Neuro Flashcards
(208 cards)
1
Q
What are emergent properties of the brain
A
properties of whole system but not individual components e.g. consciousness
2
Q
what is neocortex and paleocortex involved in
A
neocortex - higher thinking
paleocortex - memory and emotion
3
Q
what is septum pellucidum
A
separates anterior lateral ventricles
4
Q
where is limbic system. what it contains. involved in?
A
under cerebrum. contains amygdala, hippocampus, fornix etc.
5 F’s - fighting, fleeing, feeding, feeling, fucking
5
Q
where is the calcarine sulcus
A
occipital lobe
6
Q
where is lateral sulcus
A
between temp and parietal lobe
7
Q
where is insular cortex and what involved in
A
deep folding inside lateral sulcus. consciousness, emotion, homeostasis
8
Q
what is corona radiata of brain
A
sheet of axons from and to cerebrum
9
Q
what is caudate nucleus and function
A
part of basal ganglia. voluntary movement
10
Q
where is basal ganglia and what consist of
A
below cerebrum and surrounds thalamus. corpus striatum + substantia nigra + subthalamic nuclei
11
Q
what is corpus striatum
A
globus pallidus and (neo)striatum
12
Q
what separates L and R cerebellum and cerebri
A
falx cerebri, falx cerebelli
13
Q
what separates cerebrum from cerebellum. What coonects the 2 cerebral hemispheres
A
corpus callosum and anterior and posterior white commussures
tentorium cerebelli
14
Q
what is striatum
A
caudate nucleus + putamen
15
Q
what is cerebellum peduncle
A
connecs cerebellum to mid brain. Sup, mid and inf fibres per hemisphere of cerebellum
16
Q
what is forebrain and brainstem
A
forebrain - cerebrum, thalamus, hypothalamus
brainstem - midbrain, hindbrain (pons, medulla, cerebellum)
17
Q
give venous sinuses of brain
A
see book
sup and inf sagittal, straight, confluence, transverse, sigmoid, IJ vein
18
Q
what is conus medullaris
A
Taper end of T12-L1
19
Q
what is filum terminale
A
strand of fibrous tissue from apex of conus medullaris to end of vertebral foramen
20
Q
where lumbar puncture and in kids
A
L3/4
kids - L5/S1
21
Q
where is SG and what is contained
A
lamina 2
contains - C fibres, lissauers fibres synapsing
22
Q
what is ataxia and apraxia
A
ataxia - loss of full control of body movements
apraxia - unable to perform complex movements
23
Q
what is aphasia, aphonia, dysarthria
A
aphasia - speech disorder
aphonia - physical inability to produce sound
dysarthria - disruption of articulation of speech
24
Q
what is chorea
A
involuntary jerks e.g. huntingtons
25
what is spasticity vs rigidity
spasticity is unidirectional, velocity and amplitude dependent
spasticity = corticospinal tract damage
rigidity = extrapyramidal lesion
26
how detect spina bifida before birth
alpha fetoprotein in blood, USS
27
types of spina bifida
occulta - just vertebrae
meningocoele - meningele involvement
myelomeningocoele - neural tissue outside body
28
symptoms of spina bifida
bladder conrol, orthopedic issues, pressure sores, weakness in lower limbs
29
what is rachischisis
posterior neuropore fails to close resulting in motor and sensory deficits
30
how treat hydrocephalus and symptoms
treat with shunt (jugular)
| symptoms - tunnel vision, headaches, convulsion, vomiting
31
parts of neural tube and what they become
prosencephalon - telencephalon (cerebrum) and dienceph (thalamus)
mesenceph - mesenceph (midbrain)
rhombenceph - metenceph (pons) and myelenceph (medulla)
Tell Di Mes Met My
32
label ventricles
see book
| 3rd, 4th, lateral, cerebral aqueduct, IV foramen
33
what does alcohol effect in neuroembryology
neural crest cell migration
34
what is hirschprungs diseasse
lack of ganglions in large intestine, therefore no function
35
astrocyte functions
BBB, removes neurotransmitters, nutrients to neurones
36
function of microglia
phagocytose material and debris. APC
37
what is BBB made of
tight endothelial junction, astrocyte foot process, basement membrane
38
types of neurotransmitters
AAs e.g. GABA, glycine, glutamate
biogenic amines e.g. dopamine, 5-HT, histamine
peptides e.g. dynorphin, CCK
39
is glutamate excitatory or inhibitory. what receptor types are there
excitatory
ionotropic and metabotropic
ionotropic - AMPA, kainate, NMDA
40
how does LTP occur and what happens in LTP
calcium goes through mGluRs or NMDAR.
| Upregulation of AMPARs
41
where is gaba found. what ions does it let in
Cl-
| found in spinal cord and brainstem
42
dopamine pathways and function
nigrostriatal - motor control (parkinsons)
mesolimbic and mesocortical - mood, arousal and reward (schizophrenia)
tuberoinfundibular - prolactin release and endocrin function
43
serotonin pathway function
sleep, wakefulness, mood, vomiting
44
label circle of willis
see book
| ant post comm, ant mid post cerebral, ICA, sup ant inf post inf cerebellar, pontine, basilar, ant spinal, vertebral
45
what supplies spinal cord blood
anterior spinal, paired post spinal, anatastamoses between arteries (arterial vasocorona). Artery of ademkiewicz (thoracolumbar)
46
what arteries supplies cerebrum
outside cerebrum middle cerebral artery does majority of ant cerebrum
sagittal view - anterior cerbral artery does majority of ant cerebrum
posterior cerebral always does posterior section
47
symptoms of sub acute hemorrhage and cuases
thunderclap headache, rapid onset, vomiting, confusion, decrease consc
causes - trauma, cerebral aneurysm rupture in circle of willis
48
what removes and adds CSF
remove - arachnoid granulations at sup saggital sinus
| add - ependymal cells of choronoid plexus
49
how many mls of CSF are there and how much produced per day
500 ml per day
| 125 mls of CSF
50
what is communicating hydrocephalus? causes
impaired csf resborp without csf flow obstruction
| caused by scarring of arachnoid granulations
51
cause of non comm hydrocephalus
obstruction
52
csf composition
decrease glucose, ca, protein
| increase na, mg, cl than blood
53
list what CNs go through what foramina
```
cribiform plate - 1
optic canal - 2
SOF - 3, 4, 5a, 6
foramen rotundum - 5b
foramen ovale - 5c
IAM - 7,8
jugular foramen - 9-11
hypoglossal canal - 12
```
54
what does pacinian, merkels, meissners, and riffini sense
riffini - temp
pacinian - pressure
merkels - press, vibration, texture
meissners - touch and vibration
55
what receptors are in muscle. what they sense
muscle spindle proprioceptor = length
| golgi tendon organs = tension
56
how is stronger stimuli recognised by receptors
increase AP frequence and activation of neighbour cells
57
difference between tonic and phasic receptors
tonic - slow adapting, continual firing
| phasic - fast, desensitises
58
how is acuity achieved in sensation
lateral inhibition and divergence
| convergence decreases acuity
59
what factors affect 2 point discrimination
size of receptor field and density of sensory receptors
60
where does sensation go after nerve stimulated
to somatosensory cortex on post central gyrus
61
what is perception
sense stimuli and discriminate between different types
62
what happens in a sensory cortex lesion
lose 2 point discrimination, epileptic event
63
how orientate spinal cord
dorsal median sulcus and ventral median fissuer
64
modality of ascending nerves
dorsal column - light touch and conscious proprioception
spinothalamic lateral - pain and temp
spinothalamic ant - crude touch
spinocerebellar ant - golgi tendon (tension), unconscious
spinocerebellar post - muscle spindle (length), unconscious
65
what 2 fascicles make up dorsal column and where are they positioned. where do they start
gracile and cuneate (t6 start)
| gracile is medial (sacrolumbar), cuneate lateral (cervicothoracic)
66
describe route of dorsal column
DRG (1) to cuneate and gracile nuclei in medulla (2), then decussates (internal arcuate fibre) and becomes medial lemniscus fibres in pons, then to ventral posterolateral nucleus in thalamus (3), then to post central gyrus
67
route of spinothalamic
ascends 1-2 spinal levels in lissauers fasciculus, then dorsal horn in SG(1) and decussates (via anterior white commissure) to thalamus (2) to sensory cortex (3)
68
what type of neuron is used in the 1st order for sensory pathways
pseudounipolar
69
route of spinocerebellar ant
DRG (1) then decussates in spinal cord (via anterior white commissure) then up to pons and decussates again then to cerebellum.
70
route of spinocerebellar post
DRG (1) then synapse with clarkes nucleus in dorsal horn (2) to cerebellum
71
modality of descending nerves inc extrapyramidal. damage to vestibular spinal?
lateral corticospinal - limb
anterior corticospinal - axial
corticobulbar - face and neck muscles
extrapyramidal:
ruberospinal - voluntary skeletal contraction
reticulospinal - posture and locomotion
tectospinal - automatic reactions to visual and auditory stimuli
vestibularspinal - posture maintenance. damage = loss of righting reflex and posture instability
72
route of corticospinal
lateral - motor cortex to internal capsule to medulla and decussate then to ventral horn
anterior - same but decussates at ventral horn
73
route of corticobulbar
motor cortex to internal capsul to motor nuclei of cranial nerves bilaterally
74
what is syringomyelia
cyst forms in spinal cord causing pain, paralysis, weakness
75
explain brown sequard syndrome
hemilateral lesion of spinal cord - loss of ipsilateral dorsal column therefore ipsilateral proprioception and ifne touch (no decussation). Loss of counterlateral pain and temp due to spinothalamic decussation.
76
what is friedrichs ataxia
sclerosis and degen of DRG, spinocerebellar, corticospinal, and dorsal columns. progressive
77
what is shingles symptoms
increased sensitivity and rash. dormant in DRG. can lead to post herpetic neuralgia and chronic pain.
78
anatomy of cerebellum
see book
| vermis, ant lobe, post love, flocculonodular love
79
give function of cerebellar parts
spinocerebellum - vermis - error correction
vestibulocerebellum - follculonodular lobe - balance and ocular reflexes
cerebrocerebellum - lateral parts - movement planning and motor learning
80
what happens in damage to cerebellum and vermis
vermis damage - fall backwards
| cerebellum damage - fall and decrease coordination on ipsilateral side
81
UMN lesion signs
increase reflex, tone, spasticity, rigidity, chorea (extrapyramidal), babinski (pyramidal)
82
LMN lesion signs
atrophy, fasciculations, paralysis
83
where are cell bodies of LMNs found in what lamnia
8 and 9
84
what is a motor unit
motoneurone and muscle fibre it supplies
85
define stretch reflex
involuntary, unlearned, repeateable, automatic reaction to a specific stimulus which doesnt require brain intact
86
components of stretch reflex
strech receptor, affereent fibre, integration centre, efferent fibre, effector
87
muscle tone in newborn
suppressed to aid birth
88
extrapyramidal lesion signs
akathisia (muscle restlessness), spasm, parkinsonian. Way that movements are carried out
89
parkinsonian symptoms
tremor (pill rolling), cog wheel rigidity, postural instability, mask like expression, bradykinesia, shuffling gait
90
decorticate and decerebrate
decorticate - mummy. damage to cerebrum, mid brain, thalamus, internal fibres poss
decerebrate - full exntension. brainstem damage
91
why fasciculations occur in LMN lesion
hypersensitive ACh receptors
92
what is spinal shock
damage to descending tracts leads to areflexia and flaccid which then become UMN signs. Due to release of GABA in damage
93
what symptoms of cerebellar dysfunction
DANISH
| dysdiadochokinasia, ataxia, nystagmus, intention tremor, scanning dysarthria, hypotonia + heel shin positivity test
94
what romberg test and what positive meants
tests proprioception of lower body. suggests cerebellar damage
95
Thalamic nuclei
VPL - spinothalamic and dorsal column
VPM - trigeminal - Face sensation and taste - Makeup on Face
LGN - Cn2 - vision - lateral = light
MGN - Hearing - Medial = music
VL - cerebellum and basal ganglia - Motor
96
hypothalamic functions
TANHATS
Thirst and water balance, ant pit regulation, neural hormone release, hunger, autonomic regulation, temp regulation, sexual urges
97
what is the cause of parkinsons
nigrostriatal and SN degeneration
98
what is nociception
percetion of pain
99
how does pain thershold and tolerance vary for people
threshold same, tolerance varies
100
stages of nociception
transduction - activation of fibres
transmission - to CNS
modulation - CNS or other peripheral nerves can inhibit
perception
101
what type of pain does Adelta and C fibre feel
Adelta - mechanical
| C - mechanical, thermal, chemical
102
properties of adelta and c fibre
a delta - sharp, stabbing, well localised, lower threshold, withdrawal reflex
C - burning, throbbing, poorly localised, higher thershold, tissue damage ongoign
103
how is cerebellum mostly damaged and what is parkinsons damage of
parkinsons damage to extrapyramidal
| cerebellum - tumours and strokes
104
through what lamina do adelta C and visceral fibres travel
adelta - 1, 5
C - 1, 2 and 5
visceral - 5
105
explain process of pain transduction
damage to tissue releases K, prostaglandins, serotonin, bradykinin and activates nociceptor. AP occrs and substance P is released. Substance P releases histamine from mast cells
106
how do NSAIDs and steroids act as analgesics
NSAIDs inhibit prostaglandins
| steroid inhibit IL
107
explain pain modulation
gate control theory. Endorphins reduce nociception
| Periaqueductal grey matter in midbrain projects to nucleus raphe magnus and both mediate pain.
108
define chronic pain
>3 mths and no ongoing tissue damage.
109
define hyperalgesia and allodynia
allodynia - non painful stimulus = pain
| hyperalgesia - lowered threshold to pain.
110
explain process of winding up
repeated nociceptor stimulation leads to upregulation of neurones (reduced threshold and increased receptive field). Also change in somatosensory mapping
111
chronic pain types
nociceptive, neuropathic, visceral, FMS (fibromyalgia)
112
what is neuropathic pan. tgive example
sponteanous, shooting, pins and needles. not responsive to opioids.
e.g. phantom limb
113
what is complex regional pain syndrome type 1 and 2
type 1 - no identifiable lesion
| type 2 - lesion
114
What is complex regional pain syndrome. give stages 1 to 3
severe continous burning pain.
1 - acute
2 - thickening skin. muscle atrophy. odema
3 - limited ROM. contractures. waxy skin
115
function of opioid receptor
close vocc, open K, inhibit cAMP and neurotransmission
116
give the 3 types of endorphin receptors and the associated endorphin
MOP - endomorphin
KOP - dynorphin
DOP - enkephalin
117
give exmaple of strong and weak opioid
strong - fentanyl, morphine
| weak - codein
118
what is WHO pain ladder
1) non opioid e.g. paracetemol or NSAID, adjuvant
2) weak opioid +/- adjuvant
3) strong opioid +/- adjuvant
119
how treat central pain
antidepressant, AED, anasthetic, opioid
120
what causes inner ear deafness
teratogneic agents and infections e.g. rubella
121
what is coloboma and what causes
hole in structyure of eye. caused by fialure of optic stalk to fuse
122
give optic tract anatomy
see book
| optic nerve to chiasm to tract to LGN to radiation
123
what happens in full lesion of optic radiation, temporal lesion and nasal lesion?
full - homonymous hemi
temporal - homonymour superior quadrantanopia
nasal - homonymous inferior quadrantanopia
124
what happens in midline lesion of optic chiasm
bitemporal hemianopia
125
what is meyers loop
temporal part of optic radiation
126
properties of rods and cones
rods - dark, not in fovea, converge on bipolar
127
what are the neurons in the eye
photoreceptors, interneurons, ganglion cells
128
give types of interneurons and their function
interneurons combine photoreceptor signals
| bipolar, horizontal, amacrine
129
what is the magnocellular and parvocellular cells
both in LGN. Magno responsible for resolving motion and outlines. Parvo responsible for colour contract
130
give sign of fovea hyperplasia
nystagmus
131
what is amblyopia and give causes
decreased vision in 1 eye due to disuse in childhood
cause - strabismus (inability to focus both eyes on a object), anisometropia (refractive diff in both eyes), deprivation e.g. ptosis or cataracts
132
give types of strabismus and lesion causing
esotropia - inwards. CN 6 palsy
exotropia - outwards
hypertropia - upwards. CN 4 palsy
133
how treat amblyopia
glasses or eyepatch
134
waht is glaucoma
increased intraocular pressure poss cause opitic nerve damage or peripheral field defect
135
what is function on inner and outer hair cells of ear. where is high and low frequency heard
outer - amplification
inner - sense
high frequency at base, low at apex
136
how does AP in hair cells occur
bending of stereocilia opens K channels leading to depolarisation and calcium influx and neurotransmitter release to spiral ganglia neurones (afferents axons of CN 8)
137
what is function of olivocochlear system
regulates outer hair amplification
138
how is sound localised
delays and difference in volume between left and right ear
139
how are loud sounds transmitted
increase AP and recruitment of neighbour cells
140
give auditory pathway
cochlear nerve to cochlear nucleus to olivary nucleus to colliculus to MGN to auditory cortex
141
give causes of hearing impairment
congenital, age, infection, gentamicin, loud noise
142
how treat hearing loss
hearing aid or cochlear implant
143
what artery casues most strokes
mid cerebral
144
what does the PCA feed
occipital, midbrain, thalamus, half temporal
145
define stroke and TIA
stroke - poor blood flow to brain over 24 hours symptoms
| TIA -
146
symptoms of temporal lobe stroke
tsate and smell, memory, superior quadrantanopia, wernickes aphasia
147
what is wernickes and brocas aphasia
wenickes - problem comprehending
| brocas - problem talking
148
parietal lesion symptoms
speech, sensation, inferior quadrantanopia
149
symptoms of lacunar stroke
pure motor, sensory, sensorimotor, ataxic, hemiparesis
150
what structures involve din a POCS
brainstem, cerebellar, occipital
151
how investigate and treat stroke
ct or mri
| treat alteplase
152
how can spinal cord blood supply be damaged and symptoms
cause - vasculitis, sickle cell, hypotension
| symptoms - spinal shock, motorsymptoms
153
what is flaccid and reflex bladder. where is lesion
flaccid - lesion below T12. LMN
| reflex - T12 or above. UMNL
154
how manage head trauma or loss of conscious
ABCD, history, exam
| O2, if hypo IV glucose
155
what is function of reticular activating system. affected by?
regulates sleep wake cycle
| affected by alcohol, senses, drugs, parkinsions, schizo, PTSD, depression, alzheimers
156
what is coup and contrecoup injury
coup - front brain
| contrecoup - rebound
157
what is contrusion
bruise
158
what is primary and secondary insult to brain
primary - haematoma, hemorrhage, contusion
| secondary - hypoxia, oedema, increased ICP
159
what happens in disruption of BBB?
vasogenic oedema due to protein influx, increase ICP
160
what is cytotoxic oedema
Na retention in cells leads to swelling and increase ICP
161
how is increase ICP compensated. wjhat is cushings reflex
decrease venous blood and CSF
| cushings reflex - increase BP, irregular breathing, decrease HR
162
why might use barbiturates or propofol in increase ICp
both reduce cerebral metabolic rate of o2
163
symtpoms of opioid
antitussive, analgesia, constipation, hypotensive
164
function of mannitol
decrease cerebral oedema. osmotic diuretic
165
what are the 4 brain waves and when are they seen
alpha - awake and resting
beta - awake and mental activity
theta - sleeping
delta - deep sleep
166
what happens in locked in syndrome
loss of RAS descending pathways by lesion below pons
167
what is coma, brain death
coma - state of unconsciousness which patient cannot be roused from. no voluntary movement but signs of active brain
brain death - irreversible loss of all features of brain
168
function of sleep
allows cns to reset and memories to proces
169
what control sleep wake cycle
RF and hypothalamus (by inhibiting RF)
170
what happens in REM and non REM sleep
REM - active brain inactive body. increase RR, HR, BMR. Alpha and beta waves
non REM - inactive brain active body. neuroendocrine. decrease RR, HR, BMR. theta and delta waves
171
what happens to wake us up
serotonin and ACh release stimulates thalamus
172
what is parasomnia, hypersomnia, narcolepsy
parasomnia - sleep paralysis
hypersomnia - day time sleepiness
narcolepsy - constant hypersomnia
173
if loss of consciousness occurs, why?
damage to Reticular formation
174
give GCS
eye 1-4 - none, pain, speech, spontaneous
verbal 1-5 - none, incomprehensible, inappropriate words, confused, orientated
motor 1-6 - none, extension to pain, flexion, flexion to pain, localise pain, obey commands
175
symptoms of extradural hemorrhage
trauma, slow onset, lucidity then decrease consc, increasing severity headache, vomiting and confusion
176
subdural features and subarachnoid hemorrhage
subdural - slow onset, atrophy of brain, age, trauma, fluctuating consciousness, insidious physical or intellectual slowing
SAH - thunderclap headache, vomiting, seizures, neck stiffness
177
parietal dominant and non dominant features
dom - speech, logic, sensation integration
| non dom - emotion, language, music/art, visioaspatial, body awareness
178
anterior frontal lesion
apathy, loss of personality, asocial, amoral, loss of social inhibition
179
temporal lesion
speech (dominant), memory
180
function of angular gyrus
takes written word interpretation from occipital to wernickes area
181
where 2 diffeerent type sof memory stored
declarative - hippocampus, cortex
| procedural - cerebellum, basal ganglia
182
how is memory consolidated in neurones. techniques to consolidate memory?
rehearsal, association, emotion
| via LTP
183
causes of amnesia
trauma, stroke, infection, dementia
184
hippocompal lesion
anterograde amnesia
185
define dementia and symptoms. how does delirium differ
acquired loss of brain function significant enough to affect daily function and QOL. decrease intellect, reason, personality without loss of consciousness (delirium is loss of consciousness)
symptoms - progressive loss of memory. intellect, personality, behaviour, spech, movement
186
causes of dementia
vascular, alzheimers, lewy bodies, drugs, fronto-temporal dementia
187
describe pathogenesis of AD. RF?
aB amyloid deposits, tau neurofibrillary tangles.
| RF - age and female
188
lewy body dementia pathogenesis and symptoms
alpha synuclein amyloidosis. REM sleep behaviour disturbed, delusions, paranoia, goes on to have AD features
189
AD pre-dementia, early, mid, late symptoms
pre - subtle - forgetfullness, planning, apathy
early - anterograde amnesia starts (harder to learn things), loss oral and written fluency
mid - speech problems, aggression, irritability,
late - complete loss language, exhaustion, extreme apathy, poss bedridden
190
fronto-temporal dementia
increase tau protein, lack of empathy, disinhibiton, personality loss
191
normal pressure hydrocephalus symptoms
dementia, incontinence, gait
192
causes of meningitis
neonates - e coli
1-5 - h influenza
5-30 - n meningitidis
>30 - strep pneumoniae
193
what is encephalitis
viral infection of brain parenchyma
194
what brain part does herpes infect and symptom
infect temporal lobe, lead to seizures
195
what is perviascular cuffing
aggregation of lymphocytes around a BV in encephalitis
196
what is normal brain pressure, in coughing, and what can it get up to
normal - 0-10
coughing - 20
up to 60mmHG
197
what is subfalcine hernia. ischemia of?
cingulate gyrus goes under falx cerebri. ischemia of parietal, frontal, corpus callosum
198
what is tentorial hernia. damage to?
uncus and parahippocampus through tentorial notch. damage to CN3 and occlusion of PCA and sup cerebellar arteries
199
what is tonsillar hernia and damage?
cerebellar tonsils through foramen magnus, compressing brainstem. apnoea.
200
symptoms of increased ICP
headahce, vomiting, papilloedema - leading to pupil dilation, coma
201
types of brain tumours
meningioma, astrocytoma (malignant), metastases (Skin, lungs, kidney, breast, GI)
202
difference taste and flavour
flavour inc smell
203
what produces and absorbs intraocular fluid
produced - ciliary body
| absorbed - schlemm (venous sinuses)
204
what is presbyopia
long sighted with age
205
what is scotomata
pathological blind spot
206
how test colour vision
ishihara chart
207
symptoms of TACS and PACS
TACS is all of HHHH, PACS is 2 of 4
| hemiparesis, higher cerebral dysfunction (dysphagia, hemineglect, agnosia), hemianopia, hemisensory loss
208
POCS symptoms
loss of consciousness, visual disturbance, DANISH
