Week 3

Question 1

What is tinnitus?

Answer 1

This is a sensation of a sound when there is no auditory stimulus

Question 2

What is vertigo?

Answer 2

Definitive illusion of movement of the subject , surroundings which indicates a disturbance of vestibular VIII CN brainstem or cortical function

Question 3

What is Ménière’s disease ?

Answer 3

An excessive accumulation of endolymph in the membraneous labyrinth . The volume of endolymph increases with the distension of the Scala media untill the membrane ruptures

Question 4

Clinical features of Ménière’s disease ?

Answer 4

Tinnitus
Fluctuating sensorineural hearing loss
Vertigo
Sensation of fullness in the ear

Question 5

Treatment for Ménière’s disease ?

Symptomatic relief and surgical interventions

Answer 5

Symptomatic - during acute episodes with antiemetics and anticholinergics
Keeping a low sodium diet may help reduce vol of endolymph
Cessation of smoking

Surgical-
Shunts in place to drain excess endolymph
Removal of portions of the vestibulocochlear nerve and destruction of the membraneous labyrinth are option .

Question 6

Explain tendon jerk reflexes

Answer 6

Stimulus - tendon tap stretches muscle and activates muscle spindle receptors then there is conduction along afferent sensory fibres .
Transmission at synapses between the afferent and motor neuron then there is conduction along the efferent motor fibres.
Neuromuscular transmission-> excitation contraction coupling -> twitch contraction of skeletal muscle

Question 7

What are the three main divisions of the frontal lobe?

Answer 7

Prefrontal cortex - personality expression , complex cognitive behaviour

Premotor cortex - voluntary muscle movement

Primary motor cortex ( motor homunculus) - voluntary muscle movement

Question 8

What cortex is in the parietal lobe?

Answer 8

Somatosensory cortex which is essential to the processing of the body’s senses . Pressure , touch , pain

Question 9

The occipital lobe is the main centre for visual processing , what cortex is situated here?

Answer 9

Primary visual cortex.
This region of the brain receives visual input from the retina via the optic nerve and these visual signals are interpreted on the occipital lobes

Question 10

What are the structures of the limbic system and what lobe are they in?

Answer 10

The olfactory cortex
Amygdala
Hippocampus
- all located in temporal lobe

Question 11

What is wernicke’s area ?

Answer 11

Sensory language understanding , lexical processing .

Damage to here will result in aphasia and poor comprehension

Question 12

What happens if there is damage to Broca’s area?

Answer 12

Results in aphasia , non fluent and slow speech because it is the motor aspect of speech

Question 13

What is the primary auditory cortex?

Answer 13

Processing of auditory info

Question 14

What parts is the basal ganglia divided into?

Answer 14

Corpus striatum
Subthalamic nuclei
Substantia Nigra

Question 15

What is the corpus striatum made up of ?

Answer 15

Caudate nucleus

Putamen

Globus pallidus

Question 16

What does the subthalamic nuclei produce?

Answer 16

The excitatory neurotransmitter glutamate

Question 17

Substantia Nigra produces what?

Answer 17

The neurotransmitter dopamine which is involved in Nigro-striatal pathway. Damage to this causes Parkinson’s

Question 18

What does the medulla oblongata do?

Answer 18

Deals with autonomic / involuntary functions . Carries out many life sustaining functions such as breathing , heart rate , blood pressure , swallowing

Question 19

What does the pons connect?

Answer 19

Connects the cerebral cortex to the medulla

Question 20

What is the thalamus ?

Answer 20

(Relay station)

It the location of the cell bodies of 3rd order neurons in ascending pathways

Question 21

What is the hypothalamus

Answer 21

The control centre for many autonomic functions of the PNS

Influences the pituitary gland

Question 22

What does the Amygdala do?

Answer 22

Almond shaped group of neurons located in medial temporal lobes that perform processing and memory of emotional reactions

Question 23

The cranial cavity has 2 dural reflections what are they called and where are they?

Answer 23

Tentorium cerebelli ( between occipital lobes and cerebellum )

Falx cerebri ( between cerebral hemispheres in the longitudinal cerebral fissures )

Question 24

What are the muscles of mastication

Answer 24

Temporalis

Masseter

Medial and lateral pterygoids

Question 25

What nerves come of the trigeminal nerve CN V

Answer 25

Opthalamic Maxillary Mandibular

Question 26

Function of the facial nerve ?

Answer 26

Motor- fascist muscles Sensory - anterior 2/3 of tongue Parasympathetic - submandibular , sublingual , lacrimal, pharyngeal glands.

Question 27

What is the Rinne test?

Answer 27

Place a sounding tuning fork on the patients mastoid process and then to their ear and ask which is louder . Normal patient finds second position louder

Question 28

What is webers test ?

Answer 28

Place the tuning fork base down in the centre of the patients forehead and ask if it's louder in either ear - should be heard equally in both ears

Question 29

Function of glossopharyngeal nerve CN IX

Answer 29

Sensory - posterior 1/3 of tongue , middle ear cavity , soft palate and tonsils Motor- stylopharyngeus muscle Parasympathetic - parotid gland

Question 30

Function of the vagus nerve ?

Answer 30

Sensory - larynx , laryngopharynx, external acoustic meatus Motor- most muscles of the larynx and pharynx Parasympathetic - smooth muscles of the bronchioles , SA node of the heart , GI motility

Question 31

Clinical test for vagus nerve ?

Answer 31

Patient says aghhhhhhh The uvula should be observed to check that it lies centrally and doesn't deviate Asking the patient to speak

Question 32

What nerve controls the sternocleidomastoid and the trapezium ?

Answer 32

Spinal accessory

Question 33

What does the hypoglossal nerve do?

Answer 33

Muscles of the tongue except palatoglussus which is innervated by CN X

Question 34

Picks out and destroys the temporal lobe ?

Answer 34

Herpes simplex

Question 35

Impairment in person knowledge . Can't put names to face or recognise peoples voice

Answer 35

Prosopagnosia

Question 36

Implicit memory

Answer 36

No conscious access to implicit memory stores Can function independently of explicit like typing Profound amnesia can occur in context of normal implicit memory (korsakoffs) Dependent on networks involving basal ganglia and cerebellum Can't be tested at the bedside

Question 37

Where does the facial nerve exit the skull?

Answer 37

Internal acoustic meat is and the Stylomastoid foramen

Question 38

What is excitotoxicity?

Answer 38

Excitotoxicity is the pathological process by which neurons are damaged and killed by the overactivations of receptors for the excitatory neurotransmitter glutamate, such as the NMDA receptor and AMPA receptor.

Question 39

What is intracranial pressure

Answer 39

Intracranial pressure (ICP) is the pressure inside the skull and thus in the brain tissue and cerebrospinal fluid (CSF). ICP is measured in millimeters of mercury (mmHg) and, at rest, is normally 7–15 mmHg for a supine adult.

Question 40

Cerebral perfusion pressure is what?

Answer 40

Cerebral Perfusion Pressure (CPP) is defined as the difference between the Mean Arterial Pressure (MAP) and the Intracranial Pressure (ICP). CPP = MAP - ICP. This represents the pressure gradient driving cerebral blood flow (CBF) and hence oxygen and metabolite delivery.

Question 41

what epithelium is seen in the choroid plexus in lateral ventricle

Answer 41

simple cuboidal with microvilli

Question 42

How can you assess the depth of consciousness by a method involving one of the trigeminal divisions

Answer 42

By applying pressure to the supraorbital nerve

Question 43

what thin membrane seperates the two lateral ventricles

Answer 43

septum pellucidum

Question 44

the third ventricle lies in the midline of the forebrain

Answer 44

diencephalon

Question 45

where is the 4th ventricle located

Answer 45

located between the brainstem and the cerebellum

Question 46

where does the cerebral aqueduct pass through

Answer 46

the mid brain

Question 47

where does the CSF escape?

Answer 47

the fluid reaches the 4th ventricle and from here escapes through foramina to enter the subarachnoid space which surrounds the brain. the CSF is removed from the space through the arachnoid granulations which project into the superior sagittal sinus and thus reenters the blood stream.

Question 48

Which nerve provides somatosensory | innervation to the nasal cavity?

Answer 48

Innervation of the nasal cavity responsible for the sense of smell is via the olfactory nerve, which sends microscopic fibers from the olfactory bulb through the cribriform plate to reach the top of the nasal cavity. General sensory innervation is by branches of the trigeminal nerve (V1 & V2)

Question 49

what is the superior oblique muscle of the eye innervated by?

Answer 49

trochlear nerve

Question 50

lateral rectus muscle of the eye is innervated by?

Answer 50

abducens nerve

Question 51

what are ballistic movements

Answer 51

pre programmed. movement based largely on a set of pre-programmed instructions . rapid but at expense of accuracy