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First Aid STEP 1 - Neurology > Anatomy and Physiology > Flashcards

Anatomy and Physiology Flashcards

(110 cards)

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1
Q

What type of cell are neurons?

A

permanent cells that do NOT divide in adulthood

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2
Q

What organelle is NOT present in the axon of neurons?

A

RER

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3
Q

If an axon is injured, what type of generation occurs?

A

Wallerian degeneration = degeneration distal to the injury and axonal retraction proximally

This allows for potential regeneration of axon (if in PNS)

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4
Q

What is the function of astrocytes?

A 
physical support
repair
K+ metabolism
removal of excess neurotransmitter (NT)
component of BBB
glycogen fuel reserve buffer
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5
Q

If neural injury occurs, what is the response of astrocytes?

A

reactive gliosis

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6
Q

What are astrocytes derived from?

A

neuroectoderm

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7
Q

What is the function of microglia?

A

CNS phagocytes

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8
Q

What are microglia derived from?

A

mesoderm

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9
Q

HIV can infect what cell type?

A

HIV-infected microglia fuse to form multinucleated giant cells in the CNS

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10
Q

What is the function of myelin?

A

Wraps and insulates axons –> increases space constant and increases conduction velocity

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11
Q

What type of neurons are located in the CNS? PNS?

A

CNS - oligodendrocytes

PNS - Schwann cells

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12
Q

What myelinated the axons of neurons in the CNS?

A

oligodendroglia

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13
Q

What is the predominant type of glial cell in white matter?

A

oligodendroglia (1 cell can myelinated 30 axons)

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14
Q

What are oligodendroglia derived from?

A

neuroectoderm

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15
Q

What do oligodendroglia appear on H & E stain?

A

“fried egg” appearance

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16
Q

What diseases are associated with injury to the oligodendroglia?

A

Multiple sclerosis
progressive multifocal leukoencephalopathy (PML)
leukodystrophies

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17
Q

What disease destroys Schwann cells?

A

Guillain-Barre Syndrome

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18
Q

What tumor is associated with Schwann cells?

A

acoustic neuroma (type of schwannoma)

*If bilateral, strongly associated with neurofibromatosis type 2

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19
Q

What type of sense do Meissner corpuscles sense?
Where are they located?
What is their description?

A

Sense: dynamic, fine/light touch (position sense = proprioception)
Location: glabrous (hairless) skin
Description: large, myelinated fibers, adapt quickly

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20
Q

What type of sense do Pacinian corpuscles sense?
Where are they located?
What is their description?

A

Sense: vibration, pressure (e.g. monofilament test)
Location: deep skin layers, ligaments, and joints
Description: large, myelinated fibers, adapt quickly

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21
Q

What type of sense do Merkel discs sense?
Where are they located?
What is their description?

A

Sense: pressure, deep static touch (e.g. shapes, edges), position sense
Location: basal epidermal layer, hair follicles
Description: large, myelinated fibers, adapt slowly

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22
Q

What nerve fibers are slow and unmyelinated?

A

C fibers

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23
Q

What nerve fibers are fast and myelinated fibers?

A

A-delta fibers

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24
Q

What do free nerve endings sense?

A

pain and temperature

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25
What must be rejoined in microsurgery for limb reattachment?
perineurium (permeability barrier)
26
Match the location of the neurotransmitter synthesized in the following area of the brain: ``` locus ceruleus (pons) ventral tegmentum and SNc (midbrain) Raphe nucleus (pons, medulla, midbrain) Basal nucleus of Meynert nucleus accumbens ```
locus ceruleus (pons) - NE ventral tegmentum and SNc (midbrain) - DA Raphe nucleus (pons, medulla, midbrain) - 5-HT Basal nucleus of Meynert - ACh nucleus accumbens - GABA
27
What NTs decrease in depression?
NE DA 5-HT
28
What NTs increase in anxiety?
NE
29
What NTs decrease in anxiety?
5-HT | GABA
30
What NT changes are seen in Parkinson's disease?
decrease in DA increase in 5-HT increase in ACh
31
What NT changes are seen in Hungtington disease?
increase in DA decrease in ACh decrease in GABA
32
What 3 structures form the BBB?
1. tight junctions b/t nonfenestrated capillary endothelial cells 2. basement membrane 3. astrocyte foot processes
33
What 3 structures form the BBB?
1. tight junctions b/t nonfenestrated capillary endothelial cells 2. basement membrane 3. astrocyte foot processes
34
How do glucose and amino acids cross the BBB?
slowly by carrier mediated transport
35
How do nonpolar/lipid-soluble substances cross the BBB?
rapidly via diffusion
36
What is the function of the BBB?
helps prevent bacterial infection from spreading into the CNS restricts drug delivery to brain
37
Infarct and/or neoplasm destroys endothelial cell tight junctions and results in what pathology?
vasogenic edema
38
What is the function of the hypothalamus?
TAN HATS ``` Thirst and water balance Adenohypophysis control Neurohypophysis releases hormones produced in the hypothalamus Hunger Autonomic regulation Temperature regulation Sexual urges ```
39
What are the 2 inputs of the hypothalamus (areas not protected by the BBB)?
OVLT (organum vasculosum of the lamina terminalis - senses changes in osmolarity) area pastrema (responds to emetics)
40
What are the 2 inputs of the hypothalamus (areas not protected by the BBB)?
OVLT (organum vasculosum of the lamina terminalis - senses changes in osmolarity) area postrema (responds to emetics)
41
What does the lateral area of the hypothalamus control? What happens if this area is destroyed? What stimulates or inhibits it?
Controls hunger Destruction --> anorexia Inhibited by leptin *If you zap your LATERAL nucleus, you shrink LATERALly
42
What does the ventromedial area of the hypothalamus control? What happens if this area is destroyed? What stimulates or inhibits it?
Controls satiety Destruction (e.g. craniopharyngioma) --> hyperphagia Stimulated by leptin *If you zap your VENTROMEDIAL nucleus, you grow VENTRALly and MEDIALly.
43
What does the anterior area of the hypothalamus control? What happens if this area is destroyed? What stimulates or inhibits it?
Controls cooling and parasympathetics *Anterior nucleus = cool off (cooling, and pArasympathetic) A/C = anterior cooling
44
What does the posterior area of the hypothalamus control? What happens if this area is destroyed? What stimulates or inhibits it?
Controls heating and sympathetics *If you zap your posterior hypothalamus, you become a poikilotherm (cold-blooded, like a snake)
45
What does the suprachiasmatic nucleus (SCN) area of the hypothalamus control? What happens if this area is destroyed? What stimulates or inhibits it?
controls circadian rhythm
46
What drives the sleep cycle?
the circadian rhythm which is driven by the SCN of the hypothalamus
47
What regulates the SCN?
the environment (e.g. light)
48
What is the pathway for secreting melatonin from the pineal gland?
SCN --> releases NE --> pineal gland --> releases melatonin
49
What are the two stages of sleep?
REM and non-REM sleep
50
What decreases REM sleep?
alcohol benzodiazepines barbiturates NE
51
When does bedwetting, night terrors, and sleepwalking occur?
Stage N3 of Non-REM sleep
52
What is one treatment for bedwetting?
oral desmopressin acetate (DDAVP) - mimics ADH
53
What is one treatment for night terrors and sleepwalking?
benzodiazepines
54
What stage of the sleep cycle does bruxism occur?
Stage N2 of Non-REM sleep
55
During what stage of the sleep cycle do you have variable pulse and BP?
REM sleep
56
During what stage of the sleep cycle do you have dreaming, penile/clitoral tumescence, and possibly memory processing?
REM sleep
57
What is the order of the sleep cycle stages and what are their EEG waveforms?
``` Awake (eyes open) - beta Awake (eyes closed) - alpha Non-REM sleep Stage N1 - Theta Stage N2 - Sleep spindles and K complexes Stage N3 - Delta REM sleep - Beta ``` *At night, BATS Drink Blood.
58
Where does ADH originate from in the brain?
supraoptic nucleus in the hypothalamus
59
Where does oxytocin originate from in the brain?
paraventricular nucleus in the hypothalamus
60
What is the function of the thalamus?
major relay for all ascending sensory information except olfaction
61
What is the input, info, and destination for the VPL of the thalamus?
input: spinothalamic and dorsal columns/medial lemniscus info: pain and temperature, pressure, touch, vibration, and proprioception destination: primary somatosensory cortex
62
What is the input, info, and destination for the VPM of the thalamus?
input: trigeminal and gustatory pathway info: FACE sensation and taste destination: primary somatosensory cortex * "M"akeup goes on the FACE (VP"M")
63
What is the input, info, and destination for the LGN of the thalamus?
input: CN II info: vision destination: calcarine sulcus * Lateral = Light
64
What is the input, info, and destination for the MGN of the thalamus?
input: superior olive and inferior colliculus of tectum info: hearing destination: auditory cortex of temporal lobe * Medial = Music
65
What is the input, info, and destination for the VL of the thalamus?
input: basal ganglia, cerebellum info: motor destination: motor cortex
66
What is the function of the limbic system?
Collection of neural structures involved in emotion, long-term memory, olfaction, behavior modulation, and ANS function
67
What are the structures in the limbic system?
hippocampus, amygdala, fornix, mammillary bodies, and cingulate gyrus
68
What is a helpful pneumonic to remember the functions of the limbic system?
The famous "4 F's" ``` Feeding Fleeing Fighting Feeling Sex ```
69
What is the function of the cerebellum?
modulate movement | coordination and balance
70
What are the deep nuclei of the cerebellum?
lateral --> medial Dentate, Emboliform, Globose, Fastigial *Don't Eat Greasy Food
71
What physical findings are seen with a lateral lesion to eh cerebellum?
decreased movement of extremities (propensity to fall towards injured IPSILATERAL side)
72
What are findings seen with a medial lesion of the cerebellum?
truncal ataxia, nystagmus, and head tilting, wide based (cerebellar) gait, deficits in tranquil coordination Typically bilateral motor deficits
73
What disease is associated with degeneration of the CNS, Lewy bodies, and loss of DA neurons?
Parkinson disease
74
What is the main component of Lewy bodies in Parkinson disease?
alpha-synuclein
75
Where is the location of the dopaminergic neurons affected in Parkinson disease?
substantia nigra pars compacta
76
What are physical symptoms of Parkinson disease?
*Parkinson "TRAPS" your body ``` "T"remor (at rest - pill rolling tremor) cogwheel "R"rigidity "A"kinesia "P"ostural instability "S"huffling gait ```
77
What are the genetics associated with Huntington disease?
AD | trinucleotide repeat disorder (CAG) on chromosome 4
78
What are physical symptoms of Huntington disease?
choreiform movements aggression depression dementia
79
What are the NT changes seen in the brain in Huntington disease?
decrease in GABA and ACh
80
What lesion can be seen in the brain of Huntington disease?
atrophy of the caudate nuclei
81
A lesion to the contralateral sub thalamic nucleus (e.g. lacunar stroke) would result in what movement disorder?
hemiballismus (sudden, wild flailing of 1 arm +/- ipsilateral leg)
82
A lesion to the basal ganglia (e.g. Huntington disease) will result in what movement disorder?
chorea (sudden, jerky, purposeless movements) AND athetosis (slow, writhing movements - esp. in the fingers)
83
Myoclonus can commonly be seen in which diseases?
renal and liver failure
84
What is an essential tremor (postural tremor)?
action tremor, exacerbated by holding posture/limb position
85
What are treatments for essential tremors?
beta-blockers or primidone Others self-medicate with EtOH
86
What is an intention tremor?
slow, zigzag motion when pointing/extending toward a target Often seen with cerebellar dysfunction
87
What is a consequence or a lesion to the amygdala? Are there are associated diseases with this lesion?
Kluver-Bucy Syndrome (hyperorality, hypersexuality, disinhibited behavior) Assoc. with HSV-1
88
What is a consequence or a lesion to the frontal lobe? Are there are associated diseases with this lesion?
Disinhibition and deficits in concentration, orientation, and judgement
89
What is a consequence or a lesion to the right parietal-temporal cortex? Are there are associated diseases with this lesion?
Spatial Neglect Syndrome (agnosia of the contralateral side of the world)
90
What is a consequence or a lesion to the left parietal-temporal cortex? Are there are associated diseases with this lesion?
agraphia, acalculia, finger agnosia, and left-right disorientation
91
What is a consequence or a lesion to the reticular activating system (midbrain)? Are there are associated diseases with this lesion?
reduced levels of arousal and wakefulness
92
What is a consequence or a lesion to the mammillary bodies (bilateral)? Are there are associated diseases with this lesion?
Wernicke-Korsakoff Syndrome (confusion, ataxia, memory loss, confabulation, personality changes) Assoc. with thiamine (B1) deficiency and excess EtOH use; can be precipitated by giving glucose without B1 to a B1-deficient patient
93
What is a consequence or a lesion to the basal ganglia? Are there are associated diseases with this lesion?
tremor at rest, chorea, or athetosis Assoc. with Parkinson disease
94
What is a consequence or a lesion to the cerebellar hemisphere? Are there are associated diseases with this lesion?
intention tremor, limb ataxia, and loss of balance IPSILATERAL deficits --> fall towards side of lesion *Cerebellar hemispheres are LATERALly located - affect LATERAL limbs
95
What is a consequence or a lesion to the cerebellar vermis? Are there are associated diseases with this lesion?
truncal ataxia and dysarthria *Vermis CENTRALly located - affect CENTRAL body
96
What is a consequence or a lesion to the sub thalamic nucleus?
contralateral hemiballismus
97
What is a consequence or a lesion to the hippocampus (bilateral)?
anterograde amnesia
98
What is a consequence or a lesion to the paramedic pontine reticular formation?
eyes look away from side of lesion
99
What is a consequence or a lesion to the frontal eye fields?
eyes look toward lesion
100
What are the physical findings in central pontine myelinolysis?
acute paralysis, dysarthria, dysphagia, diplopia, and loss of consciousness
101
What is the pathogenesis of central pontine myelinolysis?
massive axonal demyelination in pontine white matter tracts secondary to osmotic forces and edema (a result of overly rapid correction of HYPOnatremia)
102
What tracts are affected by central pontine myelinolysis?
corticospinal and corticobulbar tracts
103
What is a helpful pneumonic to remember whether central pontine myelinolysis will occur or cerebral edema will occur d/t Na+ correction?
"From low to high, your pons will die" (CPM) "From high to low, your brain will blow" (cerebral edema/herniation)
104
What are signs of Broca aphasia?
nonfluent aphasia with INTACT comprehension Broca area - inferior frontal gyrus of FRONTAL LOBE
105
What are signs of Wernicke aphasia?
fluent aphasia with IMPAIRED comprehension and repetition Wernicke area - superior temporal gyrus of TEMPORAL LOBE
106
What are signs of global aphasia?
NONFLUENT aphasia with IMPAIRED comprehension Both Broca and Wernicke areas affected
107
What are signs of conduction aphasia?
poor repetition but fluent speech, intact comprehension Can be caused by damage to left superior temporal lobe and/or left supramarginal gyrus *Can't repeat phrases such as, "No ifs, ands, or buts."
108
What are signs of transcortical motor aphasia?
nonfluent aphasia with good comprehension and repetition
109
What are signs of transcortical sensory aphasia?
fluent speech and repetition with POOR comprehension
110
What are signs of mixed transcortical aphasia?
confluent speech, poor comprehension, good repetition

First Aid STEP 1 - Neurology (6 decks)

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