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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
Regulates the release of gonadodtropic hormones (LH and FSH)
Anterior and Preoptic Nuclei
26
Responsible for sweating and cutaneous vasodilation in hot temperatures
Anterior and Preoptic Nuclei
27
Responsible for shivering and decreased cutaneous blood flow in the cold
Posterior and Lateral nuclei
28
Stage 1 sleep
* Light sleep * Theta waves * 5% of total sleep
29
Stage 2 sleep
* Deeper sleep * Bruxism (teeth grinding) * Sleep spindles and K complexes * 45% of total sleep (majority)
30
Stage 3 sleep
* 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
Stage 4 sleep
* 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
Treatment for restless legs syndrome
* **Pramipexole or ropinirole qHS (or levodopa/carbidopa)** * Iron replacement * Avoid caffeine * Clonazepam qHS * Gabapentin * Opioids
33
EEG waveforms in sleep:
*BATS Drink Blood* * Awake = **b**eta * close eyes = **a**lpha * Stage 1 = **t**heta waves * Stage 2 = 2 **s**leep spindles, K complexes ; * Stage 3/4 = **D**elta, low frequency, high amplitude ; * REM = **b**eta waves (high frequency, low amplitude)
34
Mechanism by which retinal information induces the release of melatonin
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
$ What is the pharyngeal apparatus composed of?
* Branchial apparatus * Composed of: *(CAP covers outside from inside)* * **Clefts** = ectoderm * **Arches** = mesoderm * **Pouches** = endoderm
36
$ Branchial pouch derivatives
*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 (**t**o = **t**hymus) * 4 (**top** = superior parathyroids)
37
Aberrant development of 3rd and 4th pouches --\>
* **DiGeorge syndrome** -\> * Cell deficiency (thymic aplasia) * Hypocalcemia (failure of parathyroid development) * 22q11 Deletion
38
$ Branchial arch derivatives
*When at the restaurant of the golden **arches**, children tend to first **chew** (1), then **smile** (2), then **swallow styl**ishly (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 i**nnervated by glosso**pharyngeal** nerve 4. 4-6 = **Cricothyroid and Larynx -** all intrinsic muscles of larynx except cricothyroid
39
Branchial arch abnormalities
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
CN III damage
* Eye looks down and out * Ptosis * Pupillary dilation * Loss of accommodation
41
CN IV damage
* Eye drugs upward causing vertical diplopia (problems reading newspaper or going down stairs)
42
CN VI damage
Medially directed eye
43
**Mastication muscles** innervation?
* 3 close jaw: **M**asseter, te**M**poralis, **M**edial pterygoid (*M's Munch*) * 1 opens: lateral pterygoid (Lateral Lowers) * All are innervated by the **mandibular division of the trigeminal nerve**
44
CN VII Branches
*"To Zanzibar By Motor Car"* * Temporal * Zygomatic * Buccal * Mandibular * Cervical
45
Cranial Nerve testing: KLM Sounds
* *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
Vestibulocochlear Nerve Lesion
* Vertigo * Nystagmus * Nausea and vomiting
47
The "Executive Arm" of the Parasympathetic nervous system
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
Nucleus Solitarius
contains sensory information: taste, baroreceptors, gut distension
49
Lesion to Nucleus ambigus will result in
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
Dorsal motor nucleus
Autonomic information to Heart, Lungs, Upper GIT
51
Symptoms of excess parasympathetic activity?
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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