Neuroscience Post-Midterm Flashcards
(265 cards)
1
Q
Lower motor neuron
A
Motor neuron that communicates directly with somatic muscle
2
Q
Upper motor neuron
A
Motor neuron that arises from motor centers in the brain that communicate with lower motor neurons directly or through local interneurons
3
Q
Pyramidal motor system
A
Corticolspinal tract (ventral medulla)
4
Q
Paralysis
A
Complete loss of motor function due to lesion of neurons or muscle
5
Q
Plegia
A
Paralysis
6
Q
Paresis
A
Subparalytic muscle weakness
7
Q
Hemiparesis
A
Partial paralysis on one side of the body
8
Q
ALS
A
Amyotrophic lateral sclerosis is a progressive NM disease that initially affects and later destroys lower motor neurons and eventually parts of the corticospinal/bulbar tracts and primary motor area
Classic presentation: 50% cases begin in hand; loss of muscle bulk thenar, hypothenar, interossei, arm/shoulder
Symptoms: Weakness and difficulty speaking/swallowing
Pts. require ventilation/gastronomy; reduction cough reflex (aspiration pneumonia), fasiculations/weakness tongue
Unaffected: sphincter control, sensory function, intellect
Prognosis: death 3-5 years after diagnosis; death from respiratory insufficiency and aspiration pneumonia
9
Q
ASA syndrome
A
Cause: ASA infarction, less commonly: tumor, epidural abscess
Symptoms: Spastic paraparesis, bilateral extensor plantar response, bilateral loss pain, temp below, touch/vib/prop in tact, retention of urine, sexual functions imparied
* ASA supplies anterior 2/3 spinal cord
Lesion: 2nd order motor neurons in anterior horn, ALS, Corticospinal tracts (lateral and anterior)
* Rare, can cause paraplegia (damage of LMN in anterior horn) and lateral Corticospinal tract (UMNS’s)
* Bladder, lung infections, PE, pressure sores
10
Q
Central medullary syndrome
A
Cause: Syringomyelia, tumor, hemorrhage
Pathological cyst in central canal; cervical involvement
* Develops anterior; pressure to anterior horns and anterior white commissure
* Segmental muscle atrophy (muscles of hand/fingers); loss of pain/temperature due to destruction of anterior white commissure
*Other symptoms: pain/weakness, stiffness in back, arms, shoulders, legs; disturb sweating, sexual function and bladder/bowel control
11
Q
Which descending tracts are concerned with flexion vs. extension?
A
Flexion: Doral/Lateral; lateral corticospinal, rubrospinal, medullary lateral reticulospinal
Extension: Anterior/Medial; (lat+medial) vestibulospinal, pontine medial reticulospinal
12
Q
Where is the lateral corticospinal tract located in the spinal cord?
A
Lateral horn
13
Q
All motor pathways, except the _________________ tract ends at synapses on LMN in the spinal cord or on interneurons
A
Corticobulbar
14
Q
Name the descending motor pathways
A
Cortical – CS, CB
Subcortical – Rubrospinal, reticulospinal, vestibulospinal
15
Q
Where are the descending motor fibers for the proximal vs. distal muscles?
A
Proximal: medial
Distal: lateral
16
Q
Which of the motor pathways is involuntary?
A
Vestibulospinal (medial-medulla+pons and lateral-pons)
17
Q
Damage to corticobulbar fibers innervating the facial nucleus results in…
A
Contralateral lower facial paralysis (upper facial nucleus is innervated by both ipsi/contra-lat
18
Q
Damage to corticobulbar fibers to the hypoglossal nucleus results in…
A
Contralateral deviation of the tongue
19
Q
A central lesion of PPRF results in…
A
Deviation of eyes towards the side of the lesion
20
Q
A unilateral internal capsule infarction results in…
A
Contralateral UMN syndrome
21
Q
Differentiate between the pre-frontal, pre-motor and primary motor cortices
A
Pre-frontal: planning, social restraint
Pre-motor: motor programs
Primary motor: Strong excitation LMN
22
Q
Differentiate between simple, complex and imagined motor tasks
A
Simple: Primary motor, primary sensory
Complex: Pre-motor (supplementary-medial) & primary motor
Imagined: Supplementary-medial
23
Q
> 90% of ______________________ fibers decussate in the ventral medulla
A
Corticospinal
23
Q
> 90% of ______________________ fibers decussate in the ventral medulla
A
Corticospinal
24
Spinal shock
Flacidity, areflexia several weeks following a lesion to a motor tract
24
Spinal shock
Flacidity, areflexia several weeks following a lesion to a motor tract
25
Paraplegia
Bilateral s/c lesion; UMN below the lesion
25
UMN's release _________________ onto ____________ receptors of LMN's or interneurons
Glutamate; AMPA
26
Brown-Sequard Syndrome
Ipsilateral UMN, DC/ML below
Contralateral: ALS below
Segmental LMN @ level lesion
26
Brown-Sequard Syndrome
Ipsilateral UMN, DC/ML below
Contralateral: ALS below
Segmental LMN @ level lesion
27
Paraplegia
Bilateral s/c lesion; UMN below the lesion
28
UMN's release _________________ onto ____________ receptors of LMN's or interneurons
Glutamate; AMPA
33
From where does input come for the motor cortex?
Premotor, somatosensory, posterior parietal, BG, cerebellum
34
Decerebrate posturing
A lesion at or caudal (below) the red nucleus impairs CS, CB, Rubrospinal
Patient extends upper and lower limbs
* 2 GCS points
35
Decortiate posturing
A lesion rostral (above) the red nucleus that impairs CB and CS fibers
* Flex the upper limbs and extend the lower limbs (following a noxious stimulus or spontaneously)
* 3 GCS points
36
Who is responsible for tuning of the intrafusal muscle fibers?
Gamma motor neuron
37
Specialized aggregations of _______________ fibers form muscle spindles.
Intrafusal fibers
38
The pontine reticulospinal tract primarily innervates alpha/gamma motor neurons.
Gamma
39
The ____________________ tract primarily innervates gamma motor neurons.
pontine reticulospinal
40
The rubrospinal pathway...
Is it contralateral or ipsilateral?
From where does its input come?
Flexion in the upper limbs
* Excites alpha and gamma motor neurons
** Contralateral
Input: ipsilateral motor cortex, contralateral cerebellar nuclei
41
The medullary reticulospinal pathway...
| Is it contralateral or ipsilateral?
Flexion limbs
* Contra + Ipsilateral
* Bilateral cortical input
42
The pontine reticulospinal tract...
| Ipsilateral or contralateral?
Ipsilateral
43
The lateral pontine vestibulospinal tract innervates which motor neurons?
Alpha
| ** Axial and limb
44
The medial vestibulospinal tract innervates motor neurons in an excitatory or inhibitory manner?
Inhibitory (glycine)
| ** Cervical and upper thoracic
45
Differentiate between cervical/neck & axial/limb innervation among the lateral and medial vestibulospinal tracts.
Cervical neck: medial
| Axial/limb: lateral
46
Intrafusal fiber
Specialized muscle fiber within a muscle spindle
47
Extrafusal fiber
Muscle fiber located outside of muscle spindles forming the bulk of the muscle
48
Motor neuron pool
All motor neurons innervating a given muscle
49
How do you test for hypotonia?
Reduced muscle tone; detectable by palpation and testing resistance to passive stretch of the limb.
Damage to either the 1a afferent or alpha motor neurons will reduce muscle tone, yielding hypotonia and flaccid paralysis
Can also arise from lesion in other parts of the motor system, even when alpha motor neurons and 1a afferents have been spared
50
Myotatic reflex
A reflex whereby stretching of a muscle provokes contraction of the same muscle. It is mediated by a monosynaptic connection between 1a afferents and alpha motor neurons
51
Inverse myotatic reflec
A reflex where muscle relaxation is evoked by increased tension developed in the same muscle. Mediated by 1b afferents and alpha motor neurons
52
The conduction velocity of a nerve is dependent on...
Myelination (faster) and diameter (faster)
53
Muscles involved in fine movement have more density/less density of muscle spindles.
More density
54
With respect to Group 1A and 2 sensory neurons, what is the difference between the type of stretch that they sense.
1A: static + dynamic (rate of change of length): static nuclear bag, nuclear chain + dynamic nuclear bag
2: static (static nuclear bag, nuclear chain)
55
What fibers are in series with the extrafusal muscle fibers?
Golgi tendon organ fibers
56
What type of afferent fiber innervates the golgi tendon organ?
1B (unmyelinated on the inside)
57
Who is responsible for the "inverse myotatic" reflex and what is the reflex?
Golgi tendon organ; at very high levels of tension/over-active alpha-motor neurons, the golgi tendon relaxes the agonist muscle and excites the antagonist muscle
58
What are Renshaw cells?
Inhibitory interneurons innervated by alpha motor neurons
59
Motor neuron pools are derivatives of the alar/basal plate?
Basal
60
Where is the greatest density of lower motor neurons in the S/C? (2 locations)
Cervical and lumbar
61
Motor neurons receive input from 3 different types of neurons.
1. Muscle spindle afferents
2. Local interneurons
3. Upper motor neurons
62
What is the formal definition of a motor unit?
Alpha motor neuron and the extrafusal fibers that it innervates
63
Each alpha motor neuron controls how many extrafusal muscle fibers for: (a) postural; (b) ocular: 1, 10, 100, 1000?
Postural: 1000
Ocular: 10
64
Approximately how many motor neurons control a single muscle?
100
65
Differentiate between types I, IIA, IIB motor units.
I: slow-twitch, low tension, aerobic, low number of nerves
IIa: fast twitch; 1/2 aerobic
IIb: fast twitch; anaerobic, large number of motor neurons
66
What are the two major factors that control skeletal muscle contraction?
1. Firing rates
| 2. Motor units recruited
67
What types of motor disorders can cause muscle weakness?
All!
68
What types of motor disorders can cause muscle atrophy?
All but NMJ disorders
69
What types of motor disorders can cause fasiculations?
Motor neuron damage
70
What types of motor disorders can cause a reduction in conduction velocity?
Schwann cells
71
What types of motor disorders can cause fluctuations in amplitude of EMG?
NMJ
72
EMG consisent with denervation...
Motor neuron or Schwann cell disorders
73
What is Myotonia congenita?
Cl- channel syndrome; smaller stimulus for depolarization -- prolonged repetitive firing even without stimulus
74
What is the difference in distribution of nAChR in embryo vs adult?
Embryo: widely spread out
Adult: concentrated
75
2 congenital myasthenias
Deficiency in ACh-esterase
| Slow channel syndrome
76
What condition is associated with a "facilitating neuromuscular block"
Lambert-Eaton syndrome
77
Polio destroys...
cell body of lower motor neuron
78
What is a characteristic sign of cortical damage?
Aphasia
79
T/F The primary motor cortex handles movements of individual muscles.
False -- that is the role of the lower motor neuron
80
Acute stage motor lesions can cause...
Flaccid paralysis
81
What are the 4 types of tremor?
1. Physiological
2. Resting -- BG/Parkinson's
3. Kinetic (intention) -- cerebellum -- when moving
4. Essential/Postural -- with a certain posture
82
What is chorea?
Involuntary, jerky movements (as in choreography)
83
What is ballismus? Where is the lesion?
Flinging, rotating
| *Sub-thalamus
84
What is athetosis?
Slow writhing of fingers, toes, hands
85
How do we assess gait?
Walk straight path (heel-to-toe) or heel or toe; turn smoothly
86
How do we assess station?
Feet together, eyes closed
87
How do we assess posture?
Muscle tone; decortiate/decerebrate
88
Chorea is most associated with these 2 diseases
Huntington disease
| * Sydenham disease (childhood rheumatic fever)
89
Describe the 5 stages of Parkinson's
1. Unilateral
2. Bilateral with posture
3. Bilateral without posture
4. Sever disability/with falls
5. Akinesia
90
Describe the features of Parkinson's disese
```
(TRAPS)
Tremor (resting tremor)
Rigidity
Akinesia
Postural changes (stooped)
Stare (serpentine stare)
· To remember what kind of tremor and postural change, can look at letter that follows in TRAPS: Tremor is Resting, Posture is Stooped.
```
91
What is spasmodic torticollis?
Dystonia/muscle spasm
92
What is tardive dyskinesia?
Drug induced oral movements (dopamine receptor antagonists)
93
What are the major hyperkinesia disorders?
Parkinson's
Drug induced Parkinson's
Vascular - Strokes interrupting the nigrostriatal pathway may cause parkinsonism,
affecting both direct and indirect pathways
Dementia pugilistica - trauma
Post-encephalitic
Neoplastic
94
What are the major hypokinesia disorders?
```
Huntington
Sydenham Disease (Autoimmune)
```
Drug-induced Chorea
Athetosis
Hemiballismus
95
How is Huntington disease treated?
Treatment: D2 antagonists, VMAT inhibitor
96
Describe drug-induced Parkinsons
Phenothiazines, which block D2 receptors in the forebrain in the treatment
of psychosis (or hyperkinesis), may cause parkinsonism by limiting
dopamine-mediated inhibition of striatal neurons contributing to the
indirect pathway
• Drugs that deplete dopamine stores within nerve endings (e.g. reserpine)
may diminish striatal dopaminergic transmission to affect both the direct
and indirect pathways, thereby producing parkinsonism
• A metabolite of MPTP, a contaminant produced during improper
preparation of a synthetic narcotic, causes parkinsonism by damaging
nigral mitochondria
97
Describe several treatmens for Parkinson's
Treatments
L-dopa, D2 agonist, dopamine enhancers, Anticholinergics, MAOI/COMTi, Ablative surgery (subthal or GPI), deep brain stimulation (thal, GPI)
98
An infarct to the vestibulocerebellum
•Disturbances affect equilibrium-related motor functions
o Nystagmus (ocular ataxia)
o Tilted head
o Titubation (head-nodding)
o Truncal ataxia (imbalance) with compensatory wide-based stance.
99
Disturbance to the spinocerebellum
Disturbances affect posture and movement of limbs
o Ataxias of the limbs common (ipsilateral)
•Gait ataxia accompanied by lurching to the side of the lesion
100
Disturbance to the cerebrocerebellum
```
Disturbances affect accuracy and timing of movement
o Ataxia
o Decomposition of movement
o Dysarthria (slurred monotonous speech)
o Dyssynergia (uncoordination of limbs)
Dysdiadokinesia (inability to perform rapidly alternating
movements)
Dysmetria (past-pointing)
o Hypotonia
o Intention tremor
o Rebound phenomenon
```
101
Louis-Bar Syndrome
* Autosomal recessive disorder with widespread degeneration of cerebellar Purkinje cells and compromised immune function (chromosome 11)
* Delayed development of motor skills accompanies increased vulnerability to infection
* Most obvious signs relate to walking, talking, facial and ocular movements
* On the longer term, sensitivity to ionizing radiation is observed along with increased vulnerability to cancers
* Skin and eyes tend to express small dilated blood vessels
102
Cerebellar cognitive affective syndrome
•Lesions of the posterior lobe are considered (by some) to correlate with failures of cognitive and emotional systems, leading to:
o Emotional blunting and depression, disinhibition, and psychotic features
o Executive, visual-spatial, and linguistic deterioration
•The condition is conceptualized in relation to “dysmetria of thought,” suggesting a larger role for the cerebellum in cortical control
103
Dementia pugilistica
Parkinson's secondary to trauma
104
Define muscle tone
Force with which a muscle resists being lengthened
105
Define spasticity
A hypertonic state with increased deep tendon reflexes
106
Define falccidity
Weak, lax and soft muscle, without resistance to passive movement
107
Define clonus
Rhythmic palpable oscillations between flexion and extension
108
When a muscle is passively stretched, it reflexively
contracts
109
Biceps reflex
C5, 6, 7
110
Triceps reflex
C6, 7, 8
111
Knee-jerk reflex
L2, 3, 4
112
Ankle-jerk reflex
S1, 2
113
Differentiate between 0, 1+, 2+, 3+, 4+ reflex scale
```
0 - no response
1+ - weak
2+ - normal
3+ - high normal
4+ - brisk with clonus
```
114
Anal sphincter reflex
S2, 3, 4
115
What is the objective of the Golgi Tendon Organ relfex
Protection of muscle/tendon; maintenance of posture
116
What is the flexion reflex?
Noxious stimulus (A-delta and C fibers) causes ipsilateral flexion, and contralateral extension
117
Positive Babinski Sign
Extension of big toe (dorsiflexion) often accompanied by fanning of other toes
* Problem with lateral CS tract
118
Which response is slower: myotatic or inverse myotatic?
Inverse myotatic
119
Dysarthria
Slurred, monotnous speech
120
Dyssynergia
Uncoordinated limbs
121
Dysdiadokinesia
Inability to perform rapidly alternating movements
122
Dysmetria
Past-pointing (Finger-to-nose)
123
Alcoholics are at risk of this cerebellar dysfunction
Anterior cerebellar lobe; degeneration of Purkinje cells; motor signs
124
Vermis/Paravermis/Lateral hemispheres of the cerebellum communicate with which deep nuclei?
Fastigial/Interposed/Dentate
125
HTLV infection can causes (in addition to leukemia)
Tropical spastic paresis (demyelination of S/C)
126
Paresthesia
Morbid/abnormal sensation (burning, prickling, pins/needles, numbness)
127
Ephapse
Pathological contact between parallel nerve fibers where electrical nerve impulses can leak from one fiber to the other
128
Guillan Barre
Acute inflammatory polyneuropathy (begins distal) following an infection
129
Leprosy
Profound sensory loss (pain/temperature)
| Preferentially unmyelinated axons
130
Hansen disease
Profound sensory loss (pain/temperature)
| Preferentially unmyelinated axons
131
Lead poisioning
Motor loss in fingers/arms
Encephalopathy/Memory loss
No sensory loss
132
Alcoholic polyneuropathy
Symmetrical motor and sensory loss
| * Numbness, tingling, burning in feet
133
Diabetic neuropathy
```
Symmetric sensory (starts), asymmetric motor loss
*Stocking distribution
```
134
Differentiate between negative loss and positive gain (with respect to neuropathy)
Loss: weakness, tendon reflexes, ANS, impaired sensory
Gain: Paresthesia, pain
135
Motor neuron soma, peripheral nerve, demyelination, axonal degradation, NMJ
* Any sensory/motor NCV damage?
Peripheral nerve & Demyelination
136
3 major type of nerve trauma
1. Compression
2. Crush
3. Axotomy
137
Describe axotomy
1. Wallerian degradation -- distal axon
2. Anterograde degredation -- distal n. cell
3. Retrograde degradation -- proximal n. cell
138
Describe regeneration of nerves in the PNS
Axonal sprouting, lingering Schwann cells
* NGF, laminin, adhesion molecules
* 1mm/day
139
Describe regeneration of nerves in the CNS
Not possible; oligodendrocytes do not secrete NGF
140
What is gliosis?
A scar formed by astrocytes; a mechanical barrier to sprouting axons
141
Axons differentiate into nerve terminals when they contact...
The basal lamina
142
T/F Inner parts of the nerve are more vulnerable to damage compared to outer parts, i.e. the epinerieum
True
143
Complex regional pain syndrome
Neuropathic pain secondary to resolved injury of bone, soft tissue, nervous tissue
*Increased sympathetic output; hyperhidrosis, sensitization to NE
144
Hirschsprung disease
Congenital decrease in motility/peristalsis of the distal colon
Lack of Mesiner's and Auerbach's plexuses
-Trapped feces dilation
145
Sympathetic T1-T2
Superior cervical ganglion (face, eyes)
146
Sympathetic T2-T6
Inferior cervical ganglion/upper thoracic (upper extremity, heart, bronchi)
147
Sympathetic T6-L1
Celiac ganglion (liver/GI)
148
Sympathetic T9-L1
LS plexus; lower extremeity
149
Sympathetic T10-L1
Adrenal gland
150
Sympathetic T11-L1
SMG
151
Sympathetic L1-L2
IMG
152
Parasympathetic: CN 3, 7, 7, 9, 10, S2-4
```
CN3: EW nucleus -- ciliary
CN7 SS nucleus -- PT/SM
CN9 IS nucleus -- Otic
CN10 Dorsal motor nucleus (bronchial tree, heart, GIT)
S2-4: rectum, bladder, repro
```
153
Differentiate between pathological hypothermia/hyperthermia
Hypothermia: damage to posterior
Hyperthermia: damage to anterior
154
Diabetes insipidus
Damage to supraoptic/paraventricular nuclei, no ADH, excessive thirst
* Treatment: ADH agonist
155
Frolich syndrome
Lesion to medial thalamus (unopposed lateral hunger stimulation)
156
Hypothalamus: feeding
Medial: satiety
Lateral: hunger
157
Hypothalamus: h2o balance
ADH, angiotensin receptors, vagal afferents
158
Name the 6 anterior pituitary hormones and their hypothalamic control hormones
```
DA -inhib-> Prolactin
GHRH --> Growth hormone
GnRH --> FSH/LH
CRH --> ACTH
TRH --> TSH
```
159
Parvo/magnocellular with respect to hypothalamus (anterior vs. posterior)
Parvo: anterior
Magno: posterior
160
Milk ejection: prolactin or oxytocin?
Oxytocin
161
Functions of hypothalmus
```
Temperature/Thirst
Apetite
Libido
Emotion/Emergency
BP/Electrolytes
```
162
Horner's syndrome
Loss of sympathetic input to the head (unilateral ptosis, miosis, anhydrosis, facial flushing)
*Pre-ganglionic/Post-ganglionic; hypo-spinal (entire 1/2 of body)
163
Atonic bladder
Interruption of urinary reflex arc; sensation of fullness is lost; dribbling and loss of reflexive emptying
164
Automatic bladder
Supra-sacral spinal cord lesion
| *Bladder fills until a threshold and then spontaneously, reflexively empties
165
Sleep-wake cycles in blind people
Lack of visual input (zeitgeber); mismatch in circadian rhythm
166
Suprachiasmatic nucleus
Light-sensitive retinal cells (optic nerve/chiasm)
| * Also reaches pineal gland
167
T/F Humans have a free-running biological clock which nearly lines up with a 24 hour day
True (approximately 25 hours)
168
T/F Hypothalamo-spinal fibers can contribute pupillary dilation
True
169
Describe the 3 levels of innervation of the bladder. Which is most important clinically?
Parasympathetic
1. Supratentorial (frontal lobe, hypothal)
2. Subtentorial (pontine micturition center)
3. Spinal (T/L sympa -- S2-4 para)
170
Stretch receptors in the bladder can influence neurons in 3 different places
1. DRG --> Sympa/Para
2. Pons
3. Cortex
171
Androgen insensitivity syndrome
Mutated androgen receptor
Testicular feminization; act like XX's
Primary amenorrhea, female distribution of fat
172
Fetal exposure to DES
```
Synthetic estrogen (++ homosexuality "DES daughters") in the 50's
Enlarged SDN in females
```
173
When is the sexual "critical period" during development
Weeks 12-20
174
Are testosterone and estradiol required for male sexual development?
Yes
175
Homosexuals have a larger _______________ and smaller _____________.
Larger: Suprachiasmatic
Smaller: INAH3 (interstitial nucleus of the anteror hypothalamus)
176
Differentiate between the James-Lange and Cannon-Bard theories of emotion
Lange: express then feel
Cannon: feel than express
177
Describe the modern concept of the limbic system
Cortex, cigulate, hippocampus, hypothalamus, anterior thalamus
178
Kluver-Bucy
Bilateral removal of the amygdala; flat emotions, hyper-orality, hypersexual (temporal lobe lesion)
179
Describe the fear conditioning experiment
Remove amygdala --> no fear
180
Describe the different roles of the amygdala and the hippocampus in regulating a physiological stress response
Amygdala: enhanced response
Hippocampus: dampened response
181
A tumor in this location can induce olfactory and gustatory hallucinations
Temporal lobe
182
T/F Direct input to the amygdala can lead to immediate defensive behavior
True
183
The motor pathway that is required for fine control of digits of the hand is the:
Lateral corticospinal
184
Identify the cortical region involved in the planning of a complex sequence of movements that will cluminate in rising from a seated position, wlking across the room, opening and exiting a door, walking down a hall, turning left, and opening a refrigerator.
Prefrontal
185
The chart of a patient states that he has a right uncal herniation due to a right intracerebral hypertensive hemorrhage. Which of the following neurological deficits would you find upon examination?
Left extensor plantar response
186
Sympathetic sweat gland receptors: Muscarinic or Nicotinic?
Muscarinic
187
Treatment Schizophrenia
Typical: Haldol, D2 antagonist
Atypical: D3, D4 antagonist (less Parkinson-like motor side effects)
188
Describe the relationship between schizophrenia and Parkinsons
Inverse; hence treatment for one can induce the other
189
Define dysthymia
Less severe form of depression
190
Treatments for depression
MAOI, 3cyclic, SSRI
191
Functional imaging of mania
Pre-frontal cortex below the genu of the corpus callosum (increased activity with mania; decreased activity with depression)
192
Dyslexia
Developmental or secondary; read words backwards
193
Alexia
Word blindness, can't read L visual field; disruption of transfer to the left hemisphere; damage to splenium corpus callosum
194
Aphasias
```
Fluent
Wernicke's
Transcortical sensory
Gerstmann (written)
Conduction (can understand, can't repeat -- L superior temporal)
```
Nonfluent
Broca's
Transcortical motor
Global (B+W+Conduction)
195
What is prosody?
Pattern intonation -- grammatical role, sarcasm, emotion
196
Where is emotion (L or R)
R
197
Where is language center (L or R)
L
198
Incoming spoken word is processed
Wernicke
199
Outgoing spoken word
W, B
200
Reading
W
201
Writing
W, B
202
When does language develop?
```
5-7 months: language like sounds
7-8 months: syllables
1-2 year: first word
2 year: rich phrases
3 year: correct words and grammar
```
203
Agraphia
Writing
204
A lesion to the angular gyrus
Gerstmann Syndrome (can't comprehend written)
205
Lesion to secondary association cortex
transcortical sensory aphasia
206
Lesion to arcuate fasiculus
Conduction aphasia
207
Lesion to left dorsolateral frontal
Transcortical motor aphasia
208
A 17 year old female patient of yours has never had a period. That is odd because she has developed all of the other secondary sex characteristics. During examination you notice the absence of axillary & pubic hair.
Androgen insensitivity syndrome
| X-recessive; mutation in testosterone receptor
209
20. What enzyme is responsible for converting testosterone into estrogen?
Aromatase
210
Where is the estradiol receptor located?
Cytosol
211
What region of the brain has the highest number of estradiol receptors?
Hypothalamus
212
The use of what synthetic estrogen in the 1940s-1970s to prevent spontaneous abortion led to a higher incidence of bisexual & homosexuality in girls?
DES [Diethylstilbestrol]
213
When is the critical period of sexual differentiation
12-20 weeks gestation
214
Testosterone producing cells
Leydig cells
215
On what chromosome is the gene for testis determining factor?
Y
216
3 brain regions that exhibit sexual dimorphism
1. Corpus callosum
2. Anterior commussure
3. Hypothalamus
217
Which hypothalamic nucleus is not sexually dimorphic?
Arcuate
218
Which thalamic nucleus is 1/2 the size in homosexual men vs. heterosexual men? INAH 1, 2, 3, 4
INAH 3
219
Which hypothalamic nucleus is responsible for reducing feeding behavior? Paraventricular or Ventromedial
Ventromedial
220
Which hypothalamic nucleus is 2x as large in males vs. females?
INAH1, SDN
221
Which hypothalamic nucleus is 2x as large in homosexual men vs. heterosexual men?
Suprachiasmatic nucleus
222
Anatomical changes during a manic/depressive episode
Depressive phase: Reduced activity in area of prefrontal cortex below the genu of the corpus callosum
Manic phase: Increased activity in area of prefrontal cortex below the genu of the corpus callosum
This subgenul region is important for mood states & has connections w/ other regions involved in emotion [amygdala, lateral hypothalamus, nucleus accumbens, NorE, serotnergic, dopaminergic systems of the brain]
223
Dysthmia
Less severe form of depression
224
How long does it generally take before anti-depressive medications show their effects?
3-4 (sometimes 8 weeks)
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Antipsychotics that have almost no side effects on the extrapyramidal system?
Clozapine, olazapine
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D3/4 receptor antagonists
Clozapine, olazapine
227
Mood stabalizers
Carbamacepine, Lamotrigine, Lithium, Valproate
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Typical anti-psychotic drugs
Haldol, perphenazine
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These drugs can have tardive dyskinesia as side effect
Haldol, perphenazine
230
Anatomical anomolies seen in schizophrenics
*Reduced blood flow to left globus pallidus
(Disturbance is system connecting basal ganglia to frontal lobes)
*Blood flow does not increase in frontal lobes during tests of working memory:
*Cortex of medial temporal lobe is thinner & the anterior portion of the hippocampus is smaller than in normal people: memory defects
*Lateral & 3rd Ventricles are enlarged & reduced volume of temporal & frontal lobes:
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Individuals with these types of schizophrenic symptoms have the worst prognosis
Negative
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Would you characterize a schizophrenic w/ grossly disorganized or catatonic behavior as having positive, negative, or disorganized symptoms?
Negative
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What are the prodromal signs of a psychotic episode?
Social isolation & withdrawal, Impairment in normal fulfillment of expected roles, Odd behavior & ideas, Neglect of personal hygiene, Flat affect
234
What types of hallucinations are most common in schizophrenics?
Auditory
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3 major classes of symptoms in schizophrenics
Positive symptoms: Additional pathological symptoms
Negative symptoms: Loss of function [presence indicates poorer prognosis]
Disorganized symptoms: Disorder of thought & memory dysfunction & confusion
236
The ventral tegmentum releases.... onto the ___________________.
Dopamine; nucleus accumbens
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People that are genetically prone to addiction have what difference in NT activity compared w/ people that don’t?
Seem to have a general reduction in serotonin [5-HT]
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How did Cloniger describe his two “types” of addiction?
Type 1: Low novelty seeking, High harm avoidance, High reward dependence
Type 2: High novelty seeking, Low harm avoidance, Low reward dependence
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Ketamine is a stimulant/sedative/hallucinogen
Hallucinogen
240
Out of hallucinogens, sedatives & stimulants, which drugs cause psychological dependence?
All
241
Out of hallucinogens, sedatives & stimulants, which drugs cause physical dependence?
Sedatives
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What change in what NT results in psychotic symptoms in alcohol withdrawal?
Dopamine
243
What change in what NT results in epileptic seizures in alcohol withdrawal?
Glutamate
244
What drug is used most often in the treatment of alcohol withdrawal?
Benzodiazapenes
245
What are more serious symptoms of alcohol withdrawal?
Marked tremor [the shakes], Delirium [psychomotor agitation, confusion, optic hallucinations], Seizures, Hallucinations May result in death
246
Can opiate withdrawal cause death?
No
247
What are the symptoms of opiod detox?
```
GI flu (nausea, tachy)
* Warm or Cold (methadone)
```
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EEG is used to assess:
Brain death, Brain damage, epilepsy, sleep
249
Awake, active & thinking individuals w/ open eyes
Background frequency of awake person or closed eyes
* Alpha/Beta; Frontal/Posterior
Awake, open eyes: beta, frontal
| Awake, closed eyes: alpha, posterior
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When your waves have a lower frequency than they should they are known as?
Slow waves [the slower the wave the more severe the abnormality]
251
Epilepsy is a chronic condition of...
Repetitive seizures
252
What are some drugs that enhance the activity of GABAergic receptors & are used in the treatment of epilepsy?
Barbs & Benzos
253
An aura precedes a partial or generalized seizure?
Partial
254
A seizure that has a focus in one part of the brain and remains in a localized region is known as a…
Partial epileptic seizure
| - Negative LOC
255
What are two drugs used in the treatment of epilepsy that work by REDUCING the # of Na+ channels? Phenytoin, Carbamazepine
Phenytoin, Carbamazepine
256
Todd's paralysis
Brief period of transient (temporary) paralysis following a seizure
257
Which of the seizures are also known as Petit-Mal seizures? Absence typical or absence atypical
Absence typical
258
Absence typical or atypical
| Gradual/sudden
Typical: sudden
Atypical: gradual
259
Grand mal seizure characteristics
Tonic-Clonic-Post-tictal
260
Seizures can be classified into 2 general categories. What are they?
Primary
Secondary (Focal or generalized)
* Localized = partial; start local, then spreads = 2econdary generalized and LOC
261
What is the difference between a simple partial and complex partial seizure?
Simple: No LOC
| Complex partial: Aura
262
A petit mal, or absence seizure...
specific pattern of generalized convulsion - brief (usually seconds); no movement (except maybe eye blink or lip movement), no loss of tone; no memory for time; no postictal period; it is most common in children and may be "outgrown.
263
Ampa receptors, phosphorylation
GluR1, GluR2
Hippocampus, cerebellum
LTP, LTD
Hippocampus: GluR1, phosphorylation, LTP
264
How are NMDA receptors activated in the brain with respect to memory?
Increased AMPA conductance, receptors, synapses
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Alzheimers brains can show...
Senile amyloid plaques (ECF)
| ICF -- tangles/tau proteins, granulovascular degeneration
