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Clinical Neuroscience > Exam III > Flashcards

Exam III Flashcards

1
Q

when light enters the eye, what happens?

A

the light is INVERTED and REVERSED

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2
Q

how do the superior and inferior visual fields project onto the retina?

A

(1) superior: projects onto the lower retina

(2) inferior: projects onto the upper retina

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3
Q

how do the right and left visual fields project onto the retina?

A

(1) right: left side of the retina

(2) left: right side of the retina

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4
Q

where does the normal visual field extend?

A

it extends more to the periphery than it does medially (or toward our nose), and extends more inferiorly than superiorly

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5
Q

what is the central fixation for each eye?

A

fovea

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6
Q

what area of the retina has the highest visual acuity?

A

fovea

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7
Q

what surrounds the fovea?

A

macula

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8
Q

what forms the optic disc?

A

axons leaving the retina

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9
Q

where is the blind spot located in the eye

A

where the optic disc is; 15 degrees lateral and slightly inferior to the central fixation point

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10
Q

what are the 3 layers of the retina? what is found in each layer?

A

(1) outermost: contains photoreceptors (rods and cones)
(2) middle: bipolar cells
(3) innermost: ganglion cells (parasol and midget cells)

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11
Q

where do the photoreceptors synapse?

A

bipolar cells

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12
Q

where are the cones primarily located? what is their function?

A

(1) fovea and macula

(2) high resolution visual images and color

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13
Q

where are the rods primarily located? what is their function?

A

(1) periphery of the retina

(2) vision in low light; provide low resolution visual images, and do NOT detect color

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14
Q

what is the function of the bipolar cells?

A

(1) receive input from the photoreceptors

(2) send input to ganglion cells

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15
Q

what do parasol cells respond to? what can be said about the size of their cell bodies and diameter of their fibers?

A

(1) gross stimulus features and movement

(2) LARGE cell bodies and LARGE diameter

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16
Q

where do parasol cells project to?

A

magnocellular layers of the LGN (lateral geniculate nucleus) of the thalamus

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17
Q

what do midget cells respond to? what can be said about the size of their cell bodies and diameter of their fibers?

A

(1) fine visual details and colors

(2) SMALL cell bodies and SMALL diameter

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18
Q

where do midget cells project to?

A

parvocellular layers of the LGN of the thalamus

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19
Q

where does the optic nerve receive input from?

A

retinal ganglion cells

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20
Q

what information is carried by the optic nerve?

A

(1) the entire visual field for the right eye is carried in the right optic nerve
(2) the entire visual field for the left eye is carried in the left optic nerve

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21
Q

what fibers cross in the optic chiasm?

A

nasal fibers (responsible for the lateral part of our vision)

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22
Q

what information does the RIGHT optic tract carry?

A

(1) info from the right side of the retina in the right eye

(2) info from the right side of the retina in the left eye

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23
Q

what would damage to the optic tract result in?

A

contralateral homonymous hemianopsia

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24
Q

what would damage to the optic chiasm result in?

A

bitemporal hemianopsia (AKA tunnel vision)

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25
Q

what do the optic tracts wrap around? where do they synapse?

A

(1) midbrain

(2) LGN of the thalamus

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26
Q

the RIGHT LGN recieves infromation from what visual field?

A

left visual field (right hemiretinas of both eyes)

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27
Q

which layers are the magnocellular layers of the LGN? where do these layers recieve input from?

A

(1) Layers 1-2

(2) parasol cells of the retina

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28
Q

which layers are the parvocellular layers of the LGN? where do these layers recieve input from?

A

(1) Layers 3-6

(2) midget cells of the retina

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29
Q

a minority of fibers in the optic tract bypass the LGN and enter what areas of the thalamus? what pathway does this form?

A

(1) superior colliculus AND pretectal area

(2) extrageniculate visual pathways

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30
Q

what area of the thalamus is involved with the pupillary light reflex?

A

pretectal areas

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31
Q

what areas of the thalamus is involved in directing visual attention and eye movements toward visual stimuli?

A

(1) pretectal areas

(2) superior colliculus

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32
Q

what are optic radiations?

A

axons leaving the LGN that sweep over the lateral ventricle and fan out to the Primary Visual Cortex

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33
Q

what would damage to the optic radiations result in?

A

homonymous contrateral visual field loss

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34
Q

left optic radiations carry information from what side of the body?

A

right side

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35
Q

right optic radiations carry information from what side of the body?

A

left side

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36
Q

the inferior optic radiations carry information from where?

A

SUPERIOR VISUAL FIELD

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37
Q

the superior optic radiations carry information from where?

A

INFERIOR VISUAL FIELD

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38
Q

damage to the temporal lobe causing damage to meyer’s loop (inferior optic radiations) results in what?

A

contralateral superior quadrantanopia (pie in the sky)

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39
Q

where do superior optic radiations terminate?

A

upper bank of the calcarine fissure

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40
Q

where do inferior optic radiations terminate?

A

lower bank of the calcarine fissure

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41
Q

damage to the parietal lobe that caused damage to the superior optic radiations results in what?

A

contralateral inferior quadrantanopia (pie on the floor)

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42
Q

where is the primary visual cortex?

A

upper and lower banks of the calcarine fissure

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43
Q

what is the name of the upper bank of the calcarine fissure?

A

cuneus

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44
Q

what is the name of the lower bank of the calcarine fissure?

A

lingula

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45
Q

where are the fovea and macula represented in the brain?

A

occipital pole of calcarine fissure

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46
Q

where is peripheral vision represented in the brain?

A

anterior along calcarine fissure

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47
Q

where in the higher-order visual association cortex do the magnocellular parasol cells transmit?

A

DORSAL PATHWAYS

dorsolateral parieto-occipital cortex

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48
Q

where in the higher-order visual association cortex do the parcocellular and interlaminar midget cells transmit?

A

VENTRAL PATHWAYS

inferior occiptiotemporal cortex

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49
Q

in regards to visual processing, what do the dorsal pathways transmit?

A

motion and spatial analysis

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50
Q

in regards to visual processing, what do the ventral pathways transmit?

A

form and color

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51
Q

what is often used to measure visual acuity?

A

Snellen eye chart (at 20 feet)

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52
Q

what are the two divisions of visual disturbances?

A

(1) negative phenomena: region of vision a person can’t see

2) positive phenomena: extra things are added to the visual field (lights, colors, shapes

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53
Q

what is a formed positive phenomena? where in the brain does this phenomena arise?

A

(1) visual hallucinations

(2) inferior temporo-occipital visual association cortex

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54
Q

what is release phenomena?

A

occurs in patients who have undergone visual deprivation where they see people, animals in the region of visual loss

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55
Q

what would cause a right monocular visual loss?

A

(1) lesion to the right optic nerve (or lesion of entire retina)
(2) glaucoma, optic neuritis, tumors, trauma

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56
Q

what would cause a scotoma?

A

(1) damage to small part of the retina

(2) retinal infarcts, hemorrhages, degeneration, infections

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57
Q

what would cause a bitemporal hemianopsia?

A

(1) lesion to the optic chiasm

(2) pituitary adenoma, hypothalamic glioma, tumor pressing on the optic chiasm

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58
Q

what would cause contralateral homonymous hemianopsia?

A

(1) lesion to the optic tract, LGN; wiped out entire optic radiations or primary visual cortex
(2) tumors, infarct to artery, demyleniation to tracts or radiations

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59
Q

what would cause contralateral inferior quadrantanopia?

A

(1) lesion to superior optic radiations or superior upper bank of the calcarine fissure
(2) infarct to blood supply (superior division of MCA or PCA)

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60
Q

what would cause contralateral superior quadrantanopia?

A

(1) lesion to inferior optic radiations superior and lower bank of the calcarine fissure
(2) infarct to an artery

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61
Q

what is macular sparing?

A

where partial lesions to the visual field occur where the central (fovea / macula) visual field is spared

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62
Q

what would cause a central scotoma?

A

(1) a lesion to just the occipital pole (fovea and macular area)
(2) head injury to the back of the head at bottom of the occiput

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63
Q

what is the primary source of blood flow for the retina?

A

opthalmic artery

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64
Q

what are 3 possible causes for reduced blood flow to the retina?

A

(1) embolus
(2) stenosis
(3) vasculitis

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65
Q

what are the 2 main branches of the retinal artery

A

(1) superior branch

(2) inferior branch

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66
Q

an occlusion of the the superior or inferior branch of the retinal artery can cause what?

A

altitudinal scotoma

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67
Q

what is an amaurosis fugax? how does it present?

A

(1) transient occlusion of the superior or inferior branch of retinal artery
(2) patients report browning out (shade being pulled over eye)

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68
Q

what is an amaurosis fugax a warning sign for?

A

similar to a TIA (but for the eye); a common cause is an ipsilateral stenosis of the internal carotid artery

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69
Q

what supplies blood flow to the optic nerves, optic chiasm, and optic tracts?

A

numerous small branches off ACA and MCA (rarely see clinically significant infarcts)

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70
Q

what supplies blood to the LGN? what decificts might present with a lesion to this area?

A

(1) anterior choroidal artery, PCA, thalamogeniculate artery

(2) contralateral homonymous hemianopsia and contralteral hemiparesis

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71
Q

what lobe do the superior optic radiations pass through? which arteries supply blood to this structure?

A

(1) parietal lobe

(2) superior divisions of the MCA

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72
Q

what lobe do the inferior optic radiations pass through? which arteries supply blood to this structure?

A

(1) temporal lobe (meyer’s loop)

(2) inferior divisions of the MCA

73
Q

what supplies blood to the primary visual cortex? what deficit might a patient with this infarct present with?

A

(1) PCA

(2) contralateral homonymous hemianopsia

74
Q

KNOW CRANIAL NERVES, ROMAN NUMERALS, AND FUNCTION

A

KNOW CRANIAL NERVES, ROMAN NUMERALS, AND FUNCTION

75
Q

the brainstem is composed of structures?

A

the midbrain, pons, and medulla

76
Q

where is the rostral limit of the brainstem?

A

midbrain / diencephalic junction

77
Q

where is the caudal limit of the brainstem?

A

cervicomedually junction

78
Q

the tectum (in the midbrain) of the brainstem is made up of what structures?

A

(1) superior colliculi

(2) inferior colliculi

79
Q

where are the cerebral peduncles of the brainstem located?

A

midbrain

80
Q

where in the brainstem are the pyramids and pyramidal decussation located?

A

medulla

81
Q

where are the cerebellar peduncles of the brainstem located?

A

pons

82
Q

where does CN 1 (olfactory) exit?

A

cribiform plate

83
Q

where does CN 2 (optic) exit?

A

optic canal; travels around midbrain to LGN)

84
Q

all crainal nerves 3-12 leave the brainstem either ventrally or ventral-laterally with what exception?

A

CN 4 (exits dorsal midbrain)

85
Q

where does CN 3 (oculomotor) exit?

A

superior orbital fissure; travel through interpenduncular fossa of midbrain

86
Q

where does CN 4 (trochlear) exit?

A

superior orbital fissure

87
Q

where does CN 5 (trigeminal) exit?

A

mnemonic SRO
(V1) superior orbtial fissure
(V2) foramen rotundum
(V3) foramen ovale

88
Q

where does CN 6 (abducens) exit?

A

superior orbital fissure

89
Q

where does CN 7 (facial) exit?

A

travels through internal auditory canal and EXITS through stylomastoid foramen

90
Q

where does CN 11 (accessory) exit?

A

jugular foramen (laterally from multiple rootlets along upper cervical cord)

91
Q

where does CN 12 (hypoglossal) exit?

A

hypoglossal foramen (travels between pyramid and olive of the medulla)

92
Q

where does CN 8 (vestibulocochlear) exit?

A

travels through internal auditory canal and ENTERS auditory canal

93
Q

where does CN 9 (glossopharyengeal) exit?

A

jugular foramen

94
Q

where does CN 10 (vagus) exit?

A

jugular foramen

95
Q

mature cranial nerves have how many motor and how many sensory columns?

A

3 motor and 3 sensory

96
Q

where do olfactory nerves synapse?

A

olfactory bulb and carry information via olfactory tract

97
Q

what is anosmia? what can cause this condition?

A

(1) olfactory loss of smell

2) damage to olfactory nerve; secondary to head trauma, infection, PD, Az, intracranial lesions (tumors

98
Q

where is the nucleus of CNs 3 and 4 located?

A

midbrain

99
Q

where is the nucleus of CN 6 located?

A

pons

100
Q

what is trigeminal neuralgia (AKA tix douloureux)?

A

(1) trigeminal nerve dysfunction; brief severe pain provoked by chewing, shaving
(2) unknown cause; can occur in MS patients

101
Q

an UMN lesion to the facial nerve results in what?

A

weakness of the lower part of the face, but the forehead is spared (may have UE weakness and other deficits)

102
Q

a LMN lesion to the facial nerve results in what?

A

unilateral weakness from top to bottom (localized)

103
Q

what is LMN weakness of the facial nerve known as?

A

Bell’s Palsy

104
Q

what is the dividing line between the external ear and middle ear?

A

tympanic membrane

105
Q

what are the three ossicles of the middle ear?

A

(1) malleus
(2) incus
(3) stapes

106
Q

what bone attached to the tympanic membrane?

A

malleus

107
Q

what bone attaches to the oval window?

A

stapes

108
Q

what is the purpose of the tensor tympani and stapedius muscles?

A

attach to the ossicles and regulate sound energy (dampen loud sounds)

109
Q

what structures are contained within the inner ear?

A

(1) bony labyrinth
(2) membranous labyrinth
(a) cochlea (organ of corti)
(b) vestibule (saccule and utricle)
(c) semicircular canals

110
Q

what are the two main ducts of the cochlea? what are their functions?

A

(1) scala vestibuli: sound vibrations enter here from the oval window
(2) scala tympani: found at the end of the apex, spiral around and ends at round window

111
Q

the scala vestibuli and scala tympani contain what type of fluid?

A

perilymphatic fluid

112
Q

the scala media (or central duct) contains what type of fluid?

A

endolymphatic fluid

113
Q

where are higher frequency sounds managed in the ear?

A

near the oval window

114
Q

where are lower frequency sounds managed in the ear?

A

near apex of the cochlea

115
Q

the scala media is bound by what two membranes?

A

(1) basilar membrane

(2) Reissner’s membrane

116
Q

what is the function of the organ of corti?

A

receptor organ responsible for hearing (converts auditory signals into nerve impulses)

117
Q

how is information relayed to the organ of corti?

A

deflection of hair cells and vibrations of the basilar membrane are relayed to the organ of corti

118
Q

how is sound transmitted through the outer, middle, and inner ear?

A

(1) Outer ear: air pressure causes the tympanic membrane to vibrate
(2) Middle ear: this causes oscillatory movements of the stapes against the oval window
(3) Inner ear: endolymph inside the cochlea causes vibration of the basilar membrane
(4) Organ of Corti: hair cells are deflected and transmit information to CN VIII

119
Q

where do the contralateral auditory tracts project to?

A

(1) RAS to the cortex
(2) spinal cord in response to loud sounds
(3) cerebellum in response to sudden noise

120
Q

is unilateral hearing loss typically seen with a lesions in the brain?

A

no; there are decussations at multiple levels and information ascends bilaterally; a lesion of the cochlear nuclei could cause unilateral hearing loss

121
Q

what is the main blood supply to the vestibule and cochlea of the ear?

A

labyrinthine artery (usually a branch off AICA)

122
Q

the bony labyrinth of the vesibular part of the ear contains what? and what type of fluid?

A

(1) three semicircular canals
(2) vestibule
(3) perilymph

123
Q

the membranous labyrinth of the vesibular part of the ear contains what? and what type of fluid?

A

(1) three semicircular canals
(2) utricle and saccule
(3) endolymph

124
Q

what is the purpose of the semicircular canals? how are these positioned?

A 
respond to angular or rotational movement of the head
Positions
(1) R and L lateral
(2) L anterior, R posterior
(3) L posterior, R anterior
125
Q

where is the ampulla located? what structure does it contain?

A

(1) bulge at the base of the semicircular canals

(2) contains the crista ampullaris

126
Q

what plane of motion does the utricle relay information about the position of the head?

A

in response to gravity in the horizontal plane (ex. riding in a car)

127
Q

what plane of motion does the saccule relay information about the position of the head?

A

in response to gravity in the vertical plane (ex. riding in an elevator)

128
Q

what is the primary sensory structure located within the urticle and saccule?

A

macula

129
Q

what is the purpose of the hair cells found within the utricle and saccule?

A

convert displacement of head movement into neural firing

130
Q

if there is a lesion to the vermis in the cerebellum, what can occur?

A

gait ataxia and trunk instability

131
Q

if there is a lesion to the flocculus in the cerebellum, what can occur?

A

impaired ability to keep vision stable while the head is being moved (VOR)

132
Q

what are the 2 mechanisms for motor output of the vestibulochochlear nerve?

A

(1) VOR: keep vision stable while the head is being moved

(2) VSR: keep head and body stabilized

133
Q

what can cause conductive hearing loss?

A

(1) otitis

(2) tympanic membrane perforation

134
Q

what can cause sensorineural hearing loss?

A

(1) disorders of the cochlea or CN 8
(2) exposure to loud sounds
(3) Meniere’s disease
(4) tumor

135
Q

what is the gold standard test for hearing loss?

A

audiometry

136
Q

what clinical assessment is used to determine conductive hearing loss?

A

Rinne Test

137
Q

what clinical assessment is used to determine sensorineural hearing loss?

A

Weber Test

138
Q

where could a lesion be present to cause vertigo?

A

anywhere along the vestibular pathway

139
Q

what is BPPV?

A

benign paroxysmal positional vertigo

140
Q

what is vestibular neuritis? what does this condition present with?

A

(1) inflammation of the vestibular ganglia or nerve

(2) intense vertigo for days and loss of postural control from weeks to months

141
Q

what is Meninere’s Disease? what does this condition present with?

A

(1) excessive fluid and pressure in the endolympahic system

(2) recurrent episodes of vertigo accompanied by fluctuating hearing loss and tinnitus

142
Q

what is acoustic neuroma? what does this condition present with?

A

(1) vestibular schwannoma (tumor)

(2) hearing loss, tinnitus, vertigo, LOB

143
Q

how will a patient following a lesion to the hypoglossal nucleus?

A

ipsilateral weakness of the tongue (UMN lesion would present with contralateral lesion to the tongue)

144
Q

what is dysarthria? what can cause this condition?

A

(1) abnormal articulation of speech

(2) CVA, MS, brainstem lesions, lesions of cerebellar and BG pathways

145
Q

what is dysphagia? what can cause this condition?

A

(1) impaired swallowing

(2) neoplasms, esophageal strictures, neural components

146
Q

what is the main function of olfactory nerve?

A

olfaction (smell)

147
Q

what is the main function of optic nerve?

A

vision

148
Q

what is the main function of oculomotor?

A

elevate eye lid; all eye movements except abduction and downward medial rotation; constricts the pupil

149
Q

what is the function of the trochlear nerve?

A

downward medial rotation of the eye

150
Q

what is the function of the trigeminal nerve?

A

facial sensation; muscles of mastication

151
Q

what is the function of the abducens nerve?

A

abducts the eye

152
Q

what is the function of the facial nerve? (3)

A

(1) facial expression
(2) taste of anterior 2/3 of tongue
(3) mandibular and sublingual salivary glands; lacrimal gland (and others of nose and palate)

153
Q

what is the function of the vestibulocochlear nerve? (2)

A

(1) hearing

(2) position and movement sense

154
Q

what are the functions of the glossopharyngeal nerve? (3)

A

(1) swallowing
(2) parotid gland innervation
(3) taste posterior 1/3 of tongue

155
Q

what are the functions of the vagus nerve?

A

(1) parasympathetic to most organs
(2) laryngeal muscles (voice)
(3) pharyngeal muscles (swallowing)
(4) conductive system of the heart

156
Q

what is the function of the spinal accessory nerve?

A

innervates the SCOM and traps (head turning)

157
Q

what is the function of the spinal hypoglossal nerve?

A

intrinsic and extrinsic muscles of tongue

158
Q

what does the edinger westphal nucleus control?

A

parasympathetic nucleus of CN 3; causes pupil constriction

159
Q

what might a patient present with following a lesion to the oculomotor nerve? (4)

A

(1) eye deviation laterally
(2) diplopia
(3) ptosis
(4) impaired pupillary light and accommodation reflexes

160
Q

what might a patient present with following a lesion to the trochlear nerve?

A

difficulty moving eye downward and laterally

161
Q

what might a patient present with following a lesion to the abducens nerve?

A

(1) difficulty turning eye outward
(2) medial strabismus
(3) diplopia

162
Q

what are long tracts in the brain stem?

A

the long motor and sensory tracts

163
Q

what is the periaqueductal gray area of the midbrain responsible for? what tract is this a part of?

A

pain modulation (via spinothalmic tract)

164
Q

what is the reticular formation responsible for? what tract is this a part of?

A

conciousness, sleep / wake cycles (via reticulospinal tract)

165
Q

what is the substantia nigra responsible for?

A

creates dopamine in the BG

166
Q

what is the function of the rostral reticular formation?

A

alertness, consciousness, and arousal

167
Q

what is the function of the caudal reticular formation?

A

reflexes, motor, and autonomic functions (respiration and circulatory control)

168
Q

what systems are involved with consciousness? (4)

A

(1) sensory
(2) motor
(3) memory
(4) emotional

169
Q

regarding the subcortical arousal system, what neurotransmitters are used in the upper brain stem neurons? where do their neurons project?

A

(1) norepinephrine
(2) serotonin
(3) dopamine
Projects to:
-cortical and subcortical forebrain

170
Q

regarding the subcortical arousal system, what neurotransmitters are used in pontomesencephalic reticular formation neurons? where do their neurons project?

A

(1) acetylcholine
(2) glutamate
Projects to:
-thalamus, hypothalamus, basal forebrain

171
Q

regarding the subcortical arousal system, what neurotransmitters are used in posterior hypothalamic neurons? where do their neurons project?

A

(1) histamine
(2) orexin
Projects to:
-cortical and subcortical targets

172
Q

regarding the subcortical arousal system, what neurotransmitters are used in the basal forebrain neurons? where do their neurons project?

A

(1) acetylcholine
Projects to:
-cerebral cortex

173
Q

regarding the subcortical arousal system, what neurotransmitters are used in the rostral thalamic intralaminar nuclei and medial thalamic nuclei? where do their neurons project?

A

(1) glutamate
Projects to:
-cerebral cortex

174
Q

damage to what areas of the brain often results in a coma? (2)

A

(1) upper brain stem

(2) widespread, bilateral damage to the cortex

175
Q

what are the first 4 stages of sleep considered? what neurotransmitters control these phases of sleep?

A

(1) nonREM sleep

(2) neurons of the raphe nuclei release serotonin

176
Q

what are the 5th stage of sleep considered? what neurotransmitters control these phases of sleep?

A

(1) REM sleep

(2) neurons of the locus cereleus release norepinephrine

177
Q

damage to what areas of the brain often results in death?

A

lower brain stem

178
Q

what nucleus is responsible for respiration and circulatory control? where is it located?

A

nucleus soltarius of the medulla

179
Q

where in the brain is responsible for autonomic respiratory control? what about voluntary respiratory control?

A

(1) autonomic: medulla

(2) voluntary: forebrain

Clinical Neuroscience (4 decks)

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