Anatomy and Physiology 1 Review for Final Exam

• Focus for Adelphi University and Nassau Community College students.

• 100-question exam, primarily on neurology.

• Video available on YouTube for further reference.

Neurological Systems Overview

• Somatic vs. Autonomic Nervous System (ANS)

  • Understand the differences.

    • The Somatic Nervous System is associated with voluntary movements like skeletal muscle movements

    • The Autonomic Nervous System is associated with involuntary movements in the body like the heart beating

  • Branches of ANS:

    • Sympathetic - The sympathetic nervous system prepares the body for physical activity or the “fight or flight” response

    • Parasympathetic - The parasympathetic nervous system helps the body cool down and lowers the heart rate + breathing

Central Nervous System (CNS) vs. Peripheral Nervous System (PNS)

• CNS - Composes of the brain and spinal cord, Sensory Output + Motor Input

• PNS - Composes of the nervous system that lies outside the brain and spinal cord, Sensory input + Motor output (Includes Somatic and Autonomic)

• Key differences should be clearly understood.

Outflows of the Nervous System

• Sympathetic Division: Thoracolumbar outflow.

• Parasympathetic Division: Craniosacral outflow.

• Effects on digestion:

  • Sympathetic: Slows digestion.

  • Parasympathetic: Speeds up digestion.

Neural Signals

• Distinguish between action potentials and graded potentials.

  • Action Potentials - Used for long distance signaling, digital signal, and is located in the axon

  • Graded Potentials- Used for information integration, short distance, located in dendrites

• Types of channels in neuron membranes:

  • Leakage channels - Constantly open channels allowing a small steady flows of ions across the membrane

  • Gated channels - Channels that open and close for certain stimuli

  • Ligand channels - Open and close in response to the binding of a certain chemical molecule to the channel protein

• Resting Membrane Potential (RMP):

  • RMP = -70mV;

  • Understand intracellular and extracellular contexts

  • Sodium and potassium distribution:

    • More sodium extracellularly.

    • More potassium intracellularly.

Action Potential Stages

• Key phases include:

  1. Resting Membrane Potential (-70mV)

  2. Threshold (-55mV)

  3. Sodium gates open, peak at +30mV.

  4. Sodium gates close, potassium gates open.

  5. Repolarization to -70mV.

  6. Hyperpolarization below -70mV (potassium gates close slowly).

• Know correct order for matching section.

Conduction Types

• Continuous vs. Saltatory Conduction.

  • Continuous Conduction - is a slower process of action potential propagation in unmyelinated axons.

  • Saltatory Conduction - is a process that allows action potentials to travel much faster along myelinated axons.

• Summation Types:

  • Spatial summation - multiple presynaptic neurons send signals to a single postsynaptic neuron simultaneously

  • Temporal summation - focuses on the timing of signals from a single presynaptic neuron.

Fiber Types

• Familiarize with A, B, C fibers:

  • A fibers - These fibers are the thickest and are heavily myelinated. They are primarily responsible for somatic motor function and proprioception.

  • B fibers - These fibers are moderately myelinated and have a small diameter. Their primary role is to transmit autonomic information

  • C fibers - These fibers are unmyelinated and have a small diameter. They are involved in the afferent transfer of temperature, burning pain, and itch.

• excitatory (or EPSPs) if they increase the likelihood of a postsynaptic action potential occurring, and inhibitory (or IPSPs) if they decrease this likelihood.

• Neurotransmitter removal from synaptic cleft.

Key Neurotransmitters

• Know these neurotransmitters:

  • Acetylcholine - an important neurotransmitter that plays a role in brain functions, such as memory, and body functions, such as muscle contractions to move your muscles

  • GABA - It's known for its calming effect and is thought to play a role in controlling anxiety, stress, and fear. 

  • Glutamate - it stimulates nerve cells to send chemical messages. Glutamate is essential for learning, memory, and mood regulation

  • Dopamine - It plays a role in many important body functions, including movement, memory and pleasurable reward and motivation

  • Serotonin - it regulates various activities, including behavior, mood, memory, and gastrointestinal homeostasis

  • Norepinephrine - neurotransmitter of the brain that plays an essential role in the regulation of arousal, attention, cognitive function, and stress reactions

  • Epinephrine - a hormone and medication used to treat life-threatening allergic reactions and other medical emergencies:

• Review effects regarding conditions like Parkinson's disease, neuroplasticity, and neuroregeneration in CNS vs PNS.

• Importance of neurolemma in regeneration.

  • The neurolemma forms a regeneration tube that guides the axon to reconnect

Meninges and Spinal Cord Anatomy

• Review meninges:

  • Dura Mater, Arachnoid, Subarachnoid Space, Pia Mater.

  • Denticulate Ligament

• Basic spinal cord anatomy:

  • Dorsal and Ventral Roots, cauda equina, filum terminale, conus medullaris.

• Understand myelination status inside vs. outside spinal cord.

• Identify sensory and motor tracts; sensory tracks ascend and motor tracts descend.

Aspects of Pain and Temperature

• Review posterior columns, fasciulus cuneatus and fasciulus gracilis.

• Familiarity with reflex arcs and their components:

  • Golgi tendon organ reflex, stretch reflex, flexor reflex, Babinski reflex, crossed extensor reflex.

Peripheral Nerves and Plexi

• Understand epineurium, endoneurium, and perineurium.

• Review the plexi:

  • Cervical, Brachial, Lumbar, Sacral

  • Associated levels and nerves (e.g., phrenic nerve).

• Clinical conditions resulting from nerve damage:

  • Radial nerve damage (drop hand), Ulnar nerve damage (claw hand), Median nerve damage (ape hand).

Sciatica and Cranial Nerves

• Review sources and causes of sciatica.

• Go over cranial nerves - especially cranial nerve five and its sensory and motor components.

• Study dermatomes for upper and lower extremities (C5-T1, L1-S1).

Central Nervous System Structures and Functions

• Blood supply (Circle of Willis), flow of cerebrospinal fluid (ventricles, foramen of Monroe, cerebral aqueduct).

• Key areas:

  • Medulla oblongata and cranial nerves, vagus nerve significance

  • Midbrain features: Red nucleus, Substantia nigra

  • Functions of cerebellum, thalamus vs. hypothalamus, pituitary vs. pineal glands.

  • Basal ganglia vs. limbic system.

Brain Function and Pathophysiology

• Differentiate between precentral gyrus (motor area) and postcentral gyrus (sensory area).

• Understand functions of Broca's and Wernicke's areas and types of aphasia.

• Left and right hemisphere functions.

• EEG and wave types associated with it.

Strokes and TIA

• Know definitions and differences between ischemic and hemorrhagic strokes, and the nature of TIA.

Cranial Nerves Matching

• Expect 10 questions on cranial nerves by Roman numeral, name, and function.

Exam Format

• Mixed format: multiple choice, matching, true/false.

• Importance of thorough review and study to perform well.