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Spring Semester 2014 > Med Neuro > Flashcards

Med Neuro Flashcards

1
Q

What does the anterior choroidal artery supply? (2)

A
  1. Choroid plexus

2. Hippocampus

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2
Q

What does the ACA supply?

A
  1. Anterior frontal lobe
  2. Medial aspect of the hemisphere
  3. Medial cortex - medial aspect of motor/sensory strip
  4. Basal ganglia
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3
Q

What main branch does the MCA give off and what does it supply?

A
  1. Lenticulostriate

2. Basal ganglia, internal capsule, and thalamus

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4
Q

What fissure does the MCA run through?

A

The lateral fissure of Sylvius

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5
Q

What does the MCA supply

A

Many deep and lateral structures of cerebrum

  1. Speech and language
  2. Swallowing
  3. Lateral motor and sensory strip
  4. Broca’s and Wernicke’s area
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6
Q

What does the anterior spinal artery supply?

A
  1. Medial medulla (medullary pyramids)

2. Anterior 2/3 of cervical spinal cord

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7
Q

What does the basilar artery supply? (3)

A
  1. Thalamus
  2. Midbrain
  3. Pons
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8
Q

What does the PCA supply?

A
  1. Occipital lobe
  2. Choroid plexus of 3rd and lateral v.
  3. Lower surface of temporal lobe
  4. Midbrain
  5. Thalamus
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9
Q

What else does the posterior inferior cerebellar supply?

A
  1. Cerebellum and

2. Lateral rostral medulla

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10
Q

What does a stroke in the PCA look like?

A
  1. Sense of smell
  2. Cranial nerve damage
  3. Visual problems
  4. Visual agnosia, hemianopsia and alexia
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11
Q

What does AICA supply?

A
  1. Inferior cerebellum

2. Lateral caudal pons

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12
Q

What does the superior cerebellar supply?

A
  1. Superior cerebellum
  2. Parts of midbrain
  3. Lateral pons
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13
Q

What do the internal auditory/labyrinthine arteries supply?

A

Inner ear

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14
Q

Where does the pericollosal artery run?

A

Curves across the corpus collosum in the collosal sulcus

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15
Q

Where does the collosamarginal artery run?

A

Follows the cingulate sulcus

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16
Q

What are two branches of the ACA?

A
  1. Pericollosal

2. Collosamarginal

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17
Q

What do the posterior communicating arteries supply?

A
  1. Optic chiasm
  2. Thalamus
  3. Parahippocampal gyrus
  4. Interpenduncular region
  5. Crus cerebri
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18
Q

Peripheral nerve regeneration requires _________.

A

Laminin

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19
Q

Schwann Cell growth promoting factors (3)

A
  1. Laminin
  2. NgCAM/L1 - cell adhesion
  3. NGF - maybe
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20
Q

Oligodendrocyte axonal inhibitors (4)

A
  1. Central myelin
  2. MAG
  3. NI-35
  4. Nogo gene & proteins
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21
Q

Ependymal cells have _____________, not tight junctions.

A

Desmosomes

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22
Q

Both Schwann cells and oligodendrocytes have ______ and ______, while only oligodendrocytes have _______.

A
  1. MBP
  2. MAG
  3. MOG
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23
Q

MBP is a major structural protein of CNS and PNS, located on the cytoplasmic face of myelin membrane or the _______________.

A

Major dense line

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24
Q

______ is a CNS autoimmune disease target - experimental allergic encephalomyelitis.

A

MBP

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25
____ is on the surface of oligodendrocytes and is a target antigen in autoimmune aspect of CNS demyelinating diseases.
MOG
26
PNS nodes are ________, and CNS nodes are ________.
1. Covered by schwann cell cytoplasm | 2. Bare
27
At the nodes of Ranvier the _____________ is exposed to the extracellular environment.
Axolemma
28
Axon branching (collaterals) occur at ________________.
Nodes of Ranvier
29
Clefts of incisures are split between _________________.
Major dense lines
30
Dendrites experience both ___________ and __________ summation.
1. Temporal | 2. Spatial
31
Summation and length constant are __________ properties of neurons.
Passive (cable)
32
Length constant
The distance over which the potential falls by 63% of its original value
33
Active (Action Potential) properties of neurons
1. Threshold 2. All or none 3. Latency 4. Refractory Period 5. Propagation
34
Latency
Time form onset of initial depolarization to the onset of action potnetial
35
Threshold
Reaching it causes majority of Na channels to open - more Na open - larger depol
36
Absolute refractory period
No AP - due to "inactive" Na channles
37
Relative refractory period
AP can be generated - but difficult - need more stimulus
38
AP propagation is _____________.
Unidirectional
39
Speed of propagation is determined by the ________________.
Length constant
40
The length constant can be increased by (2)
1. Increasing the diameter of the neuron - reduce longitudinal resistance 2. Myelination - Increasing the resistance of the axonal membrane
41
Hyperkalemic periodic paralysis
Cells are depolarized - can't fire AP
42
What causes hyperkalemic periodic paralysis?
Mutation of voltage gated Na - can't open or close - stuck as "inactive"
43
What does TTX (pufferfish) block?
Na channels of peripheral nerves
44
Active zones are a _______________ specialization.
Pre-synaptic
45
5 characteristics of Grey's Type 1 Synapse
1. Asymmetric 2. Round 3. Wide cleft 4. Prominent PSD 5. Excitatory
46
5 characteristics of Grey's Type 2 Synapse
1. Symmetric 2. Flat 3. Narrow cleft 4. Less prominent PSD 5. Inhibitory
47
3 characteristics of monoaminergic synpases
1. Dense-core vesicles 2. Axonal varicosities 3. Wide clefts and no PSDs
48
Peptidergic Synapse characteristic
1. Large dense-core vesicles
49
Myasthenia Gravis
Autoimmune - destroys ACh receptors (nicotinic)
50
How do you treat myasthenia gravis
AChE inhibitors
51
Approach
1. Synthesis of NT, channel proteins, and vesicles delivered to presyn. site 2. AP propagated
52
Attach
1. Dephos'd synapsin 1 anchors vesicles to cytoskel 2. Phos'd synapsin 1 releases vesicles from cytoskel 3. RAB 3A helps propel vesicles to active zone
53
Docking
1. NSF (ATPase), SNAP and SNAREs help with vesicle membrane and presyn membrane interaction 2. v-SNAREs bind to t-SNAREs - mediates fusion of vesicular membrane
54
Fusion
1. Ca dependent | 2. Ca binds to synpatotagmin on the vesicle membrane to trigger rapid fusion
55
Fusion is ____ dependent
Ca
56
Fission (Opening)
1. Nt released by exocytosis | 2. Diffuse across cleft
57
What triggers rapid fusion
Ca binding to synptotagmin
58
Collapse and Retrieval
1. Postsyn cell response w/ slow graded potentials/AP | 2. termination of NT action by diffusion, AChE, negative feedback, reuptake
59
4 ways NT action is terminated
1. Diffusion 2. AChE 3. Negative feedback 4. Reuptake
60
Properties of chemical transmission (5)
1. Amplification 2. Plasticity 3. Diversity (plurichem, chemical coding) 4. Neuromodulation (neuropeptides) 5. Synaptic delay
61
Steps in NO/CO transmission
1. Activation of nNOS with Ca/calmodulin and NADPH 2. NO binds heme in guanylate cyclase 3. cGMP made 4. Altered gating of ion channels in postsyn 5. Inactivation/removal of NO (spontaneous)
62
Does glutamate cross the BBB?
No
63
How is glutamate synthesized?
1. Major - recycled from Gln in astrocytes using glutamate/glutamine synthase and glutaminase 2. Minor - de novo from α-KG via GluDH
64
How is Glu stored?
In vesicles via active transport via VGluT
65
How is Glu released
Increase in intracellular Ca
66
What inhibits Glu release?
Autoreceptors that inhibit release or reduce synthesis
67
How is Glu inactivated?
High expression of receptors in astrocytes | Co-transport of Na - 2˚ active transport
68
What are the 4 types Glu receptors?
1. AMPA - conducts Na opens and closes quickly 2. Kainate - conducts Na 3. NMDA - conducts Ca - needs glycine cofactor - opens and closes slowly 4. mGluR
69
NMDA is a ________________ channel
High conductance
70
NMDA receptors play a role in (2)
1. Long term potentiation | 2. Memory formation and synaptic plasticity
71
Long term potentiation needs
1. Ca | 2. NMDA
72
NMDA is almost always found with _____.
AMPA
73
Overactive glutaminergic systems occur when _______________ and lead to __________.
1. Brain deprived of O2 or glucose | 2. Hyperexcitability (can't keep Glu low) - seizures
74
What are two examples of overactive glutaminergic disease
1. Huntingtons | 2. Amyotrophic lateral sclerosis (ALS)
75
What does receptor does 2-AG bind?
Cannabinoid: CB1
76
Where is 2-AG found?
1. Cerebellum 2. Hippocampus 3. Amygdala 4. Limbic cortex
77
How is 2-AG synthesized?
1. Phospholipase C: PIP2 -> DAG and IP3 | 2. DAG lipase: DAG -> 2-AG (~40%)
78
How and where is 2-AG synthesized?
It is made on demand on the postsynaptic side
79
What is the regulated step in 2-AG synthesis?
DAP lipase - requires PLC & increase in intracellular Ca
80
How is 2-AG inactivated?
Monoacylglycerol lipase: glycerol and arachadonic acid
81
What type of a receptor is CB1and where is it found?
GPCR - on the presynaptic nerve terminal
82
What is CB1's mechanism of action?
Inhibits opening of voltage operated Ca channels - inhibits NT release
83
What are 2-AG's effets
Fat, dumb and happy; calm, cool, and collected
84
2-AG is activated by _________ and is also turned on by ____________.
1. Glutamate (modulate) | 2. Stress
85
What is the lifetime prevalence of major depression?
15%
86
What are risk factors of major depression? (4)
1. 2x more common in women 2. Family hx 3. Mean age - 40 4. Inc. risk after significant relationship loss
87
What is the recurrence risk of MDD?
1/3 - never 1/3 - spaced out 1/3 - frequent
88
How long does an episode last?
Untreated: 6-12 months Treated: ~ 2months
89
What are symptoms of major depression? (8)
1. Change in sleep/appetite 2. Decrease energy 3. Suicidal 4. Anhedonia 5. Decreased concentration/memory 6. Feeling worthless, helpless, excessive guilt 7. Irritability/tearfulness 8. Psychosis?
90
To be considered major depression a patient must exhibit ________________.
5 or more symptoms for 2+ weeks
91
What else is on a differential for major depression?
1. Bipolar 2. Dysthymia - chronic, personality related 3. Grief 4. Substance abuse - chronic cocaine depletes catecholamines 5. Hypothyroidism or adrenal disorder 6. Stimulant withdrawal 7. Congestive Heart Failure 8. Parkinsons, HIV
92
What can depression be misdiagnosed as?
Alzheimer's or dementia
93
What is the suicide risk in patients with MDD?
10-15%
94
How do you treat MDD?
SSRI, SNRI, tricyclics, MAOIs
95
How is serotonin synthesized?
1. Trp-hydroxylase: Trp -> 5-hydroxyTrp | 2. Amino acid decarb: 5-hydroxyTrp -> Serotonin (5-HT)
96
How is serotonin broken down?
1. Monoamine oxidase | 2. Aldehyde DH
97
How do SSRI's function?
Block reuptake of serotonin
98
What clinical observation implies there is a 2˚ mechanism to SSRI and MAOI action?
There is a 2-8 week delay
99
What is the lifetime prevalence of schizophrenia?
1-2%
100
When do females and males tend to present with it?
Females: early 20's Males: late adolescence
101
What are symptoms of schizophrenia? (8)
1. Delusions 2. Paranoia 3. Hallucinations 4. Disorganized thought process 5. Blunted affect 6. Social isolation 7. Lack of motivation 8. Anhedonia
102
What doe you need to be considered with schizophrenia?
1. 2 or more of the 5 major categories of systems for a couple weeks
103
What will a person with schizophrenia experience throughout their life/
1. Recurrent psychotic exacerbations 2. Negative symptoms 3. 10% suicide risk
104
What is on your differential with schizophrenia? (6)
1. Bipolar mania - more grandiosity in delusions 2. Substance induced 3. Depressive - morbid psychotic episodes 4. Schizoidal PD - hermits - not psychotic 5. Schizotypal PD - atypical thinking, not quite psychotic 6. Delirium - seen w/ dementia, hospitalized patients
105
What is the dopamine theory for schizophrenia?
1. Too much in mesolimbic area | 2. Too little in mesocortical/prefrontal
106
How do you treat schizophrenia?
D2 blockers - treats psychotic - worsens negative symptoms | Atypical: D2/4 blockers, 5-HT blockers
107
What are risk factors for schizophrenia?
Genetic - identical twin - 66% chance
108
A watershed area of an artery is _______________.
An area where the vascular beds of two arteries overlap
109
What does hemisection of the spinal cord lead to?
1. Loss of fine touch, vibration, and propioception ipsilateral to/below lesion 2. Loss of pain and temp contra/below lesion 3. Spastic paralysis ipsi/below lesion
110
Ventral root lesions result in (3)
1. Weakness, 2. Flaccid paralysis 3. Atrophy - possible autonomic dysfunction
111
Dorsal root lesions result in _______________.
Hypothesia or anesthesia
112
If a lesion hits the posterior funiculus what is the result?
Ipsilateral loss of fine touch, proprioception and vibration
113
If a lesion hits the lateral corticospinal tract what is the result?
Spastic ipsilateral paralysis
114
If a lesion hits the spinothalamic tract what is the result?
Contralateral loss of pain, temp and crude touch

Spring Semester 2014 (6 decks)

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