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Clinical Neuroscience > Exam 2 Content Week 3 > Flashcards

Exam 2 Content Week 3 Flashcards

1
Q

what cranial nerves comes out of what parts of the brainstem

A

midbrain (3 and 4)
pons (5-8)
medulla (9,10,12)

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2
Q

where is the 4th ventricle

A

between the pons and the cerebellum

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3
Q

what is the reticular formation

A

in the brainstem, it

  • integrates sensory and cortical information
  • regulates somatic motor activity (reticulospinal) and ANS
  • regulates sleep and consciousness
  • modulates nocioceptive information
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4
Q

what are the 4 reticular nuclei

A

ventral tegmental area
pedunculopontine nucleus
locus coeruleus
rahphe nuclei

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5
Q

describe the NT/MN and function of the VTA

A

dopamine
responsible for reward seeking behavior and motivation and decision making.
When too much activity: addiction, schizophrenia

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6
Q

describe the NT/MN and function of the PPN

A

ACh
influences movement, like walking and gait. With Parkinson’s you loss this, so you get decreases in movement, sleep issues and cannot initiate walking.

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7
Q

describe the NT/MN and function of the locus coeruleus

A

NE

directs attention. so when it is active, we can pay attention

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8
Q

describe the NT/MN and function of the raphe nuclei

A

serotonin
mood!
antidepressants prolong the serotonin in the junction, so it inhibits the re-uptake

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9
Q

which part of the brainstem are the reticular nuclei

A

rostral part

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10
Q

what is the ascending reticular activating system

A

ARAS project to the thalamic nuclei, then project to the cortex.
regulates sleep/wake cycles, and consciousness (self awareness and surroundings) and attention while awake.

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11
Q

what are the three reticular formation descending tracts

A

reticulospinal
ceruleospinal
raphespinal

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12
Q

what is the reticulospinal

A

posture and gross limb movements

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13
Q

what is the ceruleospinal

A

from the locus coeruleus. autonomic, physiologic responses to stress and panic, and alertness. Inhibits pain and nocioception

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14
Q

what is the raphespinal

A

from raphe nuclei,

sensory, autonomic and motor. cardiovascular system, and inhibits pain signals.

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15
Q

coma

A

un-arousable, no response to strong stimuli

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16
Q

stupor

A

arousable only by a strong pinch

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17
Q

obtunded

A

spelling more then awake

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18
Q

vegetative state

A

complete loss consciousness, spontaneous eye opening, regular sleep wake cycles, normal respiratory patterns.

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19
Q

minimally conscious state

A

following minimally simple commands, gestures to yes/no, intelligible speech,

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20
Q

syncope

A

brief loss consciousness because of drop in BP

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21
Q

delirium

A

reduced attention, orientation and perception. also agitation

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22
Q

what is the Glasgow Coma Scale

A

eyes, are they already open, do you need a strong stimulus, soft, are they not opening.
verbal, can give name place and date, or not oriented or no words, just sounds, or none.
motor: can they move on command, is it normal or abnormal

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23
Q

what are the red flags for brainstem dysfunction

A

dysphagia (swallowing, 5,7,9,10,12)
dysarthria (speaking, CN 5,7,10,12)
diplopia (double vision)
dysmetria (impaired control of movement, like missing a target)

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24
Q

where are the pyramids on the medulla? whats laterally

A

anterior, and just lateral are the olives

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25
Q

where does CN 12 exit

A

between the pyramids and olives

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26
Q

where do CN 9 + 10 exit

A

lateral to the olives

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27
Q

which side of the medulla are the inferior cerebellar peduncles

A

the posterior side

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28
Q

the central canal is continuous with the SC and in the upper medulla widens and becomes the

A

4th ventricle

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29
Q

what cranial nerve nuclei are in the medulla

A

7,8,9,10,12

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30
Q

what cranial nerves make up the solitary nucleus

A

7,9,10: visceral afferents, and taste

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31
Q

what CN make up the nucleus ambiguous

A

motor fibers to the striated muscles in the phkyaryn, larynx and upper esophagus, so CN 9 + 10

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32
Q

what do the lateral corticospinal tracts do in the medulla

A

their axons decussate

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33
Q

where do the Doral columns decussate

A

medial lemniscus of the medulla

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34
Q

TF: the spinothalamic tracts run through the medulla

A

true

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35
Q

the spinocerebellar tracts get to the cerebellum via the

A

inferior cerebellar peduncle

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36
Q

what are the functions of the medulla

A
  • eye and head movements and postural control (vestibular nuclei- CN 8)
  • swallowing (nuclei ambiguous- CN9,10)
  • cardio and respiratory (dorsal motor vagus, CN10)
  • visceral activity/taste (solitary nucleus, 7,9,19)
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37
Q

what CN come from the pons

A

the trigeminal (5)- face sensation
abducens (6)- lateral eye movement
facial (7)- facial muscles and chewing
vestibulocochlear (8)- head and neck and ear

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38
Q

the anterior portion of the pons contains the

A
  • descending tracts (corticospinal, corticobrainstem and corticopontine),
  • pontine nuclei
  • pontocerebellar axons.
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39
Q

the posterior portion of the pons is called the

A

tegmentum

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40
Q

what does the tegmentum of the pons contain

A

the sensory tracts,

  • reticular formation,
  • autonomic tracts and
  • CN nuclei (5-8)
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41
Q

how does the pons communicate with the cerebellum

A

the cerebellar peduncles

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42
Q

what are the functions of the pons

A 
face sensation (CN 5)
expressions and taste (7)
chewing (7 and 5)
lateral eye movement (6)
hearing, head position and neck position (8)
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43
Q

what is another name for the midbrain

A

the mesencephalon

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44
Q

the midbrain connects what two things

A

the diencephalon, and the pons

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45
Q

what structure passes through the midbrain

A

the cerebral aqueduct, which connects the 3rd and 4th ventricle

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46
Q

there are three parts of the midbrain, what are they from anterior to posterior

A

basal pedunculi
tegmentum
tectum

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47
Q

the basal pedunculi is the anterior portion of the midbrain. what is on this surface

A
  • the cerebral peduncles (descending tracts from the cerebral cortex)
  • substantia nigra (part of the BG)
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48
Q

the tegmentum houses what tracts

A

the vertical sensory tracts

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49
Q

there are lots of important things in the tegmentum… name them

A
  • superior cerebellar peduncle (midbrain to the cerebellum, efferent info)
  • red nucleus (from the cerebellum/cortex to the cerebellum or SC. rubrospinal tract and the reticular formation)
  • PPN: regulates muscle tone, part of BG)
  • CN 3 and 4 nuclei:
  • periaqueductal gray
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50
Q

in the tegmentum, what does the oculomotor nuclei do

A

efferent to the extra-occular muscles, and PNS control of pupillary contraction and the ciliary muscle.

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51
Q

what does the trochlear nuclei do

A

superior oblique

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52
Q

what is the function of the periaqueductal gray

A

around the cerebral aqueduct, this coordinates somatic and ANS responses to pain, threats and emotions
starts the fight or flight, laughing and crying.

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53
Q

what is the tectum

A

the posterior midbrain

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54
Q

what is in the tectum

A

the pretectal area (reflexes of the eye)

and the colliculi (superior and inferior )

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55
Q

what does the inferior colliculi do

A

relays auditory information from the cochlear nuclei to the superior colliculi and the medial geniculate body

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56
Q

what does the superior colliculi do

A

orientation and sensory and motor and reflex, orients the eyes and head to external stimuli and movements.

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57
Q

the vertebral artery branches from the

A

subclavian

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58
Q

where does the vertebral artery enter the skull

A

the foramen Magnum

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59
Q

the vertebral arteries join to form the ___ at the base of the ____

A

basilar,

pons

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60
Q

the basilar artery will divide at the junction of the ___ and ___ to become the _____

A

pons and midbrain

posterior cerebral artery

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61
Q

the posterior cerebral artery supplies the ____

A

inferior and middle portions of the posterior cerebellum

62
Q

the basilar artery has two branches…

A

the superior cerebellar and the anterior inferior cerebellar

63
Q

the superior cerebellar supplies the

A

the superior 1/2 cerebellum and some midbrain

64
Q

the anterior inferior cerebellar artery supplies

A

the anterior and inferior cerebellum (at junction of pons and medulla)

65
Q

the posterior inferior cerebellar artery is off what artery? and supplies what

A

the vertebral, supplies the post and inf part of the cerebellum

66
Q

disruption of the posterior inferior cerebellar artery causes

A

lateral medullary syndrome.

67
Q

disorders of the brainstem include CN’s and tracts as well. how would each present

A

CN ipsilateral

tracts: contralateral

68
Q

when there is ischemia in the brainstem, what are some rapid symptoms

A

dizzy, visual disorders, weak, incoordination and somatosensation disruption

69
Q

what happens when there is vertebrobasilar artery insufficiency

A

transient symptoms, (especially with head and neck extended and rotated)

70
Q

the cerebellum is also known as the

A

little brain

71
Q

there are __x as many neurons in the cerebellum, compared to the cortex

A

4

72
Q

the cerebellum integrates information from the __ lobe, and compares it to actual movement

A

planned movement from the frontal lobe, with actual movements.

73
Q

what are the functions of the cerebellum

A

compares actual motor output with intended movement, and coordinates and refines activity.
movement rhythm, timing and synchronization

74
Q

is the cerebellum conscious or non conscious

A

non

75
Q

are there direct connections between the cerebellum and motor neurons

A

no

76
Q

if there are no connections, how can it influence movement.

A

it is connected to motor tract cell bodies int he motor, premotor cortex and the brainstem,

77
Q

what happens if there is damage to the cerebellum

A

impaired coordination, postural control and decreases in emotional dan cognitive function

78
Q

cerebellum controls/regulates ___ movements

A

ipsilateral

79
Q

what is the cerebellum anatomy, outer and inner

A

outer is grey matter with output purjunkie fibers. inner is white.

80
Q

where is the cerebellum in the head

A

in the posterior cranial fossa, posterior to the brainstem and inferior to the occipital lobe

81
Q

what separates the cerebellum and the occipital lobe

A

the tentorium cerebelli (dura)

82
Q

what are the three lobes of the cerebellum

A

the anterior posterior and flocculonodular.

83
Q

what is the inferior part of the posterior lobe, and what is damage to this called

A

the tonsils, and damage here is when they herniate in the foramen Magnum, this is called the Arnold chari malformation, and it compromises breathing, cardio and the 4th ventricle.

84
Q

each hemisphere of the cerebellum is attached to the brainstem by 3…

A

peduncles

85
Q

what does the superior peduncle do

A

cerebellar output and efferents to the midbrain, then to the cortex and red nucleus

86
Q

what does the middle peduncle do

A

input to the cortex by the pons, afferent

87
Q

what does the inferior peduncle do

A

input from brainstem and SC, output to vestibular and reticular nuclei

88
Q

what is the rule of 3s with the cerebellum

A

there are 3 of everything, hemispheres/lobes, regions, layers, arteries, peduncles.

89
Q

what 3 branches give blood to the cerebellum

A

the superior cerebellar
the anterior inferior
the posterior inferior

90
Q

what portions of the cerebellum are supplied by the superior cerebellar

A

superior cerebellum and a little bit of the pons (rostral lateral dorsal)

91
Q

what portions of the cerebellum are supplied by the anterior inferior cerebellar

A

lateral caudal pons, and small part cerebellum

92
Q

what portions of the cerebellum are supplied by the posterior inferior cerebellar

A

supplies the lateral medulla and inferior cerebellum

93
Q

an infarct in which artery will cause unilateral hearing loss. why?

A

AICA, because it gives rise to the internal auditory artery

94
Q

where are infarcts more common

A

the SCA and PICA

95
Q

what can infarcts cause

A

swelling, brainstem compression

96
Q

what is the patient presentation in someone with a cerebral artery infarct

A

vertigo, nausea, dizzy, nystagmus, limb ataxia, unsteady gait, HA.

97
Q

what are the three functional regions of the cerebellum

A

the vestibulocerebellum, spinocerebellum, and cerebrocerebellum

98
Q

the vestibulocerebellum is part of what lobe

A

flocculonodule

99
Q

what is the purpose of the vestibulocerebellum

A

regulate equilibrium, coordination, postural control and eye and head movement.

100
Q

what happens with damage to the vestibulocerebellum

A

unsteady while reaching for a book, trunk ataxia, and nystagmus

101
Q

what regions make up the spinocerebellum

A

the vermis and paravermal region

102
Q

what does the spinocerebellum portion of the cerebellum do

A

connects with the SC and coordinated gross limb movements.

103
Q

what does injury to the spinocerebellum look like

A

jerky and inaccurate movement, tremor, ataxic gait, dysarthria, dysdiadochokinesia, dysmetria, and movement decomposition.

104
Q

what regions make up the cerebrocerebellum

A

the lateral hemispheres.

105
Q

what does the cerebrocerebellum in the cerebellum do

A

coordinates precise, distal voluntary movement. movement planning and timing

106
Q

what happens with damage to the cerebrocerebellum

A

finger ataxia, dysarthria, and cannot correct movements, as they are going wrong.

107
Q

the cerebellum is contra or ipsilateral movement

A

ipsilateral

108
Q

what are some of the roles of the BG

A

goal directed behavior, social and emotional and motor control

109
Q

where is the BG located

A

deep within the white matter of the cerebral hemispheres.

110
Q

how does the BG control movement

A

it predicts the effects of an action, and makes and executes a motor plan.

111
Q

TF: the BG is vital for normal motor function, sequencing of movements, and cognitive functions

A

true

112
Q

what are the main components of he BG

A

the caudate nucleus, the putamen, globus pallidus, sub thalamic nucleus, and substantial nigra.

113
Q

where is the substantia nigra located

A

the midbrain (basal pedunculi), dorsal to the cerebral peduncles

114
Q

the caudate nucleus has a

A

head, body and tail

115
Q

the putamen is what

A

a large nucleus, forming the lateral parts of the BG

116
Q

what connects the caudate and the putamen

A

the striatum, which are cellular bridges.

117
Q

where is the globus pallidus

A

just medial to the putamen “pale globe”

118
Q

the globus pallidus and putamen together are known as the

A

lenticular nucleus

119
Q

what is the ventral and dorsal portions of the substantia nigra called

A

ventral: substantia nigra pars reticulata
dorsal: substantia nigra pars compacta

120
Q

the substantia nigra plays a big role in

A

parkinsons

121
Q

inputs to the basal ganglia arrive via the

A

striatum (caudate nucleus, and the putamen.)

122
Q

what NT/NM is associated with inputs to the BG

A

glutamate, from the cortical motor areas, this excites the striatum

123
Q

outputs exit vie the

A

internal segment of the globus pallidus and the substantia nigra pars compacta.

124
Q

the substantia nigra pars compacta (dorsal part) send neurons to where and cause the release of what

A

striatum (caudate nucleus and putamen) and release dopamine.

125
Q

the release of dopamine from the striatum does what to the output signals,

A

it adjusts them, and inhibits target nuclei.

126
Q

the globus pallidus internus inhibits

A

motor thalamus, pedunculopontine nucleus and midbrain locomotor region.

127
Q

what does the basal ganglia motor circuit output regulate

A

muscle contraction, force, multi-joint movements, and sequencing.

128
Q

does the BG have direct output to LMN

A

no

129
Q

how does the BG get motor outputs out there

A

motor thalamus, PPN, midbrain locomotion region.

130
Q

what are the BG loops, and what do they do

A

they all contribute to full BG functioning. they predict future events, control desired and undesired behaviors and motor leaning, shift attention and spatial working memory

131
Q

what is the motor loop connection

A

links the putamen, globus pallidus and VL thalamic nucleus to the motor and premotor cortex.

132
Q

what is the role of the motor loop

A

movement selection, action, regulating contraction, force, multi-joint movement and sequencing.

133
Q

what is the oculomotor loop connections

A

links the frontal and supplementary eye fields with the caudate body, SN reticular and the VA thalamic nucleus.

134
Q

what is the role of the oculomotor loop

A

regulate spatial attention, eye movements, and reactive prosaccades.

135
Q

what are prosaccades

A

the eyes moving rapidly, to read a book or watch a train pass by

136
Q

what is the goal directed loop links

A

the head of the caudate, globus pallidus and the VA of thalamic nucleus to prefrontal cortex.

137
Q

what is the role of the goal directed loop

A

goal directed behavior, perpetual decision making, and plans and decides on actions, in context.

138
Q

give an example of how the goal directed loop may work

A

you are running late and the light is turning red. You decide if you have time to run the red light. you also decide which is more important, the interview or going for beers.

139
Q

what kind of deficits do we see with the goal directed BG loop

A

inattention, distracted, disoriented, poor concentration and short term memory issues.

140
Q

what are the links in the social behavior loop

A

head caudate SN reticular and the mediodorsal thalamic nucleus to the VL prefrontal and lateral orbital cortex.

141
Q

what is the role of the social behavior loop

A

recognize social disapproval, self control, discerning relevant and irrelevant information, maintaining attention, and stimulus response learning. if granny, in the passenger seat, does or doesn’t want you to run that red light.

142
Q

what happens if there is damage to the social behavior loop

A

violent and sexual behavior, and inappropriate. impulsive, frustrated, violent.

143
Q

what are the links of the emotional loop of the BG

A

ventral striatum, ventral pallidum, and MD thalamic nucleus to the medial prefrontal cortex.

144
Q

the ventral striatum links the ___, ____ and ___ systems

A

limbic, cognitive and motor

145
Q

the emotional loop is responsible for what

A

reward seeking, addition, gambling.

146
Q

what is the role of the emotional loop

A

determines the value of a stimulus, reward based behaviors, monitors predicted errors and pleasure seeking.

147
Q

what are the types of movement disorders of the BG

A

hypo or hyper kinetic.

148
Q

the BG inhibits the

A

motor nucleus, PPN, and the midbrain locomotor region.

149
Q

if there is excessive inhibition

A

hypo kinetic,

parkinsons

150
Q

if there is inadequate inhibition

A

hyper kinetic. Huntington’s (jerky movements and dementia, and you move in your sleep), dystonia (sustained contraction, abnormal posture and testing, but disappears in sleep. THINK BRENDAN), Tourettes (vocal and tics), dyskinetic CP (abnormal muscle tone and posture and involuntary movement.)

Clinical Neuroscience (20 decks)

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