Neuro Flashcards
sensation with no thalamic relay
olfaction (CNI)
VPL nucleus
spinothalamic tract (pain and temperature) and medial lemniscus/dorsal columns (position and proprioception)
VPM nucleus
trigeminal and gustatory pathway
-FACE SENSATION, TASTE
LGN
relay nucleus for VISION
-receives impulses from the optic nerve and transmits via optic radiations to visual cortex (calcarine sulcus)
MGN
input from superior olivary nucleus and inferior colliculus of the pons-relay for HEARING
VL
input form basal ganglia, cerebellum
MOTOR info to motor cortex
opiods gen mech
G protein linked receptors that
open K, close ca2+ channels decreasing synaptic transmission and release of Ach, Ne, 5HT, glutamate, substance P
Benzos gen mech
allosterically bind and modulate GABA receptor-Cl channel in CNS-increasing frequency of opening
-influx of Cl–less excitable
anxiolytics, anticonvulsants, muscle relaxants, sedatives-hynotics
-benzo tolrance via downregulation of GABA receptors
barbituates gen mech
bind and increase GABA receptor-Cl channel opening in CNS (bind at different site than benzos do)
- at high doses cause direct gating of the ion channels (ie channel opening without the need of GABA to bind as well)
- cause more hangover
drugs to avoid with lithium use
thiazide diuretics (working at DCT therefore not loop), ACEi, NSAIDs increase lithium levels and more likely to cause lithium toxicity
triptans mech
serotonin 5ht agonists that lead to inhibition of vasoactive substance release (ie substance P and calcitonin gene related peptide (CGRP)) , vasoconstriction and block pain pathways
SSRIs
block presynaptic serotonin reuptake
TCAs/SNRIs
block serotonin/NE PREsynaptic reuptake
buproprion
blocks presynaptic dopamine and NE reuptake
phenytoin mech
reduces ability of Na channels to recover from inactivating, reducing overall firing
carbamezapine mech
increases Na refractory period making longer inactivation and decreasing AP firing
free nerve endings
pain/temperature
c-slow unmelyinated type
Adelta-fast, myelinated type
on all skin, some viscera
Meissner corpuscles
dynamic, fine/light touch, position sense
large myelinated fibers, adapt quickly
on glabrous (hairless) skin
Pacinian corpuscles
vibration/pressure
large myelinated fibers, adapt quickly
deep skin layers, ligaments, joints
Merkel discs
pressure, deep static touch (shapes/edges), position sense
large myelinated fibers adapt slowly, fingertips, superficial skin
RUffini corpuscles
pressure, slippage of objects along joint skin, joint angle change
dendritic endings with capsule, adapt slowly
fingertips, joints
nucleus accumbens
GABA
down in HD, anxiety
locus ceruleus
NE
up in anxiety
down in depression
ventral tegmentum and SN pars compacta
dopamine
up in HD
down in PD, depression
Raphe nuclei (pons, medulla, midbrain)
serotonin
down in depression, anxiety
basal nuclei of myenert
ACh
down in alzheimers, huntintons
up in PD
tongue innervation
taste: ant 2/3 VII via chorda typmani, post 1/3 IX (glossopharyngeal)
Pain: ant 2/3 via V3 mandibular, post 1/3 IX
motor: styloglossus (taco) genoglossus, hypoglossus via XII hypoglossal, palatoglossal via X
organum vasculosum of the lamina terminalis
OVLT
in hypothalamus
-area not protected by BBB
-senses change in osmolarity
area postrema
in hypothalamus
not protected by BBB
-responds to emetics
supraoptic nuclues
in hypothalamus
makes ADH
paraventricular nucleus
in hypothalamus
makes oxytocin
lateral hypothalamus
hunger
-if injured anorexia, FTT in infants
ventromedial area of hypothalamus
satiety (stimulated by leptin)
-if injured majes you fat
anterior hypothalamus
cooling, parasympathetic
posterior hypothalamus
heating, parasymptathetic
if injured-cold blooked “poikilotherm”
suprachiasmatic nucleus
circadian rhythmm
-causes NE release which acts on the pineal gland to release melatonin
At night, BATS Drink Blood
Sleep cycle EEG pattern:
Awake (eyes open): Beta
Awake (eyes closed): Alpha
NREM stage 1: theta
NREM stage 2: sleep spindles and K complexes
NREM stage 3: delta (lowest frequency, high amp)
REM: Beta
kluver bucy syndrome
damage to amygdala
disinhibted personality, hypersexual, hyperphagia, hyperorality
gerstmann syndrome
damage to dominant parietal-temporal lobe
-agraphia, acalcula, finger agnosia, left-right disorientation
wing beating tremor, psychosis, cirrhosis
wilsons dz
damage to lentiform nucleus -putamen, GP
clasp knife spasticity
damage to internal capsule-get initial resistance then release
no upper motor block of spinal stretch reflex
central post stroke pain syndrome
after thalamic stroke, allodyina and dysesthesia (pain with things that would normally not cause any pain)
riluzole
treatment for ALS
glutamate antagonist
B12 vs tabes dorsalis
B12-demyelination of spinocerebellar, dorsal columns, corticospinal
Tabes dorsalis-demyelination of dorsal columns
poliomyeltis csf
increase WBC
slight increase in protein
no change in glucose
-damage to anterior horns (LMN)
SMA-werdnigg hoffman
AR
LMN destruction of anterior horns
death by 7 months
floppy baby
parinaud syndrome
paralysis of conjugate verticla gaze due to lesion of superior colliculus (commonly pinealoma ie germinoma or aqeuductal compression-obstructive hydrocephalous
APP, prenisilin 1, presnisilin 2
increased risk for early onset AD
APP=amyloid precursor protein
Apoe4
increased risk of AD
Apoe2
decreased risk of AD
CSF in GBS
increased protein with normal cell count
albuminocytologic dissociation
Krabbe disease
AR lysosomal storage disorder due to deficiency of galactocerebrosidase leading to the buildup of galactocerebroside and psychosine which destroy myelin
-p/w peripheral neuropathy, developmental delay, optic atrophy, globoid cells
metachromic leukodystrophy
AR lysosomal storage disorder due to deficiency of arylsulfatase A with resulting buildup of sulfatides, impaired production and destruciton of myelin sheath
-central AND peripheral demylination with ataxia and dementia
progressive multifocal leukodystrophy PML
associated with JC virus CNS disruption of oligodendrocytes in AIDS pts rapidly progressive usually fatal increased risk with natalizumab rituximab
adrenoleukodystrophy
AR
disruption of metabolism of long chain fatty acids leading to excess buildup in nervous system, adrenal glands, testes,
can lead to long term coma/death and adrenal crisis
STURGE
Sporadic, port wine Stain Tram track calcification Unilateral Retardation Glaucoma, GNAQ gene Epilepsy
HAMARTOMAS
Hamartomas in CNS and skin Angiofibromas/angiomyolipomas (bilateral) Mitral regurgitation Ash leaf spots Rhabdomyoloma (cardiac) TUBEROUS SCLEROSIS dOminant (autosomal) Mental retardation Angiomyolipomas Seizures/shaggreen patches increased incidence of subependymal astrocytomas and ungual fibromas(growth under toes/fingernails)
von Hippel Lindau diseae
Autosomal Dominant
hemangioblastomas (in retina, cerebellum, brainstem, spine)
pheochromocytomas
angiomatosis (cavernous hemangiomas in skin, mucosa, organs)
bilateral renal cell carcinomas
Neurofibromatosis I
NFI gene on chromosome 17 cafe au lait lisch nodules(pigmented iris hamartomas) cutaneous neurofibromas optic gliomas pheochromocytoma
GBM
grade IV astrocytoma, highly malignant
stain for GFAP
-histo: pseudopalisading pleomorphic tumor cells-border central ares of necrosis and hemorrhage
Meningoma
near surfaces of brain, extra-axial, arises from arachnoid cells-
+/- tail=dural attachment
histo: spindle cell, concentrically in whorled pattern, psamomma bodies
oligodendroglioma
chicken wire pattern of capillaries
- slow growing usually at frontal lobe
- fried eggs-round nuclei with clear cytoplasm
pilocytic astrocytoma
low grade-usually in posterior fossa (ie cerebellum)
GFAP +, low grade
-histo: rosenthal fibers-eosinophilic corkscrew fibers, spindle cells with hairlike glial processes
-cystic + solid (gross)
medulloblastoma
highly malignant cerebellar tumor
possibility of drop mets, obstructive hydrocephalous
-histo: homer wright rosettes, small blue cells (deeply basophilic with scant cytoplasm), sheets of primitive cells with many mitotic figures
ependymoma
usually in 4th ventricle causes obs hydrocephalous, GFAP poor prognosis histo: perivascular resettes, rod shaped blepharoplasts (basal ciliary bodies) found near nucleus
craniopharyngioma
causes bitemporal hemianopia
HA, visual changes, growth failure,
from rathke pouch remants
-cystic calcification
uncal/transtentorial herniation
ipsi fixed/dilated pupil
ipsi oculomotor paralysis (down and out)
ispi hemiparesis–>contra corticospinal tract (contra crus cerebri) at Kernohan notch
contra homonymous hemianopia with macular sparing (PCA)
cingulate (subfalcine) herniation under falx cerebri
can compress ACA (lower motor weakness)
cribiform plate
CNI
superior orbital fissure
CN III, IV, V1, VI
foramen rotundum
V2
foramen ovale
V3
optic canal
CN II
foramen spinosum
Middle meningeal artery
internal auditory meatus
CN VII, VIII
jugular foramen
CN IX, X, XI
foramen mangum
spinal roots of CN XI
hypoglossal canal
CN XII
varibale opthalmoplegia, decreased corneal sensation, Horner syndrome, occasional decreased maxillary sensation
cavernous sinus syndrome
- 2/2 pituitary tumor, carotid cavernous fistula, cavernous sinus thrombosis related to infection
- CN VI most susceptible
