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Medical Phys II > Normal Neuro > Flashcards

Normal Neuro Flashcards

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USMLE® Step 1 flashcards
1
Q

The electrical activity flows from cell body down to the

A

synapse

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2
Q

Na is normally found ____ the cell

A

Outside

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3
Q

K is normally found ____ the cell

A

inside

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4
Q

What helps increase the speed on conduction?

A

Myelin

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5
Q

What is myelin produced by in CNS?

A

Oligodendroglial cells

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6
Q

What is fast action potential propagation along myelin channels called?

A

Saltatory conduction

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7
Q

WHat type channels allow Na to flow in and K to flow out?

A

Voltage gated ion channels

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8
Q

What type things determine the action potential conduction in nerve axons?

A 
Axon diameter (larger is better for conduction) 
Myelin
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9
Q

What produces myelin in the PNS?

A

Schwann cell

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10
Q

What type of axons are pain, thermal, autonomic axons associated with?

A

small diameter unmyelinated axons

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11
Q

When diseases affect myelin, what happens?

A

Leads to dysfunction due to lack of myelin regeneration, signal can’t be transmitted as quickly

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12
Q

What are proprioception axons associated with?

A

Large diameter myelinated axons

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13
Q

What are tactile, motor axons associated with in terms of axon?

A

Medium diameter, lightly myelinated

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14
Q

When nerve impulse arrives at terminal what happens with calcium?

A

Binds to the receptor and causes the synaptic vesicles to release their neurotransmitter (NT) into the synaptic cleft

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15
Q

How is NT taken out of synaptic cleft?

A

By a enzymes in post-synaptic terminal

Reuptake in pre-synaptic terminal

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16
Q

These are all common what?

Acetylcholine, Norepinephrine, Dopamine, Serotonin, GABA, Glycine, Glutamate, Substance P

A

Neurotransmitters

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17
Q

What is the sites of actions of many drugs?

A

Synaptic cleft and associated receptors

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18
Q

What are the slowest conducting fibers?

A

Pain

slowest are the suffering aspect

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19
Q

larger fibers associated with pain allow you to what?

A

Localize the pain (why you can tell where the pain is before you feel the pain)

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20
Q

When type of fibers cross at the spinal cord?

A

Pain; go from grey matter to white matter at this point

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21
Q

What type of fibers do not cross at the spinal cord?

A

Proprioception, tactile

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22
Q

How much overlap is there on midline for somatic dermatomes?

A

3-5 cm

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23
Q

What is the pain and termal pathway from the body called?

A

Spinothalamic (starts in spinal cord, goes to thalamus)

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24
Q

What is the thalamus?

A

Integrator of all sensory information coming in

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25
Q

After going through the thalamus, where does the spinothalamic tract go?

A

To postcentral gyrus

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26
Q

If you have a lesion in the medulla, where will you lose pain sensation?

A

Contralateral side

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27
Q

If you have a lesion in the medulla, where will you lose motor movement?

A

Ipsilateral side

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28
Q

In the spinothalamic (anterior, lateral) tract what happens are neurons come up from spinal cord?

A

They collect together

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29
Q

What position does the pain pathway (spinothalamic tract) maintain up through the brainstem?

A

Lateral position

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30
Q

Where does pain come to conscious appreciated?

A

Contralateral cerebral cortex (post central gyrus)

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31
Q

What cerebral artery services the lateral surface of the post central gyrus?

A

Middle cerebral artery

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32
Q

Why is there referred pain?

A

Skin and developing organ get innervated by the same level, but then organ descends

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33
Q

Where can you have pain from the gallbladder and liver?

A

Right shoulder

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34
Q

Visceral pain is poorly _____

A

Localized

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35
Q

What is visceral pain originating in an organ and “felt” on the body surface?

A

Referred pain

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36
Q

Where does pain with the appendix usually start?

A

Umbilical area because appendix first irritates visceral peritoneum

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37
Q

Onces irritation of appendix spreads to parietal peritoneum and body wall- where does it “moves” (this is somatic pain)

A

RLQ

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38
Q

What is involved in the conscious proprioception pathway?

A

Discriminative tactile
Vibratory
Position Sense

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39
Q

What is discriminative tactile sensation?

A

Being able to discriminate things based on feel alone

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40
Q

Where does conscious proprioception pathway go to

A

Post central gyrus

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41
Q

What is know where your body parts are in space?

A

Proprioception

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42
Q

Ways to test proprioception

A

Identify items in hand w/o looking
Identify a number on traced on your hand
Big toe moved by clinical and patient reports toe position (has whole pathway)

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43
Q

Where is the conscious proprioception pathway?

A

Dorsal columns of the cord

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44
Q

Where do the dorsal columns cross?

A

Brainstem (medulla)

doesn’t cross in spinal cord

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45
Q

What are the two aspects of the dorsal columns?

A 
Fasciculus gracilis (lower half of body)
Faciculus cuneatus (upper half of body)
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46
Q

What is a sign where patient looses sense of balance w/ feet together and eyes closed (indicated dysfunction of dorsal columns)

A

Rhomberg sign

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47
Q

What type patient is a Rhomberg sign seen in?

A

Multiple sclerosis (tend to fall as soon as they close their eyes)

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48
Q

Where are the synaptic nuclei in the dorsal columns pathway?

A

Medulla

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49
Q

In the medulla, where is the dorsal columns pathway located?

A

Medially

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50
Q

Where do pain and thermal pathway of trigeminal enter then go?

A

Enter at pons then go down through the lateral aspect of the brainstem, crossing at the medulla then coming up medially

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51
Q

If an individual losses pain and thermal sensation on the ipsilateral side of the face, but on the contralateral side of the body- where is the lesion?

A

Pons/ medulla lateral region

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52
Q

When do tactile and proprioception fibers of the trigeminal cross?

A

Right when entering the medulla

53
Q

Where do non-conscious proprioception fibers go?

A

cerebellum and vesicular nuclei in the brainstem

54
Q

An injury to the spinocerebellar tract causes what?

A

Ataxia

55
Q

What direction does the voluntary motor pathway go?

A

Descending

56
Q

What controls the reticular formation?

A

Hypothalamus

57
Q

What type neurons does the reticular formation affect?

A

Parasympathetic,

58
Q

What do descending axons of the reticular formation modulate?

A

Pain

59
Q

What are the three things that modulate pain?

A

Reticular formation
Periaquiductal gray
Raphe’ nuclei (center of brainstem)

60
Q

What sends axons to the Raphe nuclei?

A

Trigeminal
Ascending pain path from contralateral body
(Raphne nuclei is where most of these end)

61
Q

Pain pathways send tremendous amounts of axons into the…

A

Raphe nuclei, which go up to the thalamus and hypothalamus

62
Q

Raphe nuclei project _____ to the trigeminal nuclei & dorsal horns enkephalin neurons.

A

serotonin

63
Q

_____ inhibits trigmenial and dorsal horn pain transmission neurons.

A

Enkephalin

64
Q

Serotonin goes down the enkephalin neuron which then synapses with a neuron in the DRG causing it to be____

A

inhibited

65
Q

What other fibers also activate enkephalin inhibitory neuron?

A

Tactile fibers (why massaging a injured muscle can help, acupuncture)

66
Q

Where is the precentral gyrus located?

A

Anterior to the central fissure

67
Q

The motor areas serve the _____ aspect of the body

A

Contralateral

68
Q

What neurons do the precentral gyrus contain?

A

Neurons for initiating a movement

69
Q

Where do you deposit information of how to do a learned movement?

A

Supplemental Motor Area (SMA)

70
Q

Which area “integrates visual, spatial, tactile and proprioceptive sensory data; important in sequencing and visual guidance of complex movements.”

A

Somatosensory area (SSA)

71
Q

What artery supplies the lateral side of the brain?

A

Middle cerebral anterior

72
Q

What artery supplies the medial side of the brain?

A

Anterior cerebral artery

73
Q

The lower extremity is located on the _____ aspect of the precentral gyrus.

A

Medial

74
Q

What is the internal capsule?

A

Continuation of white matter of the central hemisphere.

Within this structure are the axons from the cortex going down to form the motor pathway

75
Q

What are the three components of the basal ganglia?

A

Caudate
Putamen
Globus pallidus

76
Q

What are the two parts of the internal capsule?

A 
Anterior part (limbic)
Posterior part (fibers than innervate CNs)
77
Q

What are the two tracts of the upper motor neurons of the descending motor pathway?

A

Corticospinal tract to spinal cord

Corticonuclear tract to cranial nerves

78
Q

What descending motor pathway has mostly crossed axons serving the contralateral face, but with some cranial nerves receiving ipsilateral input?

A

Corticonuclear tract

79
Q

What descending motor pathway has axons that cross to the contralateral spinal cord in the medulla, and innervate motor neurons in the contralateral cord?

A

Corticospinal tract

80
Q

What two aspects make up the lower motor neurons of the descending motor pathway?

A

Motor neurons of cranial nerves

Motor neurons of spinal cord

81
Q

Does the descending motor pathway (corticospinal tracts) synapse in the brain stem?

A

No- don’t synapse until they reach the lower motor neuron

82
Q

What do lower motor neurons innervate?

A

Skeletal muscle

83
Q

Both cortices innervate what part of the face equally?

A

Forehead

84
Q

What cortex innervates the lower Right side of the face?

A

Left cortex

85
Q

What does a peripheral lesion involving the facial muscles effect?

A

Motor neuron going to the muscle. Lose all function on that side of the face

86
Q

What does a central lesion involving the facial muscles effect?

A

Upper motor pathway, rostral to facial nucleus (pons).

87
Q

What symptoms will you have with a central lesion involving the facial muscles?

A

Lose movement of the lower, contralateral side of the face

88
Q

What lobe of the cerebellum receives input from the musculoskeletal system and controls non-conscious proprioception and position sense?

A

Anterior lobe

89
Q

What lobe of the cerebellum gets input from the motor cortex about the next intended movement?

A

Posterior lobe

90
Q

What lobe of the cerebellum receives input from the vestibular system for balance and reflexes related to gravity & movement?

A

Fllocculonodular lobe

91
Q

What are the three cerebellar peduncles?

A

Superior
Middle
Inferior

92
Q

What is found in a peduncle?

A

Largely myelinated axons

93
Q

What would a lesion to the cerebellum result in?

A

Inability to make a movement accurate, strong, and in time

Ataxia, intension tremor

94
Q

What cerebellar peduncle gives input to the cerebellum from the vestibular system and spinocerebellar tracts?

A

Inferior peduncle

95
Q

What cerebellar peduncle gives input to the cerebellum from the motor cortex concerning the next motor movement?

A

Middle peduncle

96
Q

What cerebellar peduncle gives output of the cerebellum to the thalamus and motor cortex. Informs cortex of body position, limb orientation, movement and tension on musculoskeletal structures?

A

Superior peduncle

97
Q

What peduncle does an intension (action) tremor usually involve

A

Superior peduncle

98
Q

What is an intension (action) tremor?

A

Individual is fine standing still, but start to shake as soon as they move. Only shows up when they try to make a movement. Seen mostly on one side

99
Q

What side of the body does the cerebellum take care of?

A

Ipsilateral

100
Q

What do patients with cerebellar dysfunction often complain of?

A

Dizziness and weakness with eyes open

101
Q

What is an essential tremor?

A

Where an individual has a tremor at all times. Head and upper extremities affected first than moves downward

102
Q

Do lesions in the cerebellum result in paralysis?

A

NO

103
Q

What 2 components make up the corpus striatum?

A

Putamen

Caudate

104
Q

What does the basal ganglia help with?

A

Learning and memory of complex motor behaviors

How you orient your body to do a movement

105
Q

What do lesions in the basal ganglia result in?

A

Inability to learn a new motor activity or use one you have learned before

106
Q

What is dyskinesia?

A

Motor movements that aren’t normal

Ex- shaking, abnormal gait, many different forms

107
Q

Where is the lesion most likely when an individual has a tremor at rest but the tremor goes away when they make a movement?

A

lesion in basal ganglia

108
Q

What part of the basal ganglia gives output of the striatum to the thalamus?

A

Globus pallidus

109
Q

In Huntington’s disease, what part of the basal ganglia is destroyed?

A

Caudate nucleus

110
Q

What is related to behavior function. When you have a certain emotion there is a particular position you assume.

A

Ventral striatum

111
Q

What gives doapmine input to the caudate and putamen?

A

Substantia niagra

112
Q

What disease causes you to lose dopamine receptors?

A

Parkinson’s Disease

113
Q

Where do the function of the basal ganglia and cerebellum come together?

A

Thalamus

114
Q

The basal ganglia regulate and integrate movements on the _______ side of the body?

A

Contralateral

115
Q

What part of the basal ganglia is involved in retaining and applying patterns related to learned skill movements?

A

Putamen

116
Q

What part of the basal ganglia controls sequencing and speed of movements and selection of appropriate movement pattern?

A

Caudate

117
Q

What is ballismus?

A

Wild flinging movements of extremities

118
Q

Lesions in the _______ lead to ballismus (usually only on one side of the body)

A

Subthalamic nucleus

119
Q

Lesions in the caudate-putamen lead to what?

A

Corea- brisk movements of all extremities

120
Q

What is a variant of chorea, but movements are slow and writhing?

A

Athetosis

121
Q

What is a twisted movement where an individual is stuck in a position. Can do a movement but will always go back to that position.

A

Dystonia

122
Q

What disease is caused by an injury to the basal ganglia during birth?

A

Cerebral palsy

123
Q

What is hyperextended antigravity posture due to?

A

Vestibulospinal nuclei and tracts being unopposed (result of injury to basal ganglia)

124
Q

A lesion in what type motor neuron will result in hyperreflexia?

A

Upper motor neuron

125
Q

Lower motor neuron symptoms are ______?

A

Ipsilateral

126
Q

A lesion in what type motor neuron will result in hyporeflexia?

A

Lower motor neuron lesion

127
Q

What is ALS a disease of?

A

Lower motor neurons

128
Q

What is the extensor-plantar reflex (Babinski reflex) due to?

A

Interruption of the corticospinal tract somewhere along it scourse

129
Q

A lesion in what type motor neuron will result in a Babinski response?

A

Upper motor neuron

Medical Phys II (16 decks)

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