Neurology Flashcards

1
Q

What are 5 main functions of the NS?

A

1) Sensation
2) Motor capability
3) Cognition
4) Homeostasis
5) Emotions

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2
Q

What are the 5 main parts of a neuron?

A

1) Dendrites
2) Soma / cell body
3) Axon hillock
4) Axon
5) Presynaptic terminal

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3
Q

What are the 4 lobes of the brain and what are their functions?

A

1) Frontal – personality, motor planning, motor cortex
2) Parietal – integration of multiple sensory systems, somatosensory cortex
3) Occipital – visual cortex
4) Temporal – auditory processing

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4
Q

What are the 3 regions of gray matter?

A

1) Dorsal horn
2) Lateral horn
3) Ventral horn

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5
Q

What is found in the dorsal horn?

A

Cell bodies of interneurons upon which afferent neurons terminate

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6
Q

What is found in the lateral horn?

A

Cell bodies of autonomic efferent nerve fibres

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7
Q

What is found in the ventral horn?

A

Cell bodies of somatic efferent neurons

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8
Q

Is Na+ more concentrated in the ICF or ECF?

A

ECF

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9
Q

Is K+ more concentrated in the ICF or ECF?

A

ICF

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10
Q

Is Cl- more concentrated in the ICF or ECF?

A

ECF

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11
Q

Is Ca2+ more concentrated in the ICF or ECF?

A

ECF

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12
Q

Is Mg2+ more concentrated in the ICF or ECF?

A

ECF

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13
Q

What direction is the passive flow of Na+ and K+?

A

Na+ flows in and K+ flows out

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14
Q

What direction is the active transport of Na+ and K+?

A

K+ transported in and Na+ transported out

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15
Q

What is the net movement at equilibrium potential?

A

Zero

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16
Q

What is equilibrium potential?

A

The membrane which would produce an electrical force that would be equal to and in the opposite direction to the chemical force produced by the ion concentration gradient

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17
Q

What should be assumed when considering equilibrium potentials?

A

100% permeability

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18
Q

Why is resting membrane potential not equal to Ek?

A

At rest, the cell is not completely permeable to K+ ions and there is a small permeability to Na+ ions

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19
Q

What forces act on Na+ ions at the point of threshold?

A

Chemical and electrical

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20
Q

What happens before reaching ENa+?

A

The voltage-dependent Na+ channels inactivate

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21
Q

What other channel beside K+ channels contribute to afterhyperpolarization?

A

Ca2+ activated K+ channels

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22
Q

What is the effect of a drug that opens Na+ channels?

A

Depolarization

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23
Q

What is the effect of a drug that opens K+ channels?

A

Hyperpolarization

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24
Q

What is the effect of a drug that opens Na+ and K+ channels?

A

Depolarization (Na+ wins)

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25
Q

What is the most important intracellular cation?

A

Potassium

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26
Q

What is the function of potassium?

A

Maintain cellular osmolarity and membrane potential inside the cell

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27
Q

What is the concentration of K+ in normal plasma?

A

3.5 - 5 meq

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28
Q

What is hyperkalimia?

A

When the concentration of K+ in plasma is greater than 5 meq

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29
Q

Why will injecting a high concentration of potassium into the ECF cause death?

A

Ek will depolarize, which causes neurons and muscle cells to depolarize, meaning that muscle contraction and the heart stay in contraction

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30
Q

Where does synaptic transmission occur?

A

Over the dendrites, soma, and axon hillock

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31
Q

What are the 7 events of chemical synaptic transmission?

A

1) Action potential propagation
2) Depolarization of presynaptic terminal
3) Opening of vdep Ca2+ channels
4) Ca2+-induced fusion of vesicles with presynaptic membrane
5) Binding of transmitter to postsynaptic receptor
6) Postsynaptic action
7) Termination of transmitter action

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32
Q

What 2 events happen when calcium enters the presynaptic terminal?

A
  • Triggers the fusion of vesicles with presynaptic membrane

- Releases transmitters into synaptic cleft

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33
Q

How much calcium is needed for synaptic function?

A

Very little

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34
Q

What is an analogy that can describe the relationship between transmitters and receptors, and what describe the transmitters in this analogy?

A
  • Lock in key

- Transmitters are the key

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35
Q

What are 2 classifications of transmitters?

A

1) Small fast-acting

2) Large slow-acting

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36
Q

What are 3 examples of small fast-acting transmitters?

A

1) Acetylcholine
2) Dopamine
3) GABA

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37
Q

What is one example of a large slow-acting transmitter?

A

Endorphins

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38
Q

What is the main excitatory neurotransmitter?

A

Glutamate

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39
Q

What are the 2 main inhibitory neurotransmitters?

A

1) Glycine

2) GABA (gamma-ammobutyric acid)

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40
Q

What are 2 ways that the postsynaptic terminal can be excited?

A

1) Na+ entry into the cell by opening Na channels (depolarization)
2) Close K+ channels, causing less positive ions to leave (depolarization)

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41
Q

What is central inhibition?

A

Inhibitory neurotransmitters bind to a receptor that causes ion channels to open and produce a postsynaptic hyperpolarization

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42
Q

What 2 things cause central inhibition?

A

1) K+ leaving postsynaptic cell

2) Cl- entering

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43
Q

What is an excitatory response?

A

Neutron depolarizes and if it reaches threshold an AP is initiated

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44
Q

What is an inhibitory response?

A

Neutron hyperpolarizes and APs are harder to elicit

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45
Q

Define ionotropic

A

Receptor is linked to an ion channel and opens/closes the channel

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46
Q

Define metabotropic

A

Receptor is linked to a G protein, which can activate second messengers

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47
Q

What can metabotropic synapse-activated second messenger channels do?

A
  • Open/close channels

- Activate enzymatic pathways

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48
Q

Define motoneuron

A

A motor neuron that innervates muscles

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49
Q

What is the transmitter released by motoneurons?

A

Acetylcholine

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50
Q

What are 4 attributes of a stimulus?

A

1) Modality
2) Intensity
3) Location
4) Duration

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51
Q

What are the 4 types of mechanoreceptors that convey touch?

A

1) Meissner’s corpuscle
2) Merkel cells
3) Pacinian corpuscle
4) Ruffini endings

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52
Q

What is special about Meissner’s corpuscle and Merkel cells?

A
  • Closer to surface
  • Finer discrimination
  • Smaller receptive field
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53
Q

What is special about Pacinian corpuscle and Ruffini endings?

A
  • Courser discrimination
  • Larger receptive field
  • Further away from surface
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54
Q

Which touch mechanoreceptors are rapidly adapting and which are slowly adapting?

A

Rapidly adapting – Merkel cells and Ruffini endings

Slowly adapting – Meissner’s corpuscle and Pacinian corpuscle

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55
Q

Define proprioception

A

Knowing where your body is in space

56
Q

What kind of fibres control proprioception?

A

Large diameter myelinated sensory fibres

57
Q

What are muscle spindles?

A

Specialized sensory organs

58
Q

What 3 structures make up muscle spindles?

A

1) Intrafusal muscle fibres
2) Ia sensory fibres
3) Group 2 sensory fibres

59
Q

What is the function of Ia sensory fibres in muscle spindles?

A

Sensitive to muscle stretch (change in length)

60
Q

What is the function of group 2 sensory fibres?

A

Convey static length of muscle

61
Q

What innervates intrafusal muscle fibres?

A

Gamma-motoneurons

62
Q

What is the function of gamma motoneurons?

A

Regulate spindle length so spindles stay responsive for a range of muscle lengths

63
Q

What would happen if a muscle body was shortened by alpha motoneurons activation?

A

Spindle would go slack and Ia fibres would be unresponsive

64
Q

What is the benefit to activating alpha and gamma motoneurons together?

A

Keeps spindles responsive

65
Q

What does the dorsal column system mediate?

A

Fine touch and proprioception

66
Q

What does the dorsal column system convey and from where?

A

Afferent info from large diameter afferent myelinated sensory fibres

67
Q

What 2 sections are found in the parietal lobe?

A

1) Postcentral gyrus

2) Parietal association cortex

68
Q

Where is the postcentral gyrus found?

A

Immediately behind central sulcus

69
Q

What is the postcentral gyrus?

A

Primary sensory cortex

70
Q

Where is the sensory homunculus found?

A

Across the postcentral gyrus

71
Q

What is the parietal association cortex responsible for?

A

Awareness of body and environment

72
Q

What is pain?

A

A perception, not a sensation

73
Q

When is pain felt?

A

In the absence of activation of nociceptors

74
Q

Define nociceptor

A

Sensory receptor that when activated, pain would normally be perceived

75
Q

What are 2 examples of what can produce pain?

A

1) Tissue injury

2) Disturbed central sensory transmission

76
Q

Define paraesthesia

A

Abnormal sensation (ex: burning, pricking, tingling) sometimes due to “central” pain syndrome following a stroke

77
Q

Define phantom limb

A

Sensation that an amputated limb is still present, often with painful paraesthesia

78
Q

Define causalgia

A

Burning pain following nerve damage that persists long after tissue has healed

79
Q

Define allodynia/hyperalgesia

A

A non-painful stimulus becomes painful

80
Q

What are 3 immediate effects of pain?

A

1) Local burn
2) APs in sensory fibres
3) Reddening, swelling

81
Q

What are 2 medium effects of pain (soon after immediate effects)?

A

1) Active compounds released from sensory nerves cause release of histamine and other substances
2) Flare – further reddening and hyperalgesia

82
Q

What are 2 long-term effects of pain?

A

1) Secondary hyperalgesia due to receptor sensitization and changes in CNS transmission
2) Pain sensation lingers beyond tissue damage

83
Q

What is nociception mediated by?

A

Unmyelinated or small diameter myelinated sensory fibres

84
Q

Describe the gate theory of pain transmission

A

Activity in non-nociceptive afferents activates inhibitory interneurons that inhibit ascending spinothalmic tract neurons and decrease transmission through the nociceptive pathway

85
Q

What can cause allodynia?

A

Loss or disruption of large diameter fibres

86
Q

What happens when the inhibitory interneuron is not activated in the gate theory of pain transmission?

A

The 2nd order (ascending) spinothalmic tract neuron becomes more active

87
Q

Describe the endogenous opioid system

A

Stimulation around the cerebral aqueduct produces long lasting pain reduction

88
Q

What causes referred pain (perception of pain in a location other than the site of origin)?

A

Nociceptive afferents from viscera enter spinal cord at the same spinal segment as nociceptive afferents from skin/muscle/joints

89
Q

What are 7 strategies for managing pain?

A

1) Deliver anesthetic to avoid unwanted sites of action
2) Tailor the treatment to the pain
3) Target peripheral sensitization
4) Use Gate theory
5) Activate endogenous opioid system
6) Recognize potential “central pain”
7) Try to prevent pain rather than treat it

90
Q

What are the 5 special senses?

A

1) Olfaction (smell)
2) Vision
3) Taste
4) Hearing/audition
5) Vestibular function

91
Q

What sensory receptor does olfaction use?

A

CN 1, olfactory nerve

92
Q

What sensory receptor does vision use?

A

CN 2, optic nerve

93
Q

What sensory receptor does taste use?

A
  • CN 7, facial nerve – lateral border and anterior 2/3 of tongue
  • CN 9, glossopharyngeal nerve (posterior 1/3 of tongue)
94
Q

What sensory receptor does hearing use?

A

CN 8, vestibulocochlear

95
Q

What sensory receptor does vestibular function use?

A

CN 8, vestibulocochlear

96
Q

Define myopia

A

Nearsightedness

97
Q

What causes myopia?

A

Eyeball too long or lens too strong

98
Q

What corrects myopia?

A

Concave )( lenses

99
Q

Define hyperopia

A

Farsightedness

100
Q

What causes hyperopia?

A

Eyeball too short or lens too weak

101
Q

What corrects hyperopia?

A

Convex () lenses

102
Q

Define presbyopia

A

Loss of lens accommodation after age 40 (longer focal distance)

103
Q

What corrects presbyopia?

A

Reading glasses or bi/trifocals for those with myopia corrective lenses

104
Q

What is the function of the external ear?

A

Funneling/focusing of sound waves

105
Q

What is the function of the middle ear?

A

Mechanical conversion of sound waves to pressure waves

106
Q

What is the function of the inner ear?

A

Pressure waves converted to neural signal

107
Q

What is the function of the cochlea?

A

Changes pressure waves to vibrations of the basilar membrane

108
Q

What are the mechanoreceptors of the ear?

A

Organ of Corti hair cells

109
Q

How are organ of Cortia hair cells activated?

A

By the movement of the basilar membrane

110
Q

What can lead to irreversible hearing loss?

A

Overstimulation of hair cells

  • Too high sound levels
  • Some drugs that are toxic to receptor cells
111
Q

Define conductive deafness

A

When there is a failure in the transmission of the sound wave in the middle or inner ear

112
Q

What are 2 examples of causes of conductive deafness?

A

1) Bone calcification

2) Basilar membrane damage

113
Q

Define central deafness

A

When there is damage to the neural pathways such as the cochlear nerve, brainstem, or cortex via lesion or disease

114
Q

What causes acoustic neuroma and what does it result in?

A
  • Caused by tumor growing around CN 8

- Results in hearing loss and vestibular dysfunction symptoms

115
Q

What are the semicircular canals?

A

3 canals at right angles to each other

116
Q

What do the semicircular canals detect?

A

Rotational and angular acceleration or deceleration of the head

117
Q

How do the semicircular canals detect rotation?

A

Through movement of fluid in canal

  • Movement is detected by hair cells
  • Fluid stays stationary while head rotates
118
Q

What are the 2 otolith organs?

A

Utricle and saccule

119
Q

What do the otolith organs detect?

A

The position of head relative to gravity

120
Q

What are 3 functions of the vestibular system?

A

1) Keeps us upright
2) Tells us where we are relative to gravity
3) Senses acceleration and spinning

121
Q

What structures of the body does the vestibular system effect?

A
  • Muscles of body and neck

- Eye movements

122
Q

Define vertigo

A

Dizziness; sensation of spinning

123
Q

What are 2 examples of causes of vertigo?

A

1) Inappropriate activation of semicircular canal hair cells

2) Imbalance between the 2 sides

124
Q

Define nystagmus

A

Rhythmic vertical or horizontal eye movements triggered by vestibular stimulus

125
Q

What are 2 examples of causes of nystagmus?

A

1) Normal response (after spinning)

2) Spontaneously as a sign of underlying neuropathology (episodes of vertigo)

126
Q

What are rods specialized for?

A

Capturing light

127
Q

What are rods the primary photoreceptors for?

A

Conveying vision in dim/dark conditions

128
Q

What are the 3 types of cones?

A

1) Red
2) Blue
3) Green

129
Q

What is needed for an image to be sharp?

A

It must be focused on the retina

130
Q

When do images appear blurred?

A

When they come into focus ahead of or behind the retina

131
Q

Define glaucoma

A

Increased internal pressure in the eye

132
Q

Define cataracts

A

Clouding of normally clear lens, resulting in blurred or distorted vision

133
Q

Define dry eye

A

Not enough tears, or tears of the wrong composition

134
Q

Define colour blindness

A

Usually poor red and green discrimination

135
Q

What is the cause of cataracts?

A

Cause is unknown

136
Q

What is the auditory pathway?

A
  • Cochlea
  • CN 8
  • Brainstem nuclei of contralateral side
  • Auditory cortex (temporal lobe)