Neuro - FA p478-498 Flashcards
(206 cards)
1
Q
what induces the overlying ectoderm to differentiate into neuroectoderm and neural plate
A
notochord
2
Q
notochord becomes what in adults
A
nucleus pulposus
3
Q
list the 3 major region that makes up the three primary vesicles of developing the brain
A
fore, mid and hind brain
4
Q
what do the proescephalon form
A
telencephalon & diencephalon
5
Q
what does the telencephalon form
A
cerebral hemisphere, basal ggl and lateral ventricle
6
Q
what does the diencephalon form
A
thalamus, hypothalamus and 3rd ventricle
7
Q
what does the mesencephalon form
A
midbrain and aqueduct
8
Q
what does the rhombocephalon divide into
A
metencephalon and mylencephalon
9
Q
metencephalon forms
A
pons, cerebellum and upper part of 4th ventricle
10
Q
myelencephalon forms
A
medulla and lower part of 4th ventricle
11
Q
where do the microglia cells originate from
A
mesoderm
12
Q
failure of the bony spinal canal to close with the dura intact is associated with what pathology
A
spinal bifida occulta (tuft of hair)
13
Q
spinal problem with normal AFP
A
spinal bifida occulta
14
Q
diff btw meningocele and meningomylocele
A
meningocele: meninges herniate only thru spinal canal meninogemylocele: meninges and spinal card herniation
15
Q
anencephaly is due to which embryo error?
A
Failure of rostral neuropore to close –> no forebrain, open calvarium.
16
Q
failure of left and right hemisphere to separate; which gene and diseases is it associated with? What does MRI show?
A
holoprosencephaly, sonic hedgehog gene & patau syndrome/fetal alcohol syndrome
MRI - monoventricle and fusion of basal ggl
17
Q
Cyclopia seen with?
A
most severe form of holoprosencephaly; trisomy 13, fetal alchohol syndrome
18
Q
lack of cerebral vermis and an cystic enlarged 4th ventricle? list 2 associations
A
Dandy walker
associated with non commmunicating hydrocephalus & spinal bifida
19
Q
what disease is associated with meningomylocele; how does it present?
A
Arnold Chiari type II - Sx/ paralysis / sensory loss at or below level of lesion
20
Q
Bilateral loss of pain and temperature sensation in upper limb?
A
Sphingomyelia
21
Q
Which part of the spinal cord affected in Sphingomyelia?
A
Most common at C8–>T1
22
Q
Intention tremor plus loss of pain and temp sensation in UL?
A
Chiari I malfomation - cerebellar tonisillar ectopia >3-5mm
assoc w/ syringomyelia
23
Q
Which fibers are destroyed in Syringomyelia?
A
crossed fibers in ant white commissure ( spinothalamic tract)
24
Q
Which arches are responsible for the ant 2/3 tongue? Gen sens’n nerve? Nerve for taste?
A
1st and 2nd arch, Mandibular n (V3), Facial n (VII)
25
Which arches for the post 1/3 of tongue? N for gen sens'n and taste?
3rd and 4th arch, CN IX, root is CN X
26
Function of hyoglossus, genioglossus, and styloglossus?
Hyo - retracts and lower tongue Genio - protrudes tongue Stylo - pulls sides of tongue upwards
27
Which nerves innervates which muscles of tongue?
All muscles of tongue inn by CN XII, except palatoglossus, by CN X
28
Nissl staining stains what (what parts of neuron) and what molecular structure?
rER, so therefore only stains the body of neuron, not axon
29
What is Wallerian degeneration?
disintegration of the axon and myelin sheath distal to site of axonal injury with macrophages removing debris.
30
Where can axons regenerate?
Peripheral Nervous System
31
Which neuro cell type is a buffer for EC K+ and removes excess neurotransmitter?
Astrocytes
32
Marker of Astrocytes? embryo origin?
GFAP; from neuroectoderm
33
Embryo origin of microglial cells?
mesodermal origin, from monocytes in Bone marrow
34
In HIV, what neurological reaction occurs in the CNS and with which cell type?
fomation of multinucleated giant cells from microglia
35
Which cells produce the myelin sheath in CNS and PNS?
CNS - oligodendrocytes PNS - Schwann cells
36
What type of channels are seen at the nodes of Ranvier?
Na+ channels (where AP happens!)
37
Schwann cells are injured in which disease, causing ascending paralysis? Assoc with which microbe?
Guillan Barre syndrome, C. jejuni
38
Embryo origin of Schwann cells?
neural crest
39
What is the difference in myelination between Schwann cells and oligodendrocytes? (other than location)
A Schwann cell can only myelinate one single PNS axon An oligodendrocyte can myelinate several (about 30) CNS axons
40
What neuro cell have a fried egg appearance histo wise?
Oligodendroglia
41
What 3 diseases are associated with damage to oligodendroglia?
MS, PML (Progressive multifocal leukoencephalopathy), leukodystrophy
42
Difference between C and A delta fibers?
C - slow and unmyelinated (C student is slow) A - fast, myelinated)
43
Where are meissner corpuscles located? What do they sense?
hairless skin, fine touch and position sense
44
Where are pacinian corpuscles located? What do they sense?
Deep skin layers, ligaments, joints vibration, pressure
45
Where are Merkel discs located? What do they sense?
Finger tips, superficial skin Pressure, deep touch, position sense
46
Where are ruffini corpuscles? What do they sense?
finger tips, joints Pressure, slippage of objects along surface of skin, joint angle change
47
Location of synthesis of Ach? Inc /Dec in which disease?
Made at Basal nucleus - Inc in Parkinsons, Dec in Alzheimer, Huntingtons
48
Synthesis location of Dopamine
Ventral tegmentum, Substancia Nigra (pars compacta)
49
Inc/Dec Dopamine in which diseases?
Dec in depression, parkinson, Inc in Schizophrenia, Huntington Dopamine involved in initiation of movement, so dec in depression (dec will to do activity) and parkinson (issue starting movement)
50
GABA is made in
Nucleus Accumbens (GABANA)
51
GABA dec in
Huntingtons, Anxiety ( dec inhibition of movement)
52
Where is NE made?
Locus ceruleus
53
NE inc/Dec in?
Inc = anxiety, dec = depression
54
Serotonin is made where?
Raphe nucleus
55
Serotonin is inc/dec where?
Dec in Anxiety, Depression and Parkinson's
56
Embryo origin of dura mater vs arachnoid/pia mater?
Dura - mesoderm Arachnoid/pia - neural crest
57
3 parts to the BBB?
Tight junctions between nonfenestrated capillary endothelial cells, BM, Astrocyte foot processes
58
What substances can penetrate the blood brain barrier?
Glucose and amino acids cross slowly by carriermediated transport mechanisms. Nonpolar/lipid-soluble substances cross rapidly via diffusion.
59
Where is there a break in BBB to allow for secretion?
At the Hypothalamus for the secretion of ADH, Oxytocin and releasing factors.
60
2 major inputs to HT not protected by BBB?
1. OVLT (organum vasculosum of lamina terminalis, senses changes in Osmo 2. Area postrema
61
Which area of HT manages hunger? Stimulated/inhibited by?
Lateral area - Inc by Ghrelin, inhibited by leptin
62
A cranipharyngioma of this area of the HT leads to hyperphagia, stimulated by what hormone?
VM - can be stimulated by leptin
63
Which autonomic nervous system affects the cooling center?
PANS - bc when you're resting and digesting, you want to be cool.
64
Which nucleus causing cooling?
Ant - for A/C
65
Which nucleus is responsible for heating?
Post - her butt is HOT
66
Which nucleus is responsible for circadian rhythm?
Suprachiasmatic nucleus - You need to see light to have a good circadian rhythm
67
Ipsilateral proprioceptive information from spinal cord travel to cerebellum through ____ ?
inferior cerebellar peduncle
68
Input from contralateral cortex to cerebellum through ____ ?
middle cerebellar peduncle
69
output: Cerebellum to contralat cortex through ____ ? from what cell type, and is it stimulatory or inhibitory
Superior Cerebellar peduncle; from purkinje cells, inhibitory
70
patient has damage to lateral lobes of cerebellum. what are the symptoms?
fall towards injured sides affects voluntary movement extremities
71
Patient with truncal ataxia. which part of cerebellum, which other symptoms?
Medial lesions (vermis, fastigial nuclei, or flocculonodular lobe) - truncal ataxia w/ nystagmus, head tilting, bilateral motor defecits
72
Liste the Deep nuclei in cerebellum
Don't Eat Greasy Food Dentate, Emboliform, Globose, Fastigal
73
circardian rhythm which nucleus
suprachiasmatic nucleus
74
describe the pathway of melatonin release
SupraChiasmaticNucleus --\> NE --\> pineal gland --\> Melatonin
75
Extraocular movements during REM sleep is due to activity of what?
PPRF paramedian pontine reticular formation/conjugate gaze center
76
List the causes that decrease REM/ delta wave sleep
alcohol, benzo, barbituates - dec both. NE - dec REM sleep
77
How does Depression affect REM sleep?
Depression increases total REM sleep but decreases REM latency, dec N3, repeated nighttime awakenings, early morning awakening (terminal insomnia).
78
when stage of sleep does bedwetting occur? and what other 2 patho occurs in that stage too?
Stage N3 (Delta) others: sleep walking, night terrors
79
what are the difference between nightmares and night terrors?
nightmares in REM sleep
night terrors in Stage N3
80
treatment of night terrors and sleepwalking
BDZ - they lower stage 3 and REM sleep.
81
treatment of sleep enuresis
oral desmopressin ADH analog (nasal form is banned) Imipramine, Amitriptyline Nortriptyline (TCAs) not preferred bc of Side effects (alpha (-)'r so postural HTN, and anti-muscarinic). Tx of choice - motivational therapy
82
Bruxism, which stage
"You grind your teeth like spindles and complexes in most amount of time" - Sleep spindles and K complexes. -which is stage N2 (45% = most amount of time)
83
What happen in REM -eyes -motor -brain O2 -pulse and BP
-eyes: REM -motor: loss -brain O2: increased -pulse and BP: increased and variable - sex arousal -dream "BRAIN ON BODY OFF"
84
What EEG waveforms are seen in sleep stages, in order?
at night, BATS Drink Blood
Beta
Alpha
Theta
Sleep spindles and K complexes
Delta
Beta
85
Where do you see Beta?
eyes open (awake) and REM
86
Characteristics of Beta wave
High frequency, low amplitude
87
Which wave has low frequency and high amplitude
Delta wave slow and big
88
Thalamus relay for all ascending sensory information except
olfactory
89
VPL input/output, what does it sense?
from Spinothalamic and Dorsal Column to Primary somatosensory cortex Vibration, Pain, Pressure, Proprioception, Light touch, temperature
90
where does trigeminal and gustatory pathway go?
VPM
91
LGN is for?
vision (L=light)
92
MGN (Medial Geniculate nucleus) is for? pathway?
hearing (M = music) Superior olive + inferior colliculus of tectum --\> MGN --\> auditory cortex of temporal lobe
93
Motor info to which part of thalamus - which input?
Ventral Lateral nucleus
94
What part of thalamus is affected in W-Korsakoff?
Ant + Dorsomedial thalamus ( project to mamillary bodies)
95
what's the famous 5 F's of limbic system
Feeding, fighting, fleeing, feeling, Sex
96
Parts of Limbic system?
Truef hippocampus (red arrows in A), amygdalae, mammillary bodies, anterior thalamic nuclei, cingulate gyrus (yellow arrows in A), entorhinal cortex.
97
location of the primary motor is precentral or postcentral?
precentral
98
What is postcentral?
primary somato sensory
99
cerebral perfusion is primarily driven by
pCO2
100
what area of the brain is responsible for disinhibition and deficit in concentration, orientation, judgement and may have reemergence of primitive reflex?
frontal lobe
101
Where is Broca's area?
inf. frontal gyrus of frontal lobe
102
where is wernicke area?
Superior temporal gyrus of the temporal lobe
103
what is the equation for CPP?
MAP - ICP
104
If CPP is zero, what does that mean?
no cerebral perfusion --\> brain death
105
so in response to inc ICP, what does the body do?
inc MAP to maintain CPP
106
in what response/reflex do you see acute inc in ICP?
Cushing (hypertension, bradycardia, irregular breathing)
107
What 2 Spinal tracts are ascending and sense pressure?
Dorsal column - pressure, vibration, fine touch,proprioception
ant Spinothalamic tract - crude touch, pressure
108
which tract has a 2nd synapse on NMJ?
Lateral corticospinal tract
109
Which 2 tracts decussate at the 2ND-ORDER NEURON?
Dorsal column Spinothalamic tract (Anterolateral)
110
Which 2 tracts decussate in medulla?
Dorsal column Lateral corticospinal tract (pyramidal decussation)
111
Which 2 tracts sense pressure?
Spinothalamic tract Dorsal column
112
Which 2 tracts cell body in dorsal root ganglion?
Spinothalamic tract Dorsal column
113
Which tract decussates at anterior white commissure?
Spinothalamic tract
114
Where is the cell body of Lateral corticospinal tract?
cell body in 1° motor cortex
115
Which 2 tracts have a 3RD-ORDER NEURON end in Sensory cortex?
Spinothalamic tract Dorsal column
116
Which tract sends vibration, fine touch, and proprioception to the cortex?
Dorsal column
117
Where does the Lateral corticospinal tract become LMN?
at spinal cord as 2ND-ORDER NEURON
118
Which tract sends Lateral: pain, temperature Anterior: crude touch,
Spinothalamic tract
119
Which artery supplies ASA below ∼ T8?
Adamkiewicz
120
nerve at the belly button
T10
121
nerve at nipple
T4
122
nerve --- is IL (Inguinal Ligament).
L1
123
Nerves innervating the penis
S2,3,4
124
Diaphragm and gallbladder pain referred to the right shoulder via --- nerve
phrenic
125
Gland for melatonin secretion, circadian rhythms?
Pineal gland (neroectoderm)
126
CN nuclei that lie medially at brain stem:
III, IV, VI, XII. “Factors of 12, except 1 and 2.”
127
Area for conjugate vertical gaze center?
Superior colliculi
128
Area of midbrain for auditory?
Inferior Colliculi
129
Midbrain contains which nuclei?
CN III, IV
130
Pons contains nuclei of which CN?
CN V, VI, VII, VIII
131
Medulla contains nuclei of which CN?
CN IX, X, XII
132
Spinal cord contains nucleus of which CN?
CN XI
133
CN nuclei position: Lateral nuclei = Medial nuclei =
Lateral nuclei = sensory (aLar plate). —Sulcus limitans— Medial nuclei = Motor (basal plate).
134
Pathway of Miosis
1st neuron: Edinger-Westphal nucleus to ciliary ganglion via CN III 2nd neuron: short ciliary nerves to pupillary sphincter muscles
135
Pathway of Mydriasis
1st neuron: hypothalamus to ciliospinal center of Budge (C8–T2) 2nd neuron: exit at T1 to superior cervical ganglion (travels along cervical sympathetic chain near lung apex, subclavian vessels) 3rd neuron: plexus along internal carotid, through cavernous sinus; enters orbit as long ciliary nerve to pupillary dilator muscles. Sympathetic fibers also innervate smooth muscle of eyelids (minor retractors) and sweat glands of forehead and face.
136
(CN V2) goes through what foramen
Foramen Rotundum
137
CN I goes through what foramen? and what reproductive pathology is associated with CN 1
cribriform plate kallman syndrome
138
CN III, IV, V1, VI, goes thru
Superior Orbital Fissure
139
central retina vein goes thru which foramen? with what?
optic canal & ophthalmic artery
140
middle meningeal artery goes through
Foramen spinosum
141
what cranial nerve is been tested when you look down from already adducted eye
Superior Oblique (CN 4) trochlear
142
what nerve innervates the parotid gland
CN 9
143
head turning what nerve is responsible
Spinal Accessory
144
Visceral Sensory information (e.g., taste, baroreceptors, gut distention). is seen in what vagal nuclei
Nucleus Solitarius
145
Motor innervation of pharynx, larynx, upper esophagus (e.g., swallowing, palate elevation) is seen in what nuclei
Nucleus aMbiguus
146
tongue movement is innervated by what nerve
hypoglosseal
147
Sends autonomic (parasympathetic) fibers to heart, lungs, upper GI. is by what vagal nuclei
dorsal motor nucleus
148
list three muscles to close the jaw
Masseter, Temporalis and Medial ptyerigoid
149
what muscles open the jaw
Lateral Ptyerigoid
150
what cranial nerve pass through the cavernous sinus
CN 3, 4, V1, V2 & 6
151
what artery is also found in the cavernous sinus
Internal Carotid Artery
152
Bonus: what brachial arch does maleus incus and stapes come from
Malleus & Incus (first brachial arch) Stapes (2nd brachial arch)
153
Snail shaped fluid filled cochlea that contains basilar membranes that vibrates secondary to sound waves refers to the.....
inner ear
154
low frequency (wide ; flexible) of sound heard at apex in the inner ear is near what area?
Helicotrema
155
High frequency (thin; rigid) is best heard at ----
base of cochlea
156
what does CN V3 pass through
foramen ovale
157
what nerve is responsible for the periauricular touch sensation of the ear
Vagus Nerve post auricular
158
list 2 GABA receptors that works by Cl- influx
A and B A is in brain B is in retina
159
What is the function of parasympathetic out of CN 3
pupillary light reflex
160
What goes through internal capsule in the visual pathway?
Dorsal optic radiation
161
Where is the uncus?
medial temporal lobe
162
Inflammatory infiltrate in the endoneurium seen in which disease?
Guillan Barre
163
Embryo origin of Meninges?
Dura mater - Derived from mesoderm. Arachnoid mater—. Derived from neural crest. Pia mater—Derived from neural crest.
164
Dural venous thrombosis presents w.?
Signs of inc ICP- headache, focal neuro deficits, seizures.
165
Aff / Eff path of corneal reflex?
Aff - V1 (ophthamic, nasociliary br) Eff - VII (temporal br, orbicularis oculi)
166
Aff / Eff path of Lacrimation reflex?
Aff - V1 Eff - VII
167
Aff / Eff path of Jaw jerk?
Aff - V3 (SS) Eff - V3 (SM - motor )
168
Aff / Eff path of Pupillary reflex?
Aff - II Eff - III
169
Aff / Eff path of gag reflex?
Aff - IX Eff - X
170
Achilles reflex?
S1,S2
171
Patellar reflex?
L3, L4
172
Biceps reflex?
C5, C6
173
Triceps reflex?
C7, C8
174
Cremaster reflex?
L1, L2
175
Anal wink reflex?
s3, s4
176
Moro relfex?
“Hang on for life” reflex—abduct/extend arms when startled, and then draw together
177
Movement of head toward one side if cheek or mouth is stroked (nipple seeking)
Rooting reflex
178
Sucking relfex
Sucking response when roof of mouth is touched
179
Palmar reflex
Curling of fingers if palm is stroked
180
Dorsiflexion of large toe and fanning of other toes with plantar stimulation is sx of what in an adult?
Sign of an UMN lesion
181
Galant reflex?
Stroking along one side of the spine while newborn is in ventral suspension (face down) causes lateral flexion of lower body toward stimulated side
182
Testing for reflexes: Biceps = Triceps = Patella = Achilles =
Biceps = C5,C6 nerve root. Triceps = C6,C7 nerve root. Patella = L3,L4 nerve root. Achilles = S1,S2 nerve root
183
Level of cremaster reflex?
L1,L2
184
Level of anal wink reflex?
S3,S4
185
What is Lissencephaly?
Failure of neuronal migration resulting in a “smooth brain” that lacks sulci and gyri.
186
Ependymal cells are covered with cilia and microvilli, for what?
. Apical surfaces are covered in cilia (which circulate CSF) and microvilli (which help in CSF absorption)
187
Reaction of neuronal cell body to axonal injury. Changes reflect Inc protein synthesis in effort to repair the damaged axon - what is this?
Chromatolysis
188
Characteristics of Chromatolysis?
Round cellular swelling Displacement of the nucleus to the periphery Dispersion of Nissl substance throughout cytoplasm
189
Vomiting center coordinated by which tract? rec info from?
Solitary tract, info from the chemoreceptor trigger zone (CTZ, located within area postrema in 4th ventricle), GI tract (via vagus nerve), vestibular system, and CNS
190
5 receptors input into the CTZ - what are they?
: muscarinic (M1), dopamine (D2), histamine (H1), serotonin (5-HT3), and neurokinin (NK-1) receptors.
191
Drugs that target CTZ?
5-HT3, D2, and NK-1 antagonists used to treat chemotherapy-induced vomiting. H1 and M1 antagonists treat motion sickness; H1 antagonists treat hyperemesis gravidarum.
192
How is mesocortical pathway affected in schizophrenia?
dec activity = “negative” symptoms (eg, anergia, apathy, lack of spontaneity).
193
how is mesolimbic pathway affected in schizophrenia ?
inc activity = “positive” symptoms (eg, delusions, hallucinations).
194
What disease affects the nigrostriatal pathway - how so?
Dec activity = extrapyramidal symptoms (eg, dystonia, akathisia, parkinsonism, tardive dyskinesia). Affected in Parkinson's
195
If tuberoinfundibular pathway is affected, then?
dec activity --\> inc prolactin --\> dec libido, sexual dysfunction, galactorrhea, gynecomastia (in men).
196
When does hypoxemia increase CPP?
Hypoxemia increases CPP only if pO2 \< 50 mm Hg
197
CPP is directly proportional to Pco2 until Pco2 \_\_\_\_\_\_\_?
CPP is directly proportional to Pco2 until Pco2 \> 90 mm Hg.
198
Infarct in watershed areas lead to what sx?
Infarct due to severe hypotension --\> proximal upper and lower extremity weakness (“manin-the-barrel syndrome”), higher order visual dysfunction (if posterior cerebral/middle cerebral cortical border zone stroke).
199
Presentation of venous sinus thrombosis
—presents with signs/symptoms of inc ICP (eg, headache, seizures, papilledema, focal neurologic deficits). May lead to venous hemorrhage
200
Which conditions inc the chance of venous thrombosis
hypercoagulable states (eg, pregnancy, OCP use, factor V Leiden).
201
Solitary tract - fxn and CN?
Visceral Sensory information (eg, taste, baroreceptors, gut distention)
CN VII, IX, X
202
Nucl ambiguus - fxn and CN?
Motor innervation of pharynx, larynx, upper esophagus (eg, swallowing, palate elevation)
IX, X, XI (cranial portion)
203
Dorsal motor nucleus - fxn, CN?
```
Sends autonomic (parasympathetic) fibers to heart, lungs, upper GI
CNX
```
204
What level of spine is LP done?
b/w L3 and L5
205
Subarachnoid space extends to what level of spine?
S2 vertebra lower border
206
