NU 545 Unit 2 Study Guide
CHAPTER 15
1. Review the anatomy of the brain. Which portion is responsible for keeping you awake,
controlling thought, speech, emotions and behavior, maintaining balance and posture? (p. 448,
Fig 15.6)
● Brainstem is composed of midbrain medulla and pons. The brainstem connects
the brain’s hemispheres, cerebellum, and spinal cord.
○ A collection of cell bodies called nuclei within the brainstem makes up the
reticular formation : this controls vital reflexes such as cardiovascular
function and respiration. The reticular activating system is essential for
maintaining wakefulness and attention.
● Forebrain:
○ Two cerebral hemispheres
○ Cerebrum: Largest part of the brain (both gray and white matter).
○ The prefrontal area is responsible for goal-oriented behavior (e.g. ability
to concentrate) short-term memory of recall memory, the elaboration of
thought, and inhibition of the limbic areas of the CNS.
○ The Broca speech area is on the inferior frontal gyrus. It is usually on
the left hemisphere and is responsible for motor aspects of speech.
■ Damage to this area, commonly as a result of a cerebrovascular
accident (stroke), results in the inability to form words or at least
some difficulty in forming words (expressive aphasia)
○ In the temporal lobe, there is the Wernicke area (posterior portion of the
Brodmann area 22) and adjacent portions of the parietal lobe constitute a
sensory speech area. This area is responsible for interpretation and
reception of speech and dysfunction may result in receptive aphasia or
dysphagia.
○ The basal ganglia system is responsible for emotions.
■ The substantia nigra is a component of the basal ganglia and
synthesizes dopamine.
■ The extrapyramidal system is part of the motor control system
that causes involuntary reflexes and coordinated movement and
stabilizes motor control. Parkinson disease and Huntington disease
○ The limbic system: Its principal effects are involved in primitive
behavioral responses, visceral reaction to emotion, motivation, mood,
feeding behaviors, biologic rhythms, and the sense of smell.
■ mediates emotion and long-term memory through connections in
the prefrontal cortex (limbic cortex)
, ● Midbrain: (p. 452)
○ Corpora quadrigemina, tegmentum, and cerebral peduncles
● Hindbrain: (p. 453)
○ Cerebellum, pons and medulla
○ The cerebellum is responsible for reflexive fine-tuning of motor control
and maintaining balance and posture.
○ The medulla oblongata is responsible for sleep-wake rhythms.
● Hypothalamus, brainstem, basal forebrain- Reticular formation: KEEPING YOU
AWAKE.
● Frontal lobe: CONTROLLING THOUGHT.
● Broca’s speech area: SPEECH PRODUCTION AND MOTOR CONTROL.
● Wernicke’s area: HANDLES LANGUAGE COMPREHESION.
● Limbic system: MAINTAINING BALANCE AND POSTURE.
● Above is found on PAGE 459.
2. Know the function of the arachnoid villi.
● Finger-like projections of the arachnoid mater, the middle layer of the meninges
that cover the brain and spinal cord.
● Their primary function is to absorb cerebral spinal fluid (CSF) from the
subarachnoid space into the venous system.
○ Maintaining a constant volume of CSF is essential for protecting the brain
and spinal cord from injury.
○ CSF removal helps remove waste products and toxins from the brain.
○ It also ensures that the brain remains buoyant and properly positioned
within the skull.
● If arachnoid villi are blockers or dysfunctional, CSF cannot be properly absorbed,
leading to an accumulation of CSF in the brain.
● Above found on PAGE 459.
3. Where is the primary defect in Parkinson’s disease and Huntington’s?
● The extrapyramidal system is part of the motor control system that causes
involuntary reflexes and coordinated movement and stabilizes motor control.
Parkinson’s and Huntington’s disease are characterized by disruption of the
extrapyramidal system and various involuntary or exaggerated movements.
● Parkinsons:
○ Affected area: Dopaminergic neurons in the substantia nigra (a part of the
midbrain)
○ Mechanism: These neurons produce dopamine, which is essential for the
fine-tuning movements. Their degeneration leads to a deficiency of
dopamine in the basal ganglia.
● Huntingtons:
, ○ Affected area: GABAergic neurons in the striatum (a part of the basal
ganglia)
○ Mechanism: The loss of these neurons causes a functional predominance
of the dopaminergic system within the basal ganglia.
○ Above found on PAGE 451.
4. What is the function of the CSF? Where is it produced? Where is it absorbed?
● Function: Protects the intracranial and spinal cord structures from the jolts and
blows. It also prevents the brain from tugging on meninges, nerve roots, and
blood vessels. (CSF is buoyant).
● Production: Ependymal cells in the choroid plexuses of the lateral, third, and
fourth ventricles produce the major portion of CSF. produced continually, but
does not accumulate
● Absorption: Reabsorbed through a pressure gradient between the arachnoid villi
and cerebral venous sinuses. It is reabsorbed back in the venous circulation.
● CSF is formed from blood, and after circulation through the CNS, it returns to
blood.
● Above found on PAGE 458.
5. Review blood flow to the brain.
● PAGE 459.
● The brain derives its arterial supply from the internal carotid arteries and
vertebral arteries. The internal carotid arteries supply a proportionately greater
amount of blood flow
● Receives ~20% of the cardiac output or 800-1000mL of blood flow/min
● 3 major paired arteries perfuse the cerebellum and brainstem:
○ Posterior inferior cerebellar artery
○ Anterior inferior cerebral artery
○ Superior cerebellar arteries
● Circle of Willis - provides an alternative route for blood flow when one of the
contributing arteries is obstructed
○ Formed by the posterior cerebral arteries, posterior communicating
arteries, internal carotid arteries, anterior cerebral arteries and anterior
communicating arteries
○ From summary p. 473: The paired carotid and vertebral arteries supply blood to
the brain and connect to form the circle of Willis. The major branches projecting
from the circle of Willis are the anterior, middle and posterior cerebral arteries.
Drainage of blood from the brain is accomplished through the venous sinuses and
jugular veins.
CHAPTER 16
, 6. What is the gate control theory of pain?
From powerpoint:
- Explains the complexities of the pain phenomenon
- Pain is modulated by a “gate” in the cells of the substantia gelatinosa in the spinal cord.
- Large myelinated A-delta fibers and small unmyelinated C fibers respond to a
broad range of painful stimuli, such as mechanical, thermal, and chemical. These
nociceptive transmissions “open” the gate.
- Stimuli from nonnociceptive transmissions, such as touch and larger A-beta
fibers, “close” or partially close the gate.
● PAGES 474-475?
● The gate control theory of pain explains how pain signals are modulated and
perceived in the body.
● Key concepts:
○ Gate: A hypothetical structure in the dorsal horn of the spinal cord that
controls the transmission of pain signals to the brain.
○ Non-nociceptive (touch, pressure) signals: these signals can close the gate,
inhibiting the transmission of pain signals.
○ Nociceptive (pain) signals: these signals open the gate, allowing pain
signals to reach the brain.
7. Know the type of nerve fibers that transmit pain impulses.
● PAGE 475 & powerpoint
● Pain transmission is the conduction of pain impulses along the A & C fibers
(primary-order neurons) into the dorsal horn of the spinal cord.
● Myelinated A-delta fibers: transmission is fast and causes reflex withdrawal of
affected body part from stimulus before pain sensation is perceived
● Unmyelinated C polymodal fibers: stimulated by mechanical, thermal, and
chemical nociceptors
○ Transmission is slower and conveys dull, aching, or burning sensations.
● A-beta fibers: large myelinated fibers that transmit touch and vibration sensations
8. Where in the CNS does pain perception occur?
● PAGE 476
● Pain perception is the conscious awareness of the pain, which occurs primarily in
the reticular and limbic systems and the cerebral cortex.
● Three systems interact to produce the perceptions of pain.
○ The sensory-discriminative system is mediated by the somatosensory
cortex and is responsible for identifying the presence, character, location,
and intensity of pain.
CHAPTER 15
1. Review the anatomy of the brain. Which portion is responsible for keeping you awake,
controlling thought, speech, emotions and behavior, maintaining balance and posture? (p. 448,
Fig 15.6)
● Brainstem is composed of midbrain medulla and pons. The brainstem connects
the brain’s hemispheres, cerebellum, and spinal cord.
○ A collection of cell bodies called nuclei within the brainstem makes up the
reticular formation : this controls vital reflexes such as cardiovascular
function and respiration. The reticular activating system is essential for
maintaining wakefulness and attention.
● Forebrain:
○ Two cerebral hemispheres
○ Cerebrum: Largest part of the brain (both gray and white matter).
○ The prefrontal area is responsible for goal-oriented behavior (e.g. ability
to concentrate) short-term memory of recall memory, the elaboration of
thought, and inhibition of the limbic areas of the CNS.
○ The Broca speech area is on the inferior frontal gyrus. It is usually on
the left hemisphere and is responsible for motor aspects of speech.
■ Damage to this area, commonly as a result of a cerebrovascular
accident (stroke), results in the inability to form words or at least
some difficulty in forming words (expressive aphasia)
○ In the temporal lobe, there is the Wernicke area (posterior portion of the
Brodmann area 22) and adjacent portions of the parietal lobe constitute a
sensory speech area. This area is responsible for interpretation and
reception of speech and dysfunction may result in receptive aphasia or
dysphagia.
○ The basal ganglia system is responsible for emotions.
■ The substantia nigra is a component of the basal ganglia and
synthesizes dopamine.
■ The extrapyramidal system is part of the motor control system
that causes involuntary reflexes and coordinated movement and
stabilizes motor control. Parkinson disease and Huntington disease
○ The limbic system: Its principal effects are involved in primitive
behavioral responses, visceral reaction to emotion, motivation, mood,
feeding behaviors, biologic rhythms, and the sense of smell.
■ mediates emotion and long-term memory through connections in
the prefrontal cortex (limbic cortex)
, ● Midbrain: (p. 452)
○ Corpora quadrigemina, tegmentum, and cerebral peduncles
● Hindbrain: (p. 453)
○ Cerebellum, pons and medulla
○ The cerebellum is responsible for reflexive fine-tuning of motor control
and maintaining balance and posture.
○ The medulla oblongata is responsible for sleep-wake rhythms.
● Hypothalamus, brainstem, basal forebrain- Reticular formation: KEEPING YOU
AWAKE.
● Frontal lobe: CONTROLLING THOUGHT.
● Broca’s speech area: SPEECH PRODUCTION AND MOTOR CONTROL.
● Wernicke’s area: HANDLES LANGUAGE COMPREHESION.
● Limbic system: MAINTAINING BALANCE AND POSTURE.
● Above is found on PAGE 459.
2. Know the function of the arachnoid villi.
● Finger-like projections of the arachnoid mater, the middle layer of the meninges
that cover the brain and spinal cord.
● Their primary function is to absorb cerebral spinal fluid (CSF) from the
subarachnoid space into the venous system.
○ Maintaining a constant volume of CSF is essential for protecting the brain
and spinal cord from injury.
○ CSF removal helps remove waste products and toxins from the brain.
○ It also ensures that the brain remains buoyant and properly positioned
within the skull.
● If arachnoid villi are blockers or dysfunctional, CSF cannot be properly absorbed,
leading to an accumulation of CSF in the brain.
● Above found on PAGE 459.
3. Where is the primary defect in Parkinson’s disease and Huntington’s?
● The extrapyramidal system is part of the motor control system that causes
involuntary reflexes and coordinated movement and stabilizes motor control.
Parkinson’s and Huntington’s disease are characterized by disruption of the
extrapyramidal system and various involuntary or exaggerated movements.
● Parkinsons:
○ Affected area: Dopaminergic neurons in the substantia nigra (a part of the
midbrain)
○ Mechanism: These neurons produce dopamine, which is essential for the
fine-tuning movements. Their degeneration leads to a deficiency of
dopamine in the basal ganglia.
● Huntingtons:
, ○ Affected area: GABAergic neurons in the striatum (a part of the basal
ganglia)
○ Mechanism: The loss of these neurons causes a functional predominance
of the dopaminergic system within the basal ganglia.
○ Above found on PAGE 451.
4. What is the function of the CSF? Where is it produced? Where is it absorbed?
● Function: Protects the intracranial and spinal cord structures from the jolts and
blows. It also prevents the brain from tugging on meninges, nerve roots, and
blood vessels. (CSF is buoyant).
● Production: Ependymal cells in the choroid plexuses of the lateral, third, and
fourth ventricles produce the major portion of CSF. produced continually, but
does not accumulate
● Absorption: Reabsorbed through a pressure gradient between the arachnoid villi
and cerebral venous sinuses. It is reabsorbed back in the venous circulation.
● CSF is formed from blood, and after circulation through the CNS, it returns to
blood.
● Above found on PAGE 458.
5. Review blood flow to the brain.
● PAGE 459.
● The brain derives its arterial supply from the internal carotid arteries and
vertebral arteries. The internal carotid arteries supply a proportionately greater
amount of blood flow
● Receives ~20% of the cardiac output or 800-1000mL of blood flow/min
● 3 major paired arteries perfuse the cerebellum and brainstem:
○ Posterior inferior cerebellar artery
○ Anterior inferior cerebral artery
○ Superior cerebellar arteries
● Circle of Willis - provides an alternative route for blood flow when one of the
contributing arteries is obstructed
○ Formed by the posterior cerebral arteries, posterior communicating
arteries, internal carotid arteries, anterior cerebral arteries and anterior
communicating arteries
○ From summary p. 473: The paired carotid and vertebral arteries supply blood to
the brain and connect to form the circle of Willis. The major branches projecting
from the circle of Willis are the anterior, middle and posterior cerebral arteries.
Drainage of blood from the brain is accomplished through the venous sinuses and
jugular veins.
CHAPTER 16
, 6. What is the gate control theory of pain?
From powerpoint:
- Explains the complexities of the pain phenomenon
- Pain is modulated by a “gate” in the cells of the substantia gelatinosa in the spinal cord.
- Large myelinated A-delta fibers and small unmyelinated C fibers respond to a
broad range of painful stimuli, such as mechanical, thermal, and chemical. These
nociceptive transmissions “open” the gate.
- Stimuli from nonnociceptive transmissions, such as touch and larger A-beta
fibers, “close” or partially close the gate.
● PAGES 474-475?
● The gate control theory of pain explains how pain signals are modulated and
perceived in the body.
● Key concepts:
○ Gate: A hypothetical structure in the dorsal horn of the spinal cord that
controls the transmission of pain signals to the brain.
○ Non-nociceptive (touch, pressure) signals: these signals can close the gate,
inhibiting the transmission of pain signals.
○ Nociceptive (pain) signals: these signals open the gate, allowing pain
signals to reach the brain.
7. Know the type of nerve fibers that transmit pain impulses.
● PAGE 475 & powerpoint
● Pain transmission is the conduction of pain impulses along the A & C fibers
(primary-order neurons) into the dorsal horn of the spinal cord.
● Myelinated A-delta fibers: transmission is fast and causes reflex withdrawal of
affected body part from stimulus before pain sensation is perceived
● Unmyelinated C polymodal fibers: stimulated by mechanical, thermal, and
chemical nociceptors
○ Transmission is slower and conveys dull, aching, or burning sensations.
● A-beta fibers: large myelinated fibers that transmit touch and vibration sensations
8. Where in the CNS does pain perception occur?
● PAGE 476
● Pain perception is the conscious awareness of the pain, which occurs primarily in
the reticular and limbic systems and the cerebral cortex.
● Three systems interact to produce the perceptions of pain.
○ The sensory-discriminative system is mediated by the somatosensory
cortex and is responsible for identifying the presence, character, location,
and intensity of pain.
