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Y2 > Neuro > Flashcards

Neuro Flashcards

1
Q

Neuro cells

A

Neuron: excitable

Astrocyte: structural, most abundant

Oligodendrocyte/Schwann cell: myelin

Microglia: macrophage

Ependyma: CSF producing/regulating

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2
Q

Phases of action potential

A

RMP

Depolarisation

Upstroke: Na influx, delayed K efflux

Repolarisation: VGSC close

Hyperpolarisation

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3
Q

Factors affecting action potential propagation

A

Axon diameter

Myelinated neuron

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4
Q

Parkinson’s drug

A

Pramipexole: dopamine receptor agonist

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5
Q

Vesicular protein that mediates exocytosis of neurotransmitter

A

SNARE proteins

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6
Q

Types of receptors for neurotransmitters

A

Ionotropic(fast): Glu, GABA for CNS, ACh for NMJ

GPCR(slow): ACh, DA, NA, 5HT

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7
Q

Types of Glu receptors

A

AMPA: fast

NMDA: slow

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8
Q

Effect of Glu

A

Excitatory
Na influx
Depolarisation

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9
Q

Effect of GABA

A

Inhibitory
Cl influx
Hyperpolarisation

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10
Q

Compare PNS and SNS visceral motor neurons

A

Parasympathetic: long pre(ACh), short post(ACh)

Sympathetic: short pre(ACh), long post(NA)

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11
Q

CSF compared to blood plasma

A

Lower pH
Less glucose
Less protein
Less K

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12
Q

Motor tract for voluntary movement(pyramidal)

A

Corticospinal tract: anterior(trunk), lateral(limb)

Corticobulbar tract: face muscles

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13
Q

Motor tract for involuntary movement

A

Vestibulospinal
Tectospinal
Reticulospinal
Rubrospinal

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14
Q

Sensory tracts

A

Dorsal column pathway: fine touch, vibration, proprioception

Spinothalamic tract: pain, temperature, crude touch

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15
Q

Dorsal column pathway tracts

A

Gracile tract: lower limb

Cuneate tract: upper limb

First order synapse in medulla, second order decussates in medulla and synapses in thalamus, third order to somatosensory cortex

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16
Q

Spinothalamic tract divisions

A 
Pain and temperature(lateral)
Crude touch(anterior)

First order synapses in grey matter of spinal cord, second order decussates at same level and synapses in thalamus

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17
Q

Layers of fasciculi of PNS nerves

A

Epineurium
Perineurium
Endoneurium

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18
Q

Proprioceptors

A

Muscle spindles: muscle length change
Golgi tendon: tendon tension change
Joint receptors: start/end of movement

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19
Q

Sympathetic outflow/trunk

A

T1-L2: white ramus communicans
C1-C8: ascending sympathetics
L3-Co: descending sympathetics

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20
Q

Sciatica causes

A

Disc herniation(slipped disc): bulge
Spinal stenosis: narrowing
Spondylolisthesis: slippage
Non-disc: malignancy, arthritis, bone growth

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21
Q

Cranial nerves that emerge at midbrain

A

CN 3 and 4

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22
Q

Cranial nerves that emerge at pons

A

CN 5-8

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23
Q

Cranial nerves that emerge at medulla

A

CN 9, 10, 12

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24
Q

Frontal lobe function

A

Motor function

Cognitive function

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25
Q

Parietal lobe function

A

Sensation
Sensory language
Spacial orientation & self-perception

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26
Q

Occipital lobe function

A

Process visual info

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27
Q

Temporal lobe function

A

Process auditory info

Emotion

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28
Q

Limbic lobe

A

Hippocampus
Cingulate gyrus
Amygdala

Learning, memory, emotion, motivation and reward

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29
Q

Insular cortex

A

Deep to lateral fissure

Visceral sensation, autonomic control

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30
Q

White matter tracts in cerebral cortex

A

Association fibres: within the same hemisphere

Commisural fibres: homologous structures between hemispheres(corpus callosum and anterior commisure)

Projection fibres: lower brain structures via internal capsule (corona radiata)

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31
Q

Frontal lobe supplementary vs premotor area

A

Supplementary: internally cued
Premotor: externally cued

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32
Q

Cortical(lobe) functions after lesion

A 
Frontal: personality change
Parietal: contralateral neglect
Temporal: agnosia, anterograde amnesia
Broca’s: speech production
Wernicke’s: speech comprehension
Visual assiciation: visual interpretation deficit
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33
Q

Types of haemorrhages

A

Extradural: arterial, high pressure
Subdural: venous, low pressure
Subarachnoid: circle of Willis, aneurysm
Intracerebral: chronic hypertension

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34
Q

Causes of stroke

A

Thromboembolic(85%)

Haemorrhage(15%)

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35
Q

Symptoms of stroke

A

One sided face drooping
Cannot lift/maintain both arms
Slurred speech

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36
Q

Stroke risk factors

A 
Age
Hypertension
Cardiac disease
Smoking
Diabetes mellitus
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37
Q

Anterior cerebral artery embolism symptoms

A 
Contralateral paralysis(likely legs)
Affected intellect, cognition
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38
Q

Middle cerebral artery embolism symptoms(classic stroke)

A 
Contralateral paralysis(likely arms)
Aphasia(left sided lesion)
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39
Q

Posterior cerebral artery embolism symptoms

A

Visual deficits: homonymous hemianopia, face blindness

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40
Q

Motor cortex lesion

A

Apraxia: skilled movement disorder caused by stroke/dementia at premotor cortex/supplementary motor area

Motor neuron disease: amyotrophic lateral sclerosis(ALS)

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41
Q

Upper motor neuron lesion signs

A 
Spasticity
Hypertonia
Hyperreflexia
Babinski’s sign
Dysphagia
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42
Q

Lower motor neuron lesion signs

A

Muscle atrophy & wasting
Hypotonia
Hyporeflexia
Fasciculations

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43
Q

Basal ganglia disorders

A

Parkinson’s(substantia nigra): degeneration of dopaminergic neurons

Huntington’s(striatum): degeneration of GABAergic neurons

Ballism(subthalamic nucleus): usually stroke causing uncontrolled flinging of extremities

44
Q

Parts of cerebellum and effect of damage to that area

A

Spinocerebellum: abnormal gait/stance

Vestibulocerebellum: gait ataxia and fall tendency

Cerebrocerebellum: speech

45
Q

Outer ear function

A

Protection
Capture sound
Amplify some frequencies

46
Q

Middle ear function

A

Amplify by focussing vibrations from large surface area(tympanic membrane) to small surface area(oval window)

47
Q

Middle ear bones

A

Malleus
Incus
Stapes

48
Q

Inner ear function

A

Transduce vibration into nervous impulse

49
Q

Layers of the cochlea

A 
Scala vestibuli(bony, perilymph)
Scala media(membranous, endolymph and contains organ of Corti)
Scala tympani(bony, perilymph)
50
Q

Difference between perilymph and endolymph

A

Perilymph high Na

Endolymph high K

51
Q

Basilar membrane arrangement

A

Tonotopically

Base: narrow and tight(high freq)
Apex: wide and loose(low freq)

52
Q

Organ of Corti cells and relation to tectorial membrane

A

1 column of inner hair cells
3 columns of outer hair cells
OHCs in constant contact with tectorial membrane
Deflection of tectorial membrane ->depolarisation

53
Q

Organ of Corti afferent/efferent nerves

A

IHC: 95% of afferent info
OHC: 95% of efferent info

54
Q

Name of hairs in auditory system and function

A

Sterocilia

Deflection towards longest cilium opens K channels->depolarisation

55
Q

Classification of hearing loss

A

Conductive(outer/middle ear)
Sensorineural(inner ear/nerve)
Mixed(conduction/transduction)

56
Q

Causes of hearing loss

A

Conductive: wax, foreign body, otitis, otosclerosis

Sensorineural: presbycusis, ototoxicity, CN VIII tumour

57
Q

Hearing loss treatment

A

Treat underlying cause

Hearing aids: amplifies sound

Cochlear implant: replaces hair cells

Brainstem implant

58
Q

Vestibular system inputs and outputs

A

Inputs: visual, proprioceptive, vestibular

Outputs: ocular reflex, postural control, nausea

59
Q

Otolith organs and which one joins to SCC

A

Utricle, saccule

Semicircular canals have an ampulla that joins to utricle

60
Q

What kind of cilia do vestibular hair cells have

A

Have kinocilium and stereocilia

Endolymph movement->depolarisation

61
Q

Vestibular system functions

A

Detect head movement
Keep images fixed during movement
Postural control

62
Q

Vestibular hair cells potential

A

Excitatory: hair moves toward kinocilium
Inhibitory: hair moves away

63
Q

Which part of vestibular system detects accelerations

A

Linear: utricle(horizontal), saccule(vertical)

Angular: cupula moves and displaces hair cells in SCC, which work in pairs

64
Q

Vestibular reflexes

A

Vestibulo-ocular: vestibular and oculomotor nuclei->images stay fixed

Vestibulospinal: prevent falling and postural control

65
Q

Symptoms of balance disorder

A

Dizziness

Vertigo

66
Q

Balance disorder locations

A

Peripheral(labyrinth +/- CN VIII): vestibular neuritis, BPPV, Meniere’s disease

Central: stroke, multiple sclerosis, tumour

67
Q

What is BPPV

A

Benign paroxysmal positional vertigo

Crystals dislodged and enter SCC

68
Q

What is Meniere’s disease

A

Increased fluid buildup in labyrinth

69
Q

Layers of tear film

A

Superficial lipid layer: reduce evaporation

Aqueous tear film

Mucinous layer

70
Q

Layers of the eye

A

Sclera: tough, opaque, high water content

Choroid: blood vessels, iris that controls light levels

Retina: blind spot no photoreceptors, macula contains fovea that has high cones and low rods

71
Q

Layers of retina

A

Outer: photoreceptors
Middle: bipolar cells(process local signal)
Inner: retinal ganglion cells

72
Q

Types of photoreceptors and function

A

Cones: colour, central vision, fast response

Rods: night, peripheral vision, slow response, more sensitive to light than cones

73
Q

Causes of ametropia

A

Myopia:
Rays converge anterior to retina
Excessive long globe
Excessive refractive power

Hyperopia:
Rays converge posterior to retina
Excessive short globe
Insufficient refractive power

Astigmatism:
Rays converge at 2 focal lines
Refractive media not spherical

Presbyopia:
Loss of accommodation
>40 years
Distant vision intact

74
Q

Effect of lesion at optic chiasm

A

Bitemporal hemianopia

75
Q

Effect of lesion posterior to optic chiasm

A

Homonymous hemianopia:
Right lesion->left HH
Left lesion->right HH

76
Q

CN III palsy symptoms

A

Down and out

Droopy eyelid

77
Q

CN VI palsy

A

Affected eye cannot abduct

Double vision

78
Q

Optokinetic nystagmus reflex

A

Oscillatory eye movement

79
Q

Types of cerebral inflammation

A

Meningitis
Encephalitis
Cerebral vasculitis

80
Q

Red flags for headache

A 
Onset
Meningism(photophobia, stiff neck, fever)
Systemic symptoms
Neurological symptoms(Horner’s)
Orthostatic
Strictly unilateral
81
Q

What is carotid/vertebral artery dissection and management

A

Splitting of arterial wall
Carotid more common
Carotid: phantom of opera headache
Vertebral: occipital headache

Aspirin/anticoagulant
MRI

82
Q

Causes of unilateral headache

A

Temporal arteritis
Migraine
Cluster headache

83
Q

Meningitis symptoms

A 
Fever
Stiff neck
Photophobia
Headache
Confusion
84
Q

Meningitis management

A

Treat then diagnose
Antibiotics
Lumbar puncture
CT/MRI

85
Q

Low pressure headache symptoms and management

A

Orthostatic headache

Rehydration
Caffeine
Blood patch

86
Q

What is chiari malformation

A

Normal brain that sits low in the skull

Causes cough headache

87
Q

What is trigeminal neuralgia and management

A

Neurovascular conflict at point of entry of nerve into pons

Electric shock like pain triggered by harmless stimuli

Anticonvulsants
Posterior fossa decompression

88
Q

What is cervical spondylosis

A

Narrowing of joint space due to joint disc

Bilateral occipital pain worsened by neck movement

89
Q

Migraine symptoms

A

Visual vertigo

Unilateral pain

90
Q

Migraine phases

A 
Prodrome
Aura
Headache
Resolution
Recovery
91
Q

Migraine treatment

A

Avoid triggers(diet, sleep, weather)
Aspirin, ibuprofen(NSAIDs)
Paracetamol(anti-emetics)

92
Q

Migraine prophylaxis

A 
Antidepressants
Beta blockers
Calcium channel blockers
Anticonvulsants
Erenumab(disables calcitonin gene related peptide)
93
Q

What is tension headache and management

A

Tight muscles around head/neck bilaterally

NSAIDs, paracetamol, antidepressants

94
Q

What is cluster headache and what is it accompanied by

A

Severe unilateral pain

Conjunctival redness
Nasal congestion
Eyelid oedema

95
Q

Cluster headache management

A

Inhaled oxygen

Subcutaneous/nasal sumatriptan

96
Q

Types of hearing tests

A 
Pure tone audiometry(hearing acuity)
Audiometry(audiogram)
Tympanomentry(middle ear condition&eardrum mobility)
Otoacoustic emissions(newborn screening)
Auditory evoked potentials
Auditory brainstem response(babies)
97
Q

Colour blindness

A

Deuteranomaly: red
Achromatopsia: full

98
Q

Parkinson’s symptoms

A 
Bradykinesia
Akinesia
Rigidity
Tremor at rest
Hypomimic face
99
Q

Cerebellar dysfunction signs

A 
Scanning speech
Intention tremor
Ataxia
Dysmetria
Dysdiadochokinesia
100
Q

Alzheimer’s features

A

Amnesia
Amyloid plaques, tau
Hippocampus

101
Q

Vascular dementia features

A

Step wise deterioration

Stroke related

102
Q

Lewy body dementia features

A

Cognitive impairment
Parkinsonian symptoms
Visual hallucinations
Fluctuating cognition

103
Q

Frontotemporal dementia features

A

Behaviour change

Non fluent aphasia

104
Q

Dementia investigations

A

MMSE(mini mental state exam)
MRI
Bloods
PET

105
Q

Dementia management

A

Acetylcholinesterase inhibitors
Treat behavioural/psychological symptoms
Social services/occupational therapy

106
Q

Dementia differential

A

Delirium

Depression

Y2 (10 decks)

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