Week 1 Flashcards
What do large venous sinuses do for the CNS?
Act as fluid “cushions” to protect the delicate nervous tissues
What is the ventricular system of the CNS?
Analogous to a plumbing system both within and surrounding the CNS. It contains clear, colorless fluid- the cerebrospinal fluid (CSF) which protects and nourishes the neuraxis
What produces CSF? How many and where?
Choroid plexus which are in each of the four ventricles (all interconnected)
What takes the CSF from the cerebellum into the subarachnoid space?
Lateral apertures under the cerebellum
Where is the CSF in the spinal cord?
In the central canal
What does the ventricular system develop from? And where is each part? Why is the ventricular system important?
It develops from the neural tube of the embryo. There is a different part of the ventricular system for each division of the brain. This helps identify the part of the brain on cross sections
Name the meninges from external to internal
dura mater, arachnoid mater, and pia mater
What is the epidural space? Where is there no epidural space?
External to the dura mater and contains fat and the vertebral venous lexis. It only exists around the spinal cord. It is obliterated in the mid cervical region, C3 (C2 to C4) by fusion of the dura with periosteum. The fusion begins ventrally and is completely circumferential by the level of the foramen magnum. NO epidural space within the cranium, however there is the potential e.g. haemorrhage after trauma (epidural haematoma)
What is the dura mater?
- Dense, tough fibrous covering (composed of dense connective tissue with collagen fibres) that fuses with the periosteum of the cranial vault. - encloses the spinal roots as they leave the spinal cord and fuses with the epineurium at the intervertebral foramen.
Where is the arachnoid mater not present?
Follows the larger contours and issues but not the absolute contours of the CNS. e.g. into the longitudinal issues but not the sulci
What is the pia mater?
-Very delicate membrane which is fused to the contours of the CNS - subarachnoid space lies between the arachnoid and pia mater. It is filled with CSF. - arachnoid trabeculae are fine meningeal filaments that cross the arachnoid space between the arachnoid mater and the pia mater
What is the falx cerebri?
The fold in the longitudinal fissure between the two cerebral hemispheres. Runs from the ethmoid bone to the osseous tantrum. Contains the dorsal sagittal venous sinus draining the dorsal forebrain.
What is the tenorium cerebella?
Fold separating cerebral hemispheres from the cerebellum. Runs from the petrosal crest to the osseous tentorium, bilaterally. Inverted U, the midbrain passes through the notch along the ventral edge. - divides the cranial vault into: -the rostral fossa (rostral to the tentorium and contains the forebrain) - the caudal fossa (caudal to the tantrum and contains the cerebellum and the caudal brain stem). (often ossifies in cats)
What is the diaphragm sella?
Bridges from the dorsal sella to the caudal cloned process of the sphenoid bones near the optic canal area. It can make removal of the entire brain, with pituitary intact, difficult.
What occurs with brain herniation?
Movement of a portion of the brain under another structure. - the inelastic nature of the dural septa and the skull protect the normal brain, but compromise the diseased brain as they limits its ability to swell or adjust to expanding masses. - Swelling of the forebrain may cause herniation under the tentorium cerebella. - Swelling of the brain or any structure within the cranial vault may cause herniation through the foramen magnum
What is the essential information in order to perform a neurological examination?
* organisation of the nervous system and hierarchy of control
* cranial nerve areas and types of innervation and function
* major peripheral nerves and areas of innervation and functions
Essential information in order to interpret a neurological exam
* major structural organization of the spinal cord and brain (and tracts of the spinal cord) (what areas are most vulnerable?? what happens with a bulged disc??)
* Areas of origin of major nerves in the CNS and their function
* Paths of the cranial and peripheral nerves from the CNS to the area innervated
Other important anatomical information for clinical diagnosis in neurological cases?
* Anatomy of the meninges and their associated spaces in brain and spinal cord
* Blood supply to brain and spinal cord
* Formation and resportion areas for CSF and where to sample
Where are the cell bodies for the motor neurons? What about the sensory neurons? What are interneurons?
* Motor nerve cell bodies are in the CNS
* Sensory nerve cell bodies are outside- in a ganglion- not in the spinal cord
* Interneurons connect the two
What is a reflex arc?
The simplest form of communication.
One step further- adding an interneuron
Where is the sensory input? What is the motor output?
Sensory input- dorsal horn
motor output- ventral horn
why is it that a chicken can still run around with it’s head cut off?
Animals with less developed brains, a lot of neurological control is a result of neurological pathways at the spinal level
Basically a series of reflexes!
What reflex is for stability and postural support?
Mobility reflex?
Myotactic
Flexor withdrawal
What is an upper motor neuron?
* UMN are motor neurons that originate in the motor region of the cerebral cortex or the brain stem and carry motor information down to the LMNs (efferents are in the spinal cord and synapse with LMNs or interneurons)
What is a lower motor neuron? What are the levels of control of motor activity?
* alpha motor neuron- final common pathway for motor control– cell body in the spinal cord– impacts on the muscle cell (efferents are alpha motor neurons i.e. supply muscle fibres)
What is meant by the motor system hierarchy?
Motor cortex= senior management
Interneurons in the spinal cord= junior management
Worker= alpha motor neuron- initiating the movement
What is a nucleus?
What is a ganglion?
* Nucleus- Collection of nerve cell bodies inside the CNS- WHITE AND GRAY MATTER.
* Ganglion- collection of nerve cell bodies outside of the CNS- i.e. autonomic ganglia, sensory ganglia
Name three nuclei in the brain stem
* Red nucleus- rubrospinal tract
* Vestibular nucleus- vestibulo-spinal tract
* Reticular formation - reticulospinal tract
What does it mean to say brain stem pathways are EXTRA pyramidal?
Do not travel through the medullary pyramids
What provides most of the refined degree of motor control?
Primary motor cortex
What is the corticospinal tract? Are they pyramidal or extra-pyramidal?
Motor tract originating from the cerebral cortex. Pyramidal tract.
What does it tell us if a tract is pyramidal vs. extra pyramidal?
anatomical description. The tracts that go through the pyramids go through the cortex. Extra- pyramidal tracts go through the brain stem and are more important in animals with LESS DEVELOPED BRAINS.
What are funiculi?
Bundles of nerve fibers in the spinal cord
What is the hierarchy of control?
What is the function of the forebrain generally?
* Perception of sensory input
* Initiation of motor activity
* integration/associaton of information
* cranial nerves I and II
What is the general function of the midbrain?
* thoroughfare for ascending and descending information
* major UMN nuclei for movement
* cranial nerves III and IV
* Consciousness (during anathesia rendered unconscious)
What is the function of the hindbrain?
* Thoroughfare for ascending and descending information
* major UMN nuclei for movement
* coordination of muscle activity (cerebellum)
* cranial nerves V to XII
* regulation of many organ functions (cardiovascular, resp, gastrointestinal)
What is co transmission?
One neuron can release different neurotransmitters from different neuron processes (at one set of dendrites, compared to another). Also, that multiple neurotransmitters can be released from the same neuron process.
e.g. VIP and ACh depending on the frequency stimulation will release one or the other or both. they act as neuromodulators- which can affect the amount of release and the function. It is not just YES/NO- it depends on how much is released, frequency of impulses down the pre-synaptic nerve, and a feedback loop back to the pre-synaptic nerve
What are the steps of neurotransmission?
What are the different types of neuroreceptors?
What are the fast neurotransmitters in the CNS
* Amino acids: glutamate, glycine, gamma amino butyric acid (GABA)
* Acetyl choline
What are the slow neurotransmitters?
( slow “maranade”- important in memory, mood- changes slowly)
* Acetyl Choline
* Mono amines- dopamine, noradrenaline, 5 HT
* NANC- histamine, purines (ATP)
* Neuropeptides- endorphins, substance P
How do drugs target neurotransmitters?
What is the notorchord?
Column of cells - develops the neural tube and neural crest cells
** have to have the notochord to get development of the nervous sytem- one of the first to start developing but the last to finish (i.e. foal or calf walking straight away)
** does not form the vertebral column- marks the future location of the vertebral column (bone comes from schleritome from the somites)
What is the ectoderm? Mesoderm? Endoderm?
What is neurulation?
* The initial development of the gut, heart, and formation of the nervous system
* ectoderm above the notochord thickens to form neural plate
What is the neural groove?
Midline depression due to thickening of the neural ectoderm
What are somites?
Age an embryo by the number of somites that are there
What are neuroepithelium?
Cells lining the neural tube
* Neuroepithelium produces all neurons
* cells migrate from there to form neural crest
*neural crest cells form the peripheral ganglia
* rostral end forms the brain and the rest of the neural tube forms the spinal cord
What are the plates here? What does the mantle layer differentiate into?
What are the three parts of somites?
(somites split and peripheral nerve migrates between)
Why is there bending and folding as the brain develops?
Because it is occuring inside the skull.
What are the ventricles and what part of the brain are they developing from?
What ventricle is in the myelencephalon?
Fourth ventricle
What happens with development in the metencephalon?
Still in the hindbrain, becomes more complicated.
What level of the brain is developing here?
What happens to the midbrain in a developed brain?
Forebrain “flops” over the midbrain
Venous drainage of the brain
choroid plexus
What is cerebrospinal fluid?
An ultrafiltrate of blood. Mostly produced by the choroid plexus which develops where the ependyma is in direct contact with the pia mater on the wall of each ventricle. The choroid plexus epithelium is actively involved in numberous exchange processes in both directions as well as other processes involved in brain homeostasis.
Main arteries to the nervous system
What are the two cerebral hemispheres?
What is the ventricular system?
Cerebellum and the brain stem
The ventricular system is an expansion of the spinal cord.
What produces the CSF? Where? How does CSF flow?
Produced by the choroid plexus within the ventricles
Flows rostral to caudal and then out into the subarachnoid space and flow gradually down beside the spinal cord
What are the 12 cranial nerves?
I olfactory
II optic
III oculomotor
IV trochlear
V trigeminal- mandibular, maxillary, ophthalmic
VI abducens
VII facial
VIII vestibulocochlear
IX glossopharyngeal
X vagus
XI accessory
XII hypoglossal
“On Old Olympus’ Towering Tops A Fair Voluptuous German Vaulted And Hopped”
What happens when the CSF is at a higher pressure then the venous system?
The little balloons bulge out and you get reabsorption of the CSF into the venous system. If the production of CSF drops or pressure drops for any reason, then balloons collapse. As long as the venous pressure is lower, you get circulation and reabsorption back into the venous sinuses.
What happens at the intercostal foramina?
Nerves and blood vessels travel through. More potential CSF reabsorption. But because of the thinning of the separation between blood supply and CSF– potential route for infection!
Are any nerves purely motor? Which nerves are purely sensory?
No nerves are purely motor. They always carry proprioceptive sensory fibre afferents (muscle proprioception). However there are purely sensory nerves (I, II, VIII)
What is unique about CN I, II, and VIII?
They have meningeal coverings that extend into the periphery. Technically, they are not nerves but are evaginations of teh brain and are potential routes for the transport of bacteria, etc. into the CSN; the optic and olfactory nerves are considered to be tracts of the CNS.
What does the position of where the nerve joins the brain tell you?
The position of where the nerve joins the brain is related to the position of the cranial nerve nucleus within the brain.
Most fibres join ventrally or ventrolaterally except the trochlear nerve.
What can occur with CN V, VII, and VIII? Why?
They all attach together so they may be involved in one lesion.
What nerves would be affected by otitis interna? Why?
CN VII and VIII because they exit together through the internal acoustic meatus.
What is the innervation of the pharynx?
Sensory- IX
musculature- IX and X
What is the innervation of the larynx?
Sensory- X and XI
Musculature- X and XI
Transduction
The free nerve endings, nociceptors, of primary afferent neurones respond to noxious stimuli (tissue damage and inflamation)
What are the parts of a nociceptive pathway?
What are the three stages of nociceptive pathways?
Under general anaesthesia, what stage is blocked?
Describe the 1st stage of nociceptive pathways
* Stimuli: mechanical, thermal, chemical
* Nerve fibres: myelinated A fibers and unmyelinated C fibers
* Nociceptors: Mechanical, thermal, polymodal, silent
* Silent C fibers– only start working with an inflammatory process- the threshold will change- start decreasing (become more and more sensitive)– very painful when turned on!
* Transduction- stimulus into electric pulse. Lots of transduction channels. Transient Receptor Potential Ion Channel (TRP), Acid- sensing ion channel (ASIC), Serotonin receptors
* Transduction- Sodium channels (1.1-1.9) and Calcium channels- many different kinds
* Afferent neurons are bipolar: The body is in the dorsal root ganglia (DRG), one end is free ending in the periphery, the other finishes in the dorsal horn, corelease of aminoacids (glutamate, asparate), neuropeptides (substance P, neurokinin, CGRP)
2nd Stage of nociceptive pathways
* Spinothalamic tract (STT)- major ascending pathway
* Crosses midline and communicates with different nuclei in the thalamus (then to the cortices)
* glutamate (neurotransmitter in the thalamus)
3rd Stage of nociceptive pathways
*Thalamic nuclei
* 3rd order neurons
* Different area of the cortex- sensory-discriminative aspects of pain, motivational-affective aspects of pain, sensory and motor integration
Third order neurons
Carries sensory information from the thalamus to the cerebral cortex
Second order neuron
Carries information from the central nervous system to the thalamus. Information traveling along second order neurons deccussates from one side of the CNS to the other side of the CNS
First order neurons
Conduct impulses from receptors of the skin and from proprioceptors (receptors located in a joint, muscle, or tendon) to the spinal cord or brain stem, where they synapse with second-order neurons. First order neuron’s cell bodies reside in ganglion
Main tracts (part of the 2nd stage of nociception)
* Spinohypothalamic (SHT), Spinoreticular (SRT), Spinomesencephalic (SMT)
* SRT reaches the reticular formation (emotional reactions)
* SHT associated with neuroendocrine and autonomic changes associated with the stress response
* SMT project to the PAG
Modulation in the dorsal horn
Grey matter- cell bodies. White matter- myelin.
C fibers are the inhibitors!!
When we are pain there is a fight between the three guys in this picture….
The Gate Theory of Pain
Non-painful input closes the “gates” to painful input, which prevents pain sensation from traveling to the CNS. Therefore, stimulation by non-noxious input is able to suppress pain.
What is the antinociceptive pathway?
What pathways are involved in the antinociceptive pathways?
What are some neurotransmitters in the antinociceptive pathways (dorsal horn)?
What areas are connected to the dorsal horn that are impacted by analgesia?
Name the input to the dorsal horn from different parts of the body
What are some neurotransmitters involved in nociceptive modulation?
Peripheral sensitisation
Reduction in threshold and an increase in responsiveness of the peripheral ends of nociceptors, the high-threshold peripheral sensory neurons that transfer input from peripheral targets through peripheral nerves to the CNS.
Goes from physiological pain to pathological pain.
Direct consequence of tissue trauma and inflammation
HYPERsensitisation
* Can happen if you don’t give enough anaesthetic in surgery
e.g. male children circumsized- no analgesia- increased pain sensation later in life
Central sensitization
An increase in the excitability of neurons within the CNS, so that normal inputs begin to produce abnormal responses.
Constant activation of peripheral receptor
Glutamate and asparate activate NMDA receptors- when they are activated they tend to stay activated- do not deactivate on their own frequently
** NMDA receptors are a common target when treating chronic pain (intensive surgeries). Ketamine is the best NMDA med in the world.
Allodynia
More sensitive to normal stimulation
Acute pain vs. chronic pain
Malformations of all kinds
Cyclopic, Arthrogropotic
Reflect early and dramatic problems during CNS development- some are inherited while others reflect in utero or early post-natal exposure to teratogens (e.g. viruses, toxins, drugs, nutrient deficiencies or excesses)
Some species need post- natal development. Important point is exposure post- natally to teratogens can impact these species more.
(has to do with development of cerebellum)