Midterm 1 Flashcards

1
Q

What is the difference between afferent and efferent neurons?

A

Afferent carries info toward CNS and efferent carries info away from CNS

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2
Q

What is functional neuroanatomy?

A

Defining language and concepts needed to describe nervous system and it’s function

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3
Q

What makes up the CNS?

A

Brain and spinal cord

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4
Q

What makes up the PNS?

A

Cranial and spinal nerve fibers, ganglia

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5
Q

What are the functional divisions of the PNS?

A

Autonomic, somatic

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6
Q

What does the somatic NS control?

A

Voluntary and conscious movement

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7
Q

What does the autonomic control?

A

Unconscious or involuntary movements

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8
Q

What does the enteric NS control?

A

GI tract, works without intervention from CNS

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9
Q

What are to parts of the autonomic NS?

A

Sympathetic, parasympathetic, enteric

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10
Q

What is the sympathetic NS associated with?

A

Fight/flight

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11
Q

What is the parasympathetic NS associated with?

A

Rest/digest

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12
Q

Are sensory neurons afferent or efferent? Motor neurons?

A

Sensory is afferent

Motor is efferent

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13
Q

What part of the neuron receives input?

A

Dendrites

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14
Q

What direction do axons send signals?

A

Away from soma

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15
Q

Where is white matter and grey matter in the brain?

A

Grey matter is on outside of white matter

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16
Q

Where is white matter and grey matter in spinal cord?

A

White matter is on outside of grey matter

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17
Q

What do ependymal cells do?

A

Line the ventricles in brain and central canal in spinal cord and make CSF via making the choiroid plexus

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18
Q

What are the 3 major subtypes of macroglia?

A

protoplasmic astrocytes, oligodendrocytes, fibrous astrocytes

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19
Q

What are protoplasmic astrocytes?

A

primarily found in grey matter, support blood brain barrier

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20
Q

What are fibrous astrocytes?

A

support neruons and their functions, primarily found in white matter (similar function to protoplasmic)

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21
Q

What are oligodendrocytes?

A

found in CNS, myelinate multiple axons

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22
Q

What are schwann cells?

A

found in PNS, myelinate axon

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23
Q

How many places can be myelinated by 1 schwann cell?

A

1

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24
Q

What is the function of microglia?

A

macrophages, immune response

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25
Q

What are the primary division of the spine?

A

cervical, thoracic, lumbar, saccral

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26
Q

What are columns in the spinal cord? Where are they found?

A

long connections up and down the spinal cord, in white matter

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27
Q

What parts of the NS help maintain homeostasis?

A

Sympathetic, parasympathetic, enteric

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28
Q

What are the effector organs?

A

Skeletal, smooth, and cardiac muscle and glands

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29
Q

Where are ependymal cells and macroglia derived from?

A

Cells of the neural tube

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30
Q

Where are microglial cells derived from?

A

Monocyte precursors of the bone marrow

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31
Q

How do astrocytes assist neurons in transmitting impulses?

A

Regulating the presence of neurotransmitter substances as well as releasing gliotransmitter substances

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32
Q

What are gliotransmitters?

A

Chemicals released from glial cells that modulate synaptic transmission and neural excitability

Ex. ATP and glutamate

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33
Q

What is the telencephalon?

A

Cerebral hemispheres of brain

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34
Q

What is the diencephalon?

A

Epithalamus, thalamus, hypothalamus, subthalamus

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35
Q

What is the mesencephalon?

A

Cerebral peduncles and tectum

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36
Q

What is the metencephalon?

A

Pons and cerebellum

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37
Q

What is the myelencephalon?

A

Medulla oblangata

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38
Q

Where are the nerves responsible for somatic motor function in the spinal cord located?

A

Ventral horn, their axons leave via the ventral rootlets, inner area skeletal muscle

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39
Q

What regions is the lateral horn found in?

A

Thoracic, upper lumbar and sacral regions

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40
Q

What is the function of lateral horn?

A

Central component of the sympathetic division of autonomic NS

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41
Q

What is the function of the dorsal horn?

A

Where sensory info is brought in by dorsal root ganglia

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42
Q

What do interneurons do?

A

Connect two types of neurons to each other

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43
Q

What is an example of a connection interneurons make? Hint motor and sensory

A

Unipolar sensory neurons of DRG to motor neurons of ventral horn

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44
Q

What are the two major categories of neurons?

A

Those with axons that leave the CNS and those whose axons remain in CNS

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45
Q

How many pairs of spinal nerves are there?

A

31

8 cervical, 12 thoracic, 5 sacral, 5 lumbar, 1 coccygeal

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46
Q

Where is the boundary between sensory and motor more ambiguous the CNS or PNS?

A

CNS, especially in brain

PNS is defined and also spinal cord

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47
Q

If someone injured their C6 dorsal root ganglion what would happen to them?

A

loss of sensation in the area of C6 dermatome (arm, thumb, index finger)

b/c dorsal is sensory

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48
Q

What is the function of the dorsal root ganglion?

A

contains the cell bodies of sensory neurons

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49
Q

What is the function of the dorsal column?

A

aka. dorsal column medial lemniscus pathway (DCML)

deals with fine touch, proprioception, two-point discrimination, and vibration sensations from everywhere but head

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50
Q

If patient injures their left dorsal column which leg will show symptoms?

A

left leg, damage is ipsilateral

if it was right leg, right side is damaged

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51
Q

What is the lateral funiculus?

A

aka. lateral white column

contains lateral spinothalamic tract and the lateral corticospinal tract

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52
Q

What is the function of the lateral spinothalamic tract?

A

an ascending sensory pathway that transmits pain sensations, temperature, and potentially itching

damage typically is contralateral

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53
Q

What is the function of the lateral corticospinal tract?

A

largest descending motor pathway in body, responsible for voluntary movement of the contralateral (opposite) upper and lower limbs

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54
Q

What is the function of myelin?

A

speeds up transmission of nerve impulses

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55
Q

What part of the spinal cord contains motor neurons?

A

ventral horn

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56
Q

What is contained in the anterior root of spinal cord?

A

the axons of motor neurons that exit that spinal cord

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57
Q

What is contained in the lateral horn?

A

neurons involved in the autonomic nervous system

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58
Q

What is anterograde transport?

A

movement of materials (neurotransmitters, proteins, organelles) from the soma to the axon terminal

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59
Q

What is retrograde transport?

A

movement of materials (neurotransmitters, proteins, organlles) from the axon terminals to the soma

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60
Q

What is the vestibulospinal tract involved with?

A

balance and posture

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61
Q

What is the conus medullaris?

A

tapered end of the spinal cord

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62
Q

What is the coccyx?

A

bone at base of spinal cord

aka. tailbone

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63
Q

Who is Ian Waterman?

A

contracted a viral illness which attacked his NS, leaving him without proprioception from neck down

despite his motor neurons being unaffected he couldn’t move, pain and temperature was intact

managed to relearn to walk

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64
Q

What is sacrum?

A

shield shaped bone located between hipbones, base of lumbar vertebrae and connected to pelvis

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65
Q

What is a three neuron reflex arc?

A

made up of receptor sensory, interneuron, motor

reflex can be overidden when interneurons receive input from brain

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66
Q

What is a two neuron reflex arc?

A

made up of sensory and motor neuron, automatic and only involve part of body

ex. patellar reflex

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67
Q

Where do action potentials originate?

A

axon hillock

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68
Q

Collectively, anterograde and retrograde transport are referred to as?

A

axonal transport

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69
Q

What is axodendritic?

A

one of the potential synapse configurations

where axon of 1 neuron synpases w/dendrites of another

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70
Q

What is axon proper?

A

long part of axon that you usually think of when thinking of axons

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71
Q

Why is the axon hillock where actiona potentials start?

A

high density of Na+ channels

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72
Q

What are bipolar neurons?

A

possess an axon and dendrites

found in retina, roof of nasal cavity, inner ear

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73
Q

What is cilia? Where is it found in the NS and why?

A

short hairlike filaments

spinal canal and ventricles, b/c they help circulate CSF

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74
Q

How do presynaptic membranes stay the same size when vesicles have to fuse with it to deliver their contents?

A

form clathrin coated pits, which eventually form clathrin coated vesicles, then recycled by SER to be used in forming new vesicles

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75
Q

What are schmidt-lantermann clefts/incisures?

A

small pockets of cytoplasm in myelin sheaths made by schwann cells

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76
Q

What is the function of shcmidt-lantermann clefts/incisures?

A

believed to help sustain the growth and function of compact myelin

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77
Q

What are dendritic spines?

A

tiny protrusions from dendrities, form contacts with axons of other neurons

very plastic, have diff shapes and size

(filopodia, mushroom, etc)

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78
Q

What are docking complexes?

A

oblong electron dense, protein structures located at presynaptic membrane, form presynaptic grid

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79
Q

What is the purpose of docking complexes?

A

some synaptic vesicles are bound by them near the active site so they are ready when an action potnetial comes

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80
Q

What type of synapse is faster?

A

electrical

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81
Q

Are electrical synapses found in mammals?

A

only in retina, cerebral cortex, and brainstem

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82
Q

What is a type I synapse?

A

aka. asymmetric synapse b/c postsynaptic density is thicker than presynaptic density, round vesicles, excitatory

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83
Q

What is a type II synapse?

A

aka. symmetric synapse b/c 2 densities are = thickness, flattened vesicles, inhibitory

84
Q

What are G-proteins?

A

specialized proteins with the ability to bind GTP and GDP

used in metabotropic receptors

85
Q

What are gap junctions?

A

continuous channels that connect two molecules together

electrical synapse uses these

86
Q

What is the glial-limiting membrane?

A

formed by astrocytes (end-feet) at interface of brain and pia mater, barrier against unwanted things entering CNS

87
Q

What are glioblastoma?

A

type of neuroglial tumor, malignant and highly fatal, formed by astrocytes

88
Q

What is the initial segment?

A

transition between axon hillock and axon proper, repsonsbile for intiial and propagation of action potential, membrane is thicker

89
Q

What is inner mesaxon?

A

when schwann cells myelinate they wrap around axon, inner mesaxon is the part of schwann cell membrane that connects to the innermost wrapping around axon

beginning of intraperiod gap

90
Q

What are internodes?

A

between 2 nodes of ranvier, the myelinated part

91
Q

WHat are intraperiod gaps?

A

gaps betweeen the membrane of shcwann cell wrapping around axon

beleived to be so small molecules can reach axon

92
Q

What are ionotropic receptors?

A

ligand gated channels, when neurotransmitter binds it changes shape to open the channel

direct, rapid

93
Q

What is plasmalemma?

A

cell membrane

94
Q

What are metabotropic receptors?

A

bind neuromodulators/ neurohormones, binds to a receptor molecule which triggers a signaling cascade

indirect, slow

95
Q

What are microfilaments?

A

mostly actin filaments

associated with cell membrane and aid in dendrites/axon elongation, and movement of membrane

96
Q

What do microtubules do?

A

create a scaffold-like structure to maintain cell shape and aid in transport of materials

97
Q

What are multipolar neurons?

A

1 axon and 2 or more dendrites

ex. motor neurons in spinal cord

98
Q

What are neurites?

A

any protrusion form neuron

ex. axon, dendrite

99
Q

What do neurofilaments do?

A

help with regenaration and development of axons/dendrites

aka. intermediate filaments

100
Q

What is neurolemma?

A

outermost layer of the Schwann cell that surrounds an axon in the peripheral nervous system

not same as myelin sheath (multple layers)

protects neurons, support repair

101
Q

Compare neurotransmitters and neuromodulators?

A

NT act locally at synapse, cause immediate effects, short lived

ex. glutamate, gaba,

NM affect larger area, slower more prolonged changes, modulate overall state of neuron

ex. neuropeptides like oxytocin, endorphins, some NT like dopamine/serotonin

102
Q

What is outermesaxon?

A

the outermost wrapping of the outer cell membrane to the myelin sheath

103
Q

What is pervivascular covering?

A

formed by astrocytes around blood vessels

104
Q

What are psudounipolar neurons?

A

start out bipolar, then axon and dendrite fuse before later spliting

105
Q

What is collapse fusion?

A

permanent fusion, vesicle fuses to membrane after emptying contents

106
Q

What is kiss and run fusion?

A

temporary fusion, vesciles contact presynaptic membrane empties its content and then leaves

107
Q

What is the anterior spinal artery?

A

located in ventral median fissure, from cranial cavity through entire spinal cord, has small branche sthat supply white and grey mater, only 1

small in thoracic area

108
Q

What do ascending tracts transmit?

A

sensory info to brain

109
Q

What is the cauda equina?

A

nerve fibers at end of spinal cord, within the lumbar cistern

area for lumbar puncture

110
Q

What is the central canal?

A

continuous with 4th ventricle, CSF filled in spine, entire lenght of cord in young adults

111
Q

What is dermatome?

A

strip of skin a aprticular spinal nerve is responsible for

112
Q

What do descending tracts do?

A

relay motor info from brain to rest of body

113
Q

What is the dorsal median sulcus?

A

runs entire lenght of spine, less deep than anterior

114
Q

What is dorsal primary ramus?

A

after spinal nerve exits the spinal cord, it splits into two primary branches, dorsal and ventral ramus

The dorsal primary ramus innervates the deep muscles of the back, carries sensory information from the skin and tissues along the back

115
Q

Where is the dorsointermediate sulcus?

A

located between dorsomedian sulcus and dorsolateral sulcus, only in cervical and upper thoracic

116
Q

Where is the dorsolateral sulcus?

A

on either side of dorsomedian sulcus, can be distinguished by presence of dorsal rootlets of spinal nerves

117
Q

What is the dorsolateral tract of lissauer

A

small bundle of nerve fibers located in the spinal cord lateral to dorsal horn

carries pain, temperature, and light touch information from the body to the spinal cord, modulates sensory input before it enters the central pathways

118
Q

What is foramen magnum?

A

base of skull, where spinal cord starts

119
Q

What is GSA?

A

general somatic afferent

snesory info (touch, pressure, proprioception, pain, temperature) that is perceived in body and transmitted to spinal cord

120
Q

What is GSE?

A

genereal somatic efferent

provide motor innervation to skeletal muscles

121
Q

What is GVA?

A

general visceral afferent

sensory info perceived in viscera (organs, glaands, membranes) that is transmitted to spinal cord

122
Q

What is GVE?

A

general visceral efferent

motor innervation to glands, cardiac muslce, smooth muslce

123
Q

What is the gray commisure?

A

strip of gray matter that connects the “wings” of spinal cord together

subdivided into posterior and anterior gray commisure, associated w/autonomic

124
Q

What is gray ramus communicans?

A

connects a spinal nerve to the sympathetic chain, carries postganglionic fibers

125
Q

What is great ventral radicular artery? (artery of adamkiewicz)

A

arises from the left side in most people, supplies the anterior spinal artery in the lower two-thirds of the spinal cord, arises from L2 to T9 usually

126
Q

What are intersegmental tracts?

A

convey info between spinal segments

help with intersegmental spinal refelxes

127
Q

What are intervertebral foramen?

A

gaps in the vertebrae of spinal cord where spinal nerves and blood vessels pass through

128
Q

What is lumbar cistern?

A

CSF filled space at bottom of spinal cord where there is no cord

129
Q

What are myotomes?

A

groups of muscles innervated by same spinal nerve

130
Q

What is a neuropil?

A

any area in the nervous system composed of mostly unmyelinated axons, dendrites and glial cell processes that forms a synaptically dense region containing a relatively low number of cell bodies

131
Q

How does the spine receive blood flow?

A

from anterior and posterior spinal arteries as well as small segmental radicular arteries

132
Q

How many posterior spinal arteries are there?

A

2

133
Q

Where do the anterior and posterior spinal arteries originate from?

A

vertebral arteries

134
Q

How many pairs of radicular arteries are there?

A

32

135
Q

What is a sclerotome?

A

the ligaments and bones that are innervated by same spinal nerve

136
Q

What is spina bifida?

A

developmental disroder where neural tube doesn’t close fully, 1-2% prevalence, different types depending on the severity

137
Q

What is spina bifida anterior?

A

when it occurs along the ventral surface of the vertebral column

138
Q

What is spina bifida cystia? (aka aperta)

A

more serious, involves herniation of spinal and/or meninges, potnetially can rupture the skin resulting in leaking CSF and miningitis

139
Q

What is spina bifida occulta?

A

least serious and most common, may not have symptoms, someotimes able to see tuft of hair on area

140
Q

What is a spinal segment?

A

region of the spinal cord associated with a particular pair of spinal nerves

141
Q

What is subarachnoid space?

A

between arachnoid mater and pia mater, filled with csf, protects spinal cord from injury

142
Q

What is substantia gelatinosa centralis?

A

layer of neuroglia intersperesed with nerve fibers and nerve fibers, surrounding ependymal cells of central canal

143
Q

What is syringomyelia?

A

spinal cord disroder marked by loss of the sense of pain/temperature at levels involving several consecutive spinal cord segments

can be caused by a cleft or an increased central canal size

144
Q

What are ventral primary rami?

A

carry sensory and motor fibers for the innervation of the muscles, joints, and skin of the lateral and ventral body walls and the extremities, also autonomic

145
Q

What is ventrolateral sulcus?

A

in spinal cord, btwn posterolateral sulcus and anterior median fissure, where ventral rootlets emrege from cord

146
Q

What is white ramus communicans?

A

contains preganglionic fibers of the sympathetic system, a structure that anteriorly connects the spinal nerve to the sympathetic trunk

147
Q

What is the archicortex? aka allocortex

A

oldest region, three layers, in limbic system

148
Q

What is mesocortex? aka juxtallocortex

A

younger than archicortex, 3 to 6 layers, predominantly located in insula and cingulate gyrus

149
Q

What is neocortex? aka isocortex?

A

youngest, 6 layers, bulk of cerebral cortex

150
Q

What do association fibers do?

A

connect regions of hemisphere to other regions of the same hemisphere

aka arcuate fibers

the axons of pyrimidal cells and fusiform neurons

151
Q

What is the basal nuclei?

A

used to be called basal ganglia

composed of caudate nucleus, putamen and globus pallidus (lenticular nucleus), subthalamic nucleus of ventral thalamus, substantia nigra

152
Q

What are input, output, and intrinsic nuclei of basal nuclei mean?

A

input receive input, output project to other neurons, intrinsic means they receive input, project and have local interconnections

153
Q

What is the calcarine fissure?

A

sulcus in occipital lobe, marks where the primary visual cortex is (cuneate gyrus and lingual gyrus)

154
Q

What is the central sulcus?

A

separates the frontal lobe from the parietal lobe

155
Q

How is the cerebellum connected to brain?

A

connected to brainstem via the superior, middle, and inferior cerebral peduncles

156
Q

What does the cerebral aqueduct do?

A

connects the fourth ventricle to the third ventricle

157
Q

What is the cingulate gyrus?

A

located above corpus callosum, separated from it by the callosal sulcus, continues as the isthmus, included in limbic lobe

158
Q

What is the cingulate sulcus?

A

borders the frontal lobe medially, forms the superior boundary of the cingulate gyrus

159
Q

What are commissural fibers?

A

bundles fo axons that connect the left and right hemispere

160
Q

What are the four bundles of commissural fibers?

A

corpus callosum, anterior commissure, posterior commissure, hippocampal commissure

161
Q

What does the anterior commissure connect?

A

right and left amygdalas, olfactory bulbs, several regions of temporal lobes

162
Q

What does the posterior commissure connect?

A

right and left pretectal regions and related cell gorups of mesencephalon

163
Q

What does the hippocampal commissure conenct?

A

aka commissure of the fornix, left and right hippocampi

164
Q

What are the regions of the corpus callosum?

A

anteriormost rostrum, curved genu, the body, and the posteriormsot spenium

165
Q

What are corticofugal fibers?

A

efferent fibers that transmit info from cerebral cortex to lower centres of the brain and spinal cord

consist of corticobulbar, corticopontine, corticospinal, corticothalamic fibers

166
Q

What are corticopetal fibers?

A

afferent fibers that bring info from thalamus to the cerebral cortex

consist thalamocortical fibers

167
Q

Where is the cuneate gyrus?

A

located above calcarine sulcus, primary visual cortex

168
Q

What is gyrification?

A

the process by which the brain undergoes changes in surface morphology to create sulcal and gyral regions

169
Q

What is hydrocephalus?

A

abnormal buildup of cerebrospinal fluid in the ventricles in the brain, puts pressure on brain

170
Q

What is the insula?

A

forms the floor of the lateral sulcus, surrounded by circular sulcus

beleived to be associated with taste and potentially other viscera functions

171
Q

What is the interventricular foramen?

A

connects the lateral hemispheres to the third hemisphere

172
Q

What is ataxia?

A

lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements

contralateral to lesion

173
Q

What are the autonomic centers?

A

in the medulla, controls respiratory, cardiovasuclar, and gastrointestinal functions

174
Q

What is the basal pons?

A

anterior portion of pons, facilitates communication between the cerebral cortex and cerebellum, role in coordinating voluntary motor activity
The corticospinal and corticobulbar tracts are essential for motor control of the body and face

175
Q

What are projection fibres?

A

restricted to a single hemisphere and connect the cerebral hemispheres with lower centers (corpus striatum, diencephalon, spinal cord, brainstem)

subdivided into corticopetal and corticofugal

176
Q

What is the septum pellucidum?

A

non-nervous membranes that adhere to each other, separate lateral ventricles

177
Q

What are splitbrain patient?

A

people whose corpus callosum has been partially or fully removed

178
Q

What is the superior parietal lobule involved with?

A

association area for somatosensory function

179
Q

What is the inferior parietal lobule involved with?

A

has 2 regions

supramarginal gryus, involved with integrating info from somatosensoyry, auditory and visual sensese

angular gyrus, receives visual input

180
Q

Where is wernicke’s area located?

A

superior temporal gyrus

181
Q

Where is broca’s area located?

A

inferior frontal gryus

182
Q

What is the basilar artery?

A

main artery that supplies blood to brainstem, cerebellum, and occipital lobes mainly

183
Q

What is bradykinesia?

A

slowness of movement and difficulty initiating movements, reduced facial expression

184
Q

What does the inferior cerebellar peduncle connect?

A

cerebellum to medulla

185
Q

What does the middle cerebellar peduncle connect?

A

cerebellum to pons

186
Q

What does the superior cerebellar peduncle connect?

A

cerebellum to midbrain

187
Q

Where is the midbrain located?

A

Above the pons, below the thalamus

188
Q

What role does the midbrain play?

A

vision, hearing, motor control, sleep and wakefulness, arousal, and temperature regulation

189
Q

Astrocytosis is involved with?

A

many disroders, like ALS, parkinson, huntington, autism, schizophrenia

190
Q

What are extrafusal fibers?

A

contract to produce the movements of skeletal muscles, receive alpha fiber projections

191
Q

Where are intrafusal muscle fibers found?

A

inside muscle spindles

192
Q

WHat is contained in intrafusal muscle fibers?

A

nuclear chain intrafusal fibers and nuclear bag intrafusal fibers

193
Q

What are nuclear chain and nuclear bag fibers innervated by?

A

gamma motor neurons in spinal cord

194
Q

What is type 1a?

A

Annulospiral endings, primarily wrapped around non-contrcticle regions and spinal length and quick changes in length

195
Q

What are the symptoms of lateral medullary (wallenberg) syndrome?

A

vertigo, nystagmus, ataxia, ipsilateral pain/temperature loss on face, contralateral in body, dysphagia, dysphonia, diminshed gag refelx

196
Q

What is the cause of lateral medullary (wallenberg) syndrome?

A

Occlusion of the posterior inferior cerebellar artery (PICA) or vertebral artery

197
Q

What are the symptoms of medial medullary syndrome?

A

contralateral hemiparesis, contralateral loss proprioception and fine touch, ipsilateral tongue deviation, dysarthia (slurred speech cause tongue weak)

198
Q

What is the cause of medial medullary syndrome?

A

Occlusion of the anterior spinal artery or paramedian branches of the vertebral arteries

199
Q

What are corticobulbular tracts?

A

Descending fibers from the cerebral cortex to cranial nerve nuclei

200
Q

Who is Jean-Dominuqe Bauby?

A

man with locked in syndrome, wrote a book by blinking his left eyelid, could only move left eye and left eyelid

201
Q

What is MPTP related to?

A

in 1980s bunch of college kids presetned with parkinsons symtpoms, accidently make mptp which is taken up by substantia nigra and causes parkinsons

202
Q

What are the symptoms of medial midbrain syndrome?

A

ipsilateral CN III palsy (oculomotor) causes ptosis, mydriasis (dialted pupil unreactive), contralateral hemiparesis

203
Q

What is auto genic inhibition?

A

Prevents muscles from exerting more force than bone/tendon can handle

204
Q

What is areflexia?

A

Absence of tendon reflexes

205
Q

What is flaccid paralysis?

A

Weakness or paralysis and reduced muscle tone with no obvious cause

206
Q

What is Golgi tendon organ?

A

Sensory receptor loactaed near tendon and muscle junction

Responds to muscle tension