UNIT FIVE  THE NEUROLOGIC SYSTEM

Structure and Function of the Neurologic

15 System

EXPLAIN THE PICTURES

Examine the pictures and answer the questions about them.

1. Which letter in the picture indicates an axon?

_______________

2. Which letter in the picture indicates a dendrite?

A _______________

3. Which letter indicates the location where an action

potential begins? _______________

4. Name the location where an action potential begins.

C
B __________________________________________________

5. Draw an arrow on the picture to indicate which way the

action potential normally travels.

E 6. Is this neuron unipolar, bipolar, or multipolar?

D
_________________________________________________

7. Name the structure marked E in the picture.

________________________________________________

8. What is the benefit of having this type of structure on

neurons?
(From Patton KT, Thibodeau GA: Anatomy & physiology, ed 8,
St Louis, 2013, Mosby.)

9. Which letter in the picture of the spinal cord indicates

B C
A
the cell body of a sensory neuron? _______________

10. Which letter in the picture indicates the cell body of a

D
motor neuron? _______________

11. What neural structures are marked C and E?

_______________
E 12. Why is the area marked A darker in color than the area
F marked B?
(From Patton KT, Thibodeau GA: Anatomy & physiology,
ed 8, St Louis, 2013, Mosby.)

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Chapter 15 Structure and Function of the Neurologic System Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc.
CHOOSE THE CORRECT WORDS

Circle the correct word from the choices provided to complete these sentences.

13. Neurons (need, do not need) insulin in order to take in glucose.

14. The principle of neural (malleability, plasticity) indicates that the central nervous system is capable of change.

15. An example of (convergence, divergence) is a primary afferent neuron whose axons synapse with several spinal cord
neurons at different levels of the spinal cord.

16. The epidural space is (potential, real) in the skull and (potential, real) in the spinal cord.

17. The basal ganglia are part of the (pyramidal, extrapyramidal) pathways.

18. Cell bodies of spinal lower motor neurons are located in the (white, gray) matter of the spinal cord; their axons
synapse with (skeletal, vascular smooth) muscles.

19. The thoracolumbar division of the autonomic nervous system is (sympathetic, parasympathetic), and the craniosa-
cral division is (sympathetic, parasympathetic).

20. The term adrenergic refers to (sympathetic, parasympathetic) nerves that are (preganglionic, postganglionic, both
preganglionic and postganglionic).

CATEGORIZE THESE PHYSIOLOGIC EFFECTS

Write the branch of the autonomic nervous system whose stimulation would cause each effect. Possible choices include:
sympathetic, parasympathetic.

�������������� 21. Increased diameter of pupils

�������������� 22. Dry mouth

�������������� 23. Contraction of bladder detrusor muscle

�������������� 24. Increased plasma free fatty acids

�������������� 25. Bradycardia

�������������� 26. Increased salivation

�������������� 27. Cool, pale skin

�������������� 28. Hyperglycemia

�������������� 29. Dilation of bronchioles

�������������� 30. Increased blood pressure

�������������� 31. Increased peristalsis in intestines

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Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. Chapter 15 Structure and Function of the Neurologic System
 Pain, Temperature Regulation, Sleep,
16 and Sensory Function

MATCH THESE DEFINITIONS

Match the word on the right with its definition on the left.

���� 1. Inflammation of the cornea A. Vertigo

���� 2. Inflammation of the eyelid B. Chalazion

���� 3. Cloudy or opaque portion of the lens of the eye C. Blepharitis

���� 4. Sensation of spinning around D. Entropion

���� 5. Lipogranuloma of oil-secreting gland of the eyelid E. Keratitis

���� 6. Eyelid margin turned inward against the eyeball F. Cataract

CHOOSE THE CORRECT WORDS

Circle the correct word from the choices provided to complete these sentences.

7. A patient who lies on a cold exam table without sufficient padding will lose body heat to the table by (convection,
conduction).

8. Nonshivering (chemical) thermogenesis occurs in (white, brown) adipose tissue as a result of the action of (epineph-
rine, acetylcholine).

9. Fever (inhibits, increases) many immune defenses against bacteria and viruses.

10. Children develop (lower, higher) fevers than do adults for minor infections; older adults often have (lower, higher)
fevers during infection.

11. Heat stroke is characterized by very high body temperature, (presence, absence) of sweat, and (pale, flushed) skin.

12. Retinoblastoma is a rare eye tumor of (young children, older adults).

13. Pain (transmission, transduction) is conversion of chemical or other stimuli into electrophysiologic activity.

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Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. Chapter 16 Pain, Temperature Regulation, Sleep, and Sensory Function
CATEGORIZE THESE SLEEP DISORDERS

Write the type of sleep disorder beside its name. Possible choices include: dyssomnia, parasomnia. Then match the
examples in the right column with each disorder.

�������������� 14. Insomnia A. Obese man snores and gasps at night, fre-
quently falls asleep at his computer at work.
Example is _______________
B. Woman awakens every night with hip pain and
�������������� 15. Arousal disorder has difficulty falling asleep again.

Example is _______________ C. Infant dies of SIDS.

�������������� 16. Hypersomnia D. Child walks while asleep several nights per
month.
Example is _______________
E. Student who works nights and goes to school
�������������� 17. Obstructive sleep apnea syndrome during the day often falls asleep while study-
ing and sometimes while driving.
Example is _______________
F. Man talks in his sleep, responds to simple
�������������� 18. Sleep–waking transition disorder questions while asleep.

Example is _______________

�������������� 19. Disorder associated with REM sleep

Example is _______________

ORDER THE SLEEP STAGES

Sequence the stages that occur during two consecutive sleep cycles starting with the individual being awake. You will
use some of the letters twice; remember to include two consecutive sleep cycles.

2 0. Write the letters here in the correct order of the stages: ______________________________
A. Awake
B. Slow-wave sleep
C. REM sleep
D. Stage N2
E. Stage N1

EXPLAIN THE PICTURE

Examine the picture and answer the questions about it.

Aδ

Spinal cord

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Chapter 16 Pain, Temperature Regulation, Sleep, and Sensory Function Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc.
 Alterations in Cognitive Systems, Cerebral
17 Hemodynamics, and Motor Function

MATCH THESE DEFINITIONS

Match the word on the right with its definition on the left.

���� 1. Loss of language production or comprehension A. Agnosia

���� 2. Involuntary rapid contractions of muscle groups in random pattern B. Athetosis

���� 3. Impaired recognition of tactile, visual, or auditory stimuli C. Myoclonus

���� 4. Involuntary rhythmic, oscillating movement of a body part D. Apraxia

���� 5. Shocklike, nonpatterned muscle contractions causing limb move- E. Akathisia

ment; may occur during sleep
F. Aphasia
���� 6. Inability to perform purposeful or skilled motor actions
G. Chorea
���� 7. Involuntary slow, twisting, writhing movements
H. Tremor
���� 8. Motor restlessness; compulsion to move lower extremities

CHOOSE THE CORRECT WORDS

Circle the correct words from the choices provided to complete these sentences.

9. Damage to the cerebellum causes (resting, intention) tremor and (ataxic, shuffling) gait.

10. Cheyne-Stokes respirations involve a (hypoventilatory, hyperventilatory) response to stimulation by (carbon dioxide,
hypoxia).

11. Changes in the pupils are useful to evaluate (cortical, brainstem) function because the areas that control arousal are
located (nearby, contralaterally).

12. When autoregulation of intracranial arterioles fails, small increases in blood volume cause intracranial pressure to
rise (minimally, greatly).

13. Inflammation from brain injury causes (vasogenic, intracellular) cerebral edema.

14. Hypertonia is caused by (upper, lower) motor neuron damage.

15. Lateral corticospinal tract damage causes (flaccidity, spasticity).

16. Amyotrophic lateral sclerosis involves degeneration of (upper, lower, both upper and lower) motor neurons.

17. Extrapyramidal motor syndromes involve (abnormal movement, paralysis).

18. Nondeclarative memory is (language, muscle) memory, but declarative memory is (language, muscle) memory.

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Chapter 17 Alterations in Cognitive Systems, Cerebral Hemodynamics,
and Motor Function Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc.
CATEGORIZE THESE DYSFUNCTIONS

Write the type of neuromotor dysfunction beside each name. Possible choices include: hyperkinesia, hypokinesia,
hypertonia.

�������������� 19. Loss of associated movements

�������������� 20. Chorea

�������������� 21. Dystonia

�������������� 22. Akathisia

�������������� 23. Bradykinesia

�������������� 24. Tremor

�������������� 25. Myoclonus

�������������� 26. Spasticity

�������������� 27. Athetosis

�������������� 28. Muscle rigidity

ORDER THE LEVELS OF CONSCIOUSNESS

Sequence the progressive changes that occur when a fully alert individual becomes comatose.

2 9. Write the letters here in the correct order of decreasing consciousness: ____________________________
A. Light coma
B. Disorientation
C. Lethargy
D. Confusion
E. Obtundation
F. Deep coma
G. Stupor

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Chapter 17 Alterations in Cognitive Systems, Cerebral Hemodynamics,
Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. and Motor Function
 Disorders of the Central and Peripheral
18 Nervous Systems and the
Neuromuscular Junction

MATCH THESE DEFINITIONS

Match the word on the right with its definition on the left.

���� 1. Forward displacement of a vertebra A. Radiculopathy

���� 2. Degeneration of vertebral structure B. Spinal stenosis

���� 3. Abnormal narrowing of the spinal canal C. Spondylolysis

���� 4. Disorder of spinal nerve root D. Spondylolisthesis

CHOOSE THE CORRECT WORDS

Circle the correct words from the choices provided to complete these sentences.

5. Open trauma that causes a traumatic brain injury occurs when a break in the (skull, dura mater) exposes cranial
contents to the environment.

6. A person who is hit forcefully in the back of the head with a bat can sustain a (coup, contrecoup) injury when the
brain hits the front of the skull and a (coup, contrecoup) injury where the bat hit.

7. Subdural hematomas typically involve (arterial, venous) bleeding.

8. (Infection, Hyperactivity) is a significant complication of a compound skull fracture.

9. In diffuse axonal injury, the axons are damaged by (stretching and tearing, penetrating injury).

10. Vertebral injuries tend to occur at the most (rigid, mobile) portions of the vertebral column.

11. Migraine causes (unilateral, bilateral) head pain.

12. Lacunar infarcts are (larger, smaller) than 1 cm in diameter and are associated with smoking and (hypoglycemia,
hypertension).

13. Blood in the subarachnoid space after hemorrhage causes (infection, inflammation) and can (impair, potentiate)
circulation of cerebrospinal fluid.

14. Hyperextension and hyperflexion vertebral injuries most often occur in the (cervical, lumbar) spine.

15. Most cases of encephalitis are caused by (bacteria, viruses).

16. The most common brain tumors are (primary, metastatic).

CATEGORIZE THESE NEURAL INJURIES

Write the type of injury beside each name. Possible choices include: primary, secondary, tertiary

�������������� 17. Subdural hematoma compresses neurons

�������������� 18. Increased intracranial pressure compresses neurons

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Chapter 18 Disorders of the Central and Peripheral Nervous Systems
and the Neuromuscular Junction Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc.
 �������������� 19. Bullet severs tracts in spinal cord

�������������� 20. Crushing blow to head compresses neurons and glia

�������������� 21. Pneumonia occurs during hospitalization for spinal cord injury

�������������� 22. Glutamate excitotoxicity causes neuronal death

COMPLETE THE CHART

Fill in the blank spaces within the chart to compare and contrast the functions after a spinal cord injury, during the
period of spinal shock, and after the return of reflexes.

Function Below the Level of a Complete

Spinal Cord Lesion During the Period of Spinal Shock After Return of Reflexes
Reflexes
Motor __________ paralysis _________ paralysis
Sensory
Bladder Atonic
Bowels Atonic

MATCH THE PROCESSES

Match the pathophysiologic processes on the right with the phases of a migraine on the left.

���� 23. Premonitory phase A. Trigeminal afferents become activated; release of proinflammatory chemi-
cals; perhaps abnormal neural processing
���� 24. Migraine aura
B. Return to normal physiology
���� 25. Headache phase
C. Involvement of hypothalamus may cause yawning or food craving.
���� 26. Recovery phase
D. Focal vasodilation followed by vasoconstriction and decreased electrical
activity spreads across cerebral cortex from the occipital region.

DRAW YOUR ANSWERS

Read the questions and draw your answers.

27. Draw a saccular aneurysm on this artery.

28. Draw a fusiform aneurysm on this artery.

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Chapter 18 Disorders of the Central and Peripheral Nervous Systems
Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. and the Neuromuscular Junction
 Neurobiology of Schizophrenia, Mood
19 Disorders, and Anxiety Disorders

MATCH THESE DEFINITIONS

Match the word on the right with its definition on the left.

���� 1. False belief that persists despite contradictory evidence A. Anhedonia

���� 2. Lack of verbal or nonverbal expression of emotion B. Psychosis

���� 3. Lack of pleasure in activities that are normally pleasurable C. Mood disorder

���� 4. Psychiatric disorder that involves loss of contact with reality D. Hallucination

���� 5. Perception that occurs in the absence of external stimuli E. Affective flattening

���� 6. Inability to connect thoughts logically F. Delusion

���� 7. Psychiatric disorder involving predominant emotions that G. Disorganized thinking

affect ability to function in society

CHOOSE THE CORRECT WORDS

Circle the correct words from the choices provided to complete these sentences.

8. Inherited disease alleles for schizophrenia show (complete, reduced) penetrance, which means that individuals who
have the disease genes (manifest, may not manifest) schizophrenia at some age.

9. The dorsolateral prefrontal cortex is important for function of (long-term, working) memory; in schizophrenia, this
brain area appears to be (hyperactive, hypoactive).

10. Brain abnormalities in schizophrenia are believed to originate in the (prenatal, adolescent) period of brain development.

11. Depression is more common in (men, women).

12. Proinflammatory cytokines (increase, decrease) the secretion of cortisol in depression.

13. Atrophy of neurons in the (hypothalamus, hippocampus) is believed to participate in the neurobiology of depression.

14. Abnormally increased sensitivity to changes in (calcium, pH) in some brain areas may underlie panic disorder.

15. Cell bodies of serotonergic neurons are located in the (locus ceruleus, raphe nuclei) in the brainstem; cell bodies of
adrenergic neurons are located in the (locus ceruleus, raphe nuclei) in the brainstem.

16. Posttraumatic stress disorder is characterized by (disorganized, intrusive) thoughts after exposure to a life-threatening
or traumatic event and involves (decreased, increased) neural activity in the amygdala and (decreased, increased)
neural activity in the prefrontal cortex.

17. Obsessive-compulsive disorder is characterized by (disorganized, repetitive) intrusive thoughts and (disorganized,
compulsive) behaviors.

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Chapter 19 Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc.
CATEGORIZE THESE CLINICAL MANIFESTATIONS OF SCHIZOPHRENIA

Write the type beside each clinical manifestation of schizophrenia. Possible choices include: positive, negative.

�������������� 18. Hallucinations

�������������� 19. Social withdrawal

�������������� 20. Delusions

�������������� 21. Blunted affect

�������������� 22. Incoherent speech that uses invented words

�������������� 23. Wearing aluminum foil on head to deflect radio waves

�������������� 24. Failure to respond to simple questions

MATCH THE ASSESSMENTS

Match the technical term on the right with the assessment on the left that it describes.
���� 25. Mr. J says, “I used to have a lot of fun activities, but they don’t make me A. Delusion
happy anymore.”
B. Pressured speech
���� 26. Mr. G believes he is Louis XIV, King of France, although he has a history
book that says Louis XIV is dead. C. Affective flattening

���� 27. Mr. A is talking so rapidly and urgently that it is difficult to understand D. Anhedonia
him.
E. Hallucination
���� 28. Mr. S is talking to his mother, whom he insists is sitting in the corner of
the room, although you are the only other person present.

���� 29. Mr. L says he is happy and excited today, but his speech is monotone and
his facial expression does not change.

COMPLETE THESE SENTENCES

Write one word in each blank to complete these sentences.

30. One hypothesis of schizophrenia involves the neurotransmitter _______________ acting on NMDA receptors.

31. The dopamine hypothesis of schizophrenia suggests that an _______________ of dopamine in the mesolimbic pathway
causes the _______________ symptoms and a _______________ of dopamine in the mesocortical pathway causes the
_______________ and cognitive symptoms.

32. Not spontaneously talking in response to questions or to express oneself is called _______________.

33. Unipolar depression also is known as _______________ depression or clinical depression.

34. Monoamine neurotransmission is hypothesized to be _______________ during depression but _______________during

mania.

35. People who have panic disorder may develop _______________, extreme avoidance of being in a crowd or other
location where it is not easy to escape.

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Copyright © 2015, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. Chapter 19 Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders