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head neck and neuro > week 1 > Flashcards

week 1 Flashcards

1
Q

What is the name of weakness on one side of the body?

A

hemiparesis

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2
Q

What is the name for difficulty with speech?

A

aphasia

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3
Q

WHat is a dermatome?

A

the region of skin supplied by a single spinal nerve

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4
Q

Where are the preganglioic neurons in the sympathetic nervous system?

A

thoracic and upper lumbar spinal cord

T1-L3

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5
Q

Where are the preganglionic neurons in the sympathetic nervous system?

A

brainstem (some cranial nerves)

sacral spinal cord (S2-4)

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6
Q

Where are sympathetic ganglia found?

A

in the sympathetic chain which is next to the vertebral column

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7
Q

Where are the parasympathetic ganglia found?

A

in the walls of the viscera that they innervate

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8
Q

What is pain?

A

an unpleasant and emotional experience associated with actual or potential tissue damage

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9
Q

What is involved in the acute catabolic stress response?

A

anxiety, depression, sleep
up BP, HR
inhibits cough, hyperventilation
etc

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10
Q

What are the four physiologic processes of nociception?

A

transduction
transmission
modulation
perception

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11
Q

Describe nociceptors

A

C
polymodal (mechano-heat-chemical)
Ad mechanical, some thermal
HIGH THRESHOLD

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12
Q

Name substances that activate pain receptors

A 
K+
5HT
bradykinin
H+
Histamine
ATP, adenosine
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13
Q

What can sensitise pain receptors?

A

prostaglandins
leukotriens
substance P
noradrenaline

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14
Q

What sort of fibres can morphine inhibit?

A

C

pathophysiology

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15
Q

Describe somatic pain

A 
skin, muscle, bone
well localised
dermatomal radiation
sharp, aching, gnawing
constant or incident
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16
Q

Describe visceral pain

A 
internal organs
vague distribution
diffuse to body surface
dull, cramp, dragging
often periodic
sweaty
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17
Q

What are some common descriptors of neuropathic pain?

A 
shooting
electric shock
burning 
tingling
numbness
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18
Q

What method do tens machines use?

A

gate control therapy

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19
Q

How many segments of the spinal cord are there?

A 
31
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
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20
Q

What is the upper limit of the spinal cord?

A

the junction with the medulla oblongata

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21
Q

What is the lower level of the spinal cord?

A

in newborn infants L3/L4

In adult L1/L2

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22
Q

What is a ganglion?

A

a collection of cell bodies

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23
Q

WHat is a fasciculus?

A

a bundle of axona

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24
Q

What is a faniculi?

A

tract of axons

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25
Q

What does the neural tube develop from?

A

a flat plate of cells (neurodevelopment-ectoderm)

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26
Q

what is the dorsal horn involved in?

A

sensory

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27
Q

What is the ventral horn involved in?

A

motor

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28
Q

What are the three layers of the meninges?

A

dura mater
arachnoid mater
pia mater

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29
Q

what is the epidural space?

A

separates the dura and the vertebrae

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30
Q

What is in the arachnoid space?

A

CSF

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31
Q

WHat is the name of the artery that supplies the lower 1/3 of the spinal cord?

A

artery of adamkiewicz

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32
Q

What does the spinal cord pass through as it leaves the skull?

A

the foramen magnum

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33
Q

WHat is the lowest part of the spinal cord called?

A

conus medullaris

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34
Q

Where does the pain pathway go?

A

the superficial dorsal horn

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35
Q

where does the gentle touch pathway go?

A

deep dorsal horn

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36
Q

WHat are a alpha fibres involved in?

A

proprioceptors of skeletal muscle

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37
Q

What are A beta fibres involved in?

A

mechanoreceptors of the skin

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38
Q

WHat are A delta fibres involved in?

A

pain, temperature

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39
Q

What are C fibres involved in?

A

temperature, pain, itch

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40
Q

What pathway is discriminative touch?

A

dorsal column

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41
Q

What pathway is pain?

A

spinothalamic pathway

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42
Q

What pathway is voluntary motor?

A

corticospinal and corticobulbar

43
Q

WHat are the four areas of the brain?

A

frontal, parietal, occipital, temporal

44
Q

what are the two main sulci of the brain called?

A

central and lateral

45
Q

what is the motor area called?

A

pre central gyrus

46
Q

what is the sensory area called?

A

post central gyrus

47
Q

Where is the area for speech?

A

motor cortex

48
Q

where is the visual cortex?

A

occipital lobe

49
Q

WHat areas are involved in the motor aspect of speech?

A

Brocca’s areas in the inferior frontal gyrus

50
Q

What side of the brain are the main broccas areas mainly found?

A

the left

51
Q

What is the auditory association cortex called?

A

Wernickes areas

52
Q

WHat makes up the corpus striatum?

A

caudate nucleus
putamen
globus pallidus

53
Q

What are the basal ganglia called?

A

corpus striatum, sub-thalamic nuclei, substantia nigra

54
Q

WHat are the boundaries of the lentiform nucleus?

A 
claustrum
internal capsule
anterior limb
genu
posterior genu
55
Q

What does the ectoderm give rise to?

A

CNS
PNS
sensory epithelium of the ear, nose and eye
epidermis, hair and nails
subcutaneous, mammary and pituitary glands
enamel of the teeth

56
Q

What does the notochord develop from?

A

the primitive node

tube extends in the opposite direction from the primitive streak

57
Q

What causes the ectoderm to thicken and form the neural plate?

A

appearance of the notochord and mesoderm

58
Q

WHat is the neural plate made from?

A

neuroectoderm

59
Q

Describe signalling in neuralation

A

Up regulation of FGF, inhibition of BMP-4 causes induction of the neural plate
chordin and noggin expressed
neural plate switches from E-cadgerin to N-cadherin expression

60
Q

WHat do the neural crest cells give rise to?

A 
ganglia
schwann cells
adrenal medulla
melanocytes
connective tissue in head region
61
Q

once the neural tube has closed what do the neuroepithelial cells give rise to?

A

neuroblasts which form the mantle layer

62
Q

What does the mantle layer become?

A

the gray matter of the spinal cord

63
Q

What does the marginal layer become?

A

white matter in the spinal cord

myelination of nerve fibres

64
Q

WHat are the three primary brain vesicles called?

A

forebrain - prosencephalon
midbrain - mesencephalon
Hindbrain - rhombencephalon

65
Q

WHat does the prosencephalon divide into?

A

the telencephalon and the diencephalon

66
Q

WHat does the mesencephalon divide into?

A

the mesencephalon

67
Q

What does the rhombencephalon divide into?

A

the mesencephalon and the myelencephalon

68
Q

What does the telencephalon become?

A

the cerebrum

69
Q

What does the diencephalon become?

A

eye cup

thalamus, hypothalamus and epithalamus

70
Q

WHat does the mesencephalon become?

A

the mid brain

71
Q

What does the mesencephalon become?

A

the pons and the cerebellum

72
Q

What does the myelincephalon become?

A

the medulla oblongata

73
Q

What are the different types of spina bifida?

A

oculta
meningocele
myelomeningeocele

74
Q

What causes hydrocephaly in spina bifida?

A

CSF build up in heat due to obstruction of the foramen magnum by the cerbellum

75
Q

What causes the resting membrane potential?

A

a difference in charge between the inside and outside of the neuron at rest

76
Q

What is the typical RMP of neurons?

A

-60 - -70mV

77
Q

What is an action potential?

A

a brief but dramatic change in membrane potential

78
Q

Describe depolarisation and depolarisation and hyperpolarisation

A

depolarisation related to increased permeability to Na+ cells
repolarisation and hyper polarisation due to increased permeability to K+ ions

79
Q

In what ways can bolted - gated sodium channel drugs be used?

A

local anaesthetics
pain treatment
epilepsy

80
Q

What type of cells are found in the CNS?

A

oligodendrocytes

81
Q

WHat sort of cells are found in the PNS?

A

schwann cells

82
Q

What are the areas that are unmyelinated called?

A

nodes of ranvier

83
Q

What is saltatory conduction?

A

action potential “jumps” form node to node in myelinated axon

84
Q

Describe synaptic transmission

A

AP enters presynaptic terminal
Ca2+ entry through voltage-gated channels
docking of synaptic vesicles containing NTs
NTs released and bind to and activate receptors on postsynaptic membrane
Ions enter cell and cause depolarisation or hyperpolarisation

85
Q

What is an excretory post synaptic potential?

A

EPSP

brings the post synaptic membrane closer to the threshold for depolarisation

86
Q

What is an inhibitory postsynaptic potential

A

IPSP

moves the post synaptic membrane further away from the threshold

87
Q

What are the two types of summation of post synaptic potentials?

A

spacial (firing at multiple sites) and temporal (frequency of firing)

88
Q

WHat is the main inhibitory neurotransmitter?

A

gamma-aminobutyric acid

89
Q

How does botulism affect synaptic transmission?

A

disrupts exocytosis preventing Ach release

90
Q

How does myasthenia gravis affect synaptic transmission?

A

antibodies bind to Each receptors in the postsynaptic motor end plate

91
Q

In what ways can cerebral function be investigated?

A

EEG
PET
fMRI
TMS

92
Q

How can a pancoast tumour affect the upper limb?

A

superior extension of the tumour may result in encasement of the C8 nerve root and cause pain in the medial 2 digits of the hand
Causes atrophy of intrinsic muscles of the hand - particularly the interosseous muscles
Infiltration of the T1 nerve root causes pain which radiates down the medial aspect of the arm and forearm as far as the wrist

93
Q

What are the results of horner’s syndrome?

A 
ptosis
mitosis
hemifacial / unilateral anhidrosis 
loss of head and neck sympathetic tone
enophthalmos
94
Q

Describe the first order neruronal fibres in the sympathetic pathway to the eye

A

arise from the poster-lateral hypothalamus

descend through brain stem to terminate in the spinal cord at the ciliospinal centre (C8-T2)

95
Q

Describe the second- order neuronal fibres in the sympathetic pathway to the eye

A

exit through the T1 root and travel close to the lung apex through the paravertebral sympathetic chain and the stellate ganglion
This is the level where a pancoast tumour could interrupt the pathway

96
Q

Describe third order neuronal fibres in the sympathetic pathway to the eye

A

exit the ganglion to form a plexus surrounding the internal carotid aftery
plexus then ascends into the cavernous sinus, runs a short course on CN VI and then follows the ophthalmic division of C5 in the orbit
Supplies the iris dilator muscles and the smooth muscle fibres if the upper and lower lid
vasomotor and sweat gland fibres follow the external carotid artery to supply the ipsilateral side of the face

97
Q

Describe the anterior compartment of the thoracic inlet

A

from the sternum to the anterior scalene muscle

contains subclavian and internal jugular veins

98
Q

Describe the middle compartment of the thoracic inlet

A

from the anterior to the posterior scalene muscle

contrains subclavian artery and branches of the subclavian artery

99
Q

Describe the posterior compartment of the thoracic inlet

A

beyond the middle scalene muscles

contains branches of the brachial plexus, the sympathetic chain and stellate ganglion

100
Q

What is a pancoast tumour?

A

a malignant neoplasm of the superior sulcus of the lung with destructive lesions of the thoracic inlet and involvement of the brachial plexus and cervical sympathetic nerves

101
Q

WHat is the most common type of pancoast tumour?

A

squamous cell carcinomas (non small cell)

102
Q

How are pancoast tumours diagnosed?

A

biopsy

imaging - CT, PET

103
Q

How are pancoast tumours managed?

A

surgery
radiation
chemo
very low 5 year survival rate

head neck and neuro (6 decks)

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