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First Aid STEP 1 - Neurology > Anatomy and Physiology > Flashcards

Anatomy and Physiology Flashcards

1
Q

What type of cell are neurons?

A

permanent cells that do NOT divide in adulthood

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2
Q

What organelle is NOT present in the axon of neurons?

A

RER

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3
Q

If an axon is injured, what type of generation occurs?

A

Wallerian degeneration = degeneration distal to the injury and axonal retraction proximally

This allows for potential regeneration of axon (if in PNS)

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4
Q

What is the function of astrocytes?

A 
physical support
repair
K+ metabolism
removal of excess neurotransmitter (NT)
component of BBB
glycogen fuel reserve buffer
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5
Q

If neural injury occurs, what is the response of astrocytes?

A

reactive gliosis

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6
Q

What are astrocytes derived from?

A

neuroectoderm

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7
Q

What is the function of microglia?

A

CNS phagocytes

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8
Q

What are microglia derived from?

A

mesoderm

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9
Q

HIV can infect what cell type?

A

HIV-infected microglia fuse to form multinucleated giant cells in the CNS

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10
Q

What is the function of myelin?

A

Wraps and insulates axons –> increases space constant and increases conduction velocity

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11
Q

What type of neurons are located in the CNS? PNS?

A

CNS - oligodendrocytes

PNS - Schwann cells

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12
Q

What myelinated the axons of neurons in the CNS?

A

oligodendroglia

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13
Q

What is the predominant type of glial cell in white matter?

A

oligodendroglia (1 cell can myelinated 30 axons)

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14
Q

What are oligodendroglia derived from?

A

neuroectoderm

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15
Q

What do oligodendroglia appear on H & E stain?

A

“fried egg” appearance

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16
Q

What diseases are associated with injury to the oligodendroglia?

A

Multiple sclerosis
progressive multifocal leukoencephalopathy (PML)
leukodystrophies

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17
Q

What disease destroys Schwann cells?

A

Guillain-Barre Syndrome

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18
Q

What tumor is associated with Schwann cells?

A

acoustic neuroma (type of schwannoma)

*If bilateral, strongly associated with neurofibromatosis type 2

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19
Q

What type of sense do Meissner corpuscles sense?
Where are they located?
What is their description?

A

Sense: dynamic, fine/light touch (position sense = proprioception)
Location: glabrous (hairless) skin
Description: large, myelinated fibers, adapt quickly

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20
Q

What type of sense do Pacinian corpuscles sense?
Where are they located?
What is their description?

A

Sense: vibration, pressure (e.g. monofilament test)
Location: deep skin layers, ligaments, and joints
Description: large, myelinated fibers, adapt quickly

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21
Q

What type of sense do Merkel discs sense?
Where are they located?
What is their description?

A

Sense: pressure, deep static touch (e.g. shapes, edges), position sense
Location: basal epidermal layer, hair follicles
Description: large, myelinated fibers, adapt slowly

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22
Q

What nerve fibers are slow and unmyelinated?

A

C fibers

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23
Q

What nerve fibers are fast and myelinated fibers?

A

A-delta fibers

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24
Q

What do free nerve endings sense?

A

pain and temperature

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25
Q

What must be rejoined in microsurgery for limb reattachment?

A

perineurium (permeability barrier)

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26
Q

Match the location of the neurotransmitter synthesized in the following area of the brain:

locus ceruleus (pons)
ventral tegmentum and SNc (midbrain)
Raphe nucleus (pons, medulla, midbrain)
Basal nucleus of Meynert
nucleus accumbens
A

locus ceruleus (pons) - NE
ventral tegmentum and SNc (midbrain) - DA
Raphe nucleus (pons, medulla, midbrain) - 5-HT
Basal nucleus of Meynert - ACh
nucleus accumbens - GABA

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27
Q

What NTs decrease in depression?

A

NE
DA
5-HT

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28
Q

What NTs increase in anxiety?

A

NE

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29
Q

What NTs decrease in anxiety?

A

5-HT

GABA

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30
Q

What NT changes are seen in Parkinson’s disease?

A

decrease in DA
increase in 5-HT
increase in ACh

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31
Q

What NT changes are seen in Hungtington disease?

A

increase in DA
decrease in ACh
decrease in GABA

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32
Q

What 3 structures form the BBB?

A
  1. tight junctions b/t nonfenestrated capillary endothelial cells
  2. basement membrane
  3. astrocyte foot processes
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33
Q

What 3 structures form the BBB?

A
  1. tight junctions b/t nonfenestrated capillary endothelial cells
  2. basement membrane
  3. astrocyte foot processes
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34
Q

How do glucose and amino acids cross the BBB?

A

slowly by carrier mediated transport

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35
Q

How do nonpolar/lipid-soluble substances cross the BBB?

A

rapidly via diffusion

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36
Q

What is the function of the BBB?

A

helps prevent bacterial infection from spreading into the CNS
restricts drug delivery to brain

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37
Q

Infarct and/or neoplasm destroys endothelial cell tight junctions and results in what pathology?

A

vasogenic edema

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38
Q

What is the function of the hypothalamus?

A

TAN HATS

Thirst and water balance
Adenohypophysis control
Neurohypophysis releases hormones produced in the hypothalamus
Hunger
Autonomic regulation 
Temperature regulation
Sexual urges
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39
Q

What are the 2 inputs of the hypothalamus (areas not protected by the BBB)?

A

OVLT (organum vasculosum of the lamina terminalis - senses changes in osmolarity)

area pastrema (responds to emetics)

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40
Q

What are the 2 inputs of the hypothalamus (areas not protected by the BBB)?

A

OVLT (organum vasculosum of the lamina terminalis - senses changes in osmolarity)

area postrema (responds to emetics)

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41
Q

What does the lateral area of the hypothalamus control?
What happens if this area is destroyed?
What stimulates or inhibits it?

A

Controls hunger
Destruction –> anorexia
Inhibited by leptin

*If you zap your LATERAL nucleus, you shrink LATERALly

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42
Q

What does the ventromedial area of the hypothalamus control?
What happens if this area is destroyed?
What stimulates or inhibits it?

A

Controls satiety
Destruction (e.g. craniopharyngioma) –> hyperphagia
Stimulated by leptin

*If you zap your VENTROMEDIAL nucleus, you grow VENTRALly and MEDIALly.

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43
Q

What does the anterior area of the hypothalamus control?
What happens if this area is destroyed?
What stimulates or inhibits it?

A

Controls cooling and parasympathetics

*Anterior nucleus = cool off (cooling, and pArasympathetic)
A/C = anterior cooling

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44
Q

What does the posterior area of the hypothalamus control?
What happens if this area is destroyed?
What stimulates or inhibits it?

A

Controls heating and sympathetics

*If you zap your posterior hypothalamus, you become a poikilotherm (cold-blooded, like a snake)

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45
Q

What does the suprachiasmatic nucleus (SCN) area of the hypothalamus control?
What happens if this area is destroyed?
What stimulates or inhibits it?

A

controls circadian rhythm

46
Q

What drives the sleep cycle?

A

the circadian rhythm which is driven by the SCN of the hypothalamus

47
Q

What regulates the SCN?

A

the environment (e.g. light)

48
Q

What is the pathway for secreting melatonin from the pineal gland?

A

SCN –> releases NE –> pineal gland –> releases melatonin

49
Q

What are the two stages of sleep?

A

REM and non-REM sleep

50
Q

What decreases REM sleep?

A

alcohol
benzodiazepines
barbiturates
NE

51
Q

When does bedwetting, night terrors, and sleepwalking occur?

A

Stage N3 of Non-REM sleep

52
Q

What is one treatment for bedwetting?

A

oral desmopressin acetate (DDAVP) - mimics ADH

53
Q

What is one treatment for night terrors and sleepwalking?

A

benzodiazepines

54
Q

What stage of the sleep cycle does bruxism occur?

A

Stage N2 of Non-REM sleep

55
Q

During what stage of the sleep cycle do you have variable pulse and BP?

A

REM sleep

56
Q

During what stage of the sleep cycle do you have dreaming, penile/clitoral tumescence, and possibly memory processing?

A

REM sleep

57
Q

What is the order of the sleep cycle stages and what are their EEG waveforms?

A 
Awake (eyes open) - beta
Awake (eyes closed) - alpha
Non-REM sleep
Stage N1 - Theta
Stage N2 - Sleep spindles and K complexes
Stage N3 - Delta
REM sleep - Beta

*At night, BATS Drink Blood.

58
Q

Where does ADH originate from in the brain?

A

supraoptic nucleus in the hypothalamus

59
Q

Where does oxytocin originate from in the brain?

A

paraventricular nucleus in the hypothalamus

60
Q

What is the function of the thalamus?

A

major relay for all ascending sensory information except olfaction

61
Q

What is the input, info, and destination for the VPL of the thalamus?

A

input: spinothalamic and dorsal columns/medial lemniscus
info: pain and temperature, pressure, touch, vibration, and proprioception
destination: primary somatosensory cortex

62
Q

What is the input, info, and destination for the VPM of the thalamus?

A

input: trigeminal and gustatory pathway
info: FACE sensation and taste
destination: primary somatosensory cortex
* “M”akeup goes on the FACE (VP”M”)

63
Q

What is the input, info, and destination for the LGN of the thalamus?

A

input: CN II
info: vision
destination: calcarine sulcus
* Lateral = Light

64
Q

What is the input, info, and destination for the MGN of the thalamus?

A

input: superior olive and inferior colliculus of tectum
info: hearing
destination: auditory cortex of temporal lobe
* Medial = Music

65
Q

What is the input, info, and destination for the VL of the thalamus?

A

input: basal ganglia, cerebellum
info: motor
destination: motor cortex

66
Q

What is the function of the limbic system?

A

Collection of neural structures involved in emotion, long-term memory, olfaction, behavior modulation, and ANS function

67
Q

What are the structures in the limbic system?

A

hippocampus, amygdala, fornix, mammillary bodies, and cingulate gyrus

68
Q

What is a helpful pneumonic to remember the functions of the limbic system?

A

The famous “4 F’s”

Feeding
Fleeing
Fighting
Feeling
Sex
69
Q

What is the function of the cerebellum?

A

modulate movement

coordination and balance

70
Q

What are the deep nuclei of the cerebellum?

A

lateral –> medial

Dentate, Emboliform, Globose, Fastigial

*Don’t Eat Greasy Food

71
Q

What physical findings are seen with a lateral lesion to eh cerebellum?

A

decreased movement of extremities (propensity to fall towards injured IPSILATERAL side)

72
Q

What are findings seen with a medial lesion of the cerebellum?

A

truncal ataxia, nystagmus, and head tilting, wide based (cerebellar) gait, deficits in tranquil coordination

Typically bilateral motor deficits

73
Q

What disease is associated with degeneration of the CNS, Lewy bodies, and loss of DA neurons?

A

Parkinson disease

74
Q

What is the main component of Lewy bodies in Parkinson disease?

A

alpha-synuclein

75
Q

Where is the location of the dopaminergic neurons affected in Parkinson disease?

A

substantia nigra pars compacta

76
Q

What are physical symptoms of Parkinson disease?

A

*Parkinson “TRAPS” your body

"T"remor (at rest - pill rolling tremor)
cogwheel "R"rigidity
"A"kinesia
"P"ostural instability
"S"huffling gait
77
Q

What are the genetics associated with Huntington disease?

A

AD

trinucleotide repeat disorder (CAG) on chromosome 4

78
Q

What are physical symptoms of Huntington disease?

A

choreiform movements
aggression
depression
dementia

79
Q

What are the NT changes seen in the brain in Huntington disease?

A

decrease in GABA and ACh

80
Q

What lesion can be seen in the brain of Huntington disease?

A

atrophy of the caudate nuclei

81
Q

A lesion to the contralateral sub thalamic nucleus (e.g. lacunar stroke) would result in what movement disorder?

A

hemiballismus (sudden, wild flailing of 1 arm +/- ipsilateral leg)

82
Q

A lesion to the basal ganglia (e.g. Huntington disease) will result in what movement disorder?

A

chorea (sudden, jerky, purposeless movements)

AND

athetosis (slow, writhing movements - esp. in the fingers)

83
Q

Myoclonus can commonly be seen in which diseases?

A

renal and liver failure

84
Q

What is an essential tremor (postural tremor)?

A

action tremor, exacerbated by holding posture/limb position

85
Q

What are treatments for essential tremors?

A

beta-blockers or primidone

Others self-medicate with EtOH

86
Q

What is an intention tremor?

A

slow, zigzag motion when pointing/extending toward a target

Often seen with cerebellar dysfunction

87
Q

What is a consequence or a lesion to the amygdala?

Are there are associated diseases with this lesion?

A

Kluver-Bucy Syndrome (hyperorality, hypersexuality, disinhibited behavior)

Assoc. with HSV-1

88
Q

What is a consequence or a lesion to the frontal lobe?

Are there are associated diseases with this lesion?

A

Disinhibition and deficits in concentration, orientation, and judgement

89
Q

What is a consequence or a lesion to the right parietal-temporal cortex?

Are there are associated diseases with this lesion?

A

Spatial Neglect Syndrome (agnosia of the contralateral side of the world)

90
Q

What is a consequence or a lesion to the left parietal-temporal cortex?

Are there are associated diseases with this lesion?

A

agraphia, acalculia, finger agnosia, and left-right disorientation

91
Q

What is a consequence or a lesion to the reticular activating system (midbrain)?

Are there are associated diseases with this lesion?

A

reduced levels of arousal and wakefulness

92
Q

What is a consequence or a lesion to the mammillary bodies (bilateral)?

Are there are associated diseases with this lesion?

A

Wernicke-Korsakoff Syndrome (confusion, ataxia, memory loss, confabulation, personality changes)

Assoc. with thiamine (B1) deficiency and excess EtOH use; can be precipitated by giving glucose without B1 to a B1-deficient patient

93
Q

What is a consequence or a lesion to the basal ganglia?

Are there are associated diseases with this lesion?

A

tremor at rest, chorea, or athetosis

Assoc. with Parkinson disease

94
Q

What is a consequence or a lesion to the cerebellar hemisphere?

Are there are associated diseases with this lesion?

A

intention tremor, limb ataxia, and loss of balance

IPSILATERAL deficits –> fall towards side of lesion

*Cerebellar hemispheres are LATERALly located - affect LATERAL limbs

95
Q

What is a consequence or a lesion to the cerebellar vermis?

Are there are associated diseases with this lesion?

A

truncal ataxia and dysarthria

*Vermis CENTRALly located - affect CENTRAL body

96
Q

What is a consequence or a lesion to the sub thalamic nucleus?

A

contralateral hemiballismus

97
Q

What is a consequence or a lesion to the hippocampus (bilateral)?

A

anterograde amnesia

98
Q

What is a consequence or a lesion to the paramedic pontine reticular formation?

A

eyes look away from side of lesion

99
Q

What is a consequence or a lesion to the frontal eye fields?

A

eyes look toward lesion

100
Q

What are the physical findings in central pontine myelinolysis?

A

acute paralysis, dysarthria, dysphagia, diplopia, and loss of consciousness

101
Q

What is the pathogenesis of central pontine myelinolysis?

A

massive axonal demyelination in pontine white matter tracts secondary to osmotic forces and edema (a result of overly rapid correction of HYPOnatremia)

102
Q

What tracts are affected by central pontine myelinolysis?

A

corticospinal and corticobulbar tracts

103
Q

What is a helpful pneumonic to remember whether central pontine myelinolysis will occur or cerebral edema will occur d/t Na+ correction?

A

“From low to high, your pons will die” (CPM)

“From high to low, your brain will blow” (cerebral edema/herniation)

104
Q

What are signs of Broca aphasia?

A

nonfluent aphasia with INTACT comprehension

Broca area - inferior frontal gyrus of FRONTAL LOBE

105
Q

What are signs of Wernicke aphasia?

A

fluent aphasia with IMPAIRED comprehension and repetition

Wernicke area - superior temporal gyrus of TEMPORAL LOBE

106
Q

What are signs of global aphasia?

A

NONFLUENT aphasia with IMPAIRED comprehension

Both Broca and Wernicke areas affected

107
Q

What are signs of conduction aphasia?

A

poor repetition but fluent speech, intact comprehension

Can be caused by damage to left superior temporal lobe and/or left supramarginal gyrus

*Can’t repeat phrases such as, “No ifs, ands, or buts.”

108
Q

What are signs of transcortical motor aphasia?

A

nonfluent aphasia with good comprehension and repetition

109
Q

What are signs of transcortical sensory aphasia?

A

fluent speech and repetition with POOR comprehension

110
Q

What are signs of mixed transcortical aphasia?

A

confluent speech, poor comprehension, good repetition

First Aid STEP 1 - Neurology (6 decks)

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