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Neuro > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Cranial Nerve Locations

A

Midbrain: CN III-IV
Pons: CN V-VIII
Medulla: CN IX-XII

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2
Q

Dopamine

A

-amine neurotransmitter produced in substantia nigra of the brain
-affects motor function, cognition, and behavior, reward seeking behaviors (good for eating, bad for addiction)
-2nd messenger systems

Abnormalities seen in:
-Parkinson’s: not enough dopamine; bradykinesia, treat with precursor
-Schizophrenia: signalling pathways, treat with drugs that prevent binding

Excessive:
-drug abuse by preventing reuptake of presynaptic terminals

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3
Q

Longitudinal Divions of BS

A

-Basilar
-Tegmentum
-Tectum

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4
Q

Basilar Divison

A

-ventral
-Descending tracts from cortex
-motor nuceli from substantia nigra, pons, inferior olive

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5
Q

TegmentumDivison

A

-Dorsal
-reticular formation (arousal)
-sensory nuclei; ascending tracts
-CN V nuclei
-medial longitudinal fasciculus (coordinate eye and head mmt)

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6
Q

Tectum Divison

A

-midbrain only
-reflexive mmts of eyes and head
-inferior and superior colliculi

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7
Q

Midbrain Divisions

A

-Basis Pedunculi
-Midbrain Tegmentum
-Tectum

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8
Q

Inferior Colliculi

A

-info from cochlear to superior colliculi and thalamus
-sound localization; integration of auditory info

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9
Q

Superior Colliculi

A

-motor and sensory info to orient head and eyes
-visual, auditorry, and somatosensory info

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10
Q

Basis Pedunculi

A

-Cerebreal peduncles (motor tracts from cortex)
-Substantia Nigra

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11
Q

Midbrain Tegmentum

A

-ascending tracts
-superior cerebellar peduncle
-red nucleus
-pedunculoponttine nucleus
-CN III and IV
-periaqueductal grey

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12
Q

Pons

A

-anterior wall of 4th ventricle; anterior to cerebellum
-most ascending tracts pass without synapsing (except corrticopontitne and corticobrainstem)

-Basilar
-Tegmentum

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13
Q

Pons Basilar Division

A

-descending tracts
-pontine nuclei
-pontocerebellar

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14
Q

Pons Tegmentum Divison

A

-ascending tracts
-reticular formation
-CN V-VIII nuclei

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15
Q

Upper Medulla

A

-most CN nuclei
-spinal trigeminal
-inferior olivary nucleus

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16
Q

Inferior Olivary Nucleus

A

-motor learning, timing, and conttrol of ongoing mmts
-info from cortical and SC then prroject to cerebellum

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17
Q

Lower Medulla

A

-decussation
-asending tracts pastt posteriorly

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18
Q

Brainstem Blood Supply

A

-Vertebral A.
-ASA
-PICA
-Basilar
-AICA
-SCA
-PCA
-Pontiene
-Internal auditory A.

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19
Q

Midbrain Blood Supply

A

-PCA
-Basilar A.

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20
Q

Pons Blood Supply

A

-Basilar
-Pontiene
-AICA

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21
Q

Medulla Blood Supply

A

-ASA
-PICA

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22
Q

Brainstem Funcion

A

-Tracts (lesion: sensory and motor loss both ipsi and contra)
-CN function (lesion: ipsi facial issues)
-Consiousness (RAS, Reticular Formation)
-Vital sign regulation (Leison: BP fluctuation, breathing issues, HR issues)

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23
Q

4Ds of Brainstem Dysfunction

A

-dysphagia (swallowing)
-Dysarthria (motor production)
-Diplopia (double vision)
-Dysmetria (lack of coordination)

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24
Q

Anteromedial Midbrain Syndrome

A

-Weber’s Syndrome
-blockage of PCA or Basilar A. (midbrain branches)

Corticospinal: hemiparesis
Occulomotor: ipsi impaired eye mmts
Red nucleus: ataxia; emotional control

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25
Q

Lateral Inferior Pontine Syndrome

A

-occulsion of AICA; 2nd most common BS stroke
-affects pons

CN VIII Cochlear: ipsi hearling loss
CN VIII Vestib): dysequilibrium; nausea
Horner’s Syndrome: ipsi
CN V: ipsi facial pain
CN VII: decreased tears/saliva; ipsi weakness in face
Antetrolateral Spinothalamic: contra sensation

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26
Q

Bell’s Palsy

A

-CN VII damage
-flaccidity in ipsi hemiphere of face
-affects upper and lower (cortical is either or)

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27
Q

Horner’s Syndrome

A

-contricted pupils
-eyelid droop
-dry skin

-SNS issue

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28
Q

Locked-In Syndrome

A

-basilar artery thrombosis or stenosis affecting ventral pons

Lost
Bilat Corticospinal: paralysis
Bilat Corticobulbar: face paralysis
Bilatt Abducens: not lat eye mmt

Spared
-RAS, vertical gaze
-mimic coma

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29
Q

Medial Medullary Syndrome

A

-ASA blockage

CN XII: ipsi tongue protrusion
DCML tract: contra loss of sensation
Corticospinal: contra hemiparesis

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30
Q

Lateral Medullar Syndrome

A

-Wallenberg’s
-Blockage of PICA; mostt common BS stroke

Solitary Nucleus: increase HR
Vestibular Nucleus: balance issues
Vagus N: Increased HR
Trigeminal: facial sensation
Inferior Cerebellar Peduncle: ataxia, coordination
Salivatory nucleus: saliva and tears, dental hygiene
Spinothalamic: contra pain and temp
Descending SNS: ipsi horner’s
Nucleus Ambiguous: swallowing, gag reflex, hoarseness

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31
Q

Mammillary Bodies

A

-recollective memory

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32
Q

Middle Cerebellar Peduncle

A

-connects cerebellum to pons
-largest
- contains afferent fibers

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33
Q

Substania Nigra

A

-production of dopamine
-body movements
-part of basal ganglia
-on midbrain

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34
Q

Cerebral Peduncles

A

-refining fine motor movements
conversion of proprioceptive information into balance and posture

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35
Q

Inferior Olivary Nucleus

A

-coordinate signals from SC to cerebellum to regulate coordination

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36
Q

Periaqueductal Grey Matter

A

-modulation and propagation of pain

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37
Q

Thalamus

A

-interprets sensation information and perceives it

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38
Q

Diencephalon

A

-subthalamus
-epithalamus
-Thalamus
-Hypothalamus

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39
Q

Subthalamus/Subthalamic Nuclei

A

-superior to substantia nigra
-inferior to thalamus
-Lateral to hypothalamus

-functionally a part of basal ganglia
-initiates and suppresses movement
-excitatory input to basal ganglia

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40
Q

Epithalamus

A

-pineal gland/body biggest in epithalamus
-innervated by SNS
-control carcadian rhythm and glandular secretions

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41
Q

Thalamic Projections

A

-all projection roject to cortex EXCEPT thalamic reticular nucleus (TRN)
TRN: projects to thalamic nuclei, RF; GABA=inhibitory

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42
Q

Relay Nuclei

A

-infor from basal ganglia, cerebellum, or sensory sys. to cerebral cortex
-motor, sensation, hearing, vision

Leision
-can disrupt contra sensation (proprioception)
-thalamic pain syndrome
-Lateropulsion/Pusher Syndrome: pushing toward weak side where it is believed to have equilibrium

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43
Q

Association Nuclei

A

-process memory and emotional info
-connect areas of cortex
-sensory integration

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44
Q

Nonspecific Nuclei

A

-consiousness, arousal and attention

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45
Q

Cerebellar and Thalamus Pathways

A

-cerebellum projects through superior cerebellar peduncle to thalamus
-spinocerebellar
-Closed Cerebro-cerebellar-cerebral loop: from lateral cerebellar cortex afferents through middle CP, efferents leave thru superior CP

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46
Q

Hypothalamus

A

Homeostasis: Vitals, digestion, sleep
Endocrine: growth, metabolism, reproduction
Autonomic control: SNS
Limbic system: emotions

-mammilarry bodies are post. hypothalamus

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47
Q

Hypothalamic Homeostasis Control

A

-carcadian rhy: light receptors
-appetite
-thirst: osmorrerceptors
-body temp
-sexual development

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48
Q

Hypothalamic Endocrine Contol

A

-Hypothal to infundibulum to pituitary stalk to pituitary gland

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49
Q

Hypothalamic Limbic Control/Amygdala

A

-emotional influences on ANS and homeostasis
-Hippocampus > fornix > mammillary bodies > mammilothalamic tract > thalamus > limbic cortex in cingulate gyrus

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50
Q

Pituitary Clinical Implications

A

-pituitary tumor 10-17% of all intracranial neoplasms
-can put pressure on optic chiasm causing Bitemportal Hemianopia

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51
Q

Posterior Pituitary

A

-continuous with brain
-release neurohormones

ADH, Oxcytocin

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52
Q

Anterior Pituitary

A

outgrowth of epthelial tissue
-activated by neurohormones that then release/inhibit specific hormones

GH, TSH, ACTH, LH

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53
Q

Bitemporal Hemianopia

A

-pituitary tumor puttiing pressure on optic chiasm
-Loss of vision on both sides of visual field
L eye: no left half vision
R eye: no right half vision

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54
Q

Pineal Body

A

-rest btwn superior coliculi
-part of epithalamus
-secretes melatonin for body’s carcadian rhythm
-modulate onset of puberty

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55
Q

Lateral Geniculate Nucleus

A

-posterior aspect of thalamus
-relay station for visual info from retina

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56
Q

Medial Geniculate Nucleus

A

-ventrolateral aspect of thalamus
-major auditory nucleus of thalamus
-directing auditory attention from inf. colliculi

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57
Q

Amygdala

A

-anterior hippocampus
-center of emotions, behavior and motivation
-process fearful info to detect harm and activate appropriate response

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58
Q

Fornix

A

-white matter tract connecting to hipocampus
-transmit info from hippocampus to mammilary bodies

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59
Q

Cingulate Gyrus

A

-limbic system; process emotions and regulate ANS

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60
Q

Septum pellucidum

A

-partition bettween lateral ventricles

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61
Q

Basal Ganglia

A

-motor control and adjustments (no direct contact to motor neurons)
-initiate and inhibit movements
-goal-directed
-social behavior
-emotions

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62
Q

Parts of Basal Ganglia

A

Caudate
Putamen
Caudate+Putamen= Striatum
Anterior/Nucleus Stiatum
Putamen + Globis Pallidus= Lentiform Nucleus
Globis Pallidus Internus
Globis Pallidus Externus
Subthalamic Nucleus
Substantia Nigra

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63
Q

Substantia Nigra

A

-produces dopamine
-in midbrain
-mood, learning, judgement, descion making

Has
-Substantia nigra compata
Substantia nigra reticularis

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64
Q

Inputs to Basal Ganglia

A

-From Cerebrum Through Corticostriatal pathways
-From Striatum

-Glutamate; excitatory
-Dopamine; excitatory
-ACH; excitory
-Serotonin; inhibitory

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65
Q

Outputs from Basal Ganglia

A

-Out of Globus Palliidus Internus
-Out of Substantia Nigra

-GABA; Inhibitory

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66
Q

Motor Loops

A

-oculomotor loop
-Motor loop

Dorsal striatal pathway

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67
Q

Non-Motor Loops

A

-Goal-directed behavior loop (prefrontal channel and dorsal striatal pathway)
-social behavior loop (prefrontal channel and dorsal striatal pathway)
-emotion loop (limbic channel and ventral striatal pathway)

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68
Q

Goal-Direct Behavior Loop

A
  1. Lateral prefrontal Cortex
  2. Head of Caudate: descision making, planning and picking actions
  3. GPi
  4. Thalamus: linking action chosen by caudate and performing movement
  5. Lateral Prefrontal Cortex

Deficits: inattention, poor concentration, disorientation, poor short term memory

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69
Q

Social Behavior Loop

A
  1. Ventral Prefrontal Cortex
  2. Head of caudate: social cues, self control, determines irrelevant
  3. Substantia Nigra Reticularis
  4. Thalamus
  5. Ventral Prefrontal Cortex

Deficits: inppulsivity, indifference, temper, risky behaviors

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70
Q

Emotion Loop

A
  1. Medial Prefrontal Cortex
  2. Ventral Striatum: emotions and motivation; links emotional, cognitive and motor systems
  3. Thalamus
  4. Medial Prefrontal Cortex

Deficits: L BG stroke causing depression and dull emotions, impaired reward seeking

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71
Q

Oculomotor Loop

A
  1. Frontal and Supplementary Eyes Fields
  2. Body of Caudate: eye motions and spacial attention (rapid eye mmts)
  3. Substatia Nigra
  4. Thalamus
  5. Frontal and Supplementary Eyes Fields

Deficits: poor saccadic eye mmts

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72
Q

Motor Loops

A
  1. Motor and Premotor Cortex
  2. Putamen: motor planning
  3. Globus Pallidius (both)
  4. Thalamus
  5. Motor and Premotor Cortex

Deficits: muscle contractions and force, sequencing

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73
Q

Disinhibition

A

-2 inhibitory neurons target 1
-2nd inhibitory neuron inhibits the first to allow excitatory activity
-fine tuning movements

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74
Q

Motor Loop Internal Pathways

A

Stop
Go
No-Go

-all of GPi as output nucleus; inhibits motor thalmus to excite cortical motor areas to excite motor neurons
-cause excessive or insufficient movement

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75
Q

Stop Pathway

A

-fastest; hyperdirect

Cortex < Glutamate < Subthalamic Nuc < Glutamate < GPi < GABA < Motor Thalamus: inhibit motor programs to stop irrelevant movement

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76
Q

Go Pathway

A

-direct pathway
-activation disinhibits motor

Cortex < Glutamate < Putamen < GABA < GPi < Dopamine (less) < Motor Thalamus: less inhibition to motor thalamus makes specific mmts to cortex via corticospinal

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77
Q

No-Go Pathway

A

-indirect pathway
-inhibits unwanted mmt, fine tuning

Cortex < Glutamate < Putamen < Dopamine (inhibits) < GPe < Glutamate (inhibits less) < Subthalamic Nucleus < Glutamate < Gpi < Dopamine (inhibits) < Motor Thalamus

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78
Q

Medium Spiny Neurons

A

-spiny projections
-GABAergic inhibitory cells in
Striatum
-Putamen’s D1 and D2 bind to Dopamine (made by Substatia Nigra)

D1: Direct pathway (Go); dopamine excites inhibitory in GPi

D2: Indirect pathway (No-go); dopamine inhibits Neurons in putamen and GPe, disinhibiting SN and stimulating GPi

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79
Q

Voluntary Muscle Activity thru Basal Ganglia

A

-motor thalamus to motor tract cells in cortex
-Glutamate
-corticospinal, corticopontine, corticobrainstem

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80
Q

Postural and Proximal Limb Muscle Activity thru Basal Ganglia

A

-pedunculopontine nucleus in midbrain to reticulospinal tracts to spinal nerves
-GABA to Glutamate

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81
Q

Walking Activity thru Basal Ganglia

A

-midbrain locomotor region to retticulospinal tracts to stepping pattern generators
-ACH than Glutamate

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82
Q

Hypokinetic Disorders

A

-too much BG inhibition
-parkinsons

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83
Q

Hyperkinetic Disorders

A

-too little inhibition cause
-Huntington’s Disease
-Dystonia
-Tourette’s

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84
Q

Parkinson’s Disease

A

-decreased dopamine from SN leads to excessive activity of GPi inhibiting motor control

Postural Instability Gait Difficulty (PIGD) Subtype:
-bradykinesia
-hypokinesia (freezing gait, pill rolling, masked face, tremor)
-rigidity
-ANS dysfunction
-Cognitive Dysfunction

Tremor Dominant Subtype:
-Hyperkinetic (resting and activie tremor)
-rigidty
-contipation
-orthostatic hypotension

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85
Q

Huntington’s Disease

A

-hyperkinetic
-genetic disease causing Cortical, striatum, Putamen progressive degeneration
-90% loss of GABA inhibitory neurons in putamen and caudate so less input to GPe (no-go)
-cause GPi to have Ballistic involuntary, continuous mmts (Chorei-form)
-thalamic neurons can fire randomly

86
Q

Dystonia

A

-genetic, nonprogressive, involuntary sustained muscle contractions, abnormal posture and repetitive mmts
-increase during stress or activity

87
Q

Putamen

A

-regulate mmts and influence learning
-part of lentiform nucleus with GP
-part of striatum with caudate nucleus

88
Q

Globus Pallidus Internus

A

-control conscious and proprioceptive mmts
-cognition and motivation
-output nucleus
-primarily inhibitory

89
Q

Globus Pallidus Externus

A

-central hub for motor and non-motor info
-control conscious and proprioceptive mmts
-motivation
-input nucleus

90
Q

Caudate Nucleus

A

-ventral striatum with putamen
-planning and execution of mmts, learning, reward, motivation, interaction

91
Q

Internal Capsule

A

Anterior: Prefrontal cortex to thalamus and BS fibers

Posterior: Corticospinal, sensory and corticobulbar

Genu: knee of internal capsule

92
Q

Eye Rectus Muscles

A

Superior: elevation
Inferior: Depression
Medial: look in
Lateral: look out (Abducens)

93
Q

Oblique Muscles

A

-Superior (Trochlear)
-Inferior (Oculomotor)

94
Q

Pupillary Light Reflex

A

-Afferent: Optic
Efferent: Oculomotor

-consensual light response

95
Q

Eye Anatomy

A

Sclera and Cornea: most anterior

Pupil: controls light into eye

Lens: accommodates for near objects

Choroid: Superficial Layer of blood vessels

Retina: Innermost layer with neurons (rods and cones)

Fovea: in retina, highest visual acuity with smallest field; only cones

Optic Disc: blind spot

Vitreous Humor: jelly substance

96
Q

Retina

A

Outer Layer: melanin to decrease light scattering

Inner Layer: phototransduction site
-Photreceptors: Rods (b/w) and Cones (color)
-Bipolar cells: transfer info to ganglion cells
-Ganglion Cells: generate AP as 1st order neuron and synapse with optic nerve

97
Q

Phototransduction

A

-release of neurotransmitter by photoreceptors generate AP in ganglion cells (1st order)

-Cones: color, low light sensitivity, small receptive field
-Rods: black and white, large receptive field, high light sensitity, more abundant

98
Q

Visual Perception

A

-Ganglion cells (1st order) < optic N. < optic chiasm < optic tract < (2nd order) lateral geniculate body in thalamus < Optic radiation < Primary visual cortex

-imiage is inverted and reversed

99
Q

Optic Nerve

A

-ipsilateral nasal (inner fibers) and temporal fibers (outer fibers)

Lesion: ipsi eye blindness

100
Q

Optic Chiasm

A

-nasal fibers cross here (inner fibers)
-Temportal fibers stay ipsi

Lesion:
-only temporal fibers
-Bitemporal hemianopsia
- Outer field of vision gone in B eyes
-LE L field gone, RE R field gone

101
Q

Optic Tract

A

-Ipsi temporal fibers
-contra nasal fibers
-hemi-visual field

Lesion:
-Homonymous hemianopsia
-contra side of lesion gone in same half of vision in both eyes
- Right lesion, LE L field gone, RE L field Gone

102
Q

Primary Visual Cortex (Eye lecture)

A

Cuneus: upper bank; lower quadrant of both eyes
Lingua: lower bank; upper quadrant of both eyes

Visual Association cortex:
-Dorsal Stream: parieto-occippital cortex; motion; localization
-Ventral Stream: occipito-temporal cortex; perception, high resolution and visual acuity, recognition

103
Q

Eye Movements/Reflexes

A

Functions

Stabilize Gaze: eye stable during head mmt
-Vestibulo-Ocular Reflex: stabilize images during slow head mmt; eyes stable with head turn in opposite direction to keep stable on retina
-Optokinetic Reflex: vestib info on eye position during head mmt; quick saccades to keep target in eye sight

Movements
-Conjugate: both eyes move in the same direction; both looking right
-Vergence: both eyes move in diff; Convergence (crossing); Divergence (away from midline)
-Saccades: rapid eye mmt to scan, read; align fovea with scene
-Smooth Pursuit: slow tracking mmt of eyes

104
Q

Eye Movement Control: Brain Stem

A

-Pontine reticular formation (horizontal gaze center)
-Rostral intersistial Nuc in RF (vertical gaze center)
-Medial longitudinal fasciculus (coordinates both neural circuits)
-CNs
-Vestib N

105
Q

Eye Movement Control: Forebrain

A

-initiates accurately shiftitng eyes toward target

Frontal eye field: contra saccades and smooth pursuit
Parieto-Occipital-temporal complex: ipsi smooth pursuit
Superior Colliculus: optic tectum, attention and acuracy of eye mmt in response

106
Q

Eye Movement Control: Basal Ganglia

A

-initiation of eye mmt
-oculomotor loop
-prefrontal loop

107
Q

Eye Movement Control: Cerebellum

A

-correction of eye mmt
-vestibulocerebellum and spinocerebellum

108
Q

Lesion to Meyer’s Loop

A

-top of radiata
-contra superior homonymous quadrantanopsia
- Right lesion, LE top left, RE top left

109
Q

Lesion to V1

A

-Opthalamic N (1st branch of Trigeminal)
-Contra homonymous hemianopsia with macular sparing
-Right lesion, LE L field with center spared, RE L field with center spared

110
Q

Cerebellum Fuction

A

-adjusts posture and coordinates mmts
-processes proprioceptive info
-compares intended mmt to actual
-make adjustments
-doesn’t cause muscle weakness, just coordination issues

111
Q

Cerebellar Peduncles

A

Superior: mostly efferents; projects to motor nuclei of thalamus, red nucleus
-afferents from spinocerebellar

Middle: afferents; from contra pontine from cortex and sup colliculus

Inferior: efferents and afferents;
-afferents: vestibular nuc, inf olivary nuc
-efferent: projectt to vestibulospinal and reticulospinal

112
Q

Cerebellar Cortical Layers

A

Molecular: interneurons; most superificial

Perkinjie: middle layer; Perkinjie cell bodies; inhibit nuclei; all cerebellar output goes through perkinjie fibers

Granular: interneurons; Deepest layer
-Mossy Fibers: pons and SC to cerebellum
-Climbing fibers: inferior olivary nuc to cerebellum

113
Q

Deep Cerebellar Nuclei

A

Dont eat geasy food
-lat to medial

Dentate
Emboliform
Globose
Fastigial

114
Q

Functional Unit of Cerebellum

A

Perkinjie (inhibiory) + Deep nuclear cell (excitatory)

115
Q

Functional Zones

A

Vestibulocerebellum (Flocculondular lobe)

Spinocerebellum (vermis and inttermediate zone)

Cerebrocerebellum (Lateral hemisphere)

116
Q

Vestibulocerebellum (Flocculondular lobe)

A

-lateral vestibular nuc
-balance, eve, proximal trunk mmts

117
Q

Spinocerebellum (vermis and inttermediate zone)

A

-only part of cerebellum receives input directly from SC

-Fastigial nuc (vermis): proximal gross mmts of body limbs, eye and prox trunk
-Interposed Nuc (Intermediate zone): distal limb voluntary mmt

118
Q

Cerebrocerebellum (Lateral hemisphere)

A

-dentate nuc
-regulates highly skilled mmts and motor planning

119
Q

Vertebrobasilar A.

A

-posterior circulation of brain
-midbrain, pons, medulla

120
Q

Posterior Inferior Cerebellar A. (Think of location)

A

-bottom, posterior cerebellum
-tonsils, inferior vermis, inf. peduncle, inf hemisphere
-medulla

121
Q

Anterior Inferior Cerebellar A.

A

-front and bottom cerebellum
-middle peduncle, anterior middle cerebellum, flocculus
-pons

122
Q

Superior Cerebellar A.

A

-under CN III
-top of cerebellum
-sup and mid peduncles

123
Q

Posterior Cerebral A.

A

-posterior cerebrum
-occipital lobe
-Posterior, medial, inferior temporal lobe
-Midbrain
-above CN III

124
Q

Internal Carotid A.

A

-anterior circulation of brain

125
Q

Ophthalmic A.

A

eyes

126
Q

Posterior Communicating A.

A

-connects PCerebralA and ICA
-connects 1 side of ant to post

127
Q

Anterior Cerebral A.

A

-medial cerebral hemisphere to parietal lobe
-from ICA

128
Q

Anterior Communicating A.

A

-between ant. cerebral A.

129
Q

Middle Cerebral A.

A

-lateral cerebral hemisphere

EXCECPT:
-superior and front parietal
-inferior temporal

130
Q

Vertebral A. Stroke

A

-prone to shear forces from AA joint from abrupt cervical rotation
-gait issues, ataxia, HA

131
Q

Basilar A. Stroke

A

-complete blockage causes death
affects Midbrain (Weber’s Syndrome), pons
-partial: tetraplegia, numbness, ataxia, CN damage, locked in syndrome (only movements)

132
Q

Anterior Cerebral A. Stroke

A

-hemiparesis loss to contra side
-personality changes
-lower limb issues

133
Q

Middle Cerebral A. Stroke

A

-hemiparesis loss to contra side
-face and upper limb issues

L side: aphasia
R side: spacial relationships, nonverbal communication

134
Q

Posteror Cerebral A. Stroke

A

-midbrain issues (thalamic syndrome and Weber’s Syndrome), eye movement issues, cortical blindness (brain cant comprehend vision), ataxia, hemiparesis

135
Q

Pontine Arteries

A

-supplies pons

136
Q

Anterior Inferior Cerebellar A. Stroke

A

-2nd most common BS stoke
-Lateral Inferior Pontine Syndrome: CN V, VII, VIII, Anteriolateral Spinothalamic issues

137
Q

Anterior Spinal A. Stroke

A

-Medial Medullary Syndrome
-CN XII, DCML tract, and Corticospinal

138
Q

Posterior Inferior Cerebellar A. Stroke

A

-Most common BS stroke
-Walenberg’s (Lateral Medullary Syndrome): Increased HR, balance issues, facial sensation, secretions, pain and temp issues, swallowing

139
Q

Inputs of Vestibulocerebellum

A

-ipsilateral vestibular nuc and visual cortex
-synapses in Flocculonodular lobe

140
Q

Outputs of Vestibulocerebellum

A

-project to vestib nuc (posture by vestibulospinal tracts, eye mmts)

141
Q

Inputs of Spinocerebellum: High Fidelity

A

-2 neurons ipsi to cerebellum to provide feedback

Posterior Spinocerebellar
-LE
-1st: propprioceptors from LE and trunk to SC FG & Clark’s Nuc
-2nd: Posterior Spinaocerebellar Pathway, ipsi into inf cerebellar ped. to cortex UNCROSSED

Cuneocerebellar
-UE
-1st: propprioceptors from UE and neck to SC FC and synapse to form Cuneocerebellar pathway in medulla, psi into inf cerebellar ped. to cortex UNCROSSED

142
Q

Inputs of Spinocerebellum: Monitoring System

A

-internal feedback, monitor spinal interneuron

Anterior Spinocerebellar Tract:
-LE
-TL grey matter, divides and most CROSS at midbrain and then CROSSES AGAIN entering sup CP
-each hemisphere gets input from both; automatic coredinated LE movements

Rostrospinocerebellar Tract:
-UE
-grey of cervical SC to T1, to ipsi cerebellum through inf and sup peduncles

143
Q

Outputs of Spinocerebellum

A

Vermis: Perkinjie cells project to deep nuclei; medial motor tracts

Intermediate zone: perkinjie cells project to interposed nuclei; lateral motor tracts; distal muscles of limbs and digits

144
Q

Inputs of Cerebrocerebellar Circuits

A

-closed cerebro-cerebello-cerebral loop
-motor planning and timing
-changes in dentate occur before cortex executes movement
-motor and premotor cortices to pontine nuc to lateral cerebellar cortex to dentate nuc to thalamus to cortex

Input: cortex info into pons then CROSS; middle CP into lateral cerebellar cortex

145
Q

Outputs of Cerebrocerebellar Circuits

A

Perkinjies of lat cerebellar cortex synapse with dentate; efferents leave sup CP, CROSS, go to thalamus then cortex

146
Q

Signs of Cerebellar Dysfunction: Everywhere

A

-coordination but does not affect strength or muscles
-Ataxia

147
Q

Vermal Ataxia

A

-trunk

148
Q

Paravermal Ataxia

A

-limbs

149
Q

Signs of Cerebellar Dysfunction: Vestibulocerebellum

A

Nystagmus: bouncy eye mmtts
-unsteadiness, trunk ataxia, disequilibrium

150
Q

Signs of Cerebellar Dysfunction: Cerebrocerebellum

A

Dysarthria: slurred speech
-ataxic finger mmts

151
Q

Signs of Cerebellar Dysfunction: Spinocerebellum

A

-Dysarthria: slurred speech
-Scanning/Explosive speech: ataxia of speech; can’t regulate tone or pitch
-Dysdiadochokinesia: rapid mmt issues
-Dysmetria: overshoot or undershoot when moving to a target
-Loss of Check/Rebound: quick removal of resistance creates strong response
-Movement Decomposition: attempting to move 1 joint at a time; compensation

152
Q

Action Tremor

A

-shaking limb during mmt

153
Q

Intention Tremor

A

-tremor worsens closer to a target
-delays in agonist activity and delay in antagonist brake

154
Q

Cerebellar Ataxia

A

-agonsit and antagonist muscles
-EC and EO
-mirror doesnt help

155
Q

Sensory Ataxia

A

-DCML
-loss of joint position
-EO helps
-can improve with visual aid

156
Q

Right Lobe Cerebellum

A

-language
-executive functions; working mem, muscle control, goal-directed

157
Q

Left Lobe Cerebellum

A

-visuospational function
-executive functions; working mem, muscle control, goal-directed

158
Q

Anterior Lobe Cerebellum

A

-mediating unconscious proprioception from SC

159
Q

Posterior Lobe Cerebellum

A

-initiation, planning and coordination of mmt
-scope of mmt
-GABA

160
Q

Primary Fissure

A

-divides ant. and post lobes

161
Q

Vermis

A

-midline of cerebellum
-coordinates mmt of central body, posture
-spinocerebellar

162
Q

Paravermal Area

A

-mmt of distal limbs
-skilled voluntary mmt
-spinocerebellar
-lateral motor tracts

163
Q

Dentate Nucleus

A

-regulates fine control of mmts, cognition, language
-send efferents to contra red nuc or thalamus
-motor planning

164
Q

Globose Nucleus

A

-connected to vestib, balance

165
Q

Emboliform Nucleus

A

-regulates precision of limb mmts

166
Q

Interposed Nucleus

A

Globose+Emboliform= interposed
-eyeblinks and reflexes; agonist-antagoinst pairs

167
Q

Fastigial Nucleus

A

-maintain balance, afferent from vermis, interprets body motion

168
Q

Function of Auditory System

A

-ear converts acoustic energy (mechanical) into AP

169
Q

External Ear

A

-transmits sound waves that vibrate tympanic membrane

170
Q

Middle Ear

A

-air filled chamber
Ossicles: malleus, incus, stapes
Muscles: tensor tympani (V3), stapedius (VII)

171
Q

Internal Ear

A

-body labyrinth
Auditory Apparatus: cochlea
Vestibular Apparatus: semicircular canals, utricle, saccule

172
Q

Auditory Apparatus

A

-Hollow cochlea, coiled and filled with fluid
-basilar membrane vibrates from sounds
-Fluid is moved because of vibration and causes hair cells on Organ of Corti to become bent, causing a mechanical transduction where they are attached to tectorial membrane
-Depolarizes and Activates Cochlear N of CN VIII

173
Q

Major Auditory Pathways

A

-Cochlea < Cochlear nuc in medulla < Superior Olive in Pons <Lat lemniscus and RF in Pons < Inferior Colliculi in midbrain < Medial genticulate body in thalamus < Primary auditory cortex (Temporal Lobe)

174
Q

Peripheral Vestibular System

A

-Vestibular Apparatus
-Semicircular Canals
-Otolithic Organs

175
Q

Central Vestibular System

A

Pathways: vestib ganglion < vestib nuclei
-Medial longitudinal fasciculus
-Vestibulospinal tracts (med/lat)
-Vestibulocolic
-Vestibulothalamocortical
-Vestibulocerebellar
-Vestibulorecticular

Vestibulocerebellum

Vestibulocortex

Vestibib Nuc

176
Q

Vestibular Apparatus

A

Semicircular Canals: ant, pos, horizontal
-each with an ampulla

Otolithic Organs: utricle, Saccule

Membranous Labyrinth
-separated by perilymph fluid
-filled with endolymph
-hair receptor cells bend with mmt

177
Q

Semicircular Canals

A

-Ampulla that contains a crista with a cupula (gelatanous structure containing hair)
-hairs constanly fire AP when at rest and with head mmts to give information about the body in space
-only actively move during acceleration or deceleration of head

-R and L work recipocally
-L anter and R post are a functional pair

178
Q

Otolith Organs

A

Urtricle and Saccule: membranous sac that responds to linear acceleration/decceleration
-have a macula that contains hair cells embedded in a gelatinous mass with microscopic cristals (otoliths) on top
-displacement of otoliths sttimulate neurons

Uricle and saccule: Rotational mmt
Otoliths: Linear mmt

179
Q

Vestibulo-cervical Reflex

A

-postural adjustments of head in response to SCC

180
Q

Vestibulo-Spinal Reflex

A

-postural tone and adjustments of the body

181
Q

Medial Longitudinal Fasciculus

A

-Bilateral connections to extraocular eye muscles and superior colliculus
-Connects eye related CN

182
Q

Cerebello-Thalamocortical Pathways

A

-ascending pathway
-lateral and superior vestib colliculi < thalamus < posterior parietal cortex

183
Q

Primary Somatosensory Cortex

A

-differentiates basic sensory info (shape, texture, size)
-Post central gyrus and central sulcus

Lesion:
-difficulty with recognizing sensory information

184
Q

Cortical Layers

A

Granular cells
Pyramidal cells
Interneurons

-6 layers except for olfactoy and medial temporal

185
Q

Secondary Somatosensory Cortex

A

-complex recognition of sensory info from primary and thalamus
-projects to motor and limbic areas
-integration of info, attention and learning memory
-located immediately behind PSC

Lesion:
-Asterognosia, tactile learning, memory

186
Q

Primary Auditory Cortex

A

-in lateral fissue and sup. temporal lobe
-allows awareness of intensity of sounds
-Cochlea < inferior col < medial genticulate (thalamus) < auditory cortex

187
Q

Sedondary Auditory Cortex

A

-contrasts and classifies sounds and makes/retrieves memories from them
-larger than primary, sup. temporal

Lesion:
-Auditory Agnosia

188
Q

Primary Visual Cortex

A

-within calcarine sulcus (occipital to deep)
-differentiates light/dark, shapes, locations, mmts

-Retina < lateral genticulate (thalamus) < cortex

189
Q

Secondary Visual Cortex

A

-Analyzes colors and mmts
-project to sup coli (guides visual vixation)

Action Stream: SSC < dorsal to PPC < frontal
-adjust limb mmts

Preception Stream: SSC < ventral to temporal

190
Q

Vestibular Cortex

A

-posterior end of lateral vissure in parieto-insular cortex

191
Q

Parietemporal Association Cortex

A

-recieves projections from somatosensory cortex and visual sys (highest degree)
-outputs to motor sys for sensory/motor integration
-part of SSC, includes Wernicke’s area

-intelligence, probelm solving, language comprehension, spatial relationship

192
Q

Dorsolateral Prefrontal Cortex

A

-self-awareness
-executive functions: planning

-lateral frontal lobe

193
Q

Ventral and Medial Dorsal Prefrontal Association Cortices

A

-impulse control
-personality
-Ventral: observable mood and demeanor (Visual Agnosia & Prosopagnosia)
-Medial Dorsal: preception of other’s demeanor and assumptions (Optic Ataxia)

-Medial frontal lobe and inferior frontal lobe

194
Q

Primary Motor Cortex

A

-execution of mmt
-controls contra fractionation mmt

-precentral gyrus

Lesion:
-loss of fractionated mmt
-weakness
-dysarthria: muscles for speech

195
Q

Premotor Cortex

A

-execution and planning of mmt
-20-30% of corticospinal tact (trunk and shoulder)
-anticipatory postural adjustments

-lateral and anteior to PMC
-attached to Broca’s Area

Lesion:
-speed and automaticity of reaching/grasping
-mmt sequencing
-posture and gait
-Perserveration
-apraxia

196
Q

Supplemental Motor Area

A

-motor planning and initiation
-planning bimanual and sequential mmts

-anterior to PMC

Lesion:
-hemiparesis/hemiplegia
-deficits of anti-phase hand mmts
-Perserveration
-apraxia

197
Q

Agnoasias

A

-inability to recognize sensory information

198
Q

Visual Object Agnosia

A

-cannot recognize objects based on sight

199
Q

Prosopagnosia

A

-inability to recognize faces visually

200
Q

Auditory Agnosia

A

-cannot recognize object/people from sound

201
Q

Anosagnosia

A

-inability to recognize deficits

202
Q

Astereognosia

A

-cannot describe object in hand
-need motor function to maniulate object

203
Q

Optic Ataxia

A

inability to use visual infor to direct mmts

204
Q

Hemineglect

A

-lesion of parietal cortex (usually R), contra neglect
-inability to attend to objects or even own body
-all sensory sys remain intact

205
Q

Perseveration

A

-uncontrolled repetition of mmt (mr egg)

206
Q

Apraxia/Dyspraxia

A

-motor plannig issues

207
Q

Ideational Apraxia

A

-inability to use objects appropriately when sequence is involved
-making coffee, brushing teeth

208
Q

Ideomotor Apraxia

A

-unable to complete motor/muscular sequence when commanded
-unbuckling seatbelt
-can be accessed either muscle memory

209
Q

Magnetic Gait

A

-always there
-feet glued to the floor

210
Q

4 As of Cerebral Cortex Disorders

A

Aphasia, apraxia, agnosia, astereognosis

211
Q

Basal Ganglia Rules

A

Cortex= excitatory
Putamen= inhibitory or less excitatory (GABA)
GPi= inhibitory
Subthalamic Nuc= excitatory

Neuro (29 decks)

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