and a
dense network of autonomic axons and is distributed to the stomach,
spleen, pancreas, liver, gallbladder, kidneys, adrenal medullae,
testes, and ovaries. The superior mesenteric plexus contains
the superior mesenteric ganglion and supplies the small and large
intestines. The inferior mesenteric plexus contains the inferior
mesenteric ganglion, which innervates the large intestine. Axons
of some sympathetic postganglionic neurons from the inferior
mesenteric ganglion also extend through the hypogastric plexus, which is anterior to the fifth lumbar
vertebra, to supply the pelvic viscera. The renal plexus contains the renal ganglion and supplies
the renal arteries within the kidneys and ureters.

Axon of what neuron from brain to lower motor neuron= upper motor neuron
Postcentral sensory neuron

Final Exam
1.restless leg syndrome Pain in legs symptoms get more when people
rest
2.parkinson question mark, tremor, rigidity, abnormal movt, shuffling
gait
3.Huntinton disease: Huntington chorea: Abnormal movement
4.Headache:tension headache due to muscles,
posture,clusterheadache(mainly orbit of eye and more in men,
unilateral, migrains(thunderclap((sudden and severe ))
5.ALS(lou gerhigs disease (slow progressive weakness and atrophy of
distal muscle start with atrophy of distal muscle start with upper limb
6.fracture of spine: cervical while limb,respiratory also affected
7.mononeurotherapy and polyneurotherapy
8.pineal gland produce melatonin help to increase production of
serotonin lack of serotonin cause depression, seasonal affected disorder
9.mother of all glands is pituitary
10.Reflex and action
11. spinal cord: dorsal is somatic sensory fiber(3 neuron), ventral
motor2 neuron)
12.white matter contains no neurons
13. neurons communicate by chemical and electrical
14.neuron ..cellbody, nucleus, dendrytes, Axon
15Parkinson: low dopamine bcoz basal ganglea is affected
16.Huntington disease:genetic disease where neurons die
17.sympathetic and parasympathetic(origin and what is it called
18.remeber gangleons: ,cervical ganglion ciliac ganglion longest
ine,aorticorenal,superior messentric renal and inferior messentric.
Adrenal it is celiac,heart 3 ganlions
19. diff between fast and slow pain
20.cranial nerve (PNS) and spinal nerves(PNS)
21.sensory : senses- eye ,nose, ear, taste
22.cranial nerve :clinical connection,CN7 bells palsy flaccid,CN5
trigeminal neuralgia,CN8 vertigo
23.Narcolepsy
24.internal carotid artery,vertebral artery blood go in to brain,blood
comes out internal jugular vein(check)
25.taste buds located in 4 areas..tongue,soft palatte,pharynx,epiglottis
26.Sympathetic prevertebral ganglion…celiac, aorticorenal,
renal,superior messentric,inferior messentric
27.Tortora page 473 spinal cord injury:cervical quadriplegia
Hemi di para quadri mono all plegias
28.bell palsy
29.EEG electroencephalogram in brain…check neuron in cerebral cortex
(waves),concussion and contusion,brain injury
30.sacral plexus,all plexuses
31.neveroot for all plexus
32. sleep disorder,sleep apnea 10 sec or more,insomnia,central sleep
apnea (people die,mortality)
33.Cranial nerve:olfactory page 507olfactory bulbs sit on cribiform
plate of ethmoid bone
34.Hypothalamus,thalamus epithalamus table 14.2 functions
35.headaches ,migrain trigger
36.Cranial nerve
37. ALS
38.Stroke CVA F.A.S.T(face,arms,speech,time)
39.Shingles:Dermatome on dorsal root gangleon is affected,sometimes
more than one dermatome is affected.
40.Brain
41.tortora page 545,Autonomic dysreflexia: pinal cord injury at and
above T6
42.cranial nerve affecting each region
43.Autonomic plexus:renal,cardial
44.brachial plexus
45.Brain
46.brain diagram