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Neuro Block 4 > Neuro block 4 > Flashcards

Neuro block 4 Flashcards

1
Q

List the 7 places the thalamus gets input from

A
  1. cerebral cortex
  2. hypothalamus
  3. brain stem
  4. spinal cord
  5. basal ganglia
  6. sensory input
  7. cerebellum
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2
Q

where is the hypothalamus compared to thalamus

A

hypothalamus is in front of the thalamus

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3
Q

what are the five divisions of the diencephalon

A
  1. epithalamus
  2. dorsal thalamus
  3. ventral thalamus
  4. subthalamus
  5. hypothalamus
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4
Q

what are the components of the epithalamus

A
  1. habenular nuclear complex
  2. pineal gland
  3. posterior commissure
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5
Q

what is the function of the habenula

A

involved in limbic pathway

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6
Q

what is the function of the posterior commissure

A

links pretectal and other nuclei of the two sides

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7
Q

what is the internal medullary lamina

A

a band of myelinated fibers that subdivide the thalamus nuclei into anterior, lateral, and medial nuclear groups

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8
Q

the reticular nucleus is part of what diencephalon component. Where is it found?

A

ventral thalamus. Found between the external medullary lamina and the internal capsule

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9
Q

what relays all sensory information (except smell) to the cortex

A

thalamus (dorsal)

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10
Q

what are the four groups of nuclei that the thalamus is divided into?

A

anterior, lateral-ventral tier, lateral-dorsal tier and medial groups

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11
Q

the anterior nuclear group of the thalamus has what efferent/afferent and function

A

afferent: mammillary body
efferent - cingulate gyrus
function - limbic

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12
Q

the ventral anterior nucleus of the thalamus has what efferent/afferent and function

A

afferent: globus pallidus
efferent - premotor cortex (area 6)
function - motor

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13
Q

the ventral-lateral nucleus of the thalamus has what efferent/afferent and function

A

afferent - dendate nucleus of cerebellum
efferent - motor and premotor (areas 4 and 6)
function - motor

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14
Q

the ventral posterior lateral group of the thalamus has what efferent/afferent and function

A 
afferent - dorsal column- medial lemniscus and spinothalamic
efferent - somatosensory cortex (areas 3,1,2)
function - somatic sensation - body
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15
Q

the ventral posterior medial group of the thalamus has what efferent/afferent and function

A

afferent - sensory nuclei of trigeminal nerve
efferent - somatosensory cortex (areas 3,1,2)
function - somatic sensation - face

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16
Q

the lateral geniculate group of the laterial-ventral tier of the thalamus has what efferent/afferent and function

A

afferent - retinal ganglion cells
efferent - primary visual cortex (area 17)
function - vision

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17
Q

the medial geniculate group of the lateral-ventral tier of the thalamus has what efferent/afferent and function

A

afferent - inferior colliculus
efferent - primary auditory cortex (areas 41, 42)
function - audition

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18
Q

what areas are the somatosensory cortex

A

3,1,2

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19
Q

what area is the premotor cortex

A

6

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20
Q

what area is the motor corex

A

4

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21
Q

what area is the primary visual cortex

A

17

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22
Q

what area is the primary auditory cortex

A

41,42

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23
Q

what is the efferent/afferent and function of the lateral dorsal group of the thalamus

A

afferent - cingulate gyrus
efferent - cingulate gyrus
function - emotional expression

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24
Q

what is the afferent/efferent and function of the lateral posterior group of the thalamus

A

afferent - parietal cortex
efferent - parietal cortex
function -sensory integration

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25
Q

what is the afferent/efferent and function of the pulvinar group of the thalamus

A

afferent - superior colliculus, parietal, occipital and temporal lobes
efferent - parietal, occipital and temporal lobes
function - integration of sensory information

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26
Q

what is the afferent/efferent and function of the medial dorsal group of the thalamus

A

affernet - amygdaloid nuclear complex, olfactory, hypothalamus
efferent - prefrontal cortex
function - limbic

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27
Q

the reticular formation is part of what

A

the non specific system (diffuse-projection nuclei). The efferent of the intralaminar nuclei.

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28
Q

what is the afferent of the non-specific system of the thalamus.

A

wide areas of the cortex from the intralaminar nuclei

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29
Q

what’s the function of the intralaminar nucleus

A

alertness and attention, wakefulness, sleep.

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30
Q

where are sensory and motor located within the thalamus

A

sensory is posteror, motor is ventral.

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31
Q

where are sensory and motor located within the cortex

A

sensory posterior, motor ventral

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32
Q

what is thalamic syndrome?

A

usually caused by vascular lesion.
damage to lateral group of thalamic nuclei (VPL)
initially transitory contralateral hemianalgesia. Then painful sensations. Later pain provoked by touch and vibration. Eventually spontaneous pain (contralateral side on lesion) without any external stimulus

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33
Q

what is dysesthesia

A

spontaneous, constant pain evoked without any external stimulus

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34
Q

what is the purpose and characteristics of the non-specific system of the thalamus?

A

activated by low-frequency, repetitive stimulation. All are interconnected nuclei. controls the level of excitability of neurons over wide areas of the cortex.

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35
Q

What is the preganglionic NT of sympathetic

A

ACh

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36
Q

what is the preganglionic NT of parasympathetic

A

ACh

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37
Q

what is the post ganglionic NT of sympathetic

A

mostly NE, ACh for sweat glands and vasodilator fibers

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38
Q

what is the post ganglionic NT of parasympathetic

A

ACh

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39
Q

which system has short preganglionic fibers

A

sympathetic

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40
Q

where is the sympathetic division found within the spinal cord?

A

thoracolumbar origin (t1-L2) the lateral horn

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41
Q

where is the parasympathetic division found in the spinal cord

A

cranio-sacral origin, cranial nerves 3,7,9,10 and S2-4

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42
Q

what are the four different routes for a sympathetic pregangionic axon?

A
  1. synapse in sympathetic trunk (paravertebral) at same level
  2. synapse in sympathetic trunk at different level
  3. pass through paravertebral ganglion to contact post ganglion within the prevertebral ganglions (celiac, etc.)
  4. pass through paravertebral in route to the medulla
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43
Q

what are the prevertebral ganglion?

A

celiac, superior and inferior mesenteric ganglions

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44
Q

which communicans has myelination?

A

white

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45
Q

which communicans exists at every level of the spinal cord?

A

gray.

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46
Q

what is the function of gray communicans

A

carry postsynaptic nerve fibers from paravertebral ganglia to their destination

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47
Q

what is the function of white communicans?

A

carry preganglionic nerve fibers from spinal cord to the paravertebral ganglia.

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48
Q

what is the muscle/gland, nuclei, and peripheral ganglia of cranial nerve III

A

edinger-westphal nucleus, sphincter pupillae muscle and ciliary ganglion

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49
Q

what is the muscle/gland, nuclei, and peripheral ganglia of cranial nerve VII

A

superior salivatory nucleus, pterygopalatine ganglion going to the lacrimal gland and the submandibular ganglion going to the submandibular and sublingual glands

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50
Q

what is the muscle/gland, nuclei, and peripheral ganglia of cranial nerve IX

A

inferior salivatory nucleus, otic ganglion, parotid gland

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51
Q

what is the muscle/gland, nuclei, and peripheral ganglia of cranial nerve X

A

dorsal motor nucleus, myenteric and submucosal ganglion, smooth muscles and glands of GI tract

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52
Q

what are the symptoms of vasovagal syncope

A

muscle weakness, warm sensation, nausea, sweating

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53
Q

what is the cause of vasovagal syncope

A

peripheral venous pooling
activation of low-pressure mechanoreceptors - the brain interprets as there is increased venous pressure
withdrawal of sympathetic activity and increase in vagus activity
inappropriate peripheral vasodilation and bradycardia -> hypotension and syncope

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54
Q

what are the receptors for the baroreceptor reflex?

A
  1. stretch receptors in carotid sinus (IX)

2. stretch receptors in aortic arch (X)

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55
Q

what are the afferent limbs of the baroreceptor reflex?

A

glossopharyngeal and vagus nerve (IX, X)

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56
Q

what is the CNS processing center for the baroreceptor reflex

A

nucleus solitarius

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57
Q

what is the effect what baroreceptors are activated

A

parasympathetic is activated (X) from nucleus ambiguus and doral motor nucleus
sympathetic is inactivated.

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58
Q

What are the symptoms of horner’s syndrome

A

ptosis
miosis
anhidrosis

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59
Q

what causes ptosis

A

loss of innervation of superior tarsal muscle

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60
Q

what causes miosis

A

loss of innervation of dilator pupillae muscle

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61
Q

what causes anhidrosis

A

loss of innervation of sweat glands

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62
Q

what tracks can be lesioned to caused horners

A

descending tract from hypothalamus, or pre/post ganglionic sympathetic nerves.

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63
Q

what are the symptoms of wallenburg syndrome (lateral medullary syndrome)

A

dysarthria (speaking), dysphagia (swallowing), contralateral loss of pain and temp. Ipsilateral loss of facial sensation, horners

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64
Q

what is the cause of autonomic dysreflexia following spinal cord injury

A

noxious stimuli (below T6) can not send signals to CNS - this causes activation of local reflexive sympathetic outflow - vasoconstirction and elevated BP. Often caused from distended bladder.

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65
Q

what are some symptoms of autonomic dysreflexia following spinal cord injury

A

can be life threatening - stroke or seizure
headache, HYPERTENSION, bradycardia, piloerection, pallor, cold clammy skin below s.c injury, red blotches on skin above injury.

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66
Q

what is the parasympathetic’s role in the bladder

A

micturition. Causes detrussor muscle contraction

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67
Q

what is the sympathetic’s role in the bladder

A

storage. contracts the internal urethral sphincter

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68
Q

what is hirshprung’s disease

A

absence of myenteric plexus - fails to produced ganglion cells located b/w layers of muscularis externa.
leads to no peristalsis in denervated colon - constipation.

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69
Q

what is the only structure the cortex receives info from?

A

the thalamus

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70
Q

what are the four structures the cortex sends information to?

A

thalamus
basal ganglia
brainstem
spinal cord

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71
Q

what is the cerebral cortex derived from?

A

the telencephalon

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72
Q

what are the three subdivisions of the cortex

A

archicortex, paleocortex, and neocortex

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73
Q

what makes up the archicortex

A

hippocampus and dentate gyrus

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74
Q

what makes up the paleocortex?

A

olfactory cortex

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75
Q

what makes up the neocortex

A

everything other than olfactory, hippo and dentate gyrus

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76
Q

what is included in the limbic lobe

A

cingulate gyrus, parahippocampal gyrus, hippocampus

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77
Q

what is the cerebral cortex supplied by?

A

ACA, MCA, PCA, and anterior and posterior communicating arteries, (Circle of willis)

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78
Q

how many cellular layers does the archicortex have?

A

3 layers

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79
Q

how many layers does the neocortex have?

A

6 layers

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80
Q

name the layers of the neocortex

A
  1. molecular layer
  2. external granular layer
  3. external pyrimidal layer
  4. internal granular layer
  5. internal pyramidal layer
  6. multiform layer
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81
Q

areas 3,1,2

A

primary somatosensory cortex - post central gyrus

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82
Q

precentral gyrus - name and areas?

A

area 4, primary motor cortex

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83
Q

area 17

A

primary visual cortex, cuneus and lingual gyri

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84
Q

primary auditory cortex - name of gyrus and area?

A

transverse gyri of heschl, areas 41, 42

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85
Q

areas 44 and 45

A

inferior frontal gyrus. Motor area of speech - broca’s area.

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86
Q

a lesion to the primary somatosensory cortex leads to

A

contralateral loss of somesthetic sensation

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87
Q

a lesion to the primary motor cortex leads to

A

contralateral spastic paralysis

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88
Q

what is the organization of the visual cortex

A

central visual field is most posterior. Peripheral visiual field most anterior.

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89
Q

where is the vertical meridian of the visual cortex found?

A

between the borders of areas 17 and 18

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90
Q

where is the horizontal meridian of the visual cortex found?

A

bisects horizontally area 17

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91
Q

a lesion restricted to either the upper of lower banks of teh calcarine fissure leads to

A

contralateral inferior or superior quadrantanopia

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92
Q

a general lesion of the visual cortex leads to

A

contralateral hemianopia

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93
Q

a lesion of the primary auditory cortex leads to

A

suppresed or loss of hearing

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94
Q

a lesion to the dominant broca’s area (usually left) leads to

A

motor aphasia, broca’s aphasia or expressive aphasia

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95
Q

a lesion to the non-dominant broca’s area (usually right) leads to

A

difficulting expressing emotional aspect of language

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96
Q

the dorsolateral prefrontal cortex is in charge of

A

working memory

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97
Q

the ventrolateral prefrontal cortex (aka orbitofrontal) is in charge of

A

limbic

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98
Q

the inferior parietal lobule, aka the supramarginal and angular gyri are responsible for?

A

association cortices

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99
Q

the superior parietal lobule are responsible for

A

association cortices

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100
Q

lesion to the supramarginal gyrus (area 40) on dominant side leads to

A

astereognosis - normal sensation but loss of meaning of sensation

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101
Q

lesion to area 39 (angular gyrus) on dominant side leads to

A

aphasia, alexia, and agraphia

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102
Q

lesions of the association cortices of the parietal lobe on the non-dominant side leads to?

A

spatial distortion or contralateral neglect

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103
Q

what is the area for wernicke’s area

A

area 22

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104
Q

wernicke’s area is responsible for

A

comprehension of language (dominant on left)

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105
Q

lesions of wernicke’s area on the dominant side

A

sensory aphasia (loss of meaning of language and speech), wernicke’s aphasia, or receptive aphasia

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106
Q

lesions of wernick’es area on the non-dominant side leads to

A

difficultly in comprehending emotional aspect of language

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107
Q

what three systems is the hypothalamus functionally related to?

A

ANS, endocrine and limbic systems

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108
Q

what is the medial border to they hypothalamus?

A

the third ventricle

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109
Q

what is the lateral border of the hypothalamsu

A

the optic tract

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110
Q

what is the anterior border of the hypothalamus

A

optic chiasm and lamina terminalis.

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111
Q

what is the posterior border of they hypothalamus

A

the mammillary bodies

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112
Q

what is the median eminence

A

the anterior portion of the infundibulum that serves as the site where classes of hypothalamic neurons releaes regulatory factors tot he anterior pituitary

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113
Q

what three zones is the hypothalamus subdivded into?

A

perventricular, medial and lateral zones.

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114
Q

what are the lateral and medial hypothalamus subdivisons diveded by?

A

separated by the fornix ventrally and the mammillothalamic tract dorsally

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115
Q

what traverses the lateral zone of the hypothalamus

A

the fibers of the medial forebrain bundle

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116
Q

what are the three nuclei of the lateral zone

A
  1. lateral preoptic nucleus
  2. lateral hypothalamic area
  3. tuberomammillary (lateral tuberal) nucleus
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117
Q

what is the function of the lateral hypothalamic area of the lateral zone of the hypothalamus

A

induces eating when stimulated.

Also contains NTs (melanin-concentrating hormone and orexins) to increase food intake

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118
Q

what happens with a lesion to the lateral hypothalamic area of the lateral zone of the hypothalamus

A

anorexia and starvation

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119
Q

what is the function of the tuberomammillary nucleus of the lateral zone of the hypothalamus

A

releases histamine to widespread portions of forebrain. ROle in attention and arousal. Inhibited during sleep

120
Q

what are the four main regions of the medial zone of the hypothalamus

A

preoptic region
anterior (supraoptic)
middle (tuberal)
posterior (mammillary)

121
Q

what nucleus does the preoptic region of the medial zone of the hypothalamus contain? What is its function

A

the medial preoptic nucleus.
Regulates gonadotropin secretion and contains interstitial nuclei of anterior hypothalamus, one of which is sexually dimorphic

122
Q

what are the four nuclei of the anterior (supraoptic) region of the medial zone of the hypothalamus

A
  1. suprachiasmatic
  2. anterior hypothalamic (aka anterior)
  3. paraventricular
  4. supraoptic
123
Q

what is the function of the suprachiasmatic nucleus of the anterior (supraoptic) region of the medial zone of the hypothalamus

A

recieves direct input from retina. Controls circadian rhythm

124
Q

what is the function of the anterior hypothalamic nucleus of the anterior (supraoptic) region of the medial zone of the hypothalamus

A

Temperature regulation - sense warmth and initiate responses to dissipate excessive heat.
Stimulatory drive of the parasympathetic division

125
Q

what happens if you lesion the anterior hypothalamic nucleus of the anterior (supraoptic) region of the medial zone of the hypothalamus

A

bilaterally - leads to hyperthermia

126
Q

what is the function of the paraventricular nucleus of the anterior (supraoptic) region of the medial zone of the hypothalamus

A

synthesize and release arginine vasopressin (AVP) for water conservation
oxytocin (milk, regulation of food intake)
CRH - stress response
Project to spinal cord and brainstem and exite sympathetic

127
Q

what is the function of the supraoptic nucleus of the anterior (supraoptic) region of the medial zone of the hypothalamus

A

Synthesize AVP and oxytocin.

Project to neurohypophysis to release hormones into general circulation

128
Q

what are the three nuclei of the middle tuberal region of the medial zone of the hypothalamus

A
  1. dorsomedial nucleus
  2. ventromedial nucleus
  3. arcuate nucleus
129
Q

what is the function of the dorsomedial nucleus of the middle tuberal region of the medial zone of the hypothalamus

A

Blood pressure regulation. Aggression and savage behavior

130
Q

what is the function of the ventromedial nucleus of the middle tuberal region of the medial zone of the hypothalamus

A

inhibits urge to eat when stimulated.Relays ingestion-related signals to the brainstem

131
Q

what happens where there is a bilateral lesion of the ventromedial nucleus of the middle tuberal region of the medial zone of the hypothalamus

A

hyperphagia - continuous eating

132
Q

what is the function of the arcuate nucleus of the middle tuberal region of the medial zone of the hypothalamus

A

controls release of adenohypophyseal hormones. Produce hypothalamic-releasing factors
plays role in feeding behavior

133
Q

where is the arcuate nucleus of the middle tuberal region of the medial zone of the hypothalamus located

A

ventral to the tuber cinereum

134
Q

what are the nuclei of the posterior (mammillary) region of the medial zone of the hypothalamus

A
  1. Posterior nucleus

2. mammillary nucleus

135
Q

what is the function of the posterior nucleus of the posterior (mammillary) region of the medial zone of the hypothalamus

A

thermoregulation - senses cold and initiates heat conservation and heat production responses.

136
Q

what happens when there is a bilateral lesion of the posterior nucleus of the posterior (mammillary) region of the medial zone of the hypothalamus

A

inability to thermoregulate - poikilothermia

137
Q

what is the function of the mammillary nucleus of the posterior (mammillary) region of the medial zone of the hypothalamus

A

receive input from hippocampus via the fornix.
project to the anterior nucleus of the thalamus via mammillothalamic tract
memory

138
Q

what happens when there is damage to the mammillary nucleus of the posterior (mammillary) region of the medial zone of the hypothalamus

A

memory disturbances

139
Q

what is the function of the periventricular nucleus within the perventricular zone of the hypothalamus?

A

unknown - sometimes considered part of the medial zone of they hypothalamus. Lines the third ventrical wall.

140
Q

describe the fornix fiber tract

A

hippocampus to mamillary bodies

141
Q

mammillothalamic tract

A

mammillary bodies to anterior nucleus of thalamus - part of papez circuit

142
Q

stria terminalis

A

fiber tract connecting amygdala with medial zone of hypothalamus

143
Q

medial forebrain bundle

A

most complex fiber pathway. extends throughout entire lateral hypothalamic zone connecting setpal nuclei to brainstem

144
Q

supraopticohypophyseal tract

A

supraotic and paraventricular nuclei to neurohypophysis.

axons of the neurons that synthesize AVP or oxytocin

145
Q

tuberoinfundibular tract

A

arcuate nucleus to hypophyseal portal system at median eminence. Carry neuropeptides that act upton anterior pituitary.

146
Q

hypothalamospinal tract

A

descending axons that regulate spinal cord preganglionic neurons to both symp. and parasymp. Originates in pareventricular nucleus

147
Q

damage to the hypothalamospinal tract leads to what

A

horner’s syndrome

148
Q

what are the three capacities of the hypothalamus

A
  1. access sensory information from entire body
  2. establishes the setpoints for temp, blood osmo, glucose, Na, and hormones
  3. responds to deviation in set points by adjusting endocrine, autonomic or behavioral responses
149
Q

what are the three areas that have a role in feeding

A

lateral hypothalamic area, ventromedial hypothalamic nucleus and arcuate nucleus.

150
Q

what are the two neuropeptides from the arcuate nucleus that have a role in increased feeding/decreased metabolism. What factors help enhance the actions of these neuropeptides

A

AgRP and NYP.

enhanced by ghrelin, MCH, and orexin.

151
Q

what are the two neuropeptides from the arcuate nucleus that have a role in decreased feeding and increased metabolism. What factor enhance the actions of these peptides

A

alpha-MSH, CART.

Enhanced by CRH, oxytocin and PPY. Also CCK, insulin, and leptin.

152
Q

output neurons from the arcute nucleus go to what nucleus to make an effect

A

the nucleus of the solitary tract

153
Q

where are MCH and orexin produced

A

the lateral hypothalmic area.

154
Q

what is a craniopharyngioma and what are the symptoms

A

congenital tumor in Rathke’s pouch (anterior pituitary) most common in children.
Pressure on optic chiasm - bitemporal heminaopia
pressure on hypothalamus - hypothalamic syndrome of adiposity, diabetes insipidus (excessive thirst and increased water excretion), temp regulation distrubances, and somnolence

155
Q

what is hypothalamic memory distrubances

A

posterior hypothalamic lesion involving mammillary bodies. Inability to form new memories.

156
Q

what is klein-levin syndrome

A

hypothalamic disorder in adolescent males. Hypersomnolence, episodic compulsive eating, hypersexuality.

157
Q

what are the responses to a lesion in the anterior hypothalamus

A

the parasympathetic area - hyperthermia, insomnia, diabetes insipidus, emaciation (extreme weight loss)

158
Q

what are the responses to a lesion in the lateral hypothalamus

A

“drinking center”

adipsia (reduced intake of water), emaciation, apathy

159
Q

what are the responses to a lesion in the medial hypothalamus

A

hyperdipsia, diabetes insipidus, syndrome of inappropriate antidiuretic hormone secretion (SIADH) - water is retained. Obesity, rage, amnesia, dwarfism, horner synd (ipsi)

160
Q

what are the responses to a lesion in the posterior hypothalamus

A

“sympathetic area” hypothermia, poikilotermia, hypersomnia, coma, narcolepsy, apathy, ipsi horner syndrome

161
Q

prader-willie syndrome

A

chromosomal deletion - inherited by father. hypothalmic dysfunction - hyperphagia -> obesity, narcoplepsy, short stature. caused by medial hypo. lesion

162
Q

as the descending hypothalamic fibers move down the brainstem, what are the fibers near?

A

the spinothalamic tract.

163
Q

what is the tract of sympathetic fibers to reach the eye?

A

pregang. exit interomediolateral tract and enters sympathetic chain. Ascends to superior cervical ganglion. Synapses onto post gang. neuron. Fibers follow internal carotid. -> cavernous sinus -> dilator muscle of pupil

164
Q

klumpke’s palsy

A

lower trunk of brachial plexus injury. May result in disrupted symp. output -> ipsilateral horner’s, ipsi finger paralysis, normal proximal arm muscle.

165
Q

pancoast syndrome

A

infiltration of superior cervical ganglion or lower brachail plexus with cancer, esp. lung cancer. Causes ipsilateral horners.

166
Q

dissection of internal carotid artery (ICA)

A

separation of layers of artery, leading to clot formation that can cause stroke. or expansion of artery leads to stretching of sympathetic fibers that travel on top of artery -> decreased symp. output. usually caused by whiplash or disease like ehlers danlos.

167
Q

cavernous sinus thrmobosis can see

A

cranial nerve injury pluse ipsilateral horners.

168
Q

pupillary light reflex is testing

A

parasym - seeing the pupils contract to light.

169
Q

pathway for pupil light reflex

A

pretectal nucleus of midbrain -> bilateral innervation of EW nucleus -> ciliary ganglion -> constrictor ciliary muscle

170
Q

to maintain continence, what center is stimulated

A

micturition inhibitory center (medial frontal cortex)

171
Q

pathway for maintaining continence

A

medial frontal cortex, inhibition of pontine micturition center, descends to lower thoracic/lumbar symp. region, inhibits parasym. contracts internal urinary sphincter and relaxes detrusor

172
Q

pathway for voiding urine (symp side)

A

pontine micturition center activated, interomediolateral colum of symp. -> lumbar splanchnic nerve -> inferior mesenteric ganglion-> internal sphincter is not stimulated, lessened inhibition of detrusor

173
Q

pathway for voiding urine (parasymp. side)

A

parasympathetic system is activated.
parasymp. region of sacral spinal cord -> pelvic splanchnic nerves -> inferior hypogastic plexus -> postganglion nerve -> stimulates detrusor to contract and relaxes internal sphincter.

174
Q

a lesion of sympathetic to urination leads to

A

hyperactive spastic bladder
or
underactive internal sphincter.

175
Q

how do you treat incontinence due to sympathetic lesion

A

anti-cholinergics to relax bladder walls

176
Q

a lesion of parasym. to urination leads to

A

hypoactive “flaccid” bladder (overflowing bladder -> leaking)
or
overactive sphincter (preventing complete emptying)

177
Q

how do you treat incontinence due to parasymp. lesion

A

anti-adrenergic to relax sphincter

intermittent self catherization

178
Q

what is the mnemonic for the functions of the limbic system

A 
HOME
homeostatis
olfaction
memory
emotion
179
Q

what is the function of the modality-specific (unimodal) association areas

A

the take info from the primary sensory and motor areas and make sense of the info. YOu know what you see is a dog

180
Q

what is the function of the higher-order (heteromodal) association areas

A

to take the infor from the modality-specific association area and make sense of the information further.
You know it’s a dog and you know the breed of the dog.

181
Q

what is in papez’s circuit

A

limbic system cingulate-> hippocampus -> fornix -> mammillary bodies -> anterior thalamus -> cingulate

182
Q

a newer model of the limbic system includes what other things other than papez’s circuit

A 
hypothalamus
septal area
oribitofrontal cortex
nucleus accumbens
amygdala
183
Q

what is high densirty in the limbic system

A

chilinergic innervation and opiate receptors

184
Q

what system is important for positive reinforcing brain mechanisms, lead to drugs and pleasure feelings

A

mesocorticolimbic dopamine system

185
Q

the fornix connects what two structures

A

hippocampus and mammillary and septal nuclei

186
Q

the mamillothalamic tract connect what two strucutres

A

mammillary bodies and anterior thalamus

187
Q

the perforant path connects what two structures

A

entorhinal cortex and dentate (hippocampus)

188
Q

what are the three main outer core-cortical areas of the limbic system

A

cingulate cortex
orbital fronal lobe
temporal lobe (hippocampus, parahip, entrohinal cortex)

189
Q

the rostral portion of the cingulate cortex is associated with

A

emotions and motor

190
Q

the caudal protion of the cingulate cortex is associated with

A

visual spatial and memory

191
Q

the orbital frontal lobe for the limbic system is associated with

A

personality, behavioral control and self awareness

192
Q

the temporal lobe with the limbic system is associated with

A

memory

193
Q

what are the three inner core-subcortical components of the limbic system

A
  1. hypothalamus
  2. amygdala
  3. septum
194
Q

what is the function of the hypothalamus with the limbic system

A

pleasure center, autonomic, endocrine integration

195
Q

what is the function of the amygdala with the limbic system

A

preservation of “self” behaviors, emotion, social behavior, aggression and defense response. Sexual behavior, visual stimuli effects

196
Q

what is the function of the septum with the limbic system

A

preservation of species behaviors, sexaul behaviors and emotionality

197
Q

the ventral amygdalofugal pathway connects what two structures

A

amygdala and hypothalamus and brainsetm

198
Q

the stria terminalis connects what two structures

A

amygdala with septum, hypothalamus, and nucleus accumbens

199
Q

which tract is the main efferent

A

the fornix

200
Q

which tract is the main afferent to the hippocampal formation

A

the perforant path

201
Q

what structures does the perforant path connect

A

etorhinal cortex and dentate gyrus

202
Q

what structures does the medial forebrain bundle connect?

A

the hypothalamic nucleiand amygadal and brainstem nuclei

203
Q

what are the symptoms of kluver-bucy syndrome

A

increased oral activity
hypersexuality
hypermetamorphosis (reacting to every visual stimulus and compulsive handling of object)
Placidity - flattened affect, lack of aggressive behavior, absence of fear
visual agnosia - loss or recognition of simple, familiar objects or people
Bulimia
anteriograde amnesia.

204
Q

what lesion causes kluver bucy syndrome

A

lesion to bilateral temporal lobe including amygdala, hippocampus and uncus (anterior temporal poles)
commonly happens with epilepsy

205
Q

what diseases cause kluver bucy syndrome

A 
post traumatic encephalopathy
herpes viral encephalitis (most common)
anoxia
subarachnoid hemorrhage
pick's disease
alzheimer's 
focal status epilepticus (seizing in hippocampus)
206
Q

what is geschwind syndrome/ interictal personality

A

sensory limbic hyperconnection - strengthening of synaptic connections
increased concern with philisophical/religious issues
altered sexual behavior (usually hyposexual)
hypergraphia - extensive writing
viscosity - diffifculty in breaking off conversation

207
Q

what are the two most pleasurable regions

A

the lateral hypothalamus and medial forebrain bundle, nucleus accumbens

208
Q

what regions are associated with pain, rage, and strong adverse reactions

A

ventromedial nucleus and hypothalamus

209
Q

main function of amygdala

A

modulation and experience of emotional reactions. Affective significance to visual stimuli. Critical for social interactions. Fear, memory

210
Q

main septal region function

A

sexual behavior and emotionality

211
Q

what are the two forms of long term memory. what structure is the main part of memory

A

explicit (declarative) and implicit (non declarative). hippocampus

212
Q

what is declarative memory

A

episodic (remembering event) and semantic (remembering facts)

213
Q

what things cause memory disorders associated with the hippocampus

A 
dementia
head trauma
stroke (MCA or basilar artery)
wernicke korsakoff
transient global amnesia
214
Q

what is wernicke korsakoff syndrome

A

due to chronic alcoholism and nutritional deficiency (thiamine) - lesion in mammillary bodies and thalamus
acute - wernickes encephalopathy - confusion, oculomotor dysfunction, ataxia.
chronic - anterograde and tempoarally-graded retrograde amnesia.

215
Q

main function of cingulate gyrus. When hyperactive, what happens? Hyporeactive

A

emotion. Hyper: OCD (anterior portion). Hypo: socipathy, akinetic mutism

216
Q

what area of brain causes gilles de la tourette syndrome

A

anterior cingulate

217
Q

what is the function of the anterior cingualte. Lesions cause..

A

integration of thought, motivation and emotion with movement.
Lesions: anxiety, OCD, tics, impulsive behavior , apathy, akinesis, mutism

218
Q

what happens with a lesion tot he orbital frontal lobe

A

disinhibited, tactless, boastful. Inattentive, tendency to dress carelessly

219
Q

what happens witha lesion to the frontal/convexity or dorsolateral frontal lobe

A

apathetic, slow, little initiative. Vacancy of expression

220
Q

what happens witha lesion to the medial frontal lobe

A

akinetic mutism , inert speech

221
Q

when the frontal cortex wins over the hypothalamus you get

A

judged thinking. Not primitive

222
Q

which area of the brain has delayed development to maturity

A

frontal cortex

223
Q

the prefrontal cortex has what function

A

production and appreciation of art. Provides order. Mediates personaltiy, executive funcion, ability to sequence and organize tasks

224
Q

a lesion to the hippocampus would cause what memory issues

A

can’t make new memories, still have old memories.

225
Q

synaptic plasticity

A

ability of synapses to change their strength in response to experience and a cellular model of learning and memory

226
Q

what are the two types of gluatmatergic receptors involved in memory

A

NMDA And AMPA

227
Q

which type of receptor involved in memory has an MG that blocks the pore

A

NMDA

228
Q

which receptor for memory stimulation/learning is activated first. what is the effect?

A

AMPA , Na influx, depolarization on post synaptic terminal

229
Q

what happens when Mg is displaced from the receptor for learning

A

Ca influx through NMDA receptor, activation of calmodulin kinase -> moves more AMPA receptors to post synaptic terminal -> potentiation

230
Q

what is calcium’s role with depression of learning response

A

Ca can activate calcineurin after its influx through NMDA receptors. Causes AMPA to be taken off of post synaptic terminal. -> depression of activation.

231
Q

Cued fear conditioning for memory/learning is caused by the

A

amygdala

232
Q

Contextual fear conditioning for memory/learning is caused by

A

the hippocampus and amygdala

233
Q

what is the impact of aging with memory/learning

A

imbalance with synaptic plasticity and changes in the levels of molecules like CaMKII and calcineurin

234
Q

long term potentiation is due to what increase

A

increased AMPA receptors at postsynaptic terminal

235
Q

long term depression is due to what decrease

A

decreased AMPA receptors at postsynaptic terminal

236
Q

what is cross dominance in terms of speech

A

condition of right hemispheric dominance for language

237
Q

what is crowding in terms of speech

A

condition that occurs after early left hemisphere damage where development of language shifts to the right hemisphere at the expense of development of cognitive capacities typically associated with right hemisphere.

238
Q

pathological left handedness

A

condition of left-handedness that has occurred because of early injury to left hemisphere that cause a shift in natural handedness pattern

239
Q

are left handers left or right brain hemisphere dominant

A

left brain dominant

240
Q

atypical dominance of brain hemisphere increases with what?

A

early brain damage

241
Q

when an injury to the brain is at less than one year of age

A

normal language function, decline of intelligence

242
Q

when an injury to the brain is between 1 and 5 years

A

Crowding: language function develops but at an expense of development of non-linguistic skills (visual spatial)

243
Q

when an injury to the brain occurs after age 5

A

specific abnormalities of language skills

244
Q

crossed dominance occurs when there is an injury to

A

the core or central speech zone.

245
Q

an injury to the anterior area of language leads to

A

shift of word retrieval to the opposite hemisphere

246
Q

an injury to the posterior area of language leads to

A

shift of comprehension to the opposite hemisphere

247
Q

disorders of speech all involve malfunction of

A

muscles of speech articulation

248
Q

what is aphonia

A

injury to peripheral nervous system that innervates the muscles of the vocal cords, preventing sound production

249
Q

what is aphemia

A

individual can produce sounds but not speech. A disconnection syndrome - white matter lesion beneath broca’s area

250
Q

all aphasias (disorder of language) can be classified by what

A

speech fluency, comprehension and repetition

251
Q

non-fluent aphasia occurs with dysfunction to

A

the anterior brain regions

252
Q

fluent aphasia occurs with dysfunction to the

A

posterior brain regions

253
Q

what connects broca’s and wernicke’s area

A

arcuate fasciculus

254
Q

what is the function of the arcuate fasciculus

A

repitition of speech

255
Q

wernicke’s area is located where? function?

A

posterior superior temporal gyrus

speech comprehension

256
Q

broca’s area is located where? function?

A

posterior and inferior frontal lobe. Speech production

257
Q

global aphasia

A

no fluent, comp. or rep.

258
Q

broca’s aphasia

A

no fluency or rep. Yes comprehension

259
Q

transcortical aphasias have what preserved

A

repetition

260
Q

transcortical motor aphasia

A

no fluency. Yes comp and rep.

261
Q

transcortical sensory aphasia

A

yes fluency and rep. no comp.

262
Q

isolation aphasia

A

no fluency or comp. Yes rep.

263
Q

wernicke’s aphasia

A

Yes fluent, no comp or rep.

264
Q

conduction aphasia

A

yes fluent and comp. NO rep

265
Q

where is conduction aphasia located?

A

within the speech sound storage area - the posterior temporal lobe. or in the arcuate fasiculus

266
Q

difference between coma and encephalopathy

A

alertness, attention and awareness are lost, but to alesser extent than in coma.

267
Q

jacksonian march

A

seizures in the primary motor cortex that travels along primary motor cortex gyrus and activates muscles in order as seen in motor homunculus. Contralateral

268
Q

lesion of frontal eye fields causes

A

ipsilateral gaze preference - eye points to side that is lesioned

269
Q

description of broca’s aphasia

A

non-fluent, halting, effortful, composed of few rods. Repition impaired

270
Q

broca’s area is supplied by what artery

A

MCA

271
Q

orbitofrontal cortex function

A

provides restraint - inhibits socially inappropriate behavior

272
Q

what are the two ways to lesion the orbitofrontal cortex

A

head trauma (brain rubs along base of skull - like cribiform plate). and meningioma

273
Q

frontotemporal dementia. AKA. Symptoms and cause

A

picks disease.
cause - neurodegeneration
affects prefrontal cortex first - personality changes, irritability, mood changes, poor executive function
moves to other areas like oribitofrontal and temporal cortex.
dementia

274
Q

function of mesiofrontal cortex (frontal lobe)

A

provides initiative - motivation. Micturition inhib center - allows voluntary inhibition of urination.

275
Q

lesion to mesiofrontal cortex

A

akinetic mutism, abulia (lack of initiative) and incontenence

276
Q

graphesthesia. part of whAT

A

ability to discern what is written on skin. part of parietal somatosensory association cortex

277
Q

stereognosis. part of what?

A

ability to discern object placed in hand based on sensation. part of parietal somatosensory association cortex

278
Q

lesion to the parietal somatosenosry association cortices in non dominant side (usually right)

A

results in contralateral neglect and apraxia

right parietal lesion leads to left neglect

279
Q

what is apraxia. lesion in what area

A

inabiltiy to perform a skilled task (brushing teeth). Lesion to parietal somatosenosry association area (non dominant side)

280
Q

Gerstmann syndrome

A

lesion of dominant parietal cortex (left) - angular gyrus

agraphia, acalculia, finger agnosia, right and left confusion.

281
Q

monocular visual field defects is usually due to

A

lesion anterior to chiasm

282
Q

homonymous - meaning and indication

A

affects both sides (ex - right eye field in both eyes). indicates that lesion is in cortex or subcortex

283
Q

lesion in the parietal region of optic radiations after LGN

A

(superior bank of occipital cortex) - contralateral inferior quadrantanopia

284
Q

lesion in temporal region of optic radiation after LGN

A

(inferior bank of occiptal cortex) - contralateral superior quadrantanopia

285
Q

bitemporal hemianopia

A

optic chaism area - only inner field vision left.

286
Q

contralateral homonymous hemianopia

A

both left of both right fields are affected. affecting both inferior and superior fibers

287
Q

how does macular sparing happen

A

dual blood supply to occipital pole (MCA and PCA)

288
Q

baliant syndrome - cause

A

lesion of bilateral occipital-parietal pathways - the “where” pathway that helps you determine spatial relations of objects
bilateral MCA/PCA watershed infarct, alzheimer’s

289
Q

baliant syndrome symptoms

A
  1. simultanagnosia
  2. optic ataxia
  3. ocular apraxia
290
Q

simultanagnosia

A

inability to perceive the visual field as a whole. Patient will focus on small protion of picture, but can’t concepualize picture as a whole

291
Q

optic ataxia

A

inability to point/reach for objects in visual field under visual guidance. Won’t know where to point

292
Q

ocular apraxia

A

inability to look at objects in visual field using saccades

293
Q

ACA MCA infarct (watershed infarct) leads to

A

man in a barrel syndrome - sparing of hands and feet.

294
Q

what is eloquent cortex

A

areas of the brain that are still functional and normal compared to a nearby tumor

295
Q

what is flair-enhanced tumor bed imaging

A

reveal edema within the tumor. less defined, but easier to see. Specific for pathologies

296
Q

how does fMRI work

A

neural activity triggers local vasodilation. Increase in oxygenated hemoglobin. Oxygenated leads to a stonger imaging signal

297
Q

what is DTI

A

diffusion tensor imaging. watches water molecule movement along a white matter tract vs. across the tract

Neuro Block 4 (1 decks)

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