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Medicine > Neuro case > Flashcards

Neuro case Flashcards

1
Q

Brainstem functions: medulla (3)

A
  • Cardio/Respiratory control
  • Nuclei for taste, hearing and balance
  • Control of neck and facial muscles
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2
Q

Brainstem functions: Pons (5)

A
  • Sleep
  • Bladder control
  • swallowing
  • Eye/facial movements
  • major input to cerebellum
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3
Q

Brainstem functions: Midbrain (2)

A
  • Components of auditory/visual systems and reflexes

- Substantia nigra: part of basal ganglia

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4
Q

Pineal body functions: (3)

A
  • Regulation of diurnal rhythms
  • synthesise melatonin
  • Pineal tumours can compress midbrain/block cerebral aqueduct
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5
Q

Cerebellum functions: (4)

A
  • Maintaining postures
  • Coordianting head and eye movements
  • Fine-tuning movements
  • Motor learning
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6
Q

Diencephalon components: (2)

A
  • Thalamus

- Hypothalamus

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7
Q

Diencephalon components: (2)

A
  • Thalamus

- Hypothalamus

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8
Q

Thalamus roles: (3)

A
  • Transfer of all sensory information (bar olfaction) to cortex
  • Involved in integration of motor control
  • influences attention and consciousness
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9
Q

Hypothalamus roles: (2)

A
  • Regulates homeostasis and reproduction

- Extensive connections to rest of CNS and pituitary gland

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10
Q

Amygdala function:

A
  • Social behaviour/emotions
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11
Q

Hippocampus function:

A
  • Memory
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12
Q

Basal nuclei function:

A
  • Control of movements
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13
Q

Basal nuclei (5)

  • C
  • P
  • G P
  • S N
  • Sub
A
  • Caudate
  • Putamen
  • Globus pallidus
  • Substantia nigra
  • Subthalamus
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14
Q

Basal nuclei (5)

  • C
  • P
  • G
  • S N
  • S
A
  • Caudate
  • Putamen
  • Globus pallidus
  • Substantia nigra
  • Subthalamus
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15
Q

White matter structure/function:

A
  • Axons

- Carrying information to and from cortex, between structures

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16
Q

Sensory cortexes (6)

  • V
  • S
  • G
  • V
  • O
  • A
A
  • Vestibular cortex
  • Somatosensory cortex
  • Gustatory cortex
  • Visual cortex
  • Olfactory cortex
  • Auditory cortex
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17
Q

Sensory cortexes: vestibular cortex

A
  • Vestibular cortex: balance
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18
Q

Motor cortexes: (3)

A
  • Primary motor cortex
  • Premotor cortex
  • Supplementary motor cortex
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19
Q

Main brain blood supplies: (2)

A
  • Internal carotid arteries

- Vertebral arteries

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20
Q

Distribution of cerebral arteries: Anterior

A
  • Anterior: motor and sensory cortex
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21
Q

Distribution of cerebral arteries: Middle

A

Middle: motor and sensory cortex of upper limb and face, also auditory cortex

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22
Q

Distribution of cerebral arteries: Posterior

A
  • Posterior: whole of visual cortex
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23
Q

Sensory cortexes: gustatory cortex

A
  • Gustatory cortex: taste
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24
Q

Watershed infarcts:

A
  • Low perfusion pressure causes insufficient supply to to terminal branches of major arteries. Areas of arteries that lose blood first
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25
Q

Prosencephalon: (2 cephalons)

A
  • Telencephalon

- Diencephalon

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26
Q

Telencephalon:

A
  • Cerebrum/cerebral hemispheres
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27
Q

Diencephalon:

A
  • Thalamus and hypothalamus
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28
Q

Mesencephalon:

A
  • Midbrain
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29
Q

Rhombencephalon: (2 cephalons)

A
  • Metencephalon

- Myelencephalon

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30
Q

Metencephalon:

A
  • Pons and cerebellum
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31
Q

Myelencephalon:

A
  • Medulla
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32
Q

Development of the nervous system: (5)

  • Time frame
  • Develops from …..
  • A ……… …….. develops
  • Neural cells proliferate, forming a ………
  • This forms
A
  • Forms in the 3rd week of development
  • Develops from ectodermal layer
  • A neural groove develops in the midline
  • Neural cells proliferate and form a neural tube
  • Neural tube forms the adult spinal cord, cephalic end swells and flexes to form the brain
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33
Q

Neural tube defects:

  • Definition
  • Anencephaly
  • Spina bifida
A
  • If the neuropores do not close at the right time then defects occur
  • Anencephaly: anterior neuropore
  • Spina Bifida: posterior neuropore
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34
Q

Meninges of the brain: (3)

A
  • Dura mater
  • Arachnoid mater
  • Pia mater
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35
Q

Falx cerebri:

A
  • A vertical fold lying in the midline between the two hemispheres
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36
Q

Tentorium cerebelli:

A
  • A fold lying above the cerebellum and below the cerebrum
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37
Q

Tentorium cerebelli:

A
  • A fold lying above the cerebellum and below the cerebrum
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38
Q

Subdural space:

A
  • Separates the dura and arachnoid mater

- Filled by film of fluid

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39
Q

Subarachnoid space:

A
  • Separates arachnoid and pia mater

- Filled with cerebrospinal fluid (CSF)

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40
Q

Arachnoid mater: (4)

  • Description
  • Bridges
  • Villi
  • Granulations
A
  • Middle layer of meninges
  • Arachnoid bridges over sulci
  • Arachnoid villi: Arachnoid projects in certain areas
  • Arachnoid granulations: collections of arachnoid villi
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41
Q

Pia mater:

  • description
  • relevance to cerebral arteries
A
  • Thinnest, inner layer. Closely follows brain surface, extending down into sulci
  • Cerebral arteries entering the brain have a covering of Pia mater
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42
Q

Headache (meninges):

A
  • Brain has no pain receptors

- Stretching/irritation of the meninges causes headache

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43
Q

CSF role: (4)

A
  • Removes waste products
  • Transports signalling molecules
  • Renders the brain buoyant
  • Supports, cushions and distributes pressure on brain
44
Q

Motor control: Descending motor control

  • System type?
  • Pathway
  • Description
A
  • Voluntary
  • Brain to muscle
  • complex, coordinated
45
Q

Motor control: reflex coordination

  • System type?
  • Pathway
  • Description
A
  • Involuntary
  • Spinal cord/brainstem to muscle and back
  • Simple, protective, reactionary
46
Q

Reflexes: involuntary movements

A
  • The involuntary coupling of sensory input to motor output in response to peripheral stimulation
47
Q

Reflexes: peripheral neurons

  • Direction
  • Innervates?
A
  • FROM peripheral receptors TO spinal cord/brainstem

- alpha neurons, gamma neurons and interneurons in the brainstem and spinal cord

48
Q

Reflexes: Lower Motor Neurons

  • Direction
  • Effect?
A
  • FROM brainstem/spinal cord TO the effector

- Stimulates or inhibits muscle contraction via NMJ

49
Q

Spinal reflexes:

  • Description
  • Role
A
  • Sensory receptors synapse onto alpha-motor neurons in the ventral horn of the spinal cord, innervating an effector
  • Avoid damage
50
Q

Myotatic (muscle stretch) reflex:

  • role
  • tested by
A
  • Prevents overstretching of muscle

- Tapping tendon, this stretches attached muscle, the muscle subsequently contracts, restoring length

51
Q

Proprioceptors:

A
  • Muscle spindles that detect stretch. Imbedded sensory neurons detect rate of change and muscle length
52
Q

Proprioceptors:

A
  • Muscle spindles that detect stretch. Imbedded sensory neurons detect rate of change and muscle length
53
Q

Motor units:

A
  • alpha motor neurone + all innervated muscle fibres
54
Q

Alpha motor neurons:

  • structure
  • role
A
  • Large multipolar neurons

- terminates at NMJ and innervates skeletal muscle

55
Q

Gamma (y) motor neurones:

  • Size
  • Innervates
  • Role (2)
A
  • Smaller neurones
  • Innervate specialised striated muscle (intrafusal)
  • Adjust sensitivity of muscle spindles and increase range of function
56
Q

Gamma (y) motor neurones:

  • Size
  • Innervates
  • Role (2)
A
  • Smaller neurones
  • Innervate specialised striated muscle (intrafusal)
  • Adjust sensitivity of muscle spindles and increase range of function
57
Q

Golgi tendon organs:

A
  • Proprioceptors
  • 1b afferent sensory neurones
  • monitor and maintain muscle tension
58
Q

Golgi tendon reflex:

  • prevents:
  • Controls
A
  • overstretching of tendons

- muscle tension

59
Q

Golgi tendon reflex pathway: (3)

A
  • Muscle contraction stretches tendon
  • Sensory neurones (1b afferent) activate interneurons
  • inhibits the a-neurons innervating muscles of origin
60
Q

Alpha motor neurone inputs: (3)

A
  • Sensory input from muscles
  • Descending input from UMN) causing voluntary movement
  • Interneurons form neuronal circuits
61
Q

Reflexes: divergence

A
  • Amplifies sensory input, coordinating muscle contractions = movement
62
Q

Reflexes: convergence:

A
  • On interneurons, increases response flexibility
63
Q

Reflexes: inhibition

A
  • reciprocal inhibition: interneurons and Crenshaw cells
64
Q

Reflexes: potentiation

A
  • (mild) Stretching of the muscle
65
Q

Brainstem reflexes: reflexes of the head/face

  • Involves
  • Examples
A
  • Cranial nerves

- Jaw, eye, throat and postural reflexes

66
Q

Myotatic reflex role:

A
  • Controls muscle length
67
Q

Golgi tendon reflex role:

A
  • controls muscle tension and tendon length
68
Q

Flexor withdrawal reflex role:

A
  • Removal from damaging stimuli
69
Q

Jaw unloading reflex role:

A
  • Protection of teeth
70
Q

Light reflex roles:

A
  • Protecting eyes (light, focus, foreign objects
71
Q

Somatosensory pathways: ascending tracts

  • Roles
  • Centres (2)
A
  • Carry information from pain, thermal, tactile, muscle and joint receptors to the cerebral:
  • Cerebral cortex (conscious centre)
  • Cerebellum/brainstem (unconscious centres)
72
Q

Peripheral receptor endings: unencapsulated/free nerve endings

  • Detects
  • Found in:
A
  • Pain, temperature, pressure

- Hair follicles, merkels disks, nociceptors

73
Q

Peripheral receptor endings: Modified/encapsulated endings

  • Detects
  • Found in:
A
  • Pressure, touch, vibration, stretch, pain, proprioception

- Pacinian corpuscles, Meiseners corpuscles

74
Q

Peripheral receptor endings: Proprioceptors

  • Detects
  • Found in:
A
  • Stretch, pressure, pain

- Muscle spindles, gold tendon organs

75
Q

Spinal tracts: ascending pathways (3)

A 
- Dorsal column: 
. Gracile fasiculus 
. Cuneate fasiculus 
- Spinocerebellar (dorsal/ventral)
- Spinothalamic/anterolateral tract
76
Q

Spinal tracts: ascending pathways (3)

A 
- Dorsal column: 
. Gracile fasiculus 
. Cuneate fasiculus 
- Spinocerebellar (dorsal/ventral)
- Spinothalamic/anterolateral tract
77
Q

Dorsal column:

  • parts (2)
  • Role
A
  • Gracile fasiculus: lower body info, T6

- Carry information regarding touch

78
Q

Spinothalamic/anterolateral tract role:

A
  • Pain/temperature information
79
Q

Spinocerebellar tract role:

A
  • proprioception: muscle/joint information
80
Q

Dorsal column: primary afferent neurones

  • Pre-spinal cord info (3)
  • Ascending tract info (2)
A
  • Detects mechanical sensation from receptor
  • Enters spinal cord through dorsal root (cell body in Dorsal Root Ganglion)
  • Main fibre remains ipsilateral (same side of cord)
  • Synapses on second order neurones in medulla
81
Q

Dorsal column: primary afferent neurones

  • Pre-spinal cord info (3)
  • Ascending tract info (2)
A
  • Detects mechanical sensation from receptor
  • Enters spinal cord through dorsal root (cell body in Dorsal Root Ganglion)
  • Main fibre remains ipsilateral (same side of cord)
  • Synapses on second order neurones in medulla
82
Q

Dorsal column: second-order neurons (2)

  • Origin
  • Sensory decussate/medial lemniscus
A
  • Originate in the medulla

- They decussate (cross over) and travel up the brainstem as the medial lemniscus

83
Q

Dorsal column: thalamus

  • Role of second order neurons
  • Role
  • amount of Nuclei
A
  • Receives info from second order neurons
  • Integrates, modulates and relays info to the sensory-motor cortex via internal capsule
  • Multiple nuclei
84
Q

Thalamic nuclei:

  • Ventral posterior lateral (VPL):
  • Ventral Posterior Medial (VPM):
A
  • VPL: somatic afferents from the body synapse

- VPM: somatic afferents from the head synapse

85
Q

Ascending tracts, Dorsal column: First neuron

  • Entry
  • Cell body location
  • Roles (2)
A
  • Enters spinal cord through dorsal root
  • Cell bodies are in DRG
  • Mediates spinal reflexes or ascends to medulla
86
Q

Ascending tracts, dorsal column: second neuron

  • Cell body location
  • Position
  • Role
A
  • Cell body in medulla oblongata
  • Axons decussate
  • Ascends to thalamus, terminating upon third neuron
87
Q

Ascending tracts, dorsal column: third neuron

  • Cell body location
  • Role
A
  • Cell body in thalamus

- Ascends to somatosensory cortex (parietal lobe of central hemisphere)

88
Q

Anterolateral/Spinothalamic tract:

transduction mechanisms: Polymodal nociceptors

A
  • Polymodal nociceptors: Respond to many stimuli, C fibre afferents
89
Q

Anterolateral/Spinothalamic tract:
transduction mechanisms:
Mechanical nociceptors

A
  • Mechanical nociceptors: High pressure, A fibre afferents
90
Q

Anterolateral/Spinothalamic tract:

transduction mechanisms: Thermal nociceptors

A
  • Thermal nociceptors: extreme temperatures, A fibres
91
Q

Nociceptive fibre types: A fibres

  • Structure
  • Examples
  • Pain type
A
  • small diameter, myelinated
  • Thermal/mechanical
  • Fast, sharp well-located pain
92
Q

Nociceptive fibre types: C-fibres

  • Structure
  • Examples
  • Pain type
A
  • Non-myelinated
  • Polymodal or specific
  • Dull, aching, burning pain
93
Q

Nociceptive fibre types: C-fibres

  • Structure
  • Examples
  • Pain type
A
  • Non-myelinated
  • Polymodal or specific
  • Dull, aching, burning pain
94
Q

Spinothalamic tracts: Direct tracts (2)

A
  • Lateral spinothalamic: pain and temperature

- Anterior spinothalamic tract: Crude touch and pressure

95
Q

Anterolateral/spinothalamic system: first order neuron

A
  • Axons enter spinal cord from DRG, may ascend/descend before synapsing
  • Synapses within the spinal cord
96
Q

Anterolateral/spinothalamic system: second order neuron

  • Roles (2)
  • Runs along the …..
  • Synapses at ….
A
  • Can form reflex arc or immediately decussate across the spine, to the spinothalamic tract
  • Runs along medial lemniscus
  • Synapses in VPL of the thalamus
97
Q

Anterolateral/spinothalamic system: third order neuron

1

A
  • Carries information to the somatostatin-sensory cortex (posterior central gyrus)
98
Q

Spinoreticular tract:

  • Role
  • Tract type
A
  • Responsible for Dull, aching pain. Alertness and arousal response to pain
  • Indirect tract via reticular formation and intra-median nuc of thalamus
99
Q

Modulating pain: descending regulation (3)

  • Projection to raphe nuclei
  • Medullary neuron projection
  • Action
A
  • Neurons from periventricular and periaqueductal grey matter project to raphe nuclei
  • Medullary neurons project to dorsal horns
  • Depressing activity of nociceptive neurons
100
Q

Sensory inputs: head

  • Main input
  • Additional inputs
A
  • Somatic sensation of face = mostly trigeminal nerve (CNV)

- Additional sensation = facial(CNVII), glossopharyngeal (CNVIII) and vagus (CNX)

101
Q

Somatosensory pathway: head

  • CN synapse location
  • 2nd order movements to thalamus
  • FInal projection
A
  • CN’s synapse onto 2nd order neurons in the ipsilateral trigeminal nucleus
  • Axons then decussate and project in the trigeminal lemniscus to the VPM nucleus of thalamus
  • Fibres project to sensory cortex
102
Q

Trigeminal nuclei: pain and temperature

A
  • Respective pathways due to location then to spinal nucleus
103
Q

Trigeminal nuclei: discriminative touch

A
  • To principle sensory nucleus
104
Q

Trigeminal nuclei: proprioception from muscles of mastication

A
  • To mesencephalic nucleus
105
Q

Trigeminal nucela: motor nucleus

A
  • Motor to muscles of mastication
106
Q

Modulating pain: afferent regulation

- presynaptic inhibition:

A
  • Presynaptic inhibition: touch /proprioceptive afferents triggers inhibitory interneurons
  • Reduces perception of pain
107
Q

Modulating pain: afferent regulation

- presynaptic inhibition:

A
  • Presynaptic inhibition: touch /proprioceptive afferents triggers inhibitory interneurons
  • Reduces perception of pain

Medicine (18 decks)

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