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202 Neuroscience & Behaviour > Theme 2 - Sensory Inputs and Motor Outputs > Flashcards

Theme 2 - Sensory Inputs and Motor Outputs Flashcards

1
Q

An ipsilateral lesion to the dorsal medial leminscus tract spinal cord (for example in MS) will result in what?

A

loss of propriception on the same side

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2
Q

What is a loss of coordination and balance without visual cues known as?

A

sensory ataxia

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3
Q

What is the test/sign for sensory ataxia?

A

Rombnerg’s sign - severe swaying on standing with eyes closed and feet together

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4
Q

An ipsilateral lesion to the white matter anterolateral column will result in what?

A

Loss of pain, temperature and crude touch on opposite side

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5
Q

What will an ipsilateral lesion to the posterior spinocerebellar tract cause?

A

Loss of lower limb muscle coordination on the same side

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6
Q

3 symptoms associated with upper motor neuron disease

A

Spastic paralysis
Overactive tendon reflexes
No significant atrophy

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7
Q

If there is a degeneration of upper motor neurons above the pyramids which side will it mainly affect?

A

opposite side

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8
Q

Three features of lower motor neuron disease

A

Flaccid paralysis
No tendon reflexes
Atrophy

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9
Q

What does amyotrophic lateral sclerosis (Lou Gehrigs disease) affect?

A

progressively and selectively affects both lower and upper motor neurons

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10
Q

What three things will be affected in anterior cord syndrome?

A

Bilateral lower motor paralysis and atrophy (lower motor neurons
Bilateral spastic paralysis descending anterior tracts
Loss of pain, temperature and fine touch

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11
Q

What sensation remain intact during anterior cord syndrome

A

proprioception
tactile descrimination
vibration

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12
Q

5 effects of Brown-Sequard hemisection?

A

ipsilateral paralysis and atrophy (lower motor)
ipsilateral spastic paralysis (upper motor)
ipsilateral anesthesia at lesion level (dorsal root)
ipsilateral loss of proprioception
contralateral loss of pain, temp and light touch

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13
Q

4 Effects of complete cord transection

A

Complete loss of sensation and voluntayy movement below transection site
Bilateral lower motor neuron paralysis and atrophy
Bilateral spastic paralysis
Bladder and bowel non voluntary

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14
Q

Outline the motor control hierarchy in terms of associated areas of the brain (high to low)

A

Association areas of neocortex, basal ganglia
Motor cortex/cerebellum
Brainstem/spinal cord

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15
Q

What are the 5 descending motor pathways?

A 
Corticospinal 
Rubrospinal 
Reticulospinal 
Tectospinal
Vestibulospinal
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16
Q

Where does the corticospinal tract begin, dessucate and synapse?

A

Motor cortex
Medullary pyramids
Lateral CS tract

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17
Q

Where does the Rubrospinal tract begin, dessucate and predominantly end up?

A

Red nuclei in midbrain
Medulla
Cervical junction

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18
Q

Where does the vestibular spinal tract begin and where do they go?

A

Medial and Lateral vestibular nucleus in brainstem
Med - neck muscles
Lateral - Limbs

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19
Q

What does the vestibular muscles facilitate?

A

Keeping a steady gaze

Steady balance and posture

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20
Q

From where does the Tectospinal tract originate?

A

Superior and inferior colliculi

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21
Q

What does the tectospinal tract from each collucili help you to do?

A

Superior collucili - instant neck and head muscle responce to fast visual stimulus

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22
Q

Where does the reticulospinal tract originate and what is it associated with?

A

Reticilum (back) of brainstem and aid with posture

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23
Q

What descending pathways are associated with control of head and neck movements?

A

Tectospinal and medial vestibulospinal

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24
Q

What descending pathways are associated with control of limb extension?

A

Lateral vestibulospinal and reticulospinal

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25
Q

What descending pathway is associated with flexion of upper limbs?

A

Rubrospinal

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26
Q

In a coma pt, what type of posturing will result in them flexing their arm and either flexing or extending their leg?

A

decorticate posturing

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27
Q

In a coma pt what type of posturing will result in them extending both their arms and legs?

A

decerebrate

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28
Q

What indication do decorticate and decerebrate posturing give about the location of the lesion?

A

decorticate - above red nucleus (Rubrospinal tract intact)

decerebrate - below red nucleus

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29
Q

Does the babinski reflex indiacate an upper or power motor neuron lesion?

A

Upper

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30
Q

Where does the corticobulbar pathway go from/to?

A

motor cortex to cranial nerves

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31
Q

What is the difference in terms of lesion localisation and facial palsy between a stroke and Bells palsy?

A

Stroke - upper motor neurone, contralateral lower half

Bell’s - lower motor neurone, ipsilateral, full half

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32
Q

What is abulia?

A

Loss or impairment of the ability to make decisions or act independently

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33
Q

A stroke associated with what type of artery is most likely to result in abulia?

A

Anterior cerebral

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34
Q

What type of seizure is associated with a “march” of symptoms?

A

Jacksonian

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35
Q

What can damage to the posterior parietal cortex result in?

A

neglect - can perceive but not attend

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36
Q

What pathways are associated with the posterior parietal cortex?

A

somatosensory afferent

visual afferent

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37
Q

Damaged to the interconnections between the sensory and motor coordination areas is likely to result in what?

A

Apraxia

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38
Q

What term describes a difficulty in sequencing and execution of movements?
Apraxia
Aphagia
Anosia

A

Apraxia

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39
Q

What is the difference between ideational and ideomotor apraxia and what areas of the brain are they assocoated with?

A

Ideational (parietal) cannot report sequence

Ideomotor (SMA) - cannot use the tool

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40
Q

What condition is best described as sustained muscle contractions, usually producing twisting and repetitive movements or abnormal postures or positions.
If only occurs with certain actions, said to be ‘task specific’.

A

dystonia

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41
Q

3 functions of the cerebellum

A

Maintenance of balance and posture
Coordination of voluntary movements
Motor learning

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42
Q

What are the 3 main inputs into the cerebellum and what area do they feed into?

A

vestibulocerebellum - flocculonoddular
cerebrocerebellum - hemispheres
spinalcerebellum - vermis

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43
Q

to what nuclei do the vermis, paravermis and hemispheres link?

A

vermis - fastigial
paradermis - interposed
hemispheres - dentate

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44
Q

To what other areas of the brain are the cerebellar fastigial, interposed, dentate and vestibular nuclei linked to?

A

Fastigial - motor
interposed - motor
dentate - motor planning
vestibular - balance and eye movements

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45
Q

4 Steps of the spinocerebellum loop

A

spinocerebellar tract
vermis
fastigial/interposed nuclei
reticulo/vestibularspinal tract

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46
Q

6 steps of the corticocerebellum loop

A 
cortex
pons
hemispheres
dendate nucleus
thalamus
cortex
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47
Q

4 steps of vestibulococlear loop

A

vestibulocochlear
fluculonodular node
vestibular nuclei
eyes/neck muscles

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48
Q

What are the 3 cerebellar peduncles and are they inputs or outputs?

A

Superior - output
Middle - input
Inferior - input

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49
Q

What tracts input via the inferior and middle cerebral peduncle?

A

inf - Spinocerebellar

mid - corticocerbellar

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50
Q

What tracts output via the superior cerebral peduncle?

A

vestibulocerebellar
corticocerebellar
spinocerebellar

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51
Q

5 effects of lesions on the cerebrocerebellar pathway

A 
dysmetria
dysnergia
disdisdochokinesia
intentional tremor
dysarthria
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52
Q

What term is defined as the inability to stop a movement in time?

A

Dysmetria

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53
Q

What term is defined as decomposition of complex movements?

A

Dsynergia

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54
Q

What term is defined as reduced ability to perform rapidly alternating movements?

A

Dysdiadochokinesia

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55
Q

What is an intentional tremor?

A

tremor arising when trying to perform a goal-directed movement

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56
Q

What term is defined as incoordination in the respiratory muscles, muscles of the larynx, etc. Uneven speech strength and velocity?

A

Dysarthria

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57
Q

What are the 2 effects of lesions on the vestibulo occular pathway?

A

Nystagmus

Inability to fixate when moving

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58
Q

What is the effect of lesion on the spinocerebellar pathway?

A

gait ataxia

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59
Q

What term is defined as involuntary, rhythmical, repeated oscillations of one or both eyes, in any or all directions of view?

A

Nystagmus

60
Q

What two types of fibre input into the cerebellum and where do they come from?

A

Mossy fibres - spinal tract

climbing fibres from - inferior olive of medulla

61
Q 
Describe/draw the cerebellar circuit in terms of
mossy fibres, 
climbing fibres
granule cell
parallel cell
purkunje cell
A

mossy to granule to parallel to perkunje

climbing to perkunje

62
Q

Give 2 genetic causes of cerebellar dysfunction

A

Frederich’s ataxia

Spinocerebellar degeneration

63
Q

5 causes of acquired symmetrical ataxia

A 
Alcohol
drugs
metabolic (B12)
degenerative
Immune
64
Q

What 3 types of tissue are innervated by the ANS?

A

Smooth muscle
cardiac
glands

65
Q

What are the 3 divisions of the ANS?

A

sympathetic
parasympathetic
enteric

66
Q

In terms of the CNS what are anatomical divisions of the sympathetic and parasympathetic nervous systems?

A

Para - brainstem, S1-S4

sym - T1 - L2

67
Q

The ANS works via a disynaptic pathway in all but one effector organ, which one?

A

adrenal glands

68
Q 
Explain/draw the disynaptic pathway i terms of
cranial nerve
ganglion
effector organ
myelenated
unmylenated
A

as described

69
Q

What is the main neurotransmitter in the preganglionic ANS?

A

Ach

70
Q

What are the three ascending pathways in the spinal cord?

A

Spinothalamic (anterolateral)
spinocerebellar
dorsal columns (medial lemniscus)

71
Q

What neurotransmitters used (post ganglion) by the sympathetic and para sympathetic nervous system?

A

sym Noradrenaline/NE

para - Ach

72
Q

What type of receptors are employed by the sympathetic and para sympathetic nervous system pre and post ganglion?

A

ganglion - nicotinic Ach

post - G protein metabotropic (except adrenal medulla)

73
Q

What are the two plexuses that make up the enteric nervous system and what do they regulate?

A

Auerbach’s - muscle contraction

Meissner’s - secretions

74
Q

What are the two possible pathways of the preganglionic fibres once they enter the sympathetic trunk?

A

Synapse in ganglion

Pass through ganglion in splancnic nerves and synapse in prevertebral ganglia

75
Q

Post ganglionic fibres are more numerous than preganglionic fibres, what is the advantage of this?

A

It allows for a mass response

76
Q

What are the two possible pathways of the POSTganglionic fibres once they exit the sympathetic trunk?

A

To periphery via grey rami

To viscera via plexuses

77
Q

What are the 3 ganglia in the cervical trunk, and what’s special about one of them?

A

Superior
Middle
Inferior - fussed to T1 ganglia to form stellate

78
Q

What are the 3 possible routes for the postganglionic fibres in the cervical sympathetic trunk?

A

via grey rami to spinal nerves and upper limbs
piggy back down carotid artery to heart
Or up internal/external carotid to head

79
Q

What condition is the disruption of sympathetic nervous supply to the head?

A

Horners syndrome

80
Q

What are the 3 possible routes of the postganglionic fibres in the thoracic sympathetic trunk?

A

grey rami to spinal nerves
medial branches to heart and lungs
splancnic nerves to abdomen

81
Q

What cranial nerves are associated with the parasympathetic nervous system

A

III
VII
IX

82
Q

5 sensations of pain

A

Sharp stab
Deep Ache
Burning
Freezing Itch

83
Q

3 classifications of pain

A

Nociceptive
Infalmmatory
Neuropathic

84
Q

Describe A alpha and A beta fibres in terms of myelenation, diameter and sensation conveyed

A

Myelenated
Thick
Light touch, proprioception

85
Q

Describe A delta fibres in terms of myelenation, diameter and sensation conveyed

A

Thinly myelenated
medium
light touch, temperature nociception

86
Q

Describe C fibres in terms of myelenaations, diameter, ans sensation

A

Unmyelenated
thin
temperature, nociception

87
Q

What are the types of nerve fibre involved in pain transmission

A

Alpha delta

C fibres

88
Q

What type of pain is conveyed by each type of pain fibres?

A

Alpha delta - sharp prick

C fibres - dull ache

89
Q

At what point on the pain transduction graph is the first and second response?

A

First large peak = A beta
First small peak = first response from A delta
last small peak = second response from C fibres

90
Q

Which transient potential receptor is responsible for detecting heat?

A

TRPV1

91
Q

Via what tract does pain ascend the spinal cord?

A

spinothalamic tract

92
Q

How does referred pain occur with regard to synapsing of neurons?

A

because the first order neurons of the vicera and cutaneous synapse on the same second order neuron

93
Q

What 2 regions involved in the descending regulation of pain?

A 
PAG (midbrain)
Raphe nucleus (medulla)
94
Q

What effect can the Raphe nucleus have on the spinothalamic tract?

A

Either excite or inhibit.

So increase or decrease pain

95
Q

2 examples of opioids that play a role in descending inhibition of pain

A

Enddorphins

Enkephalins

96
Q

What receptors do opioids act upon?

A

Inhibitory metabotropic receptors

97
Q

Give 3 sites from which opioids are released from

A

PAG - midbrain
Raphe - medulla
Dorsal horn

98
Q

Give 3 inflammation related chemical that can activate nociceptors

A

ATP
H+
Serotonin

99
Q

What 2 substances are related to neurogenic inflammation?

A

Substance P

CGRP

100
Q

What term is defined as a non-noxious stimuli producing a painful response?

A

Allodynia

101
Q

What term is defined as a noxious stimuli producing an exaggerated pain response?

A

Hyperalgesia

102
Q

With regard to pain hypersensitisation what will peripheral and central sensitisation result in?

A

Peripheral - primary hyperalgesia

central - allodynia

103
Q

How do bradykinin and NGF influence peripheral nerves sensitisation?

A

reduce threshold of heat activated channels

104
Q

What are the 6 components of the basal gangia?

A 
Putamen
Globus Pallidus Internal
Globus Pallidis External
Caudate nucleus 
Substantia Nigra
Subthalmaic nucleus
105
Q

What makes up the striatum of the basal gangia?

A

Caudate nucleus

Putamen

106
Q

Draw the direct pathway of basal ganglia 5

A 
Cortex
Striatum
GPi
Thalamus
COrtex
107
Q

Draw the indirect pathway 7

A 
Cortex
Striatum
GPe
Subthamic nucleus
GPi
Thalamus 
Cortex
108
Q

Draw the hyperdirect pathway

A

Cortex
Subthalmic nucleus
GPi

109
Q

What are the different types of dopamine receptor on medium spiney neurons in basal ganglia and what effect do they have on excitation?

A

D1 - ramp up excitation

D2 - dampen down excitation

110
Q

On what pathways are D1 and D2 receptors founnd in the basal ganglia and what effect do they have upon excitation?

A

D1 - direct - ramp up

D2 indirect - damp down

111
Q

Does the release of dopamine from substantia nigra inhibit or promote movement?

A

Promote

112
Q

What neurotransmitter opposes the effects of dopamine upon the medium spiney neurons?

A

Ach

113
Q

What condition is described as a A high amplitude flailing of the limbs on one side of the body?

A

Ballisimus

114
Q

Where on the direct/indirect pathway is affecting in ballismus and what us the commonest cause

A

Subthalmic nucleus

Stroke

115
Q

What makes tic disorders worse/better?

A

Anxeity and fatigue

Distraction and concentration

116
Q

Possible causes of tic disorders

A

Post infectious

genetic

117
Q

What condition is described as a Jerky, brief, irregular contractions that are not repetitive or
rhythmic, but appear to flow from one muscle to the next?

A

Chorea

118
Q

Commonest causes of chorea?

A

Huntingtons

Neuropeltic drugs

119
Q

The three areas impacted by Huntingtons

A

Cognitive - inability to plan
Behavioural - irritable, depression, anxiety
Motor - chorea

120
Q

What disorder is Brief movement rapid onset and offset

Positive (muscular contractions) or negative (muscular inhibitions)

A

Myoclonus

121
Q

£ common causes of myoclonus

A

Juvenile Myoclonic Epilepsy
Brain hypoxia
Prion disease

122
Q

What condition is defined as abnormal twisting posture – often axial/ facial/ truncal, may be associated with jerky tremor

A

Dystonia

123
Q

5 possible causes of dystonia

A 
Stroke
Brain injury
Encephalitis 
Huntington's 
Parkinson's
124
Q

3 types of treatment for hyperkinetic disorders

A

D2 blocking agents - haloperidol
Dopamine depleting agents - reserpine
Atypical antipsychotics - clozapine

125
Q

3 Key side effects of dopamine blocking drugs

A

Oculogyric crisis - acute
Neuroleptic malignant syndrome
Drug induced Parkinsonism

126
Q

3 features of neuroleptic malignant syndrome

A

Rigidity - raised CPK
Fever/Confusion
Autonomic instability

127
Q

What condition involves lip smacking, tongue and cheek movements?

A

tardive dyskinesia

128
Q

Treatment of tardive dyskinesia? 4

A

gradual withdrawal
substitute with atypical antipsychotic
dopamine depleting agent
use of benzodiazapine

129
Q

Type of tremor that comes with Parkinson’s?

A

Resting tremor

130
Q

5 Non motor symptoms of Parkinson’s?

A 
Dementia
Depression
Postural hypotension
Sleep disturbance
Reduced sense of smell
131
Q

4 non neurodegenerative causes of parkinson’s?

A

Drugs - haloperidol
Cerebrovascular disease
Hydrocephalus
Toxicity

132
Q

Two examples of Monoamine oxidase Inhibitors and what can they be used to treat?

A

Selegiline
Rasagiline
For parkinson’s

133
Q

Mechanism of action for lidocaine?

A

sodium channel blocker

134
Q

How does Topical capsaicin treatment work for the treatment of acute pain?

A

TRPV1 agonist
Repeated use reduces nocicpetor firing
Peripheral terminals die back

135
Q

How do NSAIDs reduce inflammation and therefore pain?

A

COX inhibited
Reduce prostaglandin synthesis
prevent’s decrease in sodium channel threshold

136
Q

What is the mechanism of action for opoids and 3 sites of action?

A

Agonists for endogenous opoid system
Brainstem
Spinal cord
Peripheral

137
Q

These statements refer to what pain related theory?
Modulation of pain at the spinal cord level

Pain evoked by nociceptors can be reduced by simultaneous activation of low threshold mechanoreceptors (Aβ fibres)

A

Gate control theory

138
Q

2 peripheral mechanisms of chronic pain?

A
  1. Peripheral sensitization

2. Spontaneous firing of nociceptors

139
Q

In chronic pain what causes the spontaneous firing of nociceptors following a nerve injury?

A

Accumulation of ion channels at regenerating tip of axon

140
Q

What is the mechanism for central sensitisation on chronic pain?

A

Due to the reduced threshold for activation of 2nd order neurons

141
Q

WHat are the 6 steps for reducing threshold for activation in chronic pain?

A

Constant firing of axons from the periphery (following injury) gives a Sustained release of glutamate
Prolonged depolarisation of the postsynaptic membrane
Massive influx of Ca2+ through NMDA receptors
Activation of kinases
Phosphorylation of NMDA/AMPA receptors
Channel protein synthesis

142
Q

What is the mechanism for central hyperalgesia?

A

Activation of nociceptors results in amplified spinal cord activation

143
Q

What is the mechanism for central allodynia?

A

Non-noxious Aβ fibres also synapse onto 2nd order spinothalamic neurons
Following central sensitization:

Non-noxious afferents activate sensitized 2nd order neurons

144
Q

3 types of drugs that can treat chronic pain?

A
  • Tricyclic antidepressants
  • Anticonvulsants
  • NMDA antagonists
145
Q

AN example of tricyclic antidepressant>

A

Amitriptyline

146
Q

Example of an anticonvulsant

A

carbamazepine

147
Q

Example of an NMDA antagonist and mechanism of action?

A

ketamine

  • NMDA receptor antagonist (reduces glutamate influx)
  • Prevents depolarization of second order neuron

202 Neuroscience & Behaviour (5 decks)

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