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(PA school) Neuroanatomy > Highlights Chapters 14-15 > Flashcards

Highlights Chapters 14-15 Flashcards

1
Q

What are the 4 main groups of things found in the brainstem?

A

1) Cranial nerve nuclei and related structures
2) Long tracts
3) Cerebellar circuitry
4) Reticular formation and related structures

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2
Q

1) Descending sympathetic pathway runs through what?
2) What does damage to this cause?

A

1) Runs through lateral brainstem
2) Horner’s Syndrome

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3
Q

In Locked-In-Syndrome:
1) Motor function is ________
2) Sensation and cognition are ________
3) What two tracts are affected?

A

1) Absent
2) Intact
3) Corticospinal and corticobulbar

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4
Q

True or false: Locked-In-Syndrome is a type of coma

A

False; they’re different

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5
Q

1) What is the end goal of the rostral end of the reticular formation?
2) What is the end goal of the caudal end of the reticular formation?

A

1) The rostral end functions to maintain an alert conscious state.
2) Carry out motor reflex and autonomic functions

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6
Q

List and define the 3 processes that control the levels of consciousness

A

1) Alertness: normal functioning of the brainstem and arousal circuits
2) Attention: same circuits as above plus the frontoparietal association cortex
3) Awareness: a combination of multiple higher order systems from different regions of the brain into a summary of mental activity that can be remembered at a later time

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7
Q

What activates the 5 arousal systems that maintain normal consciousness?

A

Reticular formation and related structures that receive input from sensory pathways

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8
Q

Numerous regions of the ___________ project to the reticular formation so that _______________________ can lead to an increased level of alertness through this system.

A

association cortex; cognitive processes and emotions

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9
Q

1) Is glutamate excitatory or inhibitory?
2) What does GABA promote?

A

1) Excitatory
2) Deep sleep

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10
Q

1) What NT causes muscle contraction?
2) What disorder involves this NT?

A

1) Acetylcholine
2) Myasthenia gravis

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11
Q

What does dopamine cause and act on?

A

Causes feelings or pleasure, satisfaction and motivation. Works on reward center.

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12
Q

What is an NT used in sympathetic response?

A

Norepinephrine

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13
Q

What NT functions in attention?

A

Norepinephrine

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14
Q

Which NT is sometimes referred to as the “feel good” chemical?

A

Serotonin

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15
Q

What is histamine used to regulate?

A

Alertness and wakefulness

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16
Q

Most histamine in the body is found outside of the CNS in __________ playing a role in _______________________________

A

mast cells; immune responses and allergic reactions

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17
Q

1) Histamine outside the CNS is found where?
2) What does it play a role in here?

A

1) In mast cells
2) Immune responses and allergic reactions

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18
Q

1) Unarousable, unconsciousness with closed eyes has to last how long to be considered a coma?
2) What is it a dysfunction of?

A

1) > 1 hour
2) Upper brainstem reticular formation

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19
Q

If the __________________ is spared, consciousness is typically spared

A

reticular formation

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20
Q

What is a very important thing to include in an exam of a patient in a coma?

A

Check their pupils

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21
Q

Define dissociative state. What neurologically is wrong?

A

Non-responsiveness (but not unconscious) from severe emotional trauma, neuro exam is normal

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22
Q

Patients with Akinetic Mutism, Catatonia display what?

A

Profound deficits in response to initiation

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23
Q

Define brain death

A

Based on clinical exam: no evidence of forebrain or brainstem function; no sleep-wake cycles

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24
Q

What does the Pre-Botzinger Complex of the medulla do?

A

Pacemaker for respirations

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25
Q

What do the Phrenic nerve efferents do?

A

Control diaphragm during inspiration

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26
Q

What can lesions in the medulla lead to?

A

Respiratory arrest and death

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27
Q

1) Where is the nucleus solitarius?
2) What is it? Where does it get input from?

A

1) In the medulla
2) Cardiorespiratory nucleus (controls heart rate and BP); receives inputs from baroreceptors in carotid body and aortic arch via CNs 9 and 10

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28
Q

What type of lesions typically cause uncoordinated movements called ataxia?

A

Cerebellar

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29
Q

What do the inferior vermis and flocculonodular lobes of the cerebellum do?

A

1) Regulate balance (proximal trunk muscle control)
2) Interact with vestibular circuitry (vestibulo-ocular control)

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30
Q

What do the anterior lobes of the cerebellum do?

A

Responsible for proprioception

31
Q

What do the intermediate cerebellar regions do?

A

Control distal limbs

32
Q

What do the lateral cerebellar hemispheres do?

A

Motor planning of distal extremities

33
Q

Deficits in coordination occur ___________ to the lesions of the cerebellum

A

ipsilateral

34
Q

What do medial cerebellar lesions do?

A

Affect the trunk muscles bilaterally

35
Q

The cerebellum is attached to the ____________ and ________________ by 3 ________________.

A

dorsal pons and rostral medulla; peduncles

36
Q

Name 2 things vermis or flocculonodular cerebellar lobe lesions affect

A

1) Unsteady gait
2) Trunk control

37
Q

Where are the cerebellar tonsils found?

A

Inferior surface

38
Q

What connect the cerebellum to the brainstem?

A

The peduncles: superior, middle and inferior

39
Q

What are the conditions for something to be a coma

A

1) Unarousable (even with sternum rub, smelling salts, etc)
2) Unconsciousness with closed eyes
3) For greater than 1 hour

40
Q

What 3 things should you give via IV to a patient in a coma?

A

Thiamine, glucose and naloxone

41
Q

Melatonin is produced by what? In what pattern?

A

Pineal gland; circadian pattern

42
Q

What condition does a patient appear fully awake, but not respond?

A

Akinetic Mutism, Catatonia

43
Q

What state is caused by emotional trauma and accompanies a normal neuro exam?

A

Dissociative

44
Q

What is required to declare brain death?

A

Clinical exam

45
Q

What type of unconscious state involves sleep-wake cycles and other responses or reflexes?

A

Vegetative state

46
Q

Aneurysm of posterior communicating artery can cause what?

A

CNIII palsy

47
Q

During the pupillary light reflex, after the fibers synapse at the superior colliculus, where do they go? What does this contain?

A

Edinger–Westphal nuclei; contain preganglionic parasympathetic neurons

48
Q

Where is the Pre-Botzinger Complex?

A

In the medulla

49
Q

1) Heart rate and BP are controlled by what?
2) What does this place receive input from?

A

1) Nucleus solitarius (of medulla)
2) Baroreceptors in carotid body and Aortic arch (via CNs 9 and 10)

50
Q

What controls the proximal trunk?

A

Vermis

51
Q

1) What part of the cerebellum does proprioception?
2) What does motor planning of distal extremities?

A

1) Anterior lobes
2) Lateral cerebellar hemispheres

52
Q

Name 1 thing in the medulla

A

Respiratory pacemaker

53
Q

True or false: the 4th ventricle is found in the brainstem

A

False; stops at the brainstem

54
Q

What is the role of the reticular formation?

A

Coordinating vital functions

55
Q

What 3 nerves play a role in mediating vestibulo-ocular reflexes?

A

CNs 3,4, and 6

56
Q

Damage to the descending sympathetic pathway that runs through the lateral brainstem can cause what symptoms?

A

Ptosis, miosis, anhidrosis

57
Q

What is formed by the fronto-parietal association cortex with the arousal circuits in the upper brainstem?

A

Consciousness system

58
Q

Which condition causes an autoimmune antibody block of acetylcholine receptors on skeletal muscle?

A

Myasthenia gravis

59
Q

Having too much of what neurotransmitter would be a finding in schizophrenia?

A

Dopamine

60
Q

Having too little of what neurotransmitter would cause depression, inattentive/ ADD?

A

Norepinephrine

61
Q

What area of the brainstem is thought to contain sleep promoting regions?

A

Medulla’s Reticular formation

62
Q

Upper brainstem reticular formation dysfunction can cause what?

A

Coma

63
Q

Akinetic Mutism/catatonia may improve a deficit in response to initiation by what?

A

Dopamine agonist

64
Q

How does a vegetative state differentiate from brain death?

A

1) Can have sleep wake cycles
2) Possible brainstem reflexes
3) May make sounds

65
Q

An aneurysm of the posterior communicating artery most commonly causes what?

A

CN 3 palsy

66
Q

Where are preganglionic parasympathetic neurons of the optic tract located?

A

Edinger-Westphal nuclei

67
Q

A patient who is in what kind of coma would have small but light responsive pupils bilaterally?

A

Pontine lesion

68
Q

Which area of the brainstem is involved in controlling heart rate and BP and receives inputs from baroreceptors in the carotid body and aortic arch via CN IX and X?

A

Nucleus solitarius

69
Q

What gives rise to many branches that supply the brainstem and cerebellum?

A

Vertebrobasilar system

70
Q

What is the most medial functional portion of the cerebellum called?

A

Vermis

71
Q

What area of the cerebellum is responsible for regulating balance and vestibulo-ocular control?

A

Inferior vermis and flocculonodular nodes

72
Q

1) What function is the anterior lobes of the cerebellum responsible for?
2) What function is the intermediate cerebellar region of the cerebellum responsible for?
3) What function is the lateral cerebellar hemispheres of the cerebellum responsible for?

A

1) Proprioception
2) Control of distal limbs
3) Motor planning of distal extremities

73
Q

1) Deficits in coordination occur _______ to cerebellar lesions, while medial lesions affect the trunk muscles __________.
2) A lesion where would cause unsteady gait, trunk control, posture, and balance?

A

1) Ipsilaterally, bilaterally
2) Vermis/Flocculonodular nodes

74
Q
A

(PA school) Neuroanatomy (22 decks)

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