Test 3 Flashcards by Kelly MacWhorter

Where is ACh synthesized?

Basal nucleus of Meynert

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What neurotransmitter is decreased in Alzheimer Disease and Huntington Disease but increased in Parkinson Disease?

ACh

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This area has no blood brain barrier in order to sense osmolarity.

OVLT

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The neurohypophysis does not have a blood brain barrier in order to release ____

ADH

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TAN HATS is a learning pneumonic that describes the _______ and stands for?

Hypothalamus

Thirst
Adenohypophysis
Neurohypophysis
Hunger
Autonomic regulation
Temperature regulation
Sexual urges

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Defect to this part of the hypothalamus could lead to failure to thrive in infants

Lateral

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Without the posterior hypothalamus we would become ___

poikilotherms! cold-blooded like a naked mole rat :)

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The circadian rhythm is regulated by this part of the hypothalamus

Suprachiasmatic nucleus

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Structures of the limbic system include

Hippocampus
Amygdala
Nucleus Accumbens
Fornix 
Mamillary bodies
Cingulate gyrus

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What are the 5fs?

Feeding
Fleeing
Fighting
Feeling
Fucking

All describe limbic system!

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Kluver Bucy syndrome is due to what lesion?

Bilateral amygdala, associated with HSV-1 encephalitis

Presents with disinhibited behavior

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Lesion to mamillary bodies results in what syndrome?

Wernicke Korsakoff

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What is Wernicke Korsakoff

CAN of beer - confusion, ataxia, nystagmus

Thiamine deficiency and alcoholism

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A patient unable to form new memories (anterograde amnesia) has issue with what structure?

Hippocampus

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ApoE4 is associated with ______ risk or sporadic form of Alzheimers disease

INCREASED

ApoE2 - too good, protective

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List two histological findings of a patient with AD

amyloid plaques and neurofibrillary tangles

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A patient presents with changes in personality and behavior. What neuropathology are you considering?

Frontotemporal dementia - Pick Disease

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The aggregation of these formations leads to dementia and parkinson depending on their location.

Lewy Bodies (a-synuclein) 
Cortex = Dementia

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A low Amyloid to Tao index supports _____

Alzheimer since amyloid are deposited in the brain and presence of tau causes degeneration of neurons and their release into CSF

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A true diagnosis of AD requires proved presence of

Aβ plaques, however, the inverse is not true: individuals can have evidence of high levels of the Aβ protein but not show clinical signs of dementia

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What do Frontotemporal dementia, Alzheimer disease, Parkinson disease and Creutzfeldt-Jakob disease all have in common?

Possible progression to dementia

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This 3 functions to go first in a patient with ED before losing procedural memory

episodic memory
expressive language
executive function

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The Pittsburg compound is used in ___ scans as a diagnosis for _____ since it specifically binds ____

PET scans
AD
AB plaques

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Hypothalamic connections to the amygdala play a role in ____

aggression

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When you hear amygdala think _______

orchestrates emotional and drive-related behavior through connection with brainstem, hypothalamus, and cord

What is the connection between the nucleus accumbens and Ventral tegmentum (VTA)?

NA is involved in the reward pathway and the VT is the location of Dopamine synthesis and release

Hippocampus role?

Learning and declarative memory (facts, places, faces, events, etc)

Damage the hippocampus and get impairments in consolidation of new _________.

declarative memories

Urbach-Wiethe disease = ?

bilateral destruction of amygdala

Which circuit plays a major role in consolidation of new declarative memories?

Papez

Symptoms of Kluver Bucy

- The animals are fearless and placid. They do not respond to threats, to social gestures by other animals, or to objects they would normally flee from or attack. - Male animals become hypersexual and are indiscriminate in their choice of mate. - They show an inordinate degree of attention to all sensory stimuli, as though ceaselessly curious.They exhibit hyperorality, mouthing and eating inappropriate objects, as well as food in larger amounts than normal animals. - Although they incessantly examine all objects in sight, these animals apparently recognize nothing and may pick up the same object over and over. This is called visual agnosia.

The _______ is the anterior part of the parahippocampal gyrus.

The entorhinal cortex

Outline the role of the entorhinal cortex

- recieves constant stream of cognitive and sensory information from the association areas of the neocortex - transmits it to the hippocampal formation for consolidation - retrieves it in consolidated form - returns it to the association areas where it is encoded in the form of memory traces.

What makes up the striate nucleus?

Caudate and putamen

What makes up the lenticulate nucleus?

Globus Pallidus and Putamen

What are the primary input nuclei?

Caudate and putamen -- striate nucleus

What are the primary output nuclei?

Globus Pallidus and Substantia nigra.

T/F The Basal Ganglia projects directly to the cortex.

F. Always goes through the thalamus.

T/F The basal ganglia thus increase or decrease thalamic activity by adjusting the degree of inhibition of the thalamus.

True

List the 4 loops of connections in the basal ganglia

Limbic Prefrontal Motor Oculomotor

What is the overall effect of activating the indirect pathway?

enhance inhibitory output of the GPi and decrease the excitatory output of the VA/VL nucleus of the thalamus, thereby blocking unwanted movements.

Give a brief outline of the indirect pathway

from the caudate and putamen to the globus pallidus external segment (GPe) to the subthalamic nucleus (STN) then to the globus pallidus internus (GPi) which is the output nucleus of the basal ganglia

The subthalamic nuclei (STN) is part of the ____ pathway.

Indirect

Damage to the STN results in ______.

Hemiballism

You would expect to see flailing unintended movements with damage to the ______ pathway

Indirect, damage = undesired movements

The basal ganglia on one side are connected to thalamus on the ____ side

same side!

Patella Reflex

Achilles Reflex

L1 dermatome

inguinal ligament

L5 dermatome

Anterior leg and middle 3 toes of dorsal foot

Dermatome for lateral foot

Dermatome for posterior leg and thigh

S1, S2

primitive reflexes normally disappear within the _____ year of life

first

Moro reflex

abduct/extend arms when startled then draw together

rooting reflex

movement of head toward one side if cheek or mouth is stroked

Galant reflex

stroking along one side of the spine while newborn is in ventral suspension (face down) causes lateral flexion of lower body toward stimulated side

This part of the ear transfers sound waves via vibration of eardrum

Outer ear

What are the three bones of the middle ear?

Malleus, incus, stapes

What part of the middle ear conducts and amplifies sound from the eardrum to inner ear?

Ossicles

This snail-shaped, fluid-filled structure lives in the inner ear

cochlea

Tonotopy describes....

how each frequency leads to vibration at specific location on basilar membrane

high frequency sounds in tonotopy are heard best at...

base of cochlea

while higher frequency sounds are heard best at the base of cochlea, lower frequency sounds are heard best at ...

apex near helicotrema

What could lateralization to the R indicate in a Weber test?

R conductive hearing loss | L sensorineural hearing loss

What does a + Rinne test mean?

Normal = air conduction perceived as louder

In conductive hearing loss, Weber results in a sound that is perceived as ______

louder

Conductive hearing involves what structures?

Outer ear, tympanic membrane, eardrum, middle ear, ossicles

A perforated ear drum will result in _______ hearing loss

Conductive

A person with a perforated R ear drum will have lateralization to the _____ ear with a Weber test and a normal Rinne test

Perforated R ear drum = lateralization to the R in Weber; normal Rinne

Sensorineural hearing involves the .....

inner ear, cochlea, CN 8

A rockband groupy would likely develop ______ hearing loss in their older years.

Sensorineural due to noise trauma

You suspect right sensorineural hearing loss which is confirmed with a - Rinne on the right. What would suspect on Weber?

Lateralization to the unaffected side = L side.

Who has a positive Rinne test?

Someone with normal hearing. Both conductive and sensorineural hearing loss result in a negative Rinne.

Aqueous humor of the eye is produced in the ______

ciliary body

Production of aqueous humor by the ciliary body can be inhibited by ________

CA inhibitor, a-2 agonists, and beta-blockers

Outflow of aqueous humor mostly goes through ____ but can also drain into the _____

Mostly trabecular, but also uvea and sclera

Increase of trabecular outflow can be achieved with _____

M3 agonist

Increase of uveoscleral outflow can be achieved with _____

prostaglandin agonist

This refers to the eye being TOO short, and light is focused behind the retina

hyperopia

Age-related impaired accomodation

Presbyopia

Presbyopia often necessitate reading glasses in older groups. The pathological process associated is ______

decreased lens elasticity

This type of glaucoma is a true opthalmic emergency

Closed-angle glaucoma

Key buzzwords for closed-angle glaucoma

Very painful, red eye, sudden vision loss, halos around light, rock-hard eye, frontal headache

What medicine do you want to avoid in closed-angle glaucoma?

Epinephrine due to its mydriatic effect

Trabecular meshwork blocked by WBC in infectious processes may lead to ...

Open-angle glaucoma

Hypopyon = ? and associated with ?

pus in anterior chamber of eye, uveitis

A patient taking preservision is likely fighting of _____

age-related macular degeneration

Drusen is associated with ______ ARMD

DRY!

As compared to dry MD which is prevented with multivitamins and antioxidants, wet MD is treated with _____

anti-VEGF

The two types of diabetic retinopathy are

Non proliferative and proliferative

Nonproliferative diabetic retinopathy is when capilaries become ______ leading to hemorrhages and _____

damaged, macular edema

Crinkled tissue = ?

retinal detachment

What are risk factors for retinal detachment?

high myopia, head truama, retinal breaks, diabetic traction, inflammatory effusions

What often precedes retinal detachment?

flashes, floaters (posterior vitreous detachment), "curtain draw down"

Cherry red spot = ?

retinal artery occlusion

What should work up of retinal artery occlusion include?

identify embolic source -- retinal artery comes off opthalmic artery from ICA

bone spicule-shaped deposits around macula = ?

retinitis pigmentosa

Increased ICP will lead to enlarged blind spot and blurred margins of optic disk, better known as ?

Papilledema

Aneurysm of the PCA will likely pinch CN3. The first functions to go will be the ______

parasympathetic output

Loss of CN3 parasympathetic output will result in ______

blown pupil

As compared to the parasympathetic output of CN3 which controls pupil constriction, loss of motor output will make the patient present with ____

ptosis and down and out

A patient with CN __ damage will tilt their head toward the side of the lesion

CN 4!

Meyer Loop is part of the optic radiation within the ______ lobe

temporal

The Meyer Loop within the temporal lobe goes to the ______ bank of the ______ fissure

Meyer = LOWER bank of Calcarine

Despite being in the LOWER bank of the Calcarine Fissure, the Meyer Loop visualizes the ______

Meyer = SUPERIOR VISUAL FIELDS

Knock out R Meyer Loop and you have ______

Left SUPERIOR quadrantic hemianopia

If you knock out the PCA, is the macula spared?

YES

Damage is done to the L cuneus of the brain. What vision is affected?

Cuneus = UPPER bank of Calcarine Fissure = lower visual field L lower quadrantic anopia

Damage to the optic chiasm gives

Bitemporal hemianopsia

Damage to the R optic nerve give

R anopia

Damage to the R optic tract gives

L homonymous hemianopia

Damage to the R PCA gives

L hemianopia with macular sparing

Damage to the L Meyer Loop gives

R upper quadrantic anopia