Short king spring Flashcards
how do you clinically test the superior and inferior rectus? [1]
how do you clinically test the superior and inferior olbique? [1]
how do you clinically test the medial / lateral rectus? [1]
how do you clinically test the superior and inferior rectus? [1]
abduct the eye
(do this to isolate the muscle so that the eye is aligned with the angle of the muscle pull)
how do you clinically test the superior and inferior olbique? [1]
adduct the eye
how do you clinically test the medial / lateral rectus? [1]
abduct / adduct the eye
how does the hypothalamus regulate water balance?
- where do you find osmoreceptors? [1]
- which hypothalamic nuclei are stimulated to increase water in ur body ? how do they work?
- where do you find osmoreceptors? [1]
- *subfornical organ (wall of third ventricle): detects osmolarity**
- subforrnical organ activates cells in the:
- *i) medial preoptic nucleus**
- this nucleus connects to the limbic system: regulates concious sense of thirst
- *ii) paraventricular nucleus & supraoptic nucleus**
- secrete ADH (makes more aquaporins in CD)
- oxytocin
which of the following is innervated by the superior laryngeal nerve?
thyroartyenoid
cricoartyenoid
cricothyroid
transverse arytenoid
olbique arytenoid
which of the following is innervated by the superior laryngeal nerve?
thyroartyenoid
cricoartyenoid
cricothyroid
transverse arytenoid
olbique arytenoid
others = recurrent laryngeal nerve
spinal accessory nerve comes from which spinal levels? [1]
C1-5
which part of the brain gives you the ability to track an object? [1]
what does ^ connect with?
which pathway mediates neck flexes triggered by seen objects? [1]
which part of the brain gives you the ability to track an object? [1]
superior colliculi
some optic nerve fibres go to the superior colliculi -> connects to the medial longitudinal fasciculi (MLF): links together and synchronises the oculomotor nuclei
which pathway mediates neck flexes triggered by seen objects? [1]
tectospinal tract
= together give synchronised eyes and neck movement
which 3 cells cause seeing stuff x
photorceptors (rods & cones - recive light signal & lose inhibitions) that connect to
bipolar cells that connect to
ganglion cels that send axons to optic nerve
where is aq humour made in the eye? [1]
ciliary body
what happens to photoreceptors in the dark? [2]
what happens to photoreceptors in the light? [1]
what happens to photoreceptors in the dark? [1]
constant inward leak of sodium in outerpart of the receptor: keeps the cell depolarised. causes the release of glutamate from its synaptic ending
what happens to photoreceptors in the light? [1]
light hyperpolarises the tonic glutamate release
describe the mechanism of HPA axis (hypothalamus-pit-adrenal axis)
describe the mechanism of HPA axis (hypothalamus-pit-adrenal axis):
- Cells in hypothalamus release CRH (Corticotropin releasing hormone)
- CRH acts on anterior pit to releease ACTH (adrenocorticotropic hormone)
- ACTH acts on adrenal cortex to release cortisol
- *BUT: negative feedback system:**
- cortisol inhbits release of above
what are three mechanisms of ADH reducing water loss? [3]
- Increase aquaporins in CD
- increases perm. of CD to urea (water follows)
- stimulates sodium reab in thick loop of henle: Na/K/2Cl
describe the mechanism of HPA axis (hypothalamus-pit-adrenal axis)
which important structures run through the posterior triangle? [3]
- spinal accessory nerve
- external jugular vein
- part of subclavian artery
- part of brachial plexus
which of the following supplies the corpus callosum?
middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery
which of the following supplies the corpus callosum?
middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery
what is role of middle ear? [3]
- impedence matching (the middle ear transfers the incoming vibration from the comparatively large, low impedance tympanic membrane to the much smaller, high impedance oval window)
- pressure equalisation
- inner ear stimulation
which nuclei in the brain determins the source of sound? [1]
superior olivary nuclei
what does Rinne’s test test?
how do u do this?
what is normal [1]
conduction deafness [1]
sensorineural deafness [1]
Rinne test: Place the base of a struck tuning fork on the mastoid bone behind the ear. Have the patient indicate when sound is no longer heard. Move fork (held at base) beside ear and ask if now audible. In a normal test, AC > BC; patient can hear fork at ear. With conductive loss, BC > AC; patient will not hear fork at ear.
- normal response: sound is heard louder and longer by air conduction. sound from tuning fork stops, but if move the fork closer - sound is still heard (bc easier to hear air conducted sound)
- conduction deafness: take tuning fork off mastoid proces, tuning fork wont be heard (bc bone conduction is better than air conduction of affected side)
sensorineural deafness: air conduction is better than bone conduction in affected ear. sound is loudest in unaffected ear
how do u conduct webers test? [1]
what is normal? [1]
what is conduction deafness response [1]
what is sensorineural deafness response [1]
vibrating tuning fork on middle of forehead & ask patient which ear it is heard.
normal patient = equally heard
conduction deafness = sound is louder in affected ear
sensorineural deafness = sound is louder in unaffected ear
which 3 functionally distinct motor pathways does UMN use? [3]
corticospinal tracts: precise movements
- *rubrospinal** tracts: gross movements, flexor movement
- *vestibulospinal** and reticulospinal tracts: posture and balance, muscle tone and position of head and limbs
label the pathways of UMN x
A: lateral corticospinal tract. key !!
B; rubrospinal tract
C: reticulospinal and vestibulospinal tracts
D: ventral and corticospinal tracts
what are functions of the:
vestibulo-cerebellum
spino-cerebellum
cerebro-cerebellum
what does damage of each of the above cause?
what are functions of the:
vestibulo-cerebellum:
- **balance & posture
- co-ordinates eye and head movements**
- damage = ability to stand and maintain posture impaired
spino-cerebellum:
- *- locomotion
- voluntary movements of arms and legs
- damage = overshoot and intention tremor, impaired gait**
cerebro-cerebellum
- **skilled motor tasks
- ataxia failure**
what are functions of the:
vestibulo-cerebellum
spino-cerebellum
cerebro-cerebellum
what does damage of each of the above cause?
what are functions of the:
vestibulo-cerebellum:
- **balance & posture
- co-ordinates eye and head movements**
- damage = ability to stand and maintain posture impaired
spino-cerebellum:
- *- locomotion
- voluntary movements of arms and legs
- damage = overshoot and intention tremor, impaired gait**
cerebro-cerebellum
- **skilled motor tasks
- ataxia failure**
what is D?
carotid canal
optic tract
olfactory tract
optic chiasm
superior sagital sinus
what is D?
carotid canal
optic tract
olfactory tract
optic chiasm
superior sagital sinus
which of the following is arachnoid mater?
A
B
C
D
E
F
G
which of the following is arachnoid mater?
A
B
C
D
E
F
G
what is muscle tone due to? [3]
which structure detects tension in the tendon? [1]
muscle tone: due to a partial state of contraction in some fibres [1]. maintained reflexievly and adjuststed to the needs and posture of movement [1]
requires integity of monosynpatic reflex to occur [1]
= resting tension !!
Q
which of the following facilitates y-motor neurons of extenors of body?
corticospinal tract
anterior spinocerebellar tract
posterior spinocerebellar tract
lateral reticulospinal tract
medial reticulospinal tractA
which of the following facilitates y-motor neurons of extenors of body?
corticospinal tract
anterior spinocerebellar tract
posterior spinocerebellar tract
lateral reticulospinal tract
medial reticulospinal tract
the upper limb & face somatosensory and motor cortices are provided by which artery?
ICA
MCA
ACA
Basilar A
PCA
the upper limb & face somatosensory and motor cortices are provided by which artery?
ICA
MCA
ACA
Basilar A
PCA
the lower limb somatosensory and motor cortices are provided by which artery?
ICA
MCA
ACA
Basilar A
PCA
the lower limb somatosensory and motor cortices are provided by which artery?
ICA
MCA
ACA
Basilar A
PCA
Q
which cell types in the arcuate nucleus
a) increase hunger? [2]
b) decreaes hunger? [2]
grehlin / insulin & other hormones travel to arcuate nucleus and interact with some cell types:
increase hunger:
- *- Agouti-related peptitde (AGRP)**
- *- neuropeptide Y neurones (NPY)**
decrease hunger
- **cocaine & amphethamine transcript neurones (CART)
- pro-opiomelanocortin (POMC)**
& interact !!
what is GLP-1?
role on:
- satiety [1]
- insulin & glucagon levels[1]
- gastric emptying [1]
Glucagon like peptide -1
- inhibits gastric emptying = produces feeling of fullness
- stimulates: insulin secretion & decreases glucagon (lowers blood glucose)
- produces rapid satiety
Q
what is pancreatic peptide YY hormone’s role:
effect on satiety? [2]
increases ileal absorbtion
slows gastric emptying
Q
ascending reticular formation (RAS) functions? [2]
descending reticular formation functions? [2]
ascending reticular formation (RAS) functions? [2]
sleep arousal (causes delta wave block)
descending reticular formation functions? [2]
modulates pain
controls motor function
name functions of reticular formation [5]
- somatic motor control
- CV & resp control
- pain modulation
- sleep & conciousness
- habituation
which part of the RF is associated with release of noradrenaline? [1]
locus coeruleus
which part of the RF is associated with release of serotonin?
raphe nuclei
describe the functions of the reticulospinal tracts from
a) medial reticulospinal tract (from the pons)
b) lateral reticulospinal tract (from the medulla):
describe the functions of the reticulospinal tracts from
a) medial reticulospinal tract (from the pons)
control axial and extensor motor neurons = extension of legs
stepping
b) lateral reticulospinal tract (from the medulla):
flexor motor neurons
inhibits medial reticulospinal tract: switches off extensors & modulates stretch reflex
BOTH are located in white matter !!
explain v basic overview of afferent –> motor for autonomic control x
- afferent receptors (like baroreceptors / chemoreceptors etc) go via visceral sensory afferents to brain & hypothalamus
- autonomic control system (i_n hypothalamus AND reticular formation_) sends information to motor output (para or sym)
how does RF influence respiratory control? [2]
- pneumotactic centre (superior pons) sends inhib impulse to inspiratory centre of medulla: switches off inspiration (allows you to breathe out !! )
- apneustic centre (inferior pons) prolongs inspiration (increases depth of inspiration for 2 secs then inhibited by pneuomotaxic centre)
which 2 arteries provide main blood supply to midbrain? [2]
basilar artery
- *- superior cerebellar artery
- posterior cerebellar artery**
choridal atery
which level of the brainstaim did you find cerebral aquaduct?
midbrain
medulla
thalamus
pons
corpus callosum
which level of the brainstaim did you find cerebral aquaduct?
midbrain
medulla
thalamus
pons
corpus callosum
describe pathway of cutaneous afferents from the face? [1]
- Cutaneous afferents from the face travel in cranial nerves and enter the trigeminal nucleus
- Post-synaptic fibres from the trigeminal nucleus decussate and run alongside the medial lemniscal fibres from the body.
- the face afferents end in the VPM thalamus (ventro-postero-medial nucleus),
Dolls eye reflex:
Afferent CN? [1]
Efferent CNs? [3]
how do u test? what is a normal reflex and abnormal reflex?
Dolls eye reflex:
Afferent CN? [1]: CN VIII
Efferent CNs? [3] CN III, CN IV, CN VI
- tested by turning head side to side
- normal reflex: head moves to right, eyes move left
- abnormal refelx: head moves to right, eyes follow
which part of spinal column does the artery of Adamkiewicz supply? [2]
lower thoracic or upper lumbar vertebrae
what structure connexts the cranial nerve nuclei controlling eye movement and the vestibular nuclei? [1]
medial longitudinal fasiculus:
CN III, IV and VI
which arteries supply the areas where the nerve roots enter and exit the spine dorsally and ventrally, respectively? [1]
radicular arteries
blink reflex: afferent and efferent CNs?
Blink reflex:
afferent CN: trigeminal - V1
(but also bright light (CN II & loud noise CN VIII))
efferent CN: CN VII - acts on orbicularis occuli muscle to close
which 3 reactions does the accomodation reflex test? [3]
constriction of pupils
thickening of lens (cilliary muscle constriction)
convergenece of eye balls ( CNIII: movement of eyeballs - medial rectus muscle !!)
a painful stimulus activates which receptors? [3]
touch receptor
wide dynamic range receptor
nociceptors
Rule of 4:
which 4 midline structures do you get?
what are their deficits?
Romberg’s test:
what is romberg’s test? what are you testing? how do you perform? what is a postive sign? [1]
Romberg’s test:
- tests proprioception
- standing patient and close eyes. instability & loss of balance is a positive sign
- called sensory ataxia (due to dorsal column damage)
whar are the SL pictured here? [1]
what type of cell? [1]
whar are the white lines pictured here? [1]
schmidt-lanterman clefts
what type of cell? [1]
schwann cell
after nerve injury:
how does the cell communicate that its injured? [3]
what transformation does cell undergo (in function?) [1]
how does the cell communicate that its injured? [3]
- get a burst of APs (alerts the cell body in DRG that damage has occurred)
- disruption of retrograde transport flow of trophic support (this is a negative injury signal bc its a stop to normal procedure)
- postive injury signals
= all alert DRG that is damaged !!
what transformation does cell undergo (in function?) [1]
cells in the DRG alter their phenotype (switch from transmission of information state to growth state.
- where does Ach bind to ACh R (specifics !!)
- describe structure of Ach R
what happens when Ach binds to ACHR?
structure: α2βγð subunits; spans across inside of cell, cell membrane and outside of cell (where the binding sites are)
when 2 Ach binds to AchR: change in hydrophobic interactions in alpha helical structure = creates an ion pore
binding occurs of Ach occurs at C loops (of cysteine-cysteine bond)
what causes vesicles to be recycled in nervous system? [1]
clathrin
what is the cellular organisation of the cerebral cortex?
what are the two main barriers to CNS repair?
- *1. hostile environment**
i) scar tissue
ii) myelin-associated inhib proteins (NOGO proteins, MAG, OMGP)
2. poor regenerative response (unlike PNS)
what is neurapraxia? [1]
what is axonotmesis?
what is neurotmesis?
which of the following are reversible?
neurapraxia: temporary loss of motor and sensory function due to blockage of nerve conduction (temporary damage to myelin). reversible
axonotmesis: disruption of the axons, resulting from severe crush or contusion. myelin and axon damaged. reversible (epineurium still intact)
neurotmesis: both the axons and nerve sheath are disrupted: 3rd degree damage. myelin and axon AND epineurium damaged. partial recovery possible
how can you tell which is the pyramidal layer in the cerebral cortex? [1]
where is the pyramidal layer more developed? [2]
how can you tell which is the pyramidal layer in the cerebral cortex? [1]
larger cell bodies
where is the pyramidal layer more developed? [2]
motor & sensory centres
which of the following helps to form BBB?
perineurium
endosteum
periosteal
endoneurium
epineurium
which of the following helps to form BBB?
perineurium
endosteum
periosteal
endoneurium
epineurium
Which of the following extrinsic muscles of the tongue is not innervated by the hypoglossal nerve?
Styloglossus
Hyoglossus
Genioglossus
Palatoglossus
Which of the following extrinsic muscles of the tongue is not innervated by the hypoglossal nerve?
Styloglossus
Hyoglossus
Genioglossus
Palatoglossus: VN instead
broca’s and wernickes areas are joined by what? [1]
What is the name for when A is damaged? [1]
what is this charactersised by? [2]
broca’s and wernickes areas are joined by arcuate fasciculus
What is the name for when A is damaged? [1]
conduction aphasia
what is this charactersised by? [2]
difficulty reading aloud / read back something
but good comprehension
broca and wernickes areas are supplied by which artery? [1]
middle cerbral artery
vestibulocochlear nerve:
where does the it arise from?
vestibular part [1]
cochlear part: [1]
vestibulocochlear nerve:
where does the it arise from? [2]
vestibular part: pons & medulla
cochlear part: cerebellar peduncle
what is the difference between myeline sheath in CNS compared to produced in PNS? [4]
- different myelin-specific proteins
- fewer schmidt-lanterman clefts
- no external lamina
- nodes of ranvier larger
- thinner
what is A?
oligodendrocytes
ependymal
astrocytes
microglial
schwann
what is A?
oligodendrocytes
ependymal
astrocytes
microglial
schwann
what is the opercular cortex?
how does it differ between L & R ?
what is the opercular cortex?
cortex on the upper and lower ‘lips’ of the lateral fissure
how does it differ between L & R ?
left
