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Year 1 Medicine > Neurosciences 2 > Flashcards

Neurosciences 2 Flashcards

1
Q

What is the name of the musle that raises the eyelid?

A

Levator palpebrae superioris

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2
Q

Which muscles have direct pulls from anatomical position?

A

Lateral rectus and medial rectus

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3
Q

What does the superior rectus do?

A

Pulls the eye up
adducts
medially rotates (intorsion)

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4
Q

What does the inferior rectus do?

A 
It pulls the eye down
Adducts 
Laterally rotates (extorsion)
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5
Q

What muscules are involved in looking down?

A

Superior Oblique and Inferior rectus:
Both depress the eye and so work as synergists

SO - Medially rotates and abducts
IR - Laterally rotates and adducts
(here they are acting as antagonists)

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6
Q

Which muscles are important when looking up?

A

The inferior oblique as superior rectus:
Acting as synergists as they both elevate the eye.

IO: laterally rotates the eye and abducts
SR: Medially rotates the eye and adducts

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7
Q

What conditions are needed for testing eyes?

A

Directly in front, eyes at same level, 2 arms lengths apart

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8
Q

which muscles are tested first and how do you test them?

A

Lateral and medial rectus. as their action is isolated.

move finger horizontally across their field of vision and look for medial and lateral eye movement

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9
Q

What muscle is tested after lateral/medial rectus and how are they tested?

A

Superior and inferior rectus.

First, abduct the eye so the muscles are in line with the angle of the gaze.
Move your finger vertically and look for elevation and depression of the eye.

In the abducted view this should only be using SR and IR.

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10
Q

How is the movement of superior and inferior rectus isolated?

A

Get patient to look laterally slightly so that the pull of superior and inferior rectus is pulling in line with the axis of the eye.

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11
Q

What is the last set of muscles to be tested?

A

the obliques

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12
Q

How do you test obliques?

A

First the eye must be adducted so that the muscles are in line with the angle of the gaze.

For superior look down and for inferior oblique look up.
Ensure that there is no rotation of the eye.

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13
Q

What is the snail shaped structure called?

A

Cochlea for hearing

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14
Q

What are the 3 looped structures in the hear called?

A

the semi-circular canals (vital for balance)

Anterior, Posterior and Lateral

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15
Q

What bone are the organs of balance and hearing in?

A

petrous part of the temporal bone

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16
Q

Where does the vestibulocochlea nerve leave the skull? and what does it leave with

A

with the facial nerve it passes through the internal acoustic meatus

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17
Q

What is the arrangement of the semicircular canals?

A

Three at 90 degrees to each other lateral anterior and posterior
this is so they can detect movement of the head in different planes

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18
Q

How do the semicircular canals sense movement?

A

When the head is moved the endolymph stays in place relative to the skull and deflects the cupula within which the hair cells are imbedded

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19
Q

What is the fluid in the semicircular canals called?

A

endolymph.

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20
Q

When are the semicurcular canals not working?

A

When you are not accelerating

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21
Q

What is nystagmus?

A

They have darting eyes

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22
Q

What can cause dizzyness

A

They can be from spinning or inflamation of the hair cells from the virus

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23
Q

What is the vestibulo-ocular reflex?

A

they eyes moving the opposite way to spinning

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24
Q

How can the vestibulo-ocular reflex be tested?

A

put cold water in the ear to cause convection currents and cause nystagmus slowly towards cold water

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25
Q

What is bottom up processing?

A

sensation

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26
Q

What is top down processing?

A

Perception

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27
Q

What is sensation?

A

A mental process resulting from the immediate external stimulation of a sense organ

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28
Q

What is perception?

A

The ability to become aware of something or understand something following sensory stimulation

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29
Q

What are the 5 types of perception?

A

Tactile, olfactory, Gustation, visual and auditry

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30
Q

What is a perceptual set?

A

They psychological factors that determine how you perceive your environment

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31
Q

What things make up our perceptual set?

A

Context, Culture, Expectations and Mood & motivation

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32
Q

What is gestalt proncipal?

A

Proximity common fate, continuity, similarity, closure, common region, symetry

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33
Q

What is a hallucination?

A

Experience involving he apparent perception of something not present

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34
Q

What is charles bonet syndrome?

A

When blind people have hallucinations

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35
Q

What can cause hallucinations?

A

Drugs, Sensory deprivation, stress, psychiatric illness(schizophernia, depression with psychosis)

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36
Q

What is involved with psychiatry treatment of hallucinations?

A

Social circumstances, medications, psychology

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37
Q

What type of wave is sound?

A

compression and rarefaction transverse waves

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38
Q

What qualities does sound have?

A

High pitch/frequency amplitude is volume

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39
Q

What is the frequency range of a human?

A

20Hz-20kHz

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40
Q

What is the variability of hearing sound ranges and speech

A

hearing a range of sound is possible but speech is heard in a small range

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41
Q

How loud is too loud and quiet?

A

10dB pain is around 130dB

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42
Q

What are the components of the auditory system?

A

The outer ear middle ear and inner ear

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43
Q

What are the conduction mediums of the 3 sections of the ear?

A

Outer- air, middle-air, inner-fluid

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44
Q

What are the names of the three ossicles?

A

Malleus incus stapes

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45
Q

What is the technical term for the ear?

A

Pinna

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46
Q

Where is the outer ear?

A

From the Pina to the tympanic membrane

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47
Q

Where is the middle ear?

A

The area around the ossicles

From the tympanic membrane to the oval window

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48
Q

What is the area of the inner ear?

A

Around the cochlea and semicircular canals

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49
Q

What is the structure of the external ear?

A

Made of cartilage, and 6 hillocks

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50
Q

What is the purpose of the ear?

A

to direct sound down the ear canal

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51
Q

What are the ridges of the ear?

A

Helix, antihelix, tragus, conchal bowl and triangula fossa

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52
Q

What is the composition of the ear canal?

A

1/3 cartialage and 2/3 bone

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53
Q

What is the structure of the ear drum?

A

Tympanic membrane, 3d structure inferior is further away. Malleus is touching it and can see incus sometiems.

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54
Q

What are the two sections of the eardrum?

A

Pars flacida top third
bottom third pars tensa
anulus around it
bottom part of the ear has 3 layers

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55
Q

Which part of the tympanic membrane is more prone to dammage?

A

The pars flaccida. as only has endoderm and ectoderm not fibrous mesoderm

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56
Q

What is in the middle ear?

A

Bones- malleus, incus and stapes
Muscles such as tensor tympani and stapedius
Tubes- eustachian tubes

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57
Q

What bone is attached to the tensor tympani?

A

The malleus

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58
Q

Which bone is attached to the stapedius?

A

the stapes

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59
Q

Which nerve innervates the tensor tympani?

A

Mandibular branch of the trigeminal nerve

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60
Q

Which nerve innervates the stapedius muscle?

A

facial nerve

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61
Q

What is the action of the muscles in the ear?

A

Reduce damage of loud sounds by dampening of the sound. tensor tympani is slightly voluntary to remove chewing sound

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62
Q

What is the purpose of the bones?

A

It turns the sound in the air into fluid
usually 99.9% is lost.
acoustic impediance. they increase force amplify it like a lever 1

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63
Q

What is the eustatian tube?

A

Ventilation of the middle ear space and drainage of secretion

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64
Q

What is the labyrinth?

A

Another name for the semicircular canals

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65
Q

How many turns does the cochlea have?

A

2.5

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66
Q

What are the two openings in the ear?

A

The round window and the oval window. the oval window is for the stapedius

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67
Q

What are the three compartments of the cochlea?

A

Scala tympani, Scala media and scala vestibuli

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68
Q

What is endolymph and where is it?

A

In the scala media and has high potassium

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69
Q

Where is perilymph and what is is?

A

Sodium rich potassium poor it is in the scala vestibuli and scala tympani

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70
Q

how are the three compartments arranged?

A

The scala vestibuli is attached to the oval windo, at the tip of the cochlea is the helicotrema and changes to the scala Tympani and between the two is the scala media

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71
Q

How does sound enter the cochlea?

A

The stapedius moves the membrane of the oval window and transfers the waves into the perilymph

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72
Q

What are the boundaries of the scala media?

A

the reissners membrane to tthe scala vestibuli and basilar membrane and organ of corti in the scala tympani

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73
Q

What is the tectorial membrane?

A

a large sheet of tissue attached to the hair fibres

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74
Q

What is the importance of the basilar membrane?

A

At the base its narrow and stiff and wide and floppy at apex. the base is good for high pitch sounds the apex is good for lower pitch sound

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75
Q

How is the sound translated to nerve impulses?

A

Basillar membrane moves up and down against the tectorial membrane which is fixed. the inner and outer hair fibres connect the basillar membrane to the tectorial membrane.

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76
Q

What do the inner hair cells do?

A

sense the movement and do mechanical transductions

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77
Q

What do the outer hair cells do?

A

fine tune the sound by stiffening the basilar membrane at the wrong frequency

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78
Q

What is the importance of the nerve in the inner hair cells?

A

There are afferent and efferent nerves

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79
Q

How is the movement of the hair cells transduced into nerve impulses?

A

The endolymph is high in potassium and lets it in when the stereocillia move. it causes depolarisation and voltage gated calcium chanells open to release neurotransmitters

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80
Q

How is the pitch encoded?

A

The frequency comes from the location of stimulation of the basilar membrane

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81
Q

How is the intensity encoded?

A

How many nerves are firing and firing rate

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82
Q

how does the signal get to the brain from the ear?

A

The sensory fibre stimulates the spiral gangleon that contributes to the cochlear nerve and then into the brain

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83
Q

What happens to sound in the brain stem?

A

Cochlea Eight nerve nucleaus superior Olivary complex lateral Lemniscus and the Inferior colliculus and crosses. medial geniculat body ECOLI

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84
Q

How is sound localised?

A

The difference between signals from the right and left ear this happens in the superoior olivary complex. from coincidence on internerons

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85
Q

What are the types of hearing loss?

A

Defective outer/ middle ear= conductive hearing loss

Defective inner ear= sensorineural hearing loss

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86
Q

Where do most of the cranial nerves come from?

A

The brainstem apart from optic and olfactory

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87
Q

What divides the frontal and parietal lobes?

A

The central sulcus

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88
Q

What divides the frontal and temporal lobes?

A

the silvian fissure or lateral sulcus

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89
Q

Which part of the brain exits the foreman magnum?

A

the medulla oblongata

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90
Q

what separates the parietal and occipital lobes?

A

Parieto-occipital sulcus on medial area of the brain

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91
Q

What are brodmans areas?

A

areas based on histology, separated into sections

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92
Q

How is the frontal lobe strucutred?

A

There are 3 main giri usually

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93
Q

Where is the hand motor cortex?

A

In the omega shaped area of brain

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94
Q

Where is brocas area?

A

in front of the central girus above the temporal lobe

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95
Q

Where is the cingulate girus?

A

Around the outside of the corpus callosum

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96
Q

What are the regions of the corpus callosum?

A

Rostrum, genue, body and splenium

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97
Q

Where is the fornix?

A

Runs under the corpus callosum into the mamillary bodies

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98
Q

Where is the calcarine sulcus?

A

The primary visual cortex medial area of occipital lobe

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99
Q

How can the temporal lobe be divided?

A

Superior middle and inferior giri

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100
Q

What is the shape of the ventricles?

A

The lateral ventricles, 3rd ventricle, and 4th ventricle

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101
Q

What are the exit points for CSF?

A

Foramaen of luska and majendie

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102
Q

What are the areas of the lateral ventricles?

A

anterior/frontal horn, posterio/occipital, lateral/ temporal

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103
Q

Where can CSF collect?

A

Prepontine system, interpeduncular system, supracella system, quadrigeminal system, cisterna magna

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104
Q

Why are the CSF systems important?

A

To see where blood collects

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105
Q

What is the corona radiata?

A

Fibres from the centre of the brain to be the descending tracts

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106
Q

What colour is CSF on MRI?

A

Black on T1 White on T2

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107
Q

What is the colour of the brain on T1 weighted scan?

A

Grey matter is grey white matter is white

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108
Q

What is stress?

A 
It is either psychological (mental or emotional strain or tension resulting from adverse or demanding circumstances)
or physiological (sensory, 	emotional and subjective experience associated with potential damage of body tissue and bodily threat
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109
Q

What is Eustress?

A

Good stress is beneficial and motivating to strive towards a goal

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110
Q

What is Distress?

A

Negative stress that is damaging and harmful

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111
Q

Is stress physical or mental?

A

Both has affects in both systems

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112
Q

What is acute stress?

A

Short-lived response to a novel situation experienced by the body as a danger

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113
Q

What is chronic stress?

A

Arises from repeated or continured exposure to threatening or dangerous situations

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114
Q

What are some causes of chronic stress?

A

Physical illness, disability and pain, physical or sexual diseases, poverty, unemployment, bullying caregiving

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115
Q

What is General adaptation syndrome?

A

There are three phases to stress response. Alarm then adaptation, and finally exaustion mental and physiological

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116
Q

What are the five elements of human stress response?

A

Biochemical, physiological, behavioural, cognitive and emotional

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117
Q

How is the stress response mediated?

A

autonomic nervous system( sympathetic-adrenal medullary) and hypothalamo-pituitary axis

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118
Q

What is the sympathomedullary pathway?

A

Hypothalamus activates the adrenal medulla. this produces adrenaline and noradrenaline into the bloodstream, this prepares for floght or flight and reinforces the sympathetic activation

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119
Q

What is the pituatary adrenal system?

A

Higher brain centres stimulate the hypothalamus to release corticootrophin, the pituitary galsnd releases adrenocortocotrophic hormone andd the adrenal cortex releases corticosteroids which cause changes in the liver and the immune system is suppressed

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120
Q

What are the biochemical stress responses?

A

Glucocorticoids(cortisol) catecholamines( adrenaline noradrenaline) this is part of inflamation and immunre response in chronic low inflamation and partial supression

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121
Q

What are some of the physiological stress responses?

A

Headache, chest pain, stomach ache, musculoskeletal pain, low energy, loss of libido, colds and infections grinding teeth

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122
Q

What are the behavioural responses to stress?

A

Easily startled, change in appetite, hard to concentrate, avoiding tasks, weight change, nail biting fidgeting and pacing, sleep disturbances, withdrawal

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123
Q

What are the cognitive responses?

A

Constant worrying, racing thoughts, fogetfulness and disorganisation, inability to focus, poor judgement, being pessimistic, learning

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124
Q

What are the emotional responses?

A

Depression sadness, tearfulness, mood swings, irritability, restlessness, aggression, low self-esteem, boredom and apathy, feeling overwhelmed, rumination, anticipation and avoidance

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125
Q

What is allostasis?

A

refers to how multiple complex systems adapt collectivels it is fragile and decompensation can happen quickly

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126
Q

What is allostatic load?

A

refers to cumulative exposure to stressors and can lead to absorption

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127
Q

What are the links between stress and illness?

A

Cancer survival, skin conditions, sexual dysfuncction Medically unexplained symptoms,, obesity, CVD GI problems

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128
Q

What is evolutionary psychiatry?

A

the application of modern evoultionary theory to understand health and disease looks at diseases of civilisation. It answers why questions

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129
Q

How can some psychiatry be linked to evolutionary processes?

A

we have mental function linked to hunter gatherer type living but we have now deviated from this which leads to problems it is a species perspective not individuals

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130
Q

What is the pleistocene environment?

A

Environment of evolutionary adaptation

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131
Q

Why is it important to look at evolution in psychiatry?

A

could offer theories about substance misuse, borderline states and schizophernia, bipolar disorder, the dementias and affective disorders as well as childhood neurodevelopmental disorders

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132
Q

What are tinbergen’s questions?

A

Mechanism how does a behaviour occur?
Development how does this arise in an individual?
Evolution how does this behaviour arise in the species
Adaptive value why is this adaptation valuable

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133
Q

what are pathways that mediate evolution causing disease problems

A

Mismatch, exposure to evolutionarrily mismatched environments
Life history: reproductive age ageing menopause
Excessive defence mechanisms: pain cough are beneficial for survival but not enjoyment
Co-evolutionary considerations: other diseases evolve
Constraints: limitations for natural selection

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134
Q

What are some evolutionary symptoms that psychiatry aims to tackle?

A

Pain sickness illness behaviour, anxiety depression OCD, feer lethargy fatigue, nausea, itching, sneezing

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135
Q

What is dunbar’s number?

A

150 number of people you can maintain a stable relationship with.

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136
Q

How can schizophrenia be potentially explained by evolution?

A

Brain designed to be hunter gatherer in small tribal band know friend from foe. our society mixes this up can lead to stress and lead to it

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137
Q

what is compassion focused therapy?

A

Based on evolutionary neruoscience and psychological. there are 3 types of regulation threat protection, drive excitment, contentment, soothing and social safeness. focused on facilitating development of the compassion theory

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138
Q

What is the receptive field of the eye?

A

The area that is sensitive to light

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139
Q

What is retinal encoding?

A

When rods and cones feed into retinal ganglion cells

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140
Q

What are parvivellular RGCs good for?

A

Low-contrast High linear spatial resolution

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141
Q

What are Koniocellular RGCs good for?

A

Blue- yellow colour opponency

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142
Q

What are magnocellular RGCs?

A

High contrast, Low resolution, motion detection and colour blind

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143
Q

What is the island of vision?

A

There is a very small part of vision that is very sensitive

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144
Q

What is the optic chiasm?

A

a structure that fuses some of the inputs of the eye to allow integratio of information from both eyes

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145
Q

What is the lateral geniculat nucleus?

A

The nucleaus in the brainstem for visual informaton. synaps of first order retinal ganglion cells to 2nd order neurons. there are layers for the three types or retinal ganglion cells

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146
Q

what is the dorsal stream pathway for vision?

A

where pathway

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147
Q

What is the ventral stream pathway

A

What pathway

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148
Q

How is depth percieved?

A

Familiar size objects can be judged small objects are assumed to be smaller, linear perspective occlusion, shadows and illumination, motion parallax can be used too

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149
Q

How is colour percieved?

A

Colour isnt a constant it is taken with context of what is around the object

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150
Q

Why do we move our eyes?

A

Clear vision of an object requires that its image be held teadily on the retina clearest when focussed on the retina, these aid vision

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151
Q

What is vestibular eyemovemnet?

A

Holds images of the seen world steady on the retina during brief head rotations or translations.

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152
Q

What is visual fixation?

A

Holda the image of a stationary object on the fovea

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153
Q

What is optokinetic eye ovement?

A

Holds images of the seen world steadt on the retina during sustained head rotation

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154
Q

what is smooth persuit eye movement?

A

holds the image of a small moving target or oposite way round with movement

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155
Q

What is nystagmus quick phases?

A

Reser the eyes during prolongued rotation to direct gaze to oncoming scene

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156
Q

What are saccades eye movements?

A

Bringing objects of interest into the fovea

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157
Q

What are vergence eye movements?

A

Moves the eyes in opposite directions so that images of a single opject are placed or held on the fovea of each eye

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158
Q

What areas of the brain are involved in eye movements?

A

THe primary visual cortex

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159
Q

What are the roles of saccades?

A

Searching the environment, reflexive to noise or touch, voluntary to look at specific things can be surpressed

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160
Q

What areas are involved with persuit saccades?

A

Parietal cortex,

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161
Q

Are the cranial nerves PNS or CNS?

A

PNS but optic and olfactory are more CNS

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162
Q

What are the sensory functions that nerves can have?

A

Somatic, general sensation and special sensation also autonomic sensations

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163
Q

What are the motor functions?

A

Muscle contraction conscious and subconscious for non skeletal muscle glands

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164
Q

Which cranial nerves carry parasympathetic fibres?

A

1937 = 10,9,7,3

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165
Q

What is CNI?

A

olfactory

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166
Q

Which nerve is the olfctory?

A

CNI

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167
Q

Where does CNI leave the skull?

A

The cribiform plate

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168
Q

What does the olfactory do?

A

Sense of smell. it goes directly to the cortex

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169
Q

What is special thing about the sense of smell?

A

it doesnt pass through the thalamus

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170
Q

How much of smell crosses sides?

A

15%

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171
Q

How can you test olfaction?

A

Get something smelly and see if they can guess it

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172
Q

What can damage the olfactory nerve?

A

Sudden deceleration severing nerves

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173
Q

What is cranial nerve 2?

A

Optic nerve

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174
Q

What is the optic nerve?

A

CNII

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175
Q

What does the optic nerve do?

A

Vision sense

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176
Q

What is the exit point of the optic nerve?

A

the optic canal

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177
Q

How can you tell if you have intercranial hypertension?

A

if the optic disk is swolen

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178
Q

How does image from the right eye travel?

A

the nasal retina crosses through the other side the temporal side stay the same side.

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179
Q

Where do thefirst neurons synapse?

A

The lateral geniculate nucleus

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180
Q

What happens when the right optic nerve is cut?

A

Blindness in the right eye only

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181
Q

What happens if you damage the right optic tract?

A

You lose the right side of vision from both eyes left sided homonomous hemianopia

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182
Q

What happens if there is damage to the optic chiasm?

A

both eyes cant see the temporal regions bitemporal hemianopia

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183
Q

What happens with damage to the temporal lobe on the right?

A

The optic radiation is affected and you cant see the upper area.

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184
Q

What happens in the pretectal nucleus superior colliculus in vision?

A

Fibres from the optic nerve synapse to there and leving to the edinger-westphal nucleuse to supply the pupil through the 3rd nerve

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185
Q

How can you test the optic nerve?

A

Visual fields, pupil reflexes, visual acuity, fundoscopy.

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186
Q

When testing the visual acuity what else are you testing?

A

The cornea the lens and humours of the eye as well as the optic nerve

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187
Q

How should the optic disk usually move when you move left or right?

A

the lighter part is a cup and the lighter part moves in the same direction as the head

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188
Q

What is the optic disk like when its swollen?

A

The lighter part moves to the oposite side that you move your head

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189
Q

How do you test the pupil?

A

Shine it into both the eyes and watch for reaction in both eyes.
look for constriction on accommodation

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190
Q

What does sympathetic innervation to the eye do?

A

Lift the eyelid and dilate the pupil

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191
Q

What is the difference with the occulomortor nerve?

A

It has parasympathetic and controls most muscles of the eye and does constriction of the pupil

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192
Q

What nerve is the occulomotor nerve?

A

The CVIII

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193
Q

Which nerve is CNIII?

A

Occulomotor

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194
Q

Which nerve is CNIV

A

trochlear

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195
Q

Which nerve is the trochlear?

A

CNIV

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196
Q

What does the trochlear nerve do?

A

Innervates the superior oblique muscle

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197
Q

What nerve is the abducens?

A

CNVI

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198
Q

What is CNVI?

A

The sixth cranial nerve abducens

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199
Q

What does the abducens nerve do?

A

Innervates lateral rectus

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200
Q

Which muscles does CNIII do?

A

superior rectus, inferior rectus, medial rectus, inferior oblique, and parasympathetic to the pupil and focus the lens

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201
Q

Where does the third cranial nerve exit the brain?

A

Through the interpeduncular fossa

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202
Q

Where does the fourth nerve leave the brain?

A

The posterior below inferior colliculus

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203
Q

Where does the sixth cranial nerve leave the brain?

A

The bulbopontine fissure

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204
Q

Where does the occulomotor nerve leave the skull?

A

The superior orbital fissure

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205
Q

Where does the absucens nerve leave the skull?

A

The superior orbital fissure

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206
Q

Where does the Troclear nerve leave the skull?

A

The superior orbital fissure

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207
Q

Which nerves pass through the superior orbital fissure?T

A

The occulomotor, the trochlea, the abducens

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208
Q

Which nerves pass though the cavernous sinus?

A

CN III oculomotor 4th trochlear parts of trigeminal opthalmic maxillary and the abducens nerve

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209
Q

What happens with the third cranial nerve pallsy?

A

Down and out from lateral rectus and superior oblique

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210
Q

What happens with trochelar nerve pallsy?

A

Double vision when looking down the stairs

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211
Q

what happens with abducens nerve problems?

A

Cant look laterally

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212
Q

What does the trigeminal nerve do?

A

Sensation to the face and mouth muscles

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213
Q

What nerve is the trigeminal?

A

CN V

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214
Q

Which nerve is CN V?

A

the trigeminal nerve

215
Q

what are the three divisions of the trigminal nerve?

A

opthalmic maillary and mandibular

216
Q

Where does the opthalmic division of the trigeminal sensation include?

A

Cornea sclera alont top of nose up to top of head and the frontal sinuses and ethmoid

217
Q

Where does the maxillary division of the trigeminal sensation include?

A

just above eyes laterally under eyes and above the mouth, roof of the mouth upper teeth, maxillary sinuses

218
Q

Where does the mandibular division of the trigeminal sensation include?

A

Lower mouth muscles of mastication floor of the mouth. normal sensation to the anterior two thirds of the tongue lower teeth

219
Q

Where does the trigeminal nerve exit the brain?

A

The edge of the pons

220
Q

Where does CN VII exit the brain?

A

The medulla

221
Q

Where does CN VIII exit the brain?

A

The pontine medulla fissure

222
Q

Where does CN IX exit the brain?

A

The medulla

223
Q

Where does CN X exit the brain?

A

The medulla

224
Q

Where does CN XI exit the brain?

A

The medulla

225
Q

Where does CN XII exit the brain?

A

The medulla

226
Q

What nerve is the facial nerve?

A

CN VII

227
Q

What is CN VII?

A

Fascial nerve

228
Q

What does the facial nerve do?

A

the muscle of the face for expression and stapedius, it also does lacrimal submandibilar andsublingual salivary glands
also the sopecial sense of taste buds of anterior two thirds of the tongue

229
Q

What can be a sign of 7th nerve palsy?

A

hearing sound too loud or better

230
Q

How many origins are ther of the facial nerve?

A

3 separate ones

231
Q

What are the superficial branches of the facial nerve?

A

Temporal zygomatic buccal mandibular, cervicle and posterior. Splits inside the parotid gland

232
Q

Where does the cranial nerve 7 leave the skull?

A

the sylo-mastoid foramen

233
Q

What is clinically relavant about the control of the facial muscles?

A

The lower half of the faces only has contralateral innervation and the top half has bilateral. forehead sparing

234
Q

What can lead to facial palsy?

A

Bells palsy virus, fracturs to the temporal bone, middle ea infections tumouts of parotid

235
Q

What does the vestibulorcochlear do?

A

It carries sound signals and balance

236
Q

Which nerve is the 8th nerve?

A

Vestibulocochlear

237
Q

Which nerve is the vestibulocochlear?

A

the CN VIII

238
Q

What is the utricle and saccule

A

Urticle detects acceleration in the horizontal plane

Saccule detects acceleration in the Verticle plane

239
Q

Where does the vestibulocochlear nerve pass through the skull?

A

The internal acoustic meatus

240
Q

How can you examine the cochlear directly?

A

By placing a vibrating tuning fork on the bone

241
Q

What is cranial nerve 9?

A

Glossopharyngeal nerve

242
Q

Which nerve is the glossopharyngeal nerve

A

the 9th nerve

243
Q

Where does the glossopharyngeal nerve leave the skull?

A

Jugular foramen

244
Q

What does the 9th nerve do?

A

motor to stylopharengeas muscle, parotid gland secretions, sensation of skin of external ear, touch to posterior third of pharynx and eustation tube, taste to the posterior thrid of the tongue also carotid bodies

245
Q

What is cranial nerve X?

A

the vagus

246
Q

What nerve is the vagus?

A

X

247
Q

What does the vagus nerve do?

A

Muscle of pharynx and larynx, autonomic motor to abdomen, sensory to external ear, sensory for parynx larynx aortic arch and abdominal viscera, taste to epiglottis

248
Q

How can the vagus and glossopharengeal nerve be examined?

A

To look at the quality of their voice look at the soft palate

249
Q

What is the acessory nerve?

A

CNXI

250
Q

What is CN XII?

A

The acressory nerve

251
Q

What does the acessory nerve do?

A

Sternocleidomastoid and trapezius muscles

252
Q

What is special about the acessory nerve?

A

They send signals from the spinal cord up the foramen manum then comes back through the juglular foramen

253
Q

What is thelink between CN 10 and 11?

A

Can have larynx linked to it

254
Q

Which nerve is the hypoglossal?

A

CNXII

255
Q

Which nerve is CNXII?

A

Hypoglossal

256
Q

Where does the hypoglossal nerve exit the skull?

A

The hypoglossal canal

257
Q

What does the hypoglossal nerve do?

A

intrinsic muscles of the tongue and extrinsic

258
Q

What is pain?

A

An unpleasant senory and emotional experience associated with the actual or potential tissue damage or described in terms of such damage

259
Q

What is nociceptive pain?

A

Pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors

260
Q

What is neuropathinc pain?

A

Pain caused by a lesion or disease of the somatosensory nervous system

261
Q

What is nociplastic pain?

A

Pain that arises from altered nociceptive despite no clear evidence of it being one of the others

262
Q

What is allodynia?

A

Pain due to a stimulus that shouldn’t provoke pain

263
Q

What is dysesthesia?

A

An unpleasant abnormal sensation, whether spontaneous or evoked

264
Q

What is hyperalgesia?

A

Increased pain from a stimulus that normally provokes pain

265
Q

What is hypoalgesia?

A

diminished pain in response to a normal painful stimulus

266
Q

What is hypoesthesia?

A

Decreased sensitivity to stimulation, excluding special senses

267
Q

What is acute pain?

A

Pain for less that 12 weeks

268
Q

What is chronic pain?

A

Pain beyond 12 weeks, longer than tissue healing

269
Q

What can chronic pain be split into?

A

cancer and non-cancer pain

270
Q

What are nociceptors?

A

They are sensory neurons that are found in any area of the body that can cause pain either externally or internally

271
Q

What areas are nociceptors found?

A

Skin cornea mucosa, organs, joints muscles

272
Q

Where are the cell bodies of the nociceptors?

A

In the dorsal root ganglion or trigeminal ganglion for the face

273
Q

What is the pain pathway?

A

Receptors in the site are activated, it enters the dorsal rood where the ganglion is, then enters te spinal cord in the dorsal horn and crosses to the contralatral side to the spinothalamic tract which runs to the thalamus, then to the somatosensory cortex

274
Q

What can switch on the pain impulse?

A

Lots of cytokines and inflamatory markers

275
Q

What are the types of pain fibres?

A

A delta fibres and C fibres

276
Q

What are the fastest fibres?

A

A delta myelinated

277
Q

What are the C fibres?

A

Pain mechanical thermal and chemical that are non myelinated

278
Q

What are A alpha fibres?

A

Proprioceptive myelinated firbes

279
Q

What are A beta fibres?

A

Touch fibres that are myelinated

280
Q

What is A delta firbes?

A

pain mechanical and thermal myelinated fibres

281
Q

Describe the stpinal thalamic path?

A

2nd order neurons are from th spinal cord the axons decussate at higher level to where they enter and then are in lateral or anterior parts

282
Q

What is the role of the thalamus in pain?

A

It relays the signal to other areas and reciprocates connections to cortex

283
Q

What is cortical reorganisation?

A

When a limb is lost the sensory cortex is remapped and signals move the homunculus that can cause pain

284
Q

What is the insular cortex involved in pain?

A

perception and motor control with self awarness and interpersonal things the degree of paincan be managed here

285
Q

What does the cingulate cortex do in chronic pain?

A

linked with the limbic system and is associated with pain interpretation

286
Q

What does the amygdala do in chronic pain?

A

Plays a key role in emotional responses and interpretation of pain

287
Q

What are the symptoms of depression?

A

Biological: poor sleep, poor appetite, reduced libido, poor concentration
Cognitive: worthlessness, Guilt, Hopelessness, Suicidal thoughts
low mood low energy

288
Q

What is the role of stress?

A

Experience, genetics can lead to body/ mind being susceptible to stress

289
Q

What is the link with depression and HPA axis?

A

High levels of cortisol stress hormone over an extended period. they have enlarged adrenals and pituitary and the negative feedback is not as good

290
Q

What is a causitive factor in HPA function?

A

Poor care when young means have less control of HPA

291
Q

How does stress damage the brain?

A

Neurotoxic steroids, neuro-vulnerability, reduced neurogenesis

292
Q

Which part of the brain is dammaged more in depressions?

A

Medial prefrontal cortex for emotional states, and dorsolateral prefrontal cortex for working memory problem soloving,
Hippocampus
Frontal lobes

293
Q

How do anti-depressants work?

A

They boost serotonergic and adrenergic transmission. increase glucocorticoid expressant gene expression in the brain through G coupled proteins. to help regulate HPA

294
Q

How can depression be explained by evolution?

A

q

295
Q

What is the default mode in the brain?

A

When you’re not thinking about things the areas of the brain that are active.

296
Q

What is the role of the default mode network relavance to depression?

A

depression is linked with thinking about yourself going in circles

297
Q

What happens in default mode network?

A

Autobiographical details, self reference, thinking about others social judgements

298
Q

What is the idea of surprise and the brain?

A

It creates models to try and reduce surprise. which can lead to depression or other mental health diseases

299
Q

What is the treatment for depression?

A

Mindfulness reduces default mode network

300
Q

What is involved in the papez circuit and memory?

A

Amygdala, hippocampus, fornix, cingulate gyrus, mamillary hodies hypothalamus

301
Q

What is the limbic system responsible for?

A

memory and emotions

302
Q

What is the hippocampus responsble for?

A

The formation of new memories. not new skills, working memory, emotional memory

303
Q

Which area of the brain is involved in working memory?

A

Prefrontal cortex

304
Q

Which area of the brain is involved in emotional memory?

A

Amygdala

305
Q

Which area is involved with conditiond reflex memory?

A

The cerebellum and others

306
Q

What is the hypothalamus like?

A

Lots oc nuclei that are involved with thirst hunger temperatrue sleep sexual urges endocrine influences

307
Q

What are the mamillary bodies involved with?

A

The laying down of new memories

308
Q

What areas of the brain are involved with movement?

A

Cerebellum, Basal ganglia, motor cortex, brainstem motor nuclei, spinal cord

309
Q

What initiates motor control?

A

The upper motor neurons in the cortex

310
Q

Where are lower motor neurons?

A

in the spinal cord and to periphery.

311
Q

Does training change the number of fibres?

A

no it just changes the area of each fibre

312
Q

How are large range and strengths of movement achieved?

A

Antagonistic arangements, recruitment so muscles fibres can be gradually activated to get the required force

313
Q

What are alpha motor neurones?

A

they are muscle fibres to muscles that are controlled voluntarily

314
Q

What is a motor unit?

A

The since alpha neuron and all the muscle fibres it innervates

315
Q

Are motor units always the same size?

A

It varies depending on the use of the muscle

316
Q

What is the motor pool?

A

all the motor neurons that innervate a single muscle. they contain alpha and gamma motor neurons,

317
Q

What are the regions of the spinal cord?

A

White matter grey matter grey in the middle, ventral and dorsal horns

318
Q

Where does sensory information enter the spinal cord?

A

Dorsal route

319
Q

What do the golgi tendon organs do?

A

They sense tension

320
Q

What do muscle spindles sense?

A

length of the muscles

321
Q

What are golgi tendon organs like?

A

They have sensory fibres 1b that exit from the tendon and are involved with inhibiting muscle tension when it risks dammage

322
Q

Why are muscle spindles important?

A

they can activate muscles when they are at risk of hyper movments and involved in proprioception to correct small movements

323
Q

what are another name for muscle spindles?

A

intrafusal muscle fibres

324
Q

what type of nerve innervates the intrafusal muscle fibre?

A

Gamma motor neurons

325
Q

What is size principal?

A

The smaller motor units are recruited first then bigger after.

326
Q

Which areas of the brain are involved by speech?

A

The primitive cortex can be controlled by the cortex though

327
Q

Where do motor commands originate?

A

In the grey matter of the cortex. and often down to the spinal cord

328
Q

What does the cerebellum do in movement?

A

it corrects movements and modulates the effects off the motor signals. also involved in motor learning and emotional processing

329
Q

What do the basal ganglia do in movement?

A

It receives cerebral cortex information and imhibits the condiction of the signals to motor neurons.
involves a double negative system. it inhibits everything and then disinhibits the selected activity

330
Q

What is the use of the hominculus?

A

It can help identify symptoms but it is overlapping and slightly variable

331
Q

Where do the descending projections go?

A

through the medulla in the primary pyramid and decussates.

332
Q

What is a pyramidal tract and why is it called that?

A

The cortical nerve cells which cary motor singals down from the cortex. they are pyramidal neurons

333
Q

What are the important tracts in motor control?

A

The dorsolateral tracts and ventromedial tracts

334
Q

What is the path of the dorsolateral corticospinal tract?

A

From the cortex down through the medullary pyramid and it decussates below that into the spinal cord

335
Q

What is the pathway of the dorsolateral corticorubrospinal tract?

A

From the cortex through the red nucleus, then decussates to the contralateral side before the pyramids

336
Q

What is the pathway of the ventromedial corticospial tract?

A

From the cortex to thespinal cord on the ipsilateral side used for the trunk

337
Q

What are the similarites between dorsolateral tracts and ventromedial tracts?

A

Both direct corticospinal route, both alternative routes via red nucleaus or tectum , dorsolateral does contralateral and other does both sides, dorsolateral does distal muscles other does proximal

338
Q

What are involved in the basal ganglia?

A

Globus pallidus, caudate, putamen,

339
Q

What is the disinhibitory mechanism in the basal ganglia

A

at rest the caudate is resting and globus palidus fires which inhibits the thalamus and motor cortex. if you activate the caudate from substantia nigra. this disinhibits the globus pallidus and allows the thalamus and motor cortex to act

340
Q

Other than motor actions, what is the basal ganglis used for?

A

It could be involved in limbic processing

341
Q

What happens in cerebellum disfunction?

A

Intention tremmor, voluntary movement is jerky and loses fluidity, oftem seem drunk

342
Q

Where does the cerebellum get signals from?

A

motor cortex, somatosensory areas, proprioceptive spinal informations, vestibular information from ear

343
Q

What is grey matter?

A

neurones and processes, less myelinates

344
Q

What are association fibres?

A

Anteior to posterior fibres

345
Q

What are commissural fibres?

A

that connect the two sides

346
Q

What are projection fibres?

A

Ones that connect vertically in the brain

347
Q

Where is the insula?

A

inside the lateral fissure

348
Q

What are the frontal lobes involved with?

A

Higher level functioning such as motor, problem solving memory judgement impulse control, higher cognitive function and language

349
Q

How do you locate the central sulcus?

A

Find 2 giri and 3 sulci. deepest continuous sulcus.

350
Q

What order is the motor homunculous in the human from corpus callosum to lateral fissure.

A

genitals foot leg shoulder elbow wrist hand fingers eyes nose face lips jaw tongue pharynx

351
Q

What is the temporal lobe involved with?

A

Semantic processing the meaning, memory language and primary auditory cortex

352
Q

What is the parietal lobes involved with?

A

In dominant perception language maths, non dominant visuospatial function

353
Q

What is the occipital lobes used for?

A

Mainly visual

354
Q

What is a structure around the occipital lobe?

A

striate cortex, stria of gennari, the calcarine fissure

355
Q

How many layers of cells are there in the neocortex?

A

6

356
Q

What is parcelation?

A

Dividing the brain into many parts like brodmann areas

357
Q

What is asymetries of the brain?

A

left occipital larger right frontal

358
Q

What is the dura mater?

A

Contains lots of collagen, it is closely associated witht he periosteum

359
Q

What layer is under the dura mater?

A

The arachnid mater where the blood vessels lie in the surface of the brain

360
Q

Where is CSF in the brain?

A

between pia mata and arachnoid mater

361
Q

Where is the pia mater?

A

It is very close to the surface of the brain

362
Q

where are areas that the dura mater dives down?

A

Falx ceribri between the two hemispheres, tentorium cerebelli between cerebrum and cerebellum and the falx cerebelli between the cerebellar hemispheres

363
Q

where is the superior sagital siunus?

A

In the falx cerbri at the top

364
Q

Where is the inferior sagital sinus?

A

In the falx ceribri lower down

365
Q

What are arachnoid cisterns

A

area between arachnoid and pia mater where CSF can collect

366
Q

What is the structure of the autonomic nerve?

A

they are often very small and fine fibres

367
Q

What is different in the autonomic to somatic in terms of synaoses?

A

There are ganglia after they leave the CNS to control things in the somatic its got no synapses after the spine

368
Q

Is the autonomic system stiumulatory or inhibitory?

A

Both

369
Q

What are the neurotransitters used in the autonomic motor neuron pathway symopathetic?

A

first ganglion is autonomic ganglion which is acetyl choline nicotinic receptors, then at the effector is noradrenaline with adrenergic receptors

370
Q

Which fibres in the autonomic nervous system are normally myelinated and which are normally unmyelinated?

A

preganglionic - myelinated

post ganglionic - unmyelinated

371
Q

What nerves are involved in the parasympathetic?

A

1937, CN X,IX,VII,III and sacral outflow

372
Q

What nerves are involved in sympathetic?

A

they sympathetic chain ganglia with nerves from 3 cervical 11 thoracic and 4 lumbar and a few sacral T1 to L2

373
Q

What are the roles of the autonomic nervous system?

A

thermoregulation, exercise digestion, sexual function

374
Q

What can the sympathetic nervous system do?

A

Adrenaline release, increased BP, glucose release pupils dilate, chest pain heart pumps faster, sweating, shallow breathing,

375
Q

What can overstimulation of sympathetic stimulation by stress do?

A

High BP dammages things causes Heart attack angina stroke, more clogging

376
Q

What often is wrong in text books?

A

Sympathetic does ejaculation, parasympathetic erection, also does vasodilation

377
Q

What are the neurotransmitters used in the autonomic motor neuron pathway parasymopathetic?

A

first ganglion is autonomic ganglion which is acetyl choline with nicotinic receptors, then at the effector is acetylcholine with muscarinic receptors

378
Q

What are some of the parasympathetic ganglia in the head?

A

Cilliary, submandibular glands, otic ganglion

379
Q

where is the origin of the sympatetic nerves?

A

The brainstem

380
Q

What are the exit pathway of the sympathetic nerves from the spinal cord?

A

The white rami communicates to enter the sympathetic chain post ganglionic is after that lateral grey horn

381
Q

What is the aortic plexus?

A

It is involved with sensing of BP

382
Q

What happens when the adrenal medulla is stimulates by the sympathetic nerve system?

A

releases adrenaline to amplify the signals to the body

383
Q

What is the enteric nervous system?

A

separate system that can function on its own in the body

384
Q

What are the receptors for noradrenaline?

A

Alpha 1 or 2 in blood vessels, beta 1 in heart 2 bronchi 3

385
Q

What are the carotid receptors?

A

in bifurcation of the carotid, has chemo receptors sensitve to oxygen and pH and also mecano receptors for stretch

386
Q

Which nerve caries signals from the carotid bodies?

A

9th CN

387
Q

What is a primary ANS isorder?

A

Where the signals are not being sent properly

388
Q

What is a secondary disorder of the ANS?

A

when the nerves carrying the system are not functioning diabetes guillain barre syndrome HIV Chagas disease

389
Q

What are symptoms of ANS disorders?

A

Postural hypertension, supine hypertension, tachycardia bradycardia and fainting, sweating excessive thermoregulation, GI problems

390
Q

What makes up the basal ganglia?

A

Striatum (putamen, caudate), globus pallidus, subthalamic nucleus substantia nigra

391
Q

Where are the basal ganglia?

A

Inside is the globus pallidus, then striatum outside

392
Q

What makes the internal wall of the lateral ventricles?

A

the caudate

393
Q

Which dysfunctions are related to the basal ganglia?

A

Parkinsons, Huntingtons, Dystonia, tourettes syndrome, OCD ADHD,cerebral palsy wilsons disease

394
Q

What are the symptoms and reason for parkinsons disease?

A

increased muscle tone, reduced movements. not enough dopamine

395
Q

What are the symptoms and reason for huntington’s disease?

A

decreased muscle tone, overshooting movements too much dopamine

396
Q

What is the synthesis of dopamine?

A

L-tyrosine, L-DOPA dopamine then norepinephrine, epinephrine

397
Q

What is produced in the substantia nigra?

A

dopamine

398
Q

How can you tell someone has parkinson’s from their brain?

A

Reduces size of substantia nigra

399
Q

How can you tell someone has Huntingtons’s from their brain?

A

extra substantia naigra

400
Q

What is reduced in size in huntingtons disease?

A

The caudate nucleus

401
Q

What is the function of the basal ganglia?

A

regulation of movement signals come from the cortex go back to cortex and then result in movement

402
Q

What does dopamine do?

A

It allows movement via the substantia nigra

403
Q

What does GABA do?

A

Inhibits movement from the striatum

404
Q

What are the symptoms of Parkinson’s?

A

Brady/Akinesia- struggle doing up buttons writing small and difficulty walking
Tremor- resting tremor
Rigidity- pain and hard to turn in bed

405
Q

What are treatments for Parkinsons?

A

Increase availability of dopamine reduces acetylcholine L-DOPA but doesn’t treat underlying cause

406
Q

What stimulation can be used in Parkinson disease sufferers?

A

Stimulation of the subthalamic nucleus

407
Q

Why does stimulation of the subthalamic nucleus reduce symptoms of PD?

A

lesioning of the nucleus means it cannot inhibit the struiatum and signals reach the thalamus

408
Q

What are the symptoms of Huntingtons?

A

Chorea, dementia psychiatric illness, personality change

409
Q

What causes Huntingtons?

A

repeat of sequence, that is normal

410
Q

What is hemiballism?

A

due to lesion in the subthalamic nucleus

411
Q

What is the lentiform nucleus?

A

the putamen and globus pallidus

412
Q

What is the ventral striatum?

A

Below the anterior commisural fibres

413
Q

What separates the caudate from the putamen?

A

The internal capsule(anterior limb)

414
Q

What separates the putamen and the globus pallidus from the thalamus?

A

The internal capsule(posterior limb

415
Q

Where is the sub thalamic nucleus?

A

beneath the thalamus

416
Q

Why is globus pallidus dark on T2 weighted scan and red nucleus?

A

Has iron in it

417
Q

How does fMRI work?

A

Uses blood oxygen level dependant contrast, done repetitions analysis by software

418
Q

How can fMRI be useful clinically?

A

Looking at how much they can remove in surgery

419
Q

What are the three main hazards present in an MR environment?

A

Projectile effect
Heating
Implants

420
Q

What is the MRI environment?

A

The room where the MRI scanner is

421
Q

What are the areas of scanners?

A

Controlled Access areas and MR environment both access cardrestricted

422
Q

When is the MRI machine turned on?

A

All the time

423
Q

What cannot go into the MR environment?

A

Money bank cards, metal items

424
Q

What are some physiological effects?

A

Peripheral nerve stimulation, vertigo nausia and its loud

425
Q

What are the three safety labels?

A

MR safe objects that are non metallic non magnetic and non conductive
MR conditional meaning it is treated under certain restrictions
MR unsafe cannot go in the room

426
Q

What is the deal with implanted devices?

A

Some are safe others are not

427
Q

What is the responsibility of the referer?

A

To notify of the problems the patient has and any potential risks

428
Q

What can persistant pain effect?

A

Ability to work, activities social daily, satisfaction enjoyment, contact with others relationships, slef conidence

429
Q

How can pain affect a patients symptoms?

A

Sleeping patters, poor concentration, mood, sense of self, pre-occupied.

430
Q

Why is chronic pain more difficult than acute pain?

A

No use like a warning, no diagnosis, treatment probably won’t cure it, others dont understand

431
Q

What are the two patterns of chronic pain?

A

Take it easy- people rest and get worried about doing things so never do it
Boom and Bust- people try too hard burn out and then have to stop then try again to catch up with what they missed

432
Q

What is the problem with take it easy?

A

Lose muscles isolation too much time on hands and focused on pain, leading to depression and deconditioning

433
Q

What are the 3 ps of pain?

A

Pacing, Prioritising and planning. work within limits while being productive as possible

434
Q

What are the challenges of 3Ps?

A

Might not do as much as really want, not as good as before, other events can’t be changed

435
Q

What can relaxation do for pain?

A

reduces muscle tension from pain, which leads to aches and discomforts. Recognises the tension, change experience of pain, helpful for dealing with stress,

436
Q

How can distraction be used for pain managment?

A

Focusing on other things other than the pain, includes activities or thinking about something like mental imagary

437
Q

What is a box of tools in pain?

A

Box of things to help them with the pain to help deal with pain

438
Q

What things can affect mental health?

A

Biological, psycological social all have their own ways of addressing things

439
Q

What are common mental health disorders/problems?

A

Depression, generalsised anxiety disorder, panic disorder, phobias, social anxiety disorder, OCD PTSD

440
Q

Who has more mental health problems?

A

Younder people/ middle age, women as well

441
Q

What is the trend with mental health problems?

A

More people asking for help, rates of problems, more antidepressants prescribed

442
Q

Are rates going up?

A

Possibly but it is hard to tell as lots of factors at play

443
Q

What could make things worse in terms of mental health?

A

worsening economic conditions, changes to services, increasing inequality isolation loss of meaning or hope

444
Q

What are the symptoms of depression?

A

Sadness loss of interest or pleasure, feelings of guilt or low self-worth diturbed sleep appetite, tiredness and poor concentration

445
Q

How common is depression and anxiety?

A

1in 6 have it at any time

446
Q

What is the link with depression and physcial health?

A

It is linked to many diseases and harder for people to follow treatments

447
Q

What is the link between physical health and depression?

A

Certain diseases can lead to depression for a variety of reasons

448
Q

What are the trends in suicide rates in the UK?

A

Leading cause of death in men under 45, less likely to seek help

449
Q

What is the blood brain barrier for?

A

To regulate the nutrients entering the CSF

450
Q

What forms the blood brain barrier?

A

the capillary endothelial cells with tight junctions, the basement membrane not fenestrated, pericytes and astrocytes foot processes

451
Q

What are the main arerial supplies to the brain?

A

Vertebral arteries, internal carotid artery.

452
Q

Which arteries are supplied by the vertebral arteries?

A

Posterior inferior cerebellar artery, anterior inferior cerebelar artery, superior cerebellar artery, pontine branches, posterior serebral artery

453
Q

What is the posterior circulation?

A

The area of arteries supplied by the vertebral arteries

454
Q

What sipplies the basilar artery?

A

the vertebral arteries

455
Q

Which vessels are in the anterior ciculation?

A

the anterior cerebral artery the middle cerebral artery

456
Q

Where does the anterior cerebral artery supply?

A

The medial surface and margins of the central sulcus.

457
Q

What does the middle cerebral artery?

A

The temporal lobes and lateral parts of the brain

458
Q

What does the posterior ccerebral artery do?

A

Supplies the medial and posteria surface of the occipital cortex

459
Q

What is the great cerebral vein of Galen?

A

Where the internal cerebral vein, straight sinus join to go into the transvers sinus and jugular vein

460
Q

What is the vasculaure of the spinal cord?

A

Along the anterior there are the spinal cord arteries and veins on the posterior thre is a complex plexus of veins

461
Q

what area is the inferior horn of the lateral ventricle in?

A

The temporal lobe

462
Q

What area of the brain is the anterior horns of the lateral ventricle?

A

It is in the frontal lobes

463
Q

What connects the 2nd and third ventricle?

A

Interventricular foramen (of monroe)

464
Q

What connects the 3rd and 4th ventricle?

A

the cerebral aqueduct/ slylvius

465
Q

What are the two exits of the fourth ventricles?

A

Foramen of majendie in middle foramen of Luska in the lateral

466
Q

Where does the crebral aqueduct pass through?

A

the basal ganglia

467
Q

What are ependymal cells?

A

They are cilliated cells that help to the flow of CSF

468
Q

What is choroid plexus and where is it?

A

Choroid plexus is in the lateral ventricles and the 4th ventricles it is responsible for production of CSF

469
Q

Where does the CSF drain?

A

Through the arachnoid granulations. also peripheral nerves and into sinuses directly

470
Q

What are the anterior visible structures of the brainstem?

A

The pons mamillary bodies, bulbo pontine sulcus, olive pyramid anterior median fissure

471
Q

What are the regions of the pons?

A

The middle, inferior and superior cerebral peduncles

472
Q

What are the strucures of te posterior brainstem?

A

The thalamus, the superior colliculi, inferior colliculi and floor of the 4th ventricle cuneate tubercle and gracile tubercle

473
Q

What do the superior colliculi do?

A

they are involved in visulal perception and communicate wiht the lateral genigulate nucleus

474
Q

What doe the inferior colliculi do?

A

They deal with auditory information, medial geniculat nucleus of the brain and thalamus

475
Q

What is the name for the 4th vetricle surface?

A

The rhomboid fossa

476
Q

What are the strucutres of the superior midbrain?

A

Tectum- the colliculi periaqueductal grey, the cerebral aqueduct
Tegmentum- crus cerebri, redu nucleus substantia nigra

477
Q

What is in the medulla cross section?

A

The pyramids, spinocerebellar tracts, nucleus cuneatus fasciculus cuneatus, the same for gracilis

478
Q

Where is the anterior commisure?

A

The front of the lateral ventricle near the hypothalamus

479
Q

Where is the pineal gland?

A

It is below the splenium of the corpus callosum

480
Q

What can interrrupt the 3rd ventircle?

A

The interthalamic adhesion

481
Q

What is involved in the papez circuit?

A

entorhinal cortex, the hippocampus, fimbria fornix mamillary bodies, thalamus, cingulate girus, cingulate bundle posteriorly into enteorhinal cortex

482
Q

where is the thalamus?

A

posterior to the globus pallidus

483
Q

What does the internal capsule separate?

A

The globus pallidus and caudate anteriorly and posteriorly the thalamus

484
Q

What does the external capsule separate?

A

It separates the putamen and the claustrum

485
Q

What does the extreme capsule separate?

A

The claustrum and the insula

486
Q

Where is the hypothalamus?

A

wither side of the ventricule,

487
Q

What does the hypothalamus?

A

Control centre for pituitary and other regulatory functions

488
Q

What is the septum pellucidum?

A

The part that separates the two lateral ventricles

489
Q

What are the divisions of the cerebellum?

A

Right and left lobe, have transverse fissure and primary lobes

490
Q

What are the three layers of cerebellum?

A

Molecular(outermost) purkinje, and granule layers

491
Q

What are mossy fibres?

A

They are inputs to the cerebellum that enter throug the middle peduncle they come from the dentate nucleus of the hippocampus

492
Q

What are climbing fibres?

A

Inputs to the cerebellum for the inferior peduncle from the inferior olive

493
Q

What are purkinje cells?

A

They are outpuut cells that go to the dentate nucleus

494
Q

What does the superior cerebellar peduncle connect?

A

Midbrain diencephalon and cerebrum

495
Q

What is the middle cerebellar peduncle?

A

It connects the cerebellum with the pons and midbrain

496
Q

What does the inferior cerebellar peduncke linkd?

A

The nuclei in the medulla as well as ascending and descending tracts to spinal cord

497
Q

What information does the inferior cerebellar peduncle carry?

A

Proprioceptive and vestibular information

498
Q

what type of information does the middle peduncle carry?

A

information about voluntary movement

499
Q

What are the roles of the spinal cord?

A

recievs afferent fibres from sensory receptors of the runk and limbs
controls movement of limbs
autonomic innervation

500
Q

Where are the enlargements of the spinal cord?

A

Between C3-T1 for the arm and L1-S3 for legs

501
Q

What is the tip of the spinal cord called?

A

The conus meullaris, the final part of arachoid mater is the filum terminale

502
Q

Where is the end of the spinal cord?

A

L3 in birth, L1 or L2 in adult hood

503
Q

How are the spinal nerves organised?

A

There 8 C 12T 5L 5S 1C c1 pairs of nerves

504
Q

What is in the dorsal root ganglions?

A

primary afferents cell bodies in the dorsal spinal root ganglion

505
Q

What is carried in the ventral roots?

A

Efferents cell bodies in grey matter

506
Q

Which levels of the spinal cord have larger amounts of white matter?

A

The upper levels have more white matter compared to grey

507
Q

what are the rexeds laminae?

A

They are layers of the grey matter 1-3 substantia gelatinosa 9 motor supply

508
Q

What are the ascending tracts of the brain?

A

Medial leminiscal or dorsal columns, spinothalamic, spinocerebelar

509
Q

What does the Medial leminiscal /dorsal column carry?

A

Proprioception vibration discriminative touch, gracilis for lower body and cuneatus for upper body. they ascend to the medulla and cross

510
Q

What does the spinothalamic tract do?

A

arries pain and temperature and crude touch ascends on the same side for 1 or 2 segments then crosses up to thalamus

511
Q

What doe the spinocerebellar tracts do?

A

proprioception going to the dorsal ipsilatral cerebellum

512
Q

What does the spinoreticular pathways do?

A

Deep/chronic pain

513
Q

What are some descending pathways?

A

corticospinal, tectospinal, rubrospial, vestibulospial, reticulospinal

514
Q

What dos the corticospinal tract do?

A

It carries control of the voluntaru muscles, decussates at the medulla

515
Q

What doe the tectospinal tracts do?

A

head turning in response to visual stimmulus

516
Q

What does the rubrospinal tract do?

A

Assistes in motor function

517
Q

What do the vestibulospinal tracts do?

A

they alter muscle tone and posture

518
Q

What do the reticulo spinal tracts do?

A

Spinal reflexes

519
Q

What is brown-sequard syndrome?

A

Hemi-section of the spinal cord. ipsilateral weakness below the lesion due to damage to ipsilateral descending motor cortico-spinal tract. Ipsilateral loss of dorsal column propreoception. contralateral loss of spinothalamic pain and temperature below lesoion

520
Q

What are nerve conduction studies?

A

They investigate the periperal nervous system

521
Q

What are electromyographies

A

Looking at the periperal nervous system and the motor neuron- root nerve junction and muscle itself

522
Q

What does electroencephalography?

A

Looks at activity in the brain?

523
Q

what are Evoked potentials?

A

electrodes on brain and arm or leg, look at stimulating the arm or leg and seeing its effect in the brain

524
Q

How is sensory system tested in nerve conduction studies?

A

Stimulate nerve endings and measure along the course off the nerve looking at speed and amplitude

525
Q

How are motor functions assessed?

A

They stimulate the nerve and look for the contraction of the muscle using the probes

526
Q

What is the speed and and amplitude representing?

A

the amplitude is the number of axons the speed is myelination

527
Q

What does the EMG measure?

A

measure motor unit function

528
Q

What can you look for in electromyography?

A

Loss of strength, NMJ, muscle related, collateral sprouting

529
Q

how can you look at myesthenia gravis?

A

The regularity of the speed of the junction

530
Q

What are EEGs?

A

Look at surface electrical energy in different areas of the brain

531
Q

What are lots of EEGs used for?

A

They are used to look at epilepsy to locate areas etc

532
Q

What do frontal lobe seisures look like?

A

Often arise in sleep, asymmetrical flexion extension

533
Q

What is a non-epileptic seizure?

A

often very long, occasional pelvic thrusting often close eyes, can talk and cry in attack

534
Q

What is trans cranial magnetic stimulation?

A

stimulating the brain with magnets and measuring signals

Year 1 Medicine (25 decks)

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