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Medicine > Neurology > Flashcards

Neurology Flashcards

1
Q

What are the two types of neurotransmitter receptors?

A

Metabotropic

Ionotropic

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2
Q

What type of receptor are the majority of neurotransmitter receptors?

A

Metabotropic

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3
Q

Name four neurotransmitters that act generally.

A

Glutamate
Gamma-amino butyric acid (GABA)
Glycine
Acetylcholine

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4
Q

Where is glutamate the main excitatory neurotransmitter?

A

In the CNS

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5
Q

Name the 3 ionotropic receptors for glutamate and state what they are permeable to.

A

AMPA - sodium
NMDA - calcium and sodium
Kainate - sodium and calcium

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6
Q

What does prolonged activation of glutamate receptors result in?

A

Hyperexcitability, leading to seizures and excitotoxicity

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7
Q

Give 2 examples of what blocks glutamate receptors and what does this cause?

A

Ketamine and alcohol

Results in sedation

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8
Q

Where in the body in GABA the main inhibitory neurotransmitter?

A

In the CNS

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9
Q

What are the two types of GABA receptor?

A

GABA A - ionotropic receptor that conducts Cl

GABA B - metabotropic receptor

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10
Q

What does activation of GABA A result in?

A

Sedation

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11
Q

Name 2 substances that activate GABA A receptors.

A

Alcohol and benzodiazapines, such as lorazepam

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12
Q

What does activation of GABA B receptors result in at the synapse?

A

Presynaptic inhibition of GABA release

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13
Q

What is the effect of positive allosteric modulators on GABA?

A

Potentiates the effect of GABA on GABA A receptors

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14
Q

What do GABA analogues do and what are the clinical signs?

A

Increase the amount of GABA available

Have a relaxing, anti-anxiety and anti-convulsive effect

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15
Q

Why are glia important for glutamate and GABA?

A

Important for the synthesis of them and also “mop up” excess neurotransmitter

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16
Q

What type of of neurotransmitter is glycine: inhibitory or excitatory?

A

Inhibitory

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17
Q

What type of receptors does glycine act on?

A

Ionotropic receptors that conduct chloride ions

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18
Q

What are glycine receptors blocked by?

A

Strychnine

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19
Q

Where is glycine mainly active?

A

Brainstem and spinal cord

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20
Q

Where in the brain is the principal source of serotonin?

A

Raphe nuclei

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21
Q

How many Raphe nuclei are there, and where are they found?

A

7-8

Located near the midline of the brainstem and around the reticular foramen

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22
Q

What is serotonin implicated in?

A 
Depression
Appetite control
Nausea
Sleep
Sexual arousal
Analgesia
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23
Q

What type of receptors are serotonin receptors?

A

All are metabotropic G-protein coupled receptors, except 5-HT 3 which is ionotropic

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24
Q

How is serotinergic action primarily terminated?

A

By reuptake of serotonin, which is down through SERT (a specific monoamine transporter for serotonin) on the presynaptic neuron

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25
Q

What is special about drug targets for serotonin?

A

All 5 elements in the life of a neurotransmitter are drug targets for serotonin

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26
Q

Name a drug type that can block transporters of serotonin.

A

SSRIs

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27
Q

What drug can activate receptor 5-HT 1B and what is this drug used to treat?

A

Sumatriptan

Treats migraines

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28
Q

Name a type of drug that activates 5-HT 2A receptors.

A

Hallucinogenic drugs

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29
Q

Name a type of drug that blocks 5-HT 2A receptors.

A

Atypical antipsychotics

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30
Q

Name a drug that blocks 5-HT 3 receptors and what is it used to treat?

A

Odansetron

An anti-emetic

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31
Q

Where does serotonin exist outside the nervous system?

A

In vast stores in enterochromaffin cells in the lining of the GI tract

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32
Q

What parts of the brain make acetylcholine and where do they project to?

A

Basal forebrain- project to cortex and hippocampus

Brainstem tegmentum - project to thalamus, brainstem and cerebellum

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33
Q

Which subdivision of the nervous system is acetylcholine the main neurotransmitter for?

A

Autonomic nervous system

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34
Q

What are the receptors for acetylcholine and what type of receptors are they?

A

Nicotinic - ionotropic

Muscarinic - metabotropic

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35
Q

Which part of the brain synthesises dopamine?

A

Ventral midbrain - substantia nigra and ventral tegmental area

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36
Q

What is the substantial nigra thought to be involved in?

A

Movement control

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37
Q

What is the ventral segmental area involved in?

A

Reward
Novelty
Motivation

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38
Q

In what disorders is there thought to be something wrong with the dopaminergic system?

A

Schizophrenia
Drug addiction
Tourettes
Parkinsons disease

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39
Q

What are the receptors of the dopaminergic system and what type are they?

A

D1 - excitatory metabotropic

D2 - inhibitory metabotropic

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40
Q

What type of drugs block dopamine receptors and name 2.

A

Antipsychotic medications - haloperidol and quetiapine

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41
Q

What part of the brain produces noradrenaline?

A

Locus coeruleus

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42
Q

What type of receptor are adrenergic receptors?

A

Metabotropic

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43
Q

What part of the brain produces histamine and where does it project to?

A

Hypothalamus -projects throughout brain

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44
Q

What are the 3 major types of endogenous opioid peptides?

A

Endorphins
Enkephalins
Dynorphins

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45
Q

What are endorphins similar to and what are their effects?

A

Like morphine

Have endogenous analgesic effect

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46
Q

Where in the brain are endogenous opioids synthesised, and what as?

A

By hypothalamus as propeptides

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47
Q

Once synthesised, where are endogenous opioids projected to?

A

Periaqueductal grey

Brainstem

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48
Q

What and where is the periaqueductal grey?

A

Grey matter located around the cerebral aqueduct within the tegmentum of the midbrain

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49
Q

What is the main function of endogenous opioids?

A

Neuromodulators that regulate the release and activity of other neurotransmitters

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50
Q

What does damage to CN VIII result in?

A

Unilateral hearing loss, tinnitus and vertigo

51
Q

What is the function of V1?

A

Sensation from the cornea, skin of forehead, scalp, eyelids, nose and mucosa of nasal cavity

52
Q

What does damage to CN XI cause?

A

Paralysis of sternocleidomastoid and trapezius muscle causing drooping of shoulder

53
Q

What is CN IV called?

A

Trochlear nerve

54
Q

How does cranial nerve I exit the cranium?

A

Through the cribiform plate

55
Q

What is the pons involved in?

A 
Sleep
Respiration
Swallowing
Posture
Taste
56
Q

What is CN XI and what is its function?

A

Spinal accessory nerve - motor innervation to sternocleidomastoid and trapezius muscle

57
Q

Through which space and then which sinus does CN IV run on its way to the orbit?

A

Through the subarachnoid space and then through the cavernous sinus

58
Q

What is CN VIII?

A

Vestibulocochlear nerve

59
Q

What is the most ventral part of the midbrain?

A

The paired cerebral peduncles

60
Q

What does damage to CN XII result in?

A

Protruded tongue deviates towards affected side
Moderate dysarthria
Disturbance of articulation

61
Q

How does CN XII leave the skull?

A

Through the hypoglossal canal

62
Q

What does damage to CN IX cause?

A

Loss of taste over posterior third of tongue
Loss of sensation over affected side of palate
Loss of gag reflex on affected side

63
Q

What 4 nerves exit the skull through the superior orbital fissure?

A

Oculomotor nerve
Trochlear nerve
Ophthalmic nerve (trigeminal nerve 1)
Abducens nerve

64
Q

In the brainstem, what does the pons link?

A

The thalamus to the medulla oblongata

65
Q

What is CN IX?

A

Glossopharyngeal nerve

66
Q

Where does CN VIII originate?

A

The vestibular nerve in the vestibular ganglion in the brain stem and the cochlear nerve in the spiral ganglion in the brainstem

67
Q

Where is CN XI formed?

A

From neurone at the top of the spinal cord

68
Q

Where does CN IX originate in the brainstem?

A

Medulla oblongata

69
Q

What is CN X?

A

Vagus nerve

70
Q

What are the motor functions of CN IX?

A

Somatic - innervation to stylopharyngeus muscle

Visceral - parasympathetic innervation to parotid gland

71
Q

What is the function of CN IV?

A

Motor innervation to direct gaze of eye inferomedially

72
Q

Which cranial nerves do not come off the brainstem?

A

CN I (olfactory) and CN II (optic)

73
Q

What is the red nucleus?

A

A motor nucleus that sends a descending tract to lower motor neurone

74
Q

Where are the inferior and superior colliculus found?

A

Tectum of the midbrain

75
Q

In what disease is the substantial nigra thought to be involved in the pathology?

A

Parkinson’s disease

76
Q

What is the function of CN VIII?

A

Vestibular nerve - vestibular sensation from semicircular ducts, urticle and saccular relating to position and movement of head
Cochlear nerve - hearing from the cochlear

77
Q

What is the superior colliculus involved in?

A

Sense of vision

78
Q

How does the cerebellum play an important role in motor control?

A

It contributes to coordination, precision and accurate timing

79
Q

What would damage to CN I lead to?

A

Loss of smell

80
Q

What is the special sensory function of CN IX?

A

Taste from the posterior third of the tongue

81
Q

What is CN II and what is its function?

A

Optic nerve - vision

82
Q

What is CN V and what are its divisions?

A

Trigeminal nerve - Ophthalmic nerve, Maxillary nerve and Mandibular nerve

83
Q

Where do the sensory and parasympathetic parts of CN VII originate from?

A

Nervus intermedius

84
Q

What is the inferior colliculus involved in?

A

Sense of hearing

85
Q

What does damage to CN IV cause?

A

Inability to rotate an adducted eye inferiorly

86
Q

What 3 nerves exit the skull through the jugular foramen?

A 
Glossopharyngeal nerve (CN IX)
Vagus nerve (CN X)
Spinal accessory nerve (CN XI)
87
Q

What does damage to CN III result in?

A

Dilated pupils
Ptosis
Eye rotates inferiorly and laterally

88
Q

What is the medulla oblongata continuous with?

A

Spinal cord

89
Q

What is contained in the brain stem?

A

Midbrain
Pons
Medulla oblongata

90
Q

What is the visceral motor function of CN VII?

A

Supplies lacrimal glands and the sublingual and submandibular salivary glands

91
Q

Where does CN VI leave the brainstem?

A

At the junction of the pons and the medulla

92
Q

Along which lateral wall does CN V1 pass along?

A

Cavernous sinus

93
Q

What is the chord tympani?

A

Nerve that originates from the taste buds in the front of the tongue, runs through the middle ear and carries taste messages to the brain

94
Q

What does the chord tympani join to and where?

A

With the facial nerve in the facial canal

95
Q

What is CN VI?

A

Abducens nerve

96
Q

How does CN X leave the skull?

A

Through the jugular foramen

97
Q

What is the function of CN VI?

A

Motor function to the lateral rectus muscle to direct gaze laterally

98
Q

What are the three lobes of the cerebellum?

A

Anterior lobe
Posterior lobe
Flocculonodular lobe

99
Q

How does CN V3 leave the skull?

A

Through the foramen ovale

100
Q

How does CN II exit the skull?

A

Through the optic canal

101
Q

Where do the 3 branches of CN V converge and where is this located?

A

Trigeminal ganglion - in Meckel’s cave

102
Q

What autonomic functions are controlled in the medulla?

A

Breathing
Heart rate
Blood pressure

103
Q

What 2 nerves exit the skull through the internal acoustic meatus?

A

Facial nerve

Vestibulocochlear nerve

104
Q

What is the substantial nigra?

A

A concentration of neurons that use dopamine and are involved in both motor function and emotion

105
Q

What is the function of CN III?

A

Somatic - innervate muscles to raie upper eyelid, and control superior, inferior and medial gaze
Visceral - control constriction of pupil and control accommodation of lens

106
Q

What is the somatic motor function of CN VII?

A

innervate muscles of facial expression

107
Q

What is the function of CN XII?

A

Motor innervation to muscles of tongue, except palatoglossus

108
Q

What is CN VII?

A

Facial nerve

109
Q

How does CN V2 leave the skull?

A

Through foramen rotundum

110
Q

What is the path of CN XI through the skull?

A

Enters through the foramen magnum and exits via jugular foramen

111
Q

What cranial nerve is most likely to be damaged if there is laceration or contusion to the parotid region and what does it cause?

A 
CN VII (facial nerve)
Bells palsy - paralysis of facial muscles
112
Q

Where does CN III originate?

A

Midbrain

113
Q

What separates the lobes of the cerebellum?

A

Primary fissure - separates anterior and posterior

Posterior fissure - above flocculonodular

114
Q

What does damage to CN VI cause?

A

Inability to rotate the eye laterally with diplopia on lateral gaze

115
Q

What are the three parts of the midbrain?

A

Tectum
Tegmentum
Paired cerebral peduncles

116
Q

How is damage to CN II usually caused?

A

Trauma
Pressure
Clot

117
Q

What is CN XII?

A

Hypoglossal nerve

118
Q

Where does CN XII emerge from the brainstem?

A

Medulla

119
Q

What is CN I and what is its function?

A

Olfactory nerve - sense of smell

120
Q

What is the function of CN V3?

A

Sensation of skin over mandible, including TMJ and mucosa of mouth
Motor innervation of muscles of mastication

121
Q

What is CN III?

A

Oculomotor nerve

122
Q

What is the function of CN V2?

A

Sensation of skin over maxilla

123
Q

Where are the pontine nuclei found?

A

Pons

Medicine (19 decks)

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