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Flashcards in NEURO Deck (51):
1

↑ α-fetoprotein (AFP) and ↑ acetylcholinesterase may indicate

anencephaly - malformation of anterior end of neural tube; no brain/calvarium, polyhydramnios

2

Abnormalities often found with an Arnold-Chiari malformation

  • Hydrocephaly - XS accumulation CSF
  • Syringomyelia - enlargement of central canal of SC.
  • Myelomeningocele

3

Where is NE made? 

Locus ceruleus (reticular formation, solitary tract)

4

Where is dopamine made?

Ventral tegmentum and SNc

5

Where is 5-HT made?

Raphe nucleus

6

Where is ACh made?

Basal nucleus of Meynert

7

Where is GABA made? What is needed to synthesize it?

Function?

  • Nucleus accumbens
  • Need vitamin B6 (pyridoxine) to convert Glutamate to GABA (deficinecy result in less GABA and convulsions)
  • Major inhibitory neurotransmitter of CNS
  • Reduced in anxiety, Huntington's

8

Inhibitory neurotransmitter of the spinal cord.

Glycine

9

Reticular Activating System

Location, function?

  • Reticular formation, Locus ceruleus (NE), Raphe nuclei (5-HT).
  • Mediates consciousness, attentiveness, alertness.
  • Lesion of RAS -> Coma

10

Name the 4 dopaminergic pathways

  • Mesocortical pathway
  • Mesolimbic pathway
  • Nigrostriatal pathway
  • Tuberoinfundibular pathway

11

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Mesocortical pathway

  • Ventral tegmental of the midbrain to the cortex
  • Increase in negative symptoms of psychosis - social withdrawal, etc.

12

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Mesolimbic pathway

  • Ventrral tegmental of midbrain to limbic system
  • Relief of psychosis

13

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Nigrostriatal pathway

  • Substantia nigra (pars compacta) to the striatum (caudate + putamen)
  • Parkinsonian symptoms (antipsychotics block mesolimbic and nigrostriatal pathway)

14

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Tuberoinfundibular pathway

  • Arcuate nucleus of hypothalamus to pituitary
  • Increase release of prolactin from pituitary -> hypogonadism -> ammenhorea/ reduced libido.

15

Damaged in Guillain-Barre syndrome

Schwann cells (PNS)

16

Damaged in MS

Oligodendrocytes (Myelinates multiple CNS axons)

17

Form multinucleated giant cells in the CNS when infected with HIV

Microglia (macrophages of CNS)

18

Cells of the blood brain barrier

  • Astrocytes (foot processes)
  • Basement membrane
  • Endothelial cells with tight junctions (non-fenestrated endothelial cells)

19

Anterior Hypothalamus (Preoptic)

• Regulates parasympathetic NS
• Responsible for sweating, cutaneous vasodilation, ↓ HR and ↓ BP
• Lesion - hyperthermia
• Releases GnRH
  ○ Regulates LH and FSH

20

Posterior and Lateral Hypothalamus

• Regulates sympathetic NS
• Stimulation
  ○ Shivering, ↑ HR and BP
• Lesion - inability to remain warm, hypothermia

21

Arcuate Nucleus

• Releases hormones that affect the anterior pituitary
• Regulates hunger and satiety

22

Savage behavior and obesity result from stimulation

Dorsomedial nucleus of hypothalamus

23

 Savage behavior and obesity result from destruction (craniopharyngioma)

Ventromedial area

24

Stimulation leads to eating and destruction leads to starvation

Lateral area

25

Regulates the release of gonadodtropic hormones (LH and FSH)

Anterior and Preoptic Nuclei

26

Responsible for sweating and cutaneous vasodilation in hot temperatures

Anterior and Preoptic Nuclei

27

Responsible for shivering and decreased cutaneous blood flow in the cold

Posterior and Lateral nuclei

28

Stage 1 sleep

  • Light sleep
  • Theta waves
  • 5% of total sleep

29

Stage 2 sleep

  • Deeper sleep
  • Bruxism (teeth grinding)
  • Sleep spindles and K complexes
  • 45% of total sleep (majority)

30

Stage 3 sleep

  • Deepest, non-REME sleep (Slow-wave sleep)
  • Sleepwalking; night terrors bedwetting
  • Delta (lowest frequency, highest amplitude)
  • 25% of total sleep
  • Imipramine treates nocturnal enurisis by reducing this stage
  • Benzodiazepines useful in this stage

31

Stage 4 sleep

  • REM sleep
  • Dreaming, loss of motor tone, memory processing function, erections, increased brain oxygen use
  • Beta waves (same as awake, paradoxical sleep)
  • 25% total sleep
  • Alcohol, benzos and barbiturates reduce this stage

32

Treatment for restless legs syndrome

  • Pramipexole or ropinirole qHS (or levodopa/carbidopa)
  • Iron replacement
  • Avoid caffeine
  • Clonazepam qHS
  • Gabapentin
  • Opioids

33

EEG waveforms in sleep:

BATS Drink Blood
  • Awake = beta
  • close eyes = alpha
  • Stage 1 = theta waves 
  • Stage 2 = 2 sleep spindles, K complexes ;
  • Stage 3/4 = Delta, low frequency, high amplitude ;
  • REM = beta waves (high frequency, low amplitude)

34

Mechanism by which retinal information induces the release of melatonin

Darkness causes the suprachiasmatic nucleus to release NE acts on pineal gland to produce melatonin. Retina receives NO light --> SCN --> NE release --> pineal gland --> melatonin

35

$ What is the pharyngeal apparatus composed of?

  • Branchial apparatus
  • Composed of:

(CAP covers outside from inside)

  • Clefts = ectoderm
  • Arches = mesoderm
  • Pouches = endoderm

36

$ Branchial pouch derivatives

Ear, tonsils, bottom-to-top:

  • 1(ear) - middle ear, ET, mastoid air cells
  • 2 (tonsils) - epithelial lining palatine tonsil
  • 3 dorsal (bottom for inferior parathyroids)
  • 3 ventral (to = thymus)
  • 4 (top = superior parathyroids)

37

Aberrant development of 3rd and 4th pouches -->

  • DiGeorge syndrome ->
  • Cell deficiency (thymic aplasia)
  • Hypocalcemia (failure of parathyroid development)
  • 22q11 Deletion

38

$ Branchial arch derivatives

When at the restaurant of the golden arches, children tend to first chew (1), then smile (2), then swallow stylishly (3) or simply swallow (4), and then speak (6)

 

  1. M and T structures - Muscles of mastication
  2. 2 S structures - Stapedius Stylohoid
  3. Pharyngeal - Stylo-pharyngeus innervated by glossopharyngeal nerve
  4. 4-6 = Cricothyroid and Larynx - all intrinsic muscles of larynx except cricothyroid

39

Branchial arch abnormalities

  1. Treacher Collins syndrome: 1st arch neural crest fails to migrate -> mandibular hypoplasia, facial abnormalities
  2. Stapedius
  3. Congenital pharyngocutaneous fistual: persistence of cleft and pouch --> fistula between tonsillar area, cleft in lateral neck
  4. 3 and 4 form posterior 1/3 of tongue, 5 makes not contribution

40

CN III damage

  • Eye looks down and out
  • Ptosis
  • Pupillary dilation
  • Loss of accommodation

41

CN IV damage

  • Eye drugs upward causing vertical diplopia (problems reading newspaper or going down stairs)

42

CN VI damage

Medially directed eye

43

Mastication muscles

innervation?

  • 3 close jaw: Masseter, teMporalis, Medial pterygoid (M's Munch)
  • 1 opens: lateral pterygoid (Lateral Lowers)
  • All are innervated by the mandibular division of the trigeminal nerve

44

CN VII Branches

"To Zanzibar By Motor Car"

 

  • Temporal
  • Zygomatic
  • Buccal
  • Mandibular
  • Cervical

45

Cranial Nerve testing: KLM Sounds

  • Mi Mi Mi - Facial nerve (CN VII) testing lips
  • La La La - Hypoglossal (CN XII) testing tongue
  • Kuh Kuh Kuh - Vagus (CN X) testing elevation of palate

46

Vestibulocochlear Nerve Lesion

  • Vertigo
  • Nystagmus
  • Nausea and vomiting

47

The "Executive Arm" of the Parasympathetic nervous system

3 vagal nuclei (NS, NA CN X, DMN) and the Preoptic (Anterior) Area of Hypothalamus, these 4 structures are the Executive arms of the parasympathetic nervous system.

48

Nucleus Solitarius

contains sensory information: taste, baroreceptors, gut distension

49

Lesion to Nucleus ambigus will result in

Lesion to Nucleus aMbigus will result in hoarseness, difficulty swallowing, and loss of the gag reflex

 

Nucleus Ambiguus - Motor innervation of Pharynx, Larynx, Upper esophagus

50

Dorsal motor nucleus

Autonomic information to Heart, Lungs, Upper GIT

51

Symptoms of excess parasympathetic activity?

Become Leaky everywhere

DUMBBELSS

  • Diarrhea
  • Urination
  • Miosis
  • Bronchospasm
  • Bradycardia
  • Excitation of skeletal muscle/CNS
  • Lacrimation
  • Sweating 
  • Salivation