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CBL Year 1 > Neurology > Flashcards

Neurology Flashcards

1
Q

What makes up the brainstem

A

the medulla oblongata
the pons
and the midbrain

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2
Q

How many cranial nerves are there

A

12 pairs

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3
Q

How many spinal nerves are there

A

31 pairs

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4
Q

What does the diencephalon compose of

A

the thalamus and hypothalamus

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5
Q

what does the cerebrum compose of

A

cortex, amygdala, hippocampus, basal ganglia and white matter

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6
Q

What does the medulla oblongata do/have

A

cardiovascular and respiratory control
nuclei that relay information about taste
hearing and balance
control of neck and facial muscles

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7
Q

What does the pons do/have (just name a couple)

A

Controls: respiration, sleep, taste, bladder control, hearing, swallowing, eye and facial movements, posture, facial sensation

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8
Q

What does the midbrain do

A

components of auditory and visual systems

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9
Q

What is the cerebellum involved in

A

maintaining posture, coordinating head movements, fine-tuning movements, and motor learning

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10
Q

What is the thalamus essential for

A

transfer of all sensory information (except olfactory)

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11
Q

what else is the thalamus for

A

gates and modulates sensory information
Involved in integration of motor control
influences attention and consciousness

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12
Q

What does the hypothalamus do

A

regulates homeostasis and behaviours necessary for sexual reproduction

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13
Q

What are the higher functions of the cerebrum

A

perception, motor planning, cognition, emotion and memory

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14
Q

What does the amygdala do/where is it located

A

involved in social behaviour and emotion

located beneath the cortex

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15
Q

What does the hippocampus do/where is it located

A

involved in memory

located beneath the temporal lobe

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16
Q

What is white matter

A

axons that carry information to and from the cortex between structures

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17
Q

What are sulci

A

grooves in the brain

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18
Q

What is a gyrus

A

Raised areas between sulk (grooves)

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19
Q

What does the autonomic nervous system compose of

A

parasympathetic and sympathetic nervous system which innervate visceral organs

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20
Q

What do the anterior cerebral arteries supply

A

motor and sensory cortex of the lower limb

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21
Q

What do the middle cerebral arteries supply

A

the motor and sensory cortex of the upper limb, face and auditory cortex

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22
Q

What do the posterior cerebral arteries supply

A

the whole of the visual cortex

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23
Q

What is a watershed infarct

A

a localized area of ischemic tissue death in an area of the brain situated at the farthest point of blood supply from two separate cerebral arterial systems that is caused by inadequate blood flow

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24
Q

Main symptoms of a stroke

A

F -face (may have drooped to one side)
A- arms (may not be able to lift them above their head due to weakness or numbness)
S- speech (slurred, garbled or unable to talk despite being conscious)
T- time (dial 999)

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25
Q

Where is the most common site for ischaemic stroke

A

middle cerebral artery

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26
Q

What happens if autoregulation of blood volume is too low in the brain

A

cerebral blood flow decreases and there is ischemic damage

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27
Q

Define ischaemic

A

deficient supply of blood to a body part

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28
Q

What happens if there is an increase of auto regulation of blood flow to the brain

A 
intracranial pressure increases
oedema and crushing brain tissue
shifting of brain structures
restriction of blood flow
herniation
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29
Q

What does glutamate act on and what does it do

A

acts on astrocytes, which increases calcium and activates nitric oxide synthase which releases nitrogen oxide and the vessels dilate

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30
Q

What contrasting agent can be used with fMRIs

A

gadolinium

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31
Q

What are the three sections of the brain

A

prosencephalon
mesencephalon
rhombencephalon

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32
Q

What does the prosencephalon compose of

A

cerebrum/cerebral hemispheres (telencephalon)

and thalamus and hypothalamus (diencephalon)

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33
Q

What does the mesencephalon compose of

A

the midbrain

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34
Q

What does the rhombencephalon compose of

A

pons and cerebellum (metencephalon)

And the medulla (myelencephalon)

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35
Q

When does the nervous system start developing

A

3rd week in utero

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36
Q

What does the nervous system develop form

A

the ectodermal layer

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37
Q

How does the nervous system develop

A

neural groove develops in midline
neural cells proliferate and form neural tube
neural tube forms adult spinal cord and at the cephalic (head) end it swells and flexes to form the brain

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38
Q

What happens in the third month of development of the spinal cord

A

spinal cord extends the entire length of the embryo and spinal nerves pass through the intervertebral foramina at their level of region

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39
Q

What happens to the spinal cord with increasing age from development

A

vertebral column and dura mater lengthen more rapidly than the neural tube, and the terminal end of the spinal cord shifts to a higher level (at birth this is the level of the third cervical vertebra)

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40
Q

In an adult where does the spinal cord terminate

A

At the level of L2 to L3, the dural sac and subarachnoid space extend until S2

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41
Q

When does the brain double in size

A

within the first year of life

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42
Q

True/false: at birth you have all the neurones you will ever need

A

true

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43
Q

When is the brain at 80% of its full adult volume

A

age 3

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44
Q

When does the brain have twice as many synapses as it will ever have

A

at age 2/3

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45
Q

What are the three meninges that surround the brain

A

the dura mater, arachnoid mater and pia mater

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46
Q

Describe the dura mater

A

thickest, outermost meninges that consists of two layers (superficial and deep)
layers are close together except for areas where meningeal layers dip down into brain fissures

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47
Q

Describe the superficial dura mater

A

Called the endosteal (periosteal) layer

not continuous with the dura of the spinal cord

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48
Q

Describe the deep dura mater

A

called the dura mater proper

is continuous with the dura of the spinal cord

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49
Q

What is the falx cerebri

A

vertical fold lying in the midline between the two hemispheres (in longitudinal fissure)

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50
Q

What is the tentorium cerebelli

A

Fold lying above the cerebellum and below the cerebrum
roofs over the posterior cranial fossa
has an opening (tentorial notch) which allows the midbrain to pass through

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51
Q

What kind of problems can arise from space occupying lesions (think tentorium cerebelli)

A

as the dura is tough and immovable the brain may be pressed against or herniate through the tentorial notch

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52
Q

Describe the arachnoid mater

A

Middle layer of meninges
Separated from dura mater by subdural space (filled by film or fluid)
Separated from Pia mater by subarachnoid space (filled with cerebrospinal fluid)
It bridges over sulci

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53
Q

Describe arachnoid villi

A

Part of the arachnoid mater where it projects through dura into venous sinus spaces
Collections of them form arachnoid granulations along sinuses
They are one-way valves which allows CSF to drain into venous sinuses and into the venous system

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54
Q

Describe the pia mater

A

Thinnest and innermost layer
closely follows brain structures, extends down into sulci
cerebral arteries that enter the brain have a covering of pia mater

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55
Q

What else lies in the subarachnoid space

A

blood vessels and cranial nerves

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56
Q

What causes a headache (think meninges)

A

(brain itself has no pain receptors)

stretching and irritation of meninges or blood vessels cause headaches

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57
Q

Describe bacterial meningitis

A

Inflammation due to streptococcus pneumoniae and neisseria meningitides
Immune response leads to cerebral oedema (build up of fluid) and increase in internal pressure (lead to herniation and reduced. blood flow)
Definitive diagnosis by CSF examination (lumbar puncture) - high white cells, high protein and low glucose

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58
Q

Total volume of CSF and what’s in ventricles

A

total ~150ml

ventricles ~25 ml

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59
Q

Amount of CSF produced daily

A

around 500ml daily

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60
Q

Describe CSF

A 
it is an ultra filtrate of blood
active secretion by the choroid plexus
Removes waste products
transports signalling molecules
supports, cushions and evenly distributes pressure on the brain
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61
Q

What is the choroid plexus

A

network of capillaries separated from ventricles by choroid epithelial cells
CP in lateral ventricles is continuous with CP in 3rd ventricles

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62
Q

What is hydrocephalus

A

build up of CSF in the brain
causes an increase in intracranial pressure
can be fatal

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63
Q

How can the stretch reflex in the calf be elicited

A

by tapping the achilles tendon with a reflex hammer

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64
Q

What does the simplest reflex pathway involve

A

involves only one synaptic relay in the spinal cord (called monosynaptic reflex) so response latency is short

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65
Q

What kind of information do ascending tracts of the somatosensory pathway carry

A

from thermal, pain, tactile, muscle and joint receptors to the cerebral cortex (Conscious centre)or the cerebellum and brainstem (unconscious centre)

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66
Q

Three types of peripheral receptors

A

unencapsulated/free nerve endings
Modified/encapsulated endings
Proprioceptors

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67
Q

Give three examples of unencapsulated peripheral receptors and what information do they carry

A

Merkel’s discs, hair follicles, nociceptors

pain, temperature and pressure

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68
Q

Give three examples of encapsulated peripheral receptors and what information they carry

A

Mesiner’s corpuscles, Pacinian corpuscles, Ruffini endings

Pressure, touch, vibration, stretch, pain, proprioception

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69
Q

Give three examples of proprioceptor peripheral receptors and what information they carry

A

Muscle spindles, Golgi tendon organ, joint kinaesthetic receptors
pain, Stretch , pressure

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70
Q

What is the dorsal medial lemniscus pathway

A

three-neuron pathway
pathway for fine touch and proprioception
is an ascending tract

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71
Q

Describe the pathway of the dorsal medial lemniscus pathway

A

First order neuron ascends the spinal cord via the cuneate fasciculus (upper limb) or gracile fasciculus (lower limb) before synapsing in the cuneate or gracile nucleus within the medulla oblongata
Second order neurones decussates here and ascends via the medial lemniscus to the thalamus
Third order neuron ascends via the internal capsule to synapse in the primary somatosensory cortex

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72
Q

Describe the thalamus

A

located either side of the third ventricle
receives information via second order neurones
Contains multiple nuclei
integrates, modulates and relays information

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73
Q

What are polymodal nociceptors

A

respond to many different stimuli(including tissue damage)
C fibre afferents
slow pain

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74
Q

What are mechanical nociceptors

A

activated by high pressure
fast conducting fibres
A fibres
Sharp pain

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75
Q

What are thermal nociceptors

A

respond to extreme heat or cold

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76
Q

What are the two classes of nociceptor fibres

A

A𝛿 (delta)

C-fibres

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77
Q

Describe A𝛿 fibres (think nociceptor)

A

small diameter, myelinated
nociceptive specific : thermal or mechanical nociceptors
Fast, sharp, well-localised pain

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78
Q

Describe C fibres (think nociceptor)

A

non-myelinated
nociceptive specifice: polymodoal
dull, aching, burning pain

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79
Q

What are the three indirect tracts of the anterolateral system

A

spinoreticular tract
spinocerebellar tract
spinotetcal tract

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80
Q

What are the two direct tract of the anterolateral system

A

anterior spinothalamic tract

lateral spinotahalamic tract

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81
Q

Describe what information the anterior spinothalamic tract carries

A

crude touch and pressure

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82
Q

Describe what information the lateral spinothalamic tract carries

A

pain and temperature

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83
Q

Generally describe the spinothalamic tract

A

conveys pain, temperature and crude touch

fast sharp pain (A𝛿 fibres) and dull ache (C-fibres)

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84
Q

Generally describe the indirect pathways of the anterolateral system

A

modulate pain and can terminate in other brain regions

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85
Q

Describe the pathway of spino-reticular tract

A

goes through reticular formation and to the cortex

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86
Q

Describe the pathway of the spino-cerebellar tract

A

goes through cerebellar peduncles and to cerebellum

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87
Q

Describe the spinotectal tract

A

orientates eyes and head towards stimuli

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88
Q

Describe the pathway of the spinothalamic tract

A

First order neurones ascend/descend 1-2 spinal levels through Lissauer’s tract before synapsing in the substantia gelatinosa at the tip of the dorsal horn
Second order neurones decussate and ascend to the thalamus via the anterior (Crude touch) or lateral (pain and temperature) spinothalamic tract
Third order neurones through internal capsule to the primary somatosensory cortex

89
Q

What is somatic sensation of the face mostly supplied by and what is additional sensation provided by

A

the trigeminal nerves

additional: facial, glossopharyngeal and vagus nerves

90
Q

Describe the sensory inputs to the head pathway

A

synapse onto second-order neurones in the ipsilateral trigeminal nucleus
axons decussate and project in the trigeminal lemniscus to the ventral posterior medial nucleus of the thalamus
fibres project onto the sensory cortex (parietal lobe)

91
Q

Three sensory nuclei of the trigeminal nerve

A

principle sensory nucleus
spinal nucleus
mesencephalic nucleus

92
Q

Describe the principle sensory nucleus of the trigeminal nerve

A

senses touch, conscious proprioception, and pressure

93
Q

Describe the spinal nucleus of the trigeminal nerve

A

senses pain and temperature

94
Q

Describe mesencephalic nucleus of the trigeminal nerve

A

non-conscious proprioceptive information

95
Q

Describe the motor nucleus of the trigeminal nerve

A

innervates the muscles of mastication

96
Q

Describe the generation of voluntary movements

A

1) Identify target/goal (visually identified in retinotopic space)
2) Locate it in external space (visually identify in retinotopic space)
3) Determine limb trajectory (Internal representation of arm/hand relative to object)
4) calculate the forces necessary to generate desired trajectory (muscle-based reference frame)

97
Q

Describe why cortical regions are involved in motor cortex

A

to plan, control and execute movements

98
Q

What is the motor homunculus

A

somatotropic map of the primary motor cortex

99
Q

What is the primary motor cortex

A

region where movement can be evoked with the least amount of electrical stimulus

100
Q

Where is the primary motor cortex located

A

on the pre-central gyrus (Brodmann’s area 4)

101
Q

What is an error signal

A

difference between desired and actual position

102
Q

What is feedforward control

A

sensory information gives advanced control
anticipation of the required movement
enables movement to be the direction of target

103
Q

What are the medial descending pathways

A 
Anterior corticospinal tract
tectospinal tract
medial reticulospinal tract
lateral vestibulospinal tract
Medial vestibulospinal tract
104
Q

What are the lateral descending pathways

A

Lateral corticospinal tract

lateral reticulospinal tracts

105
Q

describe the medial descending pathways generally

A

Controls axial muscles for posture and balance

controls anti-gravity muscles

106
Q

Describe the lateral descending pathways generally

A

controls both proximal and distal muscles

responsible for most voluntary movements of the limbs

107
Q

Describe the corticospinal tract

A

controls muscles of distal limbs and trunk
essential for fine motor movements
longest and largest descending CNS tract

108
Q

Describe the pathway of the descending corticospinal tract

A

first order neurones descends from the primary motor cortex via the internal capsule
then enters brainstem via crus cerebri
75-90% fibres decussate at the pyramids in the medulla oblongata before exiting the spinal cord via the ventral root
those that decussate descend down the lateral corticospinal tract
those that don’t (10-15%) descend ipsilaterally down the ventral/anterior corticospinal tract

109
Q

Describe the function of the lateral corticospinal tract

A

controls muscles of distal limbs
responsible for most voluntary movements of limbs
fine movement of contralateral limbs (limbs pertaining to the other side)

110
Q

Describe the function of the anterior corticospinal tract

A

controls trunk muscles

responsible for maintaining posture

111
Q

Another name of corticonuclear tract

A

corticobulbar tract

112
Q

Describe the corticonuclear(bulbar) tract

A

originates in the motor cortex
terminates in the brainstem nuclei
innervates cranial nerves

113
Q

What nuclei of cranial nerves don’t receive bilateral innervation from the cortex

A 
facial motor nucleus (controlling facial muscles below the eye)
hypoglossal nucleus (controlling tongue movements)
114
Q

Three additional motor pathways (extrapyramidal pathways)

A

rubrospinal tract
vestibulospinal tract
tectospinal tract

115
Q

Describe the rubrospinal tract

A

originates in red nucleus in brainstem
exact function is unknown
responsible for regulation of flexor muscles (upper limb flexion)

116
Q

Describe the vestibulospinal tract

A

originates in vestibular nucleus
controls muscles of neck, trunk and some leg muscles
maintains upright posture and head stabilisation

117
Q

Describe the tectospinal tract

A

Originates in superior colliculus in midbrain
information from eyes and visual cortex
innervates contralateral motor neurones controlling head position

118
Q

Generally describe the reticulospinal tract

A

originates from reticular formation (pons and medulla)
Innervates interneurons affecting corticospinal tract
Damage can lead to spasticity (continuous contractions)

119
Q

Describe the pontine reticulospinal tract

A

ipsilateral innervation of extensor motor neurones

120
Q

Describe the medullary reticulospinal tract

A

bilateral innervation of flexor motor neurone

121
Q

What do the levels of damage to motor pathways dictate

A

severity of symptoms

higher levels shows increased percentage of motor with motor deficits

122
Q

Describe some symptoms of upper motor neurone damage

A 
paralysis of movement
increased muscle tone
hyperactive stretch reflex
extensors plantar reflex (babinski sign - sharp object dragged across bottom of foot and toes flare up instead of down)
Reduction in superficial reflexes
123
Q

Describe some symptoms of lower motor neurone damage

A

paralysis of muscle
hypotonia
atrophy of muscles
fasciculations (spontaneous contractions) and fibrillations
loss of stretch reflex but superficial reflexes remain intact

124
Q

Briefly describe the cerebellum

A

Part of the hindbrain (sits in posterior fossa)
Below cerebrum (separated by tentorium cerebelli)
Connected to brainstem via cerebellar peduncles
Cerebellar cortex - gray matter (folia
cerebellar pathways - white matter tracts

125
Q

Describe cerebellum anatomy

A

Left and right hemispheres joined by median vermis
divided into anterior and posterior lobe by primary fissure
flocculonodular lobe sits behind brainstem (most primitive lobe)
Cerebellar tonsils sit below foramen magnum

126
Q

Describe cerebellar function

A

co-ordinates movement on ipsilateral side
monitors & initiates voluntary movement through manipulation of fine muscle movement
partly responsible for learning motor skills
Receives somatosensory and proprioceptive info from entire body
(including visual, auditory and vestibular info)

127
Q

What are the three inputs via the inferior cerebellar peduncles for information into the cerebellum

A 
Spinal cord (spinocerebllar ascending tracts -> anterior lobe and vermis)
Vestibular nuclei (vestibulocerebellar tract -> anterior lobe and vermis)
Inferior olive (olivocerebellar tract -> cerebellar hemispheres)
128
Q

What are the inputs via the middle cerebellar peduncle for information into the cerebellum

A

sensory/motor information -> pontine nuclei -> cerebellar cortex

129
Q

What are purkinje cells

A

inhibitory cells and so have an inhibitory action on the cells they synapse onto

130
Q

Describe purkinje cells

A

Large output neuron in cerebellar cortex
triangular cell body, single long axon
numerous branching dendrites

131
Q

What doe purkinje cells release

A

GABA (gamma aminobutyric acid) (inhibitory neurotransmitter)

it regulates and co-ordinates movement

132
Q

What are the three cell layers of the cerebellar cortex

A

outer synaptic/receptive layer (molecular layer)
Intermediate discharge layer (Purkinje cell layer)
inner receptive layer (granule cell layer)

133
Q

What five cell types do the layers of the cerebellar cortex contain

A 
purkinje cells
granule cells
basket cells
stellate cells
Golgi cells
134
Q

What is the mossy fibre circuitry

A

feedforward control

gives appropriate movement

135
Q

What is the climbing fibre circuitry

A

feedback control

for error correction

136
Q

True/false: cerebellar cortex has an output directly to the spinal cord

A

false

137
Q

Describe the pathway for pre-programming movements from the cerebellum

A

lateral hemispheric cortex -> dentate nucleus -> superior peduncle -> cerebral cortex (via thalamus)

138
Q

Describe the two pathways for motor execution from the cerebellum

A

1) paravernal cortex -> globose & emboli form nucleus -> superior peduncle -> red nucleus -> lateral descending pathways
2) vermis -> fastigial nucleus -> inferior peduncle -> medial descending pathways

139
Q

What are the 6 signs of cerebellar damage

A

impaired motor function on ipsilateral side of the body
ataxia (slow and uncoordinated voluntary movements)
intention tremor (uncoordinated, jerky movements, overshoot dysmetria)
Dysdiadochokinesis (inability to perform rapidly alternating movements)
hypotonia (reduced tone in muscles)
nystagmus (jerky eye movements)

140
Q

What is ataxia

A

slow and uncoordinated voluntary movements

141
Q

What is intention tremor

A

uncoordinated, jerky movements

overshoot dysmetria

142
Q

What is dysdiadochokinesis

A

inability to perform rapidly alternating movements

143
Q

What is hypotonia?

A

reduced tone in muscles

144
Q

what is nystagmus

A

jerky eye movements

145
Q

6 components of the basal nuclei

A 
caudate nucleus
putamen
globus pallidus
subthalamic nucleus
substantia nigra
nucleus accumbens
146
Q

What is the main function of the basal nuclei

A

initiation and control of voluntary movements

147
Q

What are some other functions of the basal nuclei

A

eye movements
learning routine behaviours
emotional and behavioural responses

148
Q

Briefly describe the direct pathway that allows movements to occur (basal nuclei)

A

activation leads to removal of inhibitory input to thalamus
leads to excitation of motor cortex
which facilitates wanted movement

149
Q

Briefly describe the indirect pathways that inhibits unwanted movements (basal nuclei)

A

Activation enhances inhibitory input to thalamus

no excitation of cortex - inhibits unwanted moves

150
Q

Describe what actually happens in the direct pathway involving basal nuclei

A

Uses GABAergic striatal neurons (D1)
motor cortex sends excitatory signals to the striatum via the corticostriatal pathway
inhibitory GABAergic neurones from the striatum send their axons to the medial globus pallidus and substantia nigra
Their axons are then sent to the thalamus (also inhibitory)
this causes disinhibition
which is an increased thalamic output to cerebral cortex which facilitates wanted movements

151
Q

Describe what actually happens in the indirect pathway involving basal nuclei

A

Uses GABAergic striatal neurones (D2)
Begins from the cortex projecting to the striatum
then axons are projected to the external globus pallidus
Neurones from GPe (external globus pallidus) send inhibitory fibres to sub thalamic nucleus
From there neurones are sent to the internal globus pallidus (GPi) and substantia nigra (SNr)
Then continue as a direct pathway with GABAergic inhibitory neurones to the thalamus and glutamate excitatory efferents to the cortex

152
Q

Describe the nigrostriatal pathway

A

largest dopaminergic pathway in the brain
originates in the substantia nigra pars compacta (SNpc)
enhances activation of D1 neurones (direct pathway)
Suppresses activation of of D2 neurones (indirect pathway)

153
Q

Two main disorders of the basal nuclei

A

parkinson’s disease

Huntington’s disease

154
Q

Describe Parkinson’s disease

A

loss of substantia nigra pars compacta dopamine neurones
excessive inhibition of (GPe) external globus pallidus which means increased inhibition of the thalamus
Have trouble initiating willed movement

155
Q

Signs/symptoms of Parkinson’s disease

A

bradykinesia = slowness of movement
akinesia = difficulty in initiating voluntary movement
rigidity = increased muscle tone, stiffness
Resting tremors of hand and jaw
cognitive deficits, depression, sleep disorders

156
Q

Describe Huntington’s disease

A

autosomal dominant progressive neurodegenerative disease
loss of striatal neurones in the indirect pathway
decreased inhibition of the thalamus and subsequent loss of cortical neurones
failure to suppress unwanted movements

157
Q

Signs/symptoms of Huntingon’s disease

A

hyperkinesia and dyskinesia (abnormal movements)
chorea - spontaneous, irregular jerky movements
Dementia
changes in mood and personality
death

158
Q

What does the left lateral temporal lobe

A

speech comprehension

159
Q

What does the right lateral temporal lobe do

A

memory for sounds, shapes and faces

160
Q

What is neglect of occipital or parietal lobe

A

when someone ignores half of space, usually the left space

such as missing half a plate of food or not noticing someone on the left

161
Q

What is hemianopia

A

visual loss in one half of space

162
Q

What is dyspraxia

A

difficulty carrying out practical tasks (dressing, washing)

163
Q

four main reasons for cognitive decline

A

acute illness (delirium)
fatigue including sleep disorders
metabolic disorders (thyroid/liver disease, vitamin deficiency (B1))
Dementia

164
Q

What are the four main types of dementia

A

alzhiemers
vascular
Lewy body
frontotemporal

165
Q

What is Wernicke encephalopathy

A 
acute sever deficiency of thiamine
common symptoms:
ocular abnormalities
mental status change
incoordination of gait and trunk ataxia
166
Q

What is Korsakoff’s syndrome

A

chronic neurological sequelae of thiamine deficiency
alcohol related brain disease
behavioural and cognitive change -amnesia

167
Q

What is dry Beri Beri

A

B1 deficiency with nervous system involvement
peripheral nervous damage
(numb, weak leg/arms)

168
Q

What is stress

A

a physical chemical or emotional factor that causes bodily or mental tension
or a state resulting from stress

169
Q

What are the limbic system centres

A 
amygdala
hippocampus
septal nuclei and nuclei accumbens
olfactory bulbs
hypothalamus
cingulate and anterior cingulate gyrus
orbitofrontal cortex
170
Q

Amygdala function in limbic system

A

episodic memory

emotion matching

171
Q

Hippocampus function in limbic system

A

memory and learning, especially spacial

172
Q

Septal nuclei and nuclei accumbens function in limbic system

A

pleasure/reward

173
Q

Hypothalamus function in limbic system

A

hormonal response

174
Q

orbitofrontal cortex function in limbic system

A

decision making

consciousness

175
Q

What does the limbic system do? generally

A

provides an emotional guidance system based on past experiences
stores information connected with past experiences to compare to current circumstances

176
Q

What is allostasis

A

process of maintaining homeostasis through the adaptive change of the organisms environment to meet perceived and anticipated demands

177
Q

Describe what happens in a chronic threat/defence (stress) response

A

increased threat monitoring in the amygdala, increased size
reproduction in quantity and complexity in the hippocampus
sensitisation of the CNS to painful stimuli

178
Q

What is the CNS response to increased vagal tone

A

Counteract HPA axis and SNS
increased seratonin
calming affects on limbic system , amygdala
increased new nerve cells and connectivity in hippocampus
general inhibitor effect in brainstem centres

179
Q

Describe the threat/defence response in terms of breathing

A

happens via mouth
upper chest breathing
the in breath is more than the out breath
oxygen overload whereas carbon dioxide is abnormally low
this is good for physical exertion
if prolonged it can lead to chronic hyperventilation states

180
Q

Describe the rest/restore response in terms of breathing

A

happens via nose
diaphragmatic breathing
smooth even breath
In breath less than out breath

181
Q

Name some of oxytocin’s wider actions

A

promotion of cell division and wound healing
reduced anxiety, increased curiosity to learn
increased maternal caring and protective behaviours
increased trust, social interaction and social memory
lower pain threshold
promotion of sexual activity

182
Q

Definition of a reflex

A

simple, stereotyped response that couples sensory input to motor input

183
Q

What are involuntary movements evoked from

A

periphery stimulation coupling sensory input to motor input

184
Q

Describe involuntary movements on peripheral neurones

A

from receptors in periphery to spinal cord or brain stem

they innervate ⍺-motor neurones and 𝛄 motor neurones and interneurones in the brainstem or spinal cord

185
Q

Describe role/pathway of lower motor neurones on involuntary movements

A

pathway: from brainstem or spinal cord to muscle/periphery

stimulate or inhibit contraction via neuromuscular junction

186
Q

Significance of divergence on reflexes

A

amplifies sensory input and coordinates muscle contractions for movement

187
Q

Significance of convergence on reflexes

A

on internerons increases flexibility of response

188
Q

What are proprioceptors

A

specialised muscle cells that detect stretch

189
Q

What is a myostatic reflex

A

one of the simplest reflex

only has one synapse

190
Q

What does a myostatic reflex prevent

A

overstretch of a muscle

191
Q

What is a myostatic reflex tested by

A

tapping tendon

192
Q

Describe reflex pathway physiology

A 
weight added/tap of tendon
muscle stretch
AP firing in afferent neuron
AP firing in efferent neuron 
muscle shortens
193
Q

What is a polysynaptic reflex

A

two (or more) synapses
stimulus is a muscle stretch
inhibitory interneurons synapse onto another alpha motor neuron

194
Q

Describe gamma motor neurones

A 
smaller neurones (up to 35mm)
innervate specialised striated muscle (intrafusal muscle fibres)
adjust sensitivity of muscle spindles and increase range of function
195
Q

Describe Golgi tendon organs (proprioceptors)

A

sensory neurones in tendon encode information on muscle tension and contraction

196
Q

What do Golgi tendon organs do

A

monitor and maintain muscle tension

inhibit further contraction

197
Q

Describe the Golgi tendon reflex that prevents overstretch of tendon

A 
muscle contraction stretches tendon
sensory neurons (Ib afferents) activate interneurons
inhibit ⍺-neurones innervating muscle of origin 
opposite of myostatic reflex
198
Q

Describe how Golgi tendon reflex controls muscle tension

A

inhibits muscle contraction
protects muscle from causing damage to tendon
fine control of tension for grasping fragile obects

199
Q

What are the 3 different sources of input for alpha motor neurones

A

sensory input from muscles
descending input from upper motor neurones (initiating and controlling voluntary movement)
interneurones (excitatory or inhibitory) form neuronal circuits that produce coordinated movement

200
Q

What are the two reflexes tested in a neurological exam

A

patellar tendon reflex (L3) and ankle jerk reflex (S1)

201
Q

What does weak or absent reflex mean

A

possible lower motor neurone lesion

202
Q

What does exaggerated reflex mean

A

possible upper motor neurone lesion

203
Q

What does Jendrassicks manoeuvre do

A

heightens lower limb tendon reflexes

204
Q

Name two additional cutaneous reflexes

A

flexion withdrawal reflex and crossed extensor reflex

205
Q

Describe the flexion withdrawal reflex

A

rapidly removing limb from harmful (noxious) stimuli
cutaneous receptors in skin
activation of primary afferent neurones (flexor reflex afferents)
disynaptic reflex: inhibitory interneurons excite flexor motor neurones and inhibit extensor motor neurones

206
Q

Describe crossed extensor reflex

A

maintains balance during flexion withdrawal reflex

simultaneous extension of contralateral limb

207
Q

Name the four brainstem reflexes

A

jaw reflexes
eye reflexes
throat reflexes
postural reflexes

208
Q

Describe the jaw jerk reflex

A

downward tap on the jaw stretches the muscle
activation of the trigeminal nerve (CNV)
contraction of the masseter muscle

209
Q

Describe the jaw unload reflex

A

initiated by sudden unloading of the jaw
activation of the trigeminal nerve (CNV)
inhibition and activation of jaw muscles
stops jaw movement, protects teeth

210
Q

What are the three visual reflexes

A

pupillary light reflex
accommodation reflex
corneal (blink) reflex

211
Q

Describe the pupillary light reflex

A 
pupil constriction (both eyes) in response to light
activation of optic nerve (CNII) constriction via oculomotor nerve (CNIII)
protection = adaptation to light levels
212
Q

Describe the accommodation reflex

A

adduction of the eye initiated by change in focus
activation of optic nerve (CNII) change in lens shape by oculomotor nerve (CNIII)
protection = prevents blurred vision

213
Q

Describe the corneal (blink) reflex

A

closure of both eyes initiated by foreign object touching eye
activation of trigeminal nerve (CNV) innervates eyelid via facial nerve (CNVII)
protective: protects eyes from foreign object

214
Q

What are two throat reflexes

A

gag reflex

swallowing reflex

215
Q

Describe the gag reflex

A

initiated by object touching the posterior wall of pharynx
activation of glossopharyngeal nerve (CNIX)
contraction of soft palate and pharynx

216
Q

Describe the swallowing reflex

A

initiated by food bolus created by chewing
causes closure of glottis, elevation of larynx, and transient cessation of respiration
protects the airway

217
Q

What are the postural reflexes

A

tectospinal and vestibulospinal reflex

218
Q

Describe the tectospinal and vestibulospinal reflex

A

initiated by visual or auditory stimuli
coordinates head and eye movements, maintains posture
protective: responsive to changes in surrounding environments

219
Q

How does stress affect the immune system

A 
increases risk of disease
reduces wound healing
reduces immune system
increases perception of pain
some symptoms are innately stressful

CBL Year 1 (7 decks)

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