BB EOYS6 Flashcards
If in A&E and a TIA occurs, which antiplatelet would you prescribe? [1]
Clopidogrel
Vestibular system
Which of the following is most sensitive to vertical acceleration when sensing movement?
Utricle
Crista
Saccle
Ampulla
Which of the following is most sensitive to vertical acceleration when sensing movement?
Utricle
Crista
Saccle
Ampulla
Which of the following is most sensitive to horizontal acceleration when sensing movement?
Utricle
Crista
Saccle
Ampulla
Which of the following is most sensitive to horizontal acceleration when sensing movement?
Utricle
Crista
Saccle
Ampulla
Meniere’s disease is associated with
A. loss of vestibular hair cells
B. damage to the vestibular nuclei
C. damage to cranial nerve VIII
D. damage to Scarpa’s ganglion
E. excess endolymph in the membranous labyrinth
Meniere’s disease is associated with
A. loss of vestibular hair cells
B. damage to the vestibular nuclei
C. damage to cranial nerve VIII
D. damage to Scarpa’s ganglion
E. excess endolymph in the membranous labyrinth
Which of the following is correct regarding vestibular nuclei?
A. There are six
B. They are located beneath the floor of the third ventricle
C. They receive afferent fibers from the spinal ganglion
D. They project only to the cerebellum
E. They are connected to the 3rd, 4th, and 6th cranial nerve nuclei by the medial longitudinal fasciculus
Which of the following is correct regarding vestibular nuclei?
A. There are six
B. They are located beneath the floor of the third ventricle
C. They receive afferent fibers from the spinal ganglion
D. They project only to the cerebellum
E. They are connected to the 3rd, 4th, and 6th cranial nerve nuclei by the medial longitudinal fasciculus
Which sensory receptor is most sensitive to angular acceleration?
A. Crista
B. Utricle
C. Saccule
D. Organ of Corti
Which sensory receptor is most sensitive to angular acceleration?
A. Crista
B. Utricle
C. Saccule
D. Organ of Corti
Linear acceleration is transduced in the:
A. Cupula
B. Cristae
C. Maculae
D. Organ of Corti
E. Scarpa’s ganglion
Linear acceleration is transduced in the:
A. Cupula
B. Cristae
C. Maculae: the maculae are more sensitive to linear, not angular acceleration
D. Organ of Corti
E. Scarpa’s ganglion
Make the best match between the below listed condition and the visual field defect. Match: occlusional of the left posterior cerebral artery
A. Contralesional superior quadranopia with macular sparing
B. Contralesional inferior quadranopia with macular sparing
C. Contralesional homonymous hemianopia with macular sparing
D. Bitemporal hemianopia
E. Inability to recognize objects or colors
Make the best match between the below listed condition and the visual field defect. Match: occlusional of the left posterior cerebral artery
A. Contralesional superior quadranopia with macular sparing
B. Contralesional inferior quadranopia with macular sparing
C. Contralesional homonymous hemianopia with macular sparing
There will be macular sparing because the caudal and lateral striate cortex receives a collateral blood supply from branches of the middle cerebral artery
D. Bitemporal hemianopia
E. Inability to recognize objects or colors
Which of the basal ganglia nuclei receive direct cortical input?
A. Claustrum and amygdala.
B. Centromedian nucleus and subthalamic nucleus.
C. Substantia nigra pars compacta and globus pallidus external.
D. Globus pallidus internal and substantia nigra pars reticulata.
E. Caudate and putamen
Which of the basal ganglia nuclei receive direct cortical input?
A. Claustrum and amygdala.
B. Centromedian nucleus and subthalamic nucleus.
C. Substantia nigra pars compacta and globus pallidus external.
D. Globus pallidus internal and substantia nigra pars reticulata.
E. Caudate and putamen
The spinocerebellum contains the…
A. vermis and intermediate zone of the anterior and posterior lobes.
B. Vermal and floccular parts of the flocculonodular lobe.
C. Lateral portions of the cerebellum.
D. Posterior lobe and interposed nuclei.
E. Anterior lobe and dentate nuclei.
The spinocerebellum contains the…
A. vermis and intermediate zone of the anterior and posterior lobes.
B. Vermal and floccular parts of the flocculonodular lobe.
C. Lateral portions of the cerebellum.
D. Posterior lobe and interposed nuclei.
E. Anterior lobe and dentate nuclei.
The lateral vestibular nuclei are functionally analogous to the…
A. Red nucleus
B. Purkinje cells
C. Basal ganglia
D. Thalamus
E. Deep cerebellar nuclei
The lateral vestibular nuclei are functionally analogous to the…
A. Red nucleus
B. Purkinje cells
C. Basal ganglia
D. Thalamus
E. Deep cerebellar nuclei
The diagnosis “Definite Alzheimer’s Disease” is established by:
A. autopsy of the patient’s brain
B. behavioral analysis
C. PET analysis
D. CAT analysis
E. MRI analysis
The diagnosis “Definite Alzheimer’s Disease” is established by:
A. autopsy of the patient’s brain
B. behavioral analysis
C. PET analysis
D. CAT analysis
E. MRI analysis
Which of the following is not a visible boundary of the hypothalamus in a hemisected brain?
A. The median eminence
B. The mammillary body
C. The optic chiasm
D. The internal capsule
E. The anterior commisure
Which of the following is not a visible boundary of the hypothalamus in a hemisected brain?
A. The median eminence
B. The mammillary body
C. The optic chiasm
D. The internal capsule
E. The anterior commisure
The hypothalamic sulcus is the rostral continuation of what anatomical feature of he brainstem?
A. The tuberculum cinereum
B. The stria medullaris
C. The sulcus limitans
D. The lateral sulcus
E. The dorsal paramedian sulcus
Which of the following hypothalamic nuclei is most important for encoding the set point for daily circadian rhythms?
A. supraoptic nucleus
B. arcuate nucleus
C. suprachiasmatic nucleus
D. preoptic anterior nucleus
E. paraventricular nucleus
Inhibition of ACTH secretion by cortisol is an example of what type of neuroendocrine feedback loop?
A. ultra-short loop feedback
B. short-loop feedback
C. indirect long-loop feedback
D. direct long-loop feedback
E. indirect ultra-long loop feedback
Inhibition of ACTH secretion by cortisol is an example of what type of neuroendocrine feedback loop?
A. ultra-short loop feedback
B. short-loop feedback
C. indirect long-loop feedback
D. direct long-loop feedback
E. indirect ultra-long loop feedback
Leptin receptors are most abundant in which of the following hypothalamic nuclei?
A. paraventricular
B. periventricular
C. preoptic/anterior
D. ventromedial
E. arcuate
Leptin receptors are most abundant in which of the following hypothalamic nuclei?
A. paraventricular
B. periventricular
C. preoptic/anterior
D. ventromedial
E. arcuate
A successful new diet drug might have which of the following effects in the hypothalamus?
A. Activates NPY receptors
B. Blocks αMSH receptors
C. Activates leptin receptors
D. Stimulates AGRP synthesis
E. Reduces CART synthesis
A successful new diet drug might have which of the following effects in the hypothalamus?
A. Activates NPY receptors
B. Blocks αMSH receptors
C. Activates leptin receptors
D. Stimulates AGRP synthesis
E. Reduces CART synthesis
The postcommissural fornix projects to which structure?
A. Substantia innominata.
B. Mammillary bodies
C. Ventromedial nuclei of the hypothalamus
D. Nucleus basalis of Meynert
E. Anterior cingulate cortex.
The postcommissural fornix projects to which structure?
A. Substantia innominata.
B. Mammillary bodies
C. Ventromedial nuclei of the hypothalamus
D. Nucleus basalis of Meynert
E. Anterior cingulate cortex.
Which structure is NOT part of the Papez circuit?
A. Anterior nucleus of the thalamus
B. Ventral nucleus of the thalamus
C. Cingulate gyrus
D. Hippocampus
E. Mammillary bodies
Which structure is NOT part of the Papez circuit?
A. Anterior nucleus of the thalamus
B. Ventral nucleus of the thalamus
C. Cingulate gyrus
D. Hippocampus
E. Mammillary bodies
A 50-year old patient with recent damage to the hippocampus from a stroke would likely have all of the following deficits EXCEPT:
A. Difficulty learning new facts
B. Difficulty describing a recent event
C. Difficulty learning a new vocabulary word
D. Difficulty recalling a childhood memory
E. Difficulty remembering a face
A 50-year old patient with recent damage to the hippocampus from a stroke would likely have all of the following deficits EXCEPT:
A. Difficulty learning new facts
B. Difficulty describing a recent event
C. Difficulty learning a new vocabulary word
D. Difficulty recalling a childhood memory
The hippocampus is involved in the formation of new memories, but not in the storage of old memories after they have been consolidated.
E. Difficulty remembering a face
Short term memories can involve all of the following processes EXCEPT:
A. Regulation of gene expression
B. Activation of second-messenger systems
C. Modulation of membrane channels
D. Modulation of transmitter release
Short term memories can involve all of the following processes EXCEPT:
A. Regulation of gene expression
Regulation of gene expression is associated with long-term memories and not short-term memories.
Classical conditioning is an example of:
A. Semantic memory
B. Episodic memory
C. Implicit memory
D. Declarative memory
E. Nonassociative memory
Classical conditioning is an example of:
A. Semantic memory
B. Episodic memory
C. Implicit memory
D. Declarative memory
E. Nonassociative memory
A 43-year old cerebral vascular accident patient was diagnosed as having persistent unilateral spatial agnosia or “visual neglect”. What cerebral region was most likely involved?
A. Non-dominant parietal-occipital cortex
B. Dominant parietal-occipital cortex
C. Dorsal prefrontal cortex
D. Dominant temporal-occipital cortex
E. Non-dominant temporal-occipital cortex
A 43-year old cerebral vascular accident patient was diagnosed as having persistent unilateral spatial agnosia or “visual neglect”. What cerebral region was most likely involved?
A. Non-dominant parietal-occipital cortex
B. Dominant parietal-occipital cortex
C. Dorsal prefrontal cortex
D. Dominant temporal-occipital cortex
E. Non-dominant temporal-occipital cortex
A delta fibers transmit primarily
A. burning diffuse pain information
B. pricking localized pain information
C. aching diffuse pain information
D. visceral pain information
E. phantom pain information
A delta fibers transmit primarily
A. burning diffuse pain information
B. pricking localized pain information This answer is CORRECT!
A delta fibers carry sharp/pricking pain, all the others are carried by C fibers
C. aching diffuse pain information
D. visceral pain information
E. phantom pain information
This photo shows the strucutres inside of a semi-circular canal.
Label A-C
A: ampulla
B: cupulla
C: crista
This photo shows the strucutres inside of a semi-circular canal.
Label A-E
A: ampulla
B: endolymph
C: membranous labyrinth
D: perilymph
E: bony labyrinth
Ampulla
Hair cells
Endolymph
Crista
Cupulla
Ampulla
Hair cells
Endolymph
Crista
Cupulla
Whta is the arrow pointing to
Ampulla
Hair cells
Endolymph
Crista
Cupulla
Ampulla
Hair cells
Endolymph
Crista
Cupulla
Which artery undergoing stenosis is attributable to 10% of all stroke? [1]
Carotid artery
Which of the following numbers depicted the vestibular tracts [1]
2c
Label A-F
A: (Macula of) utricle
B: (Macula of) saccule
C: cochlea
D: posterior semilunar canal
E: Stapes
F: Malleus and incus
Describe how the semicircular canals function to detect angular acceleration/deceleration of the head
There are three semicircular canals: anterior, posterior, and lateral. located in a different plane and each connect to an ampulla (widening of the canal) which conncects to the utricle
Within each ampulla there are hair cells and cristae with a gelatinous cupula above the hair cells * crista
Each canal is a continuous endolymph filled loop, when the head rotates endolymph displaces the gelitinous cupula and excites the hair cells causing depolarisation or hyperpolarisation
Movement towards the kinocilium causes the opening of channels and a subsequent depolarization of the cell. Movement away from the kinocilium causes the closure of channels leading to hyperpolarization of nerve fibers.
Describe the function of the utricle / saccle [1]
What is the macula of the utricle and saccle and what substance does it contain? [2]
Saccule and utricle is to keep the head vertically oriented with respect to gravity
Macula of utricle / saccle: cilia of hair cells embedded in a gelatinous mass.
Contains calcium carbonate crystals call otoliths
Describe how the VOR works
Automatically sensing head rotations and elicits a compensatory adjustment in the opposite direction of the eyes
Causes innervation on the medial-lateral rectus muscles (adduction / abduction), the inferior rectus-superior oblique pair (depression and extorsion, elevation and intorsion) and the superior rectus-inferior oblique pair (elevation and intorsion, depression and extorsion via the ascending medial longitudinal fasciulus
Where does input from the: semi-circular canals to the superior and medial vestibular subnuclei project to? [4]
Where does input from the: saccule and utricle to the lateral, inferior and medial vesibitular subnucleii project to? [3]
Semi-circular goes to ocular nuclei and reticular formation, gaze centres and tectal nuclei
(double check which pathways these are sent via)
Saccule and utricle goes to spinal motor nuclei via the lateral and medial VSTs, which are involved in postural balance
What does this image depict?
benign paroxysmal positional vertigo (BPPV)
labyrinthitis
ménière’s disease
vestibular neuritis
perilymph fistula
What does this image depict?
benign paroxysmal positional vertigo (BPPV)
labyrinthitis
ménière’s disease
vestibular neuritis
perilymph fistula
What does this image depict?
benign paroxysmal positional vertigo (BPPV)
labyrinthitis
ménière’s disease
vestibular neuritis
perilymph fistula
What does this image depict?
benign paroxysmal positional vertigo (BPPV)
labyrinthitis
ménière’s disease
vestibular neuritis
perilymph fistula
What is the name for this test of vestibular function / dysfunction? [1]
Hallpike’s Manoeuvre:
Label A-C
A: ampullae
B: utricle
C: saccle
Label A-D
A: Ampulla
B: Cupulla
C: Crista
D: Vestibulocochlea nerve
Loss of NaV1.7 can lead to which disease? [1]
Congenital insensitivity to pain (CIP): Rare condition in which individual cannot feel pain so often have wounds, broken bones, health issues not detected.
Name a disease if NaV1.7 is overexpressed / gain of function occurs [1]
Inherited erythromelalgia (IE): A painful neuropathy involving severe chronic burning pain sensations in hands and feet.
Neuropathy pain (loss of sensory fibres)
Name a disease that is caused by insensitivty to pain from a deficit in nerve growth factor [1]
Which gene mutates to create this disease? [1]
Congenital insensitivity to pain with anhidrosis (CIPA)
- TRKA gene codes for TrKA receptor to create nerve growth factor (NGF)
- NGF is crucial for development of Adelta and C-fibres
Different sensory neurons have distinct projections in the dorsal horn. State what they are
Lamina found within dorsal horn:
Lamina I to V
- Aβ: project deepest - lamina IV & V
- Aδ project middle: lamina I
- C fibres project into lamina I & II
Transmission
Describe the Aδ nociceptor pathway onto the dorsal horn [2]
Aδ nociceptor axon projects on to Lamina I via excitatory glutamate synapse on to either NMDA or AMPA receptors
Transmission
Describe the C-fibre nociceptor pathway [2]
C fibres activate lamina I cells via gluatmata onto excitatory interneurons in lamina II, which then excites lamina I dendrite with glutamate
Ischaemic stroke pathophysiolgoy
Describe the ischaemic stroke cascade at microscopic level [4]
Cellular ischaemia:
- Na / K+ pump failure
- Causes depolarisation
- Causes Ca2+ food in
- Cascade of enzymes that respond to ischaemia (like caspases)
- Causes cell death
Risk factors for stroke?
What are the key medical conditions that increase risk of stroke? [4]
Hypertension
Hypercholesteroamia
Diabetes
Cardiac - AF
TIA treatment?
