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6. Neuro > Neuro Peer Tute test > Flashcards

Neuro Peer Tute test Flashcards

1
Q

What structure has the function of initiation of appropriate / inhibition of inappropriate movements?

A

Basal ganglia

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2
Q

Which structure receives proprioceptive input and uses it to fine-tune skilled movements?

A

The cerebellum

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3
Q

Which structures are involved in motor memory?

A

Cerebellum & basal ganglia

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4
Q

What can be the result of basal ganglia damage?

A

Rigidity
Resting tremor
Uncontrolled jerky movements

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5
Q

What structure is the major sensory relay to the cortex?

A

The thalamus

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6
Q

What structure produces the CSF?

A

Choroid plexus in the ventricles

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7
Q

What structures allow outflow of CSF into the sinuses?

A

Arachnoid granulations

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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

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9
Q

Where is the cerebral aqeduct?

A

Connecting the 3rd ventricle to the 4th

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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

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11
Q

Where are the foramina of Luschka?

A

Also draining out from the 4th ventricle

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12
Q

What does communicating hydrocephalus mean?

A

CSF is blocked after leaving the ventricles - but it can still communicate freely between the ventricles

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13
Q

What is non-communicating hydrocephalus?

A

Aka obstructive

CSF is blocked along one of the passages that connect the ventricles

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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)

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15
Q

What are the glial cells of the CNS that myelinate called?

A

Oligodendrocytes

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16
Q

Do oligodendrocytes myelinate one cell or multiple cells? What about Schwann cells?

A

Multiple

Schwann cells myelinate single neurons.

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17
Q

Which glial cells are important in the BBB?

A

Astrocytes

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18
Q

Which are more numerous in the CNS - neurons or glial cells?

A

Glial cells

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19
Q

What are the three major classes of brain herniation?

A

Uncal/transtentorial
Cingulate/subfalcine
Tonsillar/cerebellar

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20
Q

What symptoms tend to accompany all herniations? (5)

A 
Headache
Nausea
Vomiting
Blurred vision
Papilloedema
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21
Q

What is papiloedema?

A

Blurring of the optic disc margins

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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)

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23
Q

What artery can be affected by a cingulate hernia?

A

ACA

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24
Q

What are the effects of tonsillar hernias?

A

Life threatening compression of medulla, - incl CV & resp centres

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25
Q

What causes watershed strokes?

A

Systemic hypoperusion

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26
Q

What would you see on a brain that has had watershed stroke?

A

Multifocal lesions at the far boundaries of the cerebral arterial terriories

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27
Q

What colour are cerebral infacts?

A

They can be pale, or haemorrhagic (due to secondary transformation)

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28
Q

What happens to an infarct if the pt survives?

A

Glial scar formation and cystic fluid filled holes

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29
Q

What is the most likely cause of a large cortical stroke?

A

Amyloid angiopathy

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30
Q

What is the most common cause of subcortical strokes?

A

Hyalinearteriolosclerosis

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31
Q

What defines cerebral dominance?

A

The side of the brain involved in language

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32
Q

Right handed people are usually ____ dominant

A

Left

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33
Q

Left handed people are usually _____ dominant

A

Left

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34
Q

What proportion of right handed people are left dominant?

A

90%

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35
Q

What proportion of left handed people are left dominant?

A

70%

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36
Q

What do non-dominant hemisphere do?

A

Visual-spacial orientation

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37
Q

What part of the brain is largely responsible for executive function?

A

PFC

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38
Q

What part of the brain is essential for working memory?

A

DLPFC

dorso-lateral prefrontal cortex

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39
Q

Which part of the brain inhibits innapropriate behaviour?

A

Orbitofrontal

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40
Q

What part of the brain is important for motivation and emotion processing?

A

MPFC

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41
Q

Which division of the MCA supplies Broca’s area?

A

Superior

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42
Q

Which devision of the MCA supplies Wernicke’s area?

A

Inferior

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43
Q

Which aphasia tends to have associated muscle weakness & what does it have?

A

Broca’s

Contralateral face & UL hemiparesis

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44
Q

What sort of sensory deficit might you expect alongside a Broca’s aphasia?

A

Decreased sensation in contralateral face & upper limb

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45
Q

What sort of sensory deficit might you expect alongside a Wenicke’s aphasia?

A

R quadrantopia

As the temporal fibres of the left brain are for the upper R side.

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46
Q

What is Broca’s aphasia is also known as?

A

Productive aphasia

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47
Q

What is Wernicke’s aphasia aka?

A

Receptive aphasia

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48
Q

What is the 1st manifestation of frontotemportal dementia?

A

Behavioural and personality changes

impulsivity, anhedonia, apathy

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49
Q

What is the 1st presentation of Alzheimers?

A

Decrease in memory

dysnomia and circumlacutory language

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50
Q

What’s the 1st presentation of vascular dementia?

A

It depends on lesion sites - no pattern

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51
Q

What is the pattern that would help you distinguish vascular dementia?

A

Stepwise progression

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52
Q

What usually causes subdural haematomas?

A

Acceleration-decelleration forces tearing the bridging veins

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53
Q

What usually causes extradural haematomas?

A

Head trauma especially skull fracture rupturing the meningeal arteries

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54
Q

What usually causes subarachnoid haematomas?

A

Aneurism rupture

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55
Q

What does an extradural haematoma look like?

A

Tends to be lenticular in shape as the dura is strong and attached at the fissures

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56
Q

What does a subdural haematoma look like?

A

Tends to fill in the sulci

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57
Q

Which haematoma bleeds slowly and may not even present?

A

Subdural - as it’s venous pressure

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58
Q

Which spinal segment has no ANS p’way originating from it?

A

Cervical

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59
Q

What is the only certain way to distinguish sympathetic NS from parasymp NS?

A

Anatomy

Symp comes from thoracolumbar
Parasymp comes from craniosacral

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60
Q

Symp vs parasymp: Which usually has longer pre-ganglionic fibres?

A

Parasympathetic

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61
Q

Symp vs parasymp: Which usually has shorter pre-ganglionic fibres?

A

Sympathetic

Think of the sympathetic trunk

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62
Q

Symp vs parasymp: Which usually has longer post-ganglionic fibres?

A

Sympathetic

63
Q

Symp vs parasymp: Which usually has shorter post-ganglionic fibres?

A

Parasympathetic

64
Q

What does “divergence’ refer to?

A

The ratio of pre- to post-ganglionic fibres

65
Q

Symp vs parasymp: Which has greated divergence?

A

Sympathetic

66
Q

Symp vs parasymp: Which has ACh from pre-ganglionic receptors acting on NicR post-synaptically?

A

Both!

67
Q

Symp vs parasymp: Which releases ACh from post-ganglionic neurons acring on MuscR on the tissue?

A

Both!

All parasympathetic ones, and sympathetic ones do in some circumstances (like it’s activation of sweat glands)

68
Q

What is Horner syndrome?

A

Unilateral damage to the sympathetic trunk

69
Q

What are the symptoms of Horner syndrome?

A

Ipsilateral ptosis
Ipsilateral miosis
Ipsilateral adiaphoresis

70
Q

What is ptosis?

A

Drooped eyelid

71
Q

What is miosis?

A

Constricted pupid

72
Q

What id mydriasis?

A

Dilated pupil

73
Q

What is diaphoresis?

A

Excessive sweating

74
Q

What is adiaphoresis?

& what is it aka?

A

Decreased sweating

aka anhidrosis

75
Q

CNS vs PSN: in which is neural regeneration poorer?

A

CNS

76
Q

List 4 reasons CNS regeneration is poorer than PNS

A

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
Q

What is the somatotopy of the spinal cord?

A

In the ventral horns, proximal muscles are represented medially, and distal muscles are represented laterally

78
Q

Do the medial decending pathways of the spinal cord have bilateral or unilateral innervation of proximal muscles?

A

Bilateral

79
Q

Do the lateral decending pathways of the spinal cord have bilateral or unilateral innervation of the distal muscles?

A

Unilateral

80
Q

Medial or lateral descending pathways: which are important for balance?

A

Medial

81
Q

LMN signs (5)

A 
Flaccid weakness
Hyporeflexia
Signs of denervation
Decreased tone
Downgoing plantar reflex
82
Q

What are 3 signs of denervation?

A

Atrophy
Fascivulations
Fibrillations

83
Q

UMN signs?

A 
Spastic weakness
Hyperreflexia (+/- clonus)
No signs of denervation
Increased tone
Positive Babinsky (upgoing)
84
Q

What does an upgoing plantar reflex indicate?

A

UMN sign

Indicates lesion above level of L5/S1 (as these are the efferent motor responses)

85
Q

In which lobe does Broca’s area lie?

A

Frontal

86
Q

In which lobe does Wernicke’s area lie?

A

Temporal

some texbooks say parietal

87
Q

Aphasias usually result from damage to which hemisphere?

A

Left

88
Q

What is the corticobulbar tract?

A

The UMN tract for all non-ocular cranial nerve nuclei

89
Q

What non-ocular, motor nuclei does the corticubulbar tract from one side supply? (bi-, uni-, ipsi-, contra-)

A

Bilateral for all of them, except for the lower face and tongue - where ennervation is unilateral (contralateral)

90
Q

What will result from a right UMN lesion of CNVII?

A

Weak bottom half of left face

91
Q

What will result from a right LMN lesion of CNVII

A

This is just facial nerve palsy - entire right side will be weak.

92
Q

Which are the nerves that only have contralateral UMN supply from the corticobulbar tract?

A

VII Facial

VXII Hypoglossal

93
Q

What does decerebrate posture exhibit?

A

Extension of lower & upper limbs

94
Q

What does decorticate posture exhibit?

A

Extension of lower limbs

Flexion of upper limbs

95
Q

Where much the lesion be to cause decerebrate posture?

A

Below the level of the red nucleus

96
Q

Where is the red nucleus located?

A

In the rostral midbrain

97
Q

Where must the lesion be to cause decorticate posture?

A

Above the level of the red nucleus

98
Q

What does the red nucleus have to do with decorticate vs decerebrate?

A

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
Q

What is the likely cause of sudden, severe, unexplained headache?

A

Berry aneurism rupture

100
Q

Where in the cerebral circulation do berry aneurisms tend to form?

A

On the circle of Willis

101
Q

What results from a berry aneurism rupture?

A

Subarachnoid haemorrhage

102
Q

Is the intraction between basal ganglia and cortex ipsi- or contralateral?

A

Ipsilateral

103
Q

The basal ganglia regulate movement on the ___‘lateral side

A

Contralateral

104
Q

The cerebellum interacts with the cortex on it’s ____‘lateral side?

A

Contralateral

105
Q

The cerebellum fine-tunes movements in ___‘lateral limbs

A

Ipsilateral

106
Q

What’s the likely cause of a R homonumous hemianopia with macular sparing?

A

L PCA infarct

as left brain see’s right field; and macular has colateral flow from MCA

107
Q

What is the afferent nerve of the pupillary reflex?

A

CNII

Optic

108
Q

What is the efferent nerve of the pupillary reflex?

A

CNIII

Occulomotor

109
Q

What part of the brainstem is tested by the puillary reflex?

A

Midbrain

110
Q

What is the afferent nerve of the corneal reflex?

A

CNV

Trigeminal

111
Q

What is the efferent nerve of the corneal reflex?

A

CNVII

Facial

112
Q

What part of the brainstem is tested by the corneal reflex?

A

Pons

113
Q

What is the afferent nerve of the gag reflex?

A

CNIX

Glossopharyngeal

114
Q

What is the efferent nerve of the gag reflex?

A

CNX

Vagus

115
Q

What part of the brainstem is tested by the gag reflex?

A

Medulla

116
Q

What’s the main motor pathway?

A

Corticospinal tract

117
Q

Superficial vs deep mechanoreceptors: which has a smaller receptive field?

A

Superficial

118
Q

Superficial vs deep mechanoreceptors: which are present in greater density?

A

Superficial

119
Q

Which are the superficial recepters?

A

Meissner & Merkel

are outer Most

120
Q

What structure is largely responsible for consciousness?

A

Reticular activating system

121
Q

Where is the reticular activating system located?

A

Midbrain

122
Q

Where are the cardio & resp centres located?

A

Medulla

123
Q

What information is carried by the dorsal column medial lemniscus system?

A

Fine touch, vibration and propioception

124
Q

On what side of the spinal cord does information in the DCML travel?

A

Ipsilateral to the stimulus

125
Q

What are the two components of the DCML?

A

Cuneate & gracile

126
Q

Cuneate vs gracile: which carries touch information from the lower limb?

A

Gracile

127
Q

Cuneate vs gracile: which carries touch info from the upper limb?

A

Cuneate

128
Q

Cuneate vs gracile: which runs more medially?

A

Gracile

129
Q

Cuneate vs gracile: which runs more laterally?

A

Cuneate

130
Q

Where does the DCML synapse?

A

Thalamus

131
Q

In the spinal cord, sensory information is carried on which side?

A

Dorsal

132
Q

In the spinal cord, motor information is carried on which side?

A

Ventral

133
Q

In the brainstem, CN motor nuclei are found on which side?

A

Medial

134
Q

In the brainstem, CN sensory nuclei are found on which side?

A

Lateral

135
Q

Which nucleus provides the branchial motor ourput for CN IX (glossoph’) and X (vagus)?

A

Nucleus ambiguous

136
Q

Which nucleus receives gustatory and visceral sensory input from CN VII, IX and X?

A

Nucleus tractus solitarius

137
Q

Which nucleus provides the motor output for CN VII?

A

Facial motor nucleus

138
Q

Which nucleus provides the preganglionic parasympathetic output on CN III?

A

Edger-Westphal nucleus

139
Q

Taste from the anterior 2/3 of the tongue travels in which CN?

A

Chora tympani of CN VII

140
Q

Touch sensation from the anterior 2/3 of the tongue travels in which CN?

A

Lingual nerve - a branch of V3

141
Q

Taste from the posterior of the tongue travels in which CN?

A

Glossopharyngeal (IX)

142
Q

Touch sensation from the posterior of the tongue travels in which CN?

A

Glossopharyngeal (IX)

143
Q

When the eye is looking pointed laterally, what muscle & nerve is being tested?

A 
Lateral rectus
CN IV (abducens)
144
Q

When the eye is pointed supero-laterally, what muscle & nerve is being tested?

A

Superior rectus

CN III

145
Q

When the eye is pointed supero-medially, what muscle & nerve is being tested?

A

Inferior oblique

CN III

146
Q

When the eye is pointed medially, what muscle and nerve is being tested?

A

Medial rectus

CN III

147
Q

When the eye is pointed inferomedially, which muscle and nerve is being tested?

A 
Superior oblique
CN IV (trochlear)
148
Q

When the eye is pointed infero-laterally, which muscle and nerve is being tested?

A

Inferior rectus

CN III

149
Q

Which 4 muscles of eye movement does CN III ennervate?

A

Medial rectus
Inferior oblique
Superior rectus
Inferior rectus

150
Q

Which muscle of eye movement does CN IV ennervate?

A

Superior oblique

151
Q

Which muscles of eye movement does CN VI ennervate?

A

Lateral rectus

the abducens abducts

152
Q

Which is the muscle that changes the curvature of the lens?

A

Ciliary muscle

153
Q

What does contraction of the ciliary muscle do to the shape of the lens?

A

It lets it “boing” back to its rounder shape (able to focus on things nearby)

154
Q

What is the intermediate structure that lets the lens relax when the ciliary muscle contracts?

A

Zonules

6. Neuro (33 decks)

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