Written Exam 1 (Labs 5-8 Combined)

All study guide bullets from labs 5-8

Which cranial nerve number is the olfactory nerve?

I (1)

Which cranial nerve number is the optic nerve?

II (2)

Which cranial nerve number is the oculomotor nerve?

III (3)

Which cranial nerve number is the trochlear nerve?

IV (4)

Which cranial nerve number is the trigeminal nerve?

V (5)

Which cranial nerve number is the abducens nerve?

VI (6)

Which cranial nerve number is the facial nerve?

VII (7)

Which cranial nerve number is the vestibulocochlear nerve?

VIII (8)

Which cranial nerve number is the glossopharyngeal nerve?

IX (9)

Which cranial nerve number is the vagus nerve?

X (10)

Which cranial nerve number is the accessory nerve?

XI (11)

Which cranial nerve number is the hypoglossal nerve?

XII (12)

Is the cranial olfactory I (1) nerve sensory, motor, or both?

Sensory

Is the cranial optic II (2) nerve sensory, motor, or both?

Sensory

Is the cranial oculomotor III (3) nerve sensory, motor, or both?

Motor

Is the cranial trochlear IV (4) nerve sensory, motor, or both?

Motor

Is the cranial trigeminal V (5) nerve sensory, motor, or both?

Both

Is the cranial abducens VI (6) nerve sensory, motor, or both?

Motor

Is the cranial facial VII (7) nerve sensory, motor, or both?

Both

Is the cranial vestibulocochlear VIII (8) nerve sensory, motor, or both?

Sensory

Is the cranial glossopharyngeal IX (9) nerve sensory, motor, or both?

Both

Is the cranial vagus X (10) nerve sensory, motor, or both?

Both

Is the cranial accessory XI (11) nerve sensory, motor, or both?

Motor

Is the cranial hypoglossal XII (12) nerve sensory, motor, or both?

Motor

What is the function of the cranial olfactory I (1) nerve?

Sense of smell (olfaction)

What is the function of the cranial optic II (2) nerve?

Vision

What are the functions of the cranial oculomotor III (3) nerve?

• Motor to 4/6 extrinsic eye muscles and the upper eyelid for eyeball movement and opening of the eye

• Changes the diameter of the pupil (constriction)

• Changes the shape of the lens

What is the function of the cranial trochlear IV (4) nerve?

• Motor to the superior oblique muscle for movement of the eye medially and inferiorly

What is the function of the cranial trigeminal V (5) nerve?

• Sensory to the face

• Motor to muscles of mastication and swallowing

What is the function of the cranial abducens VI (6) nerve?

• Motor to the lateral rectus muscle for movement of the eye laterally

What is the function of the cranial facial VII (7) nerve?

• Taste to the anterior half of the tongue

• Stimulates lacrimal and salivary glands

• Motor to the muscles of facial expression

• Sensory to the external ear, palate, and nasal cavity

What is the function of the cranial vestibulocochlear VIII (8) nerve?

• Equilibrium (vestibular branch)

• Hearing (cochlear branch)

What is the function of the cranial glossopharyngeal IX (9) nerve?

• Taste to the posterior third of the tongue

• Stimulates salivation

• Motor to the muscles of swallowing and speech

• External ear and posterior pharynx sensation

What is the function of the cranial vagus X (10) nerve?

• Taste and sensation to the pharynx

• Parasympathetic innervation to viscera for blood CO2 detection

• Swallowing and speech

• Ear skin sensation

What is the function of the cranial accessory XI (11) nerve?

• Motor to muscles that move the head, shoulders, and swallow

What is the function of the cranial hypoglossal XII (12) nerve?

Movement of the tongue during speech and swallowing

What is the main function of the sympathetic nervous system (SNS)?

“Fight or flight” during exercise, embarrassment, emotion, and emergency

Where are the nerve roots located in the sympathetic nervous system (SNS)?

Thoracolumbar portion of the spinal cord

Which neurotransmitters are released by the sympathetic nervous system (SNS)?

• Norepinephrine (NE)

• Epinephrine (E)

• Acetylcholine (ACh)

What effect does the sympathetic nervous system (SNS) have on the heart?

Increases rate and force of contraction

What effect does the sympathetic nervous system (SNS) have on the bronchioles (airway passages of the lungs)?

Bronchodilation

What effect does the sympathetic nervous system (SNS) have on the blood vessels to abdominal organs and skin?

Vasoconstriction

What effect does the sympathetic nervous system (SNS) have on the blood vessels to skeletal muscle?

Vasodilation

What effect does the sympathetic nervous system (SNS) have on secretion from digestive glands?

Decreases secretion

What effect does the sympathetic nervous system (SNS) have on urine formation and micturition (urination)?

Decreases urine formation and inhibits imicturition

What effect does the sympathetic nervous system (SNS) have on the pupils of the eye?

Dilation

What is the main function of the parasympathetic nervous system (PSNS)?

“Rest and digest” during digestion, diuresis, defecation

Where are the nerve roots located in the parasympathetic nervous system (PSNS)?

Craniosacral nerves

Which neurotransmitter is released by the parasympathetic nervous system (PSNS)?

Acetylcholine (ACh)

What effect does the parasympathetic nervous system (PSNS) have on the heart?

Decreases rate of contraction

What effect does the parasympathetic nervous system (PSNS) have on the bronchioles (airway passages of the lungs)?

Bronchoconstriction

What effect does the parasympathetic nervous system (PSNS) have on the blood vessels to abdominal organs and skin?

Vasodilation (indirect effect only)

What effect does the parasympathetic nervous system (PSNS) have on the blood vessels to skeletal muscle?

Vasoconstriction (indirect effect only)

What effect does the parasympathetic nervous system (PSNS) have on secretion from digestive glands?

Increases secretion

What effect does the parasympathetic nervous system (PSNS) have on urine formation and micturition (urination)?

Promotes urine formation and micturition

What effect does the parasympathetic nervous system (PSNS) have on the pupils of the eye?

Constriction

What is the pupillary response to a light shined into the left eye?

• Left pupil constricts

• Right pupil constricts

What is the pupillary response to light removed from the left eye?

• Left pupil dilates

• Right pupil dilates

What is the pupillary response to a light shined into the right eye?

• Left pupil constricts

• Right pupil constricts

What is the pupillary response to light removed from the right eye?

• Left pupil dilates

• Right pupil dilates

Example spinal reflex test:

1. Tap the subject’s patellar tendon and record the response

2. Give the subject a difficult math problem to work through and tap their patellar tendon again. How does the response change? Why?

The response is depressed (weaker) due to:

• A decrease in facilitation from the higher brain centers because the subject’s attention is diverted

Which system dominates during exercise, the sympathetic or the parasympathetic nervous system? How do you know?

Sympathetic nervous system (SNS)

• Increased blood pressure, heart rate, and force of contraction

Which system dominates during rest and after exercise, the sympathetic or the parasympathetic nervous system? How do you know?

Parasympathetic nervous system (PSNS)

• Blood pressure and heart rate are lowest before and 5 minutes after exercise

Damage to which cranial nerve might produce an inability to move the tongue?

Hypoglossal XII (12)

Damage to which cranial nerve might produce an inability to see?

Optic II (2)

Damage to which cranial nerve might produce an inability to masticate (chew food)?

Trigeminal V (5)

Damage to which cranial nerves might produce an inability to swallow?

• Glossopharyngeal IX (9)

• Vagus X (10)

The herbal supplement bitter orange, also known as synephrine, mimics the effects of the neurotransmitters of the SNS on the heart and blood vessels serving the abdominal viscera and skin.

1. What effect would this would have on blood pressure?

2. Should this drug be given to people with hypertension (high blood pressure)?

Causes an increase in the rate and force of contraction of the heart and constriction of the blood vessels supplying the abdominal viscera and skin

1. Raises blood pressure

2. Not recommended for people with hypertension

Draw and label the 5 steps of a reflex arc. (https://youtu.be/bY0oQnflmog)

1. Stimulus (receptor)

2. Afferent neuron

3. Information processing center in the CNS

4. Efferent neuron

5. Response (effector)

What are the 4 classifications of reflexes? (https://youtu.be/bY0oQnflmog)

1. Development - innate or acquired

2. Response - somatic or visceral

3. Complexity - monosynaptic or polysynaptic

4. Processing site - spinal cord or cranial

Draw and label the patellar reflex. (https://youtu.be/bY0oQnflmog)

Outline the events of the patellar reflex. (https://youtu.be/bY0oQnflmog)

1. Stimuli travels to intrafusal muscle fibers, muscle spindles (receptor)

2. Afferent neuron stimulation (sensory neuron)

3. Information processing (spinal reflex)

4. Efferent neuron stimulation (motor neuron)

5. Extrafusal muscle fiber stimulation (effector)

What may cause a hypotonic (flaccid) muscle? (https://youtu.be/bY0oQnflmog)

A severing of the area where efferent neurons deliver signals to the muscle

What may cause a hypertonic (spastic) muscle? (https://youtu.be/bY0oQnflmog)

A continuously firing efferent neuron with no inhibition continuously stimulates the muscle

Draw and label the polysynaptic stretch reflex. (https://youtu.be/bY0oQnflmog)

Explain the Babinsky reflex and the Babinsky sign. (https://youtu.be/bY0oQnflmog)

Pyramidal lesions (or an underdeveloped pyramidal system) cause upper motor neurons to NOT inhibit the extensor plantar muscles resulting in abnormal muscle contraction which fans the toes out and curls them upward

What 3 steps must be taken before performing a clinical cranial nerve examination?

1. Provide the patient privacy

2. Perform hand hygiene

3. Explain the procedure to the patient

How can the cranial olfactory I (1) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

1. Have the patient close their eyes

2. Put a scented object in front of the patient’s nose

3. Ask the patient to breathe in and identify the scent

How can the cranial optic II (2) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

Confrontation visual field

1. Have the patient stand an arm’s length away

2. Ask the patient to cover their right eye

3. Cover your own right eye

4. Tell the patient to stare at your left eye

5. Use your fingers to hold up numbers in the top, middle, and lower visual fields

6. Ask the patient to identify the number of fingers shown and repeat with the opposite side

Visual acuity

1. Have the patient stand 20ft away from a snellen chart

2. Ask the patient to read the lowest line they are able to with their right eye covered

3. Repeat with the patient’s left eye covered

4. Repeat with neither of the patient’s eyes covered

How can the cranial oculomotor III (3), trochlear IV (4), and abducens VI (6) nerves be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

Test 1: Nystagmus

1. Hold a pen light 12in away from the patient’s nose

2. Ask the patient to keep their head still

3. Move the pen light around the 6 cardinal fields of gaze and ask the patient to watch with just their eyes

4. Assess any abnormal involuntary shaking of the eyes

Test 2: Pupil Reactivity

1. Ask the patient to stare at a distant object

2. Shine the pen light on one eye

3. Assess the ability of both pupils to simultaneously constrict and dilate

Test 3: Accommodation

1. Ask the patient to stare at a distant object

2. Move an object slowly toward the patient’s nose

3. Assess the ability of the pupils to constrict and and become crossed

How can the cranial trigeminal V (5) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

1. Ask the patient to clench their teeth

2. Feel the masseter and temporal muscles

3. Place fingers under the patient’s jaw and apply resistance

4. Ask the patient to open their jaw

How can the cranial facial VII (7) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

1. Ask the patient to close their eyes tightly and then reopen them

2. Ask the patient to smile

3. Ask the patient to frown

4. Ask the patient to puff their cheeks

How can the cranial glossopharyngeal IX (9) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

1. Ask the patient to open their mouth and say “ah”

2. Assess movement of the patient’s uvula

3. Use a tongue depressor to poke the back of patient’s mouth to elicit the gag reflex

How can the cranial vestibulocochlear VIII (8) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

1. Cover one of the patient’s ears

2. Whisper something on the opposite side

3. Ask the patient to repeat what was said

4. Repeat on the opposite side

How can the cranial vagus X (10) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

Assess that the patient can speak without hoarseness and swallow

How can the cranial accessory XI (11) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

1. Ask the patient to move their head side to side and up and down

2. Apply resistance by placing your hands on the patient’s shoulders and ask them to shrug

How can the cranial hypoglossal XII (12) nerve be clinically examined and tested? (https://youtu.be/oZGFrwogx14)

Ask the patient to stick out their tongue and move it side to side

What are the 6 basic digestive functions?

1. Ingestion

2. Secretion

3. Propulsion

4. Digestion

5. Absorption

6. Defecation

What is the function of the 1st basic digestive process ingestion?

Food and water are brought into the digestive system via the mouth

What is the function of the 2nd basic digestive process secretion?

Production of endocrine (hormones) and exocrine (mucus, enzymes and acid) products to aid digestion

What is the function of the 3rd basic digestive process propulsion?

Movement of food and liquids by peristalsis

What is the function of the 4th basic digestive process digestion?

Mechanical and chemical breakdown of food

What is the function of the 5th basic digestive process absorption?

Movement of nutrients through the alimentary canal wall into blood or lymphatic vessels

What is the function of the 6th basic digestive process defecation?

Exit of feces composed of non-digestible or unusable materials by body

What are organs within the peritoneal cavity called?

Intraperitoneal

What are organs outside of the peritoneal cavity called?

Retroperitoneal

Which organs are intraperitoneal?

SALTD SPRSS (“salted spurs”)

• Stomach

• Appendix

• Liver

• Transverse colon

• Duodenum (first part)

• Small intestines (jejunum and ileum)

• Pancreas (tail only)

• Rectum (upper third)

• Spleen

• Sigmoid colon

Which organs are retroperitoneal?

SAD PUCKER

• Suprarenal adrenal glands

• Aorta/Inferior vena cava

• Duodenum (second, third, and fourth parts)

• Pancreas (except the tail)

• Ureters

• Colon (ascending and descending)

• Kidneys

• Esophagus

• Rectum (middle third)

Which organs are both intraperitoneal and retroperitoneal?

• Duodenum

• Pancreas

• Rectum

What is the pathway of food through the alimentary canal of the digestive system?

My purple elephant sits silently listening:

Mouth → Pharynx → Esophagus → Stomach → Small Intestine → Large Intestine