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head neck and neuro > week 1 > Flashcards

week 1 Flashcards

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1
Q

What is the name of weakness on one side of the body?

A

hemiparesis

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2
Q

What is the name for difficulty with speech?

A

aphasia

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3
Q

WHat is a dermatome?

A

the region of skin supplied by a single spinal nerve

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4
Q

Where are the preganglioic neurons in the sympathetic nervous system?

A

thoracic and upper lumbar spinal cord

T1-L3

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5
Q

Where are the preganglionic neurons in the sympathetic nervous system?

A

brainstem (some cranial nerves)

sacral spinal cord (S2-4)

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6
Q

Where are sympathetic ganglia found?

A

in the sympathetic chain which is next to the vertebral column

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7
Q

Where are the parasympathetic ganglia found?

A

in the walls of the viscera that they innervate

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8
Q

What is pain?

A

an unpleasant and emotional experience associated with actual or potential tissue damage

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9
Q

What is involved in the acute catabolic stress response?

A

anxiety, depression, sleep
up BP, HR
inhibits cough, hyperventilation
etc

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10
Q

What are the four physiologic processes of nociception?

A

transduction
transmission
modulation
perception

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11
Q

Describe nociceptors

A

C
polymodal (mechano-heat-chemical)
Ad mechanical, some thermal
HIGH THRESHOLD

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12
Q

Name substances that activate pain receptors

A 
K+
5HT
bradykinin
H+
Histamine
ATP, adenosine
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13
Q

What can sensitise pain receptors?

A

prostaglandins
leukotriens
substance P
noradrenaline

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14
Q

What sort of fibres can morphine inhibit?

A

C

pathophysiology

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15
Q

Describe somatic pain

A 
skin, muscle, bone
well localised
dermatomal radiation
sharp, aching, gnawing
constant or incident
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16
Q

Describe visceral pain

A 
internal organs
vague distribution
diffuse to body surface
dull, cramp, dragging
often periodic
sweaty
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17
Q

What are some common descriptors of neuropathic pain?

A 
shooting
electric shock
burning 
tingling
numbness
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18
Q

What method do tens machines use?

A

gate control therapy

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19
Q

How many segments of the spinal cord are there?

A 
31
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
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20
Q

What is the upper limit of the spinal cord?

A

the junction with the medulla oblongata

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21
Q

What is the lower level of the spinal cord?

A

in newborn infants L3/L4

In adult L1/L2

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22
Q

What is a ganglion?

A

a collection of cell bodies

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23
Q

WHat is a fasciculus?

A

a bundle of axona

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24
Q

What is a faniculi?

A

tract of axons

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25
What does the neural tube develop from?
a flat plate of cells (neurodevelopment-ectoderm)
26
what is the dorsal horn involved in?
sensory
27
What is the ventral horn involved in?
motor
28
What are the three layers of the meninges?
dura mater arachnoid mater pia mater
29
what is the epidural space?
separates the dura and the vertebrae
30
What is in the arachnoid space?
CSF
31
WHat is the name of the artery that supplies the lower 1/3 of the spinal cord?
artery of adamkiewicz
32
What does the spinal cord pass through as it leaves the skull?
the foramen magnum
33
WHat is the lowest part of the spinal cord called?
conus medullaris
34
Where does the pain pathway go?
the superficial dorsal horn
35
where does the gentle touch pathway go?
deep dorsal horn
36
WHat are a alpha fibres involved in?
proprioceptors of skeletal muscle
37
What are A beta fibres involved in?
mechanoreceptors of the skin
38
WHat are A delta fibres involved in?
pain, temperature
39
What are C fibres involved in?
temperature, pain, itch
40
What pathway is discriminative touch?
dorsal column
41
What pathway is pain?
spinothalamic pathway
42
What pathway is voluntary motor?
corticospinal and corticobulbar
43
WHat are the four areas of the brain?
frontal, parietal, occipital, temporal
44
what are the two main sulci of the brain called?
central and lateral
45
what is the motor area called?
pre central gyrus
46
what is the sensory area called?
post central gyrus
47
Where is the area for speech?
motor cortex
48
where is the visual cortex?
occipital lobe
49
WHat areas are involved in the motor aspect of speech?
Brocca's areas in the inferior frontal gyrus
50
What side of the brain are the main broccas areas mainly found?
the left
51
What is the auditory association cortex called?
Wernickes areas
52
WHat makes up the corpus striatum?
caudate nucleus putamen globus pallidus
53
What are the basal ganglia called?
corpus striatum, sub-thalamic nuclei, substantia nigra
54
WHat are the boundaries of the lentiform nucleus?
``` claustrum internal capsule anterior limb genu posterior genu ```
55
What does the ectoderm give rise to?
CNS PNS sensory epithelium of the ear, nose and eye epidermis, hair and nails subcutaneous, mammary and pituitary glands enamel of the teeth
56
What does the notochord develop from?
the primitive node | tube extends in the opposite direction from the primitive streak
57
What causes the ectoderm to thicken and form the neural plate?
appearance of the notochord and mesoderm
58
WHat is the neural plate made from?
neuroectoderm
59
Describe signalling in neuralation
Up regulation of FGF, inhibition of BMP-4 causes induction of the neural plate chordin and noggin expressed neural plate switches from E-cadgerin to N-cadherin expression
60
WHat do the neural crest cells give rise to?
``` ganglia schwann cells adrenal medulla melanocytes connective tissue in head region ```
61
once the neural tube has closed what do the neuroepithelial cells give rise to?
neuroblasts which form the mantle layer
62
What does the mantle layer become?
the gray matter of the spinal cord
63
What does the marginal layer become?
white matter in the spinal cord | myelination of nerve fibres
64
WHat are the three primary brain vesicles called?
forebrain - prosencephalon midbrain - mesencephalon Hindbrain - rhombencephalon
65
WHat does the prosencephalon divide into?
the telencephalon and the diencephalon
66
WHat does the mesencephalon divide into?
the mesencephalon
67
What does the rhombencephalon divide into?
the mesencephalon and the myelencephalon
68
What does the telencephalon become?
the cerebrum
69
What does the diencephalon become?
eye cup | thalamus, hypothalamus and epithalamus
70
WHat does the mesencephalon become?
the mid brain
71
What does the mesencephalon become?
the pons and the cerebellum
72
What does the myelincephalon become?
the medulla oblongata
73
What are the different types of spina bifida?
oculta meningocele myelomeningeocele
74
What causes hydrocephaly in spina bifida?
CSF build up in heat due to obstruction of the foramen magnum by the cerbellum
75
What causes the resting membrane potential?
a difference in charge between the inside and outside of the neuron at rest
76
What is the typical RMP of neurons?
-60 - -70mV
77
What is an action potential?
a brief but dramatic change in membrane potential
78
Describe depolarisation and depolarisation and hyperpolarisation
depolarisation related to increased permeability to Na+ cells repolarisation and hyper polarisation due to increased permeability to K+ ions
79
In what ways can bolted - gated sodium channel drugs be used?
local anaesthetics pain treatment epilepsy
80
What type of cells are found in the CNS?
oligodendrocytes
81
WHat sort of cells are found in the PNS?
schwann cells
82
What are the areas that are unmyelinated called?
nodes of ranvier
83
What is saltatory conduction?
action potential "jumps" form node to node in myelinated axon
84
Describe synaptic transmission
AP enters presynaptic terminal Ca2+ entry through voltage-gated channels docking of synaptic vesicles containing NTs NTs released and bind to and activate receptors on postsynaptic membrane Ions enter cell and cause depolarisation or hyperpolarisation
85
What is an excretory post synaptic potential?
EPSP | brings the post synaptic membrane closer to the threshold for depolarisation
86
What is an inhibitory postsynaptic potential
IPSP | moves the post synaptic membrane further away from the threshold
87
What are the two types of summation of post synaptic potentials?
spacial (firing at multiple sites) and temporal (frequency of firing)
88
WHat is the main inhibitory neurotransmitter?
gamma-aminobutyric acid
89
How does botulism affect synaptic transmission?
disrupts exocytosis preventing Ach release
90
How does myasthenia gravis affect synaptic transmission?
antibodies bind to Each receptors in the postsynaptic motor end plate
91
In what ways can cerebral function be investigated?
EEG PET fMRI TMS
92
How can a pancoast tumour affect the upper limb?
superior extension of the tumour may result in encasement of the C8 nerve root and cause pain in the medial 2 digits of the hand Causes atrophy of intrinsic muscles of the hand - particularly the interosseous muscles Infiltration of the T1 nerve root causes pain which radiates down the medial aspect of the arm and forearm as far as the wrist
93
What are the results of horner's syndrome?
``` ptosis mitosis hemifacial / unilateral anhidrosis loss of head and neck sympathetic tone enophthalmos ```
94
Describe the first order neruronal fibres in the sympathetic pathway to the eye
arise from the poster-lateral hypothalamus | descend through brain stem to terminate in the spinal cord at the ciliospinal centre (C8-T2)
95
Describe the second- order neuronal fibres in the sympathetic pathway to the eye
exit through the T1 root and travel close to the lung apex through the paravertebral sympathetic chain and the stellate ganglion This is the level where a pancoast tumour could interrupt the pathway
96
Describe third order neuronal fibres in the sympathetic pathway to the eye
exit the ganglion to form a plexus surrounding the internal carotid aftery plexus then ascends into the cavernous sinus, runs a short course on CN VI and then follows the ophthalmic division of C5 in the orbit Supplies the iris dilator muscles and the smooth muscle fibres if the upper and lower lid vasomotor and sweat gland fibres follow the external carotid artery to supply the ipsilateral side of the face
97
Describe the anterior compartment of the thoracic inlet
from the sternum to the anterior scalene muscle | contains subclavian and internal jugular veins
98
Describe the middle compartment of the thoracic inlet
from the anterior to the posterior scalene muscle | contrains subclavian artery and branches of the subclavian artery
99
Describe the posterior compartment of the thoracic inlet
beyond the middle scalene muscles | contains branches of the brachial plexus, the sympathetic chain and stellate ganglion
100
What is a pancoast tumour?
a malignant neoplasm of the superior sulcus of the lung with destructive lesions of the thoracic inlet and involvement of the brachial plexus and cervical sympathetic nerves
101
WHat is the most common type of pancoast tumour?
squamous cell carcinomas (non small cell)
102
How are pancoast tumours diagnosed?
biopsy | imaging - CT, PET
103
How are pancoast tumours managed?
surgery radiation chemo very low 5 year survival rate

head neck and neuro (6 decks)

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