week 4

Question 1

the 5 tonsils are:

Answer 1

palantine (2) - lie in the wall of the oropharynx
lingual tonsils (2) - lie at the base of the tongue
pharyngeal tonsil - lie in the posterior part of the nasopharynx
also have the disputed tubal tonsil located just posterior to the opening of the Eustachian tube (otitis media with effusion)

Question 2

tonsils are:

Answer 2

aggregations of lymphatic nodules which are egg-shaped masses of lymphatic tissue which are partially encapsulated. They have no afferent vessels, but do have efferent vessels.

Question 3

otitis media with effusion

Answer 3

non-specific inflammation of the middle ear mucosa associated with non-drainage ofthe resultant mucous down the eustachian tube

Question 4

conductive hearing loss

Answer 4

where sound cannot reach the cochlea, caused by dysfunction in the middle or outer ear, most often caused by ear wax.
4 main mechanisms:
obstruction, mass loading (effusion), stiffness (otosclerosis), discontinuity
Rinne negative.

Question 5

sensorineural hearing loss

Answer 5

occurs when the inner ear or the cochlear nerve are damaged, generally due to damage to the hair cells of the inner ear.
Caused by: long-term exposure to loud noises, ototoxic medications, trauma, metabolic causes, ageing
Rinne positive

Question 6

attention

Answer 6

global cognitive process encompassing multiple sensory modalities, operating across sensory domains. Component processes include:
arousal, vigilance, divided attention, selective attention

Question 7

delerium

Answer 7

impaired arousal - drowsiness
impaired vigilance - impersistance
impaired divided and selective attention - distractible

Question 8

immediate (working) memory

Answer 8

immediate recall of small amounts of verbal or spatial information. Appears to function independently of long-term memory, involves a central regulator.

Question 9

explicit memory

Answer 9

memories that are available for conscious reflection
2 branches - episodic and semantic
Episodic - personally experienced and are stored in relation to the context in which they were experienced
semantic - stored independently of context, time and personal relevance. Concerned with factual information and vocabulary

Question 10

Implicit memory

Answer 10

no conscious access to these memory stores. They function independent of explicit memory meaning that profound amnaesia can be seen but implicit memory function can be completely normal.
Dependent on networks involving the basal ganglia and cerebellum

Question 11

Parkinson’s disease

Answer 11

progressive degenerative disorder of basal ganglia function that results in variable combinations of tremor, rigidity, and bradykinesia

Question 12

functions of serotonin (5HT)

Answer 12

hallucinatory effects
Sleep, wakefullness and mood - lesions of the raphe nuclei or depletion of 5HT abolishes sleep in animals
Feeding and appetite - 5Ht agonists induce hyperphagia in patients
Sensory transmission - normal ability to disregard irrelevant forms of stimulus depends on intact 5HT pathways

Question 13

functional roles of dopamine

Answer 13

motor control (nigrostriatal pathway)
behavioural effects - mesolimbic and mesocortical pathways (reward)
endocrine control - controls the release of prolactin from the anterior pituitary (inhibitory effect)

Question 14

the monoaminergic systems include:

Answer 14

dopaminergic pathways, noradrenaline, adrenaline, serotonin

Question 15

functions of the noradrenergic systems in the brain

Answer 15

arousal and mood - activity of the LC increases with behavioural arousal. Neurons respond more strongly to

Question 16

levels of control of motor movement

Answer 16

cerebral (highest level)
Subcortical - basal ganglia, thalamus, cerebellum
local control - spinal cord and brainstem

Question 17

Dopamine synthesis

Answer 17

Synthesised from Tyrosine.

Key enzymes - tyrosine hydroxylase (rate-limiting step) and L-amino acid decarboxylase (DOPA decarboxylase)

Question 18

locus coeruleus

Answer 18

most prominent cluster of noradrenergic neurons in the pons

Question 19

pre-cursor of serotonin (5-HT)

Answer 19

tryptophan

Question 20

Location of serotonin neurons and distribution of serotonin

Answer 20

raphe nuclei

Does not cross the BBB so is concentrated in the CNS

Question 21

Cranial nerves exiting at the jugular foramen

Answer 21

Ix, X, XI

Question 22

innervation of the parotid gland

Answer 22

glossopharyngeal nerve

Question 23

what type of hearing loss would be seen in viral labyrinthitis

Answer 23

sensorineural hearing loss

Question 24

cranial nerves involved inthe corneal reflex

Answer 24

trigeminal (afferent) and facial (efferent)

Question 25

nerves involved in the gag reflex

Answer 25

glossopharyngeal (afferent), vagus (efferent)

Question 26

type of epithelium located in the lateral ventricles

Answer 26

simple cuboidal epithelium with microvilli

Question 27

maximum score on GCS

Answer 27

15

Question 28

minimum score on GCS

Answer 28

3

Question 29

three categories on the GCS

Answer 29

Eye opening (4)
Best Motor response (6)
Verbal Response (5)

Question 30

locations of the brain associated with episodic memory

Answer 30

Extended limbic system - entorhinal cortex and hippocampus (medial temporal lobe), diencephalon
Dorso-lateral pre-frontal cortex - regulates the extended limbic system. Temporal organisation of episodic memory. Interacts with the extended limbic system

Question 31

Type 1 dopamine receptors and their role

Answer 31

D1 (most numerous in the body), D5
Can be excitatory - opening of sodium channels
Can be inhibitory via opening of potassium channels

Question 32

Type 2 dopamine receptors and their role

Answer 32

D2, 3, 4

usually inhibit their target neuron

Question 33

vertebral level where trachea begins and ends

Answer 33

C6-T4

Question 34

Alar ligament

Answer 34

connects the sides of the dens to tubercles on the medial side of the occipital condyles

Question 35

how would you distinguish the internal and external carotids anatomically?

Answer 35

internal does not give off any branches in the neck

Question 36

hallmarks of parkinson’s disease

Answer 36

prescence of neuronal inclusions - lewy bodies, and loss of dopamineric neurons from the pars compacta of the substantia nigra in the midbrain

Question 37

carbidopa

Answer 37

dopa decarboxylase inhibitor to reduce peripheral side effects of L-DOPA

Question 38

COMT inhibitor

Answer 38

prolongs action of L-DOPA by inhibiting action of COMT enzyme (normally breaks down dopamine)

Question 39

Selegiline

Answer 39

Monoamine oxidase inhibitor - reduces catabolism of dopamine in the brain