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Laughing Your Way Neurology > Ch 1 Anatomy > Flashcards

Ch 1 Anatomy Flashcards

1
Q

Vermis of cerebellum is responsible for control of? hemispheres?

A

Axial = vermin

appendicular = hemispheres

AX the VERMIN!

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2
Q

Parts of cerebellum

A

Anterior Hemi

Posterior Hemi

Vermis

Flocculonodulus

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3
Q

Anterior Lobe gets input from?

A

Dorsal and ventral Spinothalamic Tract

Cuneocerebellar Tract

APe’S

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4
Q

Posterior Cerebellum is responsible for what function?

A

Precise movement

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5
Q

Flocculonodular Lobe is responsible for?

A

Equilibrium and Eye Movements

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6
Q

Way to remember old names of cerebellar lobes?

A

APeS FAVorite PreNuP

Ant = paleo or SPINAL cerebellum (ataxia)

Floc = Archi or VESTIBULOcerebellum (eyes and equilibrium)

Post = neo or PONTOcerebellum (precise mvmt)

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7
Q

Superior Middle and Inferior Cerebellar peduncles connect to?

A

Midbrain

Pons

Medulla

(makes sense)

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8
Q

Cerebellar Nuclei from lateral to medial?

A

Dentists Emulate Great Friends

Dentate

Emboliform

Globose

Fastigial

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9
Q

The dentate nucleus contributes to? What tract is it part of?

A

Dentatorubrothalamic tract which contributes to dexterity and synergy of movement.

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10
Q

What is in the dentatorubrothalamic pathway?

A

Purkinje cells -> dentate nucleus -> contralateral red nucleus -> ventral lateral thalamus -> motor cortex area 4,6

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11
Q

How does the dentate signals in the dentatorubrothalamic tract connect to the red nucleus?

A

Superior cerebellar peduncle

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12
Q

Fastigial nucleus contributes to ?

A

stance and walking

“stance and walking fast”

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13
Q

emboliform and globose nuclei are known as?

They contribute to?

A

Interposed nuclei

stability and speed in initiation of movement.

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14
Q

Lesions in the interposed nuclei cause?

A

TARDy

Titubation (makes sense cant keep the head steady)

Action tremor (cant move smoothly)

Rapid alternating movements off (cerebellum allows RAM)

DYsmetria (also makes sense)

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15
Q

Layers of the cerebellar cortex?

A

MPG
molecular

purkinje

granule cell layers

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16
Q

What cells are in molecular layer of the cerebellum?

A

Molecular

Basket cells

Stellate cells

Purkinje cell dendrites

Parallel fibers of granule cells

Golgi cell dendrites

Moleculer = miles of cells

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17
Q

What cells are in the Purkinje layer of the cerebellum?

A

just purkinje

Purkinje = Per

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18
Q

What cells are in the granular layer of the cerebellum?

A

Granule

Golgi

Glomeruli

Miles per GaLLon

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19
Q

Golgi cells make? role? acts upon what cells?

A

GABA
INHIB
GRANULE cells

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20
Q

Granule cells make? role? acts upon what cells?

A

Glutamate

Excitatory +++

Basket, Golgi, Stellate

ONLY GRANULE CELLS ARE EXCITATORY

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21
Q

Pukinje cells make? role? acts upon what cells?

A

GABA

INHIB

deep cerebellar nuclei and vestibular nuclei

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22
Q

Stellate cells make? role? acts upon what cells?

A

Taurine

inhib

Purkinje

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23
Q

Purkinje cells are inhibited by ? (2)

A

Basket cells (via GABA)

Stellate cells (via taurine)

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24
Q

Summary of Cerebellar cortex?

A

Only granule cells are excitatory

Stellate cells use taurine,

Basket, golgi and purkinje use GABA

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25
Q

Two main sources of input into the cerebellar cortex?

A

mossy and climbing fibers

moseying and climbing into the cerebellar cortex

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26
Q

Mossy fibers use? to snapse on?

A

aspartate

to synapse on granule cells, which they excite

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27
Q

Axons from the granule cells form? What do those fibers do?

A

Parallel fibers in the molecular layer, which excites purkinje cells

1 mossy fiber can stimulate >1000 purkinje cells.

1 mossy -> multiple granule cells -> 1000 purkinje cells

mossy are bossy

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28
Q

Climbing fibers provide input to the cerebellum by (explain tract)?

A

mossy fibers start in contralateral olivary nucleus

through the inferior cerebellar peduncle

to the molecular layer of the cerebellum where they excite 1000s of Purkinje cells

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29
Q

Output from the cerebellar cortex is handled by what cells?

A

Purkinje

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30
Q

The cortex provides input to the cerebellum via what pathways (3)?

A

Corticoponocerebellar

Cerebro-olivocerebellar

Cerebroreticulocerebellar

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31
Q

Info from the corticoponto cerebellar pathways enter through the ____ peduncle

A

middle cerebellar

Pons is in the middle

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32
Q

Info from the cerebro-olivocerebellar tract enter the cerebellum as?

A

climbing fibers (excitatory to Purkinje cells)

“climbing an olive tree”

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33
Q

The spinal cord sends info to the cerebellum via what pathways (4)?

A

Cuneocerebellar

Dorsal (posterior) spinocerebellar

Rostral spinocerebellar

Ventral spinocerebellar

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34
Q

Cuneocerebellar tract carries what info?

A

movement of the IPSIlateral upper extremity and rostral body to the cerebellum

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35
Q

Describe cuneocerebellar tract?

A

ipsi UE muscle -> up the tract to synapse in the accessory cuneate nucleus -> inferior cerebellar peduncle into the cerebellum.

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36
Q

Dorsal spinocerebellar tract carries what info?

A

afferent info about IPSIlateral movement of the LOWER extremity limbs and trunk to the cerebellum.

Fibers in this tract give rise to mossy fibers that into the inferior cerebellar peduncle to the cerebellum

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37
Q

Ventral spinocerebellar tract carries what info?

A

unconscious proprioceptive movement from the trunk and LE to the cerebellum

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38
Q

What is unique in how the ventral spinocerebellar tract travels? compared to other spino-cerebellar tracts?

A

Ventral goes through the SUPERIOR cerebellar peduncle

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39
Q

Rostral spinocerebellar tract carries what info?

A

proprioceptive info about the UE and rostrum (similar to cuneo)

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40
Q

Summary of spino cerebellar tracts function - cuneo vs rostral vs dorsal spino vs ventral spino?

A

UE and rostrum

Movement = cuneo

Proprio = rostral

LE and TRUNK

movement = dorsal

proprio = ventral

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41
Q

Info from the vestibular nerve enters the cerebellum through?

A

Inferior cerebellar peduncle

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42
Q

Efferent pathways from the cerebellum are?

A

Globo-emboliform-rubral pathway

Dentatothalamic/Dentatorubral pathway

Fastigial Vestibular Pathway

Fastigial reticular pathway

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43
Q

Describe the pathway of the globose-emboliform-rubral pathway?

A

leaves globose and emboliform nucleus and leaves via SUPERIOR cerebellar peduncle where it decussates into the contralateral red nucleus

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44
Q

Describe the pathway of the dentatothalamic tract?

A

leaves dentate and goes to the CONTRALATERAL ventral lateral (VL) nucleus of the thalamus

DENTists are eViL

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45
Q

Describe the dentatorubral pathway?

A

dentate to CONTRAlateral red nucleus

DENTists also cause a lot of RED blood

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46
Q

Main function of dentato/rubrothalamic pathway? Descibe the whole pathway starting from Purkinje in the cerebellum?

A

Synergy of movement

Purkinje - Dentate - contralateral RED - VL nucleus of thalamus - motor cortex (areas 4,6)

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47
Q

Fastigial Vestibular pathway travels from the fastigial nucleus to the vestibular nucleus via?

A

INFERIOR cerebellar peduncle

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48
Q

Fastigial reticular pathway travels from the fastigial nucleus to the reticular nucleus via

A

INFERIOR cerebellar peduncle

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49
Q

AFFERENT pathways through the
INFERIOR PEDUNCLE?

A

Arcuatocerebellar

Cuneo

Dorsal spino

olivo

reticulo

trigemino

vestibulo

Theres a lot of INput into the INferior cerebellar peduncle

Try Real VODCA

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50
Q

AFFERENT pathways throught the MIDDLE cerebellar peduncle?

A

Pontocerebellar

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51
Q

AFFERENT pathways through the superior cerebellar peduncle?

A

cerulocerebellar tract

tectocerebellar tract

trigeminocerebellar tract

Ventral spinocerebellar

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52
Q

EFFERENT pathways through the inferior cerebellar peduncle?

A

Fastigial vestibular

fastigial reticular

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53
Q

Efferent pathways through middle cerebellar peduncle?

A

none

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54
Q

EFFERENT pathways through the superior cerebellar peduncle?

A

Dentatorubral tract

Dentatothalamic tract

Globose-emboliform-rubral pathway

Uncinate bundle of Russell

“Following your GED, you can get superior education, like your Uncle Russell

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55
Q

Which cerebellar peduncle is primarily responsible for outputs? inputs?

A

input = inferior

outputs = superior

(middle only has afferent through the pontocerebellar)

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56
Q

What makes up the Triangle of Mollaret?

A

A triangle of signals between Red Nucleus, IO, and dentate

Neural fibers travel from the Red Nucleus to ipsilateral inferior olive via central tegmental tract

Climbing fibers from the inferior olive travel through the ICP to the contralateral dentate via climbing fibers

Dentate fibers travel via SCP to Red Nucleus

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57
Q

A lesion in the pathways of the Triangle of Mollaret causes?

A

palatal myoclonus

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58
Q

Layers of the Cerebral Cortex

A

Superficial to Deepest

Molecular

External Granular

External Pyramidal

Internal Granular

Internal Pyramidal aka ganglionic layer

Multiform Layer

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59
Q

Which layer of the cerebral cortex is responsible for cortical-cortical connections?

A

2 and 3

External granular and pyramidal

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60
Q

Which layer of the cerebral cortex gets info from the thalamus?

A

4

Internal granular layer

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61
Q

What is the brodmans area of Primary visual cortex? Wernicke? Broca?

A

17

22 and 44 (they are double)

“At 17, you take your primary view at an R rated movie”

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62
Q

Cranial nerves in order?

Which ones are sensory/motor/both?

A

1 - olfactory S

2 - optic s

3 - oculomotor m

4 - trochlear m

5 - trigeminal b

6 - abducens m

7 - facial b

8 - vestibular s

9 - glossopharyngeal b

10 vagus b

11 spinal accessory m

12 hypoglossal m

Some say marry money, but my brother says big brains matter most!

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63
Q

Function of Trigeminal Nerve?

A

BOTH

facial sensation and motor (mastication), mylohyoid muscle, Anterior belly of digastric, tensor muscles

If you try to masticate a mile of food, your A+ belly becomes more tense.

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64
Q

Function of facial nerve?

A

both sensory and motor

facial movement, taste in ant 2/3 of tongue, salivation, lacrimation.

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65
Q

Braches of Facial nerve?

A

Temporal

Zygomatic

Buccal

Mandibular

Cervical

To Zanzibar By Motor Car

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66
Q

Functions of glossopharyngeal nerve?

A

both motor and sensation

stylopharyngeus muscle

taste in post 1/3 of tongue

sensation to middle and external ear

pharynx

parotid gland

carotid body and sinus

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67
Q

Function of vagus nerve?

A

Motor and sensory

Motor to lift palate (pharynx, larynx, viscera)

carotid sinus reflexes

sensory - taste in the pharynx

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68
Q

Which CN are involved in parasympathetic system?

A

3, 7, 9, 10

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69
Q

Through which foramen does each CN exit skull?

A

1 - Cribiform Plate

2- Optic canal

3,4, 5(1) - Superior Orbital Fissure

5 (2) - Foramen rotundum

5 (3) - Ovale

6 - Superior orbital fissure

7 - Internal auditory meatus (then stylomastoid foramen)

8 - Internal auditory meatus

9, 10, 11 - Jugular foramen

12 - hypoglossal foramen

“Cleaners Only Smelling Salty Scents Right Onto Smelly Iguanas Is Justified, Justified, Justified, However!”

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70
Q

What foramen does the ICA travel through?

A

Foramen Lacerum

RUM on ICe.

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71
Q

What foramen does the middle meningeal artery travel through?

A

foramen spinosum

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72
Q

Explain the tract relay for olfaction?

A

olfactory neurons - olfactory bulbs to synapse where the olfactory tracts carry information to the olfactory cortex

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73
Q

What makes up the olfactory cortex (2)?

A

piriform cortex

periamygdaloyoid cortex

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74
Q

Once in the olfactory cortex, where do the fibers project?

A

orbitofrontal cortex

entorhinal cortex (Secondary Olfactory cortex)

hippocampus

mediodorsal nucleus of the thalamus

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75
Q

Which CN does NOT relay through the thalamus

A

CN 1

CN 1 is smelly and the other CNs dont want it there

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76
Q

What syndrome occurs when there is a lesion or meningioma in the olfactory groove?

A

Foster Kennedy Syndrome

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77
Q

What makes up Foster Kennedy Syndrome?

A
  • ipsilateral optic atrophy
  • contralateral papilledema
  • ipsilateral anosmia
  • Think of JFK if he couldnt see or smell, he’d still be groooovin man.*
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78
Q

Lesions of the uncus cause what sx?

A

olfactory hallucinations

Think of Uncle Olaf (olfactory) in Lemony Snicket

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79
Q

Functions of SO eye muscle innervated by CN 4?

A

Depression and Intorsion of the eye

People that are SO depressed become introverted.

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80
Q

What is unique about CN4?

A

Longest and smallest cranial nerve

only CN that crosses midline

only CN that exits from the dorsal brainstem

Trochlear nerve is small, depressed, and SO introverted that it exits out the back to avoid everyone.

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81
Q

branches of CN V and where they exit the skull?

A

v1 - ophthalmic (superior orbital fissure)

V2 - Maxillary (foramen rotundum)

V3 - mandibular (Ovale)

You move your mandible to drink ovaltine

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82
Q

How does V3 differ from V1 and V2?

A

V3 is motor and sensory (1 and 2 are just sensory)

does not travel through cavernous sinus like V1 and 2

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83
Q

Sensory functions of CN V

A
  • face, mouth, sinuses, meninges AND
  • SENSATION (not taste) to anterior 2/3 tongue
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84
Q

Where is the trigeminal ganglion located?

A

Meckel’s cave

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85
Q

V3 motor functions (4)?

A

Mastication muscles (mandibular)

mylohyoid muscle

anterior belly of digastric

Tensors (tympani and tensor veli palatini)

If you try to MASTICATE a MYLe of food, you BELLY becomes TENSE

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86
Q

WHat nerve supplies the Anterior and posterior belly of digastric muscle?

A

Ant = V3 and Post = CN 7

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87
Q

Explain the corneal reflex (afferent and efferent)?

A

Afferent V1

Efferent CN 7 via orbicularis oculi muscle which causes you to blink when your cornea is touched

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88
Q

Explain the jaw jerk reflex (afferent and efferent)?

A

mandibular both aff and eff

if jaw jerks with reflex hammer = UMN

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89
Q

Explain the tearing reflex (afferent and efferent)?

A

afferent V1, efferent CN 7

reflex to start tearing if something is sensed to be lodged in eye

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90
Q

Explain the oculocardiac reflex (afferent and efferent)?

A

afferent V1

efferent CN 10

pressing on the eye causes bradycardia

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91
Q

Main 4 nuclei of CN5? Their function?

A

Main sensory nucleus - fine touch sensation

Mesencephalic nucleus - position sense

Motor nucleus - all V3 motor shit (tense belly masticating)

Spinal nucleus - pain and temp sense (think spinothalamic tract)

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92
Q

WHat is unique about the mesencephalic nucleus?

A

It is the only primary sensory neuron located in the CNS rather than peripherally

Me’s in the cephalic!

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93
Q

All the trigeminal sensory functions converge where?

A

Ventral posteriormedial nucleus of the thalamus

which then projects to the postcentral gyrus (main sensory cortex)

VP Meeting area

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94
Q

What tract carries PAIN AND TEMP info from face and mouth to trigeminal ganglion?

Explain entire tract all the way to sensory cortex

A

Ventral trigeminothalamic tract

1 - information carried to trigeminal ganglion via above

2 - then carried to spinal trigeminal nucleus via spinal trigeminal tract

3 - then to contralateral VPM nucleus of the thalamus where it radiates via posterior limb of internal capsule to the somatosensory cortex responsible for sensation to the face

People vent when they are in pain

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95
Q

What tract carries TOUCH AND PRESSURE info from face and mouth to trigeminal ganglion?

Explain entire tract all the way to sensory cortex

A

Dorsal trigeminothalamic tract

1 - to trigeminal ganglion via above

2 - to principal sensory nucleus of CN V

3 - to ipsilateral VPM of the thalamus to radiate via posterior limb of internal capsule to the ipsilateral somatosensory cortex

(purple dotted line in picture)

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96
Q

explain the route of CN 7 out of the brainstem and exiting the skull

A

exits brainstem at the cerebellopontine angle, then travels through the internal auditory meatus and the facial canal

exits the skull through the stylomastoid foramen

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97
Q

Roles of CN 7? (Long - divide into motor, parasympathetic and sensory)

A

MOTOR: - facial muscles - besides mastication

MOTOR: - innervates stapedius, post. belly of digastric, stylohyoid, ant and sup. auricular muscles

PARASYMP: - innervates glands: lacrimal, parotid, submandibular, sublingual

SENS: - taste to ant. 2/3 of tongue

SENS: - sensation of the external ear

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98
Q

Motor branches of CN7?

A

temporal

zygomatic

buccal

mandibular

cervical

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99
Q

buccal branch of the facial nerve innervates?

A

buccinator

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100
Q

cervical branch of the facial nerve innervates?

A

platysma

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101
Q

mandibular branch of the facial nerve innervates?

A

orbicularis oris

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102
Q

temporal branch of the facial nerve innervates?

103
Q

zygomatic branch of the facial nerve innervates?

A

orbicularis oculi

104
Q

Difference in upper vs lower facial muscle innervation in CN 7?

A

Upper facial muscles recieve innervations from both cerebral hemispheres

Lower only receieves contralateral cortical input

UMN lesions cause lower paralysis

LMN lesions cause ipsi upper and lower facial paralysis

105
Q

First order sensory neurons of CN7 are located in?

A

geniculate ganglion

106
Q

Which nerve branch of CN 7 is responsible for sensation of taste in ant 2/3 tongue?

A

chorda tympani

107
Q

Explain the route for taste starting with ant 2/3 tongue

A

chorda tympani -> geniculate ganglion -> nucleus tractus solitarius -(via central tegmental tract)-> VPM of thalamus -> cortical taste area

Taste involves 3 sets of CTs: Chorda Tympani, Central Tegmental, cortical taste center

108
Q

Preganglionic parasympathetic fibers for CN 7 are located in the ?

A

superior salivatory nucleus

109
Q

Which CNs are involved in afferent and efferent of corneal reflex?

A

afferent V1, efferent CN 7

110
Q

Which CNs are involved in afferent and efferent of corneal reflex?

A

afferent V1, efferent CN 7

111
Q

Ramsay Hunt Syndrome?

A

Herpes zoster infection of the geniculate ganglion

  • patients have unilateral facial palsy, pain and vesicles around the ear, as well as loss of taste on ant 2/3 of tongue

spreading can lead to hearing loss

112
Q

Review the entire routes of CN 7

113
Q

Where is the vestibular ganglion located?

A

internal auditory meatus

114
Q

What detects linear vs angular acceleration?

A

Linear - utricle and saccule

Angular - semicircular canals

115
Q

Whiuch subnuclei form the vestibular nuclear complex?

A
  • Lateral vestibular nucleus
  • inferior vestibular nucleus
  • medial nucleus
  • superior nucleus
116
Q

Lateral vestibular nucleus gives rise to:

A

lateral vestibulospinal tract

117
Q

fibers from the inferior and medial vestibular nuclei travel to:

A

flocculonodular lobe of the cerebellum via the inferior cerebellar peduncle.

118
Q

The medial nucleus is the main source of fibers for the:

A

medial vestibulospinal tract

119
Q

All 4 vestibular subnuclei contribute to:

A

ascending MLF, which helps with visual fixation while the head is moving.

120
Q

Describe the transmission of sound:

A
  1. Sound waves cause the tympanic membrane to vibrate.
  2. Sound is amplified by the middle ear ossicles (malleus, incus, stapes)
  3. Sound waves then reach the oval window, which connects with the vestibule of the inner ear.
  4. then sound travels to the scala vestibuli, which contains perilymph
  5. perilymph movements are transmitted to the cochlear duct. This results in movement of the basilar membrane in reference to the tectorial membrane.
  6. This activates mechanoreceptor cilia on hair cells.
  7. At the base of the hair cells, synapses activate the dendritic processes of bipolar cells of cochlear divison of CN8.
121
Q

Where are the cell bodies of the cochlear division of CN8 located?

A

in the spiral ganglion in the temporal bone.

122
Q

The hair cells of the cochlea and their supporting structures form the:

A

Organ of Corti

123
Q

The hair cells of the organ of Corti are the:

A

auditory receptor cells

124
Q

Describe the organization of the organ of corti

A

“tonotopic organization”

The hair cells at the base of the cochlea(near the oval window) are activated by higher frequency sounds.

Apex is activated by lower freq.

125
Q

Brainstem auditory evoked potentials causes 7 waves, where are these waves from?

A

I - Nerve (CN8)

II - Cochlear nuclei (medulla)

III - Superior olivary complex (pons)
IV - Lateral lemniscus (pons)
V - Inferior Colliculus (midbrain)
VI - Medial Geniculate (thalamus)
VII - Auditory radiations (thalamocortical)

126
Q

Above the level of the ______, unilateral lesions to the auditory tract do not cause deafness, why?

A

cochlear nuclei

bilateral connections

127
Q

Weber test - conductive vs sensorineural hearing loss?

A

Conductive - vibration is better heard in the affected ear

Sensorineural - better in the normal ear

Sensorineural makes sense.

128
Q

Rinne test - conductive vs sensorineural

A

Conductive - cannot hear it vibration in affected ear (bone>air)

Sensorineural - vibration can be heard

129
Q

CN supplies motor to?

A

One muscle, stylopharyngeus

Style magazine has glossy photos

130
Q

The main motor nucleus of CN9 is formed by ?

A

nucleus ambiguus

131
Q

CN9 supplies sensation to?

A
  • middle and external ear
  • pharynx
  • posterior 1/3 of tongue
132
Q

sensory nucleus of CN9 is part of ?

A

nucleus of the tractus solitarius

133
Q

Parasympathetic fxs of CN9?

A

innervates the parotid gland

134
Q

Parasympathetic nucleus of CN9 is the?

A

inferior salivatory nucleus

135
Q

What reflexes involve CN9?

A

carotid sinus reflex - dec HR and dilates vessels

afferent limb of the gag reflex

136
Q

Lesions of CN9?

A

Glossopharyngeal neuralgia - brief sharp pains on the tongue and radiating to the ear. Usually assoc with swallowing/talking.

137
Q

CN 10 innervates which muscles?

A

muscles of the palate

pharynX, larynX

palatoglossus

(except stylopharyngeus - CN9 and Tensor Veli Palatini CNV)

Your X-PALS, pharynX, larynX, wont watch Style TV

138
Q

CN10 is responsible for taste sensation of the

139
Q

Parasympathetic functions of CN10?

A

parasymp nucleus of CN10 is the dorsal motor nucleus of the vagus. efferent fibers travel down to the distal 1/3 of the transverse colon.

140
Q

R SCM muscle moves head in which direction?

141
Q

CN 10 innervates which muscles?

A

SCM and trap

142
Q

Causes of medial vs lateral winging of the scapula?

A

Serratus Anterior - innervated by long thoracic nerve

when injured = medial winging

Trapezius - CN 11

When injured = lateral winging

Eat a SALTy wing meal, and you wont get caught in a late, 11th hour accessory trap!

143
Q

Hypoglossal Nerve CN12 innervates the muscles of?

A

tongue, except palatoglossus (CN9)

144
Q

Injury of CN12 causes?

A

tongue deviation towards the side of the lesion (ONLY IF LMN)

UMN = fibers project to the contralateral side so point away from the injured side.

CN 12 LMN injury Licks the Lesion

145
Q

Symptoms of cavernous sinus thrombosis?

A

Papilledema

Proptosis

ophthalmoplegia

“PAP, PROP and painful OP”

146
Q

What structures are in the cavernous sinus?

A

CN 2, 3, 4, V1, V2, 6

postganglionic sympathetic fibers

ICA

147
Q

What nerve is closest to the ICA in the cavernous sinus?

A

CN 6

Abducens abuts the ICA

148
Q

What is Tolosa Hunt Syndrome?

Tx?

A

Granulomatous inflammation in the cavernou sinus that results in painful ophthalmoplegia

Tx with prednisone

149
Q

Function of posterior hypothalamic nucleus?

A

heat conservation

A&P grocery store is usually too hot or too cold

150
Q

Function of anterior hypothalamic nucleus?

A

detects elevated body temperature and triggers cooling mechanism

stimulates the parasymp nervous system

A&P grocery store is usually too hot or too cold

151
Q

Function of posteror lateral hypothalamic nucleus?

A

role in transition between sleep and wake

152
Q

Function of lateral hypothalamic nucleus?

A

controls appetite

153
Q

Function of ventromedial hypothalamic nucleus?

A

inhibits appetite

154
Q

Function of paraventricular hypothalamic nucleus?

A

synthesizes ADH and oxytocin

responsible for neuroendocrine and autonomic responses to stress

provides excitatory input for preganglionic sympathetic neurons

155
Q

Function of supraoptic hypothalamic nucleus?

A

synthesizes ADH and oxytocin

156
Q

Function of arcuate hypothalamic nucleus?

A

produces dopamine

157
Q

Function of medial preoptic hypothalamic nucleus?

A

controls release of gonadotropic hormones from the pituitary

158
Q

Function of posterior tuberomammillary hypothalamic nucleus?

A

histaminergic innervation to cortex

159
Q

Function of suprachiasmatic hypothalamic nucleus?

A

circadian rhythm

160
Q

Which hypothalamic nuclei regulate appetite?

A

Ventromedial and Lateral

Very Much Late for dinner!

161
Q

Components of the limbic system

A

amygdala

basal forebrain

cingulate gyrus

habenula

hippocampus

hypothalamus

mamillary body

olfactory cortex

septal nuclei

thalamus

ventral striatum

162
Q

The main limbic system pathway is known as ? Components

A

Papez Circuit

Hippocampus > Fornix > Mammilary Body > Anterior Nucleus of Thalamus > Cingulate nucleus > Entorhinal cortex

Hippocampus named PEPE with a spraycan of MACE

163
Q

Function of stria terminalis

A

connects the amygdala to septal nuclei/ anterior hypothalamus

164
Q

Function of stria medullaris

A

connects septal nuclei/Ant hypothalamus to habenula

165
Q

Median forebrain bundle connects?

A

Midbrain

Orbitofrontal

Septal area

hypothalamus

MOSH

166
Q

Klüver Bucy Syndrome?

A

bilateral anterior temporal lobe damage, which causes patients to be

  • hyperoral
  • hypersexual
  • placid

2 dots over the u represent the bilateral ant temporal lobes.

167
Q

Korsakoff Syndrome?

A

amnestic disorder usually assoc with alcoholism/malnutrition in which patients tend to confabulate.

168
Q

Wernicke Disease?

A

due to thiamine deficiency

  • Confusion
  • Ataxia
  • Nystagmus
169
Q

Basic breakdown of spinal cord components

A

Each spinal nerve has an anterior and posterior rootlet.

dorsal rootlets are primarily sensory, and ventral are primarily motor.

Spinal nerves divide into rami after leaving the intervertebral foramen.

The anterior rami are responsible for supplying the muscles and skin of the anterolateral body

The posterior rami are responsible for supplying the skin and muscles of the back.

170
Q

What type of sensation is communicated through free nerve endings?

A

Pain and temperature

Parking and Transportation is free at the end of the day.

171
Q

What type of sensation is communicated through Paccinian receptors?

A

Touch, pressure, vibration

To play Puccini, you must apply perfect touch, pressure, and vibration in your instrument.

172
Q

What type of sensation is communicated through Merkel receptors?

A

Light touch

Angela Merkel is the first female Chancellor of Germany and so she has a light touch.

173
Q

What type of sensation is communicated through Meissner receptors?

A

Two point discrimination

A meiser is someone who is cheap and discriminates their two cents for everything!

174
Q

Dermatomal correlate for shoulder?

175
Q

Dermatomal correlate for thumb?

176
Q

Dermatomal correlate for middle finger?

177
Q

Dermatomal correlate for little finger?

178
Q

Dermatomal correlate for axilla?

179
Q

Dermatomal correlate for nipple?

180
Q

Dermatomal correlate for umbilicus?

181
Q

Dermatomal correlate for anterior thigh?

182
Q

Dermatomal correlate for knee?

183
Q

Dermatomal correlate for great toe?

184
Q

Dermatomal correlate for small toe?

185
Q

Dermatomal correlate for posterior thigh?

186
Q

Dermatomal correlate for perianal area, genitals?

187
Q

Region of the cord most vulnerabel to ischemia?

A

mid thoracic cord

188
Q

Cord segment where lumbar cistern ends?

189
Q

Cord segment where conus medullaris terminates in adults?

190
Q

Cord segment where conus medullaris terminates in newborns?

191
Q

Area of the cord AND cord levels where dorsal spinocerebellar tract arises?

A

Clarke’s column

C8-L3

192
Q

Area of the cord AND cord levels where sympathetic innervation of the body occurs?

A

Intermediolateral cell column

T1-L2

193
Q

Area of the cord AND cord levels where sacral outflow of the parasympathetic nervous system occurs?

A

Intermediolateral cell column

S2-S4

194
Q

Anterior 2/3 of the spinal cord is supplied by what artery? Where does it originate?

A

Anterior spinal artery

comes off the verts

195
Q

Anterior spinal artery supplies what tracts?

A

Anterior 2/3 of cord

  • lateral corticospinal tract
  • lateral spinothalamic tract
  • anterior horns
196
Q

Anterior spinal artery infarction causes what sx?

A

paralysis

loss of pain and temp

urinary and fecal incontinence

(DCML system is preserved)

197
Q

What artery supplies most of the lumbar and sacral spinal cord

A

Radicular artery of adamkiewicz

198
Q

Artery of Adamkiewicz arises from?

A

Descending aorta usually comes off around T9-T12

199
Q

Venous return of the cord enters epidural veins called? What is unique about these veins?

A

Batson’s Plexus

Lack valves - allow spread of infection or cancer to spread easily.

200
Q

Cuneocerebellar tract carries what info and brings it where?

A

Carries afferent information about movement of the ipsilateral upper extremity and rostral body to the cerebellum.

201
Q

DCML carries?

A

Vibration, proprioception and light touch

202
Q

DCML - nucleus gracilis vs cuneatus

A

gracilis is from lower body and cuneatus is more rostral

203
Q

Describe DCML tract

A

information travels up the DC, synapses in gracilis/cuneatus, decussates in the medulla in the medial lemniscus via arcuate fibers and goes to VPL, synapses again and then goes to prim somatosen cortex.

204
Q

Dorsal spinocerebellar tract carries?

A

unconscious proprioceptive information from the lower limbs and trunk to the cerebellum

(cuneocerebellar tract but for the lower body)

205
Q

Rostral Spinocerebellar tract carries?

A

unconscious proprioceptive information from the upper limbs and rostral body to the cerebellum, similar to the cuneocerebellar tract.

206
Q

What types of fibers mediate pain and temp via spinothalamic tract?

A

small myelinated (fast) A-delta fibers

and unmyelinated (slow) C fibers

207
Q

Course of spinothalamic tract?

A

Enter the spinal cord and synapse in lamina II, then cross the anterior commisure and ascend in the spinothalamic tract to the VPL of the thalamus, synapses again and goes to primary somatosensory cortex.

208
Q

Ventral spinocerebellar tract carries?

A

similar to dorsal spinocerebellar, carries proprioceptive info from the lower limbs and trunk, however it enters the cerebellum via the superior cerebellar peduncle and some fibers cross.

Dorsal enters via the inferior peduncle.

209
Q

Corticospinal tract is responsible for

A

voluntary motor activity

210
Q

Describe the lateral corticospinal tract

A

Starts in lamina V of cerebral cortex (primary motor cortex)

fibers travel through the corona radiate, to the posterior limb of the internal capsule and VENTRAL brainstem.

In the caudal medulla, 90% of fibers cross and descend in the lateral corticospinal tract.

The other 10% travel in the ventral corticospinal tract (ipsilateral), these fibers cross in the ventral white commisure and terminate in the cervical and upper thoracic regions.

211
Q

Intermediolateral columns are located in what levels of the spinal cord? What kind of fibers come from this region?

A

T1-L2

Preganglionic sympathetic autonomic fibers

212
Q

Function of medial reticulospinal tract?

A

facilitates antigravity muscles

213
Q

Function of lateral reticulospinal tract?

A

inhibits antigravity muscles and facilitates the antagonizing muscles.

214
Q

Rubrospinal tract is involved in?

A

similar to lateral reticulospinal tract and ventral corticospinal tract, rubrospinal tract inhibits antigravity muscles and facilitates antagonizing muscles.

215
Q

Medial vestibulospinal tract is responsible for?

A

changes in head and trunk position in reponse to information from semicircular canals.

216
Q

Medial vestibulospinal tract arises from what nucleus and descends to?

A

arises from medial vestibular nucleus and descends to anterior horn cells.

217
Q

Lateral vestubulospinal tract is responsible for?

Arises from what nucleus

A

facilitates antigravity muscles (like medial reticulospinal tract)

lateral vestibular nucleus

218
Q

Which descending tracts faciltate anti-gravity muscles?

A

lateral vestibulospinal tract

medial reticulospinal tract

219
Q

Which descending tracts antagonize ant-gravity muscles?

A

corticospinal tract

lateral reticulospinal tract

rubrospinal tract

220
Q

Site of lesion and tracts involved in the following lesion: Brown Sequard

A

spinal cord hemisection

affects the lateral corticospinal tract, lateral spinothalamic, anterior horn, dorsal column

221
Q

Site of lesion and tracts involved in the following lesion: B12 deficiency

A

dorsal columns, lateral corticospinal tracts, spinocerebellar

222
Q

Tracts involved in the following lesion:

Friedrich’s

A

dorsal columns

lateral corticospinal tract

spinocerebellar tract

223
Q

Site of lesion and tracts involved in the following lesion: Polio

A

Anterior horns

224
Q

Site of lesion and tracts involved in the following lesion:

Syphilis ( tabes dorsalis)

A

dorsal columns

225
Q

Site of lesion and tracts involved in the following lesion: Syringomyelia

A

cavitation of the cervical cord.

affects decussating lateral spinothalamic axons and anterior horns

226
Q

Site of lesion and tracts involved in the following lesion:

Ventral spinal artery occlusion

A

anterior 2/3 of the cord.

affects lateral corticospinal tracts, lateral spinothalamic tracts, anterior horns

227
Q

Site of lesion and tracts involved in the following lesion: spinal muscular atrophy

A

anterior horns

228
Q

Site of lesion and tracts involved in the following lesion: ALS

A

anterior horns

corticospinal tracts

229
Q

What is the only CN with no relay in the thalamus

230
Q

Anterior nucleus of the thalamus is involved in? Part of what circuit? Recieves info from?

A

limbic function

part of papez circuit

mamillary bodies

231
Q

Anterior nucleus of the thalamus sends info from mamillary bodies to?

A

cingulate gyrus

232
Q

intralaminal nuclear thalamic group sends info to ?

A

the striatum

233
Q

mediodorsal/dorsomedial thalamic nucleus is involved in relay from? to?

A

amygdala, temporal lobe, and substantia nigra to the prefrontal and frontal association cortex

affects motivation, memory

234
Q

Largest thalamic nucleus?

235
Q

Pulvinar thalamic nucleus is involved in?

A

visual attention

Largest thalamic nucleus attracts the most visual attention,

236
Q

Sensory info from the limbs meets where in the thalamus?

A

VPL of the thalamus

VPLimbs

237
Q

Sensory info from the face meets where in the thalamus?

238
Q

What else relays at the VPM?

A

sensation of the face via CN5

taste info from nucleus tractus solitarius

VPMeeting

VPmmm or VPyum (taste info)

239
Q

How is taste transmitted to from the tongue/epiglottis to the cortex?

A

Ant 2/3 tongue => CN 7 => geniculate nuc

Posterior 1/3 tongue = CN 9 => inferior nucleus 9

epiglottis/esophagus = CN 10 => inferior nucleus 10

these all carry to the NTS, which relays to the VPM and then to the cortex (brodman area 43)

240
Q

LGN of the thalamus receives what info?

A

visual info from the optic tract.

241
Q

MGN of the thalamus receieves what info?

A

auditory info from the inferior colliculi

and then projects it to the primary auditory cortex.

242
Q

VA nucleus of the thalamus - function?

receives info from? and sends it to?

A

important role in movement regulation via GABA

input from GPi and SNr to the VA nucleus -> sends GABA signals to the cortex.

243
Q

VL nucleus of the thalamus - function?

receives info from? and sends it to?

A

part of the dentatorubrothalamic pathway, which is how the cerebellum influences synergy of movement.

Purkinje cells > dentate nucleus > contralateral red nucleus > VL thalamus > areas 4,6 motor nucleus

244
Q

Explain the full CSF flow?

A

choroid plexus => lateral ventricles => IV foramina of monroe => 3rd vent => aqueduct of sylvius => 4th vent => foramen of Luschka and Magendie => subarachnoid space => arachnoid granulations

245
Q

How many cc of CSF do adults have?

246
Q

How many cc of CSF does the choroid plexus make?

A

20 cc/hour or 500 cc/day

if you work in the choir (choroid), youll get 20$ an hour, or 500$ a day!

247
Q

normal CSF pressure in the lateral recumbant position?

A

10-15 cm H2O

If you are lying down on the job, youll only make 10-15$ an hour

248
Q

Circumventricular organs are unique why? which organs are in this?

A

these organs have an interrupted Blood brain barrier.

  • Neurohypophysis
  • Organum vasculosum
  • Subcommisural organ
  • Pineal gland
  • Area postrema
  • Median eminence
  • sub-fornical organ

NO SPAM about FORNication

249
Q

area postrema function? what makes it unique?

A

on the surface of the medulla adjacent to the 4th ventricle, connects to the NTS (only paired circumventricular organ)

detects toxins and causes VOMITING

Eating pastrami makes you wanna vomit.

250
Q

function of the median eminence?

A

Where the hypothalamus releases hormones that are carried to the anterior pituitary

251
Q

Function of the neurohypophysis?

A

synonymous with the posterior pituitary. Secretes oxytocin and vasopressin which are synthesized from the thalamus.

252
Q

Only paired circumventricular organ?

A

Area postrema (not sure what they mean by paired organ, maybe with the NTS? look into it)

253
Q

only CN that does not relay to the thalamus?

A

CN 1 olfactory

Laughing Your Way Neurology (6 decks)

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