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

sleep, cerebellum, thalamus, basal ganglia, movement Flashcards

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

A

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

20
Q

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

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

ventral lateral (VL) - input .

A
  1. Basal ganglia 2. Cerebellum –> motor cortex

information: motor

22
Q

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

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)

A

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

24
Q

cerebellum lesion - manifestation (for every area)

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
Q

Dopaminergic pathways - types

A
  1. Mesocortical
  2. Mesolimbic
  3. Nigrostriatal
  4. Tuberoinfundibular
26
Q

Dopaminergic pathways - commonly altered by

A
  1. drugs (eg. antipsychotics)

2. movement disorders (eg. Parkinson)

27
Q

Dopaminergic pathways - types and symptoms of altered activity

A
  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
Q

Basal ganglia are important in / input

A

voluntary movements and making postural adjustments
- input: cortical
provides negative feedback to cortex to modulate movement

29
Q

basal ganglia - structures

A
  1. striatum (ραβδωτό)
  2. Lentiform (φακοειδής)
  3. Substantia nigra
  4. subthalamic nucleus
30
Q

basal ganglia - striatum =

A

putamen + caudate

31
Q

basal ganglia - Lentiform =

A

putamen + globus pallidus

32
Q

basal ganglia - putamen - responsible for

A

motion regulation

33
Q

basal ganglia - caudate - responsible for

A

cognitive

34
Q

globus pallidus is divided to

A
  1. Globus pallidus externus

2. Globus pallidus internus

35
Q

basal ganglia - 2 main pathways

A
  1. excitatory pathway (direct) –> increases motion

2. inhibitory pathway (indirect) –> decreases motion

36
Q

Movement disorders - types

A
  1. athetosis 2. chorea 3, Dystonia 4. Essential tremor
  2. Hmiballismus 6. intention tremor 7. Myoclonus
  3. Resting tremor
37
Q

Essential tremor - presentation / worsen with

A

high frequency tremor with sustained posture (eg outstretched arms), worsened with movement or when anxious

38
Q

Essential tremor - treatment

A
  1. β-blockers (nonselective –> eg. propranolol)
  2. primidone
  3. patients often self medicate with EtOH
39
Q

essential vs resting (on movement)

A

essential –> worsened on movement (and resting –> alleviated by intentional movement

40
Q

intention tremor - presentation / charact lesion

A

slow, zigzag motion when pointing extending toward a target

- cerebellar dysfunction

41
Q

essential vs intention tremor (speed)

A

essential - high frequency

intention –> slow

42
Q

Chorea - presentation / chorea means (as a world) / characteristic lesion

A

sudden, jerky purposeless movements
chorea –> dancing
- Basal ganglia (Huntington)

43
Q

hemiballismus - presentation / characteristic lesion

A

sudden, wild flailing of 1 arm +/- ispilateral leg

- contralateral subthalamic nucleus (eg. lacunar stroke)

44
Q

Myoclonus - presentation / common in

A

sudden brief uncontrolled muscle contraction
- hiccups are common
metabolic abnormalities such as liver or renal failure

45
Q

Hemiballismus course - course

A

Recovers spontaneously over months

neurology FA + STEP 2 (8 decks)

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