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NEUROLOGY > Physiology and pharmacology > Flashcards

Physiology and pharmacology Flashcards

1
Q

Which part of a neurone RECEIVES INPUTS from other neurones and which part CONVEYS OUTPUTS to other neurones?

A

Dendrites receive inputs

Axons carry outputs

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2
Q

Where is the site of initiation of the “all or none potential”?

A

Axon hillock

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3
Q

What type of neurones are peripheral neurones?

A

Unipolar

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4
Q

What type of neurones are dorsal root ganglion neurones?

A

Pseudounipolar

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5
Q

What type of neurones are retinal neurones?

A

Bipolar

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6
Q

What type of neurones are LMN?

A

Multipolar

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7
Q

What is the resting membrane potential of a neurone?

A

-70mV

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8
Q

The distance over which current spreads depends upon which two factors of a neurone?

A

Membrane resistance

Axial resistance of the axoplasm

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9
Q

What cell type surrounds axons in the CNS vs in the PNS?

A

Schwann cells in the PNS

Oligodendrocytes in the CNS

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10
Q

What term is used to describe how one action potential jumps from one node of ranvier to the next?

A

Saltatory conduction

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11
Q

What is the main excitatory neurotransmitter?

A

Glutamate

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12
Q

What is the main inhibitory neurotransmitter?

A

GABA

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13
Q

What is meant by spatial vs temporal summation?

A

Spatial summation - Many inputs converge on a neurone to determine its output

Temporal summation - A single input determines output

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14
Q

Merkel cell neurite complexes are sensory receptors of glabrous skin, what is their classification?

A

SA1

Slow adapting type 1

(type 1 = small receptive field)

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15
Q

Meissner corpuscles are sensory receptors of glabrous skin, what is their classification?

A

FA1

Fast adapting type 1

(type 1 = small receptive field)

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16
Q

Pacinian corpuscles are sensory receptors of glabrous skin, what is their classification?

A

FA2

Fast adapting type 2

(type 2 - large receptive field)

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17
Q

Drugs which are agonists vs antagonists of NA channels have what effects on neurotransmission?

A

Agonists of Na channels open the channel causing sodium influx and excitation

Antagonists of Na channels close the channels causing inhibition

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18
Q

Drugs which are agonists vs antagonists of K channels have what effects on neurotransmission?

A

Agonists of K channels cause K outflow form the cell causing inhibition

Antagonists of K channels retain K in the cell causing excitation

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19
Q

What is the difference between inotropic and metabotropic receptors?

A

Inotropic receptors form an ion channel pore. Metabotropic receptors are indirectly linked with ion channels on the plasma membrane through signal transduction mechanisms (often G proteins)

Inotropic receptors - rapid gating of ion channels

Metabotropic receptors - slower gating of ion channels

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20
Q

What is meant by ‘quanta’?

A

The amount of neurotransmitter release from a single vesicle

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21
Q

What is meant by ‘lateral inhibition’?

A

When one neurone is active, it inhibits the activity of its neighbours via inhibitory interneurons (this sharpens stimulus perception)

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22
Q

What is ‘neglect syndrome’?

A

Damage to one side of the brain results in the patient believeing the contralateral side of the world doesn’t exist and may even disclaim the existence of that side of their body

E.g - Usually due to damage to the right parietal cortex - patient doesn’t recognise the left side of their body

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23
Q

What terms are used to describe muscles which work together and muscles which oppose eachother?

A

Muscles which work together = synergists

Muscles which oppose eachother = antagonists

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24
Q

Axons of LMNs exit the spinal cord via which roots?

A

Ventral roots

they then join with dorsal roots to form a mixed spinal nerve

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25
Q

Motorneurones innervating the distal and proximal musculature are mainly found in which segments of the spinal cord?

A

Cervical and lumbar-sacral segments

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26
Q

An a-MN and al the skeletal muscle fibres which innervate it are collectively known as what?

A

A motor unit

smallest functional component of the motor system

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27
Q

The collection of a-MNs that innervate a single muscle is known as what?

A

A motor neurone pool

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28
Q

Describe the properties of slow-oxidative (type 1) muscle fibres?

A

Slow contraction and relaxation

Fatigue resistant

Red fibres/ dark meat (due to high myoglobin content)

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29
Q

Describe the properties of fast (type 2a and 2b) muscle fibres?

A

Fast contraction and relaxation
Fatigue resistant
“Red meat”

Fast contraction and relaxation
NOT fatigue resistant
“White meat”
Poor vascularisation

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30
Q

What is the “Henneman size principle”?

A

Smaller a-MNs have a lower threshold than larger

Small motor units are more easily activated and trained, so motor units are recruited from smallest to largest.

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31
Q

What is the function of golgi tendon organs?

A

Located at the junction between muscle and tendon these monitor changes in muscle tension and regulate tension to protect muscles from overload.

32
Q

Where are free nerve endings found and what is their role?

A

Connective tissue

Nociceptive function

33
Q

Where are golgi-type endings found and what is their role?

A

Ligaments

Protective role

34
Q

Where are paciniform endings found and what is their role?

A

Found in periosteum

Acceleration detectors

35
Q

Where are ruffini endings found and what is their role?

A

Found in the joint capsule

Static position and speed of movements

36
Q

What are the three mechanisms for amplification of sound in the middle ear?

A

Area ratio of the eardrum to the stapes footplate

Lever action of the ossicles

Buckling of the eardrum

37
Q

The 2 different types of hair cells within the ear are separated by what structure?

A

Rods of corti

38
Q

Which type of hair cell are the main source of afferent signal in the VIII nerve?

A

Inner hair cells

39
Q

Which type of hair cell controls stiffness and amplifies membrane vibration?

A

Outer hair cells

40
Q

Which type of movements do the semicircular canals vs the saccule and utricle detect?

A

Semicircular canals
- sense head rotation

Saccule and utricle (otolith organs)
- sense translational movement and gravity

41
Q

Describe the following;

Vestibulo-ocular reflex

Vestibulo-colic reflex

Vestibulo-spinal reflex

A

Vestibulo-ocular reflex - eyes stay still while head moves

Vestibulo-colic reflex - head stays still while body moves

Vestibulo-spinal reflex - adjustments of posture for rapid changes in position

42
Q

Describe the differences between rods and cones in the eye

A 
RODS 
Seeing in dim light - achromatic 
Peripheral retina 
High convergence, low density
High sensitivity, low acuity 
CONES 
Seeing in normal light - chromatic 
Central retina 
Low convergence, high density 
Low sensitivity, high acuity
43
Q

What is the striate cortex responsible for?

A

It is the primary sensory cortical area for vision in the brain

*Damage to this area causes scotomas (blind regions in the field of vision)

44
Q

What is meant by reciprocal inhibition?

A

Muscles on one side of a joint relax to accommodate contraction on the other side of the joint

(extensor contract, flexors relax and vice versa)

45
Q

What is the myotatic reflex?

A

The stretch reflex!

Muscle contraction in response to stretching within the muscle

(e.g contraction of an extensor will stretch an antagonistic flexor)

46
Q

What is meant by hyperalgesia and allodynia?

A

Hyperalgesia - increased perception of painful stimuli

Allodynia - perception of pain even when the stimulus is non noxious

47
Q

Describe the difference between Aδ-fibres and C-fibres, the two subtypes of nociceptors

A

Aδ-fibres

  • Thinly myelinated
  • Mediate first/ fast pain
  • Respond to mechanical stimuli and very high termperatures

C-fibres

  • Unmyelinated
  • Mediate second/ slow pain
  • Polymodal - respond to mechanical, thermal and chemical stimuli
48
Q

What is viscerosomatic pain

A

Pain caused by inflammatory exudate from an organ coming into contact with the body wall (e.g ruptured appendix)

49
Q

What are the steps on the WHO analgesic ladder?

A

1 - NSAID/ paracetamol (aspirin, diclofenac etc)

2- Weak opioid (codeine, tramadol etc)

3- Strong opioid (e.g morphine, oxycodone etc)

50
Q

What is the difference between opiates and opioids?

A 
Opiates = substances extracted from opium 
Opioids = agents acting on opioid receptors
51
Q

Describe the gate control theory

A

Non-painful input closes the gates to painful input therefore suppressing pain sensation

52
Q

What regions of the brain are involved in pain perception?

A

Cortex
Amygdala
Thalamus
Hypothalamus

53
Q

What 3 brainstem regions are involved in the regulation of pain?

A

Periaqueductal grey (PAG)

Nucleus raphe magnus (NRM)

Locus coeruleus (LC)

54
Q

List some of the major adverse effects of opioids

A 
Apnoea 
Orthostatic hypotension 
Constipation 
Confusion
Hallucinations
55
Q

PO admission of morphine is best for chronic pain. Which forms of the drug are used for immediate vs sustained release?

A

Oramorph = for immediate release

MST continus = for sustained release

56
Q

What is the side effect to be aware of with codeine?

A

Constipation

57
Q

When is fentanyl used?

A

IV for maintenance analgesia (only given by an anaesthetist)

Transdermal or buccal delivery for chronic pain

58
Q

When is pethidine used?

A

Used for acute pain - particularly for labour

59
Q

Pethidine shouldn’t be used in conjunction with which drug class?

A

Pethidine shouldn’t be used in conjunction with MAO inhibitors (used to treat depression) as it may cause convulsions and hyperthermia

60
Q

When is buprenophine used?

A

In chronic pain states with patient controlled injection systems

61
Q

Which patients should avoid tramadol?

A

Epileptic patients

62
Q

What is important about the half life of methadone?

A

It has a long plasma half life (>24 hours) so is useful in treating patients with chronic pain/ terminal cancer and heroin withdrawal

63
Q

When is naloxone used?

A

To reverse the effects of opioid toxicity

64
Q

What is important about the half-life of naloxone?

A

It has a very short half life, meaning each individual dose needs to be titrated and the patient closely monitored

*NB naltrexone is similar to naloxone but can be given PO and has a much longer half life

65
Q

What effect can naloxone have in opioid addicts?

A

Naloxone can trigger an acute withdrawal response in opioid addicts and patients who require high dose opioid analgesia regularly

66
Q

What is the mechanism of action of NSAIDs?

A

Inhibit COX enzymes which inhibits the synthesis and accumulation of prostaglandins

67
Q

What are some of the side effects of NSAIDs to be aware of?

A

Peptic ulcers

Nephrotoxicity

68
Q

Why is paracetamol not considered an NSAID?

A

It has no anti-inflammatory activity and only acts centrally

69
Q

List some conditions which are examples of causes of neuropathic pain

A

Trigeminal neuralgia
Diabetic neuropathy
Post-herpetic neuralgia
Phantom limb pain

70
Q

What drug class do gabapentin and pregabalin come under?

A

Anti-epileptics

They reduce the expression of some channels on damaged sensory neurones
- they are therefore useful in conditions like shingles

71
Q

What drug class does amitriptyline come under?

A

Tricyclic antidepressant

72
Q

What is the first line treatment for trigeminal neuralgia?

A

Carbamezepine

73
Q

Why is metoclopromide for GI issues contraindicated in patients with parkinson’s? What medication can be used instead?

A

It is a dopamine receptor antagonist so can exacerbate symptoms

Domperidone can be used instead as it doesn’t cross the BBB

74
Q

Why is haloperidol contraindicated in patients with parkinson’s disease? What medication can be used instead to manage psychosis?

A

Haloperidol is contraindicated in Parkinson’s because it causes EPSE.

Psychosis should instead be managed with quetiapine.

75
Q

What drug is used to treat Parkinson’s? What are it’s main side effects?

A

Levodopa

Main side effects; dyskinesia and drug resistance

NEUROLOGY (18 decks)

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