Unit II Flashcards

(107 cards)

1
Q

Cranial Nerve 0

A

chemoreceptors

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2
Q

Cranial Nerve I olfactory

A

one of oldest, by passes thalamus and goes to olfactory cortex first then thalamus

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3
Q

Where is CN 0 and CN I in the brain?

A

Telencephalon

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4
Q

Where is CN II in the brain?

A

Diencephalon

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5
Q

Where is CN III-XII except XI in the brain?

A

Middy
pons
medulla

rule of 4

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6
Q

Cranial nuggets (4 of them)

A

axons form CN nerve
all CN motor nerve=LMN
corticobular directly innervate CN V, VII, XI, XII
all CN have bilateral innervation except VII, XII

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7
Q

All cranial nerves have .. .?

A

2 nuclei
2 nerves

ipsilateral innervation except trochlear nerve (contralateral)

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8
Q

Nucleus of origin vs destination

A

cell body of fibers that make nerve

2nd order neuron for incoming sensory info

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9
Q

Brain stem lesion, ipsilateral vs contralateral

A

ipsilateral: cerebellar and cranial nerves
contralateral: corticospinal and dorsal column

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10
Q

Vision in general

A

only sensory system that provides accurate spatial info from a far

taste/touch=accurate but no distance
smell/hearing=distance but not accurate

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11
Q

Electromag spectrum

A

vision only encompasses small part of it

light is unidimentional, straight, and travels far=good for accurate distant sensory

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12
Q

LIght interaction with medium

A

refraction- light is bent and slowed
diffraction- light bounces around the object
absorption

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13
Q

Wavelength and frequency

A

inversely related

long wavelength, short frequency= decreased energy
short wavelength, inc frequency= increased energy

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14
Q

What determines saturation, brightness, color/hue

A

Wavelength= color/hue

amp= brightness

purity=saturation

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15
Q

eye anatomy

A

Outer: sclera/cornea

Intermediate:
ant chamber: behind cornea, front of iris/ciliary body
post chamber: behind iris/ciliary body, front of lens

inner: retina

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16
Q

Optical disk

A

blind spot, BV=no receptor there

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17
Q

Formation of image

A

flipped upside down and backward

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18
Q

Cells of retina

A

ganglion cell layer
bipolar layer
photoreceptor
amacrine/horizontal layer (lateral interneurons)

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19
Q

Lateral interneuron cells

A

inhibitory in the periphery

on ganglion cells vs off ganglion cells

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20
Q

Rods vs Cones

A
rods:
respond to all wavelengths of light
max sensitivity at 500nM
1 photoreceptor (rhodopsin)
light sensitive
for night vision in low light setting
less photon needed to elicit response thus daytime bleaches rods

cones:
responds to only certain wavelengths
blue, green, red, respond to 420,530,650 nM
3 photo receptors (iodopsin)
not light sensitive
for daytime vision (no cones=legally blind)
needs >100 photon to elicit response

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21
Q

Retinal conversion

A

only 1 million ganglion cells, over 94 rods/cones

rods:
high convergence=undetail
1 ganglion receives input from many rods
inc light gathering during night low light condition
inhibit spatial resolution (large receptive field)
no rods in fovea

cones:
low convergence=detailed
1:1 ganglion:cone
for acuity
spatial resolution (small receptive field)
almost all cones in fovea, few cones scattered too

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22
Q

Rods/Cones firing AP?

A

they don’t fire AP

fire graded potentials (decay in time/space), (don’t have enough sodium channels)

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23
Q

Ganglion cells in general

A

first cell in vision pathway to fire AP
axons of ganglion cell form optic nerve

projects to: LGN of thalamus, superior colliculus (retinofugal pathway), brainstem nuclei, suprachiasm nucleus of hypothalamus

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24
Q

Parasol vs Midget Cells

A
Parasol cells: 
monochromatic
large cell bodies/receptive field
gross movement of stimulus
large fibers to LGN magnocellular layer (4cA)
Midget cells:
numerous
small cell bodies/receptive fields
fine detailed/color
small fibers to LGN parvocellular layer (4cB)
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25
Normal path for visual perception
retina eye to LGN of thalamus to Visual cortex info is divided at chiasm shared at splenium
26
2 streams of info of vision
dorsal: tells us where ventral: tells us what
27
Visual field affected by lesion
``` Optic nerve Optic chiasm Optic tract Lower bank/meyer's loop Upper bank/optic radiation ```
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Most common eye symptom
double vision other eye movement controlled by tectum
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Intrinsic eye movement
``` iris spincter (parasymp of CN III) pupillary dilator (ascending cervical sympth) ciliary body (parasymp of CN III) ``` Vision of near object: ciliary body relaxes Vision of far object : ciliary body contracts (bends lens to converge the divering light rays) Dim light: pupillary dilator contract, iris sphinctor relax Bright light: pupillary dilator relax, iris sphinctor contract
30
Extrinsic eye movement
Superior oblique- introsion- CN IV Inferior oblique- extorsion- CN III Superior/Inf/Medial rectus- CN III Lateral rectus- CN VI
31
Oculomotor CN III autonomic vs somatic control
autonomic- iris sphinctor- edinger westphal nuclues somatic- al lthe recti except lateral, inferior oblique, and levator palpebrae (central caudal nucleus)
32
CN III lesion
impaired eye movements- extraocular mm droopy eyelids- ptosis levator mm pupilary dilation- iris sphinctor
33
CN VI nucleus and CN VII form. . .
facial colliculus at the base of 4th ventricle
34
Where is CN IV nucleus
dorsal caudal midbrain
35
CN V1 ophthalmic function
mostly sensory skin: sensory of forehead, eyelid, eyebrow orbit: eyeball, lacrimal gland, conjunctiva, nasal cavity
36
CN V2 maxillary function
sensory lower eyelid, nose, cheek, part of pharynx, upper teeth, lips, gums
37
CN V3 mandibular function
sensory and motor sensory: lower lips, gum, teeth, pharynx, ant 2/3 of tongue motor: tensory tympani, muscle of mastication
38
CN VII function
sensory: taste of ant 2/3 of tongue, outer ear motor: facial expression, lacrimation/salivation, stapedius
39
CN VIII function
hearing | equilibrium
40
semilunar ganglion project to which 3 Nucleus of destination of V?
mesencephalic, chief trigeminal sensory, spinal trigeminal
41
Mesencephalic trigeminal nucleus
Aalpha fibers, propio jaw reflex bypasses the semilunar ganglion and possess the mesencephalic nucleus within the CNS (only exception) synapses onto nearby motor nucleus of V
42
Chief trigeminal nucleus
Abeta fibers, discrimintive touch semilunar ganglion synapses onto the chief trigeminal nucleus at the pons level second order neuron crosses and continues up with the Medial lemniscus tract towards VPM of thalamus for sensory touch
43
Spinal trigeminal nucleus
Adelta c fibers, pain/pressure/temp semilunar ganglion dives down to caudal medulla continuous with C1-C2 level and synapses with spinal trigeminal nucleus second order neuron crosses and continues up with the spinothalamic tract towards VPM of thalamus for pain sensation
44
Other CN also send input to spinal trigeminal nucleus
CN VII, IX, X
45
CN VII sensory cell bodies are?
geniculate nucleus
46
CN VII Upper face
input to dorsal division of VII nucleus, bilateral innervation
47
CN VII Lower face
input to ventral division of VII nucleus, contralateral innervation
48
CN VII UMN lesion
can still wrinkle forehead, lower face below eyes is paralyzed
49
CN VII LMN lesion
whole side of face is paralyzed
50
CN VII nuclei of destination
pons (motor): facial nucleus, salivatory nucleus medulla (sensory): nucleus solitarius (receives axons from DRG in geniculate
51
CN VIII hearing and equilibrium
spiral ganglion in the cochlear projects to dorsal/ventral cochlear nuclei in pons/medulla (cross many times, lesion=not clinically relevant) vestibular ganglion in otolith/SSC project to vestibular nuclei
52
CN IX & X in general
rule of 4 function: pharyngeal, laryngeal muscle, neck, tongue, dysarthria, dysphagia bilateral neuromotor signs =ALS
53
CX IX & X both
connect to shared nuclei: VII nucleus solitarius, V trigeminal, X nucleus ambiguus superior and inferior ganglia (jugular foramen)
54
CN IX anatomy
between the inferior olive and inferior cerebellar peduncles just below CN VIII at the pontomedullary junction
55
CN IX motor
stylopharyngeus, origin: nucleus ambiguus parasympathetic inn. of parotid glands, origin: inferior salivatory nuclei
56
CN IX sensory
somatosensation: middle->external ear, pharynx, post 1/3 of tongue, origin trigeminal nuclei taste: posterior 1/3 of tongue, origin: rostral nucleus solitarius, VII, X chemo/baroreceptor of carotid body, origin: caudal nucleus solitarius X
57
CN IX gag reflex
touch/taste to back of tongue contraction by CN X stronger reflex <6months, begins diminishes 6-7 months
58
CN IX lesion signs (rare)
``` dysphagia dysfunction of parotid gland dec somatosensation of middle->external ear bitter taste of post 1/3 of tongue brachycardia, tachycardia absent gag reflex ```
59
CN X in general
longest course of CN, 80-90% of fibers for sensory viscera for swallowing, gag, taste phonation, passes through jugular foramen multifunction=often implicated in lesions, joints the cranial part of CNXI below the inferior ganglia
60
CN X motor
pharyngeus and laryngeus muscles (except stylopharyngeus) origin: nucleus ambiguus parasympathetic inn. of heart, bronchi, GI-splenic flexure, Origin: dorsal motor nucleus of X
61
CN X sensory
somatosensation of small region of posterior external accoustic meatus, pharynx, meninges, Origin: trigeminal nuclei taste: epiglottis and pharynx chemo/baroreceptor: aortic arch
62
CN X lesion (rare)
paralysis of palate, pharynx, larynx | leads to hoarseness, dysphagia, choking, dec gag reflex, ineffective cough
63
CN X lesion autonomic signs
soft palate lack of elevation deviation of uvula to opposite side of lesion abnormalities of: esophogeal mobility, gastic acid secretion, gallbladder emptying, heart rate
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CN X laryngeal recurrent signs
unilateral: dysphonia bilateral: aphonia, obstruction of airway, stridor
65
Testing CN IX and X
test in conjunction ``` say ah (uvula midline, soft palate elevation) voice quality (hoarseness, dysarthria) gag swallowing bitter taste ```
66
Reticular formation in anatomy
spans from top of cord to caudal diencephalon core of brain stem tegmentum
67
Historical view of RF
mesencephalic transection: spontaneous breathing, hypersomnia, pupillary abnormality cord transection: sleep-wake cycle (tho altered), normal EEG, normal pupillary dilation
68
Modern view of RF
3 columns lateral: 1/3 of RF, parvocellular, afferent sensory medial/medin raphe: 2/3 or RF, efferent to regulate CNS wide spread Midbrain RF: awake, arousal, attention Pontine RF: respiratory nuclei, activate neocortex during REM (AcH release) Medulla RF: spinal motor neurons (vomit/respiratory/reflex/vasomotor (BP HR)), inhibition for near total body paralysis during REM sleep
69
Reticular formation in general
lay outside of the major tracts, have polysynaptic connections receives sensory input from all except DC-ML, efferent to all levels of CNS affects responsiveness of cortex, motor/sensory/autonomic
70
Reticular Formation Nuclei
precise locations of nuclei (NOT net like) with known projections pattern and neurotransmitters several CN nuclei lay in the RF
71
RF efferent projections
``` short projections (lateral 1/3 of RF) long projections (median/medial 2/3 of RF)- long ascending fibers that synapse via collaterals with long descending fibers, bifurcating neuron that ascends and descends ```
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RF organization
Rostral: continues with diencephalon, upper pons, mesencephalon and regulates alertness/consciousness in forebrain Caudal: continues with intermediate zone of SC, lower pons, medual, collaborates with SC/CN for motor reflexes and autonomic functions
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RF Consciousness system
Cortical: medial and lateral frontalparietal association cortices subcortical: diencephalon and upperbrainstem
74
RF Consciousness system: Subcortical
forebrain innervated by upper pons, middy, brainstem/cerebellar/sc innervated by lower brainstem
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Consciousness 2 principle function
content of consciousness | level of consciousness
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Content of consciousness
comprised of systems that regulate sensory,motor,memory,emotional function when conscious system acts, brainstem system provides substrate
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Level of consciousness
regulated by consciousness system maintenance of wakeful/arousal alertness/attention/awareness
78
Alertness
regualted by diencephalon, upper pons, cortex if lesion=coma
79
Attention
same as alertness with addtion of frontalparietal association cortices
80
Awareness
un as well understood | integrates sensory input for unified summary of current mental activity
81
Acending Reticular activating system
maintenance of consciousness requires multiple sytems of ARAS not all are ascending not all originate from RF
82
Brain lesions that lead to coma
Upper brain stem lesion (not ventral pons/middy, medulla) bilateral extensive lesion to thalamus, or cortex MI, Strangulation, Drowning
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Subcortical arousal system: upperbrain stem neurons
5-HT, NE, Dopamine project -->cortical/subcortical structures AcH/pontomesencephalic neurons with Glu project -->thalamus, hypothalamus, basal forebrain
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Subcortical arousal system: posterior hypothalum neurons
orexin,histamine project --> cortical subcortical structures basal forebrain containing AcH/thalamic structures containing Glu project to --> cerebral cortex
85
Cholinergic Projections
Cell bodies: nucleus basalis of meynart, pontomesencephalic, brainstem ``` arousal selective attention learning/memory arousal input to the thalamus facilitating input from forebrain to cortex ```
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Noradrenergic projections
Cell bodies: locus coeruleus, lateral tegmentum ``` arousal selective attention sleep (active during wake, quiet during REM) sensory input especially pain autonomic function (BP/HR) ```
87
Seratonin projections
Cell bodies: rostral/caudal raphe ``` arousal selective attention sleep sensory input espeically pain reticulospinal tract, tone regulation ```
88
Dopamine projections
Cell bodies: mesolimbic, meso striatum, mesocortical motivation, fear learning, cortical/executive functioning regulate direct/indirect movement pathways
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Histamine
Cell bodies: tuberomamillary nuclei, posterior 1/3 of hypothalamus arousal sleep energy balance learning and memory
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Brain dead vs coma vs pvs vs minimally conscious vs etc
Brain dead, all absent coma, spinal and brain stem reflexes severely depressed cortical purposeful response to stim/arousal sleep wake cycle PVS, spinal and brain stem reflex sleep-wake cycle apparent, severely depressed cortical purposeful response to stim minimally conscious or better, spinal and brain stem reflex, sleep wake cycle apparent, at times some purposeful respone to stim akinetic/catatonia affects frontal cortex locked in affects basilar pons, lack of purposeful movement
91
Primary goal of vestibular system
spatial and motion orientation of head adjust muscle activity of neck and legs to maintain posture when head moves, stabilize fixed point to create stable image for retina
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Vestibular where am I going
otolith (saccules/utricles) | translational/linear
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Vestibular which way is up
``` semicircular canals (lateral/anterior/posterior SCC) angular/rotational ```
94
Peripheral apparatus of vestib
detection of linear/angular velocity relays to central system
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Central system of vestib
integrates info from many systems a bout position/movement of head
96
Motor out put system of vestib
orients head with respect to gravity generates eye/head/limb adjustments
97
For Erect posture . .
central vestib system signals about head movement and postural system to result in head/limb stabilization in conjunction with eye system allows erect posture
98
Common similarities of Auditory and Vestib system
common fluid system (bony and membranous lab) mechano receptors low Hz-balance high Hz-hearing shared CN VIII, tumor may affect hearing and balance
99
Otolith receptors are called?
maculae
100
SCC receptors are called
ampullae crista x axis - pitch y axis - yaw z- axis - roll
101
4 vestibular nuclei and its projection
medial, lateral, superior, inferior (dorsal surface of midbrain) all overlap with info and project to: SC, Cerebellum, thalamus, RF, oculomotor
102
vestibular path way
scrapas ganglion-->vestibular nuclei and cerebellum --> MLF, and vestibulospinal tract (medial and lateral)
103
Medial Longitudinal Fasciculus
ascending axons from vestibular nuclei terminating on nuclei III, IV, VI for adusting eye movements
104
Medial vs Lateral Vestibulospinal tract
``` medial: orginate: medial vestib. nuclei terminate: c-spine adjusts proximal mm. neck detection of rotational with SCC ``` ``` lateral: originate: lateral vestib. nuclei terminate: all levels of cord adjust leg mm for standing detection of linear with otolith ```
105
Vestibular signals to Cortex
``` Frontal eyefield somatosensory areas Parietal insular vestibular cortex Posterior parietal cortex hippocampus ```
106
Vestibulo-cerebellum
afferent from flocconodular nodes | vestib nuclei-->inferior cerebellar peduncles
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Vestibular signs and symptoms
``` dizziness vertigo oscillopsia light headness impaired hearing and tinnitus ```