Neuro Pre-midterm Flashcards
Above the midbrain, define the terms: Rostral, Caudal, Dorsal & Ventral
Anterior/Rostral; Posterior/Caudal
Below the midbrain, define the terms: Rostral, Caudal, Dorsal & Ventral
Anterior/Ventral; Posterior/Dorsal
What is the official boundary between the CNS & PNS?
Redlich-Obersteiner’s Zone
Where can nerves regenerate: CNS or PNS?
PNS
What are the 5 major components of the brain?
- Telencephelon
- Diencephelon
- Mesencephalon
- Metencephalon
- Myencephalon
(Myelon = S/C)
Telencephalon
Lateral ventricles, cerebrun, cortex (gray + white matter)
Differentiate between gray/white matter in the brain and spinal cord.
Brain: White inside
S/C: Gray inside
Diencephalon
3rd ventricle, thalamus & hypothalamus
Metencephalon
Midbrain
Metencephalon
Pons + Cerebellum
Myencephalon
Medulla
What are the 6 cerebral lobes?
Frontal, Temporal, Parietal, Occipital, Limbic & Insular
What are the 6 layers of the cerebral cortex (outside in)?
- Molecular layer
- External granular layer
- External pyramidal layer (small pyr)
- Internal granular layer
- Internal pyramidal (ganglionic or large pyr)
- Multiform/Polymorphus
Where are Betz cells found?
Layer 4 of the cerebrum / lumbar spinal motor neurons
Thalamic input arrives at what level of the cerebrum?
4
Corticospinal/bulbar output leaves from which cerebrum layer?
5
The efferent layers of the cerebrum are:
3 & 5 (2 and 6)
The cerebellum is responsible for
Motor function; posture, balance, smooth muscle coordination
The pons has 2 parts:
Dorsal: sensory (respiratory, taste, sleep/wake)
Ventral: motor
The 3 types of white matter:
Projection
Commisural
Association
What are basal ganglia?
Groups of neurons deep within white matter associated with initiation/organization of movement
What is the difference between T1 & T2?
T1 differentiates between white/gray matter
T2 shows white water (CSF) – ventricles are white
Differentiate between epidural, subdural, and sub-arachnoid hemorrhage.
Epidural: Football
Subdural: Crescent
Sub-arachnoid: Follows granulations
Bone Morphogenic Protein (BMP)
Suppresses neural differentiation; promotes epidermal tissue growth
Homeobox (HOX) genes
60 AA’s that recognize and bind specific DNA sequences; coordinate expression of genes (A-P axis)
Retinoic acid
Source: Hensen’s node
* Activates transcription of HOX genes; established gradient along length of embryo
Sonic hedgehog protein
Synthesized by notochord and floor plate; induces floor plate cells and motoneurons of the ventral spinal cord
EMX & OTX mutations
EMX: Schizencephaly
OTX: Epilepsy
Where do you find younger neurons on radial glia?
Younger neurons migrate further than older ones
What are radial glial cells?
Contact ventral and pial surface; neurons move along the scaffolding
Describe Cajal-Retzius/Reeler gene
Reelin tells neurons to stop migrating!
What types of cells provide an exception to the principle that radial glial cells provide migration/guidance? Name the condition.
GnRh cells
Kallmann’s Syndrome: no smell / no sexual development
What is leukemia inhibit factor?
Peptide released by the heart which can change phenotype; underscoring the principle that a neuron’s environment influences its commitment to function
Describe the role of PMP-22
This protein myelinates peripheral neurons
* Protein normally broken down in absence of axons
What is Laminin?
Promotes axonal outgrowth; found surrounding neurons and satellite cells
What is netrin?
A diffusable substance released by the floor plate; attracts axons to the developing spinal cord
What are the primary divisions of the primitive CNS?
Prosencephalon; Mesencephalon; Rhombencephalon
What is the objective of a graded potential?
Drive potential towards the axon hillock to threshold at which point an action potential can be generated
Rods/Cones convert photons into receptor potential?
Rods
Night vision: increase cGMP, Na-channels open
Day vision: decreased cGMP, hyperpolarization (decreased glutamate)
Olfactory epithelium are bipolar sensory neurons. How do they function with respect to G proteins?
Increase cAMP with increasing odor stimulus
What is spasticity?
Increased muscle tone; hyperexcited muscles with increase in voltage-gated Na-channels open
How do you differentiate between the functions of neurons and glia?
Neurons: action potentials
Glia: Ca-dependent signaling with gap junctions; no action potentials
What are the 3 layers of the cerebellum?
Molecular, Purkinje, Granular
Bipolar neurons
Interneurons
Pseudounipolar neurons
CNS PNS
What is special about herpes, polio, rabies, paravirus with respect to neurons?
They use retrograde transport up axons to reach the soma
What are the different types of glial cells?
Micro: macrophages
Macro: astrocytes, oligodendrocytes, ependymal, radial glia, perivascular astrocyes, tanycytes (PNS: satellite, Schwann, enteric)
T/F Neurons regenerate in the CNS
False
Who re-myelinates in the PNS?
Schwann cells
What is Wallerian degeneration?
Following injury, degeneration distral to the axonal damage
What is the difference between retrograde and anterograde transport?
Retrograde: Dyenin – axon–> soma
Anterograde: Kinesin – soma –> axon
What are the 3 elements of cytoskeleton important for transport in a neuron?
- Microfilaments
- Intermediate filaments
- Microtubules
What are the 4 classes of sensory receptors?
Mechano, thermo, chemo, photo - receptors
What are the 6 sensory systems?
Somatosensory, visual, vestibular, auditory, olfactory, gustatory
What are the 4 attributes that characterize a sensory stimulus?
Modality
Intensity
Duration
Location
Differentiate between slow and rapidly adapting receptors.
Slow – good for physiologic montioring; constantly depolarized
Fast – more sensitive to change
All neurons of the somatosensory system are..
Pseudounipolar neurons
The 5 modalities of somatosensory system:
- Touch, Proprioception, Vibration
2. Pain, Temperature
What are the 4 somatosensory fibers?
Fastest: 1-alpha, 2-beta, 3-delta, 4-C :Slowest
C2
Back of head
C6
Thumb
C7
Middle finger
C8
Little finger
T4
Nipple line
T10
Umbilicus
L1
groin
L5
Big toe
S1
Little toe
What are the 2 somatosensory pathways?
- Dorsal-column medical leminiscus touch/vibration/proprioception
- Anterolateral pain/temp
Describe the routes to the brain for the somatosensory pathways
- D-C/M-L – medial to lateral (leg, trunk, arm)
Leg goes to gracile fasiculus; arm goes to cuneate fasiculus in medulla - Anterolateral (spinothalamic); dorsal horn –> cross anterior white commissure –> ALS fiber tract to thalamus (Leg-lateral, arm-medial)
Describe Lissauer’s tract
Collaterals of Anterolateral system can ascend 1 or 2 levels in the dorsolateral fasiculus
Describe the sensory aspect of Brown-Sequard Syndrome
See notes
What is syringomyelia?
Pathologic enlargement of central canal of S/C
* Interrupts pain/temperature fibers that cross the anterior white commissure
Bilateral pain/temperature loss @ and below lesion;
Note Lissaeur contribution
What is shingles/herpes zoster?
Following an attack of the chickenpox, the herpes virus may become latent in dorsal root ganglion cells (or trigeminal ganglion cells). Reactivation of the virus produces painful skin irritations in the dermatomal area innervated by the related ganglion
Describe the 3 neuron chain for DRG & trigeminal ganglia touch, proprioception, and vibration
See notes
What are the 3 features of the primary somatosensory cortex?
- Somatotopic map
- Organization in columns
- Input to layer 4
With respect to 2 point discrimination, a higher resolution means…
Greater density of mechanoreceptors, small receptive fields, larger cortical area involved +/- lateral inhibition
How do we examine touch, vibration, proprioception? Basic and Complex
Touch w/ pain; vibration, proprioception - finger
What is the first somatosensation lost with peripheral neuropathies?
Vibration
What is stereogenesis and graphesthesia?
Stereo: place a stereo in hand, ask what it is
Graph: draw a number or letter in the palm
What is tapes dorsalis?
Destruction of DRG (loss of touch, proprioception) in syphillis
What is characteristic of phantom limbs?
Rearrangement of cortical neurons
Describe the 2 types of pain
- Nociceptive (stimulus driven)
2. Neuropathic (more complex/ abberent processing)
Describe the spinal and trigeminal pain pathways (First, second, third order neurons and tracts)
First order neuron: substantia gelatinosa of dorsal horn
Second order neuron: crosses midline (ant white commissure) and ascends through ALS tract to synapse at VPL in thalamus
Third order neuron: travels through posterior I/C and corona radiata to synapse in somatosensory cortex
Differentiate between hyperalgesia and allodynia
Hyperalgesia: enhanced senstion of pain in area around injury
Allodynia: Previously painful stimuli become painful
What is the optic fundus?
Back portion of the interior of the eyeball
Describe the layout of the eyeball
Cornea (sclera), a/p chambers, iris, lens; retina is innermost layer, after sclera and choriod
Differentiate between constriction and dilation (pupil)
Constriction - para - contract ciliary muscle, relax suspensory ligaments
Differentiate between myopia, hyperopia & emmetropia
Myopia: near sightedness; requires biconcave lens; eye is too long/refractive power is too strong
What is the condition called for loss of refractive capability with age?
Presbyopia
The lens has a higher/lower refractive power for near vision?
Higher
What part of the eye is responsible for the greatest refractive power?
Cornea
Light generally causes what type of reaction in photoreceptors?
Hyperpolarization (activation of cGMP phsphodiesterase)
Describe the wavelength of Red, Green, Blue
Red: longest wavelength
Blue: shortest wavelength
What are the 5 cell types in the retina?
- Photoreceptors
- Bipolar
- Ganglion
(Horizontal & amacrine)
Describe the difference between ON and OFF cells.
ON cells stimulated by light, leads to depolarization, release of INHIBITORY glutamate (metabotropic)
OFF cells stimulated by darkness, leads to depolarization, release of EXCITATORY glutamate (ionotropic)
Which vitamin is responsible for night blindness?
Vitamin A
What is the objective of horizontal cells?
Inhibits the pathway in the adjacent retinal cells
Retinitis pigmentosa
Characterized by night blindness and tunnel vision; degeneration of rods
Differentiate between the 2 major types of color-blindness.
R-G most common (X-recessive)
Protanopia: L cone (red cone absent)
Deuteranopia: M cone (green cone absent)
Rods have more/less convergence than cones
More
Which is the active version of the visual pigment retinal: cis or trans
Trans
T/F monochromatic blue light depolarizes all 3 types of cones
True
Who is more sensitive to light: rods or cones
Rods
What is the posterior boundary of the frontal lobe?
Central sulcus
How do you differentiate between a subarachnoid hemorrhage and an epidural hemorrhage?
SA: meningeal irritation
Epi: lucid interval
What are the 2 types of brain herniation?
Uncal: upper
Tonsillar: lower (bottom of pons)
What blood vessels supply the medulla?
AICA, PICA, ASA
What blood vessels supplies the pons?
Basilar artery (pontine branches)
What blood vessels supply the midbrain?
Posterior cerebral and superior cerebellar
* Oculomotor nucleus
Where is the EW nucleus located?
Midbrain
What is aphasia?
Inability to speak
What is anisocoria?
Pupils different sizes
What reflex is associated with the flocculonodular lobe of the cerebellum?
Vestibulooccular – focus eye on a point while moving head
Biceps reflex
C5, 6
Triceps reflex
C7, 8
Abdo reflex (above/below umbilicus)
8,9,10; 10,11,12
Knee jerk reflex
L 2, 3, 4
Ankle reflex
S1
Define obtunded
Lower than full mental capacity
Where are aneurysms more likely to occur?
At junctions of vessels (Lg –> Small)
What is the chief symptom of a SA hemorrhage?
Thunderclap headache
Where is there no choriod plexus?
A/P lateral ventricle; cerebral aqueduct
Differentiate between the gracile and cuneate nuclei
Gracile: medial; legs
Cuneate: lateral; arms
Where is the lamina terminalis?
Anterior to the 3rd ventricle