Flashcards in Neuroanatomy 2 Deck (71):
1
what are the four components to a reflex
sensory, circuitry, motor, effector
2
what is the motor part of the autonomic system innervate
viscera, smooth muscles, and exocrine glands
3
how many neurons is the motor autonomic system pathway
2
4
what is the function of the micturition centre
voluntary control of micturition (inhibition and initiation)
5
what is the function of the pontine micturition centre
coordinates the contraction of the bladder (detrussor, ANS) with the internal (ANS) and external (SNS) urinary sphincters
does so by activate the parasymp and inhibitin the symp. Normally inhibited by the cortex (micturition centre)
6
how is the thoracic motor nuclei in the spinal cord involved with micturition
visceral motor neurons (smooth muscle of internal sphincter. needs to be inhibited to be relaxed)
7
how is the sacral motor nuclei in the spinal cord involved with micturition (type of neurons and functions)
has alpha-motor neurons (external sphincter and pelvic floor muscles) and visceral motor neurons (parasympathetic of detrusor muscles)
8
What is the pathophysiology of a cortical pathology leading to urinary incontinence
bilateral pathology in the medial frontal cortex
9
what does a cortical pathology leading to urinary incontinence look like
normal bladder emptying that is no longer under voluntary control
10
What is the pathophysiology of a spinal pathology above the sacrum leading to urinary incontinence
bilateral spinal cord lesion above sacral levels
11
What is the pathophysiology of a spinal pathology at the level of the sacrum leading to urinary incontinence
bilateral spinal cord lesion at the level of the sacrum or bilateral lesions in the nerve roots of cauda equina
12
what does a spinal pathology above the sacrum look like
pontine micturition center can no longer control reflexes, incomplete bladder emptying
13
what does a spinal pathology at the level of the sacrum look like
damaged motor output and/or sensory input driving reflex, severe urinary incontinence
14
what is the reticular formation
central core of diffuse nuclei that runs the entire length of the brainstem
15
what parts of the brain does it join
rostrally - diencephalon, caudally - intermediate gray matter of the spinal cord
16
what does the rostral reticular formation consist of and what does it work with
consists of mesencephalon (midbrain) and rostral pons
works with diencephalic nuclei
17
what does the caudal reticular formation consist of and what does it work with
consists of caudal pons and medulla
works with cranial nuclei and spinal cord
18
what does the rostral reticular formation do
alertness and consciousness
sleep
pain perception (anterolateral pathway)
19
what does the caudal reticular formation do
nociception
respiration and cardiovascular
somatic motor (medial motor system)
reflex
autonomic functions
pain perception
20
what is the importance of the nuclei in the reticular formation
some of them are nucleus containing NT including Ach, dopamine, NE, serotonin and histamine. cell bodies are in the RF and the axons are sent out to the cortex
21
other than NT, what are some of the nuclei associated with RF
periaqueductal gray matter controlling pain
chemotactic trigger zone (medulla) - nausea
some cranial nerve nuclei
22
where does the RF receive input
motor and visceral from forebrain (to rostral...don't sleep)
cerebellum (attention)
cranial nerves (V/VIII) (to caudal)
anterolateral pathway (for alertness and perception in caudal)
23
what is the output target for rostral RF
cortex
24
what is the output target for caudal RF
integration of cranial nerve activity
25
what is the pontomesencephalic formation part of and what is is responsible for
rostral RF and is responsible for alertness by sending signals to the thalamus, hypothalamus and basal forebrain which distributes the signal to the rest of the brain
26
what are the fours ways COMA can happen
1) distruption of ARAS (ascending reticular activating system)
2) lesion withing rostral RF
3) bilateral thalamic lesions involving intralaminar nuclei
4) extensive damage to bilateral cerebral cortical areas
27
what are the three levels of consciousness and what structures are involved
alertness - RF, thalamus, cortex
attention - above plus frontoparietal association cortex
awareness - above plus emotional, sensory, and motor information
28
which NT in the caudal RF is involved with modulating and inhibiting pain transmission
serotonin
29
how does the caudal RF modulate pain
Neurons located in the midline raphe (seam) nuclei (5-HT) and the Periaqueductal gray matter send their axons down into the spinal cord to regulate the activity of the anterolateral system at the level of the dorsal horn of the spinal cord (around where it dessucates)
30
what is the PreBotzinger complex
pattern generator for inspiration and expiration
31
which cranial nerves are somatic motor only and what is the exception
3, 4, 6, and 12 (3 is the exception as it also was parasympathetic)
32
what cranial nerves are special sensory only
1, 2, and 8
33
what cranial nerves are mixed nerves and what is the exception
5, 7, 9, 10, 11 (11 is the exception as it only has one function)
34
why is it important that cranial nerve VIII is the most lateral
its in the cerebellopontine angle - nausea and dizziness can indicate a lesion in this area (ie acoustic neuroma)
35
what is the location of cranial nerve nucleus from medial to lateral
somatic motor, branchial motor, parasympathetic, visceral sensory, general somatic sensory, special sensory
36
the mixed nerves all have a branchial motor aspect. which muscles do they target
V - muscles of mastication
VII - facial expression
IX - stylopharyngeus
X - soft palate, pharynx, larynx,
XI - trapezius, SCM
37
if you damage cranial nerves, what other structures can you damage
long tracts running next to cranial nuclei
cerebellum
reticular formation and other brainstem nuclei
38
what is a deficit in cranial nerve I
anosmia
39
what is a deficit in cranial nerve II
visual deficits (acuity, visual fields)
40
what is a deficit in cranial nerve III
somatic - ptosis, impaired eye movement, diplopia (double vision)
visceral - dilation of pupils (mydriasis), impaired pupillary reflex, loss of accommodation
41
what is a deficit in cranial nerve IV
impaired eye movement, diplopia
42
what is a deficit in cranial nerve V
impaired chewing, impaired somatosensory of the head
43
what is a deficit in cranial nerve VI
impaired eye movement (lateral), diplopia
44
what is a deficit in cranial nerve VII
impaired taste, impaired facial expression, somatosensory deficits to the ear, impaired tearing and salivation
45
what is a deficit in cranial nerve VIII
impaired hearing, vertigo, nystagmus, nausea and vomiting
46
what is a deficit in cranial nerve IX
impaired gag reflex, impaired salivation, hypertension, somatosensory deficits to external ear, impaired sensory to throat, impaired taste
47
what is a deficit in cranial nerve X
Somatic motor - hoarseness, difficulty swallowing, impaired articulation, impaired gag reflex
visceral motor - impaired peristalsis, hypertension, resp deficits
somatic sensory - external ear
special sensory - taste
48
what is a deficit in cranial nerve XI
drooped shoulder and head turning
49
what is a deficit in cranial nerve XII
impaired tongue movement - (UMN - away from lesion, LMN toward lesion), impaired articulation
50
what is horizontal diplopia
abducens nerve palsy
51
what is the MLF and what does it do
medial longitudinal fasciculus - makes sure that when the right medial rectus is activated, the left medial rectus is not activated. Essentially coordinates the movement of the oculomotor, trochlear, and abducens nerves (particularly III and VI)
52
where is the centre for vertical eye movements (three parts)
midbrain at the mesencephalic RF near the oculomotor nucleus
53
where is the centre of the horizontal eye movements (three parts)
pons at the paramedian pontinereticular formation (PPRF) near the abducens nucleus
54
what is the frontal eye field in charge of
scanning (saccades)
55
what is the posterior eye filed in charge of
tracking (smooth pursuit)
56
what are the three nuclei of cranial nerve V
mesencephalic nuclei, main sensory nuclei, descending spinal nuclei
57
what information does the mesencephalic nucleus receive
proprioceptive info
58
what information does the main sensory nuclei receive
discriminative touch
59
what information does the descending spinal nuclei receive
pain and temperature
also fibres from VII, IX and X (seems like the ones that also have taste functions) for larynx and pharynx
60
what areas do the trigeminal nerve receive touch and pain info from
territories V1, V2, V3, nasal sinuses, inside nose and mouth, anterior 2/3 of mouth
61
what areas do the trigeminal nerve only recieve pain info from
supraenterorial dura mater
62
what nerves cover the infraentorial dura mater pain sensation
X, XI and first three cervical nerves
63
what is trigeminal neuralgia
recurrent episodes of brief but severe pain in V2 or V3
64
what is the treatment for trigeminal neuralgia
anticonvulsants and muscle relaxers
65
how do you tell the difference between an UMN lesion and LMN of cranial nerve VII
UMN=forehead is spared
66
what are the sensory and motor cranial nerves of the pupillary light reflex
II, III
67
what are the sensory and motor cranial nerves of the accommodation reflex
II, III
68
what are the sensory and motor cranial nerves of the jaw jerk reflex
V, V
69
what are the sensory and motor cranial nerves of the corneal reflex
V, VII
70
what are the sensory and motor cranial nerves of the vestibular-ocular reflex
VIII, III+IV+VI
71