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neurology FA + STEP 2 > sleep, cerebellum, thalamus, basal ganglia, movement > Flashcards

sleep, cerebellum, thalamus, basal ganglia, movement Flashcards

(45 cards)

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1
Q

Sleep cycle is regulated by …. , which is driven by ….

A 
circadian rhythm (noctural release of ACTH, prolactin, melatonin, norepinephrine)
suprachiasmatic nucleus of hypothalamus
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2
Q

REM - duration / time

A

increases through the night

- every 90 mins

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3
Q

benzodiazepines clinical use in sleep

A
  1. night terrors

2. sleepwalking

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4
Q

REM - extraocular movements is due to

A

activity of paramedian pontine reticular formation/conjugate gaze center

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5
Q

substance that affect delta waves

A

alcohol, benzodiazepines and barbiturates –> decrease delta wave sleep

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6
Q

substance that affect REM

A

alcohol, benzodiazepines, barbiturates and norepinephrine –> decreased REM sleep

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7
Q

stage of sleep - proportions and waves

A
  • awake with eyes open - Beta
  • awake with eyes closed - Alpha
  • Non-REM stage N1 - 5% - theta
  • Non-REM stage N2 - 45% - sleep spindles and K complexes
  • Non-REM stage N3 - 25% - delta
  • REM - 25% - beta
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8
Q

stage of sleep - situations

A 
Awake (eyes open) - alert, active metal concentration 
Non-REM stage N1 - light sleep
Non-REM stage N2 - Deeper sleep
Non-REM stage N3 - Deepest non-REM slow
REM - Loss of motor tone 
increased brain oxygen use
increased and variable pulse and BP
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9
Q

Non-REM sleep - stage N2 - special characteristic

A

when bruxism occur

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10
Q

Non-REM sleep - stage N3 - special characteristic

A

when sleepwalking, night terrors and bedwetting occur

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11
Q

REM sleep - special characteristic

A

when dreaming and penile/clitoral tumescence occur

- memory processing function

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12
Q

Cerebellum - Lateral - function

A

voluntary movement of extremities

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13
Q

Cerebellum - Lateral injured –>

A

propensity to fall toward injured (ipsilateral side)

intention tremor

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14
Q

Cerebellum - medial structures

A

midline structures (vermal cortex, fastigial nuclei) and flocculonodular lobe (vestibulocerebellum)

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15
Q

Cerebellum - medial structures lesions –>

A
  1. truncal ataxia (wide-based cerebellar gait )
  2. nystagmus
  3. head tilting
  4. dysarthria
    (bilateral motor deficits affecting axial and proximal limb musculature)
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16
Q

Thalamus - anatomical function

A

Major relay for all ascending sensory information except olfaction

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17
Q

Thalamus - most important nuclei

A 
ventral posteriolateral  (VPL)
vental posteriomedial (VPM)
lateral geniculate nucleus (LGN)
medial geniculate nucleus (MGN)
ventral lateral (VL)
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18
Q

ventral posteriolateral (VPL) - input / destination / information

A
  1. spinothalamic and 2. dorsal columns/medial lemniscus –> 1ry somatosensory cortex
    information: Pain, temperature, pressure, touch, vibration, proprioception
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19
Q

vental posteriomedial (VPM) - output / input

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A

output: 1ry somatosensory cortex
input: trigeminal and gustatory pathways

20
Q

lateral geniculate nucleus (LGN) - input /output / information

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A 
CN II (optic nerve) --> calcarine sulcus 
information: vision
21
Q

ventral lateral (VL) - input .

Study These Flashcards
A
  1. Basal ganglia 2. Cerebellum –> motor cortex

information: motor

22
Q

medial geniculate nucleus (MGN) - input / output / information

Study These Flashcards
A

superior olive and inferior colliculus of tectum –> auditory cortex of temporal lobe
- hearing

23
Q

thalamic nuclei that send informations to 1ry somatosensory cortex (and informations)

Study These Flashcards
A

VPL - Pain, temperature, pressure, touch, vibration, proprioception
VPM - trigeminal and gustatory pathways

24
Q

cerebellum lesion - manifestation (for every area)

Study These Flashcards
A
  • Lateral injured –> propensity to fall toward injured (ipsilateral side), intention tremor
  • medial lesion –> truncal ataxia (wide-based cerebellar gait ), nystagmus, head tilting, dysarthria
25
Dopaminergic pathways - types
1. Mesocortical 2. Mesolimbic 3. Nigrostriatal 4. Tuberoinfundibular
26
Dopaminergic pathways - commonly altered by
1. drugs (eg. antipsychotics) | 2. movement disorders (eg. Parkinson)
27
Dopaminergic pathways - types and symptoms of altered activity
1. Mesocortical --> negative symptoms (eg. flat affect, limited speech) 2. Mesolimbic --> positive symptoms (delusions, hallucinations) (IF INCREASED ACTIVITY) 3. Nigrostriatal --> extrapyramidal symptoms (tardive dyskenisia,akathisia, parkinsonism, dystonia) 4. Tuberoinfundibular --> increased prolactin --> decreased libido, sexual dysfunction, galactorrhea, gynecomastia (in men)
28
Basal ganglia are important in / input
voluntary movements and making postural adjustments - input: cortical provides negative feedback to cortex to modulate movement
29
basal ganglia - structures
1. striatum (ραβδωτό) 2. Lentiform (φακοειδής) 3. Substantia nigra 4. subthalamic nucleus
30
basal ganglia - striatum =
putamen + caudate
31
basal ganglia - Lentiform =
putamen + globus pallidus
32
basal ganglia - putamen - responsible for
motion regulation
33
basal ganglia - caudate - responsible for
cognitive
34
globus pallidus is divided to
1. Globus pallidus externus | 2. Globus pallidus internus
35
basal ganglia - 2 main pathways
1. excitatory pathway (direct) --> increases motion | 2. inhibitory pathway (indirect) --> decreases motion
36
Movement disorders - types
1. athetosis 2. chorea 3, Dystonia 4. Essential tremor 5. Hmiballismus 6. intention tremor 7. Myoclonus 8. Resting tremor
37
Essential tremor - presentation / worsen with
high frequency tremor with sustained posture (eg outstretched arms), worsened with movement or when anxious
38
Essential tremor - treatment
1. β-blockers (nonselective --> eg. propranolol) 2. primidone 3. patients often self medicate with EtOH
39
essential vs resting (on movement)
essential --> worsened on movement (and resting --> alleviated by intentional movement
40
intention tremor - presentation / charact lesion
slow, zigzag motion when pointing extending toward a target | - cerebellar dysfunction
41
essential vs intention tremor (speed)
essential - high frequency | intention --> slow
42
Chorea - presentation / chorea means (as a world) / characteristic lesion
sudden, jerky purposeless movements chorea --> dancing - Basal ganglia (Huntington)
43
hemiballismus - presentation / characteristic lesion
sudden, wild flailing of 1 arm +/- ispilateral leg | - contralateral subthalamic nucleus (eg. lacunar stroke)
44
Myoclonus - presentation / common in
sudden brief uncontrolled muscle contraction - hiccups are common metabolic abnormalities such as liver or renal failure
45
Hemiballismus course - course
Recovers spontaneously over months

neurology FA + STEP 2 (8 decks)

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