BBEOYS7 Flashcards
Which part of the brain has decreased activation in schizophrenia?
Orbitofrontal prefrontal
Dorsolateral prefrontal
Medial prefrontal
Posterior parietal
Which part of the brain has decreased activation in schizophrenia?
Orbitofrontal prefrontal
Dorsolateral prefrontal
Medial prefrontal
Posterior parietal
Patients with schizophrenia have reduced number of which cells
Microglial
Astrocytes
Ependymal
Oligodendrocytes
Schwann cells
Oligodendrocytes:
Key molecules regulating myelination are differentially expressed in SCH (e.g. neuregulin 1 – which is also a genetic hit)
Describe the histopathological changes that occur in MS [3]
- Perivenular inflammation
- Demyelination: ingested by macrophages
- Gliosis (axons replaced by scar tissue)
Describe the approaches of treatment for MS [2]
Immunomodulatory/immunosuppressant:
* Mainstay of traditional treatment
* dampens down the immune system
Induction therapy
* “Reset” the immune system
* Higher risk (in the short term)
* Long-lasting disease remission off treatment
genes associated with schizophrenia
Describe the role of neuregulin 1, DISC 1 and dysbindin [3]
Neuregulin 1 – involved in synaptic plasticity and myelination
Dysbindin – may affect dopamine D2 receptor levels and glutamate and GABA transmission
DISC1 – associated with neurodevelopment and also signalling in corticolimbic areas
Describe the structural changes of brain in schizophrenia patients [3]
Larger ventricles and
smaller mesial temporal lobe structures:
- Ventricular enlargement is around 25%
- Overall reduction in brain volume of around 2%
- Greater reduction in grey matter compared to normal populations
Failure to properly pass the Wisconsin Card Sorting Test would indicate dysfunction of which brain lobe? [1]
What does Wisconsin Card Sorting Test test? [1]
Frontal lobe dysfunction
assess preservation and abstract thinking in subjects
Pathophysiology of schizophrenia
Describe the impact of schizophrenia on synaptic pathways [2]
Neurodevelopmental link:
Associated with decreased synaptic spines and decreased dendritic complexity in the cortex
This occurs due to abnormalities in the formation and maturation of brain circuits
C
Dopaminergic pathways in the central nervous system
Describe the effect of SCH on mesocortical and mesolimbic patients
Mesolimbic is hyperactive
Mesocortical is hypoactive
Parkinson’s Disease sees a particular degeneration of which of the following:
locus coeruleus
raphe nucleus
thalamus
periaqueductal gray
locus coeruleus
Hallmark of PD !
Looking at the axial CT images carefully, you see mass which has taken up the contrast and appears bright. Which of these cerebral cortical regions does this mass overlie?
Prefrontal cortex
Auditory cortex
Primary motor cortex
Visual cortex
Looking at the axial CT images carefully, you see mass which has taken up the contrast and appears bright. Which of these cerebral cortical regions does this mass overlie?
Prefrontal cortex
Auditory cortex
Primary motor cortex
Visual cortex
According to a colleague of Marina - Lydia - who witnessed the event, the seizure was preceded by abnormal, repetitive movements. Looking again at the coronal view of the CT brain (below) and recalling the motor homunculus, in which body part would these abnormal movements most likely be observed:
Right face
Left face
Right upper limb
Left upper limb
RIght lower limb
Left lower limb
According to a colleague of Marina - Lydia - who witnessed the event, the seizure was preceded by abnormal, repetitive movements. Looking again at the coronal view of the CT brain (below) and recalling the motor homunculus, in which body part would these abnormal movements most likely be observed:
Right face
Left face
Right upper limb
Left upper limb
RIght lower limb
Left lower limb
The mass is probably closest to the upper limb region of the primary motor cortex. The lower limb is represented more medially and the face is represented more laterally.
Of course, the problem is in the right hemisphere, so this will manifest on the left side peripherally.
Clinically, this phenomenon of abnormal, unprovoked sensorimotor activity is known as a focal or partial seizure, and reflects involvement of distinct funtional areas of cortex.
A 70-year-old male presented to the emergency department complaining of blurred vision on his right eye. CT angiogram shows an embolus on the right ophthalmic artery. By which route would an embolus most likely reach the ophthalmic artery?
A. Internal carotid canal – foramen rotundum – cavernous sinus to medial anterior clinoid process
B. Internal carotid canal – foramen lacerum – cavernous sinus to medial anterior clinoid process
C. Internal carotid canal – foramen lacerum – cavernous sinus lateral to anterior clinoid process
D. Internal carotid canal – foramen spinosum – cavernous sinus medial to anterior clinoid process
A 70-year-old male presented to the emergency department complaining of blurred vision on his right eye. CT angiogram shows an embolus on the right ophthalmic artery. By which route would an embolus most likely reach the ophthalmic artery?
A. Internal carotid canal – foramen rotundum – cavernous sinus to medial anterior clinoid process
B. Internal carotid canal – foramen lacerum – cavernous sinus to medial anterior clinoid process
C. Internal carotid canal – foramen lacerum – cavernous sinus lateral to anterior clinoid process
D. Internal carotid canal – foramen spinosum – cavernous sinus medial to anterior clinoid process
Thalamus: lies either side of the []
Thalamus: lies either side of the lateral ventricles
Which of the following thalamic nuclei is involved with memory
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with memory
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from cerebellum
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from cerebellum
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from basal ganglia
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with motor input from basal ganglia
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with touch, pain, pressure & proprioception
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
Which of the following thalamic nuclei is involved with touch, pain, pressure & proprioception
Lateral geniculate nucleus (LGN)
Medial geniculate nucleus (MGN)
Ventral posterior lateral nucleus (VPL)
Anterior nucleus (A)
Ventral lateral nucleus (VL)
Ventral anterior nucleus (VA)
The epithalamus has two main components. What are they? [2]
Pineal gland
Habenular nuclei
Habenular
Which structure is the arrow pointing?
Thalamus
Global pallidus
Internal capsule
Caudate nucleus
Putamen
Which structure is the arrow pointing?
Thalamus
Global pallidus
Internal capsule
Caudate nucleus
Putamen
Which structure is the arrow pointing?
Thalamus
Global pallidus
Internal capsule
Caudate nucleus
Putamen
Which structure is the arrow pointing?
Thalamus
Global pallidus
Internal capsule
Caudate nucleus
Putamen
Which of the following is the tonsil
A
B
C
D
E
Which of the following is the tonsil
A
B
C
D
E
Which of the following is the floccus
A
B
C
D
E
Which of the following is the floccus
A
B
C
D
E
Which of the following is the periosteum
A
B
C
D
E
E
Where is the danger triangle of the face? [1]
Explain why this region is called the danger triangle [2]
The angular and ethmoidal veins drain this region of the face into the opthalmic veins which drain into the cavernous sinus.
This provides a potential route of infection from the nasal area to the brain, causing cavernous sinus thrombosis, meningitis or brain abscess.
What type of clinical imaging has been used in this case?
X-ray
CT
MRI T1
MRI T2
Ultrasound
MRI T2
T2 is generally the more commonly used, but T1 can be used as a reference for anatomical structures or to distinguish between fat vs. water bright signals.
T2 – TWO tissues are bright: fat and water (WW2 – Water is White in T2)
Cerebral aquaduct
Acute blood shows up brighter on which type of scan.
X-ray
CT
MRI T1
MRI T2
Ultrasound
CT
Which vessel is most likely to have ruptured?
Left anterior cerebral artery
Right anterior cerebral artery
Left middle cerebral artery
Right middle cerebral artery
The right middle cerebral artery is the most likely to have ruptured in this scenario, as this travels out laterally to supply the lateral region of the cortex.
What symptoms might the patient experience? [2]
The haemorrhage is in the region of the right middle cerebral artery
Left-sided upper limb paraesthesia and left-sided upper limb weakness.
Aphasia is less likely in this case, as Broca’s area (responsible for expressive speech) is most commonly found on the left hemisphere, along with Wernicke’s area (responsible for receptive speech).
Which bone is fractured? [1]
Acceptable responses: temporal bone, right temporal bone, temporal, right temporal
