Neuro Flashcards
Frontal lobe function (5)
- regulate and initiate motor function
- language
- cognitive functions
- attention
- memory
Parietal lobe function (3)
- sensation – touch, pain
- sensory aspects of language
- spatial orientation and self perception
Occipital lobe function (1)
process visual info
Temporal lobe function (3)
- process auditory info
- emotions
- memories
limbic lobe parts (4)
amygdala, hippocampus, cingulate gyrus, mamillary body
limbic lobe functions (5)
- learning
- memories
- reward
- emotion
- motivation
Which are white matter tracts (3)
- Association fibres
- Commissural fibres
- Projection fibres
which association fibres connect which lobes (4 pairs)
- superior longitudinal fasciculus (frontal nad occipital)
- arcuate fasciculus (frontal and temporal)
- Inferior longitudinal fasciculus (temporal and occipital)
- Uncinate fasciculus (anterior frontal and temporal)
characteristics of localisation of function in primary cortices
- function predictable
- organised topographically
- left right symmetry
function of primary motor cortex
- controls fine, discrete precise voluntary movements
- provide descending signals to execute movements
function of premotor area
planning movements (externally cued)
function of supplementary area
planning complex movements (internally cued)
function of primary somatosensory area
process somatic sensations from receptors in body (eg fine touch, vibration, proprioception, 2-point discrimination, pain, temp)
function of somatosensory assocation
interpret significance of sensory info
difference between broca’s area and wernicke’s area
Broca: speak, production of language
wernicke’s understanding of language
what happens to frontal lobe lesions
change in personality and inappropriate behavior
what happens to parietal lobe lesions (eg right hemisphere lesion)
contralateral neglect
lack of awareness of self on left side
lack of awareness of left side of extrapersonal space
what happens to temporal lobe lesions
agnosia (inability to recognise), anterogade amnesia (cannot form new memories)
what happens to broca’s and wernicke’s area lesions
broca: expressive aphasia (poor production of speech)
wernicke’s: comprehensive aphasia (poor comprehension of speech, production is fine)
what happens to primary visual cortex lesion
blindness in corresponding part of visual field
what happens to visual association lesion
deficits in interpretation of visual info
prosopagnosia (inability to recognise familiar or learn new faces
what are some scans to assess cortical function
PET (positron emission tomography)
fMRI
EEG (electroencephalography)
MEG (magnetoencephalography)
TMS (transcranial magnetic stimulation)
tDCS (transcrania direct current stimulation)
what are some scans to assess structures
DTI (Diffusion tensor imaging) –> based on diffusion of water molecules
what is MS
autoimmune
loss of myelin from neurons of CNS
main symptoms of MS (5)
blurred vision
fatigue
difficulty walking
numbness and tingling
muscle stiffness
what are the blood supplies to brain
carotid artery and vertebral
artery
what are types of haemorrhage (4)
epidural, subdural, subarachnoid, intracerebral
what is extradural haemorrhage
trauma caused
immediate clinical effects (arterial, high pressure)
what is subdural haemorrhage
trauma caused
delayed presentation of clinical effects (venous, low pressure)
what is subarachnoid haemorrhage
ruptured anneurysm
what is intracererbral haemorrhage
spontaneous hypertensive
risk factors of stroke
age
hypertension
DM
smoking
cardiac disease
what are the cerebral artery perfusion for cerebrum
anterior, middle, posterior cerebral artery
what are anterior cerebral artery symptoms lesion
paralysis of contralateral structures (leg > arm) , loss of appropriate social behavior, disturbance of intellect, executive function &w judgement
what is middle cerebral artery symptoms lesion
classic stroke
contralateral hemiplegia (arm > leg)
contralateral hemisensory deficits
hemianopia
aphasia
what is posterior cerebral artery symptoms lesion
visual deficits (homonymous hemianopia, visual agnosia)
what are the 2 major descending tracts
pyramidal(pass thru pyramids of medulla) and extrapyramidal (dont pass thru pyramids of medulla)
what are the 2 pyramidal tract pathway
corticospinal
corticobulbar
what are the 4 extrapyramidal tract pathway
tectospinal
vestibulospinal
rubrospinal
reticulospinal
function of pyramidal tracts
voluntary movements of body and face
where nerve pass from in pyramidal tracts
motor cortex to spinal cord or cranial nerve nuclei in brainstem
function of extrapyramidal tracts
involuntary movements for balance and posture and locomotion
where nerve pass from in extrapyramidal tracts
brainstem nuclei to spinal cord
function of primary motor cortex
controls fine, discrete voluntary movements
provide descending signals to execute movements
function of premotor area
plan movements
regulate externally cued movements
function of supplementary area
plan complex movements (internally cued, speech)
function of vestibulospinal
stabilise head during body &head movements
coordinate head movements with eye movemetns
mediate postural adjustments
function of tectospinal
orientation of head and neck during eye movements
from superior colliculus of midbrain
function of reticulospinal
from medulla n pons
change in muscle tone asociated with voluntary ovement
postural ability
upper motor neuron lesion negative signs (3)
loss of voluntary motor function
paresis (graded weakness of movements)
paralysis (complete loss of voluntary muscle activity)
upper motor neuron lesion positive signs (5)
increased abnormal motor function due to loss of inhibitory descending inputs
spasticity (increase muscle tone)
hyper-reflexia (exaggerated reflexes)
clonus (abnormal oscillatory muscle contraction)
babinski’s sign (abrnomal response in foot)
lower motor neuron lesion signs (6)
weakness
hypotonia
hyporeflexia
muscle atrophy
fasciculations (visible twitch)
fibrillations (twitching of individual muslce fibres, recorded in needle EMG)
what is motor neuron disease (MND)
neurodegenerative disorder of motor system
MND Upper Motor Neuron signs
spasticity (increased tone of limbs and tongue)
babinski’s sign
brisk limbs and jaw reflexes
loss of dexterity
dysarthria(difficulty speaking)
dysphagia (difficulty swallowing)`
MND lower motor neuron signs
weakness
muscle wasting
tongue fasciulations and wasting
nasal speech
dysphagias
structure of basal ganglia
caudate nucleus
lentiform nucleus (lentiform +caudate = putamen)
caudate +putamen = striatum
substantia nigra (midbrain)
function of basal ganglia
decision to move
perform associated movements (change facial expression)
perform movements in order
suppress unwanted movements
signs of parkinson’s disease
bradykinesia
hypomimic face
akinesia
rigidity
tremor at rest
what is parkinson’s disease
degeneration of dopaminergic neurons that originate in substantia nigra and project to striatum
what is huntington’s disease
degeneration of GABAergic neuron in striatium, caudate and then putamens
signs of huntington’s
choreic movements
rapid jerky involuntary mvoements (hand–> face –> legs –> rest of body)
speech impairment
difficulty swallowig
dementia
cognitive decline
unsteady gait
what is ballism
from stroke affecting subthalamic nucelus
uncontrolled flinging
contralaterally
what is cerebellum separated from cerebrum by
tentorium cerebelli
signs of cerebella dysfunction
ataxia (impairment in movement coordination and accuracy)
dysmetria (inappropriate force and distance for target directed movement)
intention tremor
dysdiadochokinesian (inability to preform rapidly alternating movements)
scanning speech (staccato)
what is alpha motor neuron
LMN of brainstem and spinal cord
innervate extrafusal muscle fibres of skeletal muscles
activate muscle contraction
what are the 3 types of motor qunit
S, type l
FR, type llA
FF, type llB
how do we regulate muscle force
recruitment and rate coding
motor unit type switching
llB to llA after training
l to ll in severe deconditioning or spinal cord injury
loss of l and ll but preferentially ll in ageing
what stimulates involuntary coordinated pattern
peripheral stimuli
example of descending control of reflexes
jendrassik manoeuvre
which dominates normal condition, inhibitory or excitatory control
inhibitory
which dominates decrebration condition, inhibitory or excitatory control
excitatory from suprasinal areas
what is order of descending control of reflexes
activate alpha motor neurons
activate inhibitory interneurons
activate propriospinal neurons
activate gamma motor neurons
activate terminals of afferent fibres
what motor neuron is hyper reflexia associated with
UMN lesion
what is clonus (abnormal, hyper reflexia) associated with
UMN lesion
involuntary and rhythmic muscle contractions
loss of descending inhibition
what is babinski’s sign associated with
UMN lesion
big toe curl upwards in adults when sole stimulated with blunt instrument (normally curl downwards) –> positive babinski’s sign
what is hypo-reflexia associated with
LMN disease
examples of primary headache
migraine
tension-type headache
cluster headache
what are secondary headache
spercipitated by other condition (eg tumor)
which is more long lasting – tension type or cluster headache
tension type , migraine
they can last long but usualy shorter (30mins-1hr)
which is more short lasting – tension type or cluster headache
cluster headche
but usually longer (45mins -3hrs)
key red flags of secondary headache
age, onset, systemic symptoms, neurological signs
migraine characteristics
unilateral
pulsating quality
moderate or severe pain intensity
aggravation by routine physical activity
last hrs or some days
does migraine associate with aura
can be with or without aura
symptoms associated with migraine
nausea and / or vomiting
photophobia and or phonophobia
what is visual aura in migraine
complex array of symptoms reflecting focal cortical or brainstem dysfunction
how long is the graded evolution of visual aura
5-20 mins (< 1hr)
describe aura in migraine
expanding C
elemental visual disturbance
4 phases of migraine
premonitory
aura
headache
recovery
acute treatment for migraine
paracetamol
NSAIDS
prokinetics
triptans
long term preventives of migraine
TCA (tricyclic antidepressants)
B-blockers
serotonin antagonists
ACEi
calcium channel blockers
anticonvulsants
is tension type headache episodic
yes
how will patients describe tension type headache
tight muscles ard head and neck
characteristics of tension type headache
bilateral
mild or moderate pain
not aggravated by any movements
no added features (eg N+V, photophobia phonophobia)