Neurosciences 2 Flashcards
What is the name of the musle that raises the eyelid?
Levator palpebrae superioris
Which muscles have direct pulls from anatomical position?
Lateral rectus and medial rectus
What does superior rectus do?
Pulls the eye up medially and rotates it inwards in torsion
What does inferior rectus do?
It pulls the eye down and medially and rotates it outwards extortion
When is the action of superior oblique used the most?
when you look down the stairs. maximal extorsion of both eyes from the inferior rectus
Which muscle is important when looking up?
The inferior oblique as superior rectus causes extorsion.
What conditions are needed for testing eyes?
Directly in front, eyes at same level, 2 arms lengths apart
which muscles are tested first?
Lateral and medial rectus. as their action is isolated.
What muscle is tested after lateral/medial rectus?
Superior and inferior rectus
How is the movement of superior and inferior rectus isolated?
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.
What is the last set of muscles to be tested?
the obliques
How do you test obliques?
For superior look down and medial for inferior look up and medial look that there is no rotation of the eye.
What is the snail shaped structure called?
Cochlea for hearing
What are the 3 looped structures in the hear called
the semi-circular canals
What bone are the organs of balance and hearing in?
petrous part of the temporal bone
Where does the vestibulocochlea nerve leave the skull? and what does it leave with
with the facial nerve it passes through the internal acoustic meatus
What is the arrangement of the semicircular canals?
Three at 90 degrees to each other lateral anterior and posterior
How do the semicircular canals sense movement?
They are filled with fluid and at one pount ther is the ampula which sticks out from the wall beneath it is the cupula. This cupula has hair cells and nerve fibres which detect movement and transduce to nerve signals
What is the fluid in the semicircular canals called?
endolymph.
When are the semicurcular canals not working?
When you are not accelerating
What is nystagmus?
They have darting eyes
What can cause dizzyness
They can be from spinning or inflamation of the hair cells from the virus
What is the vestibulo-ocular reflex?
they eyes moving the opposite way to spinning
How can the vestibulo-ocular reflex be tested?
put cold water in the ear to cause convection currents and cause nystagmus slowly towards cold water
What is bottom up processing?
sensation
What is top down processing?
Perception
What is sensation?
A mental process resulting from the immediate external stimulation of a sense organ
What is perception?
The ability to become aware of something or understand something following sensory stimulation
What are the 5 types of perception?
Tactile, olfactory, Gustation, visual and auditry
What is a perceptual set?
They psychological factors that determine how you perceive your environment
What things make up our perceptual set?
Context, Culture, Expectations and Mood & motivation
What is gestalt proncipal?
Proximity common fate, continuity, similarity, closure, common region, symetry
What is a hallucination?
Experience involving he apparent perception of something not present
What is charles bonet syndrome?
When blind people have hallucinations
What can cause hallucinations?
Drugs, Sensory deprivation, stress, psychiatric illness(schizophernia, depression with psychosis)
What is involved with psychiatry treatment of hallucinations?
Social circumstances, medications, psychology
What type of wave is sound?
compression and rarefaction transverse waves
What qualities does sound have?
High pitch/frequency amplitude is volume
What is the frequency range of a human?
20Hz-20kHz
What is the variability of
hearing a range of sound is possible but speech is heard in a small range
How loud is too loud and quiet?
10dB pain is around 130dB
What are the components of the auditory system?
The outer ear middle ear and inner ear
What are the conduction mediums of the 3 sections of the ear?
Outer- air, middle-air, inner-fluid
What are the names of the three ossicles?
Malleus incus stapes
What is the technical term for the ear?
Pinna
Where is the outer ear?
From the ear to the oval window
Where is the middle ear?
The area around the ossicles
What is the area of the inner ear?
Around the cochlea and semicircular canals
What is the structure of the external ear?
Made of cartilage, There are hillocks of his six of them. pharyngeal arches 1 and 2
What is the purpose of the ear?
to direct sound down the ear canal
What are the ridges of the ear?
Helix, antihelix, tragus, conchal bowl and triangula fossa
What is the composition of the ear canal?
1/3 cartialage and 2/3 bone
What is the structure of the ear drum?
Tympanic membrane, 3d structure inferior is further away. Malleus is touching it and can see incus sometiems.
What are the two sections of the eardrum?
Pars flacida top third bottom third pars tensa and anulus around it bottom part of the ear has 3 layers
Which part of the tympanic membrane is more prone to dammage?
The pars flaccida. as only has endoderm and ectoderm not fibrous mesoderm
What is in the middle ear?
Bones- malleus, incus and stapes
Muscles such as tensor tympani and stapedius
Tubes- eustachian tubes
What bone is attached to the tensor tympani?
The malleus
Which bone is attached to the stapedius?
the stapes
Which nerve innervates the tensor tympani?
The corda tympani part of the facial nerve
Which nerve innervates the stapedius muscle?
glossopharengeal nerve
What is the action of the muscles in the ear?
Reduce damage of loud sounds by dampening of the sound. tensor tympani is slightly voluntary to remove chewing sound
What is the purpose of the bones?
It turnes the sound in the air into the fluid but usually 99.9% is lost. acoustic impediance. they increase force amplify it like a lever 1-
What is the eustatian tube?
Ventilation of the middle ear space and drainage of secretion
What is the labyrinth?
Another name for the semicircular canals
How many turns does the cochlea have?
2.5
What are the two openings in the ear?
The round window and the oval window. the oval window is for the stapedius
What are the three compartments of the cochlea?
Scala tympani, Scala media and scala vestibuli
What is endolymph and where is it?
In the scala media and has high potassium
Where is perilymph and what is is?
Sodium rich potassium poor it is in the scala vestibuli and scala tympani
how are the three compartments arranged?
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
How does sound enter the cochlea?
The stapedius moves the membrane of the oval window and transfers the waves into the perilymph
What are the boundaries of the scala media?
the reissners membrane to tthe scala vestibuli and basilar membrane and organ of corti in the scala tympani
What is the tectorial membrane?
a large sheet of tissue attached to the hair fibres
What is the importance of the basilar membrane?
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
How is the sound translated to nerve impulses?
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.
What do the inner hair cells do?
sense the movement and do mechanical transductions
What do the outer hair cells do?
fine tune the sound by stiffening the basilar membrane at the wrong frequency
What is the importance of the nerve in the inner hair cells?
There are afferent and efferent nerves
How is the movement of the hair cells transduced into nerve impulses?
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
How is the pitch encoded?
The frequency comes from the location of stimulation of the basilar membrane
How is the intensity encoded?
How many nerves are firing and firing rate
how does the signal get to the brain from the ear?
The sensory fibre stimulates the spiral gangleon that contributes to the cochlear nerve and then into the brain
What happens to sound in the brain stem?
Cochlea Eight nerve nucleaus superior Olivary complex lateral Lemniscus and the Inferior colliculus and crosses. medial geniculat body ECOLI
How is sound localised?
The difference between signals from the right and left ear this happens in the superoior olivary complex. from coincidence on internerons
What are the types of hearing loss?
Defective outer/ middle ear= conductive hearing loss
Defective inner ear= sensorineural hearing loss
Where do most of the cranial nerves come from?
The brainstem apart from optic and olfactory
What divides the frontal and parietal lobes?
The central sulcus
What divides the frontal and temporal lobes?
the silvian fissure or lateral sulcus
Which part of the brain exits the foreman magnum?
the medulla oblongata
what separates the parietal and occipital lobes?
Parieto-occipital sulcus on medial area of the brain
What are brodmans areas?
areas based on histology, separated into sections
How is the frontal lobe strucutred?
There are 3 main giri usually
Where is the hand motor cortex?
In the omega shaped area of brain
Where is brocas area?
in front of the central girus above the temporal lobe
Where is the cingulate girus?
Around the outside of the corpus callosum
What are the regions of the corpus callosum?
Rostrum, genue, body and splenium
Where is the fornix?
Runs under the corpus callosum into the mamillary bodies
Where is the calcarine sulcus?
The primary visual cortex medial area of occipital lobe
How can the temporal lobe be divided?
Superior middle and inferior giri
What is the shape of the ventricles?
The lateral ventricles, 3rd ventricle, and 4th ventricle
What are the exit points for CSF?
Foramaen of luska and majendie
What are the areas of the lateral ventricles?
anterior/frontal horn, posterio/occipital, lateral/ temporal
Where can CSF collect?
Prepontine system, interpeduncular system, supracella system, quadrigeminal system, cisterna magna
Why are the CSF systems important?
To see where blood collects
What is the corona radiata?
Fibres from the centre of the brain to be the descending tracts
What colour is CSF on MRI?
Black on T1 White on T2
What is the colour of the brain on T1 weighted scan?
Grey matter is grey white matter is white
What is stress?
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
What is Eustress?
Good stress is beneficial and motivating to strive towards a goal
What is Distress?
Negative stress that is damaging and harmful
Is stress physical or mental?
Both has affects in both systems
What is acute stress?
Short-lived response to a novel situation experienced by the body as a danger
What is chronic stress?
Arises from repeated or continured exposure to threatening or dangerous situations
What are some causes of chronic stress?
Physical illness, disability and pain, physical or sexual diseases, poverty, unemployment, bullying caregiving
What is General adaptation syndrome?
There are three phases to stress response. Alarm then adaptation, and finally exaustion mental and physiological
What are the five elements of human stress response?
Biochemical, physiological, behavioural, cognitive and emotional
How is the stress response mediated?
autonomic nervous system( sympathetic-adrenal medullary) and hypothalamo-pituitary axis
What is the sympathomedullary pathway?
Hypothalamus activates the adrenal medulla. this produces adrenaline and noradrenaline into the bloodstream, this prepares for floght or flight and reinforces the sympathetic activation
What is the pituatary adrenal system?
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
What are the biochemical stress responses?
Glucocorticoids(cortisol) catecholamines( adrenaline noradrenaline) this is part of inflamation and immunre response in chronic low inflamation and partial supression
What are some of the physiological stress responses?
Headache, chest pain, stomach ache, musculoskeletal pain, low energy, loss of libido, colds and infections grinding teeth
What are the behavioural responses to stress?
Easily startled, change in appetite, hard to concentrate, avoiding tasks, weight change, nail biting fidgeting and pacing, sleep disturbances, withdrawal
What are the cognitive responses?
Constant worrying, racing thoughts, fogetfulness and disorganisation, inability to focus, poor judgement, being pessimistic, learning
What are the emotional responses?
Depression sadness, tearfulness, mood swings, irritability, restlessness, aggression, low self-esteem, boredom and apathy, feeling overwhelmed, rumination, anticipation and avoidance
What is allostasis?
refers to how multiple complex systems adapt collectivels it is fragile and decompensation can happen quickly
What is allostatic load?
refers to cumulative exposure to stressors and can lead to absorption
What are the links between stress and illness?
Cancer survival, skin conditions, sexual dysfuncction Medically unexplained symptoms,, obesity, CVD GI problems
What is evolutionary psychiatry?
the application of modern evoultionary theory to understand health and disease looks at diseases of civilisation. It answers why questions
How can some psychiatry be linked to evolutionary processes?
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
What is the pleistocene environment?
Environment of evolutionary adaptation
Why is it important to look at evolution in psychiatry?
could offer theories about substance misuse, borderline states and schizophernia, bipolar disorder, the dementias and affective disorders as well as childhood neurodevelopmental disorders
What are tinbergen’s questions?
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
what are pathways that mediate evolution causing disease problems
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
What are some evolutionary symptoms that psychiatry aims to tackle?
Pain sickness illness behaviour, anxiety depression OCD, feer lethargy fatigue, nausea, itching, sneezing
What is dunbar’s number?
150 number of people you can maintain a stable relationship with.
How can schizophrenia be potentially explained by evolution?
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
what is compassion focused therapy?
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
What is the receptive field of the eye?
The area that is sensitive to light
What is retinal encoding?
When rods and cones feed into retinal ganglion cells
What are parvivellular RGCs good for?
Low-contrast High linear spatial resolution
What are Koniocellular RGCs good for?
Blue- yellow colour opponency
What are magnocellular RGCs?
High contrast, Low resolution, motion detection and colour blind
What is the island of vision?
There is a very small part of vision that is very sensitive
What is the optic chiasm?
a structure that fuses some of the inputs of the eye to allow integratio of information from both eyes
What is the lateral geniculat nucleus?
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
what is the dorsal stream pathway for vision?
where pathway
What is the ventral stream pathway
What pathway
How is depth percieved?
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
How is colour percieved?
Colour isnt a constant it is taken with context of what is around the object
Why do we move our eyes?
Clear vision of an object requires that its image be held teadily on the retina clearest when focussed on the retina, these aid vision
What is vestibular eyemovemnet?
Holds images of the seen world steady on the retina during brief head rotations or translations.
What is visual fixation?
Holda the image of a stationary object on the fovea
What is optokinetic eye ovement?
Holds images of the seen world steadt on the retina during sustained head rotation
what is smooth persuit eye movement?
holds the image of a small moving target or oposite way round with movement
What is nystagmus quick phases?
Reser the eyes during prolongued rotation to direct gaze to oncoming scene
What are saccades eye movements?
Bringing objects of interest into the fovea
What are vergence eye movements?
Moves the eyes in opposite directions so that images of a single opject are placed or held on the fovea of each eye
What areas of the brain are involved in eye movements?
THe primary visual cortex
What are the roles of saccades?
Searching the environment, reflexive to noise or touch, voluntary to look at specific things can be surpressed
What areas are involved with persuit saccades?
Parietal cortex,
Are the cranial nerves PNS or CNS?
PNS but optic and olfactory are more CNS
What are the sensory functions that nerves can have?
Somatic, general sensation and special sensation also autonomic sensations
What are the motor functions?
Muscle contraction conscious and subconscious for non skeletal muscle glands
Which cranial nerves carry parasympathetic fibres?
1937 = 10,9,7,3
What is CNI?
olfactory
Which nerve is the olfctory?
CNI
Where does CNI leave the skull?
The cribiform plate
What does the olfactory do?
Sense of smell. it goes directly to the cortex
What is special thing about the sense of smell?
it doesnt pass through the thalamus
How much of smell crosses sides?
15%
How can you test olfaction?
Get something smelly and see if they can guess it
What can damage the olfactory nerve?
Sudden deceleration severing nerves
What is cranial nerve 2?
Optic nerve
What is the optic nerve?
CNII
What does the optic nerve do?
Vision sense
What is the exit point of the optic nerve?
the optic canal
How can you tell if you have intercranial hypertension?
if the optic disk is swolen
How does image from the right eye travel?
the nasal retina crosses through the other side the temporal side stay the same side.
Where do thefirst neurons synapse?
The lateral geniculate nucleus
What happens when the right optic nerve is cut?
Blindness in the right eye only
What happens if you damage the right optic tract?
You lose the right side of vision from both eyes right sided homonomous hemianopia
What happens if there is damage to the optic chiasm?
both eyes cant see the temporal regions bitemporal hemianopia
What happens with damage to the temporal lobe on the right?
The optic radiation is affected and you cant see the upper area.
What happens in the pretectal nucleus superior colliculus in vision?
Fibres from the optic nerve synapse to there and leving to the edinger-westphal nucleuse to supply the pupil through the 3rd nerve
How can you test the optic nerve?
Visual fields, pupil reflexes, visual acuity, fundoscopy.
When testing the visual acuity what else are you testing?
The cornea the lens and humours of the eye as well as the optic nerve
How should the optic disk usually move when you move left or right?
the lighter part is a cup and the lighter part moves in the same direction as the head
What is the optic disk like when its swollen?
The lighter part moves to the oposite side that you move your head
How do you test the pupil?
Shine it into both the eyes and watch for reaction in both eyes.
look for constriction on accommodation
What does sympathetic innervation to the eye do?
Lift the eyelid and dilate the pupil
What is the difference with the occulomortor nerve?
It has parasympathetic and controls most muscles of the eye and does constriction of the pupil
What nerve is the occulomotor nerve?
The CVIII
Which nerve is CNIII?
Occulomotor
Which nerve is CNIV
trochlear
Which nerve is the trochlear?
CNIV
What does the trochlear nerve do?
Innervates the superior oblique muscle
What nerve is the abducens?
CNVI
What is CNVI?
The sixth cranial nerve abducens
What does the abducens nerve do?
Innervates lateral rectus
Which muscles does CNIII do?
superior rectus, inferior rectus, medial rectus, inferior oblique, and parasympathetic to the pupil and focus the lens
Where does the third cranial nerve exit the brain?
Through the interpeduncular fossa
Where does the fourth nerve leave the brain?
The posterior below inferior colliculus
Where does the sixth cranial nerve leave the brain?
The bulbopontine fissure
Where does the occulomotor nerve leave the skull?
The superior orbital fissure
Where does the absucens nerve leave the skull?
The superior orbital fissure
Where does the Troclear nerve leave the skull?
The superior orbital fissure
Which nerves pass through the superior orbital fissure?T
The occulomotor, the trochlea, the abducens
Which nerves pass though the cavernous sinus?
CN III oculomotor 4th trochlear parts of trigeminal opthalmic maxillary and the abducens nerve
What happens with the third cranial nerve pallsy?
Down and out from lateral rectus and superior oblique
What happens with trochelar nerve pallsy?
Double vision when looking down the stairs
what happens with abducens nerve problems?
Cant look laterally
What does the trigeminal nerve do?
Sensation to the face and mouth muscles
What nerve is the trigeminal?
CN V