Notes from rest of Ballyk's lectures Flashcards

(78 cards)

1
Q

What is present in the epidural space?

A
  1. FAT

2. Blood vessels

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2
Q

The dorsal and ventral roots exit via which sulci?

A
  1. Dorsolateral and ventrolateral sulci
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3
Q

What do the lumbosacral and cervical enlargements contain

A
  1. Cervical (C5-t1) contain somatic motor to arms

2. Lumbar (L2- S3) contain somatic motor to legs

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4
Q

What do the IML columns contain (T1-L2)?

What do they contain between S2-S4?

A

Cell bodies of sympathetic preganglionic Ns

Cell bodies of Parasympathetic pre gang Ns

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5
Q

Location of IML cell columns?

A

T1- L2, S2-S4

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6
Q

Neurons of ventral horns are…

Neurons of IML cell columns are…

A
  1. Somatic motor

2. Visceral motor

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7
Q

What parts of the thalamus relay information from basal ganglia?
from cerebellum?
from skin,muscle, joints?

A
  1. Both VA and VL nuclei
  2. VL nucleus
  3. VP nucleus
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8
Q

What are the functions of the limbic system?

A
  1. Olfaction
  2. Survival
  3. memory
  4. behavior
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9
Q

What type of movement are the medial portions of the ventral horns responsible for?

A

Ipsilateral
axial muscle
(Posture and balance)

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10
Q

What type of movement are the lateral expansions in the cervical and lumbar regions responsible for?

A

Ipsilateral

Limb muscles - skilled Voluntary movement

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11
Q

List which spinal levels are tested in the following reflexes

  1. Biceps
  2. Triceps
  3. Patellar
  4. Achilles
A
  1. C6
  2. C7
  3. L4
  4. S1
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12
Q

LMN lesion will result in …. 5 things

A
  1. Ipsilateral weakness
  2. HYPOreflexia
  3. FLACCID paralysis
  4. Atrophy
  5. Fasciulations
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13
Q

UMN lesions will result in… 5 things

A
  1. Hemiplegia (depends on level)
  2. HyPER reflexia
  3. No atrophy
  4. No fasciculations
  5. BABINSKI
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14
Q

In a unilateral lesion to mandibular nerve (5) - bilaterally innervated - how does the jaw swing?

A

Towards the weak side

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15
Q

Which axon decussates in SS from body and face?

A

The second order neurone decussates

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16
Q

Where is the cell body of the first order neuron?

A

GANGLION IN PNS

  1. Body (dorsal root ganglion)
  2. Face (trigeminal ganglion)
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17
Q

Where is the cell body of the second order neuron?

A
  1. Dorsal horn of spinal cord

2. Brainstem nucleus

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18
Q

List 4 most medial voluntary motor nuclei (LMNs)

A

(3) Occulomotor
(4) Trochlear
(6) Abducens
(12) Hypoglossal

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19
Q

list 4 lateral voluntary motor nuclei (LMNs)

A

(5) The Masticator nucleus
(7) The facial nucleus
(9,10) Nucleus ambiguous
(11) Accessory

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20
Q

List 4 Visceral Motor nuclei (Contain PREGANGLIONIC Psy Ns)

A

(3) Edinger Westphal
(7) Superior salivatory - everything that drips except the parotid
(9) Inferior salivatory (Parotid)
(10) Dorsal Vagal (Thoracic and abdominal viscera)

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21
Q

List the two Somatic Sensory nuclei (Second order sensory neurons)

A
  1. Spinal trigeminal nucleus

2. Pontine trigeminal nucleus

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22
Q

List the two special sensory nuclei (Second order sensory neurons)

A
  1. The vestibular (8) - BALANCE

2. The cochlear (8) - Auditory

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23
Q

In a supratentorial lesion, what are the symptoms of increased ICP
Effects are contra or ipsilateral?

A
  1. Headache
  2. Altered mental status
  3. Nausea, vomiting
  4. Papilledema,
  5. Diplopia

EFFECTS ARE CONTRALATERAL FACE AND BODY

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24
Q

What creates the blood-ISF barrier

A

Astrocytic end feet - induce formation of Tight Junctions between endothelial cells of Cerebral BVs

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25
What forms the Blood-CSF barrier?
The choroid plexus
26
Where do cerebral BVs form continuous capillaries? | Fenestrated capillaries?
1. Continuous everywhere EXCEPT | 2. In the choroid plexus
27
Choroid ependymal cells are joined by
TIGHT JUNCTIONS
28
Function of the choroid ependymal cells?
Secrete CSF
29
Total volume of CSF: | Rate of production of CSF:
1. Volume = 140mls | 2. 500ml/day produced
30
How do you differentiate a block in CSF movement versus impaired absorption?
1. block in movement - only some of the ventricles will enlarge depending on block 2. All ventricles enlarge - due to a genesis of villi
31
Met-HB (subacute blood) appears
BRIGHT on both T1 and t2
32
Hemosiderin
Appears DARK on T1 and T2
33
Most pathologies are ..... on T1... and ..... on T2
DARK on T1 BRIGHT on T2 except for fat, calcium, melanin, blood at certain stages
34
BEST modality for imaging an acute stroke
CT scan of head with no contrast - rule out contraindications high attenuation clot/embolus can often be seen
35
BEST modality for imaging an acute stroke if in the posterior fossa
MRI - diffusion weighted - water restriction (first 7-10 days)
36
To image blood vessels you can use
Doppler - flowing blood hypo echoic, dense tissue hyper echoic - challenging for vertebral circulation cT angio MR Angio
37
What is the order of the neurological exam?
1 Mental status 2. Cranial nerves 3. Motor 4. Sensory 5. coordination 6. Stance and Gait
38
The receptors for tactile sensation are...
LOW threshold mechanoreceptors
39
Nociception receptors are...
HIGH threshold mechanoreceptors
40
Which receptors detect onset and end of stimulus?
RAPIDly acting receptors
41
Which receptors detect high frequency vibration?
RAPIDLY acting receptors
42
Which receptors report continuously on a stimulus?
Slow adapting receptors
43
Which receptors are good for reporting pressure, shape, LOW frequency vibration?
SLOW adapting receptors
44
Which are the only unmyelinated fibers?
cLASS C... they are also smallest in diameter and conduction velocity
45
Capacitance and velocity are
Inversely correlated
46
Which nerve fibers have motor and sensory targets?
Aalpha A gamma B C
47
Which class of fibers is used for Limb position and Motion - muscle spindle MOTOR - EXTRAfusal
Class A alpha
48
``` Which class of fibers is used for Skin, conscious proprioception, touch, pressure, vibration and 1B AFFERENT GOLGI tendon tension ```
Class A beta
49
Which class is for FAST pain, cold, and hair follicles
Class A delta
50
Which class of fibers is for SLOW pain, warmth, - has autonomic post-ganglionic fibers - grey rami
Class C
51
Class B fibers are
for Preganglionic autonomic, white rami
52
Where do the sensory relay neurons project
1. To neurons in the dorsal horn to suppress the pain pathway 2. to medullary and pontine reticular formations for alerting responses and modifying locomotor reflexes 3. Superior colliculus to drive orientation
53
AT THE first synapse what type of inhibition do you have/
1. Cortical descending inhibition | 2. Lateral inhibition to sharpen localization of the stimulus
54
What is the function of the secondary somatosensory area? S2?
Receives signals from S1 and thalamus | Important for tactile memory
55
Function of the Sensory association area?
Visual and somatosensory signals integrated
56
Pitch is proportional to
Frequency (Hz)
57
Intensity of sound is
Difference in pressure between compressed and rarefied patches of air - decibels, amplitude variation
58
Movement of the ossicles is modulated by 2 muscles
Tensor tympani (V3) Stapedius (7) lesions there can result in hyperacusis
59
The tympanic cavity is connected to 2 things
1. Nasopharynx (via ET) | 2. Mastoid air cells (via lots of channels)
60
The 2 special sense organs in the inner ear are
1. Vestibular apparatus : senses equilibrium | 2. Cochlea - senses sound
61
The scala vestibuli and scala tymapni both contain
Perilymph
62
The membranous labyrinth contains
Endolymph - lots of K+
63
The width of the basilar membrane is determined by
SIZE of the spiral lamina (INVERSELY)
64
Where is the basilar membrane the widest?
AT THE APEX (narrow and stiff at the base)
65
What is the name of the area through which the scala vestibuli and scala tympani are continuous?
At the Helicotrema
66
WHich scala does the oval window fit into and what does it do
The Scala Vestibuli | - INITIATES pressure waves
67
what does the round window do and where does it fit?
The scala tympani | - RELIEVES pressure waves
68
What part of the inner ear contains the auditory receptor cells and what do they do?
Organ of Corti - converts sound energy into Action potentials
69
Where is the frequency the lowest for the basilar membrane tonotopy?
AT THE APEX (higher frequency at the bASE)
70
The stereocilia of which hair cells extend INTO the Tectorial membrane?
The stereo cilia of the Inner hair cells
71
The longest or tallest hair cells are closer or further away from the modiolus?
They are furthest away
72
When the basilar membrane moves up what happens to the stereo cilia (1) and to the hair cells (2)
1) The stereo cilia move OUT | 2) The hair cells MOVE IN
73
What is the receptor potential like when the stereo cilia bend towards the tallest hair cell?
``` Depolarizing potential (towarD... Depolarize) - INCREASED K+ channel conductivity INCREASE NT release at the base along spiral ganglion ```
74
What is the receptor potential like when the stereo cilia bend away from the tallest hair cell?
Away... Hyper polarize | DECREASED K+ channel conductivity
75
Which ion is the main driving force for receptor potentials in hair cells?
K+
76
What is the function of the IHCs
Conduct auditory input by cochlear nerve
77
What is the function of the OHCs
Amplify Basilar membrane movement (100X) during low intensity (low amplitude sound)
78
When can you have deafness happening at what level?
At the cochlear nerve, damage to ear, or cochlear nucleus | ABOVE that all are bilaterally pathways