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Spring Semester 2014 > Med Neuro Block IV > Flashcards

Med Neuro Block IV Flashcards

1
Q

What are the 5 major subdivisions of the diencephaon

A
  1. Dorsal thalamus
  2. Hypothalamus
  3. Epithalamus
  4. Ventral thalamus
  5. Subthalamus
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2
Q

The thalamus receives direct input from which structures?

A
  1. Cerebral cortex
  2. Cerebellum
  3. Brainstem
  4. Spinal cord
  5. Basal Ganglia
  6. Sensory input from muscles
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3
Q

The epithalamus is made up of which 3 components?

A
  1. Habenular nuclear complex
  2. Pineal gland
  3. Posterior commissure
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4
Q

The dorsal thalamus is made up of which 3 components?

A
  1. Thalamic nuclei
  2. External medullary lamina
  3. Internal medullary lamina
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5
Q

The ventral thalamus is made up of which 2 components?

A
  1. Reticular nucleus of thalamus

2. Ventral lateral geniculate nucleus

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6
Q

The subthalamus is made up of which 2 components?

A
  1. Zona incerta

2. Subthalamic nucleus (Luys)

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7
Q

The hypothalamus is made up of which 2 components?

A
  1. Hypothalamic nuclei
  2. Infundibulum
  3. Hypophysis (pituitary)
  4. Hypophyseal portal system
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8
Q

What arteries supply the thalamus?

A
  1. Anterior communicating artery
  2. Posterior communicating artery
  3. ACA
  4. PCA
  5. ICA
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9
Q

What info does the thalamus relay to the cortex?

A
  1. Sensory - not olfaction
  2. Motor info
  3. Emotional/affective info
  4. Integrated sensory info to association cortex
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10
Q

What nuclei relays info from the mamillary body to the cingulate gyrus?

A

Anterior nuclear group - Limbic

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11
Q

What thalamic nuclei are associated with motor function?

A

VA and VL

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12
Q

Which thalamic nuclei are associated with sensation of the body and face?

A

VPL and VPM

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13
Q

Which thalamic nuclei are associated with the vision and audition?

A

LGN and MGN

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14
Q

What thalamic nuclei are associated with emotional expression and sensory integration?

A

LD, LP and Pulvinar

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15
Q

Which thalamic nuclei is associated with limbic functions?

A

MD

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16
Q

What functions are the midline nuclei associated with?

A

Limbic

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17
Q

What functions are the intralaminar nuclei (CM) associated with?

A

Pain, sleep and wakefulness - projects to wide area of cortex

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18
Q

What functions are the reticular nuclei associated with?

A

Modulation of thalamic activity

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19
Q

Which nuclei are considered “diffuse-projection nuclei”?

A
  1. Midline nuclei
  2. Intralaminar nuclei
  3. Reticular nuceli
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20
Q

The diffuse projection nuclei are apart of the __________ system and function to ______________.

A
  1. reticular formation

2. keep you awake/in a state of attention

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21
Q

The thalamic interneuron receives input from __________ and projects to the thalamic relay neuron to _________.

A
  1. Afferents going to the thalamus

2. Modify the signal before passing it on to the cerebral cortex

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22
Q

Thalamic syndrome is usually caused by ______________ and involves damage to the __________.

A
  1. Vascular lesion/tumor

2. Lateral group of thalamic nuclei (VPL)

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23
Q

What are the symptoms of thalamic syndrome (rare)?

A
  1. Initial transitory contra. hemianalgesia
  2. Painful sensation w/ noxious stimuli
  3. Later: Pain provoked by pressure, touch, and vibration
  4. Spontaneous, constant, or paroxysmal pain evoked on affected (contra) side w/o external stimulus
    - Threshold for pain/temp/tactile is raised, once reached has a strong emotional overtone
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24
Q

The reticular activating system is activated by _________________. This evokes cortical recruitment response that waxes and wanes, ultimately _____________________.

A
  1. Repetitive low-freq. stimulation

2. Controls level of excitability of neurons over wide areas of cortex

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25
The cerebral cortex only receives input from ____________.
The thalamus
26
The cerebral cortex projects to which 5 structures?
1. Thalamus 2. Basal ganglia 3. Brainstem 4. Spinal cord 5. Cerebellum - via the pons
27
The cerebral cortex is derived embryologically from ___________.
The telencephalon
28
Archicortex is composed of _____ layers, while the neocortex has ___.
3 | 6
29
What are the layers of the neocortex from superficial to deep?
1. Molecular 2. External granule layer 3. Ext. pyramidal layer 4. Int. granular layer 5. Int. pyramidal layer 6. Multiform layer
30
What are the 2 major cell types in the cortex?
1. Pyramidal cells - axons exit from cortex | 2. Non-pyramidal cells - lots of variety, most GABAnergic
31
Functional units of the cerebral cortex are ________, which are interconnected within the same hemisphere as well as _________________.
1. Vertical columns | 2. Contra hemispheres
32
The primary somatosensory cortex is composed of which Brodmann areas?
Areas 3, 1, and 2
33
The primary motor cortex is composed of which Brodmann area?
Area 4
34
The primary visual cortex is composed of which Brodmann area?
Area 17
35
The primary auditory cortex is composed of which Brodmann areas?
Area 41 and 42
36
Broca's area or the motor area of speech is composed of which Brodmann areas?
Area 44 and 45
37
The frontal eye field corresponds to which Brodmann area?
Area 8
38
Lesion of the supramarginal gyrus (Area 40) can lead to ___________________.
Astereognosis
39
Lesion of the angular gyrus (area 39) can lead to ________________.
Aphasia; alexia and agraphia
40
Lesion of the supramarginal or angular gyrus on the non-dominant side can lead to ____________.
Hemi-neglect
41
The secondary visual cortex corresponds to which Brodmann Area?
Area 18
42
Wernicke's area corresponds to which Brodmann area?
Area 22
43
A lesion of area 22 will present as what type of lesion?
Sensory aphasia, difficulty comprehending language
44
What 3 areas make up the lateral zone of the hypothalamus?
1. Lateral preoptic nucleus 2. Lateral hypothalamic area 3. Tuberomammillary nucleus
45
What is the lateral hypothalamic area main function?
Induce eating/regulation of feeding
46
What is the function of the tuberomammillary nucleus?
Synthesizes histamine - mediates attention/arousal - quiet before sleep
47
What is the function of the medial preoptic nucleus?
Regulates gonadotropin release from ant. pituitary - sexually dimorphic
48
The anterior region of the middle zone contains what nuclei?
1. Suprachiasmatic nucleus - circadian rhythms 2. Ant. hypothalamic nucleus - warmth 3. Paraventricular nucleus 4. Supraoptic nucleus - syn vasopressin or oxytocin
49
The paraventricular nucleus contains what two neurons?
Magnocellular: vasopressin/oxytocin Parvocellular: Corticotropin releasing hormone
50
The paraventricular nucleus also contains ________________ which activates the sympathetic arm of the ANS.
Hypothalmalspinal tract
51
The middle or tuberal region of the medial zone contains which 3 nuclei?
1. Dorsomedial nucleus - BP regulation 2. Ventromedial nucleus: blocks feeding - contra to lateral hypothalamic area 3. Arcuate nucleus - Release NT into portal vasc., plays a role in feeding
52
The posterior or mammillary region of the middle zone contains what 2 structures?
1. Posterior nucleus - cold | 2. Mammillary body - receives input from hippocampus, learning & memory
53
What is the most medial zone of the hypothalamus?
Periventricular zone - periventricular nucleus - overlaps w/ other nuclei
54
Fornix
Output of hippocampus to mammillary bodies - Memory & Learning
55
Mammillothalamic tract
Connects mammillary body to thalamus (ant. nucleus) | Lesions ￫ affective disorders
56
The ________________ divides the medial and lateral zone nuclei.
Mammillothalamic tract
57
Stria Terminalis
Connects amygdala with medial hypothalamus
58
Medial forebrain bundle
BS ￫ lateral hypothalamic forebrain | **very complicated
59
Supraopticohypophyseal tract
Connects magnocellular neurons (vaso/oxy) to post. pituitary
60
Tuberoinfundibular tract
Release of ant. pituitary hormones
61
Hypothalamospinal tract
Projects from paraventricular nucleus of hypothalamus to origin of sympathetic arm of ANS
62
What are the main functions of the hypothalamus?
1. Body temp regulation 2. Stress responsiveness 3. Feeding/energy metabolism 4. BP and electrolyte composition 5. Reproductive fx
63
Bilateral destruction of ant. nuclei leads to ___________.
Hyperthermia
64
Bilateral destruction of post. nuclei leads to ______________.
Inability to regulate temp at all - axons from warm sensing nuclei course thru the post. nucleus on their way to the SC
65
Paraventricular nucleus is the center for stress integration. It will _________________ via the hypothalamalspinal tract, and causes the release of _______.
1. Activates the SNS | 2. ACTH
66
The paraventricular nucleus is under the control of ____________.
The limbic system
67
Leptin
Inhbits food intake by stimulating neuron in the arcuate nucleus
68
Grelin
Stimulates feeding, released by stomach stimulates neurons in arcuate nucleus
69
PYY
Inhibits feeding - inhibits neurons in arcuate nucleus
70
Craniopharyngioma
Congential tumor from remnants of Rathke's pouch - bitemporal hemianopia and hypothalamic syndrome
71
Hypothalamic syndrome
Adiposity, diabetes insipidus, temp regulation disturbances, and somnolence
72
Posterior hypothalamic lesions involving the mammillary complex are associated with _______________.
The inability to form new memories for context and time specific events
73
Korsakoff Syndrome
Thiamine deficiency associated w/ chronic alcoholism
74
Klein-Levin Syndrome
Hypothalamic lesion in adolescent males - episodic compulsive eating, hypersomnolence, hyperseuxlaity Due to dec. in dopaminergic tone
75
The Edinger-Westphal nucleus from _____, synapses at the ________ ganglion before innervating _______________.
1. CNIII 2. Ciliary 3. Sphincter pupillae
76
The Superior Salivary nucleus from _____, synapses at the ________ ganglion before innervating _______________.
1. CN VII 2. Submandibular ￫ Submand. gland 3. Pterygopalatine ￫ Lacrimal gland
77
The Inferior Salivary nucleus from _____, synapses at the ________ ganglion before innervating _______________.
1. CNIX 2. Otic ganglion 3. Parotid gland
78
The Dorsal Motor nucleus from _____ travels to innervate the _________________________.
1. CNX | 2. Heart, bronchi, GI, kidney, etc
79
Which nerves control micturition and what muscle do they innervate?
1. S2-S4 | 2. Detrussor m.
80
Which autonomic nerves control urine storage and muscle do they innervate?
1. T11 - L1 - lumbar splanchnic nerves | 2. Internal urethral sphincter
81
Which nerves regulate somatic control of urination and what muscle do they innervate?
1. S2-S4 - pudendal | 2. External urethral sphincter
82
Vasovagal Syncope
Inappropriate peripheral vasodialtion and bradycardia | Muscle weakness, warm sensation, nausea, sweating
83
Baroreceptor Reflex afferent limb
Stretch receptor in carotid sinus (IX) and aortic arch (X)
84
Baroreceptor Reflex efferent limb
PS axons of CNX ￫ cardio inhibitory response | SYMP: interomedial cell column of spinal cord ￫ cardiostim/pressor
85
Does the baroreceptor reflex have any CNS processing?
Yes, the nucleus solitaries
86
Horners Syndrome
Ptosis, anhydrosis, miosis, and enophthalmos -- Loss of sympathetic innervation
87
Causes of Horner's Syndrome
1. Damage to sympathetic trunk 2. Damage to superior cervical ganglion 3. Hypothalamalspinal tract damage
88
Wallenberg Syndrome
Lateral Medullary Syndrome (PICA) | Dysarthria, dysphagia, contra loss of pain/temp, ipsi loss of facial sensation, Horner's Syndrome
89
Autonomic Dysreflexia
From T5 and above - sympathetic hyperreflexia Stimulus: overfull bladder/noxious stim - activation of sympathetic outflow Symptoms: Headache (elevated BP), piloerection, sweating above level of injury, flushed face, nausea, slow pulse, cold clammy skin below level of injury
90
Hirschpring's Disease
Congenital absence of myenteric (Auerbach's plexus) ￫ no peristalsis in denervated colon, smaller compared to proximal colon (distended) Correct surgically
91
Lesions to the lateral hypothalamus tend to result in what types of symptoms?
"drinking center" | Adipsia, emaciation, apathy
92
Lesions to the anterior hypothalamus tend to result in what types of symptoms?
"Parasympathetic Area" | Hyperthermia, insomnia, diabetes insipidus, emaciation
93
Lesions to the medial hypothalamus tend to result in what types of symptoms?
Ipsilateral Horners, hyperdipsia, diabetes insipidus, obesity, rage, amnesia
94
Lesions to the posterior hypothalamus tend to result in what types of symptoms?
"Sympathetic Area" | Ipsilateral Horner's, hypothermia, poikilothermia, hypersomnia, coma, narcolepsy,
95
A lesion to the suprachiasmatic nucleus (ant. region) results in what symptoms?
Insomnia | Alzheimer's & shift work
96
A lesion to the anterior nucleus (ant. region) results in what symptoms?
Hyperthermia - IL-1, PGE2 fever
97
A lesion to the medial hypothalamus results in what symptoms?
Obesity, overeating | Prader-willi syndrome, craniopharyngioma
98
A lesion to the paraventricular nucleus results in what symptoms?
Descending hypothalamic fibers originate mostly from paraventricular nucleus and travel laterally in BS next to spinothalamic tracts
99
Sympathetic preganglionic cell bodies are located in the _________________ between levels T1 and L2.
Interomediolateral cell column
100
A lesion in the thoracic cord can cause _____________.
Spastic bladder
101
What are 3 causes of sympathetic lesions that can all result in an ipsilateral Horner's?
1. Arterial dissection 2. Pancoast tumor (apical lung) 3. Cavernous sinus issues
102
What are the symptoms of arterial?
Ipsilateral Horner's, neck pain, bruilles
103
What are the symptoms of a pancoast tumor (apical lung)?
Ipsilateral Horner's, Klumpke's Palsy (brachial plexus)
104
Anisocoria
Unequal pupils
105
What symptoms are observed with a CN III lesion?
Failure to constrict w/ light on both sides - down and out and ptosis
106
Hyperactive bladder
Incontinence w/ no trapped urine - detrusor contracts too much
107
Underactive sphincter
Incontinence w/ no trapped urine - Sympathetic lesion - threat with anti cholinergics
108
Hypoactive bladder
Incontinence w/ trapped bladder, detrusor not contracting enough
109
Overactive sphincter
Lesion to PS, incomplete emptying, treat with anti-adrenergics

Spring Semester 2014 (6 decks)

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