CSD 331 - exam 3

vertebral branch

has portions that descend to provide blood supply to the spinal cord and portions that ascend to provide blood supply to the Cerebellum and Cerebral Cortex

anastomoses

points of communication between arteries. ensure constant blood supply to the brain or spinal cord

carotid branch

begins at the level of the aorta. has 2 divisions that course up on either side of the neck. these 2 course upward and enter the brain near the optic chiasm

anterior cerebral artery

supplies the medial surface of the frontal and parietal lobes, the corpus collosum, and basal ganglia

circle of willis

the most prominent anastomoses in the brain. connects the vertebral and carotid branches, around the area of the optic chiasm. helps equalize locally high or low blood pressure and promotes equal distribution of blood

middle cerebral artery

supplies lateral surfaces of the hemispheres. this includes the motor strip and brocas area. also supplies the temporal lobe (wernickes)

basilar artery

L and R branches of ascending vertebral artery join together, at the medulla to form this artery

What is the venous system?

system of blood vessels (veins) that provide means of draining co2 laden blood to lungs for reoxygenation. in brain, this is competed by series of cisterns. blood drains into these, then returns to general blood stream by ways of jugular vein

thrombosis

obstruction of blood vessel. tia warning sign for these

embolism

obstruction that moves and lodges somewhere and causes blockage. orginates in 1 place, then causes blockage in another. usually no warning signs

aneurysm

dilation or ballooning of blood vessel due to weak walls, if bubble bursts, blood seeps into brain, causing damage. may have warning signs (headaches, etc.) may burst with no warning

open head injury

an example of a ___________ injury would be a gunshot wound to the head

closed head injury; axonal shearing

a _________ injury may have skull "fracture", but no penetrating injury. see more damage from ______

coup injury; contrecoup injury

a ________ injury where skull is initially hit, whereas a __________ injury from secondary impact

what are the 6 neurotransmitters

acetylchloline, dopamine, norepinephrine, serotonin, GABA, endorphins

false; inhibitory decrease probability

excitatory effects decrease the probability that neuron will depolarize; "stop" signal

false brain is asymmetrical

the brain is symmetrical

true

L hemisphere is typically language dominant in right handed individuals

false; right hemisphere

the left hemisphere has more holistic elements (spatial and tonal info). examples include face recognition, speech intonation, melody, facial expressions, and pragmatics/social aspects of language

primary reception area for somatic sense

areas 1,2,3 or parietal lobe

auditory reception area for vision

area 17 of occipital lobe

primary reception area for auditory info

area 41 of temporal lobe (heschl's gyrus)

3 steps of motor functions (regions of primary activity)

1. target must be identified (what is it you want to do and where is body in space currently); areas 5,7,39,40 of parietal lobe
2. action must be planned; premotor area 6 in frontal lobe and area 1,2,3 in parietal lobe
3. voluntary movement is executed; motor strip/precentral gyrus of frontal lobe: area 4

what are association regions and what do they do?

responsible for highest order info processing of cerebral cortex. these areas extract info from the primary reception areas and then "connects" the info

limbic association area

integrates info for memory

temporal occipital parietal (TOP)

helps integrate info that has to do with language function

prefrontal association area; cognitive processes

integrates info in prep for motor act and important for higher level______

dysarthria

speech disorder from paralysis, weakness, or dis-coordination of speech musculature

hypokinetic dysarthria

damage to substantia nigra; parkinsons disease

ataxic dysarthria

damage to cerebellum or vestibular nucleus of brainstem; loss of coordination; may sound "drunken"

mixed dysarthria

neurological damage is not ' neat,' causing mix of diff dysarthria

spastic dysarthria

arises from bilateral damage to UMN of pyramidal and extrapyramidal pathways; can result in paralysis/muscle weakness, hyper-reflexia, hypertonia, decreased voluntary muscle contraction

hyperkinetic dysarthria

damage to extrapyramidal system; extraneous, involuntary movement of speech muscles; extraneous movements resulting in tics, tremors, athetosis, dystonia; Huntington's disease

flaccid dysarthria

damage to LMN or their cell bodies; result is muscle weakness, hypotonia, may have fasciculations, reflex responses are reduced/absent

unilateral upper motor neuron dysarthria

less devastating than bilateral UMN damage; see one side of musculature affected

what is dyspraxia/apraxia and where does the damage occur?

dysfunction of motor planning, in absence of muscular weakness or muscular dysfunction
damage to premotor area, supplementary motor area, and/or supramarginal gyrus of parietal lobe

characteristics of dyspraxia/apraxia

difficulty intitiating speech
loss of speech fluency
"groping" articulatory movements
awareness of errors often good; client tries to self-correct
automatic speech much better than "planned"
often co-occurs with brocas aphasia

wernickes aphasia

normal flow of speech, paraphrasias present, neologisms, impaired auditory comprehension, impaired repetition skills

conduction aphasia

damage to arcuate fasciculus; difficulty with repetition, verbal expression and auditory comprehension skills are good

global aphasia

damage to brocas area, wernickes area, and other subcortical structures; overall profound impairment in expressive and receptive language

brocas aphasia

damage to brocas area in frontal lobe. also could be from damage to operculum, insula, or supramarginal gyrus of parietal lobe

subcortical aphasia

language deficits with subcortical damage; damage to thalamus-anomia, neologisms, word substitutions; damage to basal ganglia-nonfluent aphasia

possible causes of cognitive linguistic deficits

usually due to l frontal lobe lesions
damage to other areas also, however (recall complexity of brain)
due to diffuse damage to CNS
TBI
dementia
anoxic events

what areas of thinking may be affected with presence of cognitive linguistic deficits?

memory (parahippocampal region)
perception
attention/concentration
organization and sequencing
problem solving skills
executive planning (ability to plan, set goals, monitor behaviors; basically is "exercising control" over cognitive functions)
emotional lability (excessive and uncontrollable emotional responses not necessarily related to, or in proportion to stimulus)

deficits seen in right hemisphere CVA

difficulty interpreting "nuance" in language
difficulty communicating humor, emotion, and intent
difficulty with concept of "shared knowledge"
impaired pragmatic skills overall
left neglect
more 'concrete'.. difficulty with figurative language (fan is running)

false; co-occurs with brocas

apraxia often co-occurs with wernickes aphasia

false; area of temporal lobe

wernickes aphasia occurs from damage to brocas area in frontal lobe

true

brocas aphasia occurs from damage to brocas area in frontal lobe

true

brocas aphasia may be accompanied by apraxia

2 requirements for production of sound

source of energy (lower respiratory tract/lungs)
vibrating element (vocal cords)

respiration

exchange of gas b/w an organism and its environment
inspiration/inhalation-carries o2 to cells to sustain life
expiration/exhalation-eliminates waste products by breathing out
gas exchange-occurs within alveoli

7 respiratory passageways

nasal cavity
oral cavity
pharynx
larynx
trachea
bronchi
lungs

3 things that join vertebrae together

intervertebral cartilages, fibrocartilages, and complex systems of ligaments

attaches spinal cord to vertebrae

denticulate ligaments

false; consist of corpus, spinous, transverse, vertebral foramen, superior/interior articular facests

vertebrae consist of only 2 things: corpus and transverse processes

false; c1 called atlas

C2 vertebrae is called atlas

false; provide basis for respiratory

thoracic vertebrae provide basis for phonatory system because they form posterior point of attachment for the ribs

true

lumbar vertebrae larger than cervical and thoracic

true

two cavities in torso are thoracic and abdominal

false; the shaft

tubercle part of ribs is largest and most anterior component of rib

true

true ribs attach to sternum through chondral portion of rib

false; larger vertebral foramen

higher cervical vertebrae have smaller vertebral foramen

false; enter spinal cord

spinal nerves emerge and enter brain stem through spaces between vertebrae

true

thoracic vertebrae have large spinous and transverse processes because more muscle and bone are attached to them

5 parts of ribs

head
neck
tubercle: articulates with transverse process of corresponding vertebrae
angle: point which rib begins significant curve in its course forward
shaft: largest and most anterior component of rib-is bulk of rib

pelvic girdle

lower extremities are attached to vertebral column via this
made up of: illium (like shoulder blade of upper body), sacrum, pubic bone, ischium

pectoral girdle

upper extremities are attached to vertebral column via this
consists of: bilateral clavicles (collar bones), bilateral scapulae (triangle shaped)

3 main parts of sternum

manubrium, corpus, and xyphoid process

there are ______ pairs of ribs that are attached __________ to thoracic vertebrae

12; posteriorly

3 general classes of ribs

true, false, and floating

right lung is _____ than the left lung

larger

esophagus is _________ to trachea

posterior

trachea made up of _______ cartilage

hyaline cartilage

3 divisions of bronchi

mainstem, lobar/secondary, segmental tertairy

rings of trachea connected by

fibroelastic membrane

open into the minute air sacs of lungs in bronchi

alveolar ducts

sternum

frontal post for thorax

pleural linings

inner surface of thoracic cavity. lined with an airtight membrane called parietal pleura. lungs encased in lingings known as visceral pleura

alveoli

where o2 and co2 are exchanged

trachea

flexible tube; 16-20 horse shoe shaped rings of hyaline cartilage

lungs

irregular shaped cone structures. located in thoracic or chest cavity. spongy, porous, and highly elastic

bronchi

tubes that extend from trachea to lungs; 3 divisions of tree

pleurisy

condition which pleural linings of thoracic cavity are inflamed. patient experiences extreme pain upon breathing as result of loss of lubricating quality of the intrapleural fluid

false; can expand in 2 ways: verticle dimension and anterior-posterior dimension

lungs can only expand by anterior-posterior dimension

false; it can be placed

diaphragm cant be placed under voluntary control

true

central tendon in diaphragm called aponeurosis

true

forced inspiration requires more than 1 muscle

true

external intercostals increase anterior-posterior dimension

false upper body

rhomboid muscles (major and minor) support lower body

3 openings in diaphragm

1. aortic hiatus: for descending abdominal aorta
2. esophageal hiatus (esophagus passes thru): immediately anterior to aortic hiatus
3. foramen vena cava: for inferior vena cava-the principle vein for lower part of body

sternocleidomastoid

can see when head turned to one side. originates mastoid process and courses downward. its insertion is sternum and clavicle. when one side contracted, it roates head toward side of contraction. when both sides are contracted, it elevates sternum and anterior ribcage

pectoralis major

has 2 origins: along sternum at costal cartilages and clavicle. its insertion is at humerus and extends the shoulder. may assist in lifting ribcage by elevating sternum

external intercostals

when muscle contract, entire ribcage elevates. this increases A-P dimension and allows for increased lung volume. there are 11 of these and they originate at lower surface of each rib. courses downward and inward and insert at upper surface of rib immediately below

trapezius

originates at spinous processes of C2-T12 and inserts at scapula and clavicle. elongates neck, contributes to head control. supports back muscles, which aids in respiration. also sometimes classified as muscle of back or upper arm

internal intercostals

11 of these and are primary muscles of expiration, with exception of chondral portion. lie just deep to external intercostals. portion of internal intercoastals close to sternum, near chondral part of ribs, are active during forced inhalation. fibers course at right angles to external intercostals

levator costarum

has 2 parts: brevis and longis. brevis originates at transverse process of c7-t11 for total of 12 and inserts into rib below. longis originates at transverse processes of t7-t10. insertion: bypass first lowest rib, then attach to next one

serratus posterior superior

originates at spinous process of C7 and t1-t3. courses downward and laterally. inserts just beyond angles of ribs 2-5. this muscle elevates ribcage

serratus anterior

originates at ribs 1-9 and inserts at vertebral border of scapula

rhomboideus major

originates at spinous processes of t2-t5 and inserts at medial border of scapula

pectoralis minor

originates at anterior surfaces of ribs 2-5 and inserts at scapula. extends shoulder and may assist in lifting ribcage