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Neuro Flashcards

1
Q

Neuron staining

A

Nissl stain - stains RER

Doesn’t stain axons, there isn’t any RER there!

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2
Q

Axonal injury

A

Wallerian degeneration - distal degen, retraction proximally

If PNS, potential regeneration

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3
Q

Astrocytes

give functions, stain, derivation

A

Physical support, repair, K+ metabolism
necessary for blood-brain barrier
- holds glycogen fuel reserve

  • marker GFAP
  • reactive gliosis
  • derived from neuroectoderm!
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4
Q

Microglia

A

scavenger cells of CNS

  • mesodermal mononuclear origin
  • HIV: fuse to form multinucleated giant cells
  • not stained by Nissl
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5
Q

Schwann cell

A

1: 1 ratio with PNS cells
- promote axonal regeneration
- neural crest!

destroyed in Guillain-Barre syndrome
- acoustic neuroma

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6
Q

Oligodendrocytes

A

1: many ratio with CNS cells
- injured in MS, PML
- neuroectoderm
- fried egg appearance

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7
Q

Peripheral nerve structure
Endoneurium
Perineurium
Epineurium

A

Endoneurium: single nerve fibers (site of inflamm infiltration in G-B)
Perineurium: surrounds fascicle of nerve fibers, rejoined in microsurgery in limb attachment
Epineurium: dense connective tissue, contains fibers and blood vessels

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8
Q

Blood brain barrier (3 things)

A

Tight junctions (endothelial cells)
Basement membrane
Astrocyte foot processes

  • glucose/AAs cross slowly
  • non-polar/lipid-soluble cross rapidly
  • no BBB: area postrema, neurohypophysis
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9
Q

Hypothalamus (regulates TAN HATS, give hormones and site of synthesis)

A

Thirst, Adenohypophysis, Neurohypophysis, Hunger, Autonomic regulation, Temp regulation, Sexual urges

Supra optic nucleus: ADH
Paraventricular: oxytocin

Inputs: area postrema, OVLT = osmolarity sensor

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10
Q 
Nuclei of hypothalamus
Lateral
Ventromedial
Ant. hypot
Post. hypot
Suprachiasmatic
A 
Lateral: hunger
Ventromedial: satiety
Ant. hypot.: cooling/parasympathetic
Post. hypot: heating, sympathetic
Suprachiasmatic: ciracidan rhythms (sleep = charismatic)
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11
Q

Sleep physiology

A

Light –> suprachiasmatic nucleus –> NE –> pineal gland –> melatonin

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12
Q 
Thalamus nuclei
VPL
VPM
LGN
MGN
VL
A
  • relay for all sensory information except olfaction
    VPL: STT/DCML tracts (everything but face!)
    VPM: trigeminal/gustatory (face sensation, taste)
    LGN: vision (L for light!)
    MGN: hearing
    VL: basal ganglia, cerebellum
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13
Q

Limbic system functions (5 F’s)

A 
feeding
fleeing
fighting
feeling
sex
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14
Q

Cerebellum inputs, outputs, lesions

A

Input:

  • middle cerebellar peduncle = contralateral cortex
  • inferior cerebellar peduncle = ipsilateral proprioceptive

Output:
- superior cerebellar peduncle = contralateral cortex to modulate movement

Lesions: lateral will fall to affected side, medial will be truncal ataxia

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15
Q

Basal ganglia anatomy

Describe direct and indirect pathways

A

Striatum = putamen (motor input) + caudate (cognitive input)
Motor functions all start in the frontal cortex

Direct pathway = D1R leads to increased GABA from striatum to inhibit GPi inhibitory neurons, leading to increased thalamus activity and increased movement

Indirect pathway = D2R leads to inhibition of GPe, releasing their inhibition of subthalamic nucleus, allowing for activation of GPi and inhibition of thalamus

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16
Q

Parkinsons

A

decreased DA secretion, leads to overall less movement and also less inhibition of movements at rest

-alpha synuclein form Lewy bodies (eosinophilic, intracellular inclusions)

TRAPS: tremor, rigidity, akinesia, postural instability, shuffling gait

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17
Q

Huntinton

A

CAG repeats

Caudate loses Ach and GABA

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18
Q 
Aphasia
Broca
Wernicke
Conduction
Global motor
Global sensory
A

Broca - nonfluent, impaired repetition (inferior frontal gyrus)
Wernicke - fluent, impaired comp/rep (superior temporal gyrus)
Conduction - fluent, poor rep (arcuate fasciculus)
Global motor - nonfluent, intact otherwise
Global sensory - poor comp, intact everything

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19
Q

Amygdala lesions

A

Hyperphagia, hypersexuality, hyperorality (HSV-1 = infectious cause)

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20
Q

Parietal-temporal lesions

A

Contralateral hemispatial neglect

21
Q

Midbrain

Reticular-activating system lesions

A

Decreased arousal, wakefulness

22
Q

Mamillary bodies lesions

A

W-K syndrome, confabulation!

23
Q

Subthalamic nucleus lesions

A

Contralateral hemiballismus

24
Q

Hippocampus lesions

A

anterograde amnesia

25
Q

Frontal eye fields lesions

A

Conjugate toward the side of the lesion

26
Q

Cerebral perfusion

A

Driven by pCO2 (central medullary chemoreceptors)

CPP = MAP - ICP

27
Q

Medial medullary syndrome

A

Paramedian ASA branches infarct

Leads to hemiparesis, decreased proprioception, hypoglossal dysfunction (tongue motor symptoms)

28
Q

Lateral medullary syndrome

A

PICA or verterbral artery
CN V, VII, VIII, IX, X, XII all affected
vomiting, vertigo, nystagmus, HOARSENESS, DYSPHAGIA

29
Q

Lateral pontine syndrome

A

AICA

Paralysis of face, decreased lacrimation/salivation

30
Q

Epidural hematoma

A

Middle meningeal, lucid interval, III palsy,

transtentorial herniation

31
Q

Subdural hematoma

A

bridging veins, slow evolving

32
Q

Subarachnoid hemorrhage

A

Saccular aneurysm rupture (Ehlers-Danlos, ADPKD)

Xanthochromic LP

33
Q

Intraparenchymal hemorrhage

A

Systemic hypertension, amyloid angiopathy

Most often in the basal ganglia or internal capsule

34
Q

Ischemia histology progression

A 
12-48 hrs: red neurons
24-72 hrs: necrosis, neuts
3-5 days: macrophage/microglia infiltration
1-2 weeks: reactive gliosis
>2 weeks: scar
35
Q

Pseudotumor cerebri dx, findings, risk factors

A

increased ICP w/o evidence of cause
Diplopia (VI palsy), papilledema
Risk factors: Vitamin A excess, danazol (endometriosis drug)
Tx: weight loss, acetazolomide, topiramate, shunt

36
Q

Polio/SMA effect on spinal cord

A

LMN damage, destruction of anterior horn

37
Q

ALS effect on spinal cord

A

Super oxide dismutase, UMN and LMN lesions

38
Q

B12 deficiency effect on spinal cord

A

demyelination of dorsal columns, lateral corticospinal tracts

39
Q

Polio

A

LMN death in anterior horn

Virus recovered from stool/throat

40
Q

Friedrich ataxia

A

GAA on ch. 9 (frataxin)

- staggering gait, falling, hypertrophic cardiomyopathy

41
Q

Reflexes

A 
Biceps: C5
Triceps: C7
Cremaster: L1
Patella: L4
Achilles: S1
Anal: S3
42
Q

Superior colliculi

A

Conjugate vertical gaze cetner

Parinaud syndrome = lesion, paralysis of conjugate gaze

43
Q

Middle cranial fossa pathways

A 
Optic canal: CN 2
Superior orbital fissure: CN 3, 4, 5-1, 6
Foramen rotundum: V2 (maxillary)
Foramen ovale: V3 (mandibular)
Foramen spinosum: middle meningeal
44
Q

Posterior cranial fossa pathways

A

Internal auditory meatus: CN 7, 8
Jugular foramen: Cn 9, 10, 11, jugular vein
Hypoglossal: 12
Foramen magnum: 11 (spinal levels only)

45
Q

Vagal nuclei

A

Nucleus solitarius - visceral sensory info
Nucleus ambiguus - motor innervation of pharynx/larynx/upper esophagus
Dorsal motor nucleus - parasympathetics to heart/lungs/upper GI

46
Q

Cavernous sinus

A

either side of the pituitary, collect blood from the eyes to the internal jugular

  • CN 3, 4, 5-1, 6 and sympathetic fibers
  • also, internal carotid
  • syndrome: ophthamloplegia, decreased corneal sensation, Horner syndrome, CN 6 most susceptible
47
Q

Inner ear

A

low freq = apex near helicotrema (wide, flexible)
high freq = base of cochlea (thin, rigid)

Stapes hits the oval window to stimulate inner ear

48
Q

Muscles of mastication

A

closes: masseter, temporalis, medial pterygoid
opens: lateral pterygoid

V3 nerve

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