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Phase 1 > Neuro Lecture notes > Flashcards

Neuro Lecture notes Flashcards

1
Q

What are the general functions of the left hemisphere?

A

Verbal, linguistic description, mathematical, sequential, analytical and direct link to conscious mind

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2
Q

What are the general functions of the right hemisphere?

A

Almost non-verbal, musical, geometrical, spatial comprehension, temporal synthesis, possible link to conscious mind

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3
Q

What are the four lobes of the brain?

A

Frontal
Temporal
Parietal
Occipital

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4
Q

What is the central sulcus?

A

A division between the frontal and parietal lobe

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5
Q

What is the lateral sulcus?

A

A division between the temporal and the frontal&parietal.

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6
Q

What are the clinical signs of UMN lesion?

A

No change in aspect
Increased tone- spasticity
Pyramidal weakness
Increased reflexes

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7
Q

What are the clinical signs of LMN lesion?

A

Muscular atrophy
Decreased tone
Focal weakness

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8
Q

What are the four ventricles?

A

A pair of lateral ventricles
III
IV

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9
Q

What are the cranial nerves?

A 
Olfactory Tract
Optic
Occulomotor
Trochlear 
Trigeminal
Abducens 
Facial
Vestibulochlear 
Glossopharyngeal
Vagus
Accessory 
Hypoglossal
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10
Q

What are the arteries feeding into the Circle of Willis?

A

The internal carotid artery- a branch of the common carotid artery
The vertebral arteries

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11
Q

What are the main branches of the Circle of Willis?

A

Anterior cerebral artery
Middle cerebral artery
Posterior cerebral artery

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12
Q

What do the vertebral arteries merge to form?

A

The basilar artery

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13
Q

What percentage of the brain is water?

A

80%

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14
Q

What are the principles of dualism?

A

There are 2 kinds of “foundation”- mental and body

The mental cannot exist without the body; and the mind cannot think

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15
Q

What is reductive physicalism?

A

Everything is applicable to the physical

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16
Q

What is interactionism?

A

Entities have an effect on one another

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17
Q

What is epiphenomenalism?

A

Physical affects mental but mental can’t effect physical

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18
Q

What is mysterism?

A

Mind is only understood by reflection

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19
Q

Why does the biomedical model predominate?

A

Power, economics, convenient, familiar, reductionism

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20
Q

What is neurology?

A

Looking for abnormal brain chemistry, genetics, perfusion, structure

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21
Q

What is psychiatry?

A

The functional consequences of distress and interaction with environment, interpersonal, psychological, social and cultural issues

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22
Q

What are the functions of the dopamine pathways?

A

Reward, pleasure, motor function, compulsion, preservation

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23
Q

What are the functions of the serotonin pathways?

A

Mood, memory processing, sleep, cognition

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24
Q

Name 3 tests of executive function

A

Wisconsin card-sorting test
Proverb interpretation
Similarities test

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25
Q

How common is schizophrenia?

A

Affects roughly 1 in 100

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26
Q

What are the positive symptoms of schizophrenia?

A

Delusions, thought disorder, hallucinations

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27
Q

What are the negative symptoms of schizophrenia?

A

Withdrawal, can’t carry on normal activities

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28
Q

What are the biological correlations of schizophrenia?

A

Brain Volume
Functional imaging
Dopamine theory
Genetic factors

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29
Q

What are the non-biological correlations of schizophrenia?

A

Urbanicity
Childhood trauma
Stress

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30
Q

Why may it be good to classify a mental disorder?

A 
Public health issues e.g. allocation of resources
Facilitates meaningful communication
Feeling of being understood
Framework for research
Treatment and prognosis
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31
Q

Why may it be bad to classify a mental disorder?

A

Arbatory thresholds
Stigma and prejudice
Over simplification and reductionism

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32
Q

What are the two divisions of the vertebrate nervous system?

A
  • CNS= within the skull and spine

- PNS= Outside the skull and spine

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33
Q

What is the difference between the somatic and automatic nervous system?

A

The somatic is the part that interacts with the external environment, the automatic is the part that regulates the bodies internal environment: organs

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34
Q

What type of sensory input is received by the spinal cord?

A

Nervous or contact stimuli

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35
Q

What type of sensory input is received by the hind brain?

A

Sudden distal stimuli

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36
Q

What type of sensory input is received by the midbrain and hypothalamus?

A

Species specific threat stimuli

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37
Q

What type of sensory input is received by the thalamus?

A

Neural stimuli

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38
Q

What type of sensory input is received by the sensory cortex?

A

Complex neural stimuli

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39
Q

What type of sensory input is received by the hippocampus and septum?

A

Context

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40
Q

What type of sensory input is recieved by the frontal cortex?

A

Cognitive analysis

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41
Q

What type of output is produced by the frontal cortex?

A

Response supression

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42
Q

What type of output is produced by the amygdala?

A

Conditioned, emotional response

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43
Q

What type of output is produced by the midbrain and hypothalamus?

A

Species-specific response

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44
Q

What type of output is produced by the hind brain?

A

“Startle” response

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45
Q

What type of output is produced by the spinal cord?

A

Reflexive withdrawal

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46
Q

Is the dorsal root afferent or efferent?

A

Afferent

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47
Q

Is the ventral root afferent or efferent?

A

Efferent

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48
Q

What is the role of the medulla?

A

Low level sensorimotor control

Same with vital functions, sleep, motor

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49
Q

What is the role of the pons?

A

Relay from cortex and midbrain to cerebellum

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50
Q

What is the role of the cerebellum?

A

Co-ordinates movement and balance. Mainly fine coordinated voluntary movement

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51
Q

What is the difference between the superior colliculus and inferior colliculus?

A

The superior is sensitive to sensory change- orienting/defence movements
The inferior is similar but for auditory events

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52
Q

What are the three components to the tegmentum?

A

The periaquidal gray
The red nucleus
The substantia Nigra

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53
Q

What are the roles of the periaquiductal gray?

A

Role in defence, pain and reproduction

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54
Q

What are the roles of the red nucleus?

A

Target of cortex and cerebellum, project to spinal cord. Role in pre cortical motor control

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55
Q

What are the roles of the specific nuclei within the thalamus?

A

Relay signals to the cortex/limbic system for all sensations (Exc smell)

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56
Q

What are the roles of the non-specific nuclei within the thalamus?

A

Role in regulating state of sleep, wakefullness, and levels of arousal. Important relays from basal ganglia and cerebellum back to cortex

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57
Q

What is the role of the hypothalamus?

A

Regulates pituitary and role in hormonal role of motivated behaviour- co-ordinates drive related behaviour

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58
Q

What are the structures contained within the limbic system?

A 
Amygdala 
Mammillary body
Hippocampus
Septum 
Cingulate Gyrus
Fornix
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59
Q

What is the role of the amygdala?

A

Associating sensory stimuli with emotion. Responsible for fear.

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60
Q

What is the role of the mammillary body?

A

Formation of recollective memory

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61
Q

What is the role of the hippocampus?

A

Long term and spatial memory. Critical for episodic memory. Essential for the construction of mental images. Has a vital role in short term memory.

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62
Q

What is the role of the septum?

A

Defense and aggression

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63
Q

What is the role of the cingulate gyrus?

A

Linking behavioural outcomes to motivation

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64
Q

What is the role of the fornix?

A

Carrying signals from the hippocampus to mammillary bodies and septal nucleus

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65
Q

What is the role of the precentral gyrus?

A

Motor instructions

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66
Q

What is the role of the primary motor cortex?

A

Contains many cells giving origin to the descending motor pathways

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67
Q

What is the role of the premotor and supplementary motor areas?

A

Higher level motor plans and initiation of voluntary movements?

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68
Q

Where are the precentral gyrus, primary motor cortex, premotor and supplemetary motor areas?

A

Within the frontal lobe

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69
Q

Where is the post-central gyrus and primary somatosensory cortex?

A

Within the parietal lobe

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70
Q

What is the role of the primary somatosensory cortex?

A

Body and head’s position in space

Permits complicated spacio-temporal predictions

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71
Q

Where are the primary auditory complex and inferotemporal cortex found?

A

Within the temporal lobe

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72
Q

What is the role of the inferotemporal cortex?

A

Recognition of faces and objects

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73
Q

Where is the visual corticies?

A

Within the occipital lobe

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74
Q

What is the dorsal stream?

A

Vision for movement

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75
Q

What is the ventral stream?

A

Vision for identification

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76
Q

What are the levels of description within the research of neuroscience?

A 
Psychological 
Systems
Microcircuit 
Neuronal
Intracellular
Molecular
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77
Q

What are some of the possible constraints of research within neuroscience?

A

Expertise, facilities, time, money, ethics

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78
Q

What is a contrast X-ray?

A

An x-ray, but using an injected substance. This provides image contrast between intravascular and extravascular components

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79
Q

What are the different techniques that can be used successfully on humans within neuroscience?

A 
Contrast X-ray
MRI
fMRI
PET
EEG
MEG
TMS&TDCS
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80
Q

What are the different invasive methods that can be used in animal models of neuroscience research?

A

Direct measurement of brain activity
Determining connectivity between structures
Distrupting connectivity between structures to determine effects on circuit function
Leison specific structures to inform us about its function
Pharmacological research
Genetic manipulations
Optogenetics

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81
Q

What is fMRI?

A

Altered MRI to be sensitive to oxygenated or deoxygenated blood. Blood changes due to brain activity.

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82
Q

How can PET scan be used in neuroscience?

A

Use a contrast agent that is specific to a biological process. The chemical will bind to the target. Attach a radioisotope to a positron emitter. Inject the tracer then image. Poor spatial and temporal resolution.

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83
Q

How can an EEG be used in neuroscience?

A

Using electrodes on scalp, can analyse regional brain activity. Good temporal resolution and bad spatial resolution. Analysis is complex. Can be used to look at brains response to stimuli.

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84
Q

When are neurons formed?

A

Mainly, but not exclusively, formed during brain development

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85
Q

What are the two types of synapse? Which is more common?

A

Chemical- majority

Electrical- Less abundant

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86
Q

Briefly describe how a synapse works

A

Nerve travels down axon, causing depolarisation. This opens voltage-gated Ca2+. Neurotransmitter is released into synaptic cleft and attaches to receptor on the post synaptic membrane.

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87
Q

What is the importance of neural plasticity?

A

It is the basis of learning and memory

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88
Q

What can change between neurons? (heterogeneity)

A

Size
Morphology
Electrical properties
Neurotransmitters

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89
Q

What is the difference between upper motor neurons and striatal interneurons?

A

Upper motor neurons- large, excitatory, glutametergic, long projection pyramidal cells.
Striatal interneuron- small, inhibatory, GABAergic

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90
Q

Describe olgiodendrocytes

A

Myelinating cells of the CNS
Unique to vertebrates
Myelin insulates axon segments, enables rapid nerve conduction
Myelin sheath segments interrupted by nodes of ranvier- saltatory conduction
Provides metabolic support for axons

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91
Q

What is the myelin sheath?

A

Formed by wrapping of axons by olgiodendrocyte processes. Highly compacted- 70% lipid, 30% protein.
Myelin specific proteins e.g. MBP, involved in compaction.

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92
Q

Describe microglia

A

Resident immune cells of the CNS. Originate from yolk sac progenitors that migrate into CNS
“Resting” state- highly ramified, motile processes that survey the environment. Upon activation, they retract their processes, becoming “ameoboid” and motile. Proliferate at sites of injury- phagocytic.

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93
Q

What are the functions of microglia?

A

Immune surveillance
Phagocytosis- debris/microbes
Synaptic plasticity- pruning

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94
Q

What are astrocytes?

A

Star-like cells. Most numerous glial cells in the CNS. Highly heterogenous. Common “marker” glial fibrillary acidic protein.

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95
Q

What are the functions of astrocytes?

A 
Developmental
Structural- define brain architecture
Envelope synapses
Homeostatic- buffer K+, glutamate etc
Metabolic support 
Disease- gliosis/astrocytosis
Neurovascular coupling
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96
Q

What are the features of the blood-brain barrier?

A 
Endothelial tight junctions
Astrocyte end feet
Pericytes
Lacks fenestrations
Specific transporters
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97
Q

What is the choroid plexus formed from?

A

Modified ependymal cells

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98
Q

What is the main site of CSF production?

A

The choroid plexus, mainly within the lateral ventricles

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99
Q

What are the functions of the frontal lobe?

A

Voluntary movement on opposite side of body
Frontal lobe of dominant area controls speech (Brocas area) and writing
Intellectual functioning, thought processes, reasoning and memory

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100
Q

What are the functions of the parietal lobe?

A

Recieves and interprets sensations, including pain, touch, pressure, size and shape, and body-part awareness

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101
Q

What are the functions of the temporal lobe?

A

Understanding the spoken word, sounds as well as memory and emotion

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102
Q

What are the functions of the occipital lobe?

A

Understanding visual images and meaning of written words

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103
Q

How does a neuron stain under H&E?

A

The haemotoxylin stains the nucleic acids blue, and the eosin stains the proteins red

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104
Q

What are the basic components of neurons?

A

Dendrites
Cell body/Soma
Axon
Presynaptic terminals

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105
Q

What are the symptoms of multiple sclerosis?

A 
Eye movements are controlled
Slurred speech
Paralysis
Tremor
Loss of co-ordination
Sensory weakness
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106
Q

What is diffusion?

A

The force driving molecules to move to areas of lower concentration

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107
Q

What is the ratio of sodium ions to potassium ions pumped by the sodium-potassium pump?

A

Three sodium ions for every two potassium ions

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108
Q

What is temporal summation?

A

One axon firing many times

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109
Q

What is spatial summation?

A

Lots of axons firing once

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110
Q

What are the symptoms of novichok poisoning?

A 
Muscle convulsions
Paralysis
Heart Failure
Asphyxiation 
Constricted Pupils
Vomiting
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111
Q

What are the five fundamental processes of synaptic transmission?

A
  1. Manufacture
  2. Storage
  3. Release
  4. Receptor activation
  5. Inactivation
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112
Q

How long do fast neurotransmitters last and give some examples

A

Short lasting

Acetyl choline, glutamate, gamma-aminobutyric acid

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113
Q

How long do slow neurotransmitters last and give some examples

A

Slow acting

Dopamine, Noradrenaline, Serotonin

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114
Q

What chemicals affect ACh?

A

Cigarettes
Poison Arrows
Spider Toxins
Nerve gas

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115
Q

What chemicals affect Noradrenaline?

A

Antidepressants (imipramine blocks reuptake)
Antidepressants (MAO inhibitors block break-down)
Stimulants

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116
Q

What chemicals affect dopamine?

A

Antipsychotic drugs
Stimulants
Antiparkinsons drugs

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117
Q

What chemicals affect serotonin?

A

Antidepressant drugs
Hallucinogens
Ecstacy

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118
Q

What are the side effects of GABA?

A

Anti anxiety
Anti convulsant
Anaesthetic

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119
Q

What are the side affects of L-DOPA?

A

Anti-psychotic

Causes Parkinsons symptoms at high doses

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120
Q

Why may CT Scans be used instead of MRI scans to analyse the brain?

A

Better for bone and calcification
Quicker scan times than MRI
MRI can be noisy and claustrophobic

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121
Q

Why may MRI scans be used instead of CT scans to analyse the brain?

A

CT scans require ionated contrast media= allergic reaction? (MRI do not)
CT scans use a high dose of X-rays
MRI provides excellent anatomical detail

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122
Q

What are the two muscles that control lid position?

A 
Orbicularis oculi (Closes lid, controlled by CN VII- facial)
Levator palpebrae muscle (elevates upper lid, sympathetic nervous supply)
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123
Q

Where are the meibomian glands and why are they important?

A

There is a series of openings on the lid. The glands themselves lie in the tarsal plate. They secrete the early components of the tear film

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124
Q

What is the function of the conjunctiva?

A

Acts as a barrier

Produces mucin from the goblet cells and aqueous part of tear film from the accessory lacrimal glands

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125
Q

What are the layers of the tear film and roles of each?

A

Anterior lipid layer- stabilizes tear film and reduces evaporation
Middle aqueous layer- Contain antibodies, enzymes and vitamin C
Deep mucin layer- Allows aqueous layer to spread over relatively hydrophobic cornea apithelial cells

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126
Q

What are the general functions of the tear film?

A

Protects

Provides smooth, clear, anterior refracting surface for cornea

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127
Q

Where are tears produced and what is their function?

A

Produced by main lacrimal gland in response to stimuli

Acts as a protective agent when the eye is irritated and helps wash out foreign bodies

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128
Q

What is the nervous supply to the cornea?

A

Opthalmic divison of the trigeminal nerve (CN V)

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129
Q

What are the layers of the cornea?

A

Epithelium (anterior)
Stroma (Middle)
Endothelium (Posterior)

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130
Q

Describe the stroma of the cornea

A

Regular lamina of collagen fibres, dehydrated, no blood vessels, thickest part

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131
Q

What is the function of the fluid pump in the endothelium of the cornea?

A

To counteract the tendancy of the cornea to become cloudy

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132
Q

Where does the cornea receive nutrients from?

A

No vessels (transparent) so receives nutrients from the tear film anteriorly and aqueous humour posteriorly

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133
Q

What is the site of the trabecular meshwork?

A

The anterior chamber angle

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134
Q

What are the muscles of the iris and their nervous supply?

A 
Dilator muscle (sympathetic branch of nerves to eye, has alpha receptors)
Sphincter muscles (parasympathetic fibres within CN III, contains muscularinic receptors)
135
Q

What is the function of the iris?

A

To control light entry

136
Q

What is the function of the lens?

A

To focus light onto the retina. Also can alter shape thus increasing or decreasing the refracting power of the eye

137
Q

What is the function of the ciliary body?

A

Pars plicata: ciliary processes that secrete aqueous humour. Enhanced by folds to increase SA
Pars plana: Thin part which merges with choroid

138
Q

What is the innervation of the ciliary muscle?

A

Parasympathetic fibres in CN III

139
Q

Where is the vitreous humour found?

A

Between the posterior lens and retina

140
Q

What does the vitreous humour consist of?

A

A scaffold of collagen fibres and large, negatively charged molecules.

141
Q

What is the retina made up of?

A

Outer layer photoreceptors
1st and 2nd order neurons (bipolar and ganglion cells)
Interneurons (amacrine and horizontal cells)
Neuroglial cells
Pigment cells
Supporting membranes

142
Q

What tools would be used to view the surface of the retina?

A

An opthalmoscope

143
Q

Describe the macula

A

3mm Central area temporal to optic disc
Thickest part of retina
Highest concentrations of cones
Yellowish pigment

144
Q

Describe the fovea

A 
Central zone of macula (concave profile)
Thinnest part of retina
Just consists of cones 
No retinal blood vessels
Best visual acuity
145
Q

What is the role of the choroid?

A

Removes heat from retina

146
Q

What is the diameter of the optic disc?

A

1.5mm

147
Q

What is the general colour of the optic disc and why?

A

Pink as there are lots of capillaries

148
Q

Where is the blind spot?

A

In the optic disc

149
Q

What is the sclera?

A

Tough, protective outer layer of globe. Perforated posteriorly by optic nerve. Openings for vessels. Irregularly arranged collagen fibres for strength. Covered in a thin, vascular episclera

150
Q

What causes the pupil diametre to change?

A
  • Changes in light intensity
  • Proximity of object
  • State of arousal
151
Q

What are the causes of abnormal light response?

A 
Afferent= Optic nerve disease, severe retinal disease
Efferent= Third nerve palsy, adie pupil, damage to iris, atropine
152
Q

What is the dark response?

A

Active dilation by sympathetic stimulation of dilator muscle as well as inhibition of sphincter muscle

153
Q

What is the ciliospinal reflex?

A

Painful stimulation of neck causes pupil dilation on the same side

154
Q

Why is there a high intraocular pressure?

A

To allow the eye to move without deforming

155
Q

What tool is used to measure intraocular pressure?

A

Tonometer

156
Q

What is glaucoma and hypotony?

A

Glaucoma- high intraocular pressure

Hypotony- Low intracular pressure

157
Q

What are the branches of the opthalmic artery and what do they supply?

A

Central retinal artery- inner retina
Ciliary arteries- outer retina and anterior part of globe
Additional Branches

158
Q

Are the retinal capillaries or choroidal capillaries leaky?

A

Choroidal

159
Q

What are the two visual systems of each eye?

A

Scotopic (monochromatic, low light conditions, function of rods)
Photopic (chromatic, bright light conditions, function of cones)

160
Q

What is the trichromatic colour theory?

A

There are three types of cones and they respond differently to wavelengths of light. The maximum response roughly matches red, green and blue light. Different cones response to different wavelengths are perceived as colour.

161
Q

What factors limit visual fields?

A

Extent of retinal photoreceptors

Facial anatomy

162
Q

What are the dimensions of the visual fields?

A

Nasally 60 degrees
Temporally 100 degrees
Superiorly 70 degrees
Inferiorly 80 degrees

163
Q

What is myopia and hyperopia?

A

Myopia- the eye is too long, short sightedness

Hyperopia- The eye is too short, long sightedness

164
Q

What happens when images are brought closer to the eye?

A

Near reflex

  • The lens increases its refracting power
  • The eyes converge
  • The pupils constrict
165
Q

What tool is used to measure visual acuity?

A

The snellen chart

166
Q

What is a strabismus?

A

A squint

167
Q

What are the clinical features of a retinal problem?

A
  • Total loss of vision in one eye
  • Loss of part of visual field in one eye that mirrors area damage
  • Loss of the upper or lower half of field of vision
  • Loss of centre of vision; central scotoma
  • Tunnel vision
168
Q

What are the clinical features of an optic nerve problem?

A
  • Enlarged blind spot
  • Loss of centre of vision
  • Loss of vision in arc shape
  • Tunnel vision
169
Q

What are the clinical features of an optic chiasm problem?

A

-Loss of temporal field of vision in both eyes; bitemporal hemianopia

170
Q

What are the clinical features of an optic tract problem?

A
  • Loss of field of vision on the contralateral side to the side of the problem. Problem is homonymous (temporal in one eye and nasal in other), affecting up to 1/2 of the visual field and greater in one eye than the other
171
Q

What are the clinical features of an optic radiation problem?

A
  • Contralateral homonymous field defects that are either predominantly in the inferior visual field (parietal lobe lesion), or the superior visual field (temporal lobe lesion). The effects are similar in both eyes.
172
Q

What are the clinical features of a visual cortex problem?

A
  • Highly congruous, contralateral, homonymous hemianopia
  • As they are often vascular and the occipital lobe has a blood supply from the middle and posterior cerebral arteries, the central visual field is often spared.
173
Q

In what order should one clinically examine the eye muscles?

A
  1. Lateral and medial rectus
  2. Superior and inferior rectus
  3. Inferior and superior oblique
174
Q

How should you examine lateral and medial rectus?

A

Sit in front of the patient. Place a finger at eye level, at about an arms length from their face and move it right to left. Observe each eye in turn.

175
Q

How should you examine superior and inferior rectus?

A

Sit in front of the patient. Get the patient to look 23 degrees to the side. Place a finger about an arms length from their face and move it up and down. Observe each eye in turn.

176
Q

How should you examine inferior and superior oblique?

A

Sit in front of the patient. Place a finger at eye level at about an arms length from their face and out to the side. Move the finger up and down. Repeat on both sides.

177
Q

What are the three semi-circular canals?

A

Anterior, posterior and lateral

178
Q

Why does dizziness occur?

A

When the semi-circular canals send signals to the brain when there is no movement.
Physiological cause= after spinning
Pathological cause= Labarynthitis

179
Q

Describe the vestibulo-ocular reflex test

A

Lie patient on side
Poor ice-cold water in the ear. This creates a convection current in the canal.
This sends a signal to the brian
The eyes should slowly move towards the cold water, then jump back to normal position.

180
Q

Define sensation

A

The mental process that results from the immediate external stimulation

181
Q

Define perception

A

The ability to become aware of something, or understand something following sensory stimulation

182
Q

What are the 5 types of perception?

A

Tactile, gustatory, visual, auditory, olfactory

183
Q

What is the perceptual set?

A 
The psychological factors that determine how you perceive your environment. 
Context
Culture
Expectations
Mood and motivation
184
Q

What is bottom up processing and top down processing?

A

Broadly speaking, bottom up processing is sensation, and top down processing is perception

185
Q

What is a hallucination?

A

Experiences involving the apparent perception of something not present.
An error in top down processing. They are unique in individuals due to their different perceptual set.

186
Q

What is the normal human hearing range?

A

20 Hz- 20 KHz

187
Q

Describe the Pinna

A

A cartilaginous structure. It is formed from pharyngeal arches 1 and 2 (6x hillocks of his).

188
Q

What is the role of the outer ear?

A

Direct sound waves towards the ear canal.

189
Q

How much of the outer ear canal is cartilage and how much is bone?

A

1/3 cartilage, 2/3 bone

190
Q

What is the pars flaccida and pars tensa?

A

The pars flaccida is the top 1/3 of the tympanic membrane

The pars tensa is the bottom 1/3 of the tympanic membrane

191
Q

What muscles are within the middle ear, and what bone are they attached to?

A 
Tensor Tympani (malleus)
Stapedius (Stapes)
192
Q

What is the role of the middle ear?

A

To amplify air-bone sound vibration

193
Q

What are the roles of the middle ear muscles?

A

Protection of inner ear from acoustic trauma
Stiffens the ossicular chain
Stapedius is stimulated acoustically
25 ms reaction time in man
Tensor tympany- Voluntary and involuntary control
Chewing

194
Q

What are the roles of the eustachian tube?

A

Ventilation of the middle ear space, keeping pressure equal

Drainage of secretions

195
Q

Describe the inner ear

A

A set of fluid filled sacs, encased in bone

Innervated by the vestibulocochlear nerve

196
Q

What is the role of the labyrinth?

A

Balance

197
Q

How many spirals are formed in the cochlear?

A

2.7

198
Q

What are the two openings of the cochlear?

A

Round window and oval window

199
Q

What are the three compartments of the cochlear?

A

Salca tympani
Salca media
Salca vestibuli

200
Q

What are the endolymph and perilymph? Where are they found?

A

Endolymph- High K+ solution , found in scala media

Perilymph- like ECF and CSF, Na+ rich, found in Scala tympani and scala vestibuli

201
Q

What is the difference between the basilar membrane base and apex?

A 
The base (tympanic membrane) is narrow and stiff. It detects high frequencies. 
The apex is wide and floppy. It detects low frequencies.
202
Q

What are the roles of the inner and outer hair cells?

A 
Inner= mechanical transducens 
Outer= Fine tuning
203
Q

How does movement of the stereocilia cause release of neurotransmitter?

A

Movement of sterocilia
Rapid response required
Mechanically gated K+ channels are opened, causing depolarization
This results in opening of voltage-gated Ca2+ channels
Release of neurotransmitter

204
Q

What are the parts of the central auditory pathway? (ECOLI)

A 
Eighth nerve
Cochlea
Olive
Lateral lemniscus
Inferior colliculus
205
Q

What is conductive hearing loss?

A

A defective outer or middle ear

206
Q

What is sensorineural hearing loss?

A

A defective inner ear

207
Q

What are the latin names of the midbrain, forebrain and hindbrain?

A

Forebrain- Prosencephalon
Midbrain- Mesencephalon
Hindbrain- Rhombencephalon

208
Q

What are the parts of the prosencephalon?

A

Telencephalon (hemispheres and basal ganglia)

Diencephalon (thalamus, subthalamus, hypothalamus, epithalamus)

209
Q

Define psychological stress

A

The state of mental or emotional strain or tension resulting from adverse or demanding circumstances

210
Q

What is eustress?

A

Positive stress which is beneficial and motivating. Typically the experience of striving for a goal which is within reach,

211
Q

What is distress?

A

Negative stress which is damaging and harmful. Typically when a challenge is not resolved by coping or adaptation.

212
Q

What is acute stress?

A

Short lived response to a novel situation experienced by the body as a danger.

213
Q

What is chronic stress?

A

Arises from repeated or continued exposure to threatening or dangerous situation, especially those that cannot be controlled.

214
Q

What are some causes of chronic stress?

A 
Physical illness
Physical or sexual abuse
Poverty
Unemployment
Bullying
Caregiving
215
Q

What are the 3 phases of Selye’s syndrome?

A

Alarm- Threat is realised
Adaptation- Body engages defense response
Exhaustion- Body runs out of defensive responses

216
Q

What are the five elements of the human stress response?

A 
Biochemical
Physiological
Behavioural
Cognitive
Emotional
217
Q

Describe the sympathomedullary path of the stress response

A

Hypothalamus activates adrenal medulla
Adrenal medulla releases adrenaline and noradrenaline into bloodstream
Body prepares for fight or flight. Adrenaline and noradrenaline reinforces the pattern of sympathetic activation
Energy

218
Q

Describe the pituitary-adrenal system of the stress response

A

Higher brain centre activates hypothalamus
Hypothalamus releases corticotrophin
Pituitary gland releases adrenocorticotrophic
Adrenal cortex releases corticosteroids
Corticosteroids causes changes- liver releases energy and immune system is suppressed

219
Q

What is the biochemical stress respose?

A

Glucocorticoids (Cortisol)
Catecholamines (Adrenaline and noradrenaline)
Inflammation and immune response

220
Q

What are the immediate physiological stress responses?

A 
Rapid breathing
Increased blood flow
Increase HR and BP
Tense muscles
Glucose release
RBC discharged from spleen
Dry mouth 
Sweating
221
Q

What are the later physiological stress responses?

A 
Headache
Chest pain
Stomach ache
Low energy
Loss of labido 
Colds and infections
222
Q

What are the behavioural stress responses?

A 
Easily startled 
Change in appetite
Change in weight
Procrastination or avoiding responsibilities 
Alcohol, drugs
Nail biting, fidgeting 
Sleep disturbances
Withdrawal
223
Q

What are the cognitive stress responses?

A 
Worrying
Racing thoughts
Forgetfulness
Inability to focus
Poor judgement
Pessimistic 
Learning
224
Q

What are the emotional stress responses?

A 
Depression and sadness
Tearfulness
Mood swings
Irritibility
Restlessness
Aggression
Low self-esteem
Boredom
Overwhelmed
Rumination, anticipation and avoidance
225
Q

What is allostasis?

A

It refers to how multiple and complex systems adapt collectively in changing environments through dynamic change

226
Q

What are the symptoms of PTSD?

A 
Vivid flashbacks and nightmares
Sweating
Nausea
Trembling 
Hyper vigilance 
Insomnia
Irritibility
227
Q

Define natural selection

A

The differential survival and reproduction of individuals due to differences in phenotype

228
Q

What is evolutionary medicine?

A

The application of modern evolutionary theory to understand health and disease. It considers a species perspective with related interests to evolutionary psychology and medicine.

229
Q

What are tinbergen’s questions?

A

Mechanism- How does this behavior occur in an individual?
Development- How does this behavior arise in an individual
Evolution- How does this behavior arise in the species
Adaptive value- Why is this behaviour adaptive for the species

230
Q

What is compassion focussed therapy?

A

Therapy rooting in evolutionary and neuroscience approach to physiological processes. CFT is aimed at facilitating development of soothing and social safeness system

231
Q

What are the three types of retinal ganglion cells and what does each do?

A

Parvocellular- Low contrast, High linear spatial resolution layers 1 and 2
Konicocellular- Blue-yellow colour oppenency, layers 3 to 6
Magnocellular- High contrast, low resolution, motion detection, colour blind, interspersed

232
Q

What does the brain use for analysing depth perception?

A 
Familiar size
Occlusion
Linear perspective
Size perspective
Shadows and illumination
Motion Parallax
233
Q

What are the symptoms of a lesion affecting the middle temporal visual area?

A

Akinetopsia (loss of motion vision)

Impaired saccades

234
Q

What are the three types of saccades?

A

Spontaneous
Reflexive
Voluntary

235
Q

What is the function of a vestibular eye movement?

A

Holds eye steady on retina during brief head rotations or translations

236
Q

What is the function of the visual fixation eye movements?

A

Holds the image of a stationary object on the fovea by minimising ocular drifts

237
Q

What is the function of the optokinetic eye movement?

A

Holds images steady on the retina during sustained head rotation

238
Q

What is the function of the smooth pursuit eye movement?

A

Holds the image of a small moving target on the fovea; or holds the image of a small near target on the retina during linear self-motion

239
Q

What is the function of a nystagmus quick phase eye movement?

A

Reset the eyes during prolonged rotation and direct gaze towards the oncoming visual scene

240
Q

What is the function of a saccade eye movement?

A

Bring images of objects of interest onto fovea

241
Q

What is the function of a vergence eye movement?

A

Moves the eyes in opposite directions so that images of a single object are placed or held simultaneously on the fovea of each eye

242
Q

Where do pyramidal motor pathways originate?

A

The cerebral cortex

243
Q

Briefly describe the difference between the lateral and anterior corticospinal tract

A

Lateral- crosses over at medulla, terminates at ventral horn synapsing with lower motor neurons. Carries limb information. Roughly 90% of pyramidal fibres are lateral
Anterior- Remains ipsilateral, terminates at ventral horn of cervical and upper thoracic segments. Carries info about axial muscles. Roughly 10% of pyramidal fibres.

244
Q

Describe the corticobulbar pyramidal tract

A

Supplies musculature of the head and neck
Terminates at the brainstem on the motor nuclei of the cranial nerves
Lower motor neurons carry motor signals to muscles of face and neck

245
Q

Where do extrapyramidal motor tracts originate?

A

The brain stem

246
Q

What are the four extrapyamidal tracts and each of their actions?

A

Tectospinal- head turning in response to visual stimuli
Rubrospinal- Assists in motor function
Vestibulospinal- Muscle tone and posture
Reticulospinal- Spinal reflexes

247
Q

What are the main differences between a UMN lesion and a LMN lesion?

A

UMN- No muscle wasting, hypertonia, paralysis affects movements of groups of muscles, hypereflexia, absent fasciculation, present babinski sign and clasp-knife reflex
LMN- Atrophy, hypotonia, flaccid paralysis, hyporeflexia, present fasciculation, absent babinski sign and clasp-knife reflex

248
Q

What are the 12 cranial nerves?

A 
Olfactory
Optic
Occulomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibulocochlear
Glossopharyngeal
Vagus 
Accessory
Hypoglossal
249
Q

Which of the cranial nerves have parasympathetic innervations?

A

3, 7, 9, 10

250
Q

Which cranial nerves have special sensory innervation?

A 
Olfactory (smell)
Optic (Vision)
Facial (Taste to anterior 2/3 of tongue)
Vestibulocochlear (Auditory)
Glossopharyngeal (Taste to posterior 1/3 of tonuge)
Vagus (Taste to epiglottis)
251
Q

Where does each cranial nerve exit the skull?

A 
1- Cribriform plate
2- Optic Canal
3- Superior orbital fissure
4- Superior orbital fissure
5- V1 - Superior orbital fissure
V2- Foramen rotundum
V3- Foramen Ovale
6- Superior orbital fissure
7- Internal acoustic meatus then stylomastoid foramen
8- Internal acoustic meatus
9- Jugular foramen
10- Jugular foramen
11- Jugular foramen
12- Hypoglossal canal
252
Q

What are the tests for each cranial nerve?

A

1- Smell test
2- Snellen chart, Fundoscopy, cover aspects of eye
3,4,6- H eye test
5- Clench teeth, test face sensation
7- Inspect face for asymmetry during facial expression, taste test
8- Whisper number into patients ear
9- Taste test
10- Analyse patients voice, gag reflex test
11- Turn head against resistance, shrug shoulders
12- Protrude tongue, inspect for asymmetry

253
Q

Cranial nerves: Is the optic nerve sensory function, motor function, or both?

A

2- Sensory (special sense of vision)

254
Q

Cranial nerves: Is the opthalmic nerve sensory function, motor function, or both?

A

1- Sensory (special sense of smell)

255
Q

Cranial nerves: Is the occulomotor nerve sensory function, motor function, or both?

A

3- Motor ( Movement of eye muscles)

Parasympathetic (pupillary reflex)

256
Q

Cranial nerves: Is the trochlear nerve sensory function, motor function, or both?

A

4- Motor (Movement of superior oblique)

257
Q

Cranial nerves: Is the trigeminal nerve sensory function, motor function, or both?

A

5- Sensory ( Face and mouth)

Motor (muscles of mastication by V3)

258
Q

Cranial nerves: Is the abducens nerve sensory function, motor function, or both?

A

6- Motor (Movement of lateral rectus)

259
Q

Cranial nerves: Is the facial nerve sensory function, motor function, or both?

A

7- Motor ( Muscles of facial expression and stapedius)
Parasympathetic (Lacrimal gland and submandibular/sublingual glands)
Special sensory (Taste to anterior 2/3 of tongue)

260
Q

Cranial nerves: Is the vestibulocochlear nerve sensory function, motor function, or both?

A

8- Special sensory (Hearing and balance)

261
Q

Cranial nerves: Is the glossopharyngeal nerve sensory function, motor function, or both?

A

9- Motor (Stylopharyngeus muscle)
Sensory (Skin of external ear, posterior 1/3 of tongue, carotid body, carotid sinus, eustachian tube)
Special sensory (Taste to posterior 1/3 of tongue)
Parasympathetic (Parotid gland)

262
Q

Cranial nerves: Is the vagus nerve sensory function, motor function, or both?

A 
10- Motor (Muscles of pharynx and larynx)
Parasympathetic (Viscera of abdomen and thoracic wall)
Sensory  (external ear)
Special sensory (Epiglottis)
263
Q

Cranial nerves: Is the accessory nerve sensory function, motor function, or both?

A

11- Motor (Sternocleidomastoid, trapezius)

264
Q

Cranial nerves: Is the hypoglossal nerve sensory function, motor function, or both?

A

12- Motor (Intrinsic and extrinsic muscles of the tongue)

265
Q

Define pain

A

Unpleasent sensory and emotion associated with actual or potential tissue damage or described in terms of such damage

266
Q

Define nociceptive pain

A

Actual or threatened damage to non-neural tissue and is due to activation of nociceptors

267
Q

Define neuropathic pain

A

Pain caused by a lesion or disease of the somatosensory nervous system

268
Q

Define allodynia

A

Pain due to a stimulus that does not normally provoke pain

269
Q

Define dysethesia

A

An unpleasent abnormal sensation, can be spontaneous or provoked

270
Q

Define hyperalgesia

A

Increased pain from a stimulus that normally provokes pain

271
Q

What is the difference between acute and chronic pain?

A

Acute = less than 12 weeks

Chronic pain= Continuous pain for more than 12 weeks. Pain persisting beyond tissue healing time

272
Q

What are the roles of the insular cortex?

A

Perception, motor control, self awareness, interpersonal experience
Plays a role in addiction
Degree of pain judged here

273
Q

What are the causes of cancer pain?

A
  1. Pain directly from tumour
  2. Cancer therapy pain
  3. Pain unrelated to the cancer
274
Q

Describe the pain pathway

A
  1. Initial injury activates nociceptors peripherally
  2. Nociceptors begin to fire (inflammatory soup)
  3. The impulse within the afferent neuron rapidly goes into the dorsal root ganglion
  4. Here, it projects into the 2nd order neuron which travels on the ipsilateral side into the spinolthalamic tract
  5. This travels up spinal cord to the thalamus and in the thalamus it projects another impulse into the sensory cortex
275
Q

What are the symptoms of depression?

A

General- Low mood, anhedonia, low energy
Biological- Poor sleep, Poor appetite, Reduced labido, Poor concentration
Cognitive- Worthlessness, guilt, hopelessness, suicidal thoughts

276
Q

Describe the HPA axis

A
  1. In response to stress, the hypothalamus causes release of corticotropin releasing hormone
  2. The anterior pituitary detects this and secretes anderrinotopic hormone
  3. The adrenal cortex thus releases cortisone, which acts as a negative feedback loop to inhibit the hypothalamus and anterior pituitary
277
Q

How does the volume of the brain alter in depressed patients?

A

Large vol loss of dorsolateral prefrontal cortex

Reduced hippocampus size

278
Q

What affect do antidepressants have on the brain?

A

Increased GR expression thus regulating HPA activity
Increased neurogenesis
Increased BDNF synthesis, increasing the number of synapses

279
Q

What is the default mode network?

A

The resting state of the brain- daydreaming and internal flow of consciousness. Includes autobiographical details, self reference and thinking about others.

280
Q

What is a motor unit?

A

A single alpha motor neuron and all the muscle fibres it innervates. Different motor neurons innervate different numbers of muscle fibres. Fewer fibres means greater movement resolution.

281
Q

What is the motor pool?

A

All the lower motor neurons that innervate a single muscle. They contain both alpha and gamma motor neurons. They are of ten arranged in a rod-like shape within the ventral horn of the spinal column.

282
Q

What are the two ways in which cell bodies in the ventral horn can be activated?

A
  1. Sensory information from the muscle

2. Descending information from the brain

283
Q

Where is the golgi tendon organs and what do they detect?

A

They are located within the tendon. Mostly, it is sending sensory information to the brain via the spinal cord about the tension in the muscle/ the muscle’s force.

284
Q

What is the innervation of intrafusal and extrafusal fibres?

A

Intrafusal- gamma motor neurons

Extrafusal- Alpha motor neurons

285
Q

Where are muscle spindles and what do they detect?

A

They are embedded within most muscles and are composed of intrafusal fibres. They detect stretch regardless of current muscle length.

286
Q

What are the role of sensory fibres within muscle spindle feedback?

A

They coil around intrafusal fibres and are innervated by gamma motor neurons. They keep the intrafusal fibres set at a length that optimises muscle strength detection.

287
Q

What is the size principle?

A

Units are recruited in order of size. Fine control is typically required at lower forces.

288
Q

What are the numbers of muscle fibre variants?

A
  1. Level of control

2. Strength

289
Q

What are the three fibre types?

A

Slow
Fast fatigue resistant
Fast fatiguable

290
Q

What is the output of the basal ganglia?

A

Mainly inhibitory information- travels to the cortex via the thalamus

291
Q

What is centralised selection?

A

There are multiple command systems that are spatially distributed. They process in parallel and all act through a final common motor path. Centralised selection decides which pathway to choose. It inhibits all other pathways to allow the chosen pathway through. It is done by the basal ganglia.

292
Q

What are the symptoms of cerebellar damage?

A 
DANISH
D- Dysdiodochokinesia
A- Ataxia
N- Nystagmus
I- Intention Tremor
S- Slurred speech
H- Hypotonia
293
Q

What is a commisure?

A

A tract connecting one hemisphere to the other

294
Q

What is asynergia?

A

Loss of co-ordination of motor movement

295
Q

What is nystagmus?

A

Abnormal eye movements

296
Q

How many layers are there of neocortex?

A

6

297
Q

What are the inputs/projections of each layer of neocortex?

A 
1- No inputs/projections
2- Inputs from other cortical areas
3- Projects to other cortical areas
4- Input from thalamus
5- Project to brainstem and spinal cord
6- Projects to thalamus
298
Q

What are the components of the parasympathetic nervous system?

A
  • Cranial outflow- CN 3,7,9,10

- Sacral outflow

299
Q

What are the components of the the sympathetic nervous system?

A

Sympathetic chain T1-L2

Adrenal gland

300
Q

What receptors and neurotransmitters are present in the sympathetic ns?

A

ACh with a nicotinic receptor, then noradrenaline

- Receptors are alpha 1 (in smooth muscle) and alpha 2 (in blood vessels)

301
Q

What receptors and neurotransmitters are present in the parasympathetic ns?

A

ACh with a nicotinic receptor, then ACh with a muscarinic receptor
- Receptors are beta 1 (in heart), beta 2 (in bronchi) or beta 3

302
Q

Give an example of an acute and a chronic primary ANS disorder

A

Acute- Pan-dysautonomia

Chronic- Parkinson’s disease

303
Q

How can the autonomic NS CVS problems be tested?

A

Testing BP
Testing BPM
Head up tilt test

304
Q

What are the components of the striatum?

A

Putamen

Caudate nucleus

305
Q

What are the components of the globus pallidus?

A

Internal segment

External segment

306
Q

Where is dopamine produced and where does it act?

A

It is produced in the substantia nigra (melanin is produced as a byproduct). It acts on the axons in the striatum.

307
Q

What is the pathalogical cause of parkinsons disease?

A

There is disease of the dopamine neurons in the substantia nigra so dopamine is not produced effectively.
The subthalamic nucleus is inhibited.

308
Q

What is the pathalogical cause of Huntington’s disease?

A

The head of the caudate and the cortex shrinks making ventricles appear bigger (can be seen on a CT). This means that there is too much dopamine.
It is autosomal dominant and fully penetrant

309
Q

What are the symptoms of Parkinsons?

A 
Increased muscle tone
Reduced movement
Not enough dopamine 
Problems with doing up buttons/ keyboards
Smaller writing
Deteriorated walking; small steps, dragging one foot, feet close together, etc. 
Tremor at rest (may be on one side only)
Pain
310
Q

What are the treatments for Parkinsons?

A

L-DOPA (to correct dopamine deficit)- but becomes less effective and more side effects develop the longer that it is used
Deep brain stimulation- functional lesioning of the subthalamic nucleus

311
Q

What are the symptoms of Huntington’s disease?

A 
Chorea
Dementia/psychiatric illness
Personality change
Decreased muscle tone
Overshooting movements
Too much dopamine
312
Q

What is the treatment for choriform movements?

A

Dopamine receptor blockers

313
Q

What is the WHO definition of mental health?

A

Mental health is a state of well being in which every individual realizes his or her own potential, can cope with normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community

314
Q

List some CMHDs

A 
Depression
Generalized anxiety disorder
Social Anxiety disorder
Panic Disorder
OCD
PTSD
Phobias
315
Q

What are the symptoms of depression?

A 
Loss of interest
Decreased energy
Feelings of guilt or low self worth
Disturbed sleep or appetite
Poor concentration
These must last most of each day, every day for more than 2 weeks
316
Q

How much more likely are women than men to have a CMHD?

A

2x more likely

317
Q

What are some social determinants of CMHDs?

A 
Low education 
Material Disadvantage
Unemployment
Debt
Loneliness
318
Q

What are the different levels of interventions for CMHDs?

A

Individual level
Service level
Community level

319
Q

What is included in individual level intervention?

A

Medication, psychological therapy, CBT
Culturally sensitive
Collaborative

320
Q

What is included in service level intervention?

A

Management within primary care, focusing on prevention and early identification
Holistic approach
Outcomes focused
Joining the gaps

321
Q

What is included in community level intervention?

A

Strengthening protective factors e.g. programmes in schools

Reducign risk factors

322
Q

What is IAPT and what is its goal?

A

Improving access to psychological therapy
Low or high intensity
Lower socio-economic groups are more likely to access treatment
Shorter waiting times

323
Q

Describe the “take it easy” trap of chronic pain

A

Avoidance of activities due to concerns about doing harm, and avoiding activities associated with pain. The patient therefore does less and less over time, and has less contact with others. This can lead to a loss of fitness and depression.

324
Q

What are the three P’s of pain management?

A

Pacing
Planning
Prioritising

325
Q

What cells line the ventricles?

A

Ciliated ependymal cells

326
Q

How does CSF drain?

A

Arachnoid granulations

Peripheral nerves to lymphatics

327
Q

How does interstitial fluid drain into the CSF?

A

Perivascular channels

328
Q

What nucleus does the superior colliculus communicate with?

A

Lateral geniculate nucleus of thalamus

329
Q

What nucleus does the inferior colliculus communicate with?

A

Medial geniculate nucleus of thalamus

330
Q

What does a small response from a NCS suggest?

A

Axonal degeneration

331
Q

What does a slow response from a NCS suggest?

A

Demylenation

332
Q

Briefly explain an EMG

A

Use a needle to pick up electrical activity from a muscle when the patient contracts it. Record the activity of individual motor units. Large motor unit- compensatory innervation, small motor unit- breakdown of muscle

333
Q

Briefly explain an EEG

A

Electrodes are placed in specific locations on the head. Ask the patient to do various things such as close eyes.

334
Q

What are the characteristics of a frontal lobe seizure?

A

Brief
Often arise in sleep
Fencing posture

Phase 1 (41 decks)

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