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Medical Physiology > Exam #6: Review > Flashcards

Exam #6: Review Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the functional differences between nuclear bag and nuclear chain fibers? What types of nerve fibers are associated with these two structures?

A

Nuclear Bag

  • Ia
  • Velocity of length change (dynamic)

Nuclear Chain

  • II
  • Change in length (static)
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2
Q

Why do UMN lesions result in hypertonia?

A
  • Loss of presynaptic inhibition of muscle spindle afferents (from UMN lesion)
  • Allows the slow and/or sustained muscle stretch reflex to elicit continual muscle contraction
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3
Q

In the vestibular system, what is the result of stereocilia movement toward the kinocilium? What about away?

A 
Toward= depolarization 
Away= hyperpolarization
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4
Q

What are the two most common etiologies of positional vertigo?

A

1) Trauma

2) Viral Labyrinthitis

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5
Q

What are the central connections of the vestibular labyrinth?

A
  • Flocculonodular lobe of the cerebellum

- Vestibular nuclei

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6
Q

What are the four projections of the vestibular nuclei?

A

1) MLF to EOM (vestibulo-ocular reflexes)
2) Lateral vestibulospinal tract
3) Medial vestibulospinal tract
4) Higher centers

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7
Q

What two pathways are implicated in decerebrate posturing?

A

Lateral vestibulospinal tract
Pontine reticulospinal tract

**Both facilitate the motor neurons of the extensor muscles

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8
Q

What is the difference between the lateral & medial vestibulospinal tracts?

A
  • Medial descends only to the throacic spinal cord & mediates reflex head movements in response to vestibular stimuli
  • Lateral descends the length of the spinal cord & facilitates extension
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9
Q

What is the function of the reticulospinal system?

A
  • Anticipatory postural adjustments

- Activating locomotion and controlling its speed

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10
Q

What is the function of the colliculospinal tract? What is the alternate name for this tract? Where does is project from/ to?

A
  • Also called the “Tectospinal tract”
  • Superior colliculus–>cervical spine
  • Reflex head movements in response to visual stimuli
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11
Q

What is the vestibulocollic reflex?

A

Head righting reflex in response to vestibular input i.e. in the absence of visual input

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12
Q

What is the cervicocollic reflex?

A

Head righting reflex in response to proprioceptive inputs from the cervical spine

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13
Q

Describe the position of a patient with an asymmetric neck reflex?

A
  • Arm & leg of one half of body extended
  • Arm & leg of opposite half flexed
  • Head rotated toward extended side
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14
Q

What are the specific boundaries of a lesion that will cause decerebrate posturing?

A
  • Below the red nucleus (caudal)
  • Above the lateral vestibular nucleus (rostral)

Generally, this is the upper pons/ lower midbrain

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15
Q

What is the major landmark used to describe the lesion that causes decorticate posturing?

A

Supratenorial i.e. above the tenorium cerebelli

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16
Q

What is gamma rigidity?

A
  • Gamma motor neuron excitation
  • Contraction of intrafusal fibers
  • Stimulation of Ia afferents
  • Contraction of muscle via alpha motor neurons
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17
Q

What is the treatment for severe CP?

A

Dorsal Rhizotomy i.e. selectively cutting some of the Ia fibers (dorsal lumbar nerves) to damped down excessive gamma rigidity that is part of the CP pathology

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18
Q

What is the Bordmann area for the motor cortex? Premotor cortex? Supplementary motor cortex? Frontal eye fields?

A

Motor= 4
Premotor= 6
Supplementary= 6
Frontal Eye Fields= 8

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19
Q

What is the function of the premotor area? What would a lesion to the premotor area cause?

A

Planning related to external stimuli/ visually guided stimuli e.g. reaching & grasping
- The ability to perform such tasks would be diminished

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20
Q

What is the function of the supplementary motor area? What would a lesion to the supplementary motor area cause?

A

Function: planning in regards to:

1) Internal acts
2) Sequential actions
3) Coordinating both sides of the body
4) Anticipatory adjustments

  • Defects in the above abilities AND difficulty initiating/ suppressing movements
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21
Q

Where would a vascular lesion be to involve the premotor cortex vs. the supplementary motor cortex?

A 
ACA= supplementary 
MCA= premotor
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22
Q

What are the ipsilateral consequences of Brown-Sequard Syndrome?

A

1) Anesthesia at the level of hemisection
2) Monoplegia
3) Babinski sign
4) Deficits in the DC/ML pathway i.e. vibration, proprioception, touch

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23
Q

What is the contralateral consequence of Brown-Sequard Syndrome?

A

Spinothalamic pathway damage= deficit in pain & temperature

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24
Q

Draw the functional divisions of the cerebellum. Labal the deep cerebellar nuclei associated with each functional region. Label the UMN or LMN projection of each functional division.

A

N/A

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25
Q

What are the manifestations of a lesion to the spinocerebellum?

A

1) Hypotonia
2) Dysmetria
3) Intention tremor
4) Pendular reflexes

26
Q

What are the manifestations of a lesion to the cerebrocerebellum?

A

1) Delay in starting & stopping movement
2) Asynergy
3) Impairment in sequenced movements

27
Q

What are the manifestations of a lesion to the vestibulocerebellum?

A

1) Ataxia
2) Cerebellar nystagmus (up & down beat nystagmus)
3) Defects in smooth eye movements

28
Q

Draw the direct and indirect loops of the basal ganglia. Label the NTs & primary areas of pathology of PD, Huntington’s Disease, & Hemiballismus.

A

N/A

29
Q

Draw the four major functional loops of the basal ganglia.

A

N/A

30
Q

What brain region is associated with REM sleep?

A

Reticular Activating System

31
Q

What NT is primarily associated with REM sleep?

A

ACh

32
Q

What NTs are associated with wakefullness?

A

NE
5-HT
Histamine
Orexin

33
Q

What brain region produces NE associated with wakefulness?

A

Locus Coeruleus

34
Q

What brain region produces 5-HT associated with wakefulness?

A

Pontine Raphe Nucleus

35
Q

What brain region produces Histamine associated with wakefulness?

A

Posterior hypothalamus

36
Q

What brain region produces Orexin/Hypocretin associated with wakefulness?

A

Lateral Hypothalamus

37
Q

List the six symptoms of Prefrontal Lobe Syndrome.

A

1) Personality changes
2) Planning deficits
3) Perseveration
4) Frontal release signs
5) Lack of ambition
6) Akinetic mutism

38
Q

What is the difference between abulia and akinetic mutism?

A

Abulia= loss or impairment in the ability to perform voluntary actions & make decisions

Akinetic mutism= patient does not move or speak despite being awake

39
Q

Review the Costanzo table on the type of information carried by different never fiber types.

A

N/A

40
Q

Outline the steps of auditory transduction.

A

1) Sound waves
2) Vibration of organ of Corti
3) Bending of cilia in Scala Media
4) Change in K+ conductance to cause depolarization & hyperpolarization
5) Oscillating receptor potential i.e. cochlear microphonic
6) Glutamate release
7) Action potential

41
Q

Outline the pathway of auditory input.

A

1) Cochlea
2) CN VIII
3) Dorsal & ventral cochlear nuclei (medulla)
4) Lateral lemniscus
5) Inferior colliculus
6) Medial geniculate nucleus of thalamus
7) Auditory cortex

42
Q

What is efferent control?

A

This is a mechanism of the auditory system to sharpen the frequency

43
Q

How do we know if the sound comes from the right or left?

A
  • Certain auditory neurons compare loudness of sound arriving in each ear
  • Other neurons compare time of arrival
44
Q

What are the typical causes of conductive deafness?

A 
Cerumen impaction 
Otosclerosis 
Fibrosis from OM 
OM w/ effusion 
Damage to DM
45
Q

What are the typical causes of sensorineural deafness?

A

Ototoxic drugs
Excessive noise
Vestibular Schwannoma
Meniere’s Syndrome

46
Q

What is is BAER?

A

Brainstem auditory evoked potentials

47
Q

What is a response or tone-click hearing test?

A
  • Most human ears cont. emit one or more pure tones
  • A click can cause the emission of tones
  • Clinically, hearing loss >30 dB will cause a patient NOT to emit these tones

*****Note that this test is done routinely to test for congenital deafness in newborns

48
Q

What is audiometry?

A

This is the headphone test of hearing that you’re familiar with from visits to the doctor’s office

49
Q

Where is the primary auditory cortex?

A

Temporal lobe

50
Q

What is binocular disparity? What is the function of binocular disparity?

A
  • Binocular disparity is the difference in image location of an object seen by the left and right eyes, resulting from the eyes’ horizontal separation (parallax).
  • Brain uses this to extract depth information from the two-dimensional retinal images in stereopsis
51
Q

What is stereopsis?

A

Perception of depth and 3-dimensional structure

52
Q

What is the difference between scotopic and phototopic vision?

A 
Scotopic= rods 
Phototopic= cones
53
Q

What is propagnosia?

A

Inability to recognize faces

54
Q

What is the function of the pretectal area in vision?

A

Pupillary and lens reflexes

55
Q

What is the function of the dorsal visual stream?

A

Motion & position of objects

56
Q

What is the function of the ventral visual stream?

A

High level object recognition

57
Q

Outline the afferent pathway for taste information.

A

1) Cranial nerve
2) NTS
3) VPM of the Thalamus
4) Insular & frontal taste cortices

58
Q

What are WDRs?

A

These are the spinothalamic neurons located in Lamina V–they receive noxious & non-noxious input

Vs. “nociceptive specific” neurons located in lamina I, II, & III of the spinothalamic tract

59
Q

How does the amygdala interact with the hypothalamus to produce behavior?

A

?????

60
Q

What is the Ventral Tegmental Area (VTA)?

A

?????

61
Q

Outline the structural and neural mechanisms responsible for the behaviors seen in fear conditioning.

A

?????

Medical Physiology (74 decks)

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