Neuroanatomy Flashcards
(129 cards)
1
Q
What parts of skull are in Anterior Middle Posterior cranial fossae?
A
Anterior- Frontal, ethmoid, lesser wing of sphenoid
Middle- temporal lobes and includes the greater wing of the sphenoid, sella turcica, and the majority of temporal bones.
Posterior- occipital lobes, cerebellum, and medulla and includes the occipital bone.
2
Q
Serotonin.
Two steps involved in making it?
A
Transformation of L-tryptophan into serotonin involves two steps:
Hydroxylation to 5-hydroxytryptophan catalysed by tryptophan hydroxylase
Followed by decarboxylation of 5-hydroxytryptophan to serotonin (5-hydroxytryptamine) by L-aromatic amino acid decarboxylase
3
Q
Serotonin.
Made from what?
Where made?
A
It is synthesised from the amino acid L-tryptophan which is obtained from the diet raphe nuclei (in the brainstem) also in the GI tract (enterochromaffin cells)
4
Q
Kluver-Bucy Syndrome
- which part of brain affected?
- which structure implicated?
- features?
- most common causes?
A
- medial temporal lobes
- amygdala
- Hyperorality (tendency to explore object with the mouth), Hypersexuality, docility, visual changes, dietary changes
- alzheimers, herpes, FTD, trauma, bilateral temporal lobe infarction
5
Q
4 macroscopic changes in alzheimers
A
cerebral atrophy
hippocampal atrophy
low brain weight
enlargement of inferior horn of lateral ventricle
6
Q
4 microscopic findings in alzheimers
A
hirano bodies tangles of tau protein amyloid beta plaques gliosis degeneration of nucleus of meynert
7
Q
what are the four types of afferent axon?
which is unmyelinated?
A
A-alpha (proprioception)
A-beta (touch)
A-delta (pain and temperature)
C (pain, temperature, and itch)
C is unmyelinated
8
Q
What are the main subtypes of neurotransmitter and give examples.
A
Small molecules-Acetylcholine, Dopamine, Norepinephrine, Serotonin, Histamine, Epinephrine
Amino acids- GABA, glutamate, glycine, aspartate
Peptides- prolactin, oxytocin
Soluble gases- nitric oxide, carbon monoxide
9
Q
BBB
Why does it have areas of fenestration?
Name 4 of these areas?
A
At several areas the BBB is fenestrated to allow neurosecretory products to enter the blood. These areas are known as circumventricular organs and include:-
Pineal body Posterior pituitary Area postrema Subfornical organ Vascular organ of the lamina terminalis Median eminence
10
Q
Broca’s Aphasia - broken or non? Brodman area?
Wernicke’s Aphasia - broken or non? Brodman area?
A
Broca’s: broken. Brodman area 44, 45.
Wernicke’s: non-broken. Brodman area 22.
11
Q
What are the three groups of white matter tract?
Give examples of each.
A
Projection. From higher centres to lower centres e.g. corticospinal, corticobulbar, optic radiation, internal capsule and corona radiata.
Commisural. Connects the two hemispheres together. e.g. anterior commisure (links the temporal lobes), corpus callosum
Association. Connects lobes from within the same hemisphere. e.g. cingulum, uncinate, and all the fasciculus ones
12
Q
Brain development:
What are the three main parts of brain development?
A
prosencephalon - split into diencephalon (thalamus and similar structures) and telencephalon (cerebrum)
Mesencephalon - bunch of stuff including cerebral peduncles + midbrain
rhombencephalon - split into metencephalon (pons, cerebellum) and myelnencephalon (medulla)
13
Q
Brain lobes and dysfunction
A
Frontal Contralateral hemiplegia, impaired problem solving, disinhibition, lack of initiative, Broca’s aphasia and agraphia (dominant)
Temporal Wernicke’s aphasia (dominant), homonymous upper quadrantanopia, auditory agnosia (non-dominant)
Parietal lobe (non-dominant) Anosognosia, dressing apraxia, spatial neglect, constructional apraxia
Parietal lobe (dominant) Gerstmann’s syndrome (agraphia, acalculia, finger agnosia and left-right disorientation), Occipital lobe Visual agnosia, visual illusions, contralateral homonymous hemianopia
14
Q
CSF
describe the flow including names of passageways.
which two layers is it between?
normal pressure?
big differences in constituency between CSF and plasma?
A
- lateral ventricles to third by foramen of munro. third to fourth by aqueduct of sylvius.
- arachnoid and pia.
- 5-15mmHg.
- most things lower. magnesium and chloride are higher. sodium is unchanged.
15
Q
When does process of myelination begin?
Last area to become myelinated?
What forms myelin in CNS/PNS?
A
14 weeks
Frontal lobes
Schwann cells in peripheral, oligodendrocytes in central
16
Q
What do each of the dopamine pathways do?
A
Mesolimbic pathway - therapeutic benefit
Mesocortical pathway - negative symptoms
Nigrostriatal pathway - EPSE’s
Tuberoinfundibular pathway - hyperprotactinemia
17
Q
Steps in dopamine synthesis.
A
Tyrosine –> L-Dopa
( tyrosine hydroxylase)
L-Dopa –> dopamine
(dopa decarboxylase)
18
Q
What type of receptors are dopamine receptors?
What do each type do?
A
Dopamine receptors are a class of metabotropic G protein-coupled receptors
There are five receptor subtypes D1, D2, D3, D4, and D5.
D1 and D5 are referred to as D1 like receptors. Increase cAMP
D2, D3, and D4 are referred to as D2 like receptors. Decrease cAMP
19
Q
What passes through Foramen spinosum? Foramen ovale? lacerum? magnum? jugular foramen?
A
Foramen spinosum Middle fossa Middle meningeal artery
Foramen ovale Middle fossa Mandibular division of trigeminal nerve
Foramen lacerum Middle fossa Internal carotid artery
Foramen magnum Posterior fossa Spinal cord
Jugular foramen Posterior fossa Cranial nerves IX, X, and XI
20
Q
What are the following gyri functions: Precentral Postcentral Angular Fusiform Cingulate ParaHippocampal Dentate Lingual Superior frontal Superior temporal
A
Precentral: movement Postcentral: touch Angular: mathematics, language, cognition Fusiform: recognition of body and faces Cingulate: emotion/learning/memory Parahippocampal- memory Dentate- memory Lingual - dreaming Superior frontal- laughter, self awareness Superior temporal- language (wernickes)
21
Q
Utilisation behaviour, which lobe?
A
utilisation: described as reaching out and automatically using objects in the environment
frontal lobe issue
22
Q
What breaks down serotonin?
What substances block the transporter than pick up serotonin from synapse (SERT)?
A
Block: MDMA, amphetamine, cocaine, TCA’s, and of course SSRI’s.
Broken down by MAO and aldehyde dehydrogenase.
23
Q
Sarcoidosis
Clinical features?
How many get psychiatric features?
A
SOB (granulomas most often form in lungs), weight loss, fatigue, dry eyes.
20%.
24
Q
Match the finding to a condition:
- Papp Lantos Bodies.
- Asteroid bodies.
- Mallory bodies.
A
- Papp Lantos Bodies are found in Multi-Systems Atrophy.
- Asteroid Bodies are found in sarcoidosis.
- Mallory boides are found in alcoholic hepatitis, alcoholic cirrhosis, Wilson’s disease, primary-biliary cirrhosis
25
Action Potential
- What is the original state of play that holds a cell in resting state?
- Membrane potential resting state?
- What does it get to to fire an AP?
- What happens here?
- Where does it reach? What then happens for repolarisation?
- More Na OUT the cell. More K IN the cell.
- Resting state is -70
- -55
- Na enters cell
- Reaches +40. Then K channels open and leaves.
26
Name 5 ionotropic receptors.
| Name 5 metabotropic receptors.
5 ionotropic receptors: GABA-A, nicotinic acetylcholine, 5HT3, glutamate, glycine
5 metabotropic receptors: GABA-B, muscarinic acetylcholine, serotonin (other than 5HT3), dopamine, adrenergic
27
When it comes to receptors,
what does the term potency mean? what 2 things make up the potency?
intrinsic?
potecncy: the concentration or dose of a drug required to produce 50% of the drug's maximal effect. depends on both affinity of a drug for its receptor and efficiency with which drug-receptor interaction is coupled to response
efficacy: also referred to as 'intrinsic activity' of a drug is the ability of the drug to elicit a response when it binds to the receptor
28
Glycine is a _____ neurotransmitter?
| It is antagonised by?
inhibitory (alongside GABA it is the other big inhibitory one)
strychnine
29
```
Reflexes; what are the sensory/motor components:
Pupillary
Accomodation
Jaw Jerk
Corneal
Vestibulo-ocular
Gag
```
```
Reflex Sensory component Motor component
Pupillary light reflex Optic Oculomotor
Accommodation reflex Optic Oculomotor
Jaw jerk Trigeminal Trigeminal
Corneal reflex Trigeminal Facial
Vestibulo-ocular reflex Vestibulocochlear Oculomotor, trochlear, abducent
Gag reflex Glossopharyngeal Vagus
```
30
Components of Gerstmanns?
| Which kind of lesion?
```
Dominant parietal lobe.
Dysgraphia (can't read)
Dyscalculia (can't do simple maths)
Finger agnosia (can't identify specific fingers)
Right-left disorientation
```
31
What do you get with non-dominant parietal lobe lesions?
```
anosognosia (lack of awareness of a disability or disease)
dressing apraxia (difficulty in getting dressed)
spatial neglect (lack of awareness of one side of the body)
constructional apraxia (inability to copy pictures or combine parts of something into a meaningful whole)
```
32
What syndrome is it with bilateral parietal lobe issues?
```
Balints.
ocular apraxia (difficulty keeping the eyes still)
optic ataxia (difficulty moving the eyes to a specific position)
simultanagnosia (inability to simultaneously perceive the different aspects of a picture and appreciate it as a whole)
```
33
What is serotonin broken down to?
5-Hydroxyindoleacetic acid (5-HIAA).
34
What types of speech problem (dysarthria) do you know?
Site of the lesions?
Conditions involved?
Features of the speech?
Type Features Associated conditions Localisation
Spastic Explosive and forceful, at a slow rate Pseudobulbar palsy, spastic hemiplegia Upper motor neuron
Flaccid Breathy, nasal voice, imprecise consonants Myasthenia gravis Lower motor neuron
Hypokinetic Slow, quiet, with a tremor Parkinson's disease Extrapyramidal
Hyperkinetic Variable rate, inappropriate stoppages, strained quality Huntington's disease, Sydenham's chorea, tardive dyskinesia Extrapyramidal
Ataxic Rapid, monopitched, slurred Friedreich's ataxia, alcohol abuse Cerebellum
35
Cerebellum.
Divided by cerebrum by?
How many physical lobes? Names?
How many functional lobes? Functions?
Tontorium cerebelli.
Ant, post and flocculonodular
Ant and post have medial (spoinocerebellar) and lateral (cerebrocellebar) areas. Vestibulocerebellum is the FNL.
Functions-
spinocerebellum - fine tuned body movement
cerebrocerebellum - planning movement
vestibulocerebellum (FNL) - balance/spatial orientation
36
3 features of MSA
3 presentations
microscopic features
macroscopic features
parkinsonism, autonomic failure, ataxia
```
Shy-Drager Syndrome (mainly autonomic features)
Striatonigral degeneration (mainly Parkinson features)
Olivopontocerebellar atrophy (mainly cerebellar features)
```
papp lantos bodies
Pallor of substantia nigra
Greenish discolouration and atrophy of the putamen
Cerebellar atrophy
37
Occlusions of arteries and effects
Anterior Cerebral Artery
MCA
PCA
ACA:
Hemiparesis of the contralateral foot and leg (more severely than the arm)
Sensory loss of the contralateral foot and leg
Motor dysphasia
MCA:
Hemiparesis of the contralateral face and limbs
Sensory loss of contralateral face and limbs
Dysphasia (when dominant hemisphere affected)
Contralateral neglect
Homonymous hemianopia or quadrantanopia
Dorsolateral prefrontal dysfunction
PCA:
Alexia without agraphia (left PCA)
Contralateral loss of pain and temperature sensation
Contralateral hemianopia
Prosopagnosia
Ipsilateral cranial nerve defects (V, VIII, IX, X, & XI)
Horner's syndrome
38
4 hormones that effect hunger
Neuropeptide Y is produced by the hypothalamus and increases appetite
Leptin is produced by adipose tissue and reduces appetite
Ghrelin is produced mainly by the gut and increases appetite
Cholecystokinine (CCK) is produced mainly by the gut and reduces appetite
39
Alexia without agraphia?
Alexia without agraphia = Infarct to left PCA
| Can write but not read
40
What agnosias do you know
Prosopagnosia Inability to recognise familiar faces
Anosognosia Inability to recognise own condition/ illness
Autotopagnosia Inability to orient parts of the body
Phonagnosia Inability to recognize familiar voices
Simultanagnosia Inability to appreciate two objects in the visual field at the same time
Astereoagnosia Inability to recognize objects by touch
41
anton babinski affects which area
Anton's syndrome (aka Anton-Babinski syndrome) occurs following damage to the occipital lobe.
Affected individuals are cortically blind but are unaware of this and deny they have a problem (anosognosia).
42
Main site of norepinephrine release?
locus coeruleus (aka 'the blue spot) which is located in the pons.
43
What triggers the release of neurotransmitter into a synaptic cleft?
An action potential that causes calcium channels to open.
| The influx of calcium leads to the release of neurotransmitter.
44
```
What are the functions of the following:
Nissl Substance.
Golgi apparatus
Mitochondria
Microfilaments
Lysosomes
Melanin
```
Nucleus Contains the nucleolus and chromosomes
Nissl substance Consists of rough endoplasmic reticulum (with free ribosomes) and is the site of protein synthesis
Golgi apparatus Modifies, sorts, and packages macromolecules for cell secretion (exocytosis) or use within the cell
Mitochondria Involved in energy production
Microfilaments and microtubules Used for structural support and transportation within the cell
Lysosomes Spherical bodies containing digestive enzymes which break up cellular debris and protect against threats such as viruses
Melanin Function unknown, possibly a by-product of neurotransmitter synthesis
45
What percentage of temporal lobe seizures are preceded by aura?
What auras do you know? 2 types.
What kind of aura could precede a parietal lobe partial seizure?
An occipital seizure?
80%
abdominal (a rising epigastric sensation) and psychic aura (fear, déjà vu, jamais vu).
Parietal lobe seizures may begin with a contralateral sensation
Occipital lobe seizures may begin with contralateral visual changes, usually of the positive type, such as colored lines, spots, or shapes, or even a loss of vision
46
Support cells aka glial cells of the nervous system functions:
Astrocytes
Oligodendrocytes
Ependymal cells
Microglia
Astrocytes- have numerous functions including structural support, repair of nervous tissue, providing nourishment to neurons, contributing to the blood brain barrier, neurotransmission, and vasomodulation. There are two main types, protoplasmic and fibrous.
are responsible for the formation of myelin sheaths.
line the ventricular system and are involved with CSF circulation and fluid homestasis in the brain. Specialised ependymal cells call choroid plexus cells are responsible for CSF production.
are the immune cells of the CNS.
47
As well as Brocas and Wernickes aphasia, we need to know about two others:
Conduction aphasia
Anomic aphasia
Conduction
Form of fluent aphasia
Poor repitition is the hallmark
Lesion is arcuate fasciculus
Anomic
Naming or word finding problems are the major feature of the syndrome
The lesion is often temporal parietal area. Or angular gyrus
Another fluent aphasia
48
Prosopagnosia. Where is the lesion?
Fusiform gyrus
49
What blood supply of caudate nucleus?
Supplied by deep penetrators of anterior and middle cerebral arteries.
50
Name the four prion diseases;
Creutzfeldt-Jakob disease
Kuru
Gerstman-Straussler-Scheinker syndrome
Fatal familial insomnia
51
Melatonin:
Synthesised by what?
Where?
Melatonin is synthesised in the pineal gland from serotonin. Melatonin released is enhanced in dark environments (e.g. during the night).
52
Histamine.
What is it made from?
How many histamine receptor types are there? What does each do?
Made from the amino acid histidine.
H1 CNS tissue, smooth muscle, and endothelium Vasodilation, bronchoconstriction, pain and itching from stings
H2 Parietal cells in stomach
Stimulates gastric acid secretion
H3 Central and peripheral nervous tissue
Decreases the release of other neurotransmitters (serotonin, noradrenaline, acetylcholine)
H4 Basophils
Chemotaxis (cellular movement)
53
Gerstmanns. Which gyrus is affected?
Anglemans gyrus.
| Dominant parietal lobe lesions.
54
What are the five key facts for the serotonin (5HT) receptors?
5-HT3 is ligand gated
5-HT3 is most associated with nausea
5-HT7 is associated with circadian rhythms
5-HT2 stimulation is thought to underlie the effects of insomnia, agitation, and sexual dysfunction associated with SSRI use
55
Major excitatory neurotransmitter in brain?
| Main inhibitory?
Glutamate.
| GABA.
56
Normal pressure hydrocephalus.
What type of hydrocephalus is it?
Triad of symptoms? Who came up with it?
Is the ICP usually high?
Communicating.
Wet (incontinence), wobbly (ataxia), whacky (dementia); Hakim's Triad
Usually high end of normal
57
Hirano Bodies are found in
Alzheimers
58
Fasciculations - UMN or LMN
LMN
59
Give four functions of the amygdala.
Control of eating.
Production of aggression.
Fear response.
Classical conditioning of autonomic responses.
60
What six points about the HPA axis and depression are useful to know?
```
HPA axis dysfunction is implicated in (but not specific to) mood disorders
Cortisol levels normally decrease in response to the administration of dexamethasone but this often does not occur in depressed patients
Early trauma can led to HPA axis dysfunction in adults (suggesting a predisposition to depression)
Glucocorticoid receptor dysfunction is thought to play a key role in some cases of depression
Some antidepressants (tricyclic) increase expression of effect glucocorticoid receptors but this is not the case for SSRIs
The hypothalamic-pituitary-adrenal (HPA) axis has been shown to be hyperactive in a significant number of patients with major depression
```
61
What four structures make up the basal ganglia?
What makes up the lenticular nucleus?
Striatum (caudate, putamen, nucleus accumbens)
Subthalamic nucleus
Globus pallidus
Substantia nigra (divided into pars compacta and pars reticulate) - located in the midbrain and has important roles in movement, reward, addiction, and mood.
The putamen and globus pallidus are collectively referred to as the lenticular nucleus.
62
Acutely psychotic patients show increased levels of dopamine where?
Are there any areas where schizophrenic patients have higher number of dopamine receptors?
Which dopamine receptor do all antipsychotics work on?
What area of brain do psychotic symptoms arise?
What area of brain do negative symptoms arise?
- In both presynaptic areas and synapse itself
- A modest (10-20%) elevation in striatal D2/3 receptor density in schizophrenia independent of the effects of antipsychotic drugs has been demonstrated
- Various studies show that at clinical doses, all currently licensed antipsychotic drugs block striatal D2 receptors
- psychosis appears to result from excessive dopamine activity in the striatum.
- The negative symptoms seen in schizophrenia appear to result from too little dopamine activity in the frontal lobe
63
What two areas are seen to be overly active in depressive neuroimaging?
Underactive?
the amygdala and subgenual ACC appear to be overactive in depression, and the DLPFC underactive.
64
What are the main nuclei and functions of hypothalamus?
Suprachiasmatic Circadian rhythm
Preoptic Secretes GnRH to stimulate LH and FSH in the anterior pituitary
Regulates body temperature
Paraventricular Synthesizes oxytocin
Anterior Regulates parasympathetics to keep cool (A/C)
Posterior Regulates sympathetics to keep warm
Supraoptic Synthesizes ADH
Arcuate Releases dopamine
GHRH to anterior pituitary
Hunger & satiety
Dorsomedial Stimulate gastrointestinal system, hunger
Ventromedial Satiety
Lateral Hunger and thirst
Dorsomedial Triggers shivering
65
Give 4 main features of lateral medullary syndrome.
| What artery is affected?
Artery is PICA; posterior inferior cerebellar artery
Features are:
- Everything at the side affected
- Sympathetic and spinocerebellar are the only ipsilateral ones. Somatic sensory (sensation of face) also ipsilaterla
- Spinocerebellar: ipsilateral ataxia
- Loss of sensation on ipsilaterla face
- Contralateral loss of pain and temperature
- Swallowing problems
66
What is alexia without agraphia?
| What artery is affected?
Able to read but not able to write.
| LPCA - left posterior cerebral artery
67
EEG waves: features, frequency and type
Type Frequency Normally found Normally seen in
Delta 1-4Hz Frontally in adults and posteriorly in children Slow wave sleep and in babies. Should not be present when awake, when present if awake this strongly suggests pathology
Theta 4-8Hz Generalised Young children, drowsy and sleeping adults, with certain medications, meditation. Small amount seen in awake adults, excessive amount when awake may indicate pathology
Alpha 8-12Hz Posteriorly When relaxed and when the eyes are closed (whilst awake)
Beta 12-30Hz Frontally When busy or concentrating
Sigma 12-14Hz Frontal and central regions (aka sleep spindles) Bursts of oscillatory activity that occur in stage 2 sleep. Along with k-complexes they are the defining characteristic of stage 2 sleep
Gamma 30-100Hz No specific areas Meditation
68
Conditions and EEG findings
```
CJD
Huntingdons
Delirium
DTs
Alzheimers
Petit-mal epilepsy (absence seizure)
Generalsied
Partial epilepsy
Mycolonic epilepsy
Encephalopathy
Normal ageing
```
Condition EEG findings
CJD (sporadic only, does not apply to variant) Early on there is non specific slowing, later periodic biphasic and triphasic synchronous sharp wave complexes superimposed on a slow background rhythm
Huntington's Low voltage EEG, in particular no alpha (flattening)
Delirium Diffuse slowing, decreased alpha, increased theta and delta
Delirium tremens Hyperactive trace, fast
Alzheimer's Reduced alpha and beta, increased delta and theta
Petit mal epilepsy (absence seizure) Generalised, bilateral, synchronous, 3Hz (3 waves per second) spike and wave pattern
Generalised epilepsy Sharp spikes, 25-30Hz
Partial epilepsy Focal spikes
Myoclonic epilepsy Generalised spike and wave activity
Encephalopathy Diffuse slowing
Normal aging Diffuse slowing, which can be focal or diffuse, if focal most commonly seen in the left temporal region
69
```
Drug effect on EEG
Antipsychotics (typical)
Antipsychotics (atypical)
Antidepressants
Anticonvulsants
Lithium
Benzos
Barbiturates
```
Stimulates (cocaine, nicotine)
Depressants (alcohol, opioids)
Cannabis
Drug class Effect on EEG
Antipsychotics (typical) Decreased beta with Increased alpha, and delta, haloperidol least effect
Antipsychotics (atypical) Varied effect, clozapine most significant effect
Antidepressants Reduce beta, increase all others
Anticonvulsants No effect
Lithium Slowing
Benzodiazepines Increase beta, decrease alpha
Barbiturates Increase beta
Stimulants (cocaine, nicotine) Increase alpha
Depressants (alcohol, opioids) Decrease alpha
Cannabis Increase alpha
70
```
what part of the basal ganglia are wrong in
huntingdons
wilsons
parkinsons
hemiballism
```
Huntington's chorea (caudate nucleus)
Wilson's disease (copper deposition in basal ganglia)
Parkinson's disease (substantia nigra)
Hemiballism (subthalamic nucleus)
71
The ventromedial prefrontal cortex is believed to be crucial for ...
moral judgement
72
Difference between an ideomotor and ideational dyspraxia?
The patient demonstrates an ideational apraxia as they fail to complete a sequenced task. Ideomotor apraxia applies to instances where someone fails to perform previously learned tasks e.g. trying to brush their teeth when given a pencil.
73
Involved in the control of the sleep wake cycle.
Plays an important role in drug addiction.
reticular formation
substantia nigra
74
what do the sylvian fissure and fissure of rolando separate?
The lateral sulcus (The Sylvian fissure) - this divides the frontal and parietal lobes above from the temporal lobe below
The central sulcus (the fissure of Rolando) - this separates the frontal from the parietal lobe
75
pathway of basal ganglia?
the cortex projects to the striatum, the striatum to the internal segment of the globus pallidus, the internal segment of the globus pallidus to the thalamus and the thalamus back to the cortex, thus creating a loop.
76
what is the pulvinar sign?
| what is it seen in?
The pulvinar sign is one of the core diagnostic features of vCJD. It is characterized by bilaterally hyperintense pulvinar nuclei of the thalamus on FLAIR or diffusion-weighted MRI images (CT is usually normal). It has a sensitivity of 78% to 90% and a specificity of 100% for vCJD in the correct clinical context.
77
describe and summarise the main forms of MND
Amyotrophic lateral sclerosis (both upper and lower motor neurone involvement, charcterised by limb weakness)
Progressive bulbar palsy (both the upper and lower motor neurone involvement, characterised by problems with speech and swallowing)
Progressive muscular atrophy (mainly lower motor neurone involvement, charcterised by weakness and clumsiness)
Primary lateral sclerosis (only upper motor neurone involvement, characterised mainly by lower limb weakness)
78
Which of the following cell types makes a significant contribution to the blood brain barrier?
astrocyte
79
what are the 6 major differences between variant and sporadic CJD?
vCJD CJD
Duration (from onset of symptoms to death) Longer, a year or more Shorter, few months
Symptoms Psychiatric and behavioural only later neurological Presents neurologically
MRI Pulvinar sign Bilateral anterior basal ganglia high signal
EEG Generalised slowing Biphasic and triphasic waves 1-2 per second
Origin Infected meat products Genetic mutation (bad luck)
Age of onset Younger people (age 25-30) Old people (age 55-65)
80
what is the significance of 5-HIAAA?
Low CSF levels of 5-HIAA are associated with depression, suicidality, and aggression.
81
Most common brain tumours in
adults?
kids?
In order of frequency the most common brain tumours in adults are:-
1) Metastatic tumours
2) Glioblastoma multiforme
3) Anaplastic astrocytoma
4) Meningioma
In order of frequency the most common brain tumours in children are:-
1) Astrocytoma
2) Medulloblastoma
3) Ependymoma
82
Who was awarded the Nobel prize for the discovery of dopamine's role as a neurotransmitter?
Its role as a neurotransmitter was discovered in 1958 by Arvid Carlsson (awarded the Nobel Prize)
83
Hormones.
Name their origin and action.
```
Gastrin.
Somatostatin
Secretin
CCK
Grehlin
```
Hormone Origin Action
Gastrin Secreted by cells in the stomach and duodenum Stimulates the exocrine cells of the stomach to secrete gastric juice (a mixture of hydrochloric acid and the proteolytic enzyme pepsin)
Somatostatin Secreted by cells in the gastric glands of the stomach On the stomach (thus a paracrine effect) it inhibits the release of gastrin and hydrochloric acid
On the duodenum it inhibits the release of secretin and cholecystokinin
On the pancreas it inhibits the release of glucagon
Secretin Secreted by cells in the duodenum when they are exposed to the acidic contents of the emptying stomach Stimulates the exocrine portion of the pancreas to secrete bicarbonate into the pancreatic fluid (thus neutralizing the acidity of the intestinal contents)
Cholecystokinin (CCK) Secreted by cells in the duodenum and jejunum when they are exposed to food On on the gall bladder stimulating it to contract and force its contents of bile into the intestine
On the pancreas stimulating the release of pancreatic digestive enzymes into the pancreatic fluid
On vagal neurons leading back to the medulla oblongata which give a satiety signal
Ghrelin Secreted by endocrine cells in the stomach Acts on the hypothalamus to stimulate feeding
84
Which part of basal ganglia play a role in addiction
The nucleus accumbens and the ventral tegmental area (VTA) both play central roles in reward processing and therefore drug addiction.
Discuss
Improve
85
What does cingulate gyrus involved in
Regulation of aggressive behaviour
| Co-ordinates the response to pain
86
Cleavage of amyloid precursor protein by which of the following prevents the formation of the abnormal amyloid protein found in senile plaques?
alpha secretase
87
What facts about serotonin receptors do you know?
5-HT3 is ligand gated
5-HT3 is most associated with nausea
5-HT7 is associated with circadian rhythms
5-HT2 stimulation is thought to underlie the effects of insomnia, agitation, and sexual dysfunction associated with SSRI use
88
Which of the following cause presynaptic vesicles to release neurotransmitter into the synaptic cleft?
calcium
89
Melatonin is synthesised from?
Serotonin
90
The septum pellucidum separates what
the lateral ventricles
91
Which cranial nerves are:
- only motor
- only sensory
```
Only motor:
III, IV, VI, XI, XII
Occulomotor
Trochlear
Abducems
Accessory
Hypoglossal
```
Only sensory:
8 (vestibulocochlear)
Olfactory
Optic
92
Which two hormoens increase appetite
| Reduce?
Neuropeptide Y is produced by the hypothalamus and increases appetite
Leptin is produced by adipose tissue and reduces appetite
Ghrelin is produced mainly by the gut and increases appetite
Cholecystokinine (CCK) is produced mainly by the gut and reduces appetite
93
What are the four folds of dura you need to know about?
Falx cerebri - this separates the two cerebral hemispheres of the brain
Tentorium cerebelli - this separates the cerebellum from the cerebrum
Falx cerebelli - this separates the cerebellar hemispheres
Sellar diaphragm - this covers the pituitary gland and forms a roof over the hypophysial fossa
94
Relevance of 5-HIAA
Low CSF levels of 5-HIAA are associated with depression, suicidality, and aggression.
95
What is the papez circuit
Mediates processes of emotion
The Papez circuit is bilateral, symmetrical and is located on the medial surface of the brain. It links the cortex to the hypothalamus.
96
how many kids with autism develop macrocephaly?
Macrocephaly is known to occur in approximately 20% of individuals with idiopathic autism (Fombonne 1999).
97
in what conditions do you get neurofibrillary tangles
Frontotemporal dementia
Dementia pugilistica
Progressive supranuclear palsy,
98
reduced planum temporale asymmetry is seen in
Reduced planum temporale asymmetry is seen in:
dyslexia
stuttering
schizophrenia
99
Where is Heschl's gyrus found?
What is contained within it?
What does Heschl's gyrus border?
Where is the planum temporale?
It is part of the temporal lobe.
Heschl’s gyrus contains the primary auditory cortex (Brodmann area 41)
Heschl’s gyrus is the anterior border of the planum temporale
Planum temporale is the triangular area that forms the heart of Wernicke’s area; the secondary auditory cortex
100
```
Pregabalin:
Ligand for what channels?
Name three effects.
Effect on GABA?
Absorption?
Bioavailability?
Metabolised by?
```
Calcium channels
Anxiolytic, anticonvulsant, analgesic effects
While GABA analogue, no effect on GABA receptors
Rapid, extensive, proportional to dose
High bioavailability
Excreted by kidneys unchanged
101
Selective attention:
| Name three models
Broadbent’s Filter model
Classed as an ‘early selection model’ (because the filtration occurs early).
Input is filtered before it is analysed for meaning
Left and right ears are separate channels
did not explain the ‘cocktail phenomenon’ (where you hear your own name across a noisy room even at relatively low volume)
Treisman’s Attenuation Theory
Intermediate selection model
Leaky filter model. Instead of a filter it is actually an attenuator (attenuate = reduce in force or effect) rather than being an all or nothing filter, it allows some things though be weakens them.
Includes a dictionary unit which emphasises that certain words have lower thresholds for getting our attention (such as our own name).
Deutsch and Deutsch Late stage model (1963)
Late selection model.
Input is analysed for meaning before filtering occurs.
102
What substances block the SERT transporter in re-taking sertraline back up?
It is taken up from the synapse by a monoamine transporter (SERT). Substances that block this transporter include; MDMA, amphetamine, cocaine, TCA's, and of course SSRI's.
103
Two facts about 5HT3
One fact about 5HT7
Facts about HT2
5-HT3 is ligand gated
5-HT3 is most associated with nausea
5-HT7 is associated with circadian rhythms
5-HT2 stimulation is thought to underlie the effects of insomnia, agitation, and sexual dysfunction associated with SSRI use
104
Whose law of effect states that the tendency of an action to occur depends on the effect it has on the environment?
Thorndike
105
The retina develops from which area of the embryonic brain?
Diencephalon
106
Which famous British psychiatrist, often associated with the antipsychiatry movement, is remembered for saying 'Madness need not be all breakdown. It may also be break-through'?
Laing
107
Antidepressants with Relatively lower sexual dysfunction?
```
Bupropion
Mirtazapine
Moclobemide
Nefazodone
Reboxetine
```
108
What compounds are involved in conjugation reactions?
The most common method is conjugation with glucuronic acid. Other added groups include sulphate, amino acids, acetate and methyl.
109
What does the fornix do?
Bridge of white matter inferior to the corpus callosum; links regions of the limbic system (‘emotional’ brain) together
110
What structures are damaged in Korsakoff's Syndrome?
The mamillary bodies are atrophied in Korsakoff's syndrome.
111
Four big features of cerebellum and function
Vermis Associated with bodily posture and locomotion
Folia Fine, transversely-oriented pleat-like gyri on the surface of the cerebellum; increase surface area
Arbor vitae Aka ‘tree of life’. This is the cerebellar white matter, so called for its branched, tree-like appearance
Cerebellar peduncles Exist in three pairs (superior, middle, and inferior). The cerebellum communicates with the rest of the nervous system via these peduncles
112
What are the parts of the striatum?
| Which part of the brain are they in?
Caudate nucelus, nucelus accumbens, putamen
| Telencephalon
113
Name four major structures in the diencephalon and what they do.
Thalamus - relay point for all sensory information
Hypothalamus + pituitary - homeostasis/hormone release
Pineal gland - releases melatonin
Mamillary body - A relay point most notably involved in memory. Damaged in Korsakoffs syndrome.
114
In which structure is the substantia nigra found?
Midbrain
115
A lesion in which gyrus is most likely to result in anomia?
Angular gyrus
116
Effect on typical antipsychotics on EEG
| Antidepressants?
Decreased beta with Increased alpha, and delta, haloperidol least effect
Antidepressants decrease beta nad increase all others
117
Macroscopic changes in MSA?
| Microscopic?
Pallor of substantia nigra
Greenish discolouration and atrophy of the putamen
Cerebellar atrophy
Papp-Lantos Bodies
118
Cleavage of amyloid precursor protein by which enzume prevents the formation of the abnormal amyloid protein found in senile plaques?
alpha secretase
119
Nmae four conditiosn were you get neurofibrillary tangles
Frontotemporal dementia
Dementia pugilistica
Progressive supranuclear palsy,
Alzheimers
120
Connections of basal ganglia
The connections of the basal ganglia are complicated but put simply, the cortex projects to the striatum, the striatum to the internal segment of the globus pallidus, the internal segment of the globus pallidus to the thalamus and the thalamus back to the cortex, thus creating a loop.
Cortex --> striatum
Striatum --> basal ganglia/GP
basal ganglia/GP --> thalamus
thalamus --> cortex
121
What part of body secreates CRH, ACTH, adrenalin
| What part of the first one secreates CRH
Hypothalamus
Pituitary
Adrenals
the part of the hypothalamus that secretes both CRH and arginine vasopressin is from the paraventricular nucleus
122
Name 6 things you get with damage to posterior cerebral artery
Alexia without agraphia (left PCA)
Contralateral loss of pain and temperature sensation
Contralateral hemianopia
Prosopagnosia
Ipsilateral cranial nerve defects (V, VIII, IX, X, & XI)
Horner's syndrome
123
Increase in what type of dopamine receptor frequency is seen in schizophrenia?
A modest (10-20%) elevation in striatal D2/3 receptor density in schizophrenia independent of the effects of antipsychotic drugs has been demonstrated (striatal D1 receptor densities are unaltered)
124
All antipsychotics block which type of dopamine receptor?
D2
125
Parts of
- Ceberum/telencephalon
- diencephalon
- cerebellum
- brainstrm
```
CEREBRUM/TELENCHEPHALON
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Insula
Corpus Callosum
Fornix
Anterior Commisure
Striatum
Amygdala
Hippocampus
```
```
DIENCEPHALON
Thalamus
Hypothalamus
Pineal gland
Mamillary body
```
```
CEREBELLUM
Vermis
Folia
Arbor vitae
Cerebellar peduncles
```
```
BRAINSTEM
Midbrain
Pons
Medulla
Olive
Colliculus (sup and inf)
Substantia nigra
```
126
An increase in Brain-derived neurotrophic factor concentrations in cortical areas compared to controls has been demonstrated for which of the following conditions?
Schizophrenia
127
Go through the two steps involved in making dopamine
Tyrosine - tyrosine hydroxylase - L-DOPA - dopa decarboxylase - dopamine
128
Where would you find the nucelus of meynert?
The nucleus of Meynert, is a group of neurons in the substantia innominata of the basal forebrain.
129
Which of the following lies within the Brodmann area 22?
Broca's area lies within Brodmann areas 44 and 45.
Wernicke's area is located in the posterior part of the superior temporal gyrus in the dominant hemisphere, and lies within Brodmann area 22.
