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Subcortical brain stuff Flashcards

1
Q

What is the only sense that is not processed through the thalamus?

A

smell

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2
Q

Identify the info, input, and output for the following thalamic nuclei:

ventral posterolateral nucleus

A

Info: all sensory (pain, temp, touch, prop vibration)

Input: spinothalamic, posterior column (medial lemniscus)

Output: somatosensory cortex

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3
Q

Identify the info, input, and output for the following thalamic nuclei:

ventral posteromedial nucleus

A

info: sensory face & taste
input: trigeminal & gustatory
output: somatosensory cortex

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4
Q

Identify the info, input, and output for the following thalamic nuclei:

lateral geniculate nucleus

A

info: vision
input: CNII
output: calcarine sulcus

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5
Q

Identify the info, input, and output for the following thalamic nuclei:

medial geniculate nucleu

A

info: hearing
input: superior olive and inferior colliculus of tectum
output: temporal lobe (auditry cortex)

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6
Q

Identify the info, input, and output for the following thalamic nuclei:

ventral lateral nucleus

A

info: motor
input: basal ganglia
output: motor cortex

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7
Q

What is the most common casue of thalamic syndrome?

Symptoms?

A

lacunar stroke

contralateral sensory loss (face, arm, legs) - all sensory modalitites

resolution - long-term chronic pain contralateral side but sensory exam is normal (severe pain in paroxysms or exacerbated by touch)

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8
Q

Identify the function & the resulting dysfunction froma lesion in the indicated hypothalamic area:

lateral

A

hunger

lesion: anorexia, failure to thrive in infants

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9
Q

Identify the function & the resulting dysfunction froma lesion in the indicated hypothalamic area:

ventromedial

A

satiety

lesion: hyperphagia, obesity

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10
Q

Identify the function & the resulting dysfunction froma lesion in the indicated hypothalamic area:

anterior

A

cooling

lesion: hyperthermia

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11
Q

Identify the function & the resulting dysfunction froma lesion in the indicated hypothalamic area:

posterior

A

heating

lesion: inability to thermoregulate

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12
Q

Identify the function & the resulting dysfunction froma lesion in the indicated hypothalamic area:

suprachiasmic nucleus

A

circadian rhythm

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13
Q

What are the immune substances that enter the brain and trigger a fever?

How do they do this

A
  • Enter brain
    • IL-1
    • IL-6
    • TNF
  • They then trigger prostaglandin E2 system
    • mediated by: (PLA2, COX2, prostaglandin E2 synthase)
  • this increases the anteior hypothalamus set point
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14
Q

What are the inhibitory homones released by the hypothalamus?

A
  • dopamine inhibits prolactin
  • prolactin inhibits GnRH
  • somatostatin inhibits GH
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15
Q

What part of the hypothalamus produces ADH?

Oxytocin?

A

ADH: supraoptic nucleus

Oxytocin: paraventricular nucleus

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16
Q

What is the location of a craniopharyngioma?

Symptoms?

A

rathke’s pouch

pressure on optic chiasm - bitemporal hemianopsia

pressure on hypothalamus - hypothalamic syndrome

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17
Q

What are the symptoms of hypothalamic syndrome?

A

DI (d/t loss of ADH)

Fatigue (d/t loss of CRH -> low cortisol)

obesity

loss of temperature regulation

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18
Q

What are the main functions & key components of the limbic system?

A

Function: emotion, long-term memory, smell, behavior modulation, autonomic nervous system function

components: cingulate gyrus, hippocampus, fornix, amygdala, mammilary bodies

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19
Q

What is the cause of Kluver-Bucy syndrome?

A

Damage to the amygdala (rare complication of HSV1 encephalitis)

  • Symptoms
    • hyperphagia - weight gain
    • hyperorality - examine with mouth
    • inappropriate sexual behavior - mounting inanimate objects
    • visual agnosia - inability to recognize visually presented stimuli
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20
Q

Common causes & sympotom of hippocampus lesion?

A

infarction: hippocampal branches PCA, anterior choroidal arteries

  • Symptoms
    • anterograde amnesia
    • cannot make new memories
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21
Q

What is the difference between Wernickes & Korsakoff syndromes?

They are both associated with what conditions?

A

Wernickes: acute encephalopathy

Korsakoff: chronic neurological condition (usually consequence of Wernickes)

Associated w/: alcoholism, thamine (vit B1) deficiency, atrophy of mammillary bodies

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22
Q

What is the triad seen in Wernicke’s syndrome?

Treatment?

A

visual disturabances/nystagmus

gait ataxia

confusion

often reversible w/ thiamine

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23
Q

What additional symptoms are seen in Korsakoff syndrome as opposed to Wernickes?

Treatment?

A

amnesia (recent more affected than long-term)

confabulation (make stuff up b/c can’t remember), lack of interest/concern, personality changes,

usually permanant

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24
Q

Which peduncles carry information into the cerebellum & which carrin info out?

Holding what type of information?

A
  • in:
    • middle: contralateral pons
    • inferior: ipsilateral spinal cord information (proprioception)
  • out:
    • superior: from deep cerebellar nuclei
      • to red nucleus & thalamus
25
What are the two types of axons that enter the cerebellum? How are they different?
climbing - from interior olivary nucleus mossy - from everywhere else both synapse on purkinje cells & deep nuclei
26
What are the 3 deep nuclei of the cerebelum? Where do they send their information?
(lateral to medial) * Dentate * contralateral VA/VL nuclei of thalamus * interposed nucleu: globus/emboliform * contralateral redu nucleus * fastigial * vestibular nuclei & reticular formation
27
What is the difference in symptoms between lateral & medial lesions of the cerebellum?
* lateral: * hemispheres * dentate * extremities * medial: * floculonodular node * emboliform, globus, fastigial nucleus * trunk both affect ipsilateral side (motor crosses twice)
28
Romberg tests for what type of ataxia?
sensory ataxia - NOT cerebellar patients with cerebellar ataxia will have instability even when eyes are open
29
In addition to ataxia, what are the other symptoms commonly seen in cerebellar lesions?
hypotonia scanning speech (irregular, slow) dyssynergia (loss of coordinated activity) - dysmetria, intention tremor, dysdiadochokinesia nystagmus (vertical) nausea/vomiting vertigo
30
Ataxia telangiectasias has what type of inheritance pattern? Mutation? Syptoms?
autosomal recessive defective ATM gene chromosome 11 (DNA hypersensitivity to ionizing radiation - failure to repair ds DNA breaks (NHEJ)) cerebellar atrophy w/in 1 yr - wheelchair by 10 yr tenangiectasias (ear, nose, face, neck) repeated sinus infections (immunodeficiency) high risk cancer
31
What is the name for the process of repairing double stranded DNA breaks?
non-homologous end joining
32
What are the lab findings seen in patients with ataxia telangiectasia?
increased AFP dysgammaglobinemia (low/absent IgA)
33
Friedriech's Ataxia has what type of inheritance pattern? Mutation? Symptoms?
* autosomal recessive * frataxin gene chromosome 9 (needed for mitochondrial function) - increased GAA repeats * begins adolescence - cerebella & spinal cord degeneration * spinocerebellar tract * ataxia, dysarthria * dorsal columns * loss of position/vibration sensation * corticospinal tract * UMN weakness in lower extremities * hypertrophic cardiomyopathy * diabetes (beta cell dysfunction) * kyphoscoliosis * foot abnormalities (high arch)
34
Identify the indicated structures
35
The striatum is composed of what structures? What about the lentiform nucleus?
striatum = putamen + caudate lentiform nucleus = putamen + globus pallidus
36
How do the direct and indirect pathways in the basal ganglia repectively impact the primary motor cortex?
direct: activates indirect: inhibits
37
The thalamus is inhibited by stimulating the cortex by what structures?
Globus pallidus interna & pars reticulata
38
What is the role of the striatum in the direct pathway?
dumps GABA onto pars reticularis & globus pallidus internus this allows the thalamus to stimulate the cortex
39
What is the role of dopamine in the direct pathway?
when the cortex stimulates the striatum, it also stimulates the pars compacta the pars compacta utilizes dopamine (D1 receptors) to amplify stimulation of the striatum
40
What is the role of the striatum in the indirect pathway?
stimulates globus pallidus externus - therefore the subthalamic nucleus is free to stimulate the globus pallidus internus- which then inhibits the thalamus
41
What is the role of dopamine in the indirect pathway?
the pars compacta stimulates D2 receptors on the striatum, which shuts it down
42
What disease results from the loss of the dopamine modification pathway in the basal ganglia?
parkinsons
43
Huntington's affects what aspect of the basal ganglia?
striatum
44
Hemibalism is due to damage of what part of the basal ganglia?
subthalamic nucleus
45
Parkinsons disease is due to damage of what part of the basal ganglia?
substantia nigra (pars compacta & reticulata)
46
Wilson's disease can result in damage to what part of the basal ganglia?
globus pallidus
47
What cells produce CSF? Absorbed by what?
ependymal cells of choroid plexus absorbed by villi
48
Common presentign complaint & key finding in communicating hydrocephalus? CT?
Headache papilledema dilation of ALL the ventricles
49
Commnicating hydrocephauls commonly follows what condition? What is the major concern with communicating hydrocephalus?
meningitis herniation
50
What is aqueductal stenosis? Presentation? Inheritance pattern of genetic kind? Cause of non-genetic kind?
blocked drainage 3rd ventricle to 4th ventricle - presents as enlarging head circumference genetic: X-linked non-genetic: inflammation d/t intrauterine infection
51
Chiari malformation II is associated with what other condition?
myelomeningocele (failure of spine & meninges to close around spinal cord- outside)
52
What is a Dandy Walker Malformation?
developmental anomaly of the 4th ventricle hypoplasia / agenesis of cerebellar vermis (massive 4th ventricle, small cerebellum)
53
3 symptoms of Dandy Walker Malformation?
hydrocephalus developmental delay motor dysfunction
54
Classic finding of patients with pseudotumor cerebri (idiopathic intracranial hypertension)? Treatment?
pulsatile tinnitus rushing water/wind sound - transmission of vascular pulsations acetazolamide
55
Physical findings seen in patients with normal pressure hydrocephalus? Classic triad? Treatment?
enlarged ventricles on imaging that compress the corona radiata normal opening pressure LP triad: urinary incontinence, gait disturbance, dementia (wet, wobbly, wacky) ventriculoperitoneal shunt
56
Cause of Hydrocephalus ex Vacuo?
ventricular enlargement that occurs d/t age and the decreased mass of the cortex (esp. in alzheimers, pick disease, HIV) the sulci _increase in proportion_ to the increase in ventricles
57
Which sinus receives CSF? Where do all of the sinuses drain to?
saggital sinus internal jugular
58
Symptoms of cavernous sinus syndrome?
headache swollen eyes impairment of ocular motor nerves Horner's syndrome sensory loss 1st & 2nd division trigeminal nerve
59
AV malformations commonly lead to enlargement of what vein?
Vein of Galen

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