Neuro Physiology and Anatomy Flashcards by Brian Andrew

Hyperopia (farsighted)

Eye cannot focus on nearby objects because light focuses behind the retina (due to shortness of the eye or an inability of the lens to become convex)

Tx: convex lens

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Myopia (nearsighted)

Eye cannot focus on distant objects because light focuses in front of the retina (due to length of the eye or an inability of the lens to flatten out)

Tx: biconcave lens

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Astigmatism

Abnormal curvature of cornea, resulting in different refractive power at different axes

Tx: cylindric lens

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Presbyopia

Decrease in focusing ability during accommodation due to sclerosis and decreased elasticity; often age-related. The “near point” (closest point on which one can focus by accommodation of the lens) moves farther from the eye

Tx: convex lens

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CN III damage

Affects eye movement (SR, IR, MR, IO), pupillary constriction (sphincter pupillae), accommodation (ciliary muscle), eyelid opening (levator palpebrae)

Causes “down and out” eye, pupillary dilation, loss of accommodation, and ptosis

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CN IV damage

Affects SO; eye looks upward with adduction

Head tilt toward the side of the lesion / the unaffected eye

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CN VI damage

Affects LR; eye looks medially

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Lesion in somatosensory cortex

Contralateral sensory deficit; may be associated with UPN-type weakness, visual field deficits, and aphasia

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Lesion in VPL

Contralateral sensory deficit; larger deficits may involve the internal capsule (hemiparesis)

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Lesion in the lateral pons or lateral medulla

Affects the anterolateral pathways and spinal trigeminal nucleus

Contralateral loss of pain and T sensation in the body, and Ipsilateral loss of pain and T sensation in the face

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Lesion in the medial medulla

Affects the medial lemniscus

Contralateral loss of vibration and joint position sense

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Lateral hypothalamus

Produces orexin (hypocretin), which stimulates hunger and wakefulness. Inhibited by leptin.

Destruction causes anorexia or failure to thrive in infants, and narcolepsy (due to decreased orexin/hypocretin production).

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Ventromedial hypothalamus

Controls satiety. Stimulated by leptin. Destruction (e.g. craniopharyngioma) causes hyperphagia and aggressive, savage behavior.

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Anterior hypothalamus

Lowers T via PSNS. Stimulated by increased heat.
Location of osmoreceptors (controls ADH release)

“A/C” of the hypothalamus

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Posterior hypothalamus

Increases T via sympathetics. Stimulated by decreased heat.

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Suprachiasmatic nucleus of the hypothalamus

Responsible for circadian rhythm

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Supraoptic nucleus of hypothalamus

Produces ADH

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Paraventricular nucleus of hypothalamus

Produces oxytocin

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Ventroposteriolateral (VPL) nucleus of the thalamus

Pressure, touch, vibration and proprioception (from the dorsal columns/medial lemniscus); pain and T (from the spinothalamic)

Projects to primary somatosensory cortex

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Ventroposteriomedial (VPM) nucleus of the thalamus

Face sensation and taste from the trigeminal and gustatory pathway (via the solitary nucleus)

Projects to primary somatosensory cortex

“Make-up goes on the face”

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Lateral geniculate nucleus (LGN) of the thalamus

Vision via CN II

Projects to calcarine sulcus (primary visual cortex)

“L = Light”

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Medial geniculate nucleus (MGN) of the thalamus

Hearing via superior olive and inferior colliculus of tectum

Projects to auditory cortex of temporal lobe

“M=Music”

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Ventrolateral (VL) nucleus of the thalamus

Motor via basal ganglia and cerebellum

Projects to motor cortex

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Deep nuclei of cerebellum (lateral –> medial)

Lateral to medial: Dentate, Emboliform, Globose, Fastigial

“Don’t Eat Greasy Foods”

Lesion of lateral cerebellum

Affects voluntary movement of extremities. Intention tremor. Fall toward injured (ipsilateral) side

Lesion of medial cerebellum

Truncal ataxia, nystagmus, head tilting, wide-based (cerebellar gait), deficits in truncal coordination, dysarthria Midline lesions usually result in bilateral motor deficits affecting axial and proximal limb musculature.

Lesion of globus pallidus

Inability to maintain postural support

Lesion of subthalamic nucleus

Contralateral hemiballismus

Lesion of striatum

Huntington's disease (atrophy of caudate nucleus)

Lesion of substantia nigra

Parkinson's disease

Kluver-Bucy syndrome

Caused by damage to bilateral amygdalas (associated with HSV-1) Causes hyperorality, hypersexuality, disinhibited behavior

Lesion of right parietal-temporal cortex

Spatial neglect syndrome (agnosia of contralateral side of world)

Lesion of left parietal-temporal cortex

Agraphia, acalculia, finger agnosia, and left-right disorientation

Wernicke-Korsakoff syndrome

Damage to bilateral mammilary bodies due to thiamine (B1) deficiency; can be precipitated by giving glucose without B1 to a B1-deficient patient Wernicke: confusion, ataxia, nystagmus Korsakoff: memory loss, confabulation, personality changes

Lesion to paramedian pontine reticular formation

Eyes look away from side of lesion. Loss of horizontal saccades towards side of lesion

Lesion to frontal eye fields

Eyes look toward lesion. Normally, stimulation of frontal eye fields cause conjugate gaze contralateral to the stimulation

Stroke of anterior spinal artery

Medial medullary syndrome. Stroke commonly bilateral. - Contralateral hemiparesis (lateral corticospinal tract) - Decreased contralateral proprioception (medial lemniscus) - Ipsilateral hypoglossal dysfunction (caudal medulla)

Stroke of posterior inferior cerebellar artery (PICA)

Lateral medullary (Wallenberg) syndrome - Vomiting, vertigo, and nystagmus (vestibular nuclei) - Decreased pain and T sensation from ipsilateral face and contralateral body (lateral spinothalamic tract, spinal trigeminal nucleus) - Dysphagia, hoarseness, and decreased gag reflex (nucleus ambiguus) - Ipsilateral Horner syndrome (sympathetic fibers) - Ataxia, dysmetria (inferior cerebellar peduncle)

Stroke of anterior inferior cerebellar artery (AICA)

Lateral pontine syndrome - Vomiting, vertigo, and nystagmus (vestibular nuclei) - Paralysis of face, decreased lacrimation and salivation, decreased taste from anterior 2/3 of tongue, decreased corneal reflex (facial nucleus) - Ipsilateral hearing deficit (cochlear nuclei) - Ipsilateral Horner syndrome (sympathetic fibers) - Ataxia, dysmetria (middle and inferior cerebellar peduncles)

Stroke of basilar artery

Produces "locked-in" syndrome

Lesion of anterior communicating artery

Common site of saccular (berry) aneurysm Produces visual field deficits

Lesion of posterior communicating artery

Common site of saccular (berry) aneurysm Produces CN3 palsy

Clinical reflexes

S1, 2 - "buckle my shoe" (Achilles reflex) L3, 4 - "kick the door" (patellar reflex) C5, 6 - "pick up sticks" (biceps reflex) C7, 8 - "lay them straight" (triceps reflex) L1, L2 - "testicles move" (cremaster reflex) S3, S4 - "winks galore" (anal wink reflex)

Corneal reflex

V1 ophthalmic (nasociliary branch) --> VII (temporal branch: orbicularis oculi)

Lacrimation reflex

V1 ophthalmic --> VII (temporal branch)

Jaw jerk reflex

V3 (sensory, muscle spindle from masseter) --> V3 (motor, masseter)

Pupillary reflex

II --> III

Gag reflex

IX --> X

Structures transversing cribiform plate

CN I olfactory bundles

Structures transversing optic canal

CN II, opthalmic artery, central retinal vein

Structures transversing superior orbital fissure

CN III, IV, V(1), VI; opthalmic vein, sympathetic fibers

Structures transversing foramen rotundum

CN V(2) - maxillary branch

Structures transversing foramen ovale

CN V(3) - mandibular branch

Structures transversing foramen spinosum

Middle meningeal artery and vein

Structures transversing internal acoustic meatus

CN VII, VIII

Structures transversing jugular foramen

CN IX, X, XI, jugular vein

Structures transversing hypoglossal canal

CN XII

Structures transversing foramen magnum

Spinal roots of CN XI, brain stem, vertebral arteries