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Year 1 Medicine > Neurosciences > Flashcards

Neurosciences Flashcards

1
Q

What is rostral acording to brain?

A

The front caudal is the back

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2
Q

What is rostral in terms of te spinal cord?

A

Towards the head

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3
Q

What are the main parts of the brain?q

A

Cerebrum, Cerebellum and brain stem

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4
Q

What are the outer layers of the brain called?

A

The meninges

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5
Q

What are the parts of the brainstem?

A

Medulla oblongata, Pons, Midbrain, Diencephalon

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6
Q

What are dermatomes?

A

The area of skin supplied by nerves from a specific spinal level

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7
Q

What are the lobes of the brain?

A

Occipital, parietal, temporal and frontal

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8
Q

What are some of the names of important fissures or giri?

A

Sylvian fissure(lateral) central fissure, cingulate girus, calcarine sulcus, parahippocampal girus

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9
Q

Where is the primary mortor cortex?

A

The precentral girus in fron of central sulcus

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10
Q

What is the premotor cortex?

A

the seccondary motor area

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11
Q

Where is the primary somatosensory cortex?

A

The post central girus

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12
Q

Where is the pituitary?

A

Below the optic chiasma, in from of the pons

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13
Q

What is mindbody dualism?

A

The belief that the mind and the body are not linked and can be separated

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14
Q

What are the criticisms of dualism?

A

What is non physical substance that makes the mind. how can an immaterial thing create physical effects? is it linked to supernatureal

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15
Q

What is reductive physicalism?

A

Everything is explicable by the physcical giving a view of depression as biological

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16
Q

What is interactionism?

A

Entities can have an effect on one another, mental distress casues symptoms and vice versa

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17
Q

What are the consequences of dualistic thinking?

A

Makes us thing things are explicable by biomedical model but we have the mind that has an effect but we can’t study it medically unexplained symptoms are hard.

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18
Q

What is the reptillia brain?

A

Part in development about homeostasis arousal survival and reflexed that most animals have

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19
Q

What is the mamalian or limbic brain?

A

Emotions nurturing habits and memory are in this part from development

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20
Q

Which part of the brain gives us the most distinct features?

A

The frontal lobe

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21
Q

Where does dopamine affect?

A

The frontal cortex givind rewards euporia motor function and compulsion

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22
Q

Where does serotonine afect?

A

all but occipital , mood memory and processsnin sleep cognition

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23
Q

How can you test the frontal lobe ?

A

Proverb interpretation, similarities test, cognitive estimates, wisconsin card-sorting test

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24
Q

What are the symptoms of schizophrenia?

A

Delusions, thought disorder when its hard to make sense of what someone says. hallucinations they can get worse and become withdraw and appear unemotional lose interest stop looking after themeselves and find it hard to do normal tasks

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25
Q

What the biological correlates for schizophrenia?

A

brain volume functional imaging neurotransmitter abnormalites and genetic factors.Dopamin blockers seem to work and this can be negated by other drugs such as for parkinsons

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26
Q

What is the non biological correlates for schizophrenia?

A

social migration to cities could cause it psychosocial treatments have an effect, associated with repeat childhood trauma. associated with stress

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27
Q

What are problems with classification and diagnosis of mental disorders?

A

have to set arbirary limits on thinds like depression, leads to stigma and prejudice, economy of thought may lead to oversimplification

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28
Q

What does evolution show about systems level architechture of the brain?

A

The brain always had the same parts just developed into different sizes but maintained function over time

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29
Q

What is the mechanism that the brain uses for defence at a low level?

A

It has receptors that go to the spinal cord and does motor autonomic endocrine responses.

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30
Q

What does the brain use for the avoidance of loom dangers?

A

Visual processing or auditory and goes to sensorimotor mid-brain to the effectors at a subconscious level

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31
Q

What is the highest level of avoidance pathway?

A

Learned threat which includes the cortex and limbic system

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32
Q

How can you look at the hierarchy of of bain function?

A

Lowest is spinal cord reflexes, hindbraind does sudden distal stimuli for the startling, midbrain and hypothalamus does species specific threat like fight or flight, then it is the thalamus sensory cortex and hippocampus using amygdala for complex avoidance

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33
Q

what is in the CNS?

A

Brain and spinal cord

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34
Q

What is the peripheral nervous system?

A

all the nerves other than the spinal cord and brain

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35
Q

What are the divisions of the peripheral nervous system?

A

Somatic under conscious control and autonomic which is subconscious nervous system

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36
Q

What is the spinal cord separated into?

A

cervical, throacic lumbar and sacral

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37
Q

What do cervical nerves usually do?

A

Head and neck diaphragm and the arms and hands

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38
Q

What do thoracic nerves usually do?

A

chest muscles breathing abdominal muscles

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39
Q

What do the lumbar nerves usually do?

A

Legs and feet

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40
Q

What do the sacral nerves do?

A

Bowel and bladder control as well as sexual function

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41
Q

What are the dorsal roots of the spinal cord?

A

The dorsal is the sensory receptor signals entering afferent signals

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42
Q

What is the ventral root of the spinal cord responsible for?

A

The motor function signals coming from the brain efferent signals

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43
Q

What is in the ganglion where the dorsal and ventral roots join?

A

The dorsal root ganglion for the sensory neurons.

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44
Q

What are the three biggest divisions of the brain?

A

Forebrain, Midbrain and Hindbrain

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45
Q

How can the forebrain be split up?

A

into the telencephalon and the diencepalon

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46
Q

What is in the telencephalon?

A

cerebral cortex basal ganglia and limbic system

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47
Q

What is the diencephalon made from?

A

The thalamus and hypothalamus

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48
Q

What is the midbrain?

A

The mesencephalon

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49
Q

What is the mesencephalon made of?

A

The tegmentum and tectum

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50
Q

What is the hindbrain made from?

A

the metencephalon and the myelencephalon

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51
Q

What is the metencephalon?

A

Pons and cerebellum

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52
Q

What is the myelencephalon?

A

The medulla

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53
Q

What is the function of the medulla?

A

Contains tracts with signals to the rest of the brain, low sensorimotor such as balance,
Responsible for autonomic functions such as vomiting and sneezing.
Contains the cardiac and respiratory and vasomotor centres.
Controls ventilation via signs from central chemoreceptors.
Controls vasomotor from central baroreceptors

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54
Q

What is the function of the pons?

A

The bridge or relay between the cortex and the mid brain to the cerebellum, it contains lots of neuronal fibers and has the pontine reticular formation which is used in pattern generation

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55
Q

What does the cerebellum do?

A

It is mainly involved with motor functions. It is unvolved with fine regulation of movement and correcting motor errors. could have a role in cognitive emotions.

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56
Q

What does the tectum made of?

A

The superior and inferior colliculus

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57
Q

What does the superior colliculus?

A

Sensitive to sensory change and orienting defensive movements. gets topical inputs of signt

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58
Q

What does the inferior colliculus do?

A

it is involved in subconscious auditory events.

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59
Q

What is the tegmentum made of?

A

The periaqueductal grey, red nucleus and substantia nigra

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60
Q

What does the periaqueductal grey do?

A

Role in defensive behaviour, role in pain ascending and descending signals, role in reproduction

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61
Q

What does the red nucleus do?

A

Relay station involved with the motor signals from the cortext and cerebellum and a role in pre-cortical motor control

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62
Q

What does the substantia nigra do?

A

It is involved in dopanin production involved in parkinsons disease

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63
Q

What is the thalamus doing?

A

Has specific nuclei and relays signals to the cortex and limbic systems for all sensations other than smell.

It has non-specific nuclei and has a role in regulating the state of sleep and wakefulness and arousal it is a relay from the basal ganglia and the cerebellum back to the cortex

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64
Q

What does the hypothalamus do?

A

Regulates the pituitary gland which regulates the hormones, tole in hormonal control of motivational behaviour hunger thirst sex pleasure pain temperature

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65
Q

What can the forbrain be split into?

A

The forebrain or cerebral cortex can be subcortical or cortical

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66
Q

What are the sructures in the subcortical area of the forebrain?

A

Basal ganglia and the limbic system

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67
Q

What are the components and what is the function of the basal ganglia?

A

Dorsal Striatum: Caudate nucleus and putamen
Ventral Straitum: Nucleus accumbens and olfactory tubercle
global pallidus
ventral pallidum
substantia nigra
subthalamic nucleus

Connects inputs of the brain by recurrent loops.
facilitates purposeful behaviour
inhibits unwanted movement
controls posture and movement
selects which competing systems are active

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68
Q

What are the constituets of the limbic system?

A

The Amygdala, hippocampus, fornix, cingulate gyrus and septum and mamillary bodies

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69
Q

What is the function of the amygdala?

A

almond associated with sensory stimuli with emotional impact

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70
Q

What is the function of the mammillary body?

A

They are important for the formation of recollective memory

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71
Q

What is the function of the hippocampus?

A

Involved with memory long term and spatial memory

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72
Q

What is the function of cigulate gyrus?

A

linking behavioural outcomes to motivation and autonomic control

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73
Q

What is the function of the septum?

A

Involved in defense and aggression

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74
Q

What is the function of the fornix?

A

It is involved with carying signals from te hippocampus to the mamillary bodies and septal nucleus

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75
Q

How many layers of cortical lobes are there?

A

6 layers of cell bodies made of white and grey matter

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76
Q

What are some important areas in the cortical lobes?

A

The primary motor cortex which is the origin of descending motor pathwaysalso premotor and supplementary motor areas wich have higher level motor plans and initiation of voluntary movement

Brocas area - production of speach and language
wernickes area - understanding verbal and written information

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77
Q

What is the frontl lobe responsible for?

A

Executive planning and judgmental roles it has the short term memory and controls behaviour based on setting.

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78
Q

What is the primary somatosensory cortex?

A

its in parietal lobe and recieves signals from the body. it maintains representations of the bodys position in spaces and predicting movement of moving objects

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79
Q

What is the temporal lobe involved with?

A

Primary auditary complex and it linkes with the limbic system and is involved with recognition of faces.

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80
Q

What is the occipital lobe doing?

A

The visual inputs with the primary visual cortex.

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81
Q

What is the dorsal stream?

A

The vision for movement where things are in relation to you.

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82
Q

What is the ventral stream?

A

It is used for identification of things meaning why it is important to us

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83
Q

What are the levels of description in neruological understanding?

A

Psychological, systems, mictocircuit, neruonal, intracellular and molecular

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84
Q

Why are X-rays bad for imaging the brain/spinal cord?

A

Not very good for the tissue but for the bone and for foreign objects.

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85
Q

How can x-rays be made more useful?

A

Using contrast x-ray. cerebral angiography can show you how well the blood vessels are working and if there is a blockage although they cant tell you about the brain function itself.

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86
Q

How is MRI used in neroscience?

A

very good for looking at the structure and composition of the brain for tumours and swellings. it is non-ionising and very high detail can be obtained from it.

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87
Q

What is functional magnetic resonance imaging?

A

It is tuning MRI to look at oxygenated and deoxygenated iron in the blood. this can tell you about what areas of the brain are using more oxygen and may be more active.

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88
Q

How does fMRI work but what is one issue with it?

A

Increased neuronal activity uses more oxygen which attracts more blood flow there so its slightly counterintuitive can’t differentiate between inhibitory or exitatory

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89
Q

What is the use of PET scanning?

A

Positron emission tomography is when a chenical that binds to or is uses is radio tagged and given to a patient then the emissions from this isotope are tracked as part of the scan to give a 3 d image. it can be useful for showing activity and/ tumours

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90
Q

What is a new type of scanner that could be good?

A

MRI PET/fMRI scanners that can be used

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91
Q

What are EEG scans?

A

Electroencephalography detects the activity of neurons but it shows the summation of many neurons from the surface.
not very spatial signals
can use repetitions of tasks to see what’s happening to get event-related potential

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92
Q

What is MEG?

A

Magnetoencephalography it pics up on magnetic activity from the flow of current through axons. it is a very big machine it is more indicative of actual activity due to less noise

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93
Q

What is TMS or TDCS?

A

Transcranial magnetic stimulation or transcrania direct current stimulation which passes current or magnetic filed through and an area of the brain to innactivate part of the brain to investigate function

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94
Q

What is galvanic skin conductors?

A

It is used for sweat measuring to measure the autonomic nervous system

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95
Q

What is important when considering which method to use?

A

Invasiveness and spatial and temporal investigations

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96
Q

What are the 3 Rs of animal models?

A

Replacement (can other methods be used?)

Refinement can it be done in a better way that maximises the benefit,

Reduction can it be done with fewer animals

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97
Q

Which animals are most used in research?

A

Mice, fish rats birds

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98
Q

What are some invasive measures usually used only in research?

A

Deep brain probes, intracellular investigaion of neurones. stimulate one region and record activity in another area. using tracer in neurones with anteriograde and retrograde tracers

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99
Q

What are the applications of invasive measures?

A

They can be mixed to look at the effect of pharmacological agents.

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100
Q

What are the uses of genetic engineering?

A

Knock out or excessive gene expression.

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101
Q

What is optogenetics?

A

Looking at stimulating with light with genetic implantation of receptors

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102
Q

What week in development do the eyes form?

A

3 weeks

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103
Q

Which week does the brain start to form properly?

A

6 weeks

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104
Q

When are the basic structures of the brain developed?

A

3 months

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105
Q

When are the CNS neurones myelinated?

A

at 5 months

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106
Q

What are some of the critical periods in deveopment in utero?

A 
rubella can affect them 
6th week eye malformations 
9th week deafness 
5th to 10th cardiac 
2nd trimester CNS
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107
Q

What is fetal alcohol syndrome?

A

When alcohol from mothers blood passes to the baby, causes abnormalities like loss of cells loss of fibres motor and intellectual impairment, flat midface thin upper lip

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108
Q

What is the effect of opiates on babies?

A

withdrawl

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109
Q

What is the problem with cocaine usage?

A

withdrawl decreased cognition, hypoxia, or abortion

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110
Q

What is a stress response in the foetus?

A

not awareness but can cause uptake of lung fluid

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111
Q

What are primitive reflexes?

A

Ones present at birth that are usually repressed in adulthood and therefore a pathaloical sign in adults

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112
Q

What is the rooting reflex?

A

Turning the head in the direction of stroking of cheek

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113
Q

What is the suckling reflex?

A

Babies will such an opject that touches their lips

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114
Q

What is the moro(startle)reflex?

A

Back archs lega and arms flung out and then brougt back in when dropped

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115
Q

What is the grasping (palmar) reflex?

A

Babies grasp objects put in their hand

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116
Q

What is the stepping reflex?

A

The mimic walking when upright

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117
Q

What is the babinski reflex?

A

fan toes when sole of the foot is stroked

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118
Q

What is the tonic- neck reflex?

A

Turn head to one side and extend arm and leg

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119
Q

When is a baby able to track objects?

A

from birth

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120
Q

When can a baby converge the gaze?

A

at 7 or 8 weeks

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121
Q

Do neonates have perpheral vision?

A

no

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122
Q

When does taste develope?

A

At birth prevers sweet

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123
Q

When does smell develop?

A

at birth

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124
Q

When does dexterity develop?

A

at age 3

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125
Q

Where does development happen and how?

A

cranial to caudal, proximal to distal, simple to complex

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126
Q

What is the left hemisphere involved with?

A

Verbal speaking reading thinking and reasoning

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127
Q

What is the right hemisphere involved with?

A

nonverbal spatial patterns drawing recognition music emotionall ecpresssion

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128
Q

What are the types of malformation in development?

A

Miss development, things not developing, DNA is wrong the DNA is not executed orrectly

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129
Q

What can cause malformations?

A

toxins, Infections, Prematurity

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130
Q

What does cytomegalovirus do to a foetus?

A

Intracranial calcification as well as Aicardi-Goutières syndrome

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131
Q

What is lissencephaly?

A

Smooth brain neuronal migration disorder

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132
Q

How much alcohol can affect a foetus?

A

Binging very bad, 2 units a day can affect them

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133
Q

What can be looked for in the brain in an ultrasound scan?

A

Ventricular haemorrahge

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134
Q

What are some red flags in development of children?

A

Syndromic childen, history of brain injury, any loss of skill at any age, visually not fixing or following objects, hearing loss, low or high muscle tone, squint after 3 or 4 months 6th nerve. can’t hold object in hand, handed ness before 3 years old, cant point at oject to share intrest by 2 years, no speach by 18 months, persistent to walking, girls not walking by 2 years, gboys not walking by 18 months, can’t sit unsupported by 12 months

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135
Q

What do skeletal muscle fibres look like?

A

Myofibres in fascicles conected with epimysium perimysyuum and endomysium, they are in bundlles with nuclei around the edges.

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136
Q

What surrounds muscles?

A

Basement membrane syrrounding myofibriles collage and glycoproteins, there.

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137
Q

What is a motor unit?

A

The group of muscle fibres that are all innervated by the same nerve

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138
Q

What is the transmitter for the muscle?

A

Acetycholine

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139
Q

What are the proprioception muscles receptors?

A

Muscle spindles which are intrafusal fibres and Golgi tendons which are tension receptors

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140
Q

What is a primary muscle disesase?

A

A disorder in the muscle its self

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141
Q

What are the needs for a muscle biopsy?

A

cant put in formalin and is frozen and needs the right direction of slice also can look at it ultrastructurally

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142
Q

How can you look at fibre types?

A

Using histochemistry with enzymes to generate colour, oxidative enzymes

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143
Q

What are the types of muscle fibres?

A

slow twitch type 1 red which are oxidative and fatigue resistant
fast twitch which are very powerful but fatigue type 2:
2 A Glycolytic and oxidative intermediate 2B glycolytic which are white and fatigue easily.

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144
Q

How do motor units structure?

A

they can overlap and intermingle, fibre type depends on innervation, the size is dependant on the amount of controlled

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145
Q

What happens in deinervatio of motor neurones?

A

Collateral sprouting of adjacent motor units which allows re innervation with larger motor units get conversion of fibre types

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146
Q

What is the Z disk?

A

The lines of protein with alpha actin titin nebulin and desmin that define the sarcomere

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147
Q

What is a sarcomere?

A

Basic unit of contraction repeating arrangement forms a fibre

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148
Q

What makes the A bands?

A

The myosin strands.

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149
Q

Do the I bands or A bands shorten?

A

I bands

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150
Q

What makes up thick fillaments?

A

Myosin

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151
Q

What does desmin do?

A

Links myofibrils to eachother and the sarcolemma

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152
Q

What is the structure of actin?

A

There are actin globular proteins, with tropomyosing strands and troponin to block the binding sites

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153
Q

What are the m lines?

A

The fibres that are in the middle of the a band

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154
Q

What causes shortening of the sarcomere?

A

The sliding of the fibres over eachother not the shortening of fibres, activated by CA2+

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155
Q

What provides energy for the contraction?

A

ATP

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156
Q

What can store ATP?

A

Creatine pospate and is replenished by creating kinase which is released when a muscle fibre is damaged.

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157
Q

What are mitochondrial cytopathies?

A

Problems with mitochondria, have maternal inherided DNA which is circular, mutations can occur in nucleus or in mitochondria, can have clinical presentations of CNS problems,

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158
Q

How can mitochondrial cytopathies be diagnosed histologcally?

A

take a muscle biopsy, ragged red fires transport cain deficites in cytochrome oxidates negative fibres

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159
Q

What is dystophin?

A

a protein that binds to actin and the sarcoglycans in the sarcolemma

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160
Q

What other proteins are involved with dystrophin?

A

Merosin dystroglycans, sarcoglycans, and actin

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161
Q

What can happen in problems with dystrophin problems?

A

When the muscle contracts the muscle loses weakness and can cause the destruction of muscle fibres they are genetic.

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162
Q

What is duchennes muscular dystrophy?

A

Deletion from gene that causes open reading phrame and short protein or no protein is produced.

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163
Q

what happens in neuromuscular transmission of nerve impulese?

A

ACh binds to receptor, cation entry results in depolarisation of the end plate the action potential crosses the membrane and into t tubule system where calcium is released from the sarcoplasmic reticulum.

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164
Q

What ends the contraction?

A

When ACh is hydrolyses by acetyl cholinesterase in the neruomuscular junction

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165
Q

What is myasthenia gravis?

A

Variabe weaknes progressive with sustained effort eyesign of ptosis. it is autoimune and anti Acetylcholine in a reduction of receptors.

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166
Q

What are the adaptations of the endoneurium and perineurium?

A

They have tight junctions to reduce transport of unwanted sustances

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167
Q

How many nerves can one swann cells look after?

A

For myelenated nervs it is only one but otherwise can be several

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168
Q

What are oligodendrocytes and how do they differe to Schwann cells?

A

They can myelenate many and they are only found in the CNS

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169
Q

What is a peripheral neuropatheis?

A

damage to motor and sensory neurons can be axonopathies or to demyelination

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170
Q

What is axonal degeneration/regeneration?

A

When an axon is damage distally the nerve dies but can regrow from there and Schwann cells can produce sprouts they won’t be as fast though

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171
Q

When does the neural tube close?

A

At the 4th week

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172
Q

Which important brain cells are derived from the ectoderm?

A

Melanocytes, Shwann cells, neurones

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173
Q

Which importan cells develop from the mesoderm?

A

Osteoblasts and osteoclasts, adipocytes and chondrocytes

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174
Q

What is it called when the neural tube fails to close at the head end?

A

anencephaly

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175
Q

What is it called when the neural tube fails to close in the spinal region?

A

Spina Bifida

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176
Q

What is a meningocele?

A

Protrusion of the meningesthrough where the vertebral spine should be

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177
Q

When does the anomaly scan take place?

A

Anomaly scan takes place at 20 weeks looking for development defects. ultrasound

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178
Q

What are the emryological areas of the brain called?

A

Prosencephalon, Mesencephalon and Rhombencephalon also the spinal cord

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179
Q

What does the Prosencephalon give rise to?

A

The frontal lobes and cortex, the telencephalon and diencephalon

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180
Q

What does the mesencephalon give rise to?

A

the thalamus and nuclei the mesencepalon

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181
Q

What does the rhombencephalon give rise to?

A

the cerebellum and brainstem

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182
Q

What can affect brain development in foetus?

A

Alcohol and valproate

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183
Q

What is the most comon developmental disorders?

A

Intellectual disability, from the malformation of the layers of the brain cortex

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184
Q

How much CSF is there?

A

About 120 mls

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185
Q

What are the causes of hydrocephalus?

A

Brain tumours menigitis, obstruction of the flow of CSF. There is also over production of non-obstructive.

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186
Q

What muscle is in the lower eye lid?

A

There isn’t one

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187
Q

What is the muscle that is there for theupper eye lid?

A

Orbicularis oculi to close the eyelid this is innervatied by 7th cranial nerve. there is levator palpebrae superiouis that elevates the eyelid innervated by the 3rd cranial nerve the occulomotor

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188
Q

what is the name of the rim of tissue in the eyelid?

A

The tarsal plate which contains meibimian/ tarsal glands

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189
Q

What innervation is there in the eyelid?

A

Motor and also sympathetic for horners gland smooth muscle

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190
Q

Where is the tarsal gland?

A

runs vertically upwards from the eye lid rim in both upper and lower lid

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191
Q

What is the conjunctiva?

A

It is a mucous membrane which covers the eyelid and frontal areas of the eyeball/globe. It merges with the cornea at the limbus

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192
Q

What is the conjunctivia like?

A

It is loosly attached to the globe and highly vasuclar alhtough the vessels are usually constricted

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193
Q

What are the layers of the tear film?

A

The anterior lipid layer from meibomian glands, aqueous layer from the lacrimal and acessory glands, the mucin layer which is crom conjunctival goblet cells

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194
Q

What is in the aqueous layer?

A

antibodies enzymes and vitamin C

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195
Q

What is the importance of the tear film?

A

protects the eye and supplies the cornea with oxygen and nutrients and gives a smooth clear anterior refracting surface.

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196
Q

What is the purpose of the mucin layer of the eye?

A

it helps the aqueous layer sit on the globe

197
Q

what is the function of the lacrimal gland?

A

Wash away foreign bodies

198
Q

What is the function of cornea?

A

Allow light into the eye and begin focusing of the light

199
Q

What are the three layers of the cornea?

A

Epithelium, Stroma and endothelium

200
Q

What is the epithelium of the cornea like?

A

Stratified non-keratinising and has limbal stem cells, it is very sensitive to pain via the 5th nerve

201
Q

What is the stroma of the cornea like?

A

Recular lamina of collagen fibres it is avascular

202
Q

What is the endothelium of the cornea like?

A

It is a single layer on the back of the eye and it is not replaced and is a fluid pump for the eye.

203
Q

What is the need for pumping of the endothelium?

A

It stops clouding of the cornea from absorption of water and the pump stops it from swelling

204
Q

What is the anterior chamber?

A

it is the space between the posterior surface of the cornea and the anterior surface of the iris and lens, it is filled with aqueous humour producesd by ciliary body

205
Q

Where does fluid exit from the anterior chamber?

A

Exits via the AC angle, the trabecular meshwork is here

206
Q

What are the special quirks of the anterior chamber?

A

Can see convection currents in the eye

207
Q

What is the function of the iris?

A

A muscular diaphragm that controls light entry to the eye

208
Q

What muscles of the iris?

A

Dilator muscle wich is sympathetically innervated and then the sphincter muscle which is parasympathetic with muscarinic receptors

209
Q

What are the two layers of the iris?

A

The anterior layer has stroma and gives iris colour,and the posterior pigment is all irides and muscle

210
Q

Where is the cilliary body located?

A

Behind the iris beneath the conjunctiva and scleralateral to the lens.

211
Q

What causes both pupils to be small?

A

Bright light
extremes of age
opiates and cholinergic.

212
Q

What are the causes of asymetric pupils anisocoria?

A

Horners syndrome RE, angle closure LE, 3rd nerve palsy LE adie pupil LE cholinergic drop RE anticolinergic drop LE symathomimetic drop LE

213
Q

What are the causes of large pupils?

A

Low light exited or amphetamines anticholinergics or death

214
Q

What is the function of the lens?

A

To focus the light or accomodation which is achieved by contraction of the ciliary body

215
Q

How does accommodation work?

A

the ciliary body (circular muscle) contracts which reduce tension in the zonule and the lens will become rounder for near vision.

when the ciliary body is relaxed it will put tension on the zonule causing it to flatten for the eye to focus on far objects

216
Q

What is presbyopia?

A

The elasticity of the lens reduces over time and its ability to become round again is reduced leading to difficulty in seeing close up objects

217
Q

what changes happen to the lens over time?

A

anterior epithelium produces fibres throughout life so the lens enlargens and the centre is the oldest, this can cause cataracts over time if the formation is imperfect

218
Q

What is the aqueous humour?

A

the fluid that is found around the lens at the anterior portion of the eye

219
Q

What is continuous with the choroid?

A

the ciliary body

220
Q

What is the pars plicata?

A

the processes of the ciliary bodies tha secrete aqueous humour.

221
Q

What are the innervation of the ciliary bodies?

A

3rd cranial nerve muscarinic receptors.

222
Q

What causes pupils to dialate?

A

anticholinergic drugs like atropine which block the action of the muscles in the pupil

223
Q

What is the vitreous humour?

A

Fills the space between te posterior surface of the lens and the retina. it is collagen fibres and large negatively charged glycosaminoglyans.it contains the remematns of blood vessels from te optic disc to the lens and becomes more liquid with age

224
Q

What is the retina?

A

the area of the eye responsible for turning the light signals into nerve impulses

225
Q

What are the layers of the retina?

A

Photoreceptors (rods and cones) 1st and 2nd order neurones (bipolar and ganglion cells) internerurones amacrine and horizontal cells, neruoglial cells pigment cells and supporting membranes

226
Q

Describe the structure of the retina

A

There are rods and cones at the bottom lowest area of the eye above the pigment epithelium and choroid. above these layers there is the bipolar cells. The bipolar cells synapse with ganglion cells that transmit the signal to the optic nerve

227
Q

what is the nutrient supply to the photo receptors?

A

no direct blood supply from diffusion from the choroidal blood supply

228
Q

What are the properties of rods?

A

dim light perception but no colour

229
Q

What are the properties of cones?

A

They allow perception of colour and are very concentrated in the fovea

230
Q

What are the most common rods or cones?

A

Rods

231
Q

What are horizontal cells?

A

recieve input from photo receptors and moduclate it and also control the activitiy of photoreceptors

232
Q

What are muller of amacrine cells?

A

receive signals from bipolar cells and ganglion cells and modulate it

233
Q

What is the optic disk?

A

An area with no rods or cones(blind spot) where the ganglion fibres leave as the optic nerve

234
Q

What are the retinal blood vessels?

A

supply the inner part of the retina but not the photoreceptors the cast a shadow over photoreceptors

235
Q

What is the Fovea?

A

the pit or depresssion at the centre of the macula that gives the best visual acuity. foveola is the most sensitive part of the retina contains only cones and no obscuring blood vessels.

236
Q

What is the macula?

A

the portion of the eye at the centre of the retina that processes sharp clear straight ahead vision highest concentration of cones

237
Q

Where is the macula?

A

in the temporal area.

238
Q

What is the largest part of the uvual tract?

A

The choroid

239
Q

What is the choroid?

A

it is highly vascular and heavily pigmented. it is the middle layer of the posterior eye it supplies blood to the outer retina which is controlled by retinal pigment epithelium

240
Q

What is the optic disk?

A

Where ganglion cells leave the retina and there are lots of capillaries there are no photo receptors it has a central cup with an opening in the sclera and adventitial tissue the size is variable. good to see ocular and neurological problems

241
Q

What is the sclera?

A

The tough outer protective layer and is the insertion point of the muscles. it is perforated by nerves and blood vessels and is opaque from collagen fibres

242
Q

How many extraocular muscles are there in each eye?

A
  1. 2 vertical recti 2 horisontal recti and two oblique muscles
243
Q

What is the innervation of most muscles other than the lateral rectus and superior oblique?

A

the occulomotor nerve CNIII

244
Q

What is the innervation of lateral rectus?

A

the 6th cranial nerve the abducens

245
Q

What is the innervation of the superior oblique?

A

the 4th cranial nerve trochlea

246
Q

Where is the origin of most muscles of the eye?

A

the orbital apex apart from inferior oblique which has an anterior origin.

247
Q

Which muscle is different to the others?

A

The superior oblique as it runs with a tendon through a trochlea or pully

248
Q

What is the orbit?

A

the bony protection of the globe. medial ehtmoidal (thin) and lateral zygomatic wall (thick) and the floor maxllary and roof are thin. opens into middle cranial fossa

249
Q

Which bones make up the orbit?

A

Frontal ethmoid maxilla, zygomatic plus manny more

250
Q

What are the opennings of the orbit?

A

The optic canal and the superior orbital fissure

251
Q

What runs in the optic canal?

A

Optic nerve and opthalmic artery and sympathetic plexus

252
Q

What runs in the superior orbital fissure?

A

the occulormotor 3rd, trochelar 4th, brances of the trigeminal 5th opthalmic and the abducents 6th,

253
Q

What affects the diameter of the pupil?

A

Changes in light intesity, proximity of object, state of arousal sympathetic nervous system .

254
Q

What is involved in the afferent limb of the pupil?

A

The retina then the optic nerve which decussates at the chiasm and then the optic tracts. this then goes to the lateral geniculate body of the thalamus and then to the superior colliculus and pre tectal nucleus

255
Q

What is involved with the efferent limb of the pupil?

A

The pretectal nucleus sends fibres to the edinger-westphal nucleus in the mid brain, parasympathetic fibres of the 3rd cranial nerve and then synapse in the ciliary ganglion in the orbit. and then short ciliary nerves innervate and contract the sphincter pupillae and the ciliaris muscle (accommodation reflex)

increases focus on near vision

256
Q

What are the differences in reflexes of pupils?

A

One eye affects the other, bilateral input to the pretectal nucleus. very quick response

257
Q

Where is the nucleus for eye reflexes?

A

The superior colliculus

258
Q

What normally happens when you shine a light in the left eye?

A

Simultaneous constriction of the pupils

259
Q

What normally happens when you remove the light from the eye?

A

The pupils both dilate

260
Q

What happens with an afferent pupillary defect with the left eye?

A

Poor or absent constriction of the left pupil and same on right when shined into left when shone on the right eye normal response. shows that can constrict but can’t sense it on the left

261
Q

What happens with an efferent pupillary defect with the left eye?

A

Could have difference sizes to begin with eg left bigger. shining light in the left causes little or no response in left but good in right. removing the light the left will stay similar and right dilates. when shining in the right it will causes poor or absent constriction of left and normal of right

262
Q

What can cause optic nerve afferent defects?

A

Optic nere disease, severe retinal disease

263
Q

What can cuase efferent defects?

A

3rd nerve palsy, adie pupil, iris damage, atropine drugs angle closure glaucoma

264
Q

What is the dark response?

A

Active dilatation by sympathetic stimulation of dilator muscles and inhibition of sphincter muscle

265
Q

What is Cliliospinal reflex?

A

pinching the neck on one side causes pupil dilation on that side,

266
Q

What is the intraocular pressure?

A

15-20mmHg this allows the eye to move without being deformed

267
Q

What is high intraocular pressure called and low?

A

Glaucoma and hypotony

268
Q

What is the device used to measure intra ocular pressure?

A

Tonometer

269
Q

What is the normal flow of aqueous humour?

A

producced in the ciliary body circulates around the lens and through the pupil and leaves the anterior chamber by the AC angle

270
Q

what is conjugate movement?

A

Movement of the eyes together?

271
Q

What is the purpose of eye movements?

A

Widens field of vision allow us to follow a target. stabilising vision acurate tracking and it maintains vision

272
Q

What is the function of lateral rectus?

A

Moves the eye laterally (abduction)

273
Q

What does medial rectus do?

A

Moves the eye medially (Adduction)

274
Q

What does superior recuts do?

A

elevates

275
Q

What does inferior rectus?

A

depresses the eye

276
Q

What does the superior oblique do?

A

Medially rotates eye inwards (intorsion)

Depresses the eye and Abducts

277
Q

What does the inferior oblique do?

A

Laterally rotates the eye outwards (extorsion)

Elevates and Abducts

278
Q

what is the blood supply for the eye?

A

Internal carotid branches to give Opthalmic artery which branches to give central retinal artery( inner retina) and ciliary arteries (outer retina circulation and anterior part of the globe). they can be affected in different ways.

279
Q

What is the structure of the retina like?

A

Tight junctions in capillaries no lymohatics and there is a blood retinal barrier to protect it/

280
Q

What are the chordal capillaries like?

A

They are leaky and transfer fluid to the retina limited by the retinal pigment epithelium which has a pump fumction it also has photoreceptors

281
Q

What is the photopic visual system?

A

The system used in good lighting conditions to give detail and color lots of cone receptors

282
Q

What is scotopic visual system?

A

I is monocromatic for low light conditions and has a function of rod photoreceptors peripheral retina.

283
Q

How long does it take for maximal sensitivity in dark?

A

10 minutes up to 30 minutes

284
Q

How many types of cones are there?

A

3 RGB

285
Q

What are the need for the types?

A

To percieve variety of coulours in our visible spectrum

286
Q

What is abnormal colour vision?

A

colourblindnes can be caused by diseae or genetice can make it hard do distinguish

287
Q

How wide is the visual field?

A

200degrees horizontal 150 degrees vertical

288
Q

How are visual fields measured?

A

Angles from nose and edge of eye

289
Q

What is it called if the eye is too long for the refractive power of the lens?

A

Myopia

290
Q

What is is called if the eye is too short?

A

hyperopia

291
Q

What is astigmatism?

A

When the refractive power of the cornea is not even

292
Q

What is accomodation?

A

Changing the focussing of the lens to get a clear image

293
Q

What causes change in accommodation with age?

A

The lens is less elsastic called presbyopia

294
Q

What is visual acuity?

A

The ability to see detail or resolution. it is best at the centre.

295
Q

How do you test visual acuity?

A

Using a snellen chart which is most commonly used or other

296
Q

Wat is binocular vision?

A

Seeing one image with both eyes.

297
Q

What is stereopsis?

A

Depth perception. it is not present at birth

298
Q

What is strabismus?

A

eyes looking in different ways

299
Q

What is the visual pathway?

A

Retina (cone, rod, bipolar, ganglion neurone),
optic nerve,
optic chiasm and optic tracts
thalamus (lateral geniculate ganglion)
optic radiations (temporal and parietal lobes)
visual cortex and visual association cortex

300
Q

What fibres cross over at the chiasm?

A

medial fibres of the eyes with information from the temporal field.

301
Q

What type of fibres do the optic tracts carry?

A

Fibres from the temporal retina( nasal visual field from the same side and the nasal fibres from the temporal visual field from the oposite side to give depth

302
Q

What fibres enter the parietal lobe radiation?

A

The superior fibres from the lower visual field

303
Q

What fibres enter the temporal radiation?

A

The inferior fibres which convey iformation from the superior visual field

304
Q

Where is the visual cortex?

A

In the calcarine sulcus either side on the medial surface of the occipital lobe

305
Q

Where do the fibres from the macula go?

A

To the posterior pole where the lood supply is from the middle and posterior cerebral artery

306
Q

What kind of problems are there with the retina?

A

Total loss of vision in one eye, loss of part of cisiual field in one eye, loss of upper or lower half of field of vision los of centre of vision macular degeneration and tunnel vision

307
Q

What are problems relating to the optic nerve?

A

Enlarged blind spot(swollen optic disc, loss of centre of visions(optic neuritis), Loss of vision in and arc shape(glaucoma) glaucoma(tunnel vission)

308
Q

What is bitemporal hemianopia?

A

The temporal field of each eye is gone. Often caused by pituitary tumours

309
Q

What happens when the optic tracts is damaged.?

A

It caues contralateral loss with same part of each eye, homonymous left of each.

310
Q

What is incongruous?

A

not the same on both sides

311
Q

What happes in optic radiations?

A

Contralateral homonymus field defects

312
Q

What is macular sparing?

A

when the macula is spared as there is a posterior cerebral artery stroke but area for macula is supplied by middle

313
Q

What is a blow out fracture?

A

frontal sinus broken causing double vision

314
Q

go back to eye lecture?

A

cvd

315
Q

What are the areas of a neuron?

A

Dendrites, Cell body, Myelinated axon, Axon terminals

316
Q

What are dendrites?

A

Areas of nerve cells that receive input from other neurons

317
Q

where is the first action potential?

A

Axon hillock

318
Q

When are neurons formed?

A

Most before birth lots later though

319
Q

What is high concentration in cell body of a neuron?

A

Nissel substance which is rough endoplasmic reticulum

320
Q

What are the two types of neronal commuication?

A

Chemical for most and also electrical which are less abundant

321
Q

What are electrical synapses like?

A

They have gap junctions electron dense material either side of junction

322
Q

How does a chemical synapse work?

A

calcium influx into the presynaptic bulb causes the release of neurotransmitters that bind to receptors on the post synaptic membranes

323
Q

What are dendritic spines?

A

They are small projections from the dendrites that hace post synaptic membranes

324
Q

What is plasticity?

A

The ability of the synapse to be changed gained lost and strengthened. the basis of learning

325
Q

How doe neurones differ?

A

Size shape electical properties neurotransmitters.

326
Q

What are upper motor neurones like?

A

Large exitatory glutaminergic and pyramidal cells

327
Q

Wat are striateal interneurons?

A

Small inhibitory GABAergic

328
Q

How many axons are there in one cell?

A

Many

329
Q

What are oligodendrocytes?

A

They myelinate neurons in the CNS not schwann cells. They are helping saltatory conduction providing metabolic support for axons

330
Q

How many neurones can one oligodendrocyte myelinate?

A

Many

331
Q

What is a myelin sheath?

A

Multiple layers of membrane with high 70% lipid and 30%protein. involved in compaction

332
Q

What are microglia?

A

They are derived from yolk sac progenitors, resident immune cells of the CNS the resting state have lots of procecess then when activated they retract and become motile

333
Q

What do the microglia do?

A

They help with synaptic placitity and pruning, immune sureillance and phagocytosis debris/microbes

334
Q

What are astrocytes?

A

Star shaped cells but have a high heterogeneity
they have marker proteins such as GFPA
fibrous in white matter
protoplasmic in grey matter

335
Q

What is the purpose of astrocytes?

A

Part of the blood-brain barrier, also go into nodes of Ranvier. they are progenitors of nerual cells, most abundant and give structure, homeostatic metabolic support through neurovascular coupling

336
Q

How are fMRI and astrocytes linked?

A

They change blood flow in the brain

337
Q

What are some special astrocytes?

A

Radial glia - progenitors of neural cells
Bergman glia in cerebellum
Muller cells in the retina

338
Q

What symptoms of MND are due to loss of…?

A

Motor neurons microglia and astrocytes

339
Q

What are involved in CNS lesisons in MS?

A

Oligodendroytes but also T lymohocytes and neurons

340
Q

What is a tract?

A

An abundance of axons in the same directions

341
Q

What are commissures?

A

Fibres that cross the mid line

342
Q

What is a nucleus in the brain?

A

An area with an abundance of nuclei (cell bodies)

343
Q

What is a ganglion?

A

Concentration of cell bodies in the PNS

344
Q

What are some of the features of the blood brain barrier?

A

Tight junctions, foot proceses of astrocytes, pericytes basement membrane whcih lack fenestrations

345
Q

Where are the Blood brain barrier thinner?

A

CIrcumventricular organs of the brain:

Pituitary, pineal gland, hypothalamus, and area postrema vomiting centre for body.

346
Q

Where is CSF removed?

A

the arachnoid granulations and the lymphatics of the brain,along nerves

347
Q

What are ependymal cells?

A

Epithelial-like cells that line ventricles and central canal of the spinal cord.
They produce CSF they are ciliated cells to give flow

348
Q

What is the choroid plexus?

A

The frond like projections of ependymal cells vasuclarised and main site of CSF production.

349
Q

What makes neurons negative inside relative to outside?

A

negative proteins inside the cytoplasm. potassium and chloride can leave. sodium can cross with difficulty and have sodium potassium pumps

350
Q

What role does diffusion have in the maintenance of themembrane potential?

A

Chloride diffuses in against electrostatic pressure, sodium in with the electrostatic pressure and potassium out against the presure

351
Q

Which ions are inside the cell?

A

Negative ions, potassium

352
Q

Which ions are usually outside the cell?

A

Chloride,sodium

353
Q

How is information transmitted through neurons even though they can only be on or off?

A

By the rate of firing of the cells

354
Q

What doe neurotransmitters do?

A

They bind to ion channels and cause them to open.

355
Q

What do exxcitatory neurotranmitter do?

A

Depolarise the membrane and increase the probability of an action potetnial taking place. excitatory post synaptic potential

356
Q

What do inhibitory neurotransmitters do?

A

They hyperpolarise the cell membrane which makes it less likely for the cell generate an action potential called inhibitory post synaptic potentials

357
Q

What is spatial sumation?

A

When signals from two neurons combine to form a larger signal making it more likely for the action potential to happen

358
Q

What is the significance of the axon hilluck?

A

If it doesn’t get a big enough voltage at the hillock it won’t transmit down the axon

359
Q

What happens once the threshold potential is met?

A

voltage gated sodium channels open and depolarise the membrane. then they close and potassium voltage gates open to depolarise. then becomes hyper polarised

360
Q

What is the absolute refractory period?

A

Moreover, the absolute refractory period is the interval of time during which a second action potential cannot be initiated, no matter how large a stimulus is repeatedly applied

361
Q

What is the relative refractory period?

A

When the membrane becomes hyperpolarised.

362
Q

What is the speed of myelinated axonal transmission?

A

Up to 150m/s

363
Q

What is the speed of unmeylinated axons?

A

2-5m/s

364
Q

What does novichok do?

A

It interferes with acetylcholine by stoping acetylcholine esterase from breaking down the ACh

365
Q

How is neurotransmitter regulated?

A

Enzymatic breakdown,

366
Q

What does atropine do?

A

Can remove ACh from receptors

367
Q

What are the 5 fundamental processes of synaptic transmission?

A

Manufacture of neurotransmittersStorage of the neurotransmittersRelease of thetransmitter via action potentialInteract with post-synaptic reveptors- diffusion across the synapseinactivation- breakdown or re-uptake

368
Q

What are some fast acting neurotransmitter?

A

Acetylcholine, Glutamate Gamma-aminobutyric acid

369
Q

What are neuroodulaters with egs?

A

They are slower acting such as Dopamine noradrenalin Serotonin

370
Q

What does procaine and lignocaine do?

A

local anaesthetics block sodium channels

371
Q

What are the most useful imaging techniques?

A

MRI and CT, Cerebral angiography

372
Q

What is x-ray useful for?

A

Skull damage MR safety

373
Q

What scanner is used for angiography?

A

CT

374
Q

What are some problems with CT?

A

High dose radiation, limited anatomical detain somewhat, contrast agents are allergic, better than MRI for bone topics

375
Q

How are CT presented?

A

Looking from the bottom of the bed to the top

376
Q

What is the strength of most MRI magnets?

A

T1.5 or T3

377
Q

What are white matter fibre tracts?

A

Water diffusion along fibre pathways

378
Q

What is PET-CT scanning?

A

used to locate brain tumours

379
Q

What does an extradural haemotoma look like?

A

Between the dura and skull causes brain compression. blood next to skull

380
Q

What colour is blood on a CT?

A

White

381
Q

What is a cerebral contusion?

A

“bruise” on the brain where it is dammaged

382
Q

What is diffuse axonal injury?

A

When white matter fibres are dammaged

383
Q

What is a T2 scan?

A

CSF white

384
Q

What is a T1 weighting?

A

CSF white

385
Q

What is the use of weighting?

A

It can help distinguish what the lesions are

386
Q

What can you see on stroke patients?

A

See which artery was damaged

387
Q

Give 3 functions of the cranial meninges.

A
  1. Protects the brain and spinal cord form injury.2. Provides a framework for cerebral and cranial vasculature. 3. Provides a space for the flow of CSF.
388
Q

What are the 3 meningeal layers?

A
  1. Dura mater (outermost).2. Arachnoid mater.3. Pia mater (inner most).
389
Q

What are the 2 connective tissue sheets of dura mater?

A
  1. Endosteal layer - lines the cranium. 2. Meningeal layer.
390
Q

Where are the dural venous sinuses located?

A

Between the endosteal layer of dura and the meningeal layer.

391
Q

What vein do the dural venous sinuses drain into?

A

The internal jugular veins.

392
Q

Name 3 locations where the dura mater folds inwards as dural reflections?

A
  1. Falx cerebri.2. Tentorium cerebelli.3. Falx cerebelli.
393
Q

Where is the falx cerebri located?

A

It lies in the longitudinal fissure between the cerebral hemispheres.

394
Q

Where is the tentorium cerebelli located?

A

The tentorium cerebelli is a thick fibrous roof lying over the posterior cranial fossa and the cerebellum.

395
Q

Where is the falx cerebelli located?

A

Between the 2 lobes of the cerebellum.

396
Q

What lies beneath the arachnoid mater?

A

The subarachnoid space containing CSF and arteries.

397
Q

What is the function of the blood-brain barrier?

A

It protects the brain by preventing the passage of some substances from the circulation into the nervous tissue.

398
Q

Which meningeal layers are highly vascularised?

A

The dura and pia mater. The arachnoid mater is avascular.

399
Q

Name the 3 elements that make up the blood-brain barrier.

A
  1. Capillary endothelial cells. 2. Basement membrane.3. Astrocytic end-feet.
400
Q

What are the 2 main arteries that supply blood to the brain?

A
  1. Vertebral arteries.2. Internal carotid arteries.
401
Q

Which arteries supply about 80% of blood to the brain?

A

The internal carotid arteries.

402
Q

What are the vertebral arteries a branch of?

A

The subclavian arteries.

403
Q

Where do the vertebral arteries enter the skull?

A

Through the foramen magnum.

404
Q

What are the internal carotid arteries branches of?

A

The common carotids. Arise from bifurcation at the same level as the upper border of the thyroid cartilage.

405
Q

What do the vertebral arteries supply?

A

The posterior cerebrum and thecontents of the posterior cranial fossa.

406
Q

What do the internal carotid arteries supply?

A

The anterior and middle parts of the cerebrum and the diencephalon.

407
Q

Where do the internal carotid arteries enter the skull?

A

Through the carotid foramina.

408
Q

What are the terminal branches of the internal carotid arteries?

A

The middle and anterior cerebral arteries.

409
Q

What does the middle cerebral artery supply?

A

The lateral surface of the hemispheres.

410
Q

What does the anterior cerebral artery supply?

A

The medial aspect of the hemispheres and the corpus callosum.

411
Q

What does the posterior cerebral artery supply?

A

The occipital lobe.

412
Q

What artery passes through foramen spinosum?

A

The middle meningeal artery.

413
Q

What do the two vertebral arteries form?

A

The basilar artery.

414
Q

Where is a berry aneurysm likely to occur?

A

At branching points in the circle of willis, especially at the anterior communicating artery.

415
Q

What is a berry aneurysm?

A

A sac-like out pouching that will progressively enlarge until it ruptures resulting in haemorrhage.

416
Q

What are the two types of stroke?

A
  1. Ischaemic.2. Haemorrhagic (intracerebral or subarachnoid).
417
Q

Where are dural venous sinuses located?

A

In between the endosteal and meningeal layers of dura.

418
Q

Where do cerebral veins drain into?

A

Into dural venous sinuses.

419
Q

What does the great cerebral vein drain?

A

Deep brain structures.

420
Q

What sinus does the great cerebral vein drain into?

A

The straight sinus.

421
Q

Where is the straight sinus located?

A

In the midline of the tentorium cerebelli.

422
Q

What vessels lie in the cavernous sinus?

A
  • Cn 3, 4, 5(1), 5(2) and 6. - Internal carotid artery.
423
Q

Why is the cavernous sinus of clinical importance?

A

If this sinus is infected Cn 3, 4, 5(1), 5(2) and 6 and the internal carotid artery could be affected.

424
Q

How do dural venous sinuses and veins outside the skull communicate?

A

Via emissary veins.

425
Q

What is the clinical significance of emissary veins?

A

They represent a possible route for infection to spread into the cranial cavity.

426
Q

Briefly describe the pathway of venous drainage starting at the great cerebral vein.

A

Great cerebral vein -> straight sinus -> transverse sinus -> sigmoid sinus -> internal jugular vein -> jugular vein -> brachiocephalic vein -> SVC.

427
Q

What sinuses form the confluence of sinuses?

A

The straight sinus and the superior sagittal sinus.

428
Q

Where is the largest aggregation of choroid plexus?

A

In the lateral ventricles.

429
Q

Where is the majority of CSF produced?

A

In the lateral ventricles (greatest amount of choroid plexus here`).

430
Q

What is ependyma?

A

A thin-epithelial like structure lining the ventricles.

431
Q

Tight junctions prevent the passage of fluid into the ventricles. Why is this important?

A

It means that the volume and composition of CSF can be closely controlled.

432
Q

What embryonic part of the brain is the midbrain formed from?

A

Mesencephalon.

433
Q

What embryonic part of the brain is the pons formed from?

A

Metencephalon of Rhombencephalon.

434
Q

What embryonic part of the brain is the medulla oblangata formed from?

A

Myelencephalon of Rhombencephalon.

435
Q

What are the characteristic features of a cervical vertebra?

A
  • Small vertebral body.- Transverse foramen for vertebral arteries. - Bifurcation of spinous processes (except C7).- Triangular intervertebral foramen.
436
Q

What region of the vertebral column has the greatest capacity for rotation?

A

The thoracic region.

437
Q

What region of the vertebral column has the least capacity for flexion?

A

The thoracic region; this is due to the presence of the ribcage.

438
Q

What are the 2 components of an intervertebral disc?

A
  1. Nucleus pulposus.2. Annulus fibrosus: concentric layers of collagen surrounding the nucleus pulposus.
439
Q

What does the ligamentum flavum connect?

A

Connects the laminae of adjacent vertebrae.

440
Q

Where does the spinal cord end?a) in an adult.b) at birth.c) in the embryo.

A

a) L2.b) L3.c) runs the entire length of the vertebral column.

441
Q

Where would you insert a lumbar puncture needle?

A

At the L3/L4 level in the sub-arachnoid space in order to take CSF.

442
Q

Where would you insert an epidural needle?

A

Between the dura mater and vertebrae in order to inject anaesthesia.

443
Q

What is the conus medullaris?

A

The tapered, lower end of the spinal cord.

444
Q

What is the filum terminale?

A

A fibrous strand that proceeds downwards from the apex of the conus medullaris.

445
Q

What is the cauda equina?

A

Spinal nerves from the lower spinal cord that hang obliquely downwards.

446
Q

Define dermatome.

A

An area of skin with a sensory nerve supply from a single root of the spinal cord.

447
Q

What is the dermatome for the thumb?

A

C6.

448
Q

What is the dermatome for the knee?

A

L3.

449
Q

What is the dermatome for the big toe?

A

L5.

450
Q

Name 4 ascending spinal pathways.

A
  1. DCML.2. Spinothalamic.3. Spinocerebellar. 4. Spinoreticular.
451
Q

What sensations does the DCML pathway convey?

A

Fine touch, 2-point discrimination and proprioception.

452
Q

What sensations does the spinothalamic pathway convey?

A

convey pain, itch, temperature, tactile and proprioceptive information from the contralateral side of the body to the brain

453
Q

Describe the DCML pathway.

A

Fine sensation is detected by touch or proprioception receptors. Afferent signals are carried along 1st order neurones to the dorsal columns and up to the medulla where they synapse. 2nd order neurones decussate in the medulla and travel up to the thalamus where they synapse. 3rd order neurones then travel through the internal capsule to the somatosensory cortex.

454
Q

Which dorsal column would an afferent signal from the lower limb use?

A

The gracile fasciculus (medial part of dorsal column). They then synapse at the gracile nucleus of the medulla.

455
Q

Which dorsal column would an afferent signal from the upper limb use?

A

The cuneate fasciculus (lateral part of dorsal column). They then synapse at the cuneate nucleus of the medulla.

456
Q

Describe the spinothalamic pathway.

A

Nociceptors or thermoreceptors detect pain, temperature or crude touch. 1st order neurones carrying these signals enter the spinal cord and ascend 2-3 spinal levels before synapsing in the dorsal horn of grey matter. 2nd order neurones decussate either through the anterior or lateral tracts and then travel up to the thalamus where they synapse. 3rd order neurones travel through the internal capsule to the primary somatosensory cortex.

457
Q

Where is the somatosensory cortex located?

A

Post-central gyrus in parietal lobe.

458
Q

What sensations is the lateral spinothalamic tract responsible for?

A

Pain and temperature.

459
Q

What sensation is the anterior spinothalamic tract responsible for?

A

Crude touch.

460
Q

What is the function of the spinocerebellar tracts?

A

They carry unconscious proprioceptive information to the ipsilateral cerebellum.

461
Q

Do the fibres decussate in the spinocerebellar tracts?

A

No! They go to the ipsilateral cerebellum.

462
Q

What sensation does the spinoreticular tract convey?

A

Deep/chronic pain.

463
Q

Name 5 descending pathways.

A
  1. Corticospinal. 2. Vestibulospinal.3. Rubrospinal.4. Tectospinal. 5. Reticulospinal.
464
Q

Where in the thalamus do the DCML and spinothalamic tracts synapse?

A

In the ventral posterio-lateral division (VPL) of the nucleus of thalamus.

465
Q

What descending pathways are described as pyramidal?

A

Corticospinal and corticobulbar tracts - responsible for voluntary control.

466
Q

What descending pathways are described as extrapyramidal?

A

Vestibulospinal, rubrospinal, tectospinal, reticulospinal - responsible for involuntary and automatic control of all musculature, such as muscle tone, balance, posture and locomotion.

467
Q

Are there any synapses within the descending pathways?

A

No. At the termination of the descending tracts, the neurones synapse with a lower motor neurone. (All the neurones within the descending motor system are UMNs).

468
Q

What are the corticospinal tracts responsible for?

A

The control of voluntary muscles. Anterior - axial muscles. Lateral - limb muscles.

469
Q

Describe the corticospinal tracts.

A

Originate in the primary motor cortex, descends through corona radiata and internal capsule to the medullary pyramids. 90% decussates here and becomes the lateral corticospinal tract; the remaining 10% forms the anterior corticospinal tract. The anterior tract then decussates through the anterior white commissure. Both tracts terminate in the ventral horn.

470
Q

Describe the corticobulbar tracts.

A

Originate in the primary motor cortex, descends through corona radiata and internal capsule to the brainstem. The fibres terminate on motor nuclei of cranial nerves. They synapse with LMN’s which carry motor signals to the face and neck.

471
Q

Where do the extrapyramidal tracts originate?

A

The brainstem.

472
Q

Where do the vestibulospinal tracts originate and what are they responsible for?

A
  1. Originate from vestibular nucleus.2. Responsible for muscle tone and postural control.- Remains ipsilateral.
473
Q

Where do the reticulospinal tracts originate and what are they responsible for?

A
  1. Originate from reticular formation.2. Responsible for spinal reflexes.
474
Q

What are the 3 layers of the eye?

A

Outer Layer: Sclera and Cornea

Middle Layer: Uvea

Inner Layer: Retina

475
Q

how much of the refractive power comes from the cornea?

A

2/3rd,

Other 1/3 comes from the lens refractive power

476
Q

What makes up the uvea (middle part of the eye)?

A

Iris
Ciliary body
Choroid

477
Q

What muscles are contained in the iris?

A

Sphincter Pupillae

Dilator Pupillae

478
Q

What is the function of the ciliary body in the uvea?

A

Glandular epithelium which produces aqueous humor

Smooth muscle that controls accommodation

479
Q

What is the function of the choroid in the uvea?

A

Blood supply to the outer third of the retina

480
Q

Explain Phototransduction of rod cells in the light

A

Rhodopsin chromophore retinal absorbs light photons
Causes conformational change from cis-11 retinal to trans-retinal
Opsin is activated
GTP binds to transducin
Transducing GPCR activates phosphodiesterase (PDE)
PDE breaks down cGMP
cGMP channels close and therefore there is less glutamate
less glutamate
Through ON/OFF cells, the level of glutamate causes depolarisation of hyperpolarisation of the bipolar/ganglion cells

481
Q

What are 2 properties of rod cells?

A

Highly senstive to light - lots of rod cells in the peripheral retina

Have low visual acuity - due to retinal convergence of 3 rod cells at a single ganglion cell

482
Q

what are 2 properties of cone cells?

A

Low sensitivity to light - need high light intensity for coloured vision

High visual acuity due to 1 cone cell per ganglion cell

483
Q

How does the attenuation reflex work?

A

Muscles attached to the ossicles contract causing an increased rigidity of the tympanic membrane and therefore sound conduction is diminished in the middle ear

484
Q

where is the organ of corti found?

A

In the scala media

485
Q

What is endocochlear potential?

A

endolymph electrical potential is greater than the perilymph electrical potential and therefore this enhances auditory conduction

486
Q

What is the auditory pathway from the eighth cranial nerve?

A

ECOLI:
Eighth Nerve (vestibulocochlear)
Cochlear nuclei (ipsilateral side) (medulla)
Olivary nucleus (superior on the contralateral side) (medulla)
Lateral lemniscus (PONS)
Inferior Colliculus (Cerebral peduncle)
medial geniculate body (MGB) (thalamus)

487
Q

explain the process of neuralation?

A

Notochord develops in the mesoderm
The notochord induces the thickening of the overlying ectoderm cells
The ectoderm cells then invaginate to form the neurual groove and the neural folds.
Continued invagination brings the neural folds together.
This produces the neural tube and some neural crest cells on the top.
The neural tube forms the CNS
The neural crest cells form the PNS and other glial cells involved in the support of the nervous system

488
Q

What is the internal Capsule?

A

White matter structure containing myelinated fibres of ascending and descending tracts that pass between the basal ganglia and connect the cerebral hemispheres with the subcortical structures, brainstem and spinal cord.

Year 1 Medicine (25 decks)

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