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Neurology > Week 1 > Flashcards

Week 1 Flashcards

1
Q

non-excitable (No AP), 50% of brain vol, 10:1 to neurons

A

Glia cells

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2
Q

White matter glia cells

A

Astroglia - fibrous

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3
Q

gray matter glia cells

A

Protoplasmic

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4
Q

Retina glia cells

A

Muller

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5
Q

myelinating cells of CNS, multiple per neuron

A

Oligodendroglia

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6
Q

myelinating cells of PNS, one to one axon, also takes up excess NT and ions

A

Schwann cells

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7
Q

derived from monocytes

A

microglia

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8
Q

stem cells for neurons and glia cellsl synpase w/ neurons, activated in demylinating dz

A

Polydendroctyes

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9
Q

Line central canal, ventricles, have cili and microvilli, epithelium that separates CSF from neurophil

A

Ependyma

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10
Q 
from neural crest, sussound pseudounipolar neurons of DRG
modified Schwann cells or oligodendrocytes
function as astrocytes in the peripheral ganglia
A

Satellites

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11
Q

determines the membrane potential

A

Nernst

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12
Q

estimates the resting membrane potential

A

Goldmann

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13
Q

gap junction composed of 6 … to make a …

A

6 connexins > connexon

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14
Q

Excitatory chemical synapse

A

Gray’s Type I, asymmetric post-syn density

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15
Q

Inhibitory chemical synapse

A

Gray’s Type II, symmetric, pre/post density

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16
Q

EPSP

A

Na channel opens to bring closer to threshold

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17
Q

IPSP

A

Cl channel opens to bring further from potential

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18
Q

2 types of neurotransmitter receptors

A

ionotropic (opens ion channel) or metabotropic (activates G protein)

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19
Q

excitatory NT made from glutamine by astroytes
Ionotropic receptors: NMDA, AMPA, Kainate
Metabotropic: mGluRs

A

Glutamate

Aspartate is also excitory

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20
Q

Inhibitory NTs

A

Glycine - spinal cord, Cl- influx

GABAa,c: CNS, Cl- influx OR
GABAb K+influx, calcium eflux, net inhibitory

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21
Q

Nicotinc

A

ionotropic, non-specific cation channel

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22
Q

Muscarinic

A

Metabotropic coupled to G proteins
M1/3 - Gq
M2= Gi

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23
Q

Includes DA, NE, HIST, 5HT

metabotropic

A

Biogenic Amines

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24
Q

Resistance equation

A

1/g = R

g = conductance
limits ion flow

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25
Q

active response; no decrement over distance, regenerative, large, binary, voltage-sensitive, refractory period

A

AP

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26
Q

passive response, no theshold, small, not voltage sensitive, no refractory period

A

graded potential

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27
Q

Sodium channel mutation, decreased inactivation of the sodium channels increases excitability

A

Generalized Epilepsy w/ Febrile Sickness

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28
Q

Familial Hemiplegic Migraine
Episodic Ataxia 2
Congential Stationary Night Blindness
Lambert Eaton

A

Calcium channelopathies

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29
Q

Sodium channel mutation in skeletal muscle, more excitable

A

Myotonia/ paralysis

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30
Q

Episodic Ataxia type I

A

K mutation in Purkinje cells

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31
Q

Benign Familial Neonatal Seizures

A

K+ channel mutation

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32
Q

antibodies to the Ach receptor in NMJ

A

Myasthenia gravis

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33
Q

serves as guide wires for neuron migration

A

radial glial cells

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34
Q

plate that develops int sensory nuclei, including dorsal horn, DRG, brainstem

A

Alar plate

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35
Q

plate that develops into motor nuclei, including ventral horn and brainstem

A

Basal

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36
Q

division between alar and basal plate

A

sulcus limitans

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37
Q

forms the cerebral hemispheres and deep structures

A

telencephalon

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38
Q

forms the thalamuc, hypothalamus, subthalamus

A

Diencephalon

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39
Q

midbrain

A

mesencephalon

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40
Q

forms the pons and cerebellum

A

metencephalon

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41
Q

forms the medulla

A

myelencephalon

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42
Q

failure of mesodermal cells to form vertebra around the spinal cord, no dorsal vertebrae, (tuft of hair over spinal tract)

A

Spina Bifida Occulta

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43
Q

Meninges outpouch

A

Spina Bifida Aperta meningocele

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44
Q

Meninges & spinal cord or filum terminale outpouch

A

Spina Bifida Aperta myelomingocele

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45
Q

displacement of cerebellar tonsils below the foramen magnum

A

Arnold-Chiari Type I

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46
Q

displacement of cerebellar tonsils below the foramen magnum + cervical encephalocele

A

Arnold-Chiari Type II

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47
Q

Lateral and medial surface of the frontal lobe

A

initiate and regulate voluntary behavior

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48
Q

Left lateral surface of the frontal lobe

A

Broca Motor Speech Area (motor to language)

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49
Q

Medal of frontal lobe emotional aspects of behavior

A

Cingulate gyrus

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50
Q

Lateral and medial surface of the parietal lobe

A

pain, touch, limb position

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51
Q

left lateral surface of the parietal lobe a/w with sensory aspects of language

A

Wernicke’s Area

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52
Q

lobe for visual information

A

Occipital lobe

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53
Q

lobe to process auditory information

A

temporal lobe

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54
Q

temporal lobe - hear and process

A

superior temporal gyrus

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55
Q

temporal lobe perception of language

A

Lateral

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56
Q

temporal lobe: learning, memory, emotion

A

anterior, medial

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57
Q

outgrowth of the pons overlying the 4rth ventricle

2 hemispheres with central vermis, attached to the brainstem via peduncles (how they carry info)

A

Cerebellum

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58
Q

CSF, made at 20ml/h from later ventricles to the 3rd ventricle

A

Foramen of Monroe

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59
Q

CSF from 3rd to the 4rth ventricle?

from the 4rth ventricle -
to subarachnoid?

to central canal?

A

3rd to the 4rth: Cerebral aqueduct / aqueduct of sylvius

lateral foramina of Luschka, medial foramen of Magendie

direct narrowing of 4th ventricle

10% reabsorbed at the egress of the nerves and 90% at the venous sinuses via subarachnoid granulations

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60
Q

blood:csf triple lining

A

capillary, pia, choroid epithelium

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61
Q

BBB

A

tight junctions in capillaries and astrocytes

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62
Q

Circumventricular organs?

A

Lack a BBB, sample blood

63
Q

monitor electrolyte balance

A

organ vasculosum

64
Q

monitors hormones

A

Neurohypophysis

65
Q

traumatic head injury with skull fracture, rupture of middle memningeal artery, pressure from bleed seperates the dura from the bone

A

Epidural hematoma

66
Q

Shaken baby syndrome, ruptures the bridging veins between the sinus and cerebral vein

A

Subdural hematoma

67
Q

Hematoma a/w arterial aneurism

A

Subarachnoid hematoma

68
Q

Meningeal layer as perineureum

layer as epineureum

A

Arachnoid - peri

Dura - epi

69
Q

Enters via carotid formain –> carotid canal, cavernous sinus, gives off opthalmic artery (anterior circulation)

A

internal carotid artery

70
Q

Subclavian > C6-C1 transverse foramen > foramen magnum > Basilar artery

A

Vertebral artery

71
Q

purely motor pathway?

A

Corticospinal tract

72
Q

Corticospinal tract, Betz cell in forebrain cortex, travels via ….
deccussates …..
synapses…..

A

travels thru the posterior limb of the internal capsule, decussates w/ pyramids in the brainstem, synpases w/ lower motor neurons in anterior horn

73
Q

Sensory for pain and temperature?

Alpha delta - fast, localized, first pain

A

Spinothalamic

74
Q

Spinothalamic sensory nerve endings?
Synpase 1
decussates?
synpase 2?

A

Alpha delta and C fibers

dorsal horn of spinal cord

deccussates at the anterior white commissure and ascends contralaterally

VPL of the thalamus

75
Q

pathway for pressure, vibration, propioception, fine touch?

A

posterior column, medial lemnisus

76
Q

dorsal column pathway:
DRG to first synpase?
decussates where?
second synpase?

A

synpases in the nucleus cuneatus or gracilus (T6)
decussates at the medulla, travels contralaterally via the medial lemniscus
VPL of the thalamus

77
Q

Type I - Displacement of the cerebellar tonsils below the foramen magnum
Type II – also includes cervical or occipital encephalocele

A

Arnold-Chiari Malformations

78
Q

separates the lateral ventricles

A

septum pellucidum

79
Q

SNS: dilator muscles of iris and the tarsal muscle of eye lids; travels along the long ciliary nerves (exits spinal cord at T1-T2 level  superior chain ganglion (lesion between hypothalamus & long ciliary nerve  Horner’s on same side as lesion)/ if in brainstem of spinal cord, expect total left anhydrosis but if over the peripheral nerve, only facial anhydrosus

A

Horner’s

80
Q

-In substantia nigra  corpus striatum: DA neurons ….. GABA and cholinergic neurons …. GABA (Parkinson’s loss of GABA neurons, tx by enhancing DOPA or decreasing muscarinic)

A

DA inhibit GABA

cholinergic excite GABA

81
Q

Somesthesis: sensory for pain, temp, crude touch

A

Protopathic

Spinothalamic tract

82
Q

Protopathic fibers?

A

small w/ little myelin

83
Q

Somesthesis: fine touch, position, vibration

A

Posterior column, epicritic

84
Q

Epicritic fibers

A

large, myelinated

85
Q

Encapsulated, concentric epithelial cells
detects gross pressure and vibrattions (250Hz)
subcut skin, joints, muscle, mesentery
Rapidly adapting: consist of free nerve endings encapsulated with Schwann cells known as lamellae – AP when these are distorted (onset and off-set of pressure)
Test with the tuning fork
posterior column

A

Pacinian corpuscule

86
Q

light touch and vibration less than 50 Hz
Glabrous skin below epidermis
Rapid adapt
posterior column

A

Meissner’s

87
Q

Non-encapsulated
Slowly adapting mechanoreceptors in skin & mucosa
Touch domes & hair disks
Slow adapt

A

Merkel’s

88
Q

Mechanoreceptors only in deep labors of glabrous skin – sustained pressure and stretch / detect objects slipping along the skin
Slow adapt
Receptors have a thin capsule and longitudinally arranged collagen fibers
A beta fibers carry this sensory

A

Ruffinis

89
Q

Protopathic pathway
Nail is in right foot -

ouch. -

sends opoids to decrease the pain

A

spinothalamic

spinoreticular

spinomesencephalic

90
Q

A alpha neurons

A

motor neurons

91
Q

A beta

A

Golgi Tendon and Ruffini endings
large, myelinated
Posterior column

92
Q

B fibers

A

small, myelinated, pre-ganglionic visceral motor

93
Q

C fibers

A

smallest, not myelinated a/w second pain - less localized, duller, synapse in substantia gelatinoasa
from free nerve endings (spinothalamic tract)

94
Q

1a neuron

A

GSA Propioception

sensory for muscle spindle

95
Q

1b neuron

A

GSA propioception
sensory from Golgi tendon and ruffini endings
sensory from joints

96
Q

2 neuron

A

sensory from skin receptors

97
Q

3 neuron

A

sensory from free nerve endings for pain, temp, hair follicles

98
Q

4 neuron

A

post-ganglionic autonomic

99
Q

up/down tract in the spinothalamic tract

A

Lissauer’s Tract

100
Q

innervate the neck and trunk – motor coordination

A

Vestibulospinal tract & reticulospinal tract

101
Q

travels closely with the lateral corticospinal tract and participates in control of the arms
flexor movements
Red nucleus –> LMN in spinal cord

A

Rubrospinal tract

102
Q

coordinates the head movements with the eye movements

A

Colliculospinal tract

103
Q

-Case 3: 74 y/o man wakes up with right half of his body numb except for his face bilaterally - where is the lesion?

A

Left thalamus (face preserved due to trigeminal nerve) – lacunar stroke

104
Q

Cell bodies for visceral pain travel with
spinal ganglia?
terminate?
project where (this is where pain is interpreted)

A

visceral pain travels w/ SNS,
Anterolateral system on the contralateral side
cell bodies in spinal ganglia T1-L2
terminate in the VPL of the thalamus
projects to the insular cortex where visceral pain is interpreted
also bilaterally to the spinoreticular system

105
Q

Visceral afferents for visceral reflexes arise from?
enter spinal cord from?
Ascend how?

A

S2-S4 pelvic nerves

enter the ANTERIOR horn thru anterolateral system and also bilaterally thru spinoreticular system

106
Q

where is wernicke’s area

superior temporal gyrus - auditory processing

A

posterior superior temporal lobe

107
Q

Signals for visceral afferents originate in?

A

hypothalamus

108
Q

Spinal cord injury rostral to the lumbosacral level

A

at first the bladder is areflexic, with complete urinary retention – next: automatic micturition via spinal reflex pathway, mechanoreceptors sense bladder fullness and directly activate sacral parasympathetics causing detrusor contraction, when the influence of the PMC is gone, external urethral sphincter is not relaxed during detrusor contraction, leading to incomplete emptying (detrusor-sphincter dyssnergia) – require daily catherization

109
Q

level for a lumbar puncture?

space?

A

L3/L4, subarachnoid

110
Q

extension of pia mater that anchors the spinal cord to the dura (separates the posterior and anterior roots), pierces the arachnoid

A

Denticulate ligament

111
Q

formed by joining 2 vertebral arteries

A

Basilar artery

112
Q

Modulatory interneurons of the spinal cord

A

Renshaw neurons

113
Q

mediates pain transmission in the posterior horn of the spinal cord; received input from the nucleus propius in laminae III and IV

A

Substantia gelatinosa

114
Q

C8-L3, proprioception to the cerebellum

Part of the spinocerebellar tract

A

Clark’s Nucleus

115
Q

Myotatic reflex

A

1a fibers in the muscle spindle synapse with alpha motor neuons which cause contraction

116
Q

Withdrawal reflex

A

pain detected by A delta and C fibers in skin, synapse with alpha motor

117
Q

Brown-Sequard Syndrome 3 things:
Spinothalamic tract
Dorsal column tract
Lateral corticospinal tract

A

Spinothalamic tract - decussates at spinal cord (loss of pain, temp, crude touch on contralat) , usually 2-3 segments below lesion

Dorsal column tract - decussates in medulla - loss of propioception, fine touch in the ipsilateral side)

Lateral corticospinal tract - ipsilateral spastic paralysis, Babinksi sign

118
Q

Tabes dorsalis?

A

Neurosphyilis, loss of the posterior column medial lemniscus pathway; can no longer feel fine touch or have conscious propioception of the body

119
Q

Friederreich ataxia mechanism

A

lesions of the spinocerebellar tract

120
Q

Common presentation of syringomylia

A

loss of pain and temperature to both hands, sensory and motor intact
Cavitation begins around the central canal where the fibers are crossing over (spinothalamic)

121
Q

Anterior horn of the spinal cord, convey information to the cerebellum about the postural stability of the lower limb

A

Spinal border cells

122
Q

right medullary glioma would cause loss of sensation on the left side because?

A

In the rostral medualla, the dorsal column medical lemniscus (fine touch, proprioception) and the spinothalamic (pain, crude touch, temp) have already crossed over

123
Q

motor tract to the head and face

A

Corticobulbar

124
Q

extra-pyramidal; body posture in response to changes in head position detected by the inner ear (lateral vestibulospinal tract: interference on a ride that whirls child around)

A

Vestibulospinal

125
Q

Extra-pyramiydal tract; originates in the red nucleus, flexion in upper extremities
(comatose patient: decerebrate posturing - arms extended and decorticate posturing, arms flexed)

A

Rubrospinal

126
Q

extra-pyramidal tract; extension in upper extremities

A

Reticulospinal

127
Q

cervical spine cord: head and neck movements during eye movements; originates in the superior colliculus

A

Tectospinal

128
Q

Posturing: lesion is in midbrain or the rostral pons , reticulospinal intact

A

Decerebrate/ Extensor Posturing

129
Q

posturing: upper arms flexed – both the rubrospinal and reticulospinal tract are intract

A

Decroticate posturing:

130
Q

affects upper and lower motor neurons; oculomotor and visceral motor neurons are spared; begins as weakness in one limb (usually distal), cramping in the morning, atrophy, fasciculations; disruption to the reticular formation can leads to inappropriate motor expression: excessive crying, laughing

A

Amyotrohic Lateral Sclerosis

131
Q

A delta fibers

A

Spinothalamic tract

first pain - sharp well localized

132
Q

Target of the descending motor tracts

A

LMN in the spinal cord

133
Q

Principal cells

A

Projection neurons (one brain area to another brain area) - aka Golgi Type I long projecting axons

134
Q

Interneurons

A

within the same brain area)

Golgi Type 2 local circuit neurons

135
Q

NMJ channel?

A

Nictonic, uses acetylcholine as the NT

136
Q

High safety factor?

A

ensures that every time a motorneuron releases transmitter, every muscle fiber it innervates has an AP and contracts (lots of release sites for NT, high number receptors,, high quantal content (occurs at the NMJ)

137
Q

Low safety factor?

A

CNS connections are simpler/ more diverse - different transmiters and receptors), lower quantal content, less secure

138
Q

Brain development summary

A

begins in 3rd week: 3 vesicle brain and 5 vesicles by week 5

139
Q

Alar plate –>

Basal plae –>

A

Alar plate is dorsal (sensory)

Basal plate is ventral (motor)

140
Q

Post ganglionic NT exceptions

A

Use ACh rather than NE as their NT

Pilo erectie, adrenal medulla, sweat glands

141
Q

Cranial nerves w/ PNS action

A

5,7,9,10

142
Q

Chemoreceptors and baroreceptors send information to what nucleus/ cranial nerves?

A

Solitary tract nucleus (X, XI)

143
Q

Locus ceruleus

A

regulates sleep/ arrousal, vigilance (releases NE in the amygdala)

144
Q

Effect of nictoine from smoking on the brain

A

a4b2 in the substantia nigra ventral tegmental area

145
Q

Substantia gelatinosa

A

Lamina I and II (dorsal) site of pain modulation and temp info

146
Q

Referred pain theory

A

Some of the collaterals of the epicritic system synpase on the same layer V cells as the protopathic cells

147
Q

Thalamus nucleus - somesthesis for:
body?
face?

A

body - VPL

face - VPM

148
Q

Rexed’s Laminae

I& II

A

Substantia Gelatinosa

149
Q

Laminae I-VI

A

Intermediate Sensory Neurons

150
Q

VII-VIII

A

Local Circuit, Autonomic, Commisural Neurons

151
Q

IX

A

Lower Motor Neurons

152
Q

gamma motor neurons

A

innervate spindle intrafusal muscle cells

153
Q

Clonus

A

UMN lesion - stretch reflex is unchecked

plantar extension of the foot when the foot is forcibly stretched upwards

Neurology (7 decks)

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