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Flashcards in Neuro Deck (208):
1

What are emergent properties of the brain

properties of whole system but not individual components e.g. consciousness

2

what is neocortex and paleocortex involved in

neocortex - higher thinking
paleocortex - memory and emotion

3

what is septum pellucidum

separates anterior lateral ventricles

4

where is limbic system. what it contains. involved in?

under cerebrum. contains amygdala, hippocampus, fornix etc.
5 F's - fighting, fleeing, feeding, feeling, fucking

5

where is the calcarine sulcus

occipital lobe

6

where is lateral sulcus

between temp and parietal lobe

7

where is insular cortex and what involved in

deep folding inside lateral sulcus. consciousness, emotion, homeostasis

8

what is corona radiata of brain

sheet of axons from and to cerebrum

9

what is caudate nucleus and function

part of basal ganglia. voluntary movement

10

where is basal ganglia and what consist of

below cerebrum and surrounds thalamus. corpus striatum + substantia nigra + subthalamic nuclei

11

what is corpus striatum

globus pallidus and (neo)striatum

12

what separates L and R cerebellum and cerebri

falx cerebri, falx cerebelli

13

what separates cerebrum from cerebellum. What coonects the 2 cerebral hemispheres

corpus callosum and anterior and posterior white commussures
tentorium cerebelli

14

what is striatum

caudate nucleus + putamen

15

what is cerebellum peduncle

connecs cerebellum to mid brain. Sup, mid and inf fibres per hemisphere of cerebellum

16

what is forebrain and brainstem

forebrain - cerebrum, thalamus, hypothalamus
brainstem - midbrain, hindbrain (pons, medulla, cerebellum)

17

give venous sinuses of brain

see book
sup and inf sagittal, straight, confluence, transverse, sigmoid, IJ vein

18

what is conus medullaris

Taper end of T12-L1

19

what is filum terminale

strand of fibrous tissue from apex of conus medullaris to end of vertebral foramen

20

where lumbar puncture and in kids

L3/4
kids - L5/S1

21

where is SG and what is contained

lamina 2
contains - C fibres, lissauers fibres synapsing

22

what is ataxia and apraxia

ataxia - loss of full control of body movements
apraxia - unable to perform complex movements

23

what is aphasia, aphonia, dysarthria

aphasia - speech disorder
aphonia - physical inability to produce sound
dysarthria - disruption of articulation of speech

24

what is chorea

involuntary jerks e.g. huntingtons

25

what is spasticity vs rigidity

spasticity is unidirectional, velocity and amplitude dependent
spasticity = corticospinal tract damage
rigidity = extrapyramidal lesion

26

how detect spina bifida before birth

alpha fetoprotein in blood, USS

27

types of spina bifida

occulta - just vertebrae
meningocoele - meningele involvement
myelomeningocoele - neural tissue outside body

28

symptoms of spina bifida

bladder conrol, orthopedic issues, pressure sores, weakness in lower limbs

29

what is rachischisis

posterior neuropore fails to close resulting in motor and sensory deficits

30

how treat hydrocephalus and symptoms

treat with shunt (jugular)
symptoms - tunnel vision, headaches, convulsion, vomiting

31

parts of neural tube and what they become

prosencephalon - telencephalon (cerebrum) and dienceph (thalamus)
mesenceph - mesenceph (midbrain)
rhombenceph - metenceph (pons) and myelenceph (medulla)

Tell Di Mes Met My

32

label ventricles

see book
3rd, 4th, lateral, cerebral aqueduct, IV foramen

33

what does alcohol effect in neuroembryology

neural crest cell migration

34

what is hirschprungs diseasse

lack of ganglions in large intestine, therefore no function

35

astrocyte functions

BBB, removes neurotransmitters, nutrients to neurones

36

function of microglia

phagocytose material and debris. APC

37

what is BBB made of

tight endothelial junction, astrocyte foot process, basement membrane

38

types of neurotransmitters

AAs e.g. GABA, glycine, glutamate
biogenic amines e.g. dopamine, 5-HT, histamine
peptides e.g. dynorphin, CCK

39

is glutamate excitatory or inhibitory. what receptor types are there

excitatory
ionotropic and metabotropic
ionotropic - AMPA, kainate, NMDA

40

how does LTP occur and what happens in LTP

calcium goes through mGluRs or NMDAR.
Upregulation of AMPARs

41

where is gaba found. what ions does it let in

Cl-
found in spinal cord and brainstem

42

dopamine pathways and function

nigrostriatal - motor control (parkinsons)
mesolimbic and mesocortical - mood, arousal and reward (schizophrenia)
tuberoinfundibular - prolactin release and endocrin function

43

serotonin pathway function

sleep, wakefulness, mood, vomiting

44

label circle of willis

see book
ant post comm, ant mid post cerebral, ICA, sup ant inf post inf cerebellar, pontine, basilar, ant spinal, vertebral

45

what supplies spinal cord blood

anterior spinal, paired post spinal, anatastamoses between arteries (arterial vasocorona). Artery of ademkiewicz (thoracolumbar)

46

what arteries supplies cerebrum

outside cerebrum middle cerebral artery does majority of ant cerebrum
sagittal view - anterior cerbral artery does majority of ant cerebrum
posterior cerebral always does posterior section

47

symptoms of sub acute hemorrhage and cuases

thunderclap headache, rapid onset, vomiting, confusion, decrease consc
causes - trauma, cerebral aneurysm rupture in circle of willis

48

what removes and adds CSF

remove - arachnoid granulations at sup saggital sinus
add - ependymal cells of choronoid plexus

49

how many mls of CSF are there and how much produced per day

500 ml per day
125 mls of CSF

50

what is communicating hydrocephalus? causes

impaired csf resborp without csf flow obstruction
caused by scarring of arachnoid granulations

51

cause of non comm hydrocephalus

obstruction

52

csf composition

decrease glucose, ca, protein
increase na, mg, cl than blood

53

list what CNs go through what foramina

cribiform plate - 1
optic canal - 2
SOF - 3, 4, 5a, 6
foramen rotundum - 5b
foramen ovale - 5c
IAM - 7,8
jugular foramen - 9-11
hypoglossal canal - 12

54

what does pacinian, merkels, meissners, and riffini sense

riffini - temp
pacinian - pressure
merkels - press, vibration, texture
meissners - touch and vibration

55

what receptors are in muscle. what they sense

muscle spindle proprioceptor = length
golgi tendon organs = tension

56

how is stronger stimuli recognised by receptors

increase AP frequence and activation of neighbour cells

57

difference between tonic and phasic receptors

tonic - slow adapting, continual firing
phasic - fast, desensitises

58

how is acuity achieved in sensation

lateral inhibition and divergence
convergence decreases acuity

59

what factors affect 2 point discrimination

size of receptor field and density of sensory receptors

60

where does sensation go after nerve stimulated

to somatosensory cortex on post central gyrus

61

what is perception

sense stimuli and discriminate between different types

62

what happens in a sensory cortex lesion

lose 2 point discrimination, epileptic event

63

how orientate spinal cord

dorsal median sulcus and ventral median fissuer

64

modality of ascending nerves

dorsal column - light touch and conscious proprioception
spinothalamic lateral - pain and temp
spinothalamic ant - crude touch
spinocerebellar ant - golgi tendon (tension), unconscious
spinocerebellar post - muscle spindle (length), unconscious

65

what 2 fascicles make up dorsal column and where are they positioned. where do they start

gracile and cuneate (t6 start)
gracile is medial (sacrolumbar), cuneate lateral (cervicothoracic)

66

describe route of dorsal column

DRG (1) to cuneate and gracile nuclei in medulla (2), then decussates (internal arcuate fibre) and becomes medial lemniscus fibres in pons, then to ventral posterolateral nucleus in thalamus (3), then to post central gyrus

67

route of spinothalamic

ascends 1-2 spinal levels in lissauers fasciculus, then dorsal horn in SG(1) and decussates (via anterior white commissure) to thalamus (2) to sensory cortex (3)

68

what type of neuron is used in the 1st order for sensory pathways

pseudounipolar

69

route of spinocerebellar ant

DRG (1) then decussates in spinal cord (via anterior white commissure) then up to pons and decussates again then to cerebellum.

70

route of spinocerebellar post

DRG (1) then synapse with clarkes nucleus in dorsal horn (2) to cerebellum

71

modality of descending nerves inc extrapyramidal. damage to vestibular spinal?

lateral corticospinal - limb
anterior corticospinal - axial
corticobulbar - face and neck muscles

extrapyramidal:
ruberospinal - voluntary skeletal contraction
reticulospinal - posture and locomotion
tectospinal - automatic reactions to visual and auditory stimuli
vestibularspinal - posture maintenance. damage = loss of righting reflex and posture instability

72

route of corticospinal

lateral - motor cortex to internal capsule to medulla and decussate then to ventral horn
anterior - same but decussates at ventral horn

73

route of corticobulbar

motor cortex to internal capsul to motor nuclei of cranial nerves bilaterally

74

what is syringomyelia

cyst forms in spinal cord causing pain, paralysis, weakness

75

explain brown sequard syndrome

hemilateral lesion of spinal cord - loss of ipsilateral dorsal column therefore ipsilateral proprioception and ifne touch (no decussation). Loss of counterlateral pain and temp due to spinothalamic decussation.

76

what is friedrichs ataxia

sclerosis and degen of DRG, spinocerebellar, corticospinal, and dorsal columns. progressive

77

what is shingles symptoms

increased sensitivity and rash. dormant in DRG. can lead to post herpetic neuralgia and chronic pain.

78

anatomy of cerebellum

see book
vermis, ant lobe, post love, flocculonodular love

79

give function of cerebellar parts

spinocerebellum - vermis - error correction
vestibulocerebellum - follculonodular lobe - balance and ocular reflexes
cerebrocerebellum - lateral parts - movement planning and motor learning

80

what happens in damage to cerebellum and vermis

vermis damage - fall backwards
cerebellum damage - fall and decrease coordination on ipsilateral side

81

UMN lesion signs

increase reflex, tone, spasticity, rigidity, chorea (extrapyramidal), babinski (pyramidal)

82

LMN lesion signs

atrophy, fasciculations, paralysis

83

where are cell bodies of LMNs found in what lamnia

8 and 9

84

what is a motor unit

motoneurone and muscle fibre it supplies

85

define stretch reflex

involuntary, unlearned, repeateable, automatic reaction to a specific stimulus which doesnt require brain intact

86

components of stretch reflex

strech receptor, affereent fibre, integration centre, efferent fibre, effector

87

muscle tone in newborn

suppressed to aid birth

88

extrapyramidal lesion signs

akathisia (muscle restlessness), spasm, parkinsonian. Way that movements are carried out

89

parkinsonian symptoms

tremor (pill rolling), cog wheel rigidity, postural instability, mask like expression, bradykinesia, shuffling gait

90

decorticate and decerebrate

decorticate - mummy. damage to cerebrum, mid brain, thalamus, internal fibres poss
decerebrate - full exntension. brainstem damage

91

why fasciculations occur in LMN lesion

hypersensitive ACh receptors

92

what is spinal shock

damage to descending tracts leads to areflexia and flaccid which then become UMN signs. Due to release of GABA in damage

93

what symptoms of cerebellar dysfunction

DANISH
dysdiadochokinasia, ataxia, nystagmus, intention tremor, scanning dysarthria, hypotonia + heel shin positivity test

94

what romberg test and what positive meants

tests proprioception of lower body. suggests cerebellar damage

95

Thalamic nuclei

VPL - spinothalamic and dorsal column
VPM - trigeminal - Face sensation and taste - Makeup on Face
LGN - Cn2 - vision - lateral = light
MGN - Hearing - Medial = music
VL - cerebellum and basal ganglia - Motor

96

hypothalamic functions

TANHATS
Thirst and water balance, ant pit regulation, neural hormone release, hunger, autonomic regulation, temp regulation, sexual urges

97

what is the cause of parkinsons

nigrostriatal and SN degeneration

98

what is nociception

percetion of pain

99

how does pain thershold and tolerance vary for people

threshold same, tolerance varies

100

stages of nociception

transduction - activation of fibres
transmission - to CNS
modulation - CNS or other peripheral nerves can inhibit
perception

101

what type of pain does Adelta and C fibre feel

Adelta - mechanical
C - mechanical, thermal, chemical

102

properties of adelta and c fibre

a delta - sharp, stabbing, well localised, lower threshold, withdrawal reflex

C - burning, throbbing, poorly localised, higher thershold, tissue damage ongoign

103

how is cerebellum mostly damaged and what is parkinsons damage of

parkinsons damage to extrapyramidal
cerebellum - tumours and strokes

104

through what lamina do adelta C and visceral fibres travel

adelta - 1, 5
C - 1, 2 and 5
visceral - 5

105

explain process of pain transduction

damage to tissue releases K, prostaglandins, serotonin, bradykinin and activates nociceptor. AP occrs and substance P is released. Substance P releases histamine from mast cells

106

how do NSAIDs and steroids act as analgesics

NSAIDs inhibit prostaglandins
steroid inhibit IL

107

explain pain modulation

gate control theory. Endorphins reduce nociception
Periaqueductal grey matter in midbrain projects to nucleus raphe magnus and both mediate pain.

108

define chronic pain

>3 mths and no ongoing tissue damage.

109

define hyperalgesia and allodynia

allodynia - non painful stimulus = pain
hyperalgesia - lowered threshold to pain.

110

explain process of winding up

repeated nociceptor stimulation leads to upregulation of neurones (reduced threshold and increased receptive field). Also change in somatosensory mapping

111

chronic pain types

nociceptive, neuropathic, visceral, FMS (fibromyalgia)

112

what is neuropathic pan. tgive example

sponteanous, shooting, pins and needles. not responsive to opioids.
e.g. phantom limb

113

what is complex regional pain syndrome type 1 and 2

type 1 - no identifiable lesion
type 2 - lesion

114

What is complex regional pain syndrome. give stages 1 to 3

severe continous burning pain.
1 - acute
2 - thickening skin. muscle atrophy. odema
3 - limited ROM. contractures. waxy skin

115

function of opioid receptor

close vocc, open K, inhibit cAMP and neurotransmission

116

give the 3 types of endorphin receptors and the associated endorphin

MOP - endomorphin
KOP - dynorphin
DOP - enkephalin

117

give exmaple of strong and weak opioid

strong - fentanyl, morphine
weak - codein

118

what is WHO pain ladder

1) non opioid e.g. paracetemol or NSAID, adjuvant
2) weak opioid +/- adjuvant
3) strong opioid +/- adjuvant

119

how treat central pain

antidepressant, AED, anasthetic, opioid

120

what causes inner ear deafness

teratogneic agents and infections e.g. rubella

121

what is coloboma and what causes

hole in structyure of eye. caused by fialure of optic stalk to fuse

122

give optic tract anatomy

see book
optic nerve to chiasm to tract to LGN to radiation

123

what happens in full lesion of optic radiation, temporal lesion and nasal lesion?

full - homonymous hemi
temporal - homonymour superior quadrantanopia
nasal - homonymous inferior quadrantanopia

124

what happens in midline lesion of optic chiasm

bitemporal hemianopia

125

what is meyers loop

temporal part of optic radiation

126

properties of rods and cones

rods - dark, not in fovea, converge on bipolar

127

what are the neurons in the eye

photoreceptors, interneurons, ganglion cells

128

give types of interneurons and their function

interneurons combine photoreceptor signals
bipolar, horizontal, amacrine

129

what is the magnocellular and parvocellular cells

both in LGN. Magno responsible for resolving motion and outlines. Parvo responsible for colour contract

130

give sign of fovea hyperplasia

nystagmus

131

what is amblyopia and give causes

decreased vision in 1 eye due to disuse in childhood
cause - strabismus (inability to focus both eyes on a object), anisometropia (refractive diff in both eyes), deprivation e.g. ptosis or cataracts

132

give types of strabismus and lesion causing

esotropia - inwards. CN 6 palsy
exotropia - outwards
hypertropia - upwards. CN 4 palsy

133

how treat amblyopia

glasses or eyepatch

134

waht is glaucoma

increased intraocular pressure poss cause opitic nerve damage or peripheral field defect

135

what is function on inner and outer hair cells of ear. where is high and low frequency heard

outer - amplification
inner - sense
high frequency at base, low at apex

136

how does AP in hair cells occur

bending of stereocilia opens K channels leading to depolarisation and calcium influx and neurotransmitter release to spiral ganglia neurones (afferents axons of CN 8)

137

what is function of olivocochlear system

regulates outer hair amplification

138

how is sound localised

delays and difference in volume between left and right ear

139

how are loud sounds transmitted

increase AP and recruitment of neighbour cells

140

give auditory pathway

cochlear nerve to cochlear nucleus to olivary nucleus to colliculus to MGN to auditory cortex

141

give causes of hearing impairment

congenital, age, infection, gentamicin, loud noise

142

how treat hearing loss

hearing aid or cochlear implant

143

what artery casues most strokes

mid cerebral

144

what does the PCA feed

occipital, midbrain, thalamus, half temporal

145

define stroke and TIA

stroke - poor blood flow to brain over 24 hours symptoms
TIA -

146

symptoms of temporal lobe stroke

tsate and smell, memory, superior quadrantanopia, wernickes aphasia

147

what is wernickes and brocas aphasia

wenickes - problem comprehending
brocas - problem talking

148

parietal lesion symptoms

speech, sensation, inferior quadrantanopia

149

symptoms of lacunar stroke

pure motor, sensory, sensorimotor, ataxic, hemiparesis

150

what structures involve din a POCS

brainstem, cerebellar, occipital

151

how investigate and treat stroke

ct or mri
treat alteplase

152

how can spinal cord blood supply be damaged and symptoms

cause - vasculitis, sickle cell, hypotension
symptoms - spinal shock, motorsymptoms

153

what is flaccid and reflex bladder. where is lesion

flaccid - lesion below T12. LMN
reflex - T12 or above. UMNL

154

how manage head trauma or loss of conscious

ABCD, history, exam
O2, if hypo IV glucose

155

what is function of reticular activating system. affected by?

regulates sleep wake cycle
affected by alcohol, senses, drugs, parkinsions, schizo, PTSD, depression, alzheimers

156

what is coup and contrecoup injury

coup - front brain
contrecoup - rebound

157

what is contrusion

bruise

158

what is primary and secondary insult to brain

primary - haematoma, hemorrhage, contusion
secondary - hypoxia, oedema, increased ICP

159

what happens in disruption of BBB?

vasogenic oedema due to protein influx, increase ICP

160

what is cytotoxic oedema

Na retention in cells leads to swelling and increase ICP

161

how is increase ICP compensated. wjhat is cushings reflex

decrease venous blood and CSF
cushings reflex - increase BP, irregular breathing, decrease HR

162

why might use barbiturates or propofol in increase ICp

both reduce cerebral metabolic rate of o2

163

symtpoms of opioid

antitussive, analgesia, constipation, hypotensive

164

function of mannitol

decrease cerebral oedema. osmotic diuretic

165

what are the 4 brain waves and when are they seen

alpha - awake and resting
beta - awake and mental activity
theta - sleeping
delta - deep sleep

166

what happens in locked in syndrome

loss of RAS descending pathways by lesion below pons

167

what is coma, brain death

coma - state of unconsciousness which patient cannot be roused from. no voluntary movement but signs of active brain
brain death - irreversible loss of all features of brain

168

function of sleep

allows cns to reset and memories to proces

169

what control sleep wake cycle

RF and hypothalamus (by inhibiting RF)

170

what happens in REM and non REM sleep

REM - active brain inactive body. increase RR, HR, BMR. Alpha and beta waves

non REM - inactive brain active body. neuroendocrine. decrease RR, HR, BMR. theta and delta waves

171

what happens to wake us up

serotonin and ACh release stimulates thalamus

172

what is parasomnia, hypersomnia, narcolepsy

parasomnia - sleep paralysis
hypersomnia - day time sleepiness
narcolepsy - constant hypersomnia

173

if loss of consciousness occurs, why?

damage to Reticular formation

174

give GCS

eye 1-4 - none, pain, speech, spontaneous
verbal 1-5 - none, incomprehensible, inappropriate words, confused, orientated
motor 1-6 - none, extension to pain, flexion, flexion to pain, localise pain, obey commands

175

symptoms of extradural hemorrhage

trauma, slow onset, lucidity then decrease consc, increasing severity headache, vomiting and confusion

176

subdural features and subarachnoid hemorrhage

subdural - slow onset, atrophy of brain, age, trauma, fluctuating consciousness, insidious physical or intellectual slowing

SAH - thunderclap headache, vomiting, seizures, neck stiffness

177

parietal dominant and non dominant features

dom - speech, logic, sensation integration
non dom - emotion, language, music/art, visioaspatial, body awareness

178

anterior frontal lesion

apathy, loss of personality, asocial, amoral, loss of social inhibition

179

temporal lesion

speech (dominant), memory

180

function of angular gyrus

takes written word interpretation from occipital to wernickes area

181

where 2 diffeerent type sof memory stored

declarative - hippocampus, cortex
procedural - cerebellum, basal ganglia

182

how is memory consolidated in neurones. techniques to consolidate memory?

rehearsal, association, emotion
via LTP

183

causes of amnesia

trauma, stroke, infection, dementia

184

hippocompal lesion

anterograde amnesia

185

define dementia and symptoms. how does delirium differ

acquired loss of brain function significant enough to affect daily function and QOL. decrease intellect, reason, personality without loss of consciousness (delirium is loss of consciousness)

symptoms - progressive loss of memory. intellect, personality, behaviour, spech, movement

186

causes of dementia

vascular, alzheimers, lewy bodies, drugs, fronto-temporal dementia

187

describe pathogenesis of AD. RF?

aB amyloid deposits, tau neurofibrillary tangles.
RF - age and female

188

lewy body dementia pathogenesis and symptoms

alpha synuclein amyloidosis. REM sleep behaviour disturbed, delusions, paranoia, goes on to have AD features

189

AD pre-dementia, early, mid, late symptoms

pre - subtle - forgetfullness, planning, apathy
early - anterograde amnesia starts (harder to learn things), loss oral and written fluency
mid - speech problems, aggression, irritability,
late - complete loss language, exhaustion, extreme apathy, poss bedridden

190

fronto-temporal dementia

increase tau protein, lack of empathy, disinhibiton, personality loss

191

normal pressure hydrocephalus symptoms

dementia, incontinence, gait

192

causes of meningitis

neonates - e coli
1-5 - h influenza
5-30 - n meningitidis
>30 - strep pneumoniae

193

what is encephalitis

viral infection of brain parenchyma

194

what brain part does herpes infect and symptom

infect temporal lobe, lead to seizures

195

what is perviascular cuffing

aggregation of lymphocytes around a BV in encephalitis

196

what is normal brain pressure, in coughing, and what can it get up to

normal - 0-10
coughing - 20
up to 60mmHG

197

what is subfalcine hernia. ischemia of?

cingulate gyrus goes under falx cerebri. ischemia of parietal, frontal, corpus callosum

198

what is tentorial hernia. damage to?

uncus and parahippocampus through tentorial notch. damage to CN3 and occlusion of PCA and sup cerebellar arteries

199

what is tonsillar hernia and damage?

cerebellar tonsils through foramen magnus, compressing brainstem. apnoea.

200

symptoms of increased ICP

headahce, vomiting, papilloedema - leading to pupil dilation, coma

201

types of brain tumours

meningioma, astrocytoma (malignant), metastases (Skin, lungs, kidney, breast, GI)

202

difference taste and flavour

flavour inc smell

203

what produces and absorbs intraocular fluid

produced - ciliary body
absorbed - schlemm (venous sinuses)

204

what is presbyopia

long sighted with age

205

what is scotomata

pathological blind spot

206

how test colour vision

ishihara chart

207

symptoms of TACS and PACS

TACS is all of HHHH, PACS is 2 of 4
hemiparesis, higher cerebral dysfunction (dysphagia, hemineglect, agnosia), hemianopia, hemisensory loss

208

POCS symptoms

loss of consciousness, visual disturbance, DANISH