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Flashcards in Neuro Peer Tute test Deck (154):
1

What structure has the function of initiation of appropriate / inhibition of inappropriate movements?

Basal ganglia

2

Which structure receives proprioceptive input and uses it to fine-tune skilled movements?

The cerebellum

3

Which structures are involved in motor memory?

Cerebellum & basal ganglia

4

What can be the result of basal ganglia damage?

Rigidity
Resting tremor
Uncontrolled jerky movements

5

What structure is the major sensory relay to the cortex?

The thalamus

6

What structure produces the CSF?

Choroid plexus in the ventricles

7

What structures allow outflow of CSF into the sinuses?

Arachnoid granulations

8

Where are the interventricular foramina? And what is it aka?

Foramina of Monro

Channels that connect the lateral ventricles with the 3rd ventricle

9

Where is the cerebral aqeduct?

Connecting the 3rd ventricle to the 4th

10

Where is the foramen of Magendie?

On the dorsal side of the 4th ventricle, it allows CSF to drain into the "cisterna magna" below the cerebelloum

11

Where are the foramina of Luschka?

Also draining out from the 4th ventricle

12

What does communicating hydrocephalus mean?

CSF is blocked after leaving the ventricles - but it can still communicate freely between the ventricles

13

What is non-communicating hydrocephalus?

Aka obstructive

CSF is blocked along one of the passages that connect the ventricles

14

What is Nissl substance & where is it found?

RER of neurons, which stains intensely purple in H&E (due to concentration of RNA)

15

What are the glial cells of the CNS that myelinate called?

Oligodendrocytes

16

Do oligodendrocytes myelinate one cell or multiple cells? What about Schwann cells?

Multiple

Schwann cells myelinate single neurons.

17

Which glial cells are important in the BBB?

Astrocytes

18

Which are more numerous in the CNS - neurons or glial cells?

Glial cells

19

What are the three major classes of brain herniation?

Uncal/transtentorial
Cingulate/subfalcine
Tonsillar/cerebellar

20

What symptoms tend to accompany all herniations? (5)

Headache
Nausea
Vomiting
Blurred vision
Papilloedema

21

What is papiloedema?

Blurring of the optic disc margins

22

What are differentiating symptoms of an uncal hernia?

LOC - via compression of RAS
Hemiparesis - via compression of corticospinal tracts
Mydriasis - via CNIII compression

(Also risk of PCA compression)

23

What artery can be affected by a cingulate hernia?

ACA

24

What are the effects of tonsillar hernias?

Life threatening compression of medulla, - incl CV & resp centres

25

What causes watershed strokes?

Systemic hypoperusion

26

What would you see on a brain that has had watershed stroke?

Multifocal lesions at the far boundaries of the cerebral arterial terriories

27

What colour are cerebral infacts?

They can be pale, or haemorrhagic (due to secondary transformation)

28

What happens to an infarct if the pt survives?

Glial scar formation and cystic fluid filled holes

29

What is the most likely cause of a large cortical stroke?

Amyloid angiopathy

30

What is the most common cause of subcortical strokes?

Hyalinearteriolosclerosis

31

What defines cerebral dominance?

The side of the brain involved in language

32

Right handed people are usually ____ dominant

Left

33

Left handed people are usually _____ dominant

Left

34

What proportion of right handed people are left dominant?

90%

35

What proportion of left handed people are left dominant?

70%

36

What do non-dominant hemisphere do?

Visual-spacial orientation

37

What part of the brain is largely responsible for executive function?

PFC

38

What part of the brain is essential for working memory?

DLPFC

(dorso-lateral prefrontal cortex)

39

Which part of the brain inhibits innapropriate behaviour?

Orbitofrontal

40

What part of the brain is important for motivation and emotion processing?

MPFC

41

Which division of the MCA supplies Broca's area?

Superior

42

Which devision of the MCA supplies Wernicke's area?

Inferior

43

Which aphasia tends to have associated muscle weakness & what does it have?

Broca's

Contralateral face & UL hemiparesis

44

What sort of sensory deficit might you expect alongside a Broca's aphasia?

Decreased sensation in contralateral face & upper limb

45

What sort of sensory deficit might you expect alongside a Wenicke's aphasia?

R quadrantopia

As the temporal fibres of the left brain are for the upper R side.

46

What is Broca's aphasia is also known as?

Productive aphasia

47

What is Wernicke's aphasia aka?

Receptive aphasia

48

What is the 1st manifestation of frontotemportal dementia?

Behavioural and personality changes
(impulsivity, anhedonia, apathy)

49

What is the 1st presentation of Alzheimers?

Decrease in memory

(dysnomia and circumlacutory language)

50

What's the 1st presentation of vascular dementia?

It depends on lesion sites - no pattern

51

What is the pattern that would help you distinguish vascular dementia?

Stepwise progression

52

What usually causes subdural haematomas?

Acceleration-decelleration forces tearing the bridging veins

53

What usually causes extradural haematomas?

Head trauma especially skull fracture rupturing the meningeal arteries

54

What usually causes subarachnoid haematomas?

Aneurism rupture

55

What does an extradural haematoma look like?

Tends to be lenticular in shape as the dura is strong and attached at the fissures

56

What does a subdural haematoma look like?

Tends to fill in the sulci

57

Which haematoma bleeds slowly and may not even present?

Subdural - as it's venous pressure

58

Which spinal segment has no ANS p'way originating from it?

Cervical

59

What is the only certain way to distinguish sympathetic NS from parasymp NS?

Anatomy

Symp comes from thoracolumbar
Parasymp comes from craniosacral

60

Symp vs parasymp: Which usually has longer pre-ganglionic fibres?

Parasympathetic

61

Symp vs parasymp: Which usually has shorter pre-ganglionic fibres?

Sympathetic

(Think of the sympathetic trunk)

62

Symp vs parasymp: Which usually has longer post-ganglionic fibres?

Sympathetic

63

Symp vs parasymp: Which usually has shorter post-ganglionic fibres?

Parasympathetic

64

What does "divergence' refer to?

The ratio of pre- to post-ganglionic fibres

65

Symp vs parasymp: Which has greated divergence?

Sympathetic

66

Symp vs parasymp: Which has ACh from pre-ganglionic receptors acting on NicR post-synaptically?

Both!

67

Symp vs parasymp: Which releases ACh from post-ganglionic neurons acring on MuscR on the tissue?

Both!

All parasympathetic ones, and sympathetic ones do in some circumstances (like it's activation of sweat glands)

68

What is Horner syndrome?

Unilateral damage to the sympathetic trunk

69

What are the symptoms of Horner syndrome?

Ipsilateral ptosis
Ipsilateral miosis
Ipsilateral adiaphoresis

70

What is ptosis?

Drooped eyelid

71

What is miosis?

Constricted pupid

72

What id mydriasis?

Dilated pupil

73

What is diaphoresis?

Excessive sweating

74

What is adiaphoresis?
& what is it aka?

Decreased sweating

aka anhidrosis

75

CNS vs PSN: in which is neural regeneration poorer?

CNS

76

List 4 reasons CNS regeneration is poorer than PNS

CNS structure/cellularity is complex

Glial scar inhibits CNS regeneration

Neuronal degeneration is slower in CNS, and debris inhibits growth

Oligodendrocytes inhibit axon regrowth (cf Schwann cells)

77

What is the somatotopy of the spinal cord?

In the ventral horns, proximal muscles are represented medially, and distal muscles are represented laterally

78

Do the medial decending pathways of the spinal cord have bilateral or unilateral innervation of proximal muscles?

Bilateral

79

Do the lateral decending pathways of the spinal cord have bilateral or unilateral innervation of the distal muscles?

Unilateral

80

Medial or lateral descending pathways: which are important for balance?

Medial

81

LMN signs (5)

Flaccid weakness
Hyporeflexia
Signs of denervation
Decreased tone
Downgoing plantar reflex

82

What are 3 signs of denervation?

Atrophy
Fascivulations
Fibrillations

83

UMN signs?

Spastic weakness
Hyperreflexia (+/- clonus)
No signs of denervation
Increased tone
Positive Babinsky (upgoing)

84

What does an upgoing plantar reflex indicate?

UMN sign

Indicates lesion above level of L5/S1 (as these are the efferent motor responses)

85

In which lobe does Broca's area lie?

Frontal

86

In which lobe does Wernicke's area lie?

Temporal

(some texbooks say parietal)

87

Aphasias usually result from damage to which hemisphere?

Left

88

What is the corticobulbar tract?

The UMN tract for all non-ocular cranial nerve nuclei

89

What non-ocular, motor nuclei does the corticubulbar tract from one side supply? (bi-, uni-, ipsi-, contra-)

Bilateral for all of them, except for the lower face and tongue - where ennervation is unilateral (contralateral)

90

What will result from a right UMN lesion of CNVII?

Weak bottom half of left face

91

What will result from a right LMN lesion of CNVII

This is just facial nerve palsy - entire right side will be weak.

92

Which are the nerves that only have contralateral UMN supply from the corticobulbar tract?

VII Facial
VXII Hypoglossal

93

What does decerebrate posture exhibit?

Extension of lower & upper limbs

94

What does decorticate posture exhibit?

Extension of lower limbs
Flexion of upper limbs

95

Where much the lesion be to cause decerebrate posture?

Below the level of the red nucleus

96

Where is the red nucleus located?

In the rostral midbrain

97

Where must the lesion be to cause decorticate posture?

Above the level of the red nucleus

98

What does the red nucleus have to do with decorticate vs decerebrate?

It's important for limb flexion - when it's knocked out, everything goes into extension
(decerebrate)

When the control of it is lost the limbs go to their "default" (decorticate)

99

What is the likely cause of sudden, severe, unexplained headache?

Berry aneurism rupture

100

Where in the cerebral circulation do berry aneurisms tend to form?

On the circle of Willis

101

What results from a berry aneurism rupture?

Subarachnoid haemorrhage

102

Is the intraction between basal ganglia and cortex ipsi- or contralateral?

Ipsilateral

103

The basal ganglia regulate movement on the ___'lateral side

Contralateral

104

The cerebellum interacts with the cortex on it's ____'lateral side?

Contralateral

105

The cerebellum fine-tunes movements in ___'lateral limbs

Ipsilateral

106

What's the likely cause of a R homonumous hemianopia with macular sparing?

L PCA infarct

(as left brain see's right field; and macular has colateral flow from MCA)

107

What is the afferent nerve of the pupillary reflex?

CNII
Optic

108

What is the efferent nerve of the pupillary reflex?

CNIII
Occulomotor

109

What part of the brainstem is tested by the puillary reflex?

Midbrain

110

What is the afferent nerve of the corneal reflex?

CNV
Trigeminal

111

What is the efferent nerve of the corneal reflex?

CNVII
Facial

112

What part of the brainstem is tested by the corneal reflex?

Pons

113

What is the afferent nerve of the gag reflex?

CNIX
Glossopharyngeal

114

What is the efferent nerve of the gag reflex?

CNX
Vagus

115

What part of the brainstem is tested by the gag reflex?

Medulla

116

What's the main motor pathway?

Corticospinal tract

117

Superficial vs deep mechanoreceptors: which has a smaller receptive field?

Superficial

118

Superficial vs deep mechanoreceptors: which are present in greater density?

Superficial

119

Which are the superficial recepters?

Meissner & Merkel

(are outer Most)

120

What structure is largely responsible for consciousness?

Reticular activating system

121

Where is the reticular activating system located?

Midbrain

122

Where are the cardio & resp centres located?

Medulla

123

What information is carried by the dorsal column medial lemniscus system?

Fine touch, vibration and propioception

124

On what side of the spinal cord does information in the DCML travel?

Ipsilateral to the stimulus

125

What are the two components of the DCML?

Cuneate & gracile

126

Cuneate vs gracile: which carries touch information from the lower limb?

Gracile

127

Cuneate vs gracile: which carries touch info from the upper limb?

Cuneate

128

Cuneate vs gracile: which runs more medially?

Gracile

129

Cuneate vs gracile: which runs more laterally?

Cuneate

130

Where does the DCML synapse?

Thalamus

131

In the spinal cord, sensory information is carried on which side?

Dorsal

132

In the spinal cord, motor information is carried on which side?

Ventral

133

In the brainstem, CN motor nuclei are found on which side?

Medial

134

In the brainstem, CN sensory nuclei are found on which side?

Lateral

135

Which nucleus provides the branchial motor ourput for CN IX (glossoph') and X (vagus)?

Nucleus ambiguous

136

Which nucleus receives gustatory and visceral sensory input from CN VII, IX and X?

Nucleus tractus solitarius

137

Which nucleus provides the motor output for CN VII?

Facial motor nucleus

138

Which nucleus provides the preganglionic parasympathetic output on CN III?

Edger-Westphal nucleus

139

Taste from the anterior 2/3 of the tongue travels in which CN?

Chora tympani of CN VII

140

Touch sensation from the anterior 2/3 of the tongue travels in which CN?

Lingual nerve - a branch of V3

141

Taste from the posterior of the tongue travels in which CN?

Glossopharyngeal (IX)

142

Touch sensation from the posterior of the tongue travels in which CN?

Glossopharyngeal (IX)

143

When the eye is looking pointed laterally, what muscle & nerve is being tested?

Lateral rectus
CN IV (abducens)

144

When the eye is pointed supero-laterally, what muscle & nerve is being tested?

Superior rectus
CN III

145

When the eye is pointed supero-medially, what muscle & nerve is being tested?

Inferior oblique
CN III

146

When the eye is pointed medially, what muscle and nerve is being tested?

Medial rectus
CN III

147

When the eye is pointed inferomedially, which muscle and nerve is being tested?

Superior oblique
CN IV (trochlear)

148

When the eye is pointed infero-laterally, which muscle and nerve is being tested?

Inferior rectus
CN III

149

Which 4 muscles of eye movement does CN III ennervate?

Medial rectus
Inferior oblique
Superior rectus
Inferior rectus

150

Which muscle of eye movement does CN IV ennervate?

Superior oblique

151

Which muscles of eye movement does CN VI ennervate?

Lateral rectus

(the abducens abducts)

152

Which is the muscle that changes the curvature of the lens?

Ciliary muscle

153

What does contraction of the ciliary muscle do to the shape of the lens?

It lets it "boing" back to its rounder shape (able to focus on things nearby)

154

What is the intermediate structure that lets the lens relax when the ciliary muscle contracts?

Zonules