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neurology Flashcards

1
Q

shapes of multipolar neurones

A

pyramidal
purkinje
golgi

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2
Q

oligodendrocyte vs schwann

A

myelin in CNS vs PNS

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3
Q

astrocyte

A

support + remove waste

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4
Q

microglia

A

macrophage of brain

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5
Q

ependyma

A

epithelial - line ventricles

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6
Q

what is an excitable cell

A

mp can change => sends electrical signals along pathways

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7
Q

saltatory conduction

A

cable transmission
action potential jumps between nodes of ranvier as myelin has high resistance and low capacitance

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8
Q

types of synaptic organisation

A

axodendritic
axoaxonic
axosomatic

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9
Q

NMJ

A

structure allowing unidirectional chemical communication between peripheral nerves + muscle

ACh at nicotinic receptors

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10
Q

end plate potential

A

voltages causing depolarisation of skeletal muscle fibres caused by neurotransmitters binding NMJ postsynaptic membrane

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11
Q

botulism

A

botulinum toxin = irreversible
disrupts ACh release from presynaptic membrane

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12
Q

myasthenia gravis

A

autoimmune abs against ACh-R on post synaptic membrane
causes fatiguable weakness (facial muscle weakness)

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13
Q

lambert eaton myasthenic syndrome

A

autoimmune antibodies against VGCCs

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14
Q

measuring MP

A

cell in saline
electrode inside
electrode outside (0 volt level)

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15
Q

electrochemical equilibrium

A

electrical forces balance diffusional
determines direction of flux

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16
Q

equilibrium potential

A

potential at which electrochemical equilibrium is reached

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17
Q

what are the nerst and goldman-hodgkins equations used to calculate

A

equilibrium potential

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18
Q

why is GH better than Nerst

A

takes permeability of membrane for each molecule into account

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19
Q

graded potential

A

small depolarisation due to weak stimulus
summate to determine if AP is initiated or prevented

AP = when GP reaches threshold

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20
Q

permeability and membrane potential

A

depolarisation: PNa > PK so MP increases towards eqbm potential of Na (+72mV)

repolarisation: PK > PNa as MP decreases towards eqbm potential of K (-90mV)

hyperpolarisation: some K+ still open => potential continues to decrease

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21
Q

absolute vs relative refractory period

A

absolute = sodium channels shut off by inactivation gate (peptide) so AP cannot be triggered

relative = some sodium channels unblocked so stronger stimulus is needed for AP triggering

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22
Q

factors slowing AP

A

cold, anoxia, compression, drugs, anaesthetics, decreased myelination, smaller diameter

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23
Q

pharmacology

A

study of how chemical agents (drugs) influence function of living systems by interacting with a specific target in a biological system to produce a physiological effect

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24
Q

effects + targets of heroin

A

analgesia (peri-aqueductal grey region)
euphoria (ventral tegmental area)
cough suppression (solitary nucleus)

receptor = opioid receptor

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25
Q

drug targets

A

receptors (e.g. Salbutamol)
enzymes (e.g. Atorvastatin)
transport proteins (e.g. Citalopram)
ion channels (e.g. Amlodipine)

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26
Q

why is selectivity more important in drugs than endogenous compounds

A

neurotransmitters are specifically delivered to their drug target (nerve → synapse → receptor)

drugs are transported via blood to relevant tissues - issue if drug can bind alternate targets

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27
Q

side effect vs adverse effect

A

side: secondary to the intended effect

advers = -ive side

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28
Q

safest drugs

A

large difference between dose required to induce desired effect and dose required to induce side effects/adverse effects

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29
Q

pramipexole

A

treat Parkinson’s disease
dopamine agonist

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30
Q

vesicle processing in presynaptic terminal

A

budding => docking => priming

vesicular proteins enable fusion + exocytosis

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31
Q

properties of synaptic transmission

A

rapid timescale
need diversity
need plasticity
role in learning + memory

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32
Q

NS poison target

A

vesicular proteins

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33
Q

alpha latrotoxin

A

activates VGCCs => ACh release until depletion
muscular paralysis as no new APs activated

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34
Q

botulinum toxin

A

Zn2+ dependant endopeptidases
inhibit transmitter release

disrupts stimulation induced ACh release from presynaptic terminal

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35
Q

all receptor types

A

slow response (sec-min) = G-protein couples
fast response (msec) = Ion channel receptor

IC excitatory = glutamate nt (Na+ influx)
IC inhibitory = GABA/glycine nt (Ca2+/Na+ influx)

fast excitatory = AMPA channel
slow excitatory = NMDA channel

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36
Q

excitatory channels

A

depolarisation
+ive influx

excitatory postsynaptic potential => mV made more +ive

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37
Q

inhibitory channels

A

hyperpolarisation
-ive influx
inhibitory postsynaptic potential => mV made more -ive

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38
Q

AMPA vs NMDA

A

AMPA: rapid onset, offset + depolarisation
NMDA: calcium second messenger

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39
Q

glutamate (synthesis, uptake, recycling)

A

S: TCA + transamination of glucose
U: excitatory aa transporters
R: glutamine synthase = glutamine

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40
Q

GABA (synthesis, uptake, recycling)

A

S: decarboxylation of glutamate via glutamic acid decarboxylase
U: GABA transporters
R: enz modified to succinic semialdehyde via GABA transaminase

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41
Q

electroencephalography

A

measures electrical activity in brain

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42
Q

SNARE

A

vesicular proteins = excytotic nt release

synapsin, synaptobrevin, SNAP25

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43
Q

tetanus on NS

A

inhibits GABA + glycine

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44
Q

2 mechanisms of nt inactivation

A

re-uptake into presynaptic terminal
enzymatic degradation

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45
Q

how to g-protein couples receptors work

A

agonist must bind to the G-protein in the membrane, which will couple to the effector → response

46
Q

diazepam

A

neurones in the temporal lobe

binds GABAA receptor + increases effectiveness of GABA activation

leads to chloride ion influx => hyperpolarize the temporal lobe neurone + decrease seizures

47
Q

lamotrigine

A

glutamatergic neurones in the temporal lobe

blocks voltage gated Na+ channels = reduced neuronal depolaristion

reduced NT release = decreased glutamate neurotransmission

less excitatory stimulation of post-synaptic neurone

48
Q

pregabalin

A

VGCCs of glutamatergic neurones in the temporal lobe

blocked Ca2+ channels → prevents calcium influx into the neurone

no vesicle exocytosis → no neurotransmitter release

decreased glutamate neurotransmission → less excitatory stimulation of the post-synaptic neurone

49
Q

levetiracetam

A

synaptic vesicle protein SV2A of glutamatergic neurones in the temporal lobe

interferes with vesicle fusion → reduced exocytosis of glutamate → decreased excitatory activation of the post-synaptic neurone

50
Q

sodium valproate

A

non-selective drug targeting:

voltage gated sodium channels
GABA transaminase
voltage gated calcium channels
NMDA receptors (blockage), etc.

51
Q

problems with sodium valproate

A

non-selective
teratogenic (abnormal foetal development)

52
Q

high blood pressure pathway

A

baroreceptors (visual sensory)
sensory afferent nerves
PNS → Brain → PNS
motor efferent nerves
visceral motor neuron
parasympathetic nervous system switched on
lowers heart rate
lowers blood pressure

53
Q

ANS control of vasculature

A

predominantly SNS controls blood vessel tone - controls both vasoconstriction and vasodilation

54
Q

where do visceral motor neurones originate + what is their course

A

originate in hypothalamus
project into brainstem/spinal cord
synapse with autonomic neurons

55
Q

ganglion

A

nerve cell cluster/group of nerve cell bodies

56
Q

PNS nerves

A

long pre-ganglionic, short post-ganglionic
ganglions close to effector tissues

pre: ACh at nicotinic
post: ACh at muscarinic

57
Q

SNA nervess

A

short pre + long post
ganglions close to spine

exist in sympathetic trunks alongside spinal cord

pre: ACh at nicotinic
post: NA at adrenergic

58
Q

what is the exception in the SNS

A

adrenal gland
only presynaptic + no ganglion

release adrenaline as hormone not bloodstream (not NT into synapse)

59
Q

ACh formation, degradation, reuptake

A

formation: choline + ACoA enzymatically converted to ACh by choline acetyl transferase

degraded by acetylcholinesterase

re-uptake into presyn by choline uptake protein

60
Q

noradrenaline formation

A

tyrosine => DOPA by tyrosine hydroxylase

DOPA => dopamine by DOPA decarboxlase

dopamine + dopamine β hydroxylase in vesicles = noradrenaline

61
Q

adrenaline formation

A

NA made => converted to adrenaline in cytoplasm by phenylethanol methyl trasnferase

diffuses into capillary

62
Q

forebrain, midbrain, hindbrain

A

F: cerebral hemispheres + diencephalon

M

H: pons, medulla, cerebellum

63
Q

ganglion vs nucleus

A

cluster of nerve cell bodies inside (N) vs outside (G) CNS

64
Q

plexus

A

network of interconnecting nerves

65
Q

frontal lobe functions

A

regulate + initiate motor function
language
cognitive functions (planning, attention, memory)

66
Q

parietal lobe functions

A

sensation
sensory aspects of language
spacial orientation
self perception

67
Q

temporal lobe functions

A

processing auditory information

68
Q

occipital lobe functions

A

processing visual information

69
Q

what does the lymbic lobe contain + main 5 functions

A

amygdala, hippocampus, mamillary body, cingulate gyrus

learning, emothion, reward, memory, motivation

70
Q

where is the insular lobe + what are the functions

A

deep inside lateral fissure

visceral sensations, autonomic control, interoception, auditory processing, visual-vestibular integration

71
Q

where is CSF made + reabsorbed

A

choroid plexus of lateral, 3rd and 4th ventricles

reabsorbed by arachnoid villi (granulations) into superior sagittal sinus

72
Q

what does CSF occupy

A

ventricular system and sub-arachnoid space (125ml)

500ml made each day

73
Q

CSF vs plasma

A

CSF = lower pH, less glucose, protein and potassium than plasma

74
Q

cervical + lumbar enlargements

A

to support innervation of upper + lower limbs

75
Q

main CNS sensory tracts

A

dorsal columns => deep touch, proprioception + vibration

lateral spinothalamic => pain, temperature

ventral spinothalamic => light touch

76
Q

main CNS motor tracts

A

lateral + ventral corticospinal

77
Q

descending CNS (motor) pathway for voluntary movement of body muscles

A

(corticospinal)

upper notor neurones = primary motor cortex (pre-central gyrus)

synapse with lower MN in spinal cord

lateral CS = decussate in medulla => limbs

ventral CS = same side => axial trunk muscles

78
Q

descending CNS (motor) pathways for voluntary movement of head muscles [6]

A

(corticobulbar)

occulomotor nucleus => CN3 => extraocular muscles

trochlear nucleus => CN4 => extraocular muscles

trigeminal nucleus => CN5 => mastication

abducens nucleus => CN6 => extraocular

facial nucleus => CN7 => facial expression

hypoglossal nucleus => CN12 => tongue

79
Q

involuntary pathways - brainstem motor tracts

A

vestibulospinal
tectospinal
reticulospinal
rubrospinal

80
Q

gracile vs cuneate (g/c)

A

gracile = lower limbs - below T6

cuneate = upper limbs - above T6

81
Q

major ascending pathway for fine touch, pressure, vibration + proprioception

A

dorsal column pathway

primary sensory neurones enter spinal cord = g/c tracts

travel ipsilaterally to medulla => synapse in g/c nuclei = secondary neurones

decussate in caudal medulla => contralateral medial leminiscus tract

synapse in thalamus = tertiary => primary somatosensory cortex (postcentral gyrus)

82
Q

major ascending pathway for pain + temperature + crude touch

A

primary neurones end upon entering spinal cord

secondary decussate immediately => synapse in thalamus

tertiary = to PSSC

83
Q

somatic meaning

A

under voluntary control

84
Q

dermatome

A

area of skin that is supplied by a single spinal nerve

85
Q

myotome

A

group of muscles innervated by a single spinal nerve

86
Q

damage to spinal cord vs spinal nerve

A

cord = damages all inferior nerves emerging from that point

nerve = only the region + muscles innovated by that single nerve

87
Q

arrangement of peripheral nerves

A

arranged fasciculi

88
Q

connective tissue layers

A

external (whole peripheral nerve) = epineurium

around fascicles = perineurium

individual axons = endoneurium

89
Q

sensory receptors (by source of stimulus)

A

external => exteroceptors (pain, temp, touch, Pa)

internal => entero (gut/pH) + proprioceptors (movement/joint position)

90
Q

proprioceptor function in muscle spindles, golgi tendon organs + joint receptors (detect:)

A

spindle => changes in muscles length

golgi => changes in tension

joint-R => start/end of movement

91
Q

sensory receptors by mode of detection [5]

A

chemo = molecules binding receptor
photo = light in retina
thermo = temp of skin
mechano = mech ion channel openning
noci = tissue damage as pain

92
Q

motor unit

A

single motor neuron together with all the muscle fibres that it innervates

smallest functional unit with which to produce force

93
Q

reflex

A

involuntary coordinated pattern of muscle contraction and relaxation elicited by peripheral stimuli

94
Q

monosynaptic stretch reflex

A

stretching stimulates sensory receptor (muscle spindle)

sensory neurone activated

within the integrating centre (spinal cord), the sensory neurone activates the motor neurone

effector contracts + sensory activates motor neurone

95
Q

features seen at back of brainstem

A

pineal gland
superior + inferior colliculus
trochlear nerve
dorsal coloumns

96
Q

features seen at front of brainstem

A

optic chiasm
pituitary stalk
mammillary body
cerebral peduncle
medullary pyramids (w/pyramidal decussation)

97
Q

midbrain cross section + cranial nerves that emerge

A

tectum: superior (visual) + inferior (auditory) colliculi

tegmentum: aqueduct (ventricle system)

base: cerebral peduncle (descending cortico tracts)

CN: 3 & 4

98
Q

pons cross section + cranial nerves that emerge

A

aqueduct becomes 4th ventricle + middle cerebellar peduncle

CN: 5,6,7,8

99
Q

medulla cross section - open + cranial nerves that emerge

A

4th ventricle w/no roof => cerebellum
inferior olivary nuclei

CN: 9,10,12

100
Q

medulla cross section - closed + cranial nerves that emerge

A

dorsal columns

central canal

decussation of pyramids => corticospinal tract

CN: 9,10,12

101
Q

brainstem blood supply

A

anterior: internal carotid
posterior: verterobasilar

102
Q

general cranial nerve fibres

A

GSA - general somatic afferent

GSE - general somatic efferent

GVA - general visceral afferent

GVE - general visceral efferent

103
Q

special cranial nerve fibres

A

special somatic afferent => carry special senses of hearing and balance

special visceral afferent => carry taste sensation

special visceral efferent => skeletal muscles of the jaw, face, larynx and pharynx

104
Q

what lies directly above sphenoid bone

A

hypothalamus

105
Q

whats in the posterior cranial fossa

A

cerebellum + brainstem

106
Q

which part of the brain passes through the foramen magnum

A

medulla oblangata

107
Q

what does the middle cerebral artery supply in brain

A

primary motor cortex (face + arm)
primary somatosensory cortex - arm
primary auditory cortex
broca’s area
wernicke’s area

108
Q

what does the anterior cerebral artery supply in brain

A

primary motor cortex for foot

109
Q

what does the posterior cerebral artery supply in brain

A

primary visual cortex

110
Q

all ventricles

A

lateral ventricles
third ventricle
(cerebral aqueduct)
fourth ventricle

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