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USMLE Neurology > Sleep physiology, Hypothalamus, Thalamus, Limbic system > Flashcards

Sleep physiology, Hypothalamus, Thalamus, Limbic system Flashcards

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USMLE® Step 1 flashcards
1
Q

What structure in the hypothalamus regulates the sleep cycle via circadian rhythm

A

Suprachiasmatic nucleus (SCN)

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2
Q

What hormones does the circadian rhythm control the nocturnal release of?

A
  • ACTH
  • Prolactin
  • Melatonin
  • NE
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3
Q

The pineal gland releases melatonin, how is this initiated - what structure initiates it?

A

SCN releases NE
- NE influences the pineal gland to release melatonin

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4
Q

What is SCN regulated by?

A

Environment (light)

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5
Q

What drugs will decrease N3 sleep and REM sleep?

A
  • Alcohol
  • Barbiturates
  • Benzodiazepines
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6
Q

What EEG waves dominate the N1 stage of sleep?

A

Theta

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7
Q

What waves have the highest frequency and lowest amplitude?

A

Beta (awake, eyes open)

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8
Q

What waves have the lowest frequency and highest amplitude?

A

Delta (stage N3)

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9
Q

During what stage of sleep does bruxism occur?

A

Stage N2

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10
Q

How are benzos useful for night terrors and sleepwalking?

A

Occur during stage N3 of sleep cycle and benzodiazepines reduce N3 and REM sleep

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11
Q

What are the 4 stages of sleep?

A
  • Stage N1 (theta)
  • Stage N2 (sleep spindles and K complexes)
  • Stage N3 (delta)
  • REM sleep (Beta waves)
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12
Q

During what stage of sleep do sleep spindles and K complexes form on EEG?

A

Stage N2

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13
Q

What percetage of sleep does each stage take up?

A
  • Stage N1 (5%)
  • Stage N2 (45%)
  • Stage N3 (25%)
  • REM sleep (25%)
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14
Q

How often does REM sleep occur?

A

Every 90 minutes, duration of REM increases through the night

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15
Q

The activity of what causes eye movements during REM sleep?

A

PPRF (Paramedian pontine reticular formation / conjugate gaze centre)

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16
Q

What wave forms will be seen on EEG during REM sleep?

A

Beta waves

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17
Q

Sleepwalking, night terrrors and bedwetting occur during what stage of sleep?

A

Stage N3

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18
Q

What stage of sleep has sexual arousal and possibly serves as a memory processing function?

A

REM sleep

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19
Q

Describe the physiological changes which occur during the REM stage of sleep?

A
  • Loss of motor tone
  • Increased brain O2 use
  • Variable HR/BP
  • Increased ACh
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20
Q

What changes occur in sleep in the elderly?

A
  • Decreased REM
  • Decreased N3
  • Increased sleep latency
  • Increased early awakenings
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21
Q

What changes occur in sleep in depression?

A
  • Increased REM
  • Decreased REM latency
  • Decreased N3
  • Repeated nightime awakenings
  • Early morning awakening (terminal insomnia)
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22
Q

What stage of sleep is effected in narcolepsy?

A

Decreased REM latency

23
Q

What part of the hypothalamus controls hunger?

A

Lateral nucleus

24
Q

What is the lateral nucleus stimulated by and inhibited by?

A
  • Stimulated by ghrelin
  • Inhibited by leptin
25
Q

What does the Anterior nucleus (hypothalamus) control?

A

Cooling (Air Con), paraympathetic

26
Q

What does the posterior nucleus control (hypothalamus)?

A

Heating, sympathetic

27
Q

What do the supraoptic and paraventricular nuclei synthesise?

A

ADH and oxytocin

28
Q

What does the Preoptic nucleus release?

A

GnRH

29
Q

What does the Preoptic nucleus control?

A
  • Thermoregulation
  • Sexual behaviour
30
Q

What condition is a result of a failure of GnRH-producing neurons to migrate from olfactory pit?

A

Kallman’s syndrome

31
Q

What is the main function of the thalamus?

A

Major relay for all ascending sensory information except olfaction

32
Q

What inputs does the Ventral postero-lateral nucleus (thalamus) receive?

A
  • Spinothalamic
  • DCML
33
Q

Where do the inputs from the Ventral postero-lateral nucleus (thalamus) go to?

A

Primary somatosensory cortex (parietal lobe)

34
Q

What inputs go to the Ventral postero-medial nucleus (in thalamus)?

A
  • Trigeminal (face sensation)
  • Gustatory pathway (taste)
    Very Pretty Makeup goes on the face
35
Q

Where do inputs go to from the Ventral postero-medial nucleus (thalamus) go to?

A

Primary somatosensory cortex

36
Q

What inputs does the Lateral geniculate nucleus (thalamus) receive?

A

Vision
- CN II
- Optic chiasm
- Optic tract

Lateral = Light

37
Q

Where do inputs from the Lateral geniculate nucleus (thalamus) go to?

A

Primary visual cortex

38
Q

Where does the Medial geniculate nucleus (thalamus) receive inputs from?

A

Superior olive and inferior colliculus of tectum (hearing)

Medial = Music

39
Q

Where do inputs from the Medial geniculate nucleus (thalamus) go to?

A

Primary auditory complex (temporal lobe)

40
Q

Where does the Ventral anterior and lateral nuclei (thalamus) receive inputs from?

A
  • Basal ganglia
  • Cerebellum
    (motor)

Venus astronauts love to move

41
Q

Where do inputs from the Ventral anterior and lateral nuclei (thalamus) go to?

A

Motor cortices (frontal lobe)

42
Q

What is the function of the limbic system?

A
  • Emotion
  • Olfaction
  • Behaviour modulation
  • ANS function

Feeding, Feeling, Fighting, Feeling, Fucking (sex) (5Fs)

43
Q

What structures does the limbic system consist of?

A
  • Hippocampus (memory)
  • Amygdalae (processing emotions associated w. fear)
  • Mammilary bodies (recollective memory)
  • Anterior thalamic nuclei (episodic memory)
  • Cingulate gyrus (processing emotions, behaviour regulation, regulate motor function)
  • Entorhinal cortex (memory formation, navigation, perception of time)
44
Q

What can damage or decreased activity to the mesocortical pathway result in?

A

Negative symptoms, anergia, apathy, lack of spontaneity (connects to frontal lobe)

45
Q

What does the mesocortical pathway connect?

A

Ventral Tegmental Area (VTA) (dopamine producing) to the frontal cortex

45
Q

What does the Mesolimbic pathway connect

A

VTA (dopamine producing) to Nucleus accumbens (ventral striatum, part of BG), Prefrontal cortex and Amygdala

46
Q

An increase in activity of the Mesolimbic system is associated with what condition?

A

Schizophrenia (delusions, hallucinations)

47
Q

A decrease in activity of the nigrostriatal pathway will result in what symptoms?

A

Extrapyramidal symptoms (dystonia, akathisia, parkinsonism, tardive dyskinesia)

48
Q

What dopamenergic pathway is targeted by antipsychotics?

A

Mesolimbic (can affect nigrostriatal leading to tardive dyskinesia OR Tuberoinfundibular -> hyperprolactinemia)

49
Q

What dopamenergic pathway is affected by movement disorders?

A

Nigrostriatal pathway

50
Q

The tuberoinfundibular pathway connects what?

A

Hypothalamus to anterior pituitary

51
Q

A decrease in activity of the tuberoinfundibular pathway can result in what side effect?

A
  • Galactorrhea (hyperprolactinemia), decr libido, gynaecomastia
52
Q

What are the 2 primary dopamine producing areas of the brain?

A
  • Ventral Tegmental Area (VTA)
  • Substantia Nigra (2 of them)
    Located in midbrain

USMLE Neurology (19 decks)

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