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Nervous System > Neuro - relevant Anatomy and Physiology > Flashcards

Neuro - relevant Anatomy and Physiology Flashcards

1
Q

What are the key features of a neurone?

A
  • High metabolic rate

- Long-living and amitotic

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2
Q

What are the different types of neurones?

Give examples of types of neurones found in each one.

A

Multipolar:

  • interneurones
  • motor neurones

Bipolar:
- olfactory mucosa
- retinal nerve fibres
(CN I + II)

Pseudounipolar:
- sensory neurones

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3
Q

What does Myelin Sheath do?

A
  • Increases conduction speed in axons by “saltatory conduction”
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4
Q

What is Myelin Sheath formed by?

A
  • Schwann cells in the PNS

- Oligodendrocytes in the CNS

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5
Q

What are the different types of Glial cells found in the PNS?

What are their functions?

A
  • Satellite cells:
  • > surround neuronal cell bodies
  • Schwann cells:
  • > myelination
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6
Q

What are the different types of Glial cells found in the CNS? (AMOE)

What are their functions?

A
  • Astrocytes:
  • > have endfeet-> surround synapses, capillaries, help in K+ buffering
  • Microglia:
  • > phagocytosis, scar tissue formation
  • Oligodendrocytes:
  • > myelination
  • Ependymal cells:
  • > lines ventricles
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7
Q

Why do drugs have to be lipid soluble or use suitable vectors (pumps) to be used in the brain?

A
  • Due to the presence of the BBB!!
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8
Q

What is the purpose of the BBB?

A
  • Protective mechanism that helps maintain a stable environment for the brain
  • Prevents harmful AAs + ions which are present in the bloodstream from entering the brain
  • At the same time, allows vital nutrients to enter the brain
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9
Q

Which part of the CNS contains CSF?

A
  • Subarachnoid space
  • > (between pia and arachnoid mater)
  • Inside ventricles
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10
Q

What is contained in the Subdural space?

A

Traversed by blood vessels penetrating into the CNS

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11
Q

What produces CSF?

A

Choroid plexus in each Ventricle

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12
Q

Where is CSF re-absorbed?

A

By Arachnoid villi/granulations into the Superior Sagittal Sinus (SSS)

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13
Q

What is the function of the Brainstem?

A
  • Produces the rigidly programmed automatic behaviours which are essential for life
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14
Q

Which CNs originate from the medulla?

A
  • final 4 CNs*
  • CN IX: Glossopharyngeal nerve
  • CN X: Vagus nerve
  • CN XI: Accessory nerve
  • CN XII: Hypoglossal nerve
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15
Q

Which CNs originate from the Pons?

A
  • CN V: Trigeminal nerve
  • CN VI: Abducens nerve (originates posteriorly -> only nerve to do that)
  • CN VII: Facial nerve
  • CN VIII: Vestibulocochlear nerve
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16
Q

What is the function of the Cerebellum?

A
  • Posture maintenance

- Fine tuning motor activity

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17
Q

How do you detect an abnormality of the Cerebellum?

A
  • Ataxia*
  • Finger-nose test
  • Knee-heel test
  • Walking in a straight line
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18
Q

What are the structures of the Diencephalon?

A
  • all around the 3rd ventricle*
  • Thalamus
  • Hypothalamus (+ pituitary)
  • Epithalamus (pineal gland)
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19
Q

What is the function of the Thalamus?

A
  • Processes sensory information

- > Sensory relay station

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20
Q

What is the role of the Hypothalamus

A
  • Main autonomic control centre
  • Homeostasis:
  • > regulation of body temp
  • > regulation of food intake
  • > regulation of water balance + thirst
  • > regulation of sleep-wake cycle
  • > control of endocrine system functioning
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21
Q

What supplies the blood to the brain?

A
  • 2 ICAs through the Carotid canal
  • 2 Vertebral arteries through the Foramen magnum
  • Circle of Willis (base of the brain) -> formed by branches of both arteries
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22
Q

What is the role of the vestibular system?

A
  • Found in the inner ear

- Controls posture and balance

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23
Q

What are the components of the vestibular apparatus?

A

Otolith Organs:

  • Utricle: 3 semi-circular canals, ampulla, cristae
  • Saccule
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24
Q

What is the function of the semi-circular canals?

A
  • Detect rotational acceleration
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25
Q

What is the function of the Utricle?

A
  • Detects front + back tilt, and horizontal acceleration

- > (as if u were in a car)

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26
Q

What is the function of the Saccule?

A
  • Detects vertical acceleration

- > (as if u were in a lift)

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27
Q

Where is the sensory apparatus of the semi-circular canals located?

What does it contain?

A

in the Ampulla

-> contains the Cupula, sensory hair cells, 1 kinocilium + several small stereocilia, and vestibular nerve (CN VIII)

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28
Q

Where is the sensory apparatus of the Utricle and Saccule called?

How does it perform its function?

What does it contain?

A
  • Macula
  • Located in 2 different orientations in the ear: one in the horizontal (Utricle) and one in the vertical plane (Saccule) -> detects movements in these respective orientations
  • , 1 kinocilium + several small stereocilia, protrudes into Otolith membrane, which contains Otoliths (crystals)
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29
Q

What are the different vestibular system reflexes?

A

1 - Tonic Labarynthine reflexes

  • > keep the axis of the head in a constant relationship w the rest of the body
  • > uses info from the maculae and the neck proprioceptors

2 - Dynamic Righting reflexes

  • > rapid postural adjustments that are made to stop you falling when you trip
  • > long reflexes -> involves extension of all limbs

3 - Vestibulo-ocular reflexes
-> strong association is evident between the vestibular apparatus, the visual apparatus and postural control

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30
Q

What is the basis of the Caloric stimulation test?

A
  • Test of the Vestibulo-ocular reflex that involves irrigating cold or warm water into the ear
  • Uses the principle of Nystagmus
  • Tests damage to the vestibulococchlear nerve (CN VIII)
  • In an intact brainstem: Warm water causes Nystagmus towards the affected side, Cold water causes Nystagmus away from the affected side (COWS - Cold Opposite, Warm Same -> cold into right ear = left nystagmus, warm into right ear = right nystagmus)
  • Absent reactive eye movement suggests vestibular weakness of the horizontal SSC of the side being stimulated
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31
Q

Which clinical conditions cause Nystagmus?

A

1 - Motion sickness (Kinetosis)

2 - Labyrinthitis

3 - Meniere’s disease

4 - If vestibular impairment is chronic: can be well-compensated by the visual system

5 - Lesions of the Brainstem -> Nystagmus at rest

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32
Q

What is the pathophysiology of Motion sickness? (Kinetosis)

A
  • Most likely to occur if visual and vestibular system inputs to the Cerebellum are in conflict
  • > ie. vestibular system indicates rotation, but visual system does not
  • Cerebellum generates a “sickness signal” to the Hypothalamus to bring about ANS changes -> ie. nausea, vomiting, reduced BP, dizziness, sweating and pallor
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33
Q

What is the pathophysiology of Labyrinthitis?

A
  • Acute interference with normal vestibular function as a result of infection
  • causes all ANS symptoms (ie. nausea, vomiting, reduced BP, dizziness, sweating and pallor) + vertigo (perception of movement in the absence of movement, there may also be nystagmus)
  • Gross impairment of posture and balance (v disabling)
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34
Q

What is the pathophysiology of Ménière’s disease

A
  • Associated with over-production of Endolymph -> unknown cause
  • Vertigo, nausea, nystagmus and tinnitus (!!!)
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35
Q

What nerve fibres are carried in the Corticospinal (pyramidal) tract?

A
  • Carries motor impulses from the Motor cortex (area 4) to skeletal muscles
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36
Q

What nerve fibres are carried in the Posterior (dorsal) column?

A
  • Fine touch
  • Vibration
  • Two-point discrimination (tactile localisation)
  • Proprioception (position) from the skin and joints
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37
Q

What nerve fibres are carried in the Lateral Spinothalamic tract?

A

Pain + Temp

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38
Q

What artery supplies the Corticospinal tract?

A

MCA

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39
Q

Where do fibres of the Corticospinal tract decussate?

A

in pyramidal decussation (Medulla)

-> (forms the Lateral corticospinal tract)

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40
Q

Where do fibres of the Corticospinal tract originate?

A

from the Motor cortex (area 4), (precentral gyrus)

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41
Q

Where is the location of the first order, second order and third order neurones of the Posterior/Dorsal column pathway?

A
  • First order: synapses at lower part of the medulla
  • Second order: lower part of Medulla (then decussates here -> now called medial lemniscus) -> Thalamus
  • Third order: Thalamus -> post-central gyrus (Area 2, 1, 3)
42
Q

Where is the location of the first order, second order and third order neurones of the Lateral Spinothalamic tract?

A
  • First order: enters into the grey matter and ends at the same level
  • Second order: decussates at same level of entry (!!) to reach the lateral column (now called lateral spinothalamic tract) -> ends in Thalamus
  • Third order: Thalamus -> post-central gyrus (area 2, 1, 3)
43
Q

Summarise the Stretch Reflex

A
  • Monosynaptic reflex*
  • Tendon stretched
  • Intrafusal muscle fibres stimulated
  • Sensory neurone activated
  • Monosynaptic reflex arc
  • > polysynaptic reflex arc to inhibitory interneurone
  • Muscle contraction
  • > Reciprocal inhibition of antagonistic muscle
44
Q

What is the purpose of the Stretch Reflex?

A
  • Important in control of muscle tone + posture
45
Q

What is the purpose of the Flexor (and Crossed Extensor) Reflex?

A
  • Helps protect the body from painful stimuli
46
Q

Summarise the Summarise the Stretch Reflex

A
  • Pain stimulus
  • Sensory neurone activated
  • Polysynaptic reflex arc
  • Flexion and withdrawal from noxious stimulus
  • Crossed extensor response to contralateral limb (only in weight-bearing limbs) -> maintains balance!
47
Q

Where would the signs and symptoms be if the lesion was…

a) above the level of decussation?
b) below the level of decussation?

A

a) contra-lateral signs and symptoms

b) ipsilateral signs and symptoms

48
Q

What is the difference in muscle tone with U|MN vs. LMN lesions?

A
  • UMN: increased tone (spasticity)

- LMN: decreased tone (flaccidity)

49
Q

What is the difference in reflexes with U|MN vs. LMN lesions?

A
  • UMN: exaggerated reflexes

- LMN: decreased reflexes

50
Q

What would you expect in terms of paralysis, reflexes and tone in a L UMN lesion at the internal capsule?

A
  • R-sided paralysis
  • Hyper-reflexia
  • Increased tone
51
Q

What would you expect in terms of paralysis, reflexes and tone in a L UMN lesion at the upper cervical spinal cord?

A
  • L-sided paralysis
  • Hyper-reflexia
  • Increased tone
52
Q

What would you expect in terms of paralysis, reflexes and tone in a L LMN lesion?

A
  • L-sided paralysis
  • Absent reflexes
  • Flaccid
53
Q

What would you expect in terms of posterior dorsal column sensory loss with a…

a) lesion at L internal capsule?
b) lesion at L cervical spinal cord?

A

a) R-sided (contralateral) sensory loss

b) L sided (ipsilateral) sensory loss
- > (nb. below the decussation!!)

sensory loss = fine touch, tactile localisation (2-point discrimination), vibration sense , proprioception

54
Q

What would you expect in terms of lateral spinothalamic tract sensory loss with a…

a) lesion at L internal capsule?
b) lesion at L cervical spinal cord?

A

a) R sided (contralateral) pain + temp loss
b) R sided (contralateral) sensory loss
* sensory loss = pain and temp*

55
Q

Brown-Sequard syndrome:

Herniated disc at C3 (LHS)

What would be the motor and sensory loss in this pt?

A
  • Left-sided paralysis (spastic) + left-sided exaggerated reflexes
  • > (below the decussation (of UMN!!))
  • > (also, LMN synapses at the same level of the spinal cord so hence UMN signs)
  • Left-sided loss of fine touch, tactile localisation, vibration sense and proprioception
  • > (below the decussation)
  • Right-sided loss of temperature on pain
  • > (above the decussation)
56
Q

What are the key features of the cerebral hemispheres?

A
  • Outer grey matter
  • Inner white matter
  • Deep within the white matter = basal ganglia (grey matter)
57
Q

What is the role of the Medial Longitudinal Fissure?

A

Separates the two cerebral hemispheres

58
Q

What is the role of the Corpus Callosum?

A

Connects the two cerebral hemispheres

59
Q

What is the function of the Lateral sulcus?

A

aka: Sylvanian fissure

separates the Temporal lobe from the Frontal and Parietal lobes

60
Q

What is the function of the Central sulcus?

A

separates the Frontal and Parietal lobes

61
Q

What is the function of the Parieto-occipital sulcus?

A

separates the Occipital lobe from the Parietal lobe

62
Q

What is the function of the Frontal lobe?

A
  • Thinking (intellect)
  • Motor cortex (pre-central gyrus) -> area 4
  • Broca’s speech (nb. expressive aphasia) (bilateral) -> area 44, 45
63
Q

What is the function of the Parietal lobe?

A

Somatosensory

(post-central gyrus) -> areas 3, 1, 2

64
Q

What is the function of the Temporal lobe?

A
  • Auditory (hearing) - areas 41, 42
  • Wernicke’s area (nb. receptive aphasia) (unilateral, in the dominant lobe)- language
  • Smell
65
Q

What is the function of the Occipital lobe?

A
  • Vision!

primary visual cortex = area 17

66
Q

What does a Parietal Lobe lesion give rise to?

A
  • on the contralateral side of the body*
  • Hemisensory neglect
  • Right-Left Agnosia
  • Acalculia
  • Agraphia
67
Q

What are the components of the Limbic lobe?

What are its functions?

A
  • Cingulate Gyrus, Hippocampus, Parahippocampal Gyrus, Amygdala
  • Memory, Emotional aspects of behaviour
68
Q

Where is Wernicke’s area?

A
  • Temporal Lobe
  • Unilateral -> in the dominant lobe
    (ie. in the left cerebral hemisphere in a right-handed person)
69
Q

What is Broca’s Aphasia?

What causes it?

A
  • Expressive aphasia*
  • Weakness/paralysis of one side of the body
  • Understands speech
  • Misses small words
  • Aware of difficulties in speech
  • Damage to the Frontal lobe
70
Q

What is Wernicke’s Aphasia?

What causes it?

A

Receptive aphasia

  • Fluent speech
  • New, meaningless words
  • Can’t understand speech
  • Unaware of their mistakes
  • No paralysis
  • Damage to the Temporal Lobe
71
Q

What is the blood supply of the Internal Capsule?

A

projection fibres passing between the thalamus and caudate nucleus medially, and lentiform nucleus laterally

  • MCA
    (frequently affected in a Stroke)
72
Q

What structures make up the Basal Ganglia?

A
  • Subcortical Nuclei deep within each cerebral hemisphere*
  • Caudate Nucleus
  • Putamen
  • Globus Pallidus
  • Substantia Nigra (in midbrain -> although functionally part of them, not anatomically!)
73
Q

What is the role of the Basal Ganglia?

A
  • Controls movement by connecting to the Motor cortex

starting and stopping of movement

74
Q

What are the different types of white matter in the brain and what are their functions?

A
  • Commissural fibres: connect corresponding areas of the 2 cerebral hemispheres (corpus callosum)
  • Association fibres: connect one part of the cortex with another -> may be short or long
  • Projection fibres: run between the cerebral cortex and various subcortical centres -> they pass through the corona radiata and the internal capsule
75
Q

Why is the Basal Ganglia often referred to as the “extra-pyramidal system”

A
  • Bc it plays a role in initiation and termination of movement (motor system)
  • (Nb. Corticospinal tract = pyramidal tract)
76
Q

Give an example of a pathology which can occur due to damage to the Basal Ganglia?

A
  • Parkinson’s

- Huntington’s

77
Q

What 4 body systems control movement?

A

1 - Descending control pathways (Cerebral cortex -> motor, premotor and supplementary motor cortex)

2 - Basal ganglia

3 - Cerebellum

4 - Local spinal cord/brainstem circuits (reflexes)

78
Q

What are and where are the sensory receptors for the stretch reflex?

A

1a afferent sensory neurones in the Muscle spindle

monitors muscle length

79
Q

What type of reflex is the stretch reflex?

A
  • Monosynaptic reflex

- > (no interneurones involved => only one that exists!!)

80
Q

What connections are made in the Stretch reflex? (3)

A

3 types of connections

1a afferent sensory neurones in the muscle spindle to…

1 - a-motorneurones in the stretched muscle
-> rapid contraction of the agonist muscle

2 - inhibitory interneurones which decrease activation of a-motorneurones to the antagonist muscle
-> rapid relaxation of the antagonist muscle (stretches) = reciprocal inhibition

3 - information travels up to the Thalamus and Somatosensory cortex -> tells brain about the length of the muscles

81
Q

What are and where are the sensory receptors for the Clasp-knife reflex?

A
  • Group 1b afferents in the Golgi Tendon Organ

monitor muscle tension

82
Q

What connections are made in the Clasp-knife reflex? (3)

A

muscle contraction leads to firing of GTO 1b afferents, leading to….

1 - activation of inhibitory interneurones to the agonist muscle
-> decrease in contraction strength

2 - activation of excitatory interneurones to antagonist muscles

3 - information travels up to the Thalamus and Somatosensory cortex -> tells brain about the length of the muscles

83
Q

What type of reflex is the clasp-knife reflex?

A

Polysynaptic reflex

involves interneurones

84
Q

What type of reflex is the flexor/withdrawal reflex with crossed extension?

A

Polysynaptic reflex

involves interneurones

85
Q

What are and where are the sensory receptors for the flexor/withdrawal reflex with crossed extension?

A

pain receptors (nociceptors) in skin, muscles and joints

-> A-Delta fibres (smaller diameter - so a slower reflex)

86
Q

What connections are made in the flexor/withdrawal reflex with crossed extension? (5)

A

1 - increased activity in the flexor muscles -> via a number of excitatory interneurones

2 - at the same time, via a number of excitatory and inhibitory interneurones, the antagonistic extensors are inhibited

extends the contralateral limb, via…
3 - excitatory interneurones crossing the spinal cord and excite the contralateral extensors

4 - other interneurones cross the spinal cord, synapse with inhibitory interneurones and inhibit the contralateral flexors

5 - sensory info ascends to the brain in the contralateral spinothalamic tract

87
Q

Can you consciously over-ride the GTO reflex?

How?

A
  • Yes
  • Because the a-motorneurones integrate and summate all of its inputs (>10,000 synapses), which influence whether it is excited or inhibited
  • Descending voluntary excitation of a-motorneurones overrides inhibition from the GTOs and maintains muscle contraction
88
Q

Can you consciously over-ride the Stretch reflex?

How do you over-ride strong descending inhibition in this reflex?

A
  • Yes

- Jendrassik manoeuvre
pt. is too busy focusing on interlocking their fingers to over-ride the stretch reflex

89
Q

Can you override the withdrawal reflex?

What can exaggerate it?

A
  • Yes
  • Anticipation of the pain -> can increase the vigour of the withdrawal reflex when the painful stimulus arrives (ie. getting a jab)
90
Q

What do reflexes elicited above (but not below) a given level in the spinal cord indicate?

A

segmental trauma to the spinal cord

at the given level

91
Q

Why is the stretch reflex quite specific in detecting spinal cord problems?

A

because spindle input is highly localised and only affects a-motorneurones at one or two spinal segments

92
Q

What is the function of the lateral pathways of the spinal cord?

A
  • (corticospinal tract (CST), rubrospinal tract (RST))*
  • Originates in the Cerebral cortex (UMNs -> primary motor (area 4) and premotor cortex (area 6))

Controls precise skilled voluntary movements

-> distal muscles (ie. hands and fingers) = under direct voluntary control

93
Q

What is the function of the ventromedial pathways of the spinal cord?

A
  • (vestibulospinal (VST), tectospinal tract (TST), pontine and medullary reticulospinal tracts*
  • Originates in the Brainstem (UMNs)
  • Controls posture balance and locomotion (orienting mechanisms)
  • > (ie. eyes, head and neck, trunk and anti-gravity muscles in limbs)
94
Q

What is the function of the Vestibulospinal tract (VST)?

A
  • (from the ventromedial pathway)*

- stabilises the head and neck

95
Q

What is the function of the Tectospinal tract (TST)?

A
  • (from the ventromedial pathway)*

- ensures eyes remain stable as body moves

96
Q

What is the function of the pontine and medullary reticulospinal tracts?

A
  • (from the ventromedial pathway)*
  • Uses sensory information about balance, body position and vision
  • reflexly maintains balance and body position
  • innervates trunk and antigravity muscles in limbs
97
Q

Describe the Motor Homunculus arrangement

A
  • Somatotopic arrangement in the Precentral gyrus (area 4)
  • from the Median Longitudinal Fissure to laterally:
  • > toes, ankle, knee, hip, trunk, shoulder, elbow, wrist, hand, neck, face, lips, jaw tongue, swallowing

there is also a sensory homunculus

98
Q

What is the function of the Premotor cortex (area 6)?

A

Helps to control and plan movements

decision-making neurones -> fire 1s before a movement occurs

99
Q

What is the pathophysiology of Parkinson’s Disease?

A
  • Caused by degeneration of neurones in the Substantia Nigra -> causes loss of dopaminergic (excitatory) inputs to the striatum
  • Dopamine enhances cortical inputs through the “direct” and “indirect” pathway
  • Loss of dopamine closes down the activation of the focussed motor activities that funnel through the Thalamus to the SMA (area 6)
  • Leads to Hypokinesia: slow-ness, rigidity, tremors of hand + jaw, difficulty making voluntary movements
100
Q

What is the pathophysiology of Huntington’s Disease?

A
  • Profound loss of caudate, putamen and globus pallidus
  • loss of the ongoing inhibitory effects of the Basal Ganglia
  • causes Hyperkinesia (characteristic chorea = spontaneous uncontroed rapid flicks and major movements with no purpose) with dementia and personality disorders
101
Q

What is the “readiness potential”?

A

A measure of activity in the motor cortex and supplementary motor area of the brain leading up to voluntary muscle movement

-> ie. the parts of the brain controlling muscle movement light up before u perform that movement

102
Q

What do Cerebellar lesions cause?

A
  • Uncoordinated movements (Ataxia)
  • Imbalance
  • Speech problems (dysarthria)
  • Visual problems (nystagmus) and vertigo as a part of the vestibulocerebellar system

Nervous System (11 decks)

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