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DIT Phase II Chapters > NEURO > Flashcards

NEURO Flashcards

1
Q

↑ α-fetoprotein (AFP) and ↑ acetylcholinesterase may indicate

A

anencephaly - malformation of anterior end of neural tube; no brain/calvarium, polyhydramnios

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2
Q

Abnormalities often found with an Arnold-Chiari malformation

A
  • Hydrocephaly - XS accumulation CSF
  • Syringomyelia - enlargement of central canal of SC.
  • Myelomeningocele
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3
Q

Where is NE made?

A

Locus ceruleus (reticular formation, solitary tract)

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4
Q

Where is dopamine made?

A

Ventral tegmentum and SNc

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5
Q

Where is 5-HT made?

A

Raphe nucleus

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6
Q

Where is ACh made?

A

Basal nucleus of Meynert

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7
Q

Where is GABA made? What is needed to synthesize it?

Function?

A
  • Nucleus accumbens
  • Need vitamin B6 (pyridoxine) to convert Glutamate to GABA (deficinecy result in less GABA and convulsions)
  • Major inhibitory neurotransmitter of CNS
  • Reduced in anxiety, Huntington’s
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8
Q

Inhibitory neurotransmitter of the spinal cord.

A

Glycine

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9
Q

Reticular Activating System

Location, function?

A
  • Reticular formation, Locus ceruleus (NE), Raphe nuclei (5-HT).
  • Mediates consciousness, attentiveness, alertness.
  • Lesion of RAS -> Coma
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10
Q

Name the 4 dopaminergic pathways

A
  • Mesocortical pathway
  • Mesolimbic pathway
  • Nigrostriatal pathway
  • Tuberoinfundibular pathway
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11
Q

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Mesocortical pathway

A
  • Ventral tegmental of the midbrain to the cortex
  • Increase in negative symptoms of psychosis - social withdrawal, etc.
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12
Q

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Mesolimbic pathway

A
  • Ventrral tegmental of midbrain to limbic system
  • Relief of psychosis
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13
Q

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Nigrostriatal pathway

A
  • Substantia nigra (pars compacta) to the striatum (caudate + putamen)
  • Parkinsonian symptoms (antipsychotics block mesolimbic and nigrostriatal pathway)
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14
Q

For the following dopaminergicy pathway, explain the function and result of blocking the pathway:

Tuberoinfundibular pathway

A
  • Arcuate nucleus of hypothalamus to pituitary
  • Increase release of prolactin from pituitary -> hypogonadism -> ammenhorea/ reduced libido.
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15
Q

Damaged in Guillain-Barre syndrome

A

Schwann cells (PNS)

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16
Q

Damaged in MS

A

Oligodendrocytes (Myelinates multiple CNS axons)

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17
Q

Form multinucleated giant cells in the CNS when infected with HIV

A

Microglia (macrophages of CNS)

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18
Q

Cells of the blood brain barrier

A
  • Astrocytes (foot processes)
  • Basement membrane
  • Endothelial cells with tight junctions (non-fenestrated endothelial cells)
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19
Q

Anterior Hypothalamus (Preoptic)

A

• Regulates parasympathetic NS
• Responsible for sweating, cutaneous vasodilation, ↓ HR and ↓ BP
• Lesion - hyperthermia
• Releases GnRH
○ Regulates LH and FSH

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20
Q

Posterior and Lateral Hypothalamus

A

• Regulates sympathetic NS
• Stimulation
○ Shivering, ↑ HR and BP
• Lesion - inability to remain warm, hypothermia

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21
Q

Arcuate Nucleus

A
  • Releases hormones that affect the anterior pituitary
  • Regulates hunger and satiety
22
Q

Savage behavior and obesity result from stimulation

A

Dorsomedial nucleus of hypothalamus

23
Q

Savage behavior and obesity result from destruction (craniopharyngioma)

A

Ventromedial area

24
Q

Stimulation leads to eating and destruction leads to starvation

A

Lateral area

25
Q

Regulates the release of gonadodtropic hormones (LH and FSH)

A

Anterior and Preoptic Nuclei

26
Q

Responsible for sweating and cutaneous vasodilation in hot temperatures

A

Anterior and Preoptic Nuclei

27
Q

Responsible for shivering and decreased cutaneous blood flow in the cold

A

Posterior and Lateral nuclei

28
Q

Stage 1 sleep

A
  • Light sleep
  • Theta waves
  • 5% of total sleep
29
Q

Stage 2 sleep

A
  • Deeper sleep
  • Bruxism (teeth grinding)
  • Sleep spindles and K complexes
  • 45% of total sleep (majority)
30
Q

Stage 3 sleep

A
  • Deepest, non-REME sleep (Slow-wave sleep)
  • Sleepwalking; night terrors bedwetting
  • Delta (lowest frequency, highest amplitude)
  • 25% of total sleep
  • Imipramine treates nocturnal enurisis by reducing this stage
  • Benzodiazepines useful in this stage
31
Q

Stage 4 sleep

A
  • REM sleep
  • Dreaming, loss of motor tone, memory processing function, erections, increased brain oxygen use
  • Beta waves (same as awake, paradoxical sleep)
  • 25% total sleep
  • Alcohol, benzos and barbiturates reduce this stage
32
Q

Treatment for restless legs syndrome

A
  • Pramipexole or ropinirole qHS (or levodopa/carbidopa)
  • Iron replacement
  • Avoid caffeine
  • Clonazepam qHS
  • Gabapentin
  • Opioids
33
Q

EEG waveforms in sleep:

A

BATS Drink Blood

  • Awake = beta
  • close eyes = alpha
  • Stage 1 = theta waves
  • Stage 2 = 2 sleep spindles, K complexes ;
  • Stage 3/4 = Delta, low frequency, high amplitude ;
  • REM = beta waves (high frequency, low amplitude)
34
Q

Mechanism by which retinal information induces the release of melatonin

A

Darkness causes the suprachiasmatic nucleus to release NE acts on pineal gland to produce melatonin. Retina receives NO light –> SCN –> NE release –> pineal gland –> melatonin

35
Q

$ What is the pharyngeal apparatus composed of?

A
  • Branchial apparatus
  • Composed of:

(CAP covers outside from inside)

  • Clefts = ectoderm
  • Arches = mesoderm
  • Pouches = endoderm
36
Q

$ Branchial pouch derivatives

A

Ear, tonsils, bottom-to-top:

  • 1(ear) - middle ear, ET, mastoid air cells
  • 2 (tonsils) - epithelial lining palatine tonsil
  • 3 dorsal (bottom for inferior parathyroids)
  • 3 ventral (to = thymus)
  • 4 (top = superior parathyroids)
37
Q

Aberrant development of 3rd and 4th pouches –>

A
  • DiGeorge syndrome ->
  • Cell deficiency (thymic aplasia)
  • Hypocalcemia (failure of parathyroid development)
  • 22q11 Deletion
38
Q

$ Branchial arch derivatives

A

When at the restaurant of the golden arches, children tend to first chew (1), then smile (2), then swallow stylishly (3) or simply swallow (4), and then speak (6)

  1. M and T structures - Muscles of mastication
  2. 2 S structures - Stapedius Stylohoid
  3. Pharyngeal - Stylo-pharyngeus innervated by glossopharyngeal nerve
  4. 4-6 = Cricothyroid and Larynx - all intrinsic muscles of larynx except cricothyroid
39
Q

Branchial arch abnormalities

A
  1. Treacher Collins syndrome: 1st arch neural crest fails to migrate -> mandibular hypoplasia, facial abnormalities
  2. Stapedius
  3. Congenital pharyngocutaneous fistual: persistence of cleft and pouch –> fistula between tonsillar area, cleft in lateral neck
  4. 3 and 4 form posterior 1/3 of tongue, 5 makes not contribution
40
Q

CN III damage

A
  • Eye looks down and out
  • Ptosis
  • Pupillary dilation
  • Loss of accommodation
41
Q

CN IV damage

A
  • Eye drugs upward causing vertical diplopia (problems reading newspaper or going down stairs)
42
Q

CN VI damage

A

Medially directed eye

43
Q

Mastication muscles

innervation?

A
  • 3 close jaw: Masseter, teMporalis, Medial pterygoid (M’s Munch)
  • 1 opens: lateral pterygoid (Lateral Lowers)
  • All are innervated by the mandibular division of the trigeminal nerve
44
Q

CN VII Branches

A

“To Zanzibar By Motor Car”

  • Temporal
  • Zygomatic
  • Buccal
  • Mandibular
  • Cervical
45
Q

Cranial Nerve testing: KLM Sounds

A
  • Mi Mi Mi - Facial nerve (CN VII) testing lips
  • La La La - Hypoglossal (CN XII) testing tongue
  • Kuh Kuh Kuh - Vagus (CN X) testing elevation of palate
46
Q

Vestibulocochlear Nerve Lesion

A
  • Vertigo
  • Nystagmus
  • Nausea and vomiting
47
Q

The “Executive Arm” of the Parasympathetic nervous system

A

3 vagal nuclei (NS, NA CN X, DMN) and the Preoptic (Anterior) Area of Hypothalamus, these 4 structures are the Executive arms of the parasympathetic nervous system.

48
Q

Nucleus Solitarius

A

contains sensory information: taste, baroreceptors, gut distension

49
Q

Lesion to Nucleus ambigus will result in

A

Lesion to Nucleus aMbigus will result in hoarseness, difficulty swallowing, and loss of the gag reflex

Nucleus Ambiguus - Motor innervation of Pharynx, Larynx, Upper esophagus

50
Q

Dorsal motor nucleus

A

Autonomic information to Heart, Lungs, Upper GIT

51
Q

Symptoms of excess parasympathetic activity?

A

Become Leaky everywhere

DUMBBELSS

  • Diarrhea
  • Urination
  • Miosis
  • Bronchospasm
  • Bradycardia
  • Excitation of skeletal muscle/CNS
  • Lacrimation
  • Sweating
  • Salivation

DIT Phase II Chapters (10 decks)

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