Review anatomy of the brain. Which portion is responsible for
-Keeping you awake
-Controlling thought
-Speech
-Emotions
-Behavior
-Maintaining balance and posture
The reticular formation- Is a large network of diffuse nuclei that connect the brainstem to the
cortex and control vital reflex, such as cardiovascular function and respiration. It is essential for
maintaining wakefulness and attention and is referred to as the reticular activating system.
Some nuclei within the reticular formation support specific motor movements such as balance
and posture.
Know the function of the arachnoid villi
The arachnoid villi protrude from the arachnoid space through the dura mater and lie within the
blood flow of the venous sinuses. The villi function as one way valves directing CSF outflow into
the blood but preventing blood flow into the subarachnoid space. Thus, CSF is formed from
blood and after circulating throughout the CNS it returns to blood.
Pg. 459
Where is the primary defect in Parkinson's Disease and Huntington's?
What is the function of the CSF?
The intracranial and spinal cord structures float in CSF and are thereby partially protected from
jolts and blows. The buoyant properties of CSF also prevent the brain from tugging on
meninges, nerve roots, and blood vessels.
Pg. 458
Where is CSF produced?
Ependymal cells in the choroid plexuses of the lateral, third, and fourth ventricles produce the
major portion of CSF
, Where is CSF absorbed?
It is reabsorbed through the arachnoid villi. CSF is reabsorbed through a pressure gradient
between the arachnoid villi and the cerebral venous sinuses.
Pg. 459
Review blood flow to the brain.
Pg. 459
What is the gate control theory of pain?
Know the type of nerve fibers that transmit pain impulses.
Nociceptors (or pain receptors) are free nerve endings in the afferent peripheral nervous
system.
There are two primary types of nociceptors
A-delta- Larger myelinated fibers that rapidly transmit sharp, well localized "fast" pain
sensations, such as intense heart or a pinprick to the skin.
C fibers- are the most numerous, are smaller, unmyelinated, and are located in muscles,
tendons, body organs, and the skin. They slowly transmit dull, aching, or burning sensations
that are poorly localized and often constant.
Pg. 475
Know endogenous opioids
a family of morphine-like neuropeptides that inhibit transmission of pain impulses in the
periphery, spinal cord, and brain by binding with specific opioid receptors (mu, kappa, and delta)
on neurons. They inhibit ion channels preventing the release of excitatory neurotransmitters,
such as substance P and glutamate, in the dorsal horn.
pg.479
Know different clinical descriptions of pain (acute, chronic, neuropathic); pain
threshold/tolerance?
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