Neuro Peer Tute test Flashcards
1
Q
What structure has the function of initiation of appropriate / inhibition of inappropriate movements?
A
Basal ganglia
2
Q
Which structure receives proprioceptive input and uses it to fine-tune skilled movements?
A
The cerebellum
3
Q
Which structures are involved in motor memory?
A
Cerebellum & basal ganglia
4
Q
What can be the result of basal ganglia damage?
A
Rigidity
Resting tremor
Uncontrolled jerky movements
5
Q
What structure is the major sensory relay to the cortex?
A
The thalamus
6
Q
What structure produces the CSF?
A
Choroid plexus in the ventricles
7
Q
What structures allow outflow of CSF into the sinuses?
A
Arachnoid granulations
8
Q
Where are the interventricular foramina? And what is it aka?
A
Foramina of Monro
Channels that connect the lateral ventricles with the 3rd ventricle
9
Q
Where is the cerebral aqeduct?
A
Connecting the 3rd ventricle to the 4th
10
Q
Where is the foramen of Magendie?
A
On the dorsal side of the 4th ventricle, it allows CSF to drain into the “cisterna magna” below the cerebelloum
11
Q
Where are the foramina of Luschka?
A
Also draining out from the 4th ventricle
12
Q
What does communicating hydrocephalus mean?
A
CSF is blocked after leaving the ventricles - but it can still communicate freely between the ventricles
13
Q
What is non-communicating hydrocephalus?
A
Aka obstructive
CSF is blocked along one of the passages that connect the ventricles
14
Q
What is Nissl substance & where is it found?
A
RER of neurons, which stains intensely purple in H&E (due to concentration of RNA)
15
Q
What are the glial cells of the CNS that myelinate called?
A
Oligodendrocytes
16
Q
Do oligodendrocytes myelinate one cell or multiple cells? What about Schwann cells?
A
Multiple
Schwann cells myelinate single neurons.
17
Q
Which glial cells are important in the BBB?
A
Astrocytes
18
Q
Which are more numerous in the CNS - neurons or glial cells?
A
Glial cells
19
Q
What are the three major classes of brain herniation?
A
Uncal/transtentorial
Cingulate/subfalcine
Tonsillar/cerebellar
20
Q
What symptoms tend to accompany all herniations? (5)
A
Headache Nausea Vomiting Blurred vision Papilloedema
21
Q
What is papiloedema?
A
Blurring of the optic disc margins
22
Q
What are differentiating symptoms of an uncal hernia?
A
LOC - via compression of RAS
Hemiparesis - via compression of corticospinal tracts
Mydriasis - via CNIII compression
(Also risk of PCA compression)
23
Q
What artery can be affected by a cingulate hernia?
A
ACA
24
Q
What are the effects of tonsillar hernias?
A
Life threatening compression of medulla, - incl CV & resp centres
25
What causes watershed strokes?
Systemic hypoperusion
26
What would you see on a brain that has had watershed stroke?
Multifocal lesions at the far boundaries of the cerebral arterial terriories
27
What colour are cerebral infacts?
They can be pale, or haemorrhagic (due to secondary transformation)
28
What happens to an infarct if the pt survives?
Glial scar formation and cystic fluid filled holes
29
What is the most likely cause of a large cortical stroke?
Amyloid angiopathy
30
What is the most common cause of subcortical strokes?
Hyalinearteriolosclerosis
31
What defines cerebral dominance?
The side of the brain involved in language
32
Right handed people are usually ____ dominant
Left
33
Left handed people are usually _____ dominant
Left
34
What proportion of right handed people are left dominant?
90%
35
What proportion of left handed people are left dominant?
70%
36
What do non-dominant hemisphere do?
Visual-spacial orientation
37
What part of the brain is largely responsible for executive function?
PFC
38
What part of the brain is essential for working memory?
DLPFC
| dorso-lateral prefrontal cortex
39
Which part of the brain inhibits innapropriate behaviour?
Orbitofrontal
40
What part of the brain is important for motivation and emotion processing?
MPFC
41
Which division of the MCA supplies Broca's area?
Superior
42
Which devision of the MCA supplies Wernicke's area?
Inferior
43
Which aphasia tends to have associated muscle weakness & what does it have?
Broca's
Contralateral face & UL hemiparesis
44
What sort of sensory deficit might you expect alongside a Broca's aphasia?
Decreased sensation in contralateral face & upper limb
45
What sort of sensory deficit might you expect alongside a Wenicke's aphasia?
R quadrantopia
As the temporal fibres of the left brain are for the upper R side.
46
What is Broca's aphasia is also known as?
Productive aphasia
47
What is Wernicke's aphasia aka?
Receptive aphasia
48
What is the 1st manifestation of frontotemportal dementia?
Behavioural and personality changes
| impulsivity, anhedonia, apathy
49
What is the 1st presentation of Alzheimers?
Decrease in memory
| dysnomia and circumlacutory language
50
What's the 1st presentation of vascular dementia?
It depends on lesion sites - no pattern
51
What is the pattern that would help you distinguish vascular dementia?
Stepwise progression
52
What usually causes subdural haematomas?
Acceleration-decelleration forces tearing the bridging veins
53
What usually causes extradural haematomas?
Head trauma especially skull fracture rupturing the meningeal arteries
54
What usually causes subarachnoid haematomas?
Aneurism rupture
55
What does an extradural haematoma look like?
Tends to be lenticular in shape as the dura is strong and attached at the fissures
56
What does a subdural haematoma look like?
Tends to fill in the sulci
57
Which haematoma bleeds slowly and may not even present?
Subdural - as it's venous pressure
58
Which spinal segment has no ANS p'way originating from it?
Cervical
59
What is the only certain way to distinguish sympathetic NS from parasymp NS?
Anatomy
Symp comes from thoracolumbar
Parasymp comes from craniosacral
60
Symp vs parasymp: Which usually has longer pre-ganglionic fibres?
Parasympathetic
61
Symp vs parasymp: Which usually has shorter pre-ganglionic fibres?
Sympathetic
| Think of the sympathetic trunk
62
Symp vs parasymp: Which usually has longer post-ganglionic fibres?
Sympathetic
63
Symp vs parasymp: Which usually has shorter post-ganglionic fibres?
Parasympathetic
64
What does "divergence' refer to?
The ratio of pre- to post-ganglionic fibres
65
Symp vs parasymp: Which has greated divergence?
Sympathetic
66
Symp vs parasymp: Which has ACh from pre-ganglionic receptors acting on NicR post-synaptically?
Both!
67
Symp vs parasymp: Which releases ACh from post-ganglionic neurons acring on MuscR on the tissue?
Both!
All parasympathetic ones, and sympathetic ones do in some circumstances (like it's activation of sweat glands)
68
What is Horner syndrome?
Unilateral damage to the sympathetic trunk
69
What are the symptoms of Horner syndrome?
Ipsilateral ptosis
Ipsilateral miosis
Ipsilateral adiaphoresis
70
What is ptosis?
Drooped eyelid
71
What is miosis?
Constricted pupid
72
What id mydriasis?
Dilated pupil
73
What is diaphoresis?
Excessive sweating
74
What is adiaphoresis?
| & what is it aka?
Decreased sweating
aka anhidrosis
75
CNS vs PSN: in which is neural regeneration poorer?
CNS
76
List 4 reasons CNS regeneration is poorer than PNS
CNS structure/cellularity is complex
Glial scar inhibits CNS regeneration
Neuronal degeneration is slower in CNS, and debris inhibits growth
Oligodendrocytes inhibit axon regrowth (cf Schwann cells)
77
What is the somatotopy of the spinal cord?
In the ventral horns, proximal muscles are represented medially, and distal muscles are represented laterally
78
Do the medial decending pathways of the spinal cord have bilateral or unilateral innervation of proximal muscles?
Bilateral
79
Do the lateral decending pathways of the spinal cord have bilateral or unilateral innervation of the distal muscles?
Unilateral
80
Medial or lateral descending pathways: which are important for balance?
Medial
81
LMN signs (5)
```
Flaccid weakness
Hyporeflexia
Signs of denervation
Decreased tone
Downgoing plantar reflex
```
82
What are 3 signs of denervation?
Atrophy
Fascivulations
Fibrillations
83
UMN signs?
```
Spastic weakness
Hyperreflexia (+/- clonus)
No signs of denervation
Increased tone
Positive Babinsky (upgoing)
```
84
What does an upgoing plantar reflex indicate?
UMN sign
Indicates lesion above level of L5/S1 (as these are the efferent motor responses)
85
In which lobe does Broca's area lie?
Frontal
86
In which lobe does Wernicke's area lie?
Temporal
| some texbooks say parietal
87
Aphasias usually result from damage to which hemisphere?
Left
88
What is the corticobulbar tract?
The UMN tract for all non-ocular cranial nerve nuclei
89
What non-ocular, motor nuclei does the corticubulbar tract from one side supply? (bi-, uni-, ipsi-, contra-)
Bilateral for all of them, except for the lower face and tongue - where ennervation is unilateral (contralateral)
90
What will result from a right UMN lesion of CNVII?
Weak bottom half of left face
91
What will result from a right LMN lesion of CNVII
This is just facial nerve palsy - entire right side will be weak.
92
Which are the nerves that only have contralateral UMN supply from the corticobulbar tract?
VII Facial
| VXII Hypoglossal
93
What does decerebrate posture exhibit?
Extension of lower & upper limbs
94
What does decorticate posture exhibit?
Extension of lower limbs
| Flexion of upper limbs
95
Where much the lesion be to cause decerebrate posture?
Below the level of the red nucleus
96
Where is the red nucleus located?
In the rostral midbrain
97
Where must the lesion be to cause decorticate posture?
Above the level of the red nucleus
98
What does the red nucleus have to do with decorticate vs decerebrate?
It's important for limb flexion - when it's knocked out, everything goes into extension
(decerebrate)
When the control of it is lost the limbs go to their "default" (decorticate)
99
What is the likely cause of sudden, severe, unexplained headache?
Berry aneurism rupture
100
Where in the cerebral circulation do berry aneurisms tend to form?
On the circle of Willis
101
What results from a berry aneurism rupture?
Subarachnoid haemorrhage
102
Is the intraction between basal ganglia and cortex ipsi- or contralateral?
Ipsilateral
103
The basal ganglia regulate movement on the ___'lateral side
Contralateral
104
The cerebellum interacts with the cortex on it's ____'lateral side?
Contralateral
105
The cerebellum fine-tunes movements in ___'lateral limbs
Ipsilateral
106
What's the likely cause of a R homonumous hemianopia with macular sparing?
L PCA infarct
| as left brain see's right field; and macular has colateral flow from MCA
107
What is the afferent nerve of the pupillary reflex?
CNII
| Optic
108
What is the efferent nerve of the pupillary reflex?
CNIII
| Occulomotor
109
What part of the brainstem is tested by the puillary reflex?
Midbrain
110
What is the afferent nerve of the corneal reflex?
CNV
| Trigeminal
111
What is the efferent nerve of the corneal reflex?
CNVII
| Facial
112
What part of the brainstem is tested by the corneal reflex?
Pons
113
What is the afferent nerve of the gag reflex?
CNIX
| Glossopharyngeal
114
What is the efferent nerve of the gag reflex?
CNX
| Vagus
115
What part of the brainstem is tested by the gag reflex?
Medulla
116
What's the main motor pathway?
Corticospinal tract
117
Superficial vs deep mechanoreceptors: which has a smaller receptive field?
Superficial
118
Superficial vs deep mechanoreceptors: which are present in greater density?
Superficial
119
Which are the superficial recepters?
Meissner & Merkel
| are outer Most
120
What structure is largely responsible for consciousness?
Reticular activating system
121
Where is the reticular activating system located?
Midbrain
122
Where are the cardio & resp centres located?
Medulla
123
What information is carried by the dorsal column medial lemniscus system?
Fine touch, vibration and propioception
124
On what side of the spinal cord does information in the DCML travel?
Ipsilateral to the stimulus
125
What are the two components of the DCML?
Cuneate & gracile
126
Cuneate vs gracile: which carries touch information from the lower limb?
Gracile
127
Cuneate vs gracile: which carries touch info from the upper limb?
Cuneate
128
Cuneate vs gracile: which runs more medially?
Gracile
129
Cuneate vs gracile: which runs more laterally?
Cuneate
130
Where does the DCML synapse?
Thalamus
131
In the spinal cord, sensory information is carried on which side?
Dorsal
132
In the spinal cord, motor information is carried on which side?
Ventral
133
In the brainstem, CN motor nuclei are found on which side?
Medial
134
In the brainstem, CN sensory nuclei are found on which side?
Lateral
135
Which nucleus provides the branchial motor ourput for CN IX (glossoph') and X (vagus)?
Nucleus ambiguous
136
Which nucleus receives gustatory and visceral sensory input from CN VII, IX and X?
Nucleus tractus solitarius
137
Which nucleus provides the motor output for CN VII?
Facial motor nucleus
138
Which nucleus provides the preganglionic parasympathetic output on CN III?
Edger-Westphal nucleus
139
Taste from the anterior 2/3 of the tongue travels in which CN?
Chora tympani of CN VII
140
Touch sensation from the anterior 2/3 of the tongue travels in which CN?
Lingual nerve - a branch of V3
141
Taste from the posterior of the tongue travels in which CN?
Glossopharyngeal (IX)
142
Touch sensation from the posterior of the tongue travels in which CN?
Glossopharyngeal (IX)
143
When the eye is looking pointed laterally, what muscle & nerve is being tested?
```
Lateral rectus
CN IV (abducens)
```
144
When the eye is pointed supero-laterally, what muscle & nerve is being tested?
Superior rectus
| CN III
145
When the eye is pointed supero-medially, what muscle & nerve is being tested?
Inferior oblique
| CN III
146
When the eye is pointed medially, what muscle and nerve is being tested?
Medial rectus
| CN III
147
When the eye is pointed inferomedially, which muscle and nerve is being tested?
```
Superior oblique
CN IV (trochlear)
```
148
When the eye is pointed infero-laterally, which muscle and nerve is being tested?
Inferior rectus
| CN III
149
Which 4 muscles of eye movement does CN III ennervate?
Medial rectus
Inferior oblique
Superior rectus
Inferior rectus
150
Which muscle of eye movement does CN IV ennervate?
Superior oblique
151
Which muscles of eye movement does CN VI ennervate?
Lateral rectus
| the abducens abducts
152
Which is the muscle that changes the curvature of the lens?
Ciliary muscle
153
What does contraction of the ciliary muscle do to the shape of the lens?
It lets it "boing" back to its rounder shape (able to focus on things nearby)
154
What is the intermediate structure that lets the lens relax when the ciliary muscle contracts?
Zonules
