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Medicine Year 4 > Neurology > Flashcards

Neurology Flashcards

1
Q

What are the three primary brain vesicles?

A

Prosencephalon (forebrain)
Mesencephalon (midbrain)
Rhombencephalon (hindbrain)

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2
Q

What are the five secondary brain vesicles?

A

Telencephalon, diencephalon (forebrain)
Mesencephalon (midbrain)
Metencephalon, myelencephalon (hindbrain)

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3
Q

What is the brainstem made up of?

A

Midbrain, pons and medulla oblongata

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4
Q

What are the two main cell types in the CNS?

A

Neurons and glial cells

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5
Q

What are the 4 types of glial cells?

A

Astrocytes, oligodendrocytes, microglia and ependymal cells

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6
Q

Which glial cells function as support cells, maintaining the blood-brain barrier and in environmental homeostasis?

A

Astrocytes

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7
Q

Which glial cells are responsible for producing myelin in the CNS?

A

Oligodendrocytes

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8
Q

Which glial cells are responsible for antigen-presenting in the CNS?

A

Microglia

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9
Q

Which glial cells line the ventricles?

A

Ependymal cells

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10
Q

What is white matter in the brain made up of?

A

Axons (mostly myelinated) and their support cells

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11
Q

What is grey matter in the brain made up of?

A

Huge numbers of neurons, cells processes, synapses and support cells

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12
Q

What is the lentiform nucleus made up of?

A

Putamen and globus pallidus

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13
Q

How many paired spinal nerves are in the spinal cord?

A

31 paired spinal nerves

C1-8
T1-12
L1-5
S1-5
Coccygeal
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14
Q

Where do the spinal nerve roots pass until they reach the appropriate intervertebral foramina?

A

Subarachnoid space

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15
Q

The spinal cord terminates in a tapered cone shape… what is this called?

A

Conus medullaris

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16
Q

What is the name of the thin connective tissue cord which connects the conus medullaris to the dorsum of the coccyx?

A

Filum terminale

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17
Q

What are the four somatic senses?

A

Touch, proprioception, pain and temperature

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18
Q

What are the three types of somatosensory fibres?

A

Non-myelinated (type C), small (type A-δ) and large (type A-α or A-β)

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19
Q

Which somatosensory fibres are the slowest and senses burning pain and hot temperatures?

A

Non-myelinated fibres (type C)

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20
Q

Which somatosensory fibres sense sharp pain, cold temperature and gross touch?

A

Small myelinated fibres (type A-δ)

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21
Q

Which somatosensory fibres are the fastest and sense proprioception, vibration and fine touch?

A

Large myelinated fibres (type A-α or A-β)

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22
Q

Where is the primary sensory cortex located?

A

Parietal lobe of the brain

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23
Q

What are the two somatosensory pathways?

A

Medial lemniscal pathway (posterior) and spinothalamic pathway (anterior)

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24
Q

What information does the medial lemniscal pathway carry?

A

Fine touch, vibration and proprioception

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25
Q

What type of somatosensory fibre make up the first-order neuron of the medial lemniscal pathway?

A

Large myelinated fibres (type A-α or A-β)

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26
Q

What part of the spinal cord do the first-order neurons of the medial lemniscal pathway run through?

A

Posterior funiculus

  • cuneate fascicle for upper body
  • gracilis fascicle for lower body
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27
Q

Where does the first synapse of the medial lemniscal pathway occur?

A

Medulla

28
Q

Where does the medial lemniscal pathway decussate?

A

Medulla

29
Q

Where does the second synapse of the medial lemniscal pathway occur?

A

Thalamus

30
Q

Where does the third synapse of the medial lemniscal pathway occur?

A

Sensory cortex of parietal lobe

31
Q

What information does the spinothalamic pathway carry?

A

Pain, temperature and crude touch

32
Q

What type of somatosensory fibres make up the first-order neuron of the spinothalamic pathway?

A

Small myelinated (sharp pain, cold temperature) and non-myelinated (hot temperature, burning pain and crude touch)

33
Q

Where does the first synapse of the spinothalamic pathway occur?

A

Posterior horn of the spinal cord

34
Q

Where does the spinothalamic pathway decussate?

A

In the spinal cord - two vertebral segments above where it entered

35
Q

After spinothalamic fibres decussate in the spinal cord, neurons are then carried through one of two tracts to the thalamus. What are these tracts?

A

Lateral tract (carries information for pain, pressure and temperature through lateral funiculus)

Anterior tract (carries information for crude touch through anterior funicular)

36
Q

Where does the second synapse of the spinothalamic pathway occur?

A

Thalamus

37
Q

Where does the third synapse of the spinothalamic pathway occur?

A

Sensory cortex of the parietal lobe

38
Q

Where is the primary motor cortex located?

A

Frontal lobe of the brain (along the precentral gyrus)

39
Q

What are the two pyramidal tracts and their functions?

A

Corticospinal tract - forms efferent nerve fibres of UMNs to conduct impulses from brain to spinal cord

Corticobulbar tract - conducts impulses from brain to cranial nerves

40
Q

Where does the corticospinal tract decussate?

A

85% at medulla to form lateral corticospinal tract.

Remaining 15% become the anterior corticospinal tract which decussates further down the spinal cord.

41
Q

What part of the body does the lateral corticospinal tract control?

A

Muscles of limbs

42
Q

What part of the body does the anterior corticospinal tract control?

A

Muscles of trunk

43
Q

What tracts make up the extra-pyramidal system?

A

Tectospinal, reticulospinal and vestibulospinal

44
Q

What is the function of the tectospinal tract?

A

Though to mediate reflex head and neck movement to visual/auditory stimuli

45
Q

What is the function of the reticulospinal tract?

A

Coordinates automatic locomotion, posture movement and voluntary movement

Has two parts, pons and medulla, with opposing actions on extensor and flexor movement

46
Q

What is the function of the vestibulospinal tract?

A

Maintains upright balance and posture through action on muscles of trunk and legs

47
Q

Spinal cord hemisection results in paralysis on the same side and loss of sensation on the opposite side. What is this called?

A

Brown-Sequard Syndrome

48
Q

What are the functions of the cerebellum?

A

Coordination movement, controlling posture, balance and fine motor movement, and for motor learning

49
Q

What is the name of the fibrous membrane separating the brain from the cerebellum?

A

Tentorium cerebelli (fold of dura mater)

50
Q

What is the name of the narrow ridge separating the cerebellar hemispheres?

A

Vermis

51
Q

What are the three layers of the cerebellar cortex?

A

Molecular layer (outer)
Purkinje cell layer (middle)
Granular cell layer (inner)

52
Q

What is deep to the cerebellar cortex?

A

White matter AKA arbor vitae

53
Q

What are the four pairs of deep cerebellar nuclei located deep within the white matter?

A

Lateral to medial

  • dentate nucleus
  • interposed nuclei (globose and emboliform nuclei)
  • fastigial nucleus
54
Q

Where does input to the cerebellum arrive?

A

Cerebellar peduncles and then project mainly to the granular cell layer

55
Q

What attaches the cerebellum to the brainstem?

A

A stalk of tissue divided into three parts: superior, middle and inferior peduncles

56
Q

What are the three lobes of the cerebellum?

A

Anterior, posterior, flocculonodular lobes

57
Q

Where does the output from the cerebellum originate from?

A

Axons from Purkinje cells

58
Q

Where do axons from Purkinje cell layer in the cerebellum synapse?

A

Neurons of the deep cerebellar nuclei

59
Q

Where do the neurons of the deep cerebellar nuclei synapse?

A

Most cross the midline and synapse in the thalamus, which in turn sends fibres to the motor cortex

60
Q

What are the three functional divisions of the cerebellum and their functions?

A

Cerebrocerebellum/pontocerebellum - largest division formed of lateral hemispheres, involved in planning movements/motor learning

Spinocerebellum - consists of the vermis and intermediate part of hemispheres, receives input from spinal cord about proprioception and aids regulation of movement

Vestibulocerebellum - consists of the flocculonodular lobe and immediately adjacent vermis, receives vestibular input about balance and eye movement

61
Q

Do cerebellar hemispheres influence the ipsilateral or contralateral side of the body?

A

Ipsilateral

62
Q

How will a unilateral hemispheric lesion of the cerebellum present?

A

Ipsilateral disturbance of limb coordination and can result in an intention tremor and unsteady gait in absence of weakness or sensory loss

63
Q

How will a bilateral hemispheric lesion of the cerebellum present?

A

Slowed, slurred speech (dysarthria), bilateral incoordination of the arms and a staggering, wide-based gait (cerebellar ataxia)

64
Q

How will a midline lesion of the cerebellum present?

A

Disturbance of postural control - patient will tend to fall over from standing or sitting despite preserved limb coordination

65
Q

How does acute alcohol exposure affect the cerebellum?

A

It will typically result in bilateral cerebellar hemisphere dysfunction and presents with cerebellar ataxia

Medicine Year 4 (2 decks)

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