CNS

Mere som dette

Attachment: “An enduring emotional tie that unites the child to the caregiver and has far reaching effects on development” (406). We can form emotional ties with our family, friends, teachers, and Heavenly Father that will enable us to create meaningful relationships and thrive.

af Nancy Chaffin

AWS Well-Architected Framework

af Yasser Moghrabiah

Physiology

af Michelle Prentice

Classification of Organisms

af vedika mandapati

Lumbar vertebrae

Thoracic vertebrae

Cervical Spine

Regions of the spine

Floating topic

3 branches of trigeminal nerve supplies

Circle of willis

Spine

Intrinsic

Deep segmental

Intertransversarii

Levator costarum

Interspinalis

Transversospinalis

Rotatores

Multifidus

Semispinalis

Erector spinae

Spinalis

Longissimus

Iliocostalis

Superficial

Splenius cervicus

attach to transverse process

Splenius capitus

Extrinsic

Intermediate extrinsic

Function for both: Respiration and proprioception

Serratus posterior inferior

Serratus posterior superior

Extrinsic superficial

levator scapulae

Rhomboid minor

Rhomboid major

Lats

Trapezius

Provides upright posture

Sites for muscular attachment

Allows and guides movement

Force attenuation

Protection of CNS and Viscera

Weight bearing

Regions

Coccygeal

3-5

Sacral

Lumbar

90 degrees

Thoracic

Rib attachment sites

Tubercle of rib

Demifacet of transverse process

Head of rib

Demifacet of vertebral body

Other ligaments

Superior and inferior costotransverse ligaments

Ligaments running the entire length of vertebral column

Supraspinous ligament

Anterior longitudinal ligament

Posterior longitudinal ligamnent

Facet orientation

60 degrees

Unique

Demifacets on transverse process: two on each side

Vertebrae

12 total

Cervical

Joints

Atlantoaxial

antlantooccipital

Facet

45 degrees

Nerves

8 nerves

Vertebrae

7 total

Craniocervical ligaments (C1 and C2)

Cruciate ligament:

Inferior longitudinal band

Transverse lig

Superior longitudinal band

Transverse ligaments: Supports posterior dens and prevents anterior translation of of atlas on axis

Apical Ligament

Alar ligament: secondary stabilization for transverse ligament

C3-C7 considered typical

Axis(C2)

Shaking head no

Dens process

Atlas(C1)

Nodding head yes

Distinguishing features: Foramina in transverse processes in which vertebral arteries go through and bifid spinous process

Communication

Neuron

Synapse

Chemical

Most common, USe of neurotransmitters

Electrical

Only in the CNS, gap junctions

Descending (motor) tracts

Rubrospinal

Decussates at midbrain

Starts in red nucleus in midbrain ends T1

Fine coordination

Tectospinal

Decussates: midbrain

Starts in superior colliculus in mid brain Ends at T1

Head and eye coordination

Reticulospinal

Posture and gait

Starts in superior colliculus in mid brain Supplies the entire cord

2 tracts

Pontine

Medullary

Medial vestibuospinal

Originates at medulla and bifurcates at medulla Ends at T1

Controls head and neck

Lateral vestibulospinal

Starts in the pons and supplies entire cord

Balance

Anterior Corticospinal

Ends at T10

Starts in cortex and bifurcates in the spinal cord

Voluntary movement for the upper extremity and trunk

Lateral corticospinal

Supplies entire cord

Starts in cortex and decussates in medulla

Voluntary movement for the whole body

Ascending(sensory) tracts

ALS Spinothalamic

Decussation: Spinal cord

F: Pain, temperature, crude touch

DCML

3rd order: VPL to post central gyrus

2nd Order: Medulla to VPL in thalamus

1st order: From effector to medulla

Decussation: At medulla

Originates in dorsal horn of SC Terminates in post central gyrus

2 fibers

FC: T6 and up

FG: T6 and below

Function: Sensory info of fine touch,vibration and proprioception to post central gyrus

Brain

Cerebellum

PICA, AICA, SCA

Output tracts

Double crossing

Ventral spinocerebellar: Pain and temp coming from the lower extremities

Rostral spinocerebellar: Pain and temp from the upper extremities

Input tracts

DO not decussate ; carry propriceptive info

Dorsal spinocerebellar tract (Carry info from lower limb and lower trunk)

Cuneocerebellar tracts (Carry info from upper limbs and upper trunk)

Nuclei

Glubose

Balance, posture, and orientation

Fastigal

Estimate movement of the body through space

Emboliform nucleus

Regulates precision of limb movements

Dentate nucleus

Fine control of voluntary mvoements

Cells

Granule cells

Smaller ; use glutamate as MT and are excitatory

Purkinje cells

Largest in brain essential to output tracts

Anatomy

Inner white matter: Arbor vitae

External feuatures

Flocculo nodular lobe

Maintenance of balance, control of eye movements

Posterior lobe

Planning of voluntary activity

Anterior lobe

regulation of muscle tone, coordination of skilled voluntary movement

Peduncles

Extremities and trunk

Median vermis

Controls trunk

Two cerebellar hemispheres right and left

control extremities

connection with brainstem by cerebella peduncles

Inferior cerebellar peduncle: Connects with medulla

Middle cerebellar peduncle: Connects with pons

Superior cerebellar peduncle: Connects with midbrain

Basal ganglia

4 channels

Limbic channel

Regulation of emotions

Prefrontal channel

Cognitive processes of frontal lobe and behavior control

Oculomotor channel

Conttrols eye movement, saccadic eye movement

Motor channel

Indirect pathway

Striatum

GPE

Subthalamic nucleus

thalamus inhibited

Breaks movement

Subthalamus nucleus releases glutamate which stimulates GPI and SNR, these release GABA to the thalamus and movement is inhibited

Striatum, GPE, Subthalamus nucleus, GPI, SNR, thalamus

Direct path

Cortex

Striatum(GABA inside)

GABA

GPI and SNR

NO GABA

Thalamus

Glutamate

To stimulate motor cortex

Structures involved

Striatum releases GABA to inhibit GPI and SNR, so no GABA is released to the thalamus , movement is stimulated

Striatum, GPI, SNR, thalamus

Most important blood supply of the basal ganglia: Lenticulostriate arteries(small vessels off the MCA)

Cranial nerves

Heavenly

Hypoglossal(motor)

Supplies: Extrinsic and intrisic muscles of the tongue F: Swallow, speak, move stuff in mouth FO: Hypoglossal canal

are

Accessory(motor)

Supplies: SCM, trapezius, pharynx , soft palate mm F: Flexion of neck, contralateral head rot, elevates and retracts scap FO: Jug foramen

vacations

Vagus(both sensory and motor)

Supplies: Pharynx, larynx, thoracic and abdominal viscera, epiglottis, aortic arch F: Main parasympathetic nerve; supplies 75% of organs Fo: Jugular foramen

good

Glossopharyngeal(both sensory and motor)

Supplies: F: lift pharyn and larynx, taste posterior tongue, blood pressure FO: Jugualr foramen

very

Vesitibulocochlear(sensory)

Supplies: Vestibulobranch(Some fibers reach cerebellum though inf cerebellar peduncle) ; cochlear branch Involved with: Lateral and medial vestibulospinal tracts F: posture, static and dynamic balance *mostly sensory FO: IAM

final

Facial(Both sensory and motor)

Supplies: Muscles of facial expression, anterior 2/3rds tongue F: Muscles of facial expression, taste, sensation of touch, pain, temperature *Helps with corneal reflex Fo: Internal auditory meatus

anatomy

Abducens(motor)

Supplies: Lateral rectus F: Eye movement Fo: Superior orbital fissure

If CN6 affected: Esotropia

the

Trigeminal (Both sensory and motor)

V3: Mandibular

V2: maxillary

V1: Opthalamic

Supplies: Muscles of mastication amongst others F: Sensation of pain, Blink reflex(corneal) V1 Fo: Sup orbital fissure V2: Fo: Foramen rotundum V3 Fo: Foramen ovale

takes

Trochlear(motor)

Only one that starts in dorsal view Supplies: Superior oblique F: Eye movement FO: Superior orbital fissure

one

Oculomotor(Motor)

Supplies: eye muscles Involved with: Tecto spinal tract F: Controls pupil size FO: Superior orbital fissure

once

Optic(sensory)

Pathway

eye --> Nerve --> Optic chiasm--> Optic tract--> Lateral geniculate body

Supplies: Photoreceptors F: Vision, light reflex Fo: optic canal

Oh

Olfactory(Sensory)

F: Smell Fo: Olfactory foramina

Connects to reticular formation, and amygdala

Blood supply

PCA feeds

Medial inferior temporal and occipital lobe, thalamus and hypothalamus

MCA feeds

Basal ganglia, lateral inferior frontal, parietal, inferior temporal)

ACA feeds

Medial frontal and parietal lobes, part of the basal ganglia

Circle of willis(6)

ACA, ICA, MCA, ACOMM, PCA, PCOMM

Posterior circulation(7)

PCOMM, PCA, Basilar, SCA, AICA, PICA, vertebral

Anterior circulation(4)

ACA, ICA,ACOMM,MCA

main arteries supplying the brain

Internal carotid artery

Vertebral arteries

Protection

Skull

Fossa

Posterior fossa

Jugular foramen

Houses CN 9,10,11

Internal acoustic meatus

Houses CN 7,8

Middle fossa

Spinosum

CNV3

Rotundum

CN v2

superior orbital fissure

Houses CN 3,4,V1, 6

Anterior fossa

CN 1, CN2

Neurocranium

Ethmoid, frontal, occipital, parietal, sphenoid, temporal

Viscerocranium

Maxilla, mandible, zygomatic bones, lacrimal bones, nasal conchae

Brain development

Rhombencephalon(hind brain)

Myelencephalon

Medulla oblongata

Metencephalon

cerebellum , pons

fourth ventricle

Mesencephalon(midbrain)

Mid brain (brain stem)

cerebral aquaduct

prosencephalon(forebrain)

Diencephalon

thalamus, hypothalamus, epithalamus, retina

third ventricle

Telencephalon

Cerebral hemispheres, cerbral cortex, basal ganglia

Embryonic Development

Stages

Fetal

Myelination takes place

End of week 8 to conception

Embryonic

Formation of neural tube occurs

Tube -->CNS

Crest--> PNS

If it DOES NOT close

Spina bifida

Stage 2 development

Dermatomes

Skin

myotomes

Muscles

Sclerotomes

Bones

Mesoderm develops into

Muscles, skeleton, excretory and circulatory systems

Ectoderm develops into

Epidermis

nervous system

sensory organs

Endoderm develops into

Gut, liver, pancreas, respiratory system

day 15 to week 8

Pre embryonic

embryonic disk forms(ectoderm, endoderm) mesoderm forms toward end of stage

Conception to day 14

Lobes

Insula

Sensorimotor processing

risk reward

Emotional processing

Taste

Gustatory cortex

Occipital

eye movements

Spatial reasoning

Visual perception

Calcarine fissure (medial occipital lobe) *seperates cuneus and lingual gyrus

Lingual gyrus

Cuneus

Primary visual cortex

Secondary visual cortex

Parieto occipital sulcus

Temporal

Language comprehension

Auditory processing

memory

Auditory association area

Primary auditory cortex

Heschells gyrus

Sylvian(lateral) fissure

Wernickes area(left side)

Speech comprehension

Parietal

Functions

Subtopic

Somatosensory info: Pain, touch, pressure, temperature, vibration

Spatial information or proprioception

Lateral ventricles

Where CSF is made

CSF made from choroid plexus

Flow of CSF through the brain:

1. Lat ventricles

2. Interventricular foramina

3. 3rd ventricle

4. Cerebral aquaduct

4th ventricle

5. Spine

6. Back to blood

Wernickes extends into inferior paietal

Post central gyrus

Primary somatosensory cortex

frontal