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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
Q

The cerebral cortex only receives input from ____________.

A

The thalamus

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26
Q

The cerebral cortex projects to which 5 structures?

A
  1. Thalamus
  2. Basal ganglia
  3. Brainstem
  4. Spinal cord
  5. Cerebellum - via the pons
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27
Q

The cerebral cortex is derived embryologically from ___________.

A

The telencephalon

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28
Q

Archicortex is composed of _____ layers, while the neocortex has ___.

A

3

6

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29
Q

What are the layers of the neocortex from superficial to deep?

A
  1. Molecular
  2. External granule layer
  3. Ext. pyramidal layer
  4. Int. granular layer
  5. Int. pyramidal layer
  6. Multiform layer
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30
Q

What are the 2 major cell types in the cortex?

A
  1. Pyramidal cells - axons exit from cortex

2. Non-pyramidal cells - lots of variety, most GABAnergic

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31
Q

Functional units of the cerebral cortex are ________, which are interconnected within the same hemisphere as well as _________________.

A
  1. Vertical columns

2. Contra hemispheres

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32
Q

The primary somatosensory cortex is composed of which Brodmann areas?

A

Areas 3, 1, and 2

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33
Q

The primary motor cortex is composed of which Brodmann area?

A

Area 4

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34
Q

The primary visual cortex is composed of which Brodmann area?

A

Area 17

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35
Q

The primary auditory cortex is composed of which Brodmann areas?

A

Area 41 and 42

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36
Q

Broca’s area or the motor area of speech is composed of which Brodmann areas?

A

Area 44 and 45

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37
Q

The frontal eye field corresponds to which Brodmann area?

A

Area 8

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38
Q

Lesion of the supramarginal gyrus (Area 40) can lead to ___________________.

A

Astereognosis

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39
Q

Lesion of the angular gyrus (area 39) can lead to ________________.

A

Aphasia; alexia and agraphia

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40
Q

Lesion of the supramarginal or angular gyrus on the non-dominant side can lead to ____________.

A

Hemi-neglect

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41
Q

The secondary visual cortex corresponds to which Brodmann Area?

A

Area 18

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42
Q

Wernicke’s area corresponds to which Brodmann area?

A

Area 22

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43
Q

A lesion of area 22 will present as what type of lesion?

A

Sensory aphasia, difficulty comprehending language

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44
Q

What 3 areas make up the lateral zone of the hypothalamus?

A
  1. Lateral preoptic nucleus
  2. Lateral hypothalamic area
  3. Tuberomammillary nucleus
45
Q

What is the lateral hypothalamic area main function?

A

Induce eating/regulation of feeding

46
Q

What is the function of the tuberomammillary nucleus?

A

Synthesizes histamine - mediates attention/arousal - quiet before sleep

47
Q

What is the function of the medial preoptic nucleus?

A

Regulates gonadotropin release from ant. pituitary - sexually dimorphic

48
Q

The anterior region of the middle zone contains what nuclei?

A
  1. Suprachiasmatic nucleus - circadian rhythms
  2. Ant. hypothalamic nucleus - warmth
  3. Paraventricular nucleus
  4. Supraoptic nucleus - syn vasopressin or oxytocin
49
Q

The paraventricular nucleus contains what two neurons?

A

Magnocellular: vasopressin/oxytocin
Parvocellular: Corticotropin releasing hormone

50
Q

The paraventricular nucleus also contains ________________ which activates the sympathetic arm of the ANS.

A

Hypothalmalspinal tract

51
Q

The middle or tuberal region of the medial zone contains which 3 nuclei?

A
  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
Q

The posterior or mammillary region of the middle zone contains what 2 structures?

A
  1. Posterior nucleus - cold

2. Mammillary body - receives input from hippocampus, learning & memory

53
Q

What is the most medial zone of the hypothalamus?

A

Periventricular zone - periventricular nucleus - overlaps w/ other nuclei

54
Q

Fornix

A

Output of hippocampus to mammillary bodies - Memory & Learning

55
Q

Mammillothalamic tract

A

Connects mammillary body to thalamus (ant. nucleus)

Lesions ￫ affective disorders

56
Q

The ________________ divides the medial and lateral zone nuclei.

A

Mammillothalamic tract

57
Q

Stria Terminalis

A

Connects amygdala with medial hypothalamus

58
Q

Medial forebrain bundle

A

BS ￫ lateral hypothalamic forebrain

**very complicated

59
Q

Supraopticohypophyseal tract

A

Connects magnocellular neurons (vaso/oxy) to post. pituitary

60
Q

Tuberoinfundibular tract

A

Release of ant. pituitary hormones

61
Q

Hypothalamospinal tract

A

Projects from paraventricular nucleus of hypothalamus to origin of sympathetic arm of ANS

62
Q

What are the main functions of the hypothalamus?

A
  1. Body temp regulation
  2. Stress responsiveness
  3. Feeding/energy metabolism
  4. BP and electrolyte composition
  5. Reproductive fx
63
Q

Bilateral destruction of ant. nuclei leads to ___________.

A

Hyperthermia

64
Q

Bilateral destruction of post. nuclei leads to ______________.

A

Inability to regulate temp at all - axons from warm sensing nuclei course thru the post. nucleus on their way to the SC

65
Q

Paraventricular nucleus is the center for stress integration. It will _________________ via the hypothalamalspinal tract, and causes the release of _______.

A
  1. Activates the SNS

2. ACTH

66
Q

The paraventricular nucleus is under the control of ____________.

A

The limbic system

67
Q

Leptin

A

Inhbits food intake by stimulating neuron in the arcuate nucleus

68
Q

Grelin

A

Stimulates feeding, released by stomach stimulates neurons in arcuate nucleus

69
Q

PYY

A

Inhibits feeding - inhibits neurons in arcuate nucleus

70
Q

Craniopharyngioma

A

Congential tumor from remnants of Rathke’s pouch - bitemporal hemianopia and hypothalamic syndrome

71
Q

Hypothalamic syndrome

A

Adiposity, diabetes insipidus, temp regulation disturbances, and somnolence

72
Q

Posterior hypothalamic lesions involving the mammillary complex are associated with _______________.

A

The inability to form new memories for context and time specific events

73
Q

Korsakoff Syndrome

A

Thiamine deficiency associated w/ chronic alcoholism

74
Q

Klein-Levin Syndrome

A

Hypothalamic lesion in adolescent males - episodic compulsive eating, hypersomnolence, hyperseuxlaity
Due to dec. in dopaminergic tone

75
Q

The Edinger-Westphal nucleus from _____, synapses at the ________ ganglion before innervating _______________.

A
  1. CNIII
  2. Ciliary
  3. Sphincter pupillae
76
Q

The Superior Salivary nucleus from _____, synapses at the ________ ganglion before innervating _______________.

A
  1. CN VII
  2. Submandibular ￫ Submand. gland
  3. Pterygopalatine ￫ Lacrimal gland
77
Q

The Inferior Salivary nucleus from _____, synapses at the ________ ganglion before innervating _______________.

A
  1. CNIX
  2. Otic ganglion
  3. Parotid gland
78
Q

The Dorsal Motor nucleus from _____ travels to innervate the _________________________.

A
  1. CNX

2. Heart, bronchi, GI, kidney, etc

79
Q

Which nerves control micturition and what muscle do they innervate?

A
  1. S2-S4

2. Detrussor m.

80
Q

Which autonomic nerves control urine storage and muscle do they innervate?

A
  1. T11 - L1 - lumbar splanchnic nerves

2. Internal urethral sphincter

81
Q

Which nerves regulate somatic control of urination and what muscle do they innervate?

A
  1. S2-S4 - pudendal

2. External urethral sphincter

82
Q

Vasovagal Syncope

A

Inappropriate peripheral vasodialtion and bradycardia

Muscle weakness, warm sensation, nausea, sweating

83
Q

Baroreceptor Reflex afferent limb

A

Stretch receptor in carotid sinus (IX) and aortic arch (X)

84
Q

Baroreceptor Reflex efferent limb

A

PS axons of CNX ￫ cardio inhibitory response

SYMP: interomedial cell column of spinal cord ￫ cardiostim/pressor

85
Q

Does the baroreceptor reflex have any CNS processing?

A

Yes, the nucleus solitaries

86
Q

Horners Syndrome

A

Ptosis, anhydrosis, miosis, and enophthalmos – Loss of sympathetic innervation

87
Q

Causes of Horner’s Syndrome

A
  1. Damage to sympathetic trunk
  2. Damage to superior cervical ganglion
  3. Hypothalamalspinal tract damage
88
Q

Wallenberg Syndrome

A

Lateral Medullary Syndrome (PICA)

Dysarthria, dysphagia, contra loss of pain/temp, ipsi loss of facial sensation, Horner’s Syndrome

89
Q

Autonomic Dysreflexia

A

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
Q

Hirschpring’s Disease

A

Congenital absence of myenteric (Auerbach’s plexus) ￫ no peristalsis in denervated colon, smaller compared to proximal colon (distended)
Correct surgically

91
Q

Lesions to the lateral hypothalamus tend to result in what types of symptoms?

A

“drinking center”

Adipsia, emaciation, apathy

92
Q

Lesions to the anterior hypothalamus tend to result in what types of symptoms?

A

“Parasympathetic Area”

Hyperthermia, insomnia, diabetes insipidus, emaciation

93
Q

Lesions to the medial hypothalamus tend to result in what types of symptoms?

A

Ipsilateral Horners, hyperdipsia, diabetes insipidus, obesity, rage, amnesia

94
Q

Lesions to the posterior hypothalamus tend to result in what types of symptoms?

A

“Sympathetic Area”

Ipsilateral Horner’s, hypothermia, poikilothermia, hypersomnia, coma, narcolepsy,

95
Q

A lesion to the suprachiasmatic nucleus (ant. region) results in what symptoms?

A

Insomnia

Alzheimer’s & shift work

96
Q

A lesion to the anterior nucleus (ant. region) results in what symptoms?

A

Hyperthermia - IL-1, PGE2 fever

97
Q

A lesion to the medial hypothalamus results in what symptoms?

A

Obesity, overeating

Prader-willi syndrome, craniopharyngioma

98
Q

A lesion to the paraventricular nucleus results in what symptoms?

A

Descending hypothalamic fibers originate mostly from paraventricular nucleus and travel laterally in BS next to spinothalamic tracts

99
Q

Sympathetic preganglionic cell bodies are located in the _________________ between levels T1 and L2.

A

Interomediolateral cell column

100
Q

A lesion in the thoracic cord can cause _____________.

A

Spastic bladder

101
Q

What are 3 causes of sympathetic lesions that can all result in an ipsilateral Horner’s?

A
  1. Arterial dissection
  2. Pancoast tumor (apical lung)
  3. Cavernous sinus issues
102
Q

What are the symptoms of arterial?

A

Ipsilateral Horner’s, neck pain, bruilles

103
Q

What are the symptoms of a pancoast tumor (apical lung)?

A

Ipsilateral Horner’s, Klumpke’s Palsy (brachial plexus)

104
Q

Anisocoria

A

Unequal pupils

105
Q

What symptoms are observed with a CN III lesion?

A

Failure to constrict w/ light on both sides - down and out and ptosis

106
Q

Hyperactive bladder

A

Incontinence w/ no trapped urine - detrusor contracts too much

107
Q

Underactive sphincter

A

Incontinence w/ no trapped urine - Sympathetic lesion - threat with anti cholinergics

108
Q

Hypoactive bladder

A

Incontinence w/ trapped bladder, detrusor not contracting enough

109
Q

Overactive sphincter

A

Lesion to PS, incomplete emptying, treat with anti-adrenergics

Spring Semester 2014 (6 decks)

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