NEURO Flashcards

1
Q

Hydrocephalus

A

Enlarged ventricles due to increased CSF produced in choroid plexus.
Lateral third and fourth ventricles swell

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2
Q

Hypoxia

A

The brain becomes acidic. Acidosis in the brain causes necrotic changes secondary to hypoxemia.

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3
Q

Cerebral infarction/Stroke

A

When I don’t have enough oxygen in the tissues around the brain.
Causes two types of pathologies:
Thombotic from atherosclerosis
Embolic stroke from cardiac thrombi to middle cerebral arteries.

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4
Q

Cranial nerves

Numbers, names, and classification.

A
CN1 - Olfactory - sensory
CN1 - Optic - sensory
CN3 - Ocular motor
CN4 - Trochlear - motor
CN5 - Trigeminal - mixed
CN6 - Abducens - motor
CN7 - Facial - mixed
CN8 - Vestibulocochlear - sensory 
CN9 - Glossopharangeal - mixed
CN10 - Vagus - mixed
CN11 - Accessory - motor
CN12 - Hypoglossal - motor
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5
Q

What does the olfactory nerve do?

A

Smell

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6
Q

There are CN2 and CN3 reflexes

A

Like strikes -> Afferent fibers of CN2 -> Synapse in Edinger-Westphal Nuclei (midbrain) -> Efferent Parasympathetic fibers of CN3 travel to Sphincter Pupillae muscle in the iris, causing contraction.

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7
Q

Remember - visual fields are going to be the inverse retinal fields

A

When you look at something projected into the retina, it is the opposite of what the person is looking at. When you look at something from in the medial aspect of your nose, it is projected towards the lateral aspect of the eye.

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8
Q

What happens to this information to the retina when it goes to the brain?

A

The temporal or lateral activity or lateral receptive fibers stay on the same side of the brain. The medial fibers cross. 50% of visual information crosses over at the optic chiasm.
The pituitary gland is below the two fibers that cross medially. If there is a tumor then there is a loss of visual fields.

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9
Q

What are cones for?

A

COLOR vision. Lower sensitivity, higher activity. The cones make color vision. They have 1:1 with bipolar cells. Cones are tunes into three color categories.
Hence: C for C

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10
Q

What are rods for?

A

Nigh vision. Higher sensitivity, lower activity.

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11
Q

What is the function of CN4?

A

Superior oblique = movement of the eye down and out.

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12
Q

CN6 - Abducens

A

Lateral rectus - abducts the eyes.

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13
Q

What gives sympathetic activity to the ciliary, pterygopalatine, submandibular, and otic muscles?

A

The superior cervical ganglion.

It gives sympathetic activity to the eyes, nose, ear, and throat area.

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14
Q

Where does the thoracic area get its parasympathetic activity from?

A

Vagus nerve. Upper portion

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15
Q

When we get to the urogenital and lower digestive part of the body where do we get our innervation?

A

Sympathetic - inferior mesenteric.

Parasympathetic - pelvic splanchnic nerves.

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16
Q

POINT AND SHOOT

A
Parasympathetic = arausal 
Sympathetic = Climax
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17
Q

How is the nervous system divided?

A

Into the central nervous system and peripheral nervous system.

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18
Q

What makes up the CNS?

A

Spinal cord and the brain.

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19
Q

What is the peripheral nervous system divided into?

A

Somatic and autonomic.

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20
Q

Somatic Nervous System

A
  • heavily myelinated
  • singular
  • acetylcholine
  • deliberates motion
  • always stimulatory
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21
Q

Autonomic Nervous System

A
  • two neuron chain
  • pre and postganglionic ganglions
  • acetylcholine or norepinephrine
  • Stimulatory and inhibitory
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22
Q

What is the autonomic nervous system divided into?

A

Sympathetic and parasympathetic nervous systems.

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23
Q

Sympathetic Nervous System

A
  • raising heart rate
  • blood vessels constrict
  • glucose release
  • fight and flight
  • fibers originate in the thoracic and lumbar regions of the spinal cord
  • Short preganglionic and long postganglionic fibers
  • regulates sweating, influences metabolism and kidney activity
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24
Q

Parasympathetic Nervous System

A
  • digestion of food
  • expulsion of waste
  • general maintenance
  • rest and digest
  • fibers originate in the brain and sacral region
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25
Q

What are the types of cells in the Nervous System?

A

Neurons

  • main cells of NS
  • composed of cell body
  • groups of cell bodies in CNS -> nucleus
  • group of cell bodies outside CNS -> ganglion
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26
Q

Dendrites and ganglions

A

Dendrites receive information and axons pass information on

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27
Q

What is it called (space) when two neurons come together

A

Synapse

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28
Q

What cells are found in the grey matter?

A

Cell bodies of neurons, neuropils( dendrites and unmyelinated axons), glial cells (astrocytes and oligodendrocytes), synapses, and capilaries.

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29
Q

How is the cerebral cortex divided?

A

Into the parietal lobe, temporal lobes, frontal lobe, and occipital lobe.

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30
Q

What does each part of the cortex control?

A

Frontal lobe - movement and executive function.
Parietal - sensory information, guides movements in 3D.
Temporal lobe - hearing, smell, memory, visual recognition, and languages.
Occipital - vision.

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31
Q

What is the resting membrane potential?

A

-70 mV

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32
Q

What ions are mostly found outside of neurons?

A

Sodium, chloride, and calcium ions.

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33
Q

What ions are mostly found inside neurons?

A

Potassium and negatively charged anions

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34
Q

Polar

A

Negative

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35
Q

Depolarization

A

Becoming positive

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36
Q

Repolarization

A

Becoming negative

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37
Q

What is the threshold potential?

A

-55 mV

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38
Q

What happens after the threshold potential value is achieved?

A

The neuron becomes less negatively charged thus causing voltage-gated sodium channels to open at the start of the axon called axon Hillock.
A chain reaction of having multiple voltage-gated sodium channels to open

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39
Q

What is the depolarization value during an action potential?

A

+40 mV

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40
Q

What unique feature do the voltage-gated sodium channels have?

A

It has the inactivation gate

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41
Q

Voltage-gated potassium channels

A

They do not open until sodium channels have opened and are inactivated.

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42
Q

Fatty myelin

A

Allows action potential to propagate faster.

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43
Q

Where does it come from?

A

From Schwan cells or oligodendrocytes

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44
Q

Saltatory conduction

A

Conducting action potential from nodes of Ranvier to the next through the fatty myelin sheath.

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45
Q

What are the impacts of oxygen deprivation on the brain?

A

Strokes, seizures, coma, or death.

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46
Q

Blood supply to the brain

A

Aorta - aortic arch

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47
Q

Dual circulation to the brain

A

Anterior - carotid arteries

Posterior - vertebral arteries

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48
Q

Where does the dual circulation meet?

A

Circle of Willis

49
Q

What is the blood-brain barrier’s purpose?

A

CNS homeostasis

  • Providing selective nutrient passage.
  • Controlling fluid movement.
  • Protecting from toxins, microbes.
50
Q

How is CSF moved?

A

By the cilia of ependymal cells.

51
Q

How many pairs of cranial nerves are there?

A

12

52
Q

Where do they originate from?

A

Brain and brain stem

53
Q

Precentral gyrus

A

Responsible for voluntary movements

ANterior to the central sulcus

54
Q

Proprioceptors

A

Detect position and movement.
Initiate reflexes.
Prevent damage from overstretching or over-contracting

55
Q

Type Ia neuron fibers

A

Central region

How far and how fast muscle is being stretched

56
Q

Type II

A

Attaches to the ends of the central region.

How far muscle is being stretched.

57
Q

gamma motor neurons

A

Innervate both ends of intrafusal muscle.

cause ends to contract.

58
Q

What is a muscle spindle?

A

A bunch of intrafusal fibers

59
Q

Extrafusal fibers

A

They connect with tendons.

Generate movement.

60
Q

Intrafusal fibers

A

They are proprioceptors.
They tell us the position of our muscles in a 3D space.
They pick up the degree of stretch of the muscle.
The speed at which the muscle is being stretched.

61
Q

What are the two kinds of intrafusal fibers?

A

Nuclear bag fibers and nuclear chain fibers.

62
Q

Nuclear bag fibers

A

At the central point of this fiber, you find a lot of nuclei.
It looks “baggy”.
They pick up length and velocity.
These are more sensitive than the nuclear chain fibers to length and velocity.

63
Q

Nuclear chain fibers

A

Their nuclei are linear.

They are sensitive to length.

64
Q

Mechanoreceptors are divided in how many classes?

A

4

65
Q

What are the 4 mechanoreceptors for touch (mechanosensors)?

A

Meissner corpuscles, Merkel discs, Ruffini corpuscles, and Pacinian corpuscles.

66
Q

Meissner (tactile) corpuscles

A
Touch
Encapsulated
In fingertips
Hair follicle sensors
Sense vertical indentations on the skin.
Fast adapting
Small receptive fields = high resolution
67
Q

Merkel discs

A

Pressure
Not encapsulated
Slow adapting

68
Q

Ruffini (Bulbous) corpuscles

A
Encapsulated 
Detect skin stretching
In joints for detection of rotation
Slow adapting
Big receptive fields = low resolution
69
Q

Pacinian (lamellar) corpuscles

A

Encapsulated
Sense vibration
Fast adaptive
Big receptive fields

70
Q

3 types of proprioceptors

A

Muscle spindle -

Joint Receptors

71
Q

Muscle Spindle

A

Detects when a muscle is being stretched
Spindle-shaped
Found on perimysium which surrounds muscle cells

72
Q

Golgi Tendon Organ

A

Located in tendons
They sense when a muscle is being stretched (indirectly senses force exerted by muscle).
Inhibits the action so no further damage is caused

73
Q

Joint Receptors

A

Ruffini corpuscles in joints

Provide joint position and motion info (senses stretch in articular capsules).

74
Q

Thermo Receptors

A

Slow adapting
Detect changes in skin temperature
Transient receptor potential channels

75
Q

Cholinergic receptors

A

Classes:
Nicotinic (nicotine stimulation)
. Receptor that operates on acetylcholine as its neurotransmitter.
. Ganglionic antagonist: Hexamethonium.
. Motor antagonist: turbocurarine (Curare).
Muscarinic (muscarine stimulation)
. Antagonist: Atropine (Belladonna).

76
Q

Adrenergic Receptors

A
They come in 4 categories.
Alpha receptors 
. Excitatory 
. Type 1 and 2
. Vasoconstriction
Beta receptors
. Inhibitory
. Type 1 and 2
Vasodilation
77
Q

What does adrenergic means?

A

Adrenaline acting or adrenaline liking.

78
Q

What are the classes of adrenergic receptors?

A

Alpha receptors -Alpha 1 and alpha 2

Beta receptors - Beta 1 and beta 2

79
Q

What happens with the vascular system during fight or flight? alpha 1

A

The vascular system is going to tighten up and contract.
We need TPR and blood flow to go up.
I don’t need to be digesting at this, so it will be inhibitory instead of excitatory,

80
Q

Alpha 2 receptors

A

Alpha 2 receptors calm the nervous system down.

81
Q

When I have ventral horn problems…

A

I have paralysis usually such as polio.

82
Q

Where are most amino acids (non-essential) mostly produced in the body?

A

Liver

83
Q

What are the excitatory neurotransmitters?

A
Norepinephrine
Dopamine
Epinephrine
Glutamate
Serotonin
Acetylcholine
Histamine
84
Q

What are the inhibitory neurotransmitters?

A

GABA
Glycine
Nitric Oxide
Neurosteroids

85
Q

What is another term for LIGAND?

A

Messenger

86
Q

REMEMBER

A

Choline acetylase creates acetylcholine

The enzyme that breaks Acetylcholine is called acetylcholine esterase.

87
Q

Vitamin B3

A

Niacinamide.

It is very important inside the brain. The bain in a deficit of B3 will make niacinamide out of tryptophan.

88
Q

What is the amino acid that starts the production of dopamine, norepinephrine, and epinephrine?

A

It all first starts with phenylalanine, then Tyrosine, then L-dopa, Dopa, NE, and finally E.

89
Q

What are the co-factors for creating E?

What is the enzyme that converts NE to E?

A

to go from NE to E, SAMe, B12, and folate are needed,

N-methyl-transferase

90
Q

Remember

A

In the CNS most catecholamines remain dopamine and NE.

In the peripheral NS, 80% of the catecholamines are epinephrine.

91
Q

If there is an issue with the MAO or COMT…

A

ADH, aggression, anxiety due to catecholamine build up in the brain

92
Q

Is glutamate excitatory or inhibitory?

A

Excitatory

93
Q

What is GABA formed from?

A

Glutamine and the CNS

94
Q

What does GABA do?

A

Causes inhibitory activity in the CNS.

95
Q

Functions of the cerebellum

A

Vestibulocerebellum - control of balance and eye movement.
Pontocerebellum - planning and initiation of movement.
Spinocerebellum - synergy, which is control of rate, force, range, and direction of movement

96
Q

Huntington’s Chorea

A

Genetic
Age 20-50
Progressive to death
Loss of GAA containing neurons.

97
Q

Parkinson’s disease

A

Damage to the substantia nigra dopaminergic system
Idiopathic (autoimmune) or toxic
Festinating gait, cog-wheel rigidity, pill-rolling resting tremor

98
Q

Ventricular system

A

Network of communicating cavities within the brain that contains CSF.
There are two lateral, third ventricles, and a 4th ventricle.
The function of these ventricles is to produce CSF, circulate, and reabsorb it.

99
Q

ALS - Amyotrophic lateral sclerosis

A

Amyotrophic - No muscle nourishment
Men 50-60
Loss of both lower and upper motor neurons
Muscular atrophy, weakness, hyperreflexia
Death following respiratory complication.
10% dt autosomal dominance.

100
Q

CNS Infection

A

Will kill you quickly

101
Q

Encephalitis

A
Severe
Headache with systemic sn/SX (fever, n/v)
Often focal neurological deficit
Infection of the brain itself
Will kill you quicker
102
Q

Meningitis

A

Infection of the meninges

Outside of the brain

103
Q

Tumors and Myelin diseases

A

Astrocytoma - categorized by grades 1-4
1 and 2 are benign
3 malignant
Grade 4 astrocytomas = Glioblastoma Multiforme or GBM. Very aggressive

104
Q

Multiple sclerosis

A

In CNS
female > males
Autoimmune demyelination
Optic neuritis,

105
Q

Guillain-Barre Syndrome

A

Symmetrical ascending paralysis
Imminent respiratory failure - a matter of time for this to happen
Cranial nerve mostly affected is CN7

106
Q

Remember

A

Cowdry bodies - inclusions you see in patients that have herpes infections

107
Q

Remember

A

Negri bodies - Rabies

108
Q

Wernicke-Korsakoff syndrome

Nutrition deficiency

A

Thiamine (B1) deficiency due to alcoholism
ETOH metabolism used B1 (among other nutrients). Vitamin B1 is responsible for dehydrogenase metabolism. If I am doing a lot of this, I am using a lot of B1.
Confabulations/no short term memory
Tx. With B1 IV reverses many Sn/Sx

When I don’t have B1, I do not have short-term memory. People with B1 deficiency make things up due to bad short-term memory - not on purpose

109
Q

Niacin (vitamin B3) deficiency

Nutrition deficiency

A

Dementia, dermatitis, diarrhea (death)

Niacin is important to every process in the brain that explains dementia.

110
Q

Vitamin B12 (cobalamin) deficiency

A

Macrocytic anemia
degeneration of the spinal cord - does not happen in folate deficiency.
Spasticity weakness, dementia, loss of proprioception.
Some PNS Sx
Not cured by Folate supplementation.

111
Q

Dementia

A

It is a clinical sign/symptom
Dementia is a clinical finding that correlates to diseases that causes dementia
Dementia - lost higher activity in the brain
It can be caused by drugs, alcohol, trauma, infections,

112
Q

Alzheimer’s disease

A

The most common reason for dementia

Inflammatory change

113
Q

Tay-Sachs

A

Lysosomal storage dz
Progressive, neurodegenerative disorder
Cause by an enzymatic deficiency (hexosaminidase A)
Inability to catabolize GM2 gangiosides

114
Q

AVM

A

Congenital
May occur anywhere
Causes chronic H/A

115
Q

Berry aneurysm

A

Congenital

Happens on the anterior communicating arteries or posterior communicating arteries in the circle of Willis

116
Q

Hypertensive Encephalopathy

A

Diastolic blood pressure 120
Grade 4 retinal changes
Confusion, drowsiness, h/a, nausea
may lead to rupture and hemorrhage

117
Q

What can increased intracranial pressure cause?

A

It can lead to papilledema (swelling of the disk) and brain herniation

118
Q

What is the right hemisphere dominant for?

A

Facial expression, intonation, body language, and spatial tasks

119
Q

Left hemisphere

A

language