Neuroscience: Nervous System, Brain Structures, and Reflexes

What are the two major divisions of the nervous system

Central Nervous System and Peripheral Nervous System

What structures make up the CNS

Brain and spinal cord

What structures make up the PNS

All nerves outside CNS including cranial and spinal nerves

What do afferent fibers do

Carry sensory messages to CNS

What do efferent fibers do

Carry motor messages from CNS to muscles and glands

What is the outer layer of the cerebrum called

Cerebral cortex

What is the function of the cerebral cortex

Governs thought, memory, reasoning, sensation, voluntary movement

What lobe controls personality and behavior

Frontal lobe

Which lobe contains Broca's area

Frontal lobe

What is Broca's area responsible for

Motor speech

Damage to Broca's area results in what

Motor aphasia (inability to speak but can understand)

What does the parietal lobe control

Primary center for sensation

What lobe controls vision

Occipital lobe

What lobe controls hearing, taste, and smell

Temporal lobe

Which area of the temporal lobe controls language comprehension

Wernicke's area

Damage to Wernicke's area causes

Receptive aphasia (cannot understand speech)

What does the basal ganglia do

Controls automatic movements (e.g., walking)

Function of the thalamus

Main relay station for sensory pathways

Function of the hypothalamus

Regulates temperature, appetite, sex drive, heart rate, blood pressure

Function of cerebellum

Coordination, balance, posture

What structures make up the brainstem

Midbrain, pons, medulla

Function of the spinal cord

Main pathway for ascending and descending nerve tracts

What sensory pathway transmits pain & temperature

Spinothalamic tract

What sensory pathway transmits vibration & position

Dorsal columns

Another name for dorsal columns

Posterior columns

What tracts control voluntary motor movement

Corticospinal (pyramidal) tracts

What system controls automatic movements like walking

Extrapyramidal system

What system helps maintain balance and coordination

Cerebellar system

What is a reflex

Basic defense mechanism; involuntary response to stimuli

Example of a deep tendon reflex

Knee jerk

Example of a superficial reflex

Plantar reflex

Example of a visceral reflex

Pupillary response

How many cranial nerves are there

12 pairs

What nerve innervates heart and GI tract

Vagus nerve (CN X)

How many spinal nerves are there

31 pairs

What are dermatomes

Skin areas supplied by spinal nerves

Dermatome landmark for thumb

C6

Dermatome landmark for nipple line

T4

Dermatome landmark for umbilicus

T10

Dermatome landmark for knee

L4

How does infant neuro development progress

Cephalocaudal (head → toe)

What happens to nerve conduction with aging

Slows down

What does dizziness in aging increase risk for

Falls

What is the FAST acronym for stroke

Face drooping, Arm weakness, Speech difficulty, Time to call 911

Most strokes are caused by what

Ischemia (blocked vessel)

What is a hemorrhagic stroke

Bleeding into brain tissue

What questions do you ask for headache

Onset, location, duration, characteristics

What do you assess for seizures

Onset, duration, postictal phase, triggers

What do you assess for tremors

Onset, location, factors, ADL impact

Sequence of complete neurologic exam

Mental status → cranial nerves → motor → sensory → reflexes

Cranial nerve for smell

CN I Olfactory

Cranial nerve for vision

CN II Optic

Cranial nerves for eye movements

CN III, IV, VI

Cranial nerve for facial sensation

CN V Trigeminal

Cranial nerve for facial expression

CN VII Facial

Cranial nerve for hearing

CN VIII Acoustic

Cranial nerve for gag reflex

CN IX Glossopharyngeal

Cranial nerve for saying "ahh" and swallowing

CN X Vagus

Cranial nerve for shoulder shrug

CN XI Spinal Accessory

Cranial nerve for tongue movement

CN XII Hypoglossal

What is the Romberg test for

Balance and proprioception

Positive Romberg indicates what

Proprioception or cerebellar dysfunction

What is stereognosis

Identify objects by touch

What is graphesthesia

Identify number traced on skin

Normal DTR score

2+

What does 4+ reflex indicate

Hyperactive with clonus (disease)

Biceps reflex level

C5-C6

Triceps reflex level

C7-C8

Brachioradialis reflex level

C5-C6

Patellar reflex level

L2-L4

Achilles reflex level

L5-S2

What is clonus

Rhythmic muscle contractions with hyperreflexia

Normal plantar reflex response

Toe flexion (downward)

Positive Babinski in adults indicates

UMN lesion

What infant reflex should disappear by 3-4 months

Rooting reflex

What infant reflex disappears by 12 months

Sucking reflex

What infant reflex disappears by 8-10 months

Plantar grasp

What reflex disappears by 24 months

Babinski

What is decorticate posture

Flexed arms — lesion in cerebral hemisphere

What is decerebrate posture

Extended arms — lesion in brainstem (worse)

What gait is associated with cerebellar disease

Ataxic gait

What gait has scissoring legs

Spastic gait (cerebral palsy)

What gait has foot slap

Steppage gait

What type of rigidity occurs in Parkinson's

Cogwheel rigidity

What tremor occurs at rest

Rest tremor (Parkinson's)

What tremor worsens with movement

Intention tremor (cerebellar disease)

What system coordinates voluntary movement, posture, and balance

Cerebellar system

What do lower motor neurons do

Transmit signals from spinal cord to muscles

What does LMN damage cause

Flaccidity, muscle atrophy, fasciculations

What does UMN damage cause

Spasticity, hyperreflexia, Babinski sign

What part of the CNS controls HR and respiratory rate

Medulla

What is crossed representation

Left brain controls right body, and vice versa

What exam step evaluates LOC change

Neurologic recheck

What scale assesses level of consciousness

Glasgow Coma Scale

What is the GCS eye-opening max score

4

What is the GCS best verbal response max score

5

What is the GCS best motor response max score

6

What is a normal GCS score

15

What GCS score indicates coma

<8

What is the first sign of increased ICP

Change in LOC