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bioregulatory systems y2 > neurology and neuroscience > Flashcards

neurology and neuroscience Flashcards

1
Q

what is the cerebral cortex

A

outer layer
covers entire surface of brain
together with deep nuclei, contains grey matter (neuronal cell bodies and glial cells)
highly folded with gyri and sulci
organised into lobes

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2
Q

what is the cerebral cortex organised into microscopically

A

layers and columns

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3
Q

how many regions are identified by Brodmann in 1909 and what are they based on

A

52
based on cytoarchitecture - cell size, spacing or packing density and layers

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4
Q

what are the 2 main regions that are shown to relate to function and where are they

A

primary motor cortex (4)
separated by the central sulcus
primary somatosensory (1,2,3)

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5
Q

what is the frontal lobe responsible for (IM CALM)

A

Initiating Motor
- primary motor cortex (Execution)
- pre motor cortex (selection)
cognitive executive function (eg planning)
- pre frontal cortex
Attention
- pre frontal cortex
Language
- Brocas area (left) - speech production
memory
- pre frontal cortex

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6
Q

what is the parietal lobe responsible for (SSSS)

A

sensation - touch, pain
sensory aspects of language
spatial orientation
self perception

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7
Q

what is the occipital lobe responsible for (V)

A

processing visual info

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8
Q

what is the temporal lobe responsible for (MEAL)

A

memories - limbic association area
emotions - limbic association area
auditory - auditory cortex
language - Wernickes area (left) - speech comprehension

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9
Q

what is within the limbic lobe

A

includes the amygdala, hippocampus, mamillary body and cingulate gyrus

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10
Q

what is the limbic lobe responsible for (LeMMER)

A

Learning
motivation
memory
emotion
reward

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11
Q

where is the insular cortex

A

lies deep within lateral fissure

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12
Q

what is the insular cortex responsible for (AVIVA)

A

auditory processing
visual vestibular integration
interoception
visceral sensation
autonomic control

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13
Q

what is contained within internal structure

A

grey matter
- neuronal cell bodies and glial cells - around 85 billion each
white matter
- myelinated neuronal axons arranged in tracts
- white matter tracts connect cortical areas

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14
Q

what are the 3 types of fibres

A

association
commissural
projection

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15
Q

what are association fibres and the different types

A

connect areas within the same hemisphere so they do not cross the midline
short (U) fibres (adjacent gyri)
long fibres
superior longitudinal fasciculus - connects frontal and occipital lobes
arcuate fasciculus - connects frontal and temporal lobes
inferior longitudinal fasciculus - connects temporal and occipital lobes
uncinate fasciculus - connects anterior frontal and temporal lobes (orange one)

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16
Q

what are commissural fibres and what are the 2 types

A

connect homologous structures in left and right hemispheres
corpus callosum - superior
anterior commissure = inferior

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17
Q

what are projection fibres and what are the types

A

connect cortex with lower brain structures eg thalamus, brain stem and spinal cord
afferent - towards cortex
efferent - away from cortex
deeper to cortex radiate as the corona radiata
converge through internal capsule between thalamus and basal ganglia
eg to skeletal muscles

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18
Q

what are the differences in primary and secondary/association cortices in function/organisation and symmetry

A

primary
function predictable
organised topographically
symmetry between left and right
secondary
function less predictable
not organised topographically
left-right symmetry weak or absent

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19
Q

what are the motor areas in the frontal lobe

A

primary motor cortex
supplementary area
premotor area

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20
Q

what is the primary motor cortex responsible for and where is it located

A

controls fine, discrete, precise voluntary movements
by descending signals to execute movements
last pathway before descending signals for movement
(located inprecentral gyrus - topographically arranged)

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21
Q

what is the supplementary area responsible for

A

involved in planning movements eg externally cued
like moving an arm

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22
Q

what is the premotor area responsible for

A

internally cued movements eg speech

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23
Q

what areas are within the parietal lobe

A

primary somatosensory
somatosensory association

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24
Q

what is the primary somatosensory responsible for

A

processes somatic sensations arising from receptors in the body
post central gyrus and topographically arranged
eg fine touch, vibrations, two point discrimination, proprioception, pain and temperature
dorsal column pathway (fine touch vibration proprioception) and spinothalamic pathway (pain, temp)

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25
Q

what is the somatosensory association responsible for

A

interpret significance of sensory info
eg recognising an object placed in the hand
awareness of self and awareness of personal space

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26
Q

what are the areas in the occipital lobe

A

primary visual cortex
visual association

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27
Q

what is the primary visual cortex responsible for

A

processes visual stimuli

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28
Q

what is the visual association for

A

gives meaning and interpretation of visual input

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29
Q

what areas are within the temporal lobe

A

primary auditory
audiotory association

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30
Q

what is the primary auditory responsible for

A

processes auditory stimuli
diff freq - topographically mapped here

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31
Q

what is the auditory association responsible for

A

gives meaning and interpretation of auditory input

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32
Q

what are 3 other association areas

A

prefrontal cortex
Brocas area
Wernickes area

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33
Q

what is the prefrontal cortex responsible for (APPS)

A

attention
planning and decision making (executive function)
personality
social behaviour

34
Q

where and what is Brocas and Wernickes area

A

in the left hemisphere
in front of motor regions
production of speech/formulate mouth/lang = broca (L frontal lobe)
Wernike’s = understanding/interpretation/meaning (L temporal lobe)

35
Q

what happens after frontal lobe lesions

A

changes in personality
inappropriate behaviour eg phineas gage in 1848
lack of attention
inability to plan actions

36
Q

what happens after parietal lobe lesions

A

eg lesion in right hemisphere
contralateral neglect syndrome
lack of awareness of self on left side
lack of awareness of left side of extrapersonal space
neglect themselves and the world contralateral to their lesion

37
Q

what happens after temporal lobe lesions

A

lateral or medial
leads to agnosia - inability to recognise
patient HM - bilateral resection of anterior medial temporal lobe structures to cure epilepsy
could not form new memories - anterograde amnesia
recognition in temporal lobe - may not be able to name objects

38
Q

what happens after Brocas area lesions

A

expressive aphasia - poor production of speech, comprehension intact
non fluent aphasia - struggle to produce speech leading to stammer
broca = broken speech (understand but cannot respond)

39
Q

what happens after Wernickes area lesions

A

receptive aphasia - poor comprehension of speech, production is fine
connected by arcuate fasciculus

40
Q

what happens after primary visual cortex lesions

A

blindness in the corresponding part of the visual field

41
Q

what happens after visual association lesions

A

deficits in interpretation of visual info eg prosopagnosia - inability to recognise familiar faces or learn new faces (face blindness)

42
Q

how can we use PET imaging to assess cortical function

A

positron emission tomography (PET)
blood flow directly to brain region
radioactive glucose and scanned used in seeing for eg processing speech

43
Q

how can we use fMRI to assess cortical function

A

functional magnetic resonance imaging (fMRI)
used in research
amount of blood oxygen in a brain region

44
Q

how can we use EEG to assess cortical function

A

electroencephalography (EEG)
measures electrical signals produced by the brain
compare signals of diff regions, used a lot in sleep disorders/epilepsy

45
Q

how can we use MEG to assess cortical function

A

magnetoencephalography (MEG)
measures magnetic signals produced by the brain
more recent
event related or evoked potentials are measured
response is small so you need a stimulus like checkerboard = stimulation and then average many traces to see waveforms
signal diff can let you see where issues are along the path eg where it is slowing

46
Q

what are somatosensory evoked potentials

A

series of waves that reflect sequential activation of neural structures along the somatosensory pathways
somatosensory activity, thalamic activity, mid cervical cord activity, impulses arriving at shoulder
follow the pathway - sequential activation can show you where lesion is along a path
used to check the integrity of the sensory pathway

47
Q

how can we use brain stimulation to assess cortical function

A

transcranial magnetic stimulation (TMS)
rather than assess signals up to the brain, stimulate the brain and track it
pass signal through coil to make EM field > produces EM in brain/nerves
non invasive and position or shape of coil can affect which muscles
investigate neural interactions controlling movement following spinal cord injury
investigate whether a specific brain area = responsible for a function
using field to interrupt ongoing activity showing that it was in use - can modulate overactive regions

48
Q

what is tDCS

A

transcranial direct current stimulation (tDCS)
uses low direct current over the scalp to increase or decrease neuronal firing rates
becoming more common
direct electrical stimulation
negative electrode reduces, positive increases firing rates
useful potentially for chronic pain

49
Q

how can we use DTI to assess cortical function

A

diffusion tensor imaging (DTI)
based on diffusion of water molecules
DTI with tractography
3D reconstruction to assess neural tracts
can help understand connections between brain regions - insight of workings of cortical regions

50
Q

what are some perfusion demands of the brain

A

10-20% cardiac output
20% of O2 consumption
66% of liver glucose
vulnerable if blood supply is impaired

51
Q

what are the 3 vessels that provide blood supply to the brain

A

internal carotid artery (towards the back of the head)
common carotid artery
vertebral artery

52
Q

what is the structure of the arteries of the brain and make sure you can draw and label this

A

circle of Willis

53
Q

what is the venous drainage process of the brain

A

cerebral veins
↓
venous sinuses in the dura mater
↓
internal jugular vein

54
Q

what are the 4 types of haemorrhage

A

extradural
subdural
subarachnoid
intracerebral

55
Q

describe an extradural haemorrhage

A

mostly caused by trauma
immediate clinical effects
arterial
high pressure

56
Q

describe a subdural haemorrhage

A

trauma
can be delayed clinical effects
venous
lower pressure

57
Q

describe a subarachnoid haemorrhage

A

due to ruptured aneurysms
blood vessel has a weakness in its wall and ruptures
congenital

58
Q

describe an intracerebral haemorrhage

A

spontaneous hypertensive
uncontrolled chronic hypertension

59
Q

what is right behind the pterion (soft spot on head) and supplies the dura mater

A

middle meningeal artery

60
Q

what is the definition for a stroke

A

CVA (cerebrovascular accident)
rapidly developing focal disturbance of brain function of presumed vascular origin and of >24 hours in duration

61
Q

what are 85% of strokes caused by

A

thromboembolism
15% by haemorrhage

62
Q

what is a transient ischaemic attack

A

rapidly developing focal disturbance of brain function of presumed vascular origin that resolves completely within 24 hours
sometimes in minutes
(temporary blockage)

63
Q

what is the definition for an infarction

A

degenerative changes which occur in tissue following occlusion of an artery
dead tissue

64
Q

what is the definition for cerebral ischaemia

A

lack of sufficient blood supply to nervous tissue resulting in permanent damage if blood flow is not restored quickly

65
Q

what is thrombosis

A

formation of a blood clot (thrombus)

66
Q

what is an embolism

A

plugging of small vessel by material carried from larger vessel eg thrombi from the heart or atherosclerotic debris from the internal carotid

67
Q

how can the general public recognise a stroke

A

FACE
face
arms
speech
time

68
Q

what are the risk factors for stroke (CHADS)

A

Cardiac disease
Hypertension
Age
Diabetes Mellitus
Smoking

69
Q

what are some anterior cerebral artery symptoms

A

paralysis of contralateral structures (leg > arm, face)
disturbance of intellect, executive function and judgement (abulia)
loss of appropriate social behaviour

70
Q

what are some middle cerebral artery symptoms

A

“classic stroke”
contralateral hemiplegia : arm > leg
contralateral hemisensory deficits
hemianopia (visual fields)
aphasia (L sided lesion)
perfusion is not superficial
Brocas aphasia = expressive aphasia
Wernickes = receptive aphasia

71
Q

what are some posterior cerebral artery symptoms

A

visual deficits
homonymous hemianopia (same side loss of half visual field)
visual agnosia eg propagnosia

72
Q

what is multiple sclerosis

A

autoimmune inflammatory disorder - results in myelin loss from neurones in the CNS (slow AP)

73
Q

what is orthodromic

A

travelling in normal direction in nerve fibre

74
Q

what is antidromic

A

travelling in opposite direction to that normal in nerve fibre

75
Q

what is an M wave in peripheral nerve stimulation

A

an electrical stimulus of an appropriate intensity to a peripheral nerve can activate sensory and motor axons
activation of motor axons can cause action potentials to travel along the nerve to cause muscle contraction - a twitch - can be recorded w electromyography (EMG)
fast response = M (motor) wave

76
Q

what is a H reflex in peripheral nerve stimulation

A

same stimulus can cause activation of the sensory axons (subject feels stimulus)
APs can travel along nerve to spinal cord
can cause lower motor neurons in spinal cord to become activated
APs in motor axons can travel along motor neuron to muscle > muscle contraction (twitch)
= reflex activation of muscle
this later response = H reflex

77
Q

what is an F wave in peripheral nerve stimulation

A

large electrical stimulus can cause activation of the motor axons to conduct antidromically
APs travel along the motor nerve to the spinal cord (opposite way to normal) but meets cell body before reaching SC
can cause lower motor neurons in spinal cord to become activated
APs in motor axons can travel along motor neuron to muscle > cause muscle contraction (twitch)
later response = called F wave (not a reflex)
(does not actually reach spinal cord!!)

78
Q

how is the total motor conduction time and the peripheral motor conduction time in patients with MS different from normal

A

total motor conduction time - delayed
peripheral motor conduction time - normal as the problem is with the CNS not PNS

79
Q

what is the difference between neglect and agnosia

A

neglect is lack of awareness of sensory info in visual field
result of parietal lobe damage

agnosia is when they acknowledge stimulus but cannot report what it is
- temporal lobe damage

80
Q

what happens if you have a lesion in the arcuate fasciculus

A

conduction aphasia

81
Q

what are some symptoms of multiple sclerosis

A

optic neuritis (blurred vision)
fatigue
difficulty walking
paraesthesia
muscle stiffness
spasms
varies in every patient due to where myelin is lost

82
Q

how can we confirm conduction problem in MS is related to neurones of CNS and not PNS

A

using peripheral nerve and brain simulation techniques

bioregulatory systems y2 (6 decks)

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