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Neuro > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What are the 2 ways a person can be unconscious?

A

Sleep
Coma

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2
Q

What are the 3 levels of Consciousness?

A

Wakefulness (alert, detects objects)
Core Consciousness (wakefulness + emotional response and memory)
Extended Consciousness (all above + self awareness, language and creativity)

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3
Q

How does an EEG (electroencephalogram) work?

A

Picks up activity of synchronised dendritic activity (the more neurons synchronised, the bigger the peaks on EEH)
Doesn’t pick up individual neurons

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4
Q

How do neurons become synchronised?

A

Either by neuronal interconnections or by pacemaker

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5
Q

How many pairs of electrodes are used in an EEG?

A

19 pairs

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6
Q

List the stages of sleep?

A

Awake
Stage 1-4
REM

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7
Q

Describe the Awake stage of sleep

A

Eyes closed - alpha high frequency + low amp
Eyes open - beta waves + waves of activity

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8
Q

Describe Stage 1 of sleep

A

Easily roused, slow rolling eye movements
Some theta waves w/ slower freq + higher amp waves

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9
Q

Describe Stage 2 of sleep

A

Begin K complexes & sleep spindles
No eye movement but body movement still possible

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10
Q

Describe Stage 3 of sleep

A

Slower freq w/ delta waves
Harder to rouse
Few spindles

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11
Q

Describe Stage 4 of sleep

A

Deepest sleep, hardest to rouse
High amplitude (delta waves)
Heart rate & BP lower

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12
Q

Describe REM sleep

A

Fast beta waves and REM
Easier to rouse than stage 4
Dreaming, recalled + low muscle tone

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13
Q

What structure in the brain helps turn on and off sleep?

A

Reticular formation through interactions w/ thalamus

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14
Q

Excitation of the reticular formation will lead to what result in the context of sleep?

A

Depolarisation of thalamus (excitation) which will lead to non-rhythmic output from thalamus, therefore Increased arousal

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15
Q

Inhibition of the reticular formation will lead to what result in the context of sleep?

A

Hyperpolarisation of the thalamus (less excited) which will lead to rhythmic output of the thalamus, therefore slow EEG waves in cerebral cortex

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16
Q

What is the broad definition of Epilepsy?

A

A continuing tendency to have recurrent, unprovoked seizures

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17
Q

What are individuals w/ epilepsy at risk of?

A

SUDEP
Sudden Unexpected Death
1 in 1,000 epileptics

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18
Q

How do you realistically determine what type of epileptic seizures an individual suffers from?

A

History taking and witness testimony of the seizure

+/- Aura, Deja vu, Fear, Warning
Abnormal Movements
Memory loss after, confusion

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19
Q

What are the 3 main categories of epileptic seizures?

A

Focal (Aware / Unaware)
Generalised seizures
Unclassified seizures

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20
Q

What are all the subtypes of Generalised seizures?

A

Absence (typical / atypical)
Myoclonic
Clonic
Clonic-tonic
Tonic
Atonic

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21
Q

What are some potential symptoms of Focal aware seizures?

A

Consciousness is preserved
Aura
Elaborate motor output
Rhythmic movement
May see faces
Contralateral visual hallucination
Underwater hearing
Hear music

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22
Q

What are some symptoms of Focal unaware seizures?

A

May be impaired consciousness
Temporal lobe seizures not common (40% of all cases)
Often benign with aura, linked to location
Automatisms & unusual sounds
Occasionally autonomic responses
Post ictal headache w/ confusion
May evolve into Generalised seizures

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23
Q

Describe Typical Absence seizures

A

Sudden onset (no aura)
Abrupt cessation
Brief duration (20s)
May be w/ clonic jerking of eyelids

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24
Q

Describe Atypical Absence seizures

A

Postural tone changes
Autonomic phenomena
Automatisms

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25
Q

What can’t be used to treat Myoclonic seizures?

A

Carbamazepine

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26
Q

Describe Atonic seizures

A

Sudden loss of postural tone; often in children but can be present w/ adults

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27
Q

Describe Tonic-clonic seizures

A

Major convulsions w/ rigidity (tonic) and jerking (clonic)
slows over 60-120 sec

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28
Q

Describe Status Epilepticus

A

More than 5 mins of continuous conclusive seizure activity
or
2 or more sequential seizures spanning this period without full recovery between seizure

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29
Q

What are some diagnostic tests for Epilepsy?

A

ECG (cardiac problems can correlate with epilepsy)
EEG
CT scan (only if suspicious of brain tumour)
MRI (areas of scarring, reduced perfusion)

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30
Q

What may pre-dispose one to an epileptic seizure?

A

Scar tissue
Developmental issues
Pyramidal cell damage
Tumours

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31
Q

What are examples of potential triggers of epileptic seizures?

A

Tiredness
Alcohol
Certain drugs
Change of medication

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32
Q

Treatment for epilepsy

A

Anti-Epileptics (AED)
Treats the symptoms of epilepsy but not the cause

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33
Q

Targets for AEDs

A

Supress excit neurotransmitter system (inhib Na channels)
Enhance the inhib neurotransmitter system (GABA (Benzodiazepines))
Block voltage-gated inwards +ve currents (NA+ or Ca++)
Increase outward +ve current (K+)
Many AEDs pleiotropic

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34
Q

What is always present in Generalised seizures?

A

Alteration to consciousness

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35
Q

What are some drugs used in the treatment of Focal onset seizures?

A

Carbamazepine
Lamotrigine

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36
Q

What are some drugs used in the treatment of Generalised onset seizure?

A

Valproic acid
Lamotrigine

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37
Q

What drug is used to treat Absence seizures?

A

Ethosuximide

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38
Q

What mechanisms happens to cause Hebbian learning?

A

Cells fire simultaneously to increase the synaptic associations

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39
Q

Define Habituation

A

The process by which repeated stimulus leads to a decreased response (& decreased NT release)

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40
Q

Define Sensitisation

A

The process by which repeated stimulus leads to an increased response
This is mediated by an interneuron

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41
Q

Describe long term potentiation (LTP)

A

Needed for long term memory, +ve reinforcement of a signal will lead to a strengthened signal
PATH SPECIFIC

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42
Q

Describe long term depression (LTD)

A

Used to modulate LTP or even reverse it
When synapses become less efficient at transmitting signals

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43
Q

Describe short term memory

A

Brief memory (seconds)
Easily displaced by another stimulus
Can be extended into working memory by:
a) repetition in phonic loop or
b) chunking which links familiar chunks together to extend the size of chunk

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44
Q

What is the most commonly used clinical test for short term memory chunks?

A

Digit span - told no. of digits and asked to immediately repeat same numbers (norm is about 6-7 digits)

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45
Q

Define working memory

A

Maintenance and integration of info in an active state for a relatively brief time in order to achieve a short term task/goal
Mixture of short and/or long term memory

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46
Q

Long term memory can be divided into what 2 groups?

A

Declarative memory
&
Non-declarative memory

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47
Q

What are the 4 steps in the process of learning?

A

Encoding (mem created)
Storage (persistence of mem traces)
Retrieval (mem recovery)
Consolidation (strengthening of mem traces)

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48
Q

What are some structural changes that happen during consolidation in learning?

A

Formation of more receptors or even more dendritic spines

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49
Q

What structures are involved in non-declarative memory?

A

Amygdala
Caudate nuc.
Putamen
Cerebellum

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50
Q

What’s the difference between retrograde and anterograde amnesia?

A

Retro is losing memories from their past, Antero is when they can’t properly form new memories

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51
Q

What was one valuable piece of info did we gather from the case of HM?

A

Declarative, non-declarative, short term and long term memory are not processed in the same place or by the same mechanisms

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52
Q

What is the role of association areas along with sub-cortical components within cognition?

A

Determine the perceptual qualities of the modality

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53
Q

What is multi-sensory integration?

A

Combination of processed sensory perceptions are used to determine what is happening and where it’s happening

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54
Q

Describe the process by which multi-sensory integration occurs

A

Sub-cortical structures & association fibres move info through the association cortices for processing + integration to become either a reflex or a cognitive state

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55
Q

What does the McGurk effect show?

A

Visual info is more valuable than auditory info

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56
Q

Define Synaesthesia

A

The conflation of sensory experiences from one sensory domain with those from another, or the mixing of two modalities of the same sensory domain
eg. colour-graphemic synaesthesia

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57
Q

What is conduction aphasia?

A

Link between Wernicke’s and Broca’s area is damaged
typically means reduced ability to repeat spoken words

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58
Q

Define Wernicke’s aphasia

A

Nonsensical speech due to reduced comprehension of speech
Can’t understand their own or others speech (also affects reading words)

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59
Q

Define Broca’s aphasia

A

Aka motor or non-fluent aphasia
Patients have difficulty speaking - often stuttering to find right word. Aware they are making little sense. No problem responding to the spoken or written word, can comprehend

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60
Q

Define Aprosodia

A

Robotic or monotonic speech patterns due to damage in non dominant lobe affecting variation in tone of voice

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61
Q

What is a unique trait about split brain patients and describing objects felt in either hand?

A

Assuming L dom hemisphere, they wont be able to describe objects felt in left hand nor objects seen on left side

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62
Q

What are potential causes of a lesion from fastest onset of symptoms to slowest?

A

Vascular risk factors
Infectious
Autoimmune
Tumour / Metastasis
Degenerative neuron disease

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63
Q

If a patient presents with problems with eye movement, where is there likely to be a problem in the brainstem?

A

Midbrain

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64
Q

If a patient presents with problems with mastication, where is there likely to be a problem in the brainstem?

A

Pons

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65
Q

If a patient presents with problems with phonation, speech and/or swallowing, where is there likely to be a problem in the brainstem?

A

Medulla

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66
Q

What are the 4 general functions of the limbic system?

A

Emotion + drives (amygdala)
Homeostasis + motivation (hypothalamus)
Olfaction (olfactory cortex)
Memory (hippocampus)

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67
Q

Where is the Amygdala located?

A

Anterior to the tip of the hippocampus in the temporal lobe

68
Q

Where are the Amygdala’s most significant afferent fibres from?

A

Frontal, Temporal and Parietal lobes receiving cognitive info

69
Q

Where are the amygdala’s most significant efferent fibres going to?

A

Hypothalamus and limbic cortex providing emotional cognisance, and visceral/homeostatic info

70
Q

What is Kluver-Bucy syndrome?

A

Bilateral temporal lobe lesions often affecting hippocampus and/or amygdala

71
Q

What are symptoms of Kluver-Bucy syndrome?

A

Visual recognition impairment for fear in others
Heightened sexual appetite
Flattened emotions
Oral tendencies (hyperorality)

72
Q

What are common symptoms of lesions in the amygdala?

A

A loss of recognition of fear and anger in other’s faces

73
Q

What is the main effector of the limbic system?

A

Hypothalamus

74
Q

What are the main groups of functions of the Hypothalamus?

A

Vegetative functions (Homeostasis)
Endocrine functions (Hypophyseal)
Behavioural functions

75
Q

What is the role of the anterior Insular cortex

A

Provides introspection that allows the interpretation of sensation as joy or disgust

76
Q

What sections of the limbic system has reduced activity in depression?

A

Ventromedial portion of prefrontal cortex (goal setting / planning)
Cingulate Gyrus (emotion / cognition)

77
Q

The Medial Longitudinal Fasciculus connects links what 3 CN’s in eye movement?

A

Oculomotor III
Trochlear IV
Abducens VI

78
Q

Hypothalamus receives afferents from what structures?

A

Neocortex
Eyes
Amygdala
Spinal cord
Pain & sens integration in brainstem nuclei

79
Q

Hypothalamus sends efferents to what structures?

A

Neocortex
Spinal cord
Amygdala
Medulla
Ant. & Post. Hypophyseal
Pain & sens integration in brainstem nuclei

80
Q

Describe the Limbic reward loop

A

Originates in the Ventral Tegmentum (dopamine) and projects to the medial prefrontal cortex (mPFC), amygdala & hippocampus as well as nuc. accumbens and ventral pallidum
Big role in Motivations and Addictions

81
Q

How does limbic system help with pain management?

A

Limbic system interconnects with PAG (periaqueductal grey matter). PAG can reduce activity in ascending pain pathway w/ its effects agonised by endorphins (and opiates)

82
Q

What is the relationship between Bipolar disorder and the Ventromedial portion of the Prefrontal cortex?

A

In depressive phase this is virtually inactive
In manic phase this is hyperactive

83
Q

What is the relationship between Bipolar disorder and the Cingulate gyrus?

A

ant. portion is more active during depressive phase and less active during manic
Opposite for the post. portion

84
Q

What is the mortality from meningococcal Meningitis as well as meningococcal Sepsis?

A

15% & 40% respectively

85
Q

What are some possible complications of meningitis?

A

Seizures
Hearing issues
Other CN problems
Focal paralysis
ect.

86
Q

What are some possible complications of sepsis?

A

Limb amputations
Arthritis + joint pain
Skin necrosis + scarring
Organ dysfunction

87
Q

What is the difference between Meningitis and Encephalitis?

A

Meningitis is inflammation of the meninges, Encephalitis is inflammation of the brain parenchyma

88
Q

Define sepsis

A

Life-threatening organ dysfunction caused by body’s extreme, dysregulated response to infection

89
Q

If infectious agents breach the BBB, what condition will this person get?

A

Encephalitis

90
Q

If infectious agents breach the Blood-CSF barrier, what condition will this person get?

A

Meningitis

91
Q

What are the 3 main causes of meningitis?

A

—Infection—
Auto-immune disease
Malignancy

92
Q

How could you roughly identify what bacteria may be causing meningitis when a patient comes to you?

A

By their age
Different bacteria will cause meningitis based on age

93
Q

Describe Neisseria Meningitidis

A

G -ve Bacteria
Normal microbiota in nasopharynx
transmission via droplet spread

94
Q

Describe Haemophilus Influenzae

A

G -ve Bacteria
6 capsular serotypes (a-f)

95
Q

Describe Streptococcus Pneumoniae

A

G +ve Bacteria
Normal microbiota in nasopharynx
Common cause of meningitis in young children and adults with specific risk factors

96
Q

What are the 3 main bacteria that cause meningitis?

A

Neisseria Meningitidis
Haemophilus Influenzae
Streptococcus Pneumoniae

97
Q

What are some clinical features of Meningitis in babies/young children?

A

Fever
Headache
Non-blanching rash
Photophobia
Seizures

98
Q

What are some diagnostic blood tests you can do to look for meningitis?

A

Biochemistry - U&E, lactate, glucose
Haematology - FBC, clotting
Microbiology - blood culture, PCR

99
Q

What are some diagnostic CSF tests you can do to look for meningitis?

A

Biochemistry - protein & glucose
Microbiology - WBC count, PCR, Bacteria culture

100
Q

How do you typically treat bacterial meningitis?

A

Antibiotics
+/-
Steroids

101
Q

How do we prevent bacterial meningitis?

A

Routine vaccinations

102
Q

What is different between bacterial and viral meningitis?

A

Viral is less severe and more common than bacterial

103
Q

How do we identify viral meningitis?

A

PCR or CSF

104
Q

What treatment is there for viral meningitis?

A

None as it’s regarded as ‘benign’ & self limiting

105
Q

What is the most common cause of Encephalitis?

A

Herpes Simplex Virus - 1
(HSV-1)

106
Q

What are the main symptoms & signs of encephalitis?

A

Altered Cerebration:
confusion, abnormal behaviour, seizures, fever

107
Q

How do we treat Encephalitis?

A

High dose IV Aciclovir

108
Q

What often cause brain abscess’?

A

Oral nasopharyngeal microbiota

109
Q

What is the pathophysiology of brain abscess’?

A

Diffuse inflammation -> focal lesion and pia matter suppuration

110
Q

What are the symptoms & signs of a brain abscess?

A

Headache, focal neurology, seizures

111
Q

How do we test for brain abscess’?

A

CT / MRI scan
+/- invasive sampling

112
Q

How do we treat brain abscess’?

A

Antibiotics

113
Q

What are the 2 segments of the eye called?

A

Ant. and Post. Segment

114
Q

What is the largest layer of the Cornea?

A

Stroma

115
Q

What is the role of the Endothelial cells in the Cornea?

A

Remove water/moisture from the stroma to keep it dry (allows clear vision)

116
Q

What is the Near Triad?

A

Miosis
Convergence
Accommodation

Related to looking at a very close object

117
Q

What is the name of a refractive error in the eye?

A

Presbyopia (need glasses)

118
Q

What is it called to be near sighted?

A

Myopia

119
Q

What is it called to be long sighted?

A

Hypermetropia

120
Q

What is an individual with Myopia more at risk of also getting?

A

Open angle glaucoma
Retinal detachment

121
Q

What is an individual with Hypermetropia more at risk of also getting?

A

Angle closure glaucoma
Ischaemic optic neuropathy

122
Q

What is the main cause of visual impairment in the world?

A

Uncorrected refractive error (URE)

123
Q

What is the main cause of blindness in the world?

A

Cataracts

124
Q

What is the difference between a Snellen chart and an Arclight chart?

A

Arclight is 50% smaller w/ 50% smaller letters (also use at 50% distance ie. 3m instead of 6m)

125
Q

When is a person deemed blind by WHO?

A

When they can’t read any letters from 3m (worse than 3/60 vision)

126
Q

What is Trachoma?

A

Scarring of cornea due to Chlamydia

127
Q

Name all structures in the Ant. Segment of eye

A

^^^

128
Q

What are the differences between Rods and Cones in the Eye?

A

^^^

129
Q

What cells deal with peripheral vision?

A

Rods

130
Q

What cells deal with focused vision?

A

Cones

131
Q

What vitamin is important for retinal health and what will be a result of deficiency in this vitamin?

A

Vit A
Night blindness -> Total blindness -> Death

132
Q

What retinal issue is more apparent in richer countries?

A

Age related Macular Degeneration (AMD)

133
Q

What structures act as innate defence for the eye?

A

Orbit & eyelids
Tears + mucin
Ocular Epithelium

134
Q

What structures act as adaptive defence for the eye?

A

Eye-associated lymphoid tissue
Langerhan’s cells
Lymphocytes

135
Q

What is the function of Lysozyme and where is it found?

A

Enzyme that cleaves bacterial peptidoglycans and also helps to protect against viruses and fungi
Found in tears, saliva, and mucous

136
Q

What is the function of Lactoferrin and where is it found?

A

Binds iron - starves bacteria and fungi, disrupts cell walls, anti-viral
Found in tears, saliva, mucous, and milk

137
Q

Lysozyme and Lactoferrin work together to help protect against what type of Bacteria?

A

Gramm -ve

138
Q

What are some common eye infections?

A

Conjunctivitis
Keratitis (viral, bacterial)
Onchocerciasis (parasitic infection)
Orbital Cellulitis (pre/post septal)

139
Q

What are 2 common causes of conjunctivitis in baby?

A

Gonorrhoea and Chlamydia

140
Q

What is one risk factor for Bacterial Keratitis?

A

Contact lenses that are left in for too long

141
Q

What are some causes of Corneal ulcers?

A

Tear film deficiencies
Eyelid malformation / dysfunction
Endogenous cause
Exogenous cause

142
Q

What are some symptoms of HSV Keratitis?

A

Always unilateral
Painful, red, watery, photophobic
Dendritic ulcer, new vessels, scarring

143
Q

What is used to treat HSV Keratitis?

A

Topical and oral Aciclovir

144
Q

What may cause Trachoma?

A

Chlamydia trachomatis infection
Chronic Keratoconjunctivitis

145
Q

What is used to treat Onchocerciasis?

A

Ivermectin

146
Q

What are some signs of Orbital Cellulitis?

A

Swelling
Redness
Limited eye movement
Proptosis
Diplopia w/ pain

147
Q

What pathogens may cause Orbital Cellulitis?

A

Haemophilus Influenzae
Staphylococcus Aureus

148
Q

What is Retinochoroiditis often related with?

A

HIV / AIDS / Toxoplasma

149
Q

What is used to treat Toxoplasmosis due to Retinochroiditis?

A

Corticosteroids

150
Q

What is used to treat Cytomegalovirus retinitis during late HIV disease?

A

Antiviral Ganciclovir

151
Q

What may cause Endophthalmitis in the eye AND how is it treated?

A

Post intra-ocular operation
Trauma w/ inoculation of foreign body

Intra-ocular & systemic antibiotics

152
Q

What are some common infections of the ear and nose?

A

Otitis Externa (bac + fungal / acute or chronic)
Otitis Media (viral + bac / acute, chronic, suppurative)
Mastoiditis (bac)

Sinusitis (acute or chronic)

153
Q

Who is most effected by Otitis Media AND what are some signs?

A

Small children, 50% viral in origin

Red ears, fever, poor feeding, restlessness, hearing difficulties

154
Q

What is Mastoiditis a severe complication of AND what are some symptoms and treatments?

A

Otitis Media

Redness, tenderness and pain behind ear

Treat w/ IV antibiotics

155
Q

What does sinusitis often follow?

A

Common cold

156
Q

What are some common issues of the throat?

A

Common cold
Acute Pharyngitis - sore throat
Cytomegalovirus
Tonsilitis

157
Q

What are some common symptoms of Viral Conjunctivitis?

A

Sticky eyes
Watery
Pink
Itchy

158
Q

What pathogens cause Viral Conjunctivitis?

A

Coronaviruses
&
Rhinoviruses

159
Q

What are some common symptoms of Adenovirus Conjunctivitis?

A

Bilateral, v sticky, red and painful eye
Enlarged ipsilateral Periauricular lymph node

160
Q

What are some common symptoms of Bacterial Conjunctivitis?

A

Similar to viral (sticky, red and painful)
Discharge more yellow and thick

161
Q

What are some potential causes of Bacterial Conjuntivitis?

A

Haemophilus Influenzae
Streptococcus Pneumoniae

162
Q

Name some drugs that could be used to treat Bacterial Conjunctivitis?

A

Chloramphenicol
Fusidic Acid

163
Q

What are some symptoms of Cytomegalovirus infections?

A

Cold-like symptoms
Sore throat
Fever
Fatigue
Swollen glands

164
Q

What would be used to treat Cytomegalovirus infections?

A

Ganciclovir

165
Q

What is a Quinsy Peritonsillar Abscess?

A

Collection of pus between tonsillar capsule and sup. constrictor muscles

166
Q

How do we treat Quinsy Peritonsillar Abscess’?

A

Needle aspiration / drainage
IV antibiotics
IV steroids

167
Q

What is the name of the position children w/ acute Epiglottitis may take?

A

Tripod position

Neuro (14 decks)

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