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Neurology Flashcards

0
Q

What maintains the polarised resting potential in nerves?

A

Na/K pump

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1
Q

What is a ganglion?

A

A group of lots of neuronal cell bodies

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2
Q

What is the resting potential of nerves?

A

Around -65mV

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3
Q

What are the 2 types of channels in nerves?

A

Ligand-gated: open/close in response to ligands

Voltage-gated: open/close in response to membrane potential changes

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4
Q

What ion influx causes depolarisation of the nerve thus triggering an action potential? And is it voltage- or ligand-gated?

A

Na+, ligand-gated.

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5
Q

What is myelin made of in the CNS?

A

Oligodendrocytes

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6
Q

What is myelin sheath made from in the PNS?

A

Schwann cells

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7
Q

What diseases can result from demyelination?

A

Multiple sclerosis- demyelination of the CNS
Guillain-Barré syndrome- inflammatory demyelination of the PNS
Charcot Marie- tooth- genetic mutation of schwann cells

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8
Q

How is an AP transmitted between synapses?

A

Voltage-gated Ca2+ channels open when AP arrives at presynaptic terminal. This cause NT release via vesicles.. these cross the synapse and bind to ligand-gated ion channels depolarising the postsynaptic nerve.

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9
Q

What are the 2 types of receptor in the autonomic nervous system?

A

Ionotropic- holes ions travel through when ions bind.

Metabotropic- not ion channels: connect to others eg. GPCR.

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10
Q

What is the PNS divided into?

A

Somatic and autonomic

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11
Q

What is the sympathetic system and where does it arise from?

A

‘Fight or flight’ part of the autonomic nervous system. It arises from T1- L2 in the ganglia in the sympathetic chain.

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12
Q

What is the parasympatheric system?

A

‘Rest and digest’ part of the autonomic NS and is ‘craniosacral’ i.e. arises from the brainstem and the sacrum.

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13
Q

Where are the sympathetic chains?

A

They run the entire length of the spinal cord. Sympathetic preganglions in the lateral horn of T1-L2.

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14
Q

What are the NT and receptors of the sympathetic NS?

A

Preganglionic neurones release Ach to nicotinic receptors, unmyelinated neurones release noradrenaline to a & b receptors.

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15
Q

What are the NT and receptors for the parasympathetic system?

A

Bothe pre and postgangionic neurones produce Ach, but pregangionic receptor is to a nicotinic receptor and postganglionic to muscarinic receptor.

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16
Q

What is the main NT of the autonomic NS?

A

Acytylcholine

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17
Q

What are the 2 receptor types of Ach?

A

Nicotinic- ligand-gated, excitatory. Found on postganglionic neurones and NMJ.

Muscarinic- metabotropic and are found on effectors

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18
Q

An example of a nicotinic receptor agonist and its action?

A

Nicotine: Increases HR & BP

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19
Q

An example of a nicotinic receptor antagonist?

A

Succinlcholine

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20
Q

What are the muscarinic receptors and where are they found?

A

M1- CNS
M2- myocardium, smooth muscle
M3- exocrine glands, vessels and iris sphincter muscles
M4 & 5- CNS

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21
Q

Example of an agonist and an antagonist of muscarinic receptors?

A 
Agonist= muscarine
Antagonist= atropine
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22
Q

Where are alpha 1 receptors found?

A

Vascular smooth muscle, heart, pupillary dilator muscles

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23
Q

alpha 1 agonist and antagonist examples?

A

Agonist- phenylephrine

Antagonist- Doxazocin

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24
Where are alpha 2 receptors found?
CNS, platelets, adrenergiic and cholinergic nerve terminals
25
What are the beta receptors and where are they found?
beta 1- heart beta 2- Resp, uterine, vasc smooth muscle, skeletal muscle, liver beta 3- fat cells
26
Examples of beta agonists?
Isoproterenol- increases HR & contractile force | Salbutamol- b2 agonist- asthma.
27
Examples of beta antagonists (beta blockers)?
Timolol- glaucoma Propranolol- reduces HR and contractile force Bisoprolol & atenolol are selective B1 antagonists
28
What are NANC transmitters?
Non- adrenergic, non-cholinergic, so not adrenaline or ach.
29
What is glutamate?
Main excitatory NT of the CNS and has both ionotropic and metabotropic receptors.
30
What are the 3 ionotropic receptors to glutamate?
AMPA- permeable to Na+ NMDA- Ca2+ and Na+ Kainate- permeable to Ca2+ and Na+
31
What is GABA?
Main inhibitory NT of the CNS and has 2 receptors- GABA1 and GABA2.
32
What drugs act on GABA?
BZP e.g. lorazepam
33
Where is serotonin synthesised?
Raphe nuclei. These project into the cortex, medulla, thalamus, hippocampus, spinal cord
34
Where is the majority of serotonin stored?
Enterochromaffin cells of the GI tract. Excess release can cause D&V. They are very sensitive to radio- and chemotherapy.
35
Where is Ach produced?
Basal forebrain and the brain stem tegmentum. | It's also synthsised by all motor neurones of the spinal cord
36
Where is dopamine produced?
Ventral midbrain: substantia nigra & ventral tegmental area.
37
Where is noradrenaline made?
locus coerulus
38
What are the different types of peripheral neuropathy?
Motor neuropathy Sensory neuropathy Autonomic neuropathy
39
Ulnar nerve compression at the elbow presents as?
hypothenar wasting, weakness of finger abduction and reduced thumb adduction.
40
How does medial nerve compression present?
Carpel tunnel syndrome: numbness in the lateral 3 1/2 fingers, thenar wasting
41
How does radial nerve palsy present?
wrist drop, sensory loss on thumb webbing.
42
What is Guillain-Barré syndrome?
Autoimmune condition often triggered by an infection. causes demyelination and nerve conduction is blocked.
43
What's the classical presentation of GBS?
Symmetrical weakness usually beginning in the lower limbs and progressing upwards. Patients describe 'rubbery legs'
44
What is Myasthenia Gravis?
Antibodies vs. Ach receptors on the post-synaptic membrane.
45
What are the symptoms of Myasthenia gravis?
Fatigueable weakness, ptosis, affects limbs proximal>distal and facial muscles.
46
What is neuromyotonia?
Antibodies vs. voltage-gated K+ channels.
47
What are the symptoms of Neuromyotonia?
Muscle twitching, cramps and muscle pain. | Associated with insomnia, delusions & personality changes
48
What is lambert- eaton myasthenic syndrome and what is it associated with?
Antibodies vs. voltage-gated Ca2+ channels. Associated with small cell lung carcinoma.
49
How do tricycling antidepressants work (TCAs)?
Inhibit reuptake of serotonin and noradrenaline. e.g. Imipramine and amitriptyline
50
What are the side effects of TCAs?
Long QT interval, Arrhythmias, coma, acidosis and large pupils weight gain, sedation and confusion
51
How do monoamine oxidase inhibitors work (MAOIs)?
Inhibit the breakdown of monoamine NTs e.g. serotonin, dopamine, melatonin and noradrenaline.
52
Side effects of MAOIs?
``` Cheese reaction (Tyramine)- severe hypertension - postural hypotension, restlessness, hallucinations, weight gain. ```
53
How do SSRIs cause hyponatraemia?
inappropriate ADH release -> total body fluid increased so Na+ levels diluted.
54
What are the 2 categories of BZPs?
Hypnotics- Temazepam, Zopiclone | Anxiolytics- Diazepam, Lorazepam
55
Where does the lower motor neuron start?
The anterior horn cell
56
What do renshaw cells do?
They are inhibitory neurones and are excited by a-motor neurone. They release glycine back which inhibits firing of the motor neurone.
57
What is the function of the golgi tendon organ?
Prevent damage to the muscle if a load is too prolonged or heavy. Have a higher threshold than muscle spindles.
58
What part of the muscle initiates a reflex?
Spindle
59
What do gamma motor neurones do?
Keep the muscle spindle ready to stretch- cause it to retract maintaining tension.
60
What are the descending tracts?
Corticobulbar, corticospinal, reticulospinal, vestibulospinal, tectospinal and rubrospinal
61
What does the corticospinal tract convey?
Motor control
62
What sensations does the spinothalamic tract convey?
pain, temp, touch
63
What senseations do the dorsal columns convey?
joint position and soft touch
64
What is apraxia and what are the 2 types?
Inability to produce a specific motor act even though sensory and motor pathways remain intact. Ideomotor Idiational
65
What are the symptoms of an upper motor neurone lesion?
Paralysis, weakness, hyperreflexia, increased muscle tone, spasticity, positive babinski reflex
66
What are the symptoms of a lower motor neurone lesion?
Hyporeflexia, fasciculations, muscle atrophy, denervation
67
In what tract are pain and temperature conveyed and where do they decussate?
Spinothalamic tract and they decussate in the segment of origin
68
Where are touch and pressure conveyed and where do they decussate?
Spinothalamic tract and the ascend 2-3 levels then decussate
69
What is brown-sequard syndrome?
Hemisection of the spinal cord
70
What tracts will become ischaemic if the anterior spinal artery is occluded?
Corticospinal and spinothalamic tracts
71
What does motor neurone disease cause?
Wasting of the anterior horn cells. This results in both upper and lower motor neurone signs.
72
What occurs in an intervertebral disk prolapse and what are the grades of severity?
``` The nucleus pulposus herniates out through the annulus fibrosus. 1- Disk bulge 2- Dick protrusion 3- Disk extrusion 4- Disk sequestration ```
73
What are the layers of the spinal cord?
Outermost is the dura mater, Inner is arachnoid Innermost is the Pia

Revision (12 decks)

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