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MBChB - year 2 > Week 1 HNN lectures > Flashcards

Week 1 HNN lectures Flashcards

1
Q

What does the altar plate turn into?

A

A place of sensory functions

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2
Q

What does the basal plate turn into?

A

An area of motor function

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3
Q

Where are the cell bodies of motor neurons found?

A

The ventral horn of the grey matter

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4
Q

What is found in the ventral horn?

A

The cell bodies of motor neurons

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5
Q

Where are the temperature pathways found?

A

The ventral funiculus

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6
Q

What is found in the ventral funiculus?

A

Temperature pathways

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7
Q

What type of matter is the ventral funiculus made up of?

A

White matter

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8
Q

What is the outermost of the meninges?

A

The Dura mater

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9
Q

Where are epidural spaces found?

A

Between the dura and the vertebrae

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10
Q

What is the middle meningeal layer?

A

The arachnoid mater

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11
Q

What is CSF?

A

A filtrate of the blood

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12
Q

Where is CSF made?

A

In the choroid plexus within the ventricular system of the brain

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13
Q

What is the function of CSF?

A

To give the brain and spinal cord mechanical and immunological protection

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14
Q

What is the innermost meningeal layer?

A

The pia mater

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15
Q

What is a major route for spread of cancer from deep pelvic regions?

A

Batson veins

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16
Q

What is the blood supply for the lower 1/3 of the spinal cord?

A

The artery of Adamkiewicz

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17
Q

What does the artery of Adamkiewicz supply?

A

The lower 1/3 of the spinal cord

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18
Q

Where does the artery of Adamkiewicz arise from?

A

The left posterior intercostal artery (in 70% of people)

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19
Q

Where are epidural injections usually inserted?

A

Into the epidural space at either L3/L4 or L4/L5 vertebral level

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20
Q

What type of fibres transmit pain?

A

Ad and C fibres

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21
Q

Where does pain input enter the spinal cord?

A

The superficial dorsal horn

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22
Q

Where does touch input enter the spinal cord?

A

The deep dorsal horn

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23
Q

What type of fibres transmit touch

A

Ab fibres

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24
Q

What is the function of the neuron?

A

It is a communicating unit of the nervous system

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25
Q

How do neurons communicate?

A

Via action potentials and synaptic transmitters

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26
Q

Why does a resting membrane potential arise?

A

Due to a difference in charge (due to ions) between the inside and outside of the neuron

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27
Q

What is the typical RMP (resting membrane potential) of ions?

A

-60 to -70 mV

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28
Q

How do ions cross the membrane?

A

Via ion channels

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29
Q

How are voltage gated channels controlled?

A

Depending on membrane potential

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30
Q

How are ligand gated channels controlled?

A

In response to binding or activation by a neurotransmitter or drug

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31
Q

What is an action potential?

A

A brief but dramatic change in membrane potential

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32
Q

What are action potentials used for ?

A

Neurons use action potentials to communicate information

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33
Q

What happens if the depolarisation is too small and doesn’t reach the threshold?

A

The membrane potential returns to normal and no action potential is fired

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34
Q

What happens when the depolarisation is big enough and the threshold is reached?

A

An action potential is released

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35
Q

What ion is related to depolarisation?

A

sodium ions

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36
Q

What ion is related to repolarisation and hyperpolarisation?

A

Potassium ions

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37
Q

What happens for depolarisation to occur?

A

Fast opening of voltage gated Na channels

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38
Q

What happens for repolarisation or hyperpolarisation to occur?

A

Slow opening of voltage gated K channels

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39
Q

How do local anaesthetics (e.g. lidocaine) work?

A

It is a Nav blocker that means when nerve damage occurs the nerves in the skin can’t release action potentials

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40
Q

What are the two ways positive charge can travel?

A
  1. along an axon

2. out of the axon via the membrane

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41
Q

What does the destination of the current depend on?

A
  1. axon diameter

2. number of open pores/ channels in the membrane

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42
Q

Are small diameter axons high or low resistance?

A

High

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43
Q

Are large diameter axons high or low resistance?

A

Low

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44
Q

What does it mean If there are lots of open pores or channels on an axon?

A

The charge can leak out of the axon

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45
Q

What does it mean when there aren’t many open channels on an axon?

A

Charge wont leak out as readily

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46
Q

What is myelin?

A

A fatty white substance that prevents the leaking of charge

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47
Q

what makes myelin?

A

Schwann cells and oligodendrocytes

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48
Q

Where is myelin found?

A

Some axons are insulated by myelin

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49
Q

How do action potentials move along myelinated axons?

A

It jumps from node to node on the myelinated axon

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50
Q

What is the difference between myelinated and unmyelinated fibres?

A

Myelinated fibres conduct action potentials much faster than unmyelinated fibres

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51
Q

What causes MS?

A

Antibodies attack the myelin

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52
Q

What is an EPSP?

A

An excitatory postsynaptic potential

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53
Q

What does an EPSP do?

A

Brings the post synaptic membrane closer to threshold which makes it more likely that the cell will produce an action potential

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54
Q

What is an IPSP?

A

An inhibitory postsynaptic potential

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55
Q

What does an IPSP do?

A

Moves the post synaptic membrane potential further away from threshold which reduces the likelihood of an action potential being produced

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56
Q

What is temporal summation?

A

The frequency of firing of action potentials

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57
Q

What is spatial summation?

A

Firing at multiple sites of action potentials

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58
Q

What are the types of neurotransmitter?

A

Cholinergic, Biogenic amines, Amino acids, Neuropeptides and miscellaneous

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59
Q

What is divergence?

A

When one neuron communicates with many

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60
Q

What is it called when one neuron communicates with many others?

A

Divergence

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61
Q

What is convergence?

A

when many neurons communicate with one

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62
Q

What is it called when many neurons communicate with one?

A

Convergence

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63
Q

What is an EEG?

A

Electro-encephalography

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64
Q

What is PET?

A

Positron emission tomography

65
Q

What is fMRI?

A

Functional magnetic resonance imaging

66
Q

what is TMS?

A

Transcranial magnetic stimulation

67
Q

What does an EEG do?

A

It records the electrical activity of the brain

68
Q

What does PET do?

A

Measures blood flow, via a small dose of radioactive material injected into the bloodstream

69
Q

What does fMRI do?

A

Measures blood flow

70
Q

What does TMS do?

A

Uses electromagnet to stimulate brain activity, causing depolarisation or interrupted firing

71
Q

What is EEG used for?

A

To investigate cognitive processes in response to a stimulus

72
Q

What is PET used for?

A

Locates brain activity while performing a task

73
Q

What is fMRI used for?

A

Locates brain activity while performing a task

74
Q

What is TMS used for?

A

Interrupts brain activity while performing a task

75
Q

By what stage of gestation will the majority of neurons be present?

A

10-11 weeks

76
Q

What is a heterotopia?

A

An area of neural tissue that isn’t in the right place

77
Q

Where are movements planned?

A

The cerebellum

78
Q

What area of the brain allows us to react quickly to the environment?

A

The cerebellum

79
Q

What does the cerebellum allow us to do?

A

Plan movements and react quickly to the environment

80
Q

What area of the brain does everything pass through?

A

The midbrain

81
Q

What is a sulcus

A

A groove

82
Q

What is a gyrus

A

A fold

83
Q

What is in the sagittal sulcus?

A

The sagittal sinus and a thin sheet of dura mater

84
Q

What function is in the precentral gyrus?

A

Motor

85
Q

What function is in the postcentral gyrus?

A

Sensory

86
Q

How do the motor and sensory homunculs lie in respect to each other?

A

Parallel

87
Q

What is in Brocca’s area?

A

Motor aspects of speech and speech associated gestures

88
Q

Which hemisphere is Brocca’s area most commonly found?

A

The left hemisphere

89
Q

Why is the Brocca’s area most commonly found in the left hemisphere?

A

Because most people are right handed

90
Q

What happens if there is damage to Brocca’s area?

A

Extensive aphasia - non-fluent, slow speech

91
Q

What happens in Wernicke’s area?

A

Sensory language area, lexical processing

92
Q

Where is Wernicke’s area?

A

In the dominant cerebral hemisphere (left in 90% of the population)

93
Q

What happens if there is damage to Wernicke’s area?

A

Receptive aphasia - extremely poor comprehension (you can’t understand speech)

94
Q

What do the basal ganglia do?

A

Influence motor activity and motor control

95
Q

What is the function of the lateral ventricles?

A

They provide cushioning

96
Q

Where do the lateral ventricles drain into?

A

The third ventricle and eventually onwards to the spine

97
Q

What information does the Medial Lemniscal pathway transmit?

A

Touch

98
Q

What information does the spinothalamic pathway transmit?

A

Pain

99
Q

What is it thought that claustrum neurones have something to do with?

A

Consciousness

100
Q

What is the widest type of nerve fibre?

A

Aa

101
Q

What is the fastest type of nerve fibre?

A

Aa

102
Q

What is the second widest type of nerve fibre?

A

Ab

103
Q

What is the second fastest type of nerves fibre?

A

Ab

104
Q

What is the thinnest type of nerve fibre?

A

C

105
Q

What is the slowest type of nerve fibre?

A

C

106
Q

What is the order (widest to thinnest) of the nerve fibres?

A

Aa, Ab, Ad, C

107
Q

What is the order (fastest to slowest) of the nerve fibres?

A

Aa, Ab, Ad, C

108
Q

What do Aa fibres transmit?

A

Proprioception

109
Q

What do Ab fibres transmit?

A

Touch in skin

110
Q

What do Ad receptors transmit?

A

Pain, temperature

111
Q

What do C fibres transmit?

A

Temperature, pain, itch

112
Q

Why are C fibres slower than the other fibres?

A

They are not myelinated

113
Q

What are the ascending tracts of white matter?

A

Sensory

114
Q

What do the descending tracts of white matter do?

A

Modulate activity

115
Q

Where in the sensory pathway does the primary neuron synapse to the secondary neuron?

A

In the spinal cord or brainstem

116
Q

Where in the sensory pathway does the secondary neuron synapse to the tertiary neuron?

A

In the thalamus

117
Q

Where does the tertiary neuron travel to?

A

The cerebral cortex

118
Q

What type of mechanoreceptors detect light touch?

A

Meissner’s corpuscle and Merkel disks

119
Q

What types of mechanoreceptors detect pressure?

A

Pacinian corpuscles and Ruffini endings

120
Q

Where is the medial Lemniscal pathway?

A

Dorsal column

121
Q

What does the medial Lemniscal pathway transmit?

A

Discriminative tactile sensation (touch)

122
Q

What does the spinothalamic pathway transmit?

A

Pain, temperature, crude touch

123
Q

Where does the primary neuron synapse to the secondary neuron in the pain pathway?

A

The dorsal root in the spinal cord

124
Q

Where does the secondary neuron synapse to the tertiary neuron in the pain pathway?

A

In the thalamus

125
Q

What does the corticobulbar pathway transmit?

A

Motor control (voluntary) and innervation of the cranial nerve nuclei

126
Q

Where are action potentials for the corticobulbar pathways generated?

A

The motor cortex

127
Q

Where does the upper motor neuron go?

A

The pons or medulla

128
Q

Where does the lower motor neuron go?

A

The muscle that is being triggered

129
Q

Where do the neurons from the corticospinal pathway cross over?

A

The pyramidal decussation

130
Q

What descending tracts control voluntary motor movement?

A

Corticospinal and corticobulbar tracts

131
Q

What descending tracts control muscle tone?

A

Reticulospinal, tectospinal and vestibulospinal

132
Q

What does the reticulospinal pathway control?

A

Extensors and flexors

133
Q

What are the two sections of the reticulospinal pathway?

A

Pontine tracts and medullary tracts

134
Q

What does the pontine tracts control?

A

Extensors

135
Q

What does the medullary tracts control?

A

Flexors

136
Q

What does the vestibulospinal pathway control?

A

Modulates the activity of alpha-motor neurons and is important in the maintenance of balance and posture

137
Q

What does damage/pathology of the vestibulospinal pathway lead to?

A

Loss of postural control

138
Q

Where does the tectospinal pathway run?

A

Ventromedially

139
Q

Where does the tectospinal pathway originate?

A

Contralateral superior colliculus (mid-brain)

140
Q

What is the function of the tectospinal pathway?

A

Innervates muscles of the neck and modulates activity of alpha and gamma neurons

141
Q

What is the purpose of pain?

A

Survival - protective

142
Q

What negative effects can pain have on the body?

A
  • CNS - anxiety, depression, sleep impairment
  • CVS - inhibits cough, hyperventilation
  • GI - nausea, vomiting
  • GUS - urinary retention, uterine inhibition
  • muscle - restless, immobility
143
Q

What is nociception?

A

The mechanism by which we detect the presence of a potentially tissue harming stimulus

144
Q

What are the four physiologic processes involved in nociception?

A

Transduction, transmission, modulation and perception

145
Q

Where are nociceptors found?

A

Skin, bone, muscle, internal organs, blood vessels

146
Q

Where are nociceptors not found?

A

The brain

147
Q

What type of fibres detect temperature?

A

C and Ad

148
Q

What type of fibres transmit pain?

A

C and Ad

149
Q

What type of fibres transmit touch?

A

Ab

150
Q

What are the two levels of pain modulation?

A

Spinal and supra-spinal

151
Q

what is neuropathic pain?

A

Pain that is initiated or caused by a primary lesion or dysfunction in the peripheral or central nervous system

152
Q

What can cause neuropathic pain?

A

Post-surgical and post-traumatic nerve injury

153
Q

Where is pain felt in peripheral neuropathic pain?

A

In the territory of the affected nerve or nerve root

154
Q

Where is pain felt in central neuropathic pain?

A

It is related to the site of the lesion in the spinal cord or brain

155
Q

What are the characteristics of somatic pain?

A
  • Site - well localised
  • Radiation - dermatomal
  • Character - sharp, aching, gnawing
  • Periodicity - constant +/- incident
  • Associations – rarely
156
Q

What are the characteristics of visceral pain?

A
  • vague distributiom
  • diffuse, to body surface
  • dull, cramp, dragging
  • often periodic
  • nausea, sweaty, HR & BP
157
Q

What are the 6Ps of pain relief?

A 
Prevention
Pathology
Physical therapy
Pharmacotherapy
Procedural 
Psychology
158
Q

What are the steps on the WHO ladder for analgesic pain relief?

A

Step 1 - Paracetamol, NSAIDs or cox II inhibitors

Step 2 - Codeine, Dihydrocodein (often as co-analgesics)

Step 3 - Morphine, oxycodone, tramadol, buprenorphine, fentanyl

MBChB - year 2 (25 decks)

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