Hy Neuro

Front 1

The brain stem and spinal cord have:

Back 1

-Alar plate-gives rise to sensory neurons
-basal plate-gives rise to motor neurons

Front 2

Neural tube gives rise to

Back 2

three primary vesicles, which develop into five secondary vesicles

Front 3

AFP

Back 3

-Alpha-fetoprotein

-found in the amniotic fluid and meternal serum. It is an indicator of neural tube defects (spina bifida, anencephaly). AFP levels are reduced in mothers of fetuses with Down Syndrome

Front 4

Middle meningeal artery
-branch of
-enters cranium through
-supplies
-laceration results in

Back 4

-maxillary artery
-foramin spinosum
-most of the dura
-epidural hemorrhage (hematoma)

Front 5

Vertebral Artery
-branch of
-gives rise to

Back 5

-subclavian artery
-anterior spinal artery and the posterior inferior cerebellar artery

Front 6

PICA
-supplies

Back 6

-The dorsolateral quadrant of the medulla. This quadrant includes the nucleus ambiguus (CN IX, X, and XI) and the inferior surface of the cerebellum

Front 7

Pontine Ateries
-supply

Back 7

-The base of the pons, which includes the corticospinal fibers and the exiting root finbers of the abducent nerve (CN VI)

Front 8

Labyrinthine Artery
-arises from

Back 8

-Basilar artery in 15% of people
-Ainterior Inferior Cerebellar Artery in 85% of people

Front 9

AICA
-supplies

Back 9

-The caudal lateral pontine tegmentum, including CN VII, the spinal trigeminal tract of CN V, and the inferior surface of the cerebellum

Front 10

Anterior Spinal Artery
-supplies

Back 10

-Anterior 2/3 of the spinal cord
-in the medulla, the anterior spinal artery supplies the pyramid, medial lemniscus, and root fibers of CN XII

Front 11

Posterior Communicating Artery
-supplies
-aneurysm

Back 11

-Hypothalamus and ventral thalamus
-An aneurysm of this artery is the second most common aneurysm of the circle of Willis. It commonly results in third-nerve palsy.

Front 12

Anterior Choroidal Artery
-arises from
-supplies

Back 12

-Internal Carotid
-lateral geniculate body, globus pallidus, and posterior limb of the internal capsule

Front 13

Anterior Cerebral Artery
-supplies

Back 13

-The medial surface of the hemisphere from the frontal pole to the parieto-occipital sulcus

Front 14

Anterior Communicating Artery
-connects
-aneurysm

Back 14

-The two Anterior Cerebral Arteries.
-It is the most common site of aneurysm of the circle of Willis, which may cause bitemporal lower quadrantanopia

Front 15

Medial Striate Arteries
-are the
-supply

Back 15

-The penetrating arteries of the anterior cerebral artery.
-They supply the anterior portion of the putamen and caudate nucleus and the anteroinferior part of the internal capsule

Front 16

Middle Cerebral Artery
-supplies

Back 16

-Broca's and Wernicke's speech areas
-The face and arm areas of the motor and sensory cortices
-The frontal eye field

Front 17

Lateral striate arteries
-are the
-they are
-supply

Back 17

-The penetrating branches of the middle cerebral artery.
-They are the arteries of stroke
-supply the internal capsule, caudate nucleus, putamen, and globus pallidus

Front 18

Cavernous sinus
-contains

Back 18

CN III, IV, V-1, V-2, VI, postganglionic sympathetic fibers, and the siphon of the internal carotid artery

Front 19

Hydrocephalus
-is

Back 19

-dilation of the cerebral ventricles caused by blockage of the CSF pathways. It is characterized by excessive accumulation of CSF in the cerebral ventricles or subarachnoid space.

Front 20

Noncommunicating Hydrocephalus
-results from

Back 20

-Obstruction within the ventricles (congenital aqueductal stenosis)

Front 21

Communicating hydrocephalus
-results from

Back 21

-Blockage within the subarachnoid space (adhesions after meningitis)

Front 22

Normal-pressure hydrocephalus
-occurs when

Back 22

-The CSF is not absorbed by the arachnoid villi. It may occur secondary to posttraumatic meningeal hemorrhage.
-Characterized by the triad of progressive dementia, ataxic gain, and urinary incontinence

-Remember: wacky, wobbly, and wet

Front 23

Hydrocephalus ex vacuo
-results

Back 23

-From a loss of cells in the cuadate nucleus (Huntington's disease)

Front 24

Pseudotumor cerebri
-is
-results from
-occurs in
-is characterized by

Back 24

-a benign intracranial hypertension
-from increased resistance to CSF outflow at the arachnoid villi.
-obese young women
-papilledema without mass, elevated CSF pressure, and deteriorating vision. The ventricles may be slit-like

Front 25

The two lateral ventricles communicate with the third ventricle through the

Back 25

interventricular foramina of Monro

Front 26

The third ventricle
-located
-communicates with

Back 26

-between the medial walls of the diencephalon.
-communicates with the fourth ventricle through the cerebral aqueduct

Front 27

The fourth ventricle
-communicates

Back 27

with the subarachnoid space through three outlet foramina
-2 lateral foramina of Luschka
-1 medial foramen of Magendie

Front 28

Common causes of bacterial meningitis
-in newborns (<1 month)

Back 28

-Group B strep (Streptococcus agalactiae)
-E. coli
-Listeria monocytogenes

Front 29

Common causes of bacterial meningitis
-older infants and young children (1-23 months)

Back 29

Strep pneumoniae

Front 30

Common causes of bacterial meningitis
-young adults (2-18 years)

Back 30

Neisseria meningitidis

Front 31

Common causes of bacterial meningitis
-older adults (19 years and older)

Back 31

Streptococcus pneumoniae

Front 32

The Neural Crest
-Gives rise to

Back 32

-PNS (peripheral nerves and sensory and autonomic ganglia)
-Psuedounipolar ganglion cells of the spinal cand cranial nerve ganglia, Schwann cells, Multipolar ganglion cells of autonomic ganglia, Leptomeninges (pia-arachnoid-envelop the brain and spinal cord), Chromaffin cells (of suprarenal medulla-elaborate Epi), Pigment cells (melanocytes), Odontoblasts (elaborate predentin), Aorticopulmonary septum of the heart, Parafollicular cells (calcitonin-producing C-cells), Skeletal and Connective Tissue Components of the pharyngeal Arches

Front 33

Anterior Neuropore
-gives rise to
-failure to close results in

Back 33

-The lamina terminalis
-Anencephaly (failure of the brain to develop)

Front 34

Posterior Neuropore
-failure to close results in

Back 34

Spina bifida

Front 35

Microglia
-arise from the

Back 35

monocytes

Front 36

Spina bifida occulta
-see

Back 36

-tuft of hairs
-failure of vertebral column to close
-no bulging

Front 37

Meningocele
-see

Back 37

-failure of vertebral column to close
-failure of dura to close
-subarachnoid space bulging
-spinal cord in normal spot

Front 38

Meningomyelocele
-see

Back 38

-failure of vertebral column to close
-failure of dura to close
-subarachnoid space and spinal cord bulging

Front 39

Conus Medullaris ends at
-in newborn
-in adult

Back 39

-L3
-L1

Front 40

Optic Nerve and Chiasma
-derived from
-The optic nerve fibers occupy
-failure of this fissure to close results in

Back 40

-the Diencephalon
-The optic nerve fibers occupy the choroid fissure
-failure of this fissure to close results in coloboma iridis

Front 41

Adenohypophysis
-derived from
-remnants

Back 41

-ectodermal diverticulum of the primitive mouth cavity, which is also called Rathke's pouch.
-Remnants of Rathke's pouch may give rise to a congenital cystic tumor, a craniopharyngioma

Front 42

Neurohypophysis
-develops from

Back 42

-A ventral evagination of the hypothalamsu (neuroectoderm of the neural tube)

Front 43

Fetal alcohol syndrom
-is
-includes
-most severe manifestation

Back 43

-the most common cause of mental retardation
-includes microcephaly and congenital heart disease
-holoprosencephaly

Front 44

Holoprosencephaly
-results from

Back 44

-Failure of midline cleavage of the embryonic forebrain.
-The telencephalon contains a singular ventricular cavity
-is seen in trisomy 13 (Patua syndrome)
-The corpus callosum may be absent
-is the most severe manifestation of the fetal alcohol syndrome

Front 45

The 3 Primary Brain Vesicles

Back 45

-Forebrain (prosencephalon)
-Midbrain (mesencephalon)
-Hindbrain (rhombencephalon)

Front 46

Forebrain (prosencephalon)
-gives rise to

Back 46

-Telencephalon
-Diencephalon

Front 47

Midbrain (mesencephalon)
-gives rise to

Back 47

-Mesencephalon

Front 48

Hindbrain (rhombencephalon)
-gives rise to

Back 48

-Metencephalon
-Myelencephalon

Front 49

Telencephalon
-adult derivatives of
-Walls
-Cavities

Back 49

Walls-Cerebral hemispheres
Cavities-Lateral ventricles

Front 50

Diencephalon
-adult derivatives of
-Walls
-Cavities

Back 50

Walls-Thalamus
Cavities-Third Ventricle

Front 51

Mesencephalon
-adult derivatives of
-Walls
-Cavities

Back 51

Walls-Midbrain
Cavities-Aqueduct

Front 52

Metencephalon
-adult derivatives of
-Walls
-Cavities

Back 52

Walls-Pons and Cerebellum
Cavities-Upper part of 4th ventricle

Front 53

Myelencephalon
-adult derivatives of
-Walls
-Cavities

Back 53

Walls-Medulla
Cavities-Lower Part of 4th ventricle

Front 54

Arnold-Chiari Malformation
-Common Anomalies

Back 54

-beaking of the tectal plate
-aqueductal stenosis
-kinking and transforaminal herniation of the medulla into the vertebral canal
-herniation and unrolling of the cerebellar vermis into the vertebral canal
-an accompanying meningomyelocele is common

Front 55

Dandy-Walker Malformation
-get
-common anomalies

Back 55

-Enormous Dilation of the 4th ventricle results from failure of the foramina of Luschka and Magendie to open
-Associated with occipital meningocele, elevation of the confluence of sinuses, agenesis of the cerebellar vermis, and splenium of the corpus collosum

Front 56

Psuedounipolar neurons
-located

Back 56

-In the spinal dorsal root ganglia and sensory ganglia of cranial nerves V, VII, IX, and X

Front 57

Olfactory Neurons
-are

Back 57

bipolar and unmyelinated

Front 58

Auditory Neurons
-are

Back 58

bipolar and myelinated

Front 59

Dorsal root ganglion cells
-are

Back 59

pseudounipolar and myelinated

Front 60

Motor Neurons
-are

Back 60

multipolar and myelinated

Front 61

Bipolar neurons
-found in

Back 61

cochlear and vestibular ganglia of CN VIII, in the olfactory nerve (CN I), and in the retina

Front 62

Fast Anterograde Axonal Transport
-responsible
-rate
-mediated by

Back 62

-For transporting all newly syntehsized membranous organelles (vesicles) and precursors of neurotransmitters
-200 to 400 mm/day
-neurotubules and kinesis (fast transport is neurotubule-dependent)

Front 63

Slow Anterograde Transport
-responsible
-rate

Back 63

-For transporting fibrillar cytoskeletal and protoplasmic elements
-1 to 5 mm/day

Front 64

Fast Retrograde Transport
-responsible
-rate
-transports
-mediated by

Back 64

-Returns used materials from the axon terminal to the cell body for degradation and recycling
-100 to 200 mm/day
-Nerve growth factor, neurotropic viruses, and toxins, such as herpes simplex, rabies, poliovirus, and tetanus toxin
-neurotubules and dynein

Front 65

Wallerian Degneration
-is
-occurs

Back 65

Is anterograde degeneration characterized by the disappearance of axons and myelin sheaths and the secondary proliferation of Schwann cells
-In the Central Nervous System and the Peripheral Nervous System

Front 66

Chromatolysis
-is
-occurs

Back 66

-The result of retrograde degeneration
-in neurons of the CNS and PNS
-There is a loss of nissl substance after axotomy

Front 67

Why regeneration doesnt occur in the CNS

Back 67

-there are no basement membranes or endoneural investments surrounding the axons of the CNS

Front 68

Regeneration of Nerve Cells
-In
-Process
-Rate

Back 68

In PNS
-The proximal tip of a severed axon grows into the endoneural tube, which consists of Schwann cell basement membrane and endoneurium
-The axon sprout grows at the rate of 3 mm/day

Front 69

2 biochemical markers for Astrocytes

Back 69

Glial Fibrillary Acidic Protein (GFAP) and glutamine synthetase

Front 70

Blood-Brain Barrier
-consists of

Back 70

-Tight junctions of nonfenestrated endothelial cells; some authorities include the astrocytic foot processes
-Infarction of brain tissue destroys the tight junctions of endothelial cells and results in vasogenic edema, which is an infiltrate of plasma into the extracellular space

Front 71

Blood-CSF Barrier
-consists of

Back 71

-Tight Junctions between the Cuboidal Epithelial clls of the choroid plexus.
-The barrier is permeable to some circulating peptides (insulin) and plasma proteins (prealbumin)

Front 72

Lewy bodies

Back 72

are neuronal inclusions that are characteristic of Parkinson's disease

Front 73

Negri bodies
-where found

Back 73

-In the pyramidal cells of the hippocampus and the Purkinje cells of the cerebellum

Front 74

Hirano bodies

Back 74

are intraneuronal, eosinophilic, rodlike inclusions that are found in the hippocampus of patients with Alzheimer's disease

Front 75

Neurofibrillary tangles

Back 75

consist of intracytoplasmic degenerated neurofilaments. They are seen in patients with Alzheimer's disease

Front 76

Sensory Axons
-Ia (A-alpha)
-diameter
-function

Back 76

-12-20 micrometers
-protprioception, muscle spindles

Front 77

Sensory Axons
-Ib (A-alpha)
-diameter
-function

Back 77

-12-20 micrometers
-proprioception, golgi tendon organs

Front 78

Sensory Axons
-II (A-beta)
-diameter
-function

Back 78

-5-12 micrometers
-touch, pressure, and vibration

Front 79

Sensory Axons
-III (A-delta)
-diameter
-function

Back 79

-2-5 micrometers
-touch, pressure, fast pain, and temperature

Front 80

Sensory Axons
-IV (C)
-diameter
-function

Back 80

-0.5-1 micrometers
-slow pain and temperature, unmyelinated fibers

Front 81

Motor axons
-Alpha (A-alpha)
-diameter
-where at
-innervate

Back 81

-12-20 micrometers
-Alpha motor neurons of ventral horn
-(innervate extrafusal muscle fibers)

Front 82

Motor axons
-Gamma (A-gamma)
-diameter
-where at
-innervate

Back 82

-2-10 micrometers
-Gamma motor neurons of ventral horn
-(innerate intrafusal muscle fibers)

Front 83

Preganglionic autonomic fibers (B)

Back 83

myelinated preganglionic autonomic fibers

Front 84

Postganglionic autonomic fibers (C)

Back 84

unyelinated postganglionic autonomic fibers

Front 85

Metastatic Brain tumors
-most common locations

Back 85

-in metastatic tumors, the primary site of malignancy is the lung in 35% of cases, the breast in 17%, in the GI tract in 6% melanoma in 6%, and the kidney in 5%

Front 86

Glioblastoma multiforme
-is

Back 86

the most common and most fatal type of brain tumor

Front 87

Meningioma
-is

Back 87

a benign noninvasive tumor of the falx and the convexity of the hemisphere

Front 88

Schwannoma
-is

Back 88

a benign peripheral tumor derived from Schwann cells

Front 89

Ependymoma
-is

Back 89

found in the ventricles and accounts for 60% of spinal cord gliomas

Front 90

Medulloblastoma
-is

Back 90

the second most common posterior fossa tumor seen in children and may metastasize through the CSF tracts

Front 91

Cutaneous Receptors
-Meissner's corpuscles
-Pacinican corpuscles

Back 91

-Meissner's corpuscles are encapsulated endings that are touch receptors
-Pacinian Corpuscles are pressure and vibration receptors

Front 92

Dorsal Columns
-aka

Back 92

Medial Lemniscus Pathway

Front 93

Dorsal Columns
-function

Back 93

mediates
-tactile discrimination
-vibration sensation
-form recognition
-joint and muscle sensation (conscious proprioception)

Front 94

Dorsal Columns
-receptors

Back 94

-Pacini's and Meissner's tactile corpuscles
-joint receptors
-muscle spindles
-golgi tendon organs

Front 95

Dorsal Columns
-first-order neurons located in

Back 95

the dorsal root ganglia at all levels. They project axons to he spinal cord through the medial root entry zone

Front 96

Dorsal Columns
-first-order neurons give rise to

Back 96

-the gracile fasciculus from the lower extremity
-the cuneate fasciculus from the upper extremity
-the collaterals for spinal reflexes (myotatic reflex)
-the axons that ascend in the dorsal columns and terminate in the gracile and cuneate nuclei of the causal medulla

Front 97

Dorsal Columns
-second-order neurons are located

Back 97

-in the gracile and cuneate nuclei of the caudal medulla

Front 98

Dorsal Columns
-second-order neurons
-give rise to

Back 98

-axons and internal arcuate fibers that decussate and form a compact fiber bundle (medial lemniscus)

Front 99

Dorsal Columns
-second-order neurons
-medial lemniscus-pathway

Back 99

-ascends through the contralateral brain stem and terminates in the VPL nucleus of the thalamus

Front 100

Dorsal Columns
-third-order neurons
-located

Back 100

in the VPL nucleus of the thalamus

Front 101

Dorsal Columns
-third-order neurons
-project

Back 101

through the posterior limb of the internal capsule to the postcentral gyrus, which is the primary somatosensory cortex (Brodmann's areas 3, 1, and 2)

Front 102

Dorsal Columns
-transection of the dorsal column-medial lemniscus tract
-above the sensory decussation

Back 102

transection results in contralateral loss of the dorsal column modalities

Front 103

Dorsal Columns
-transection of the dorsal column-medial lemniscus tract
-in the spinal cord

Back 103

transection results in ipsilateral loss of the dorsal column modalities

Front 104

Dorsal Columns
-crosses where
-uses what

Back 104

-at the causal medulla
-internal arcuate fibers that decussate and form medial lemniscus

Front 105

Lateral Spinothalamic Tract
-function

Back 105

-the lateral spinothalamic tract medates pain and temperature sensation

Front 106

Lateral Spinothalamic Tract
-receptors

Back 106

are free nerve endings. The lateral spinothalamic tract receives input from fast- and slow-conducting pain fibers (A-delta and C, rspectively)

Front 107

Lateral Spinothalamic Tract
-first-order neurons
-located
-project to

Back 107

-in the dorsal root ganglia at all levels
-project axons to the spinal cord through the dorsolateal tract of Lissauer (lateral root entry zone) to second-order neruons

Front 108

Lateral Spinothalamic Tract
-Second-order neurons
-located
-give rise to
-axons terminate in the

Back 108

-found in dorsal horn
-they give rise to axons that decussate in the vental white commissure and ascend in the contralateral lateral funiculus
-their axons terminate in the VPL of the thalamus

Front 109

Lateral Spinothalamic Tract
-Third-order neurons
-located
-project

Back 109

-are found in the VPL nucleus of the thalamus
-project through the posterior limb of the internal capsule to he primary somatosensory cortex (Brodmann's areas 3,1, and 2)

Front 110

Lateral Spinothalamic Tract
-transection of the lateral spinothalamic tract

Back 110

results in contralateral loss of pain and temperature below the lesion

Front 111

Lateral Corticospinal Tract
-function

Back 111

-Mediates voluntary skilled motor activity, primarily of the upper limbs. It is not fully myelinated until the end of the second year (Babinski's sign)

Front 112

Lateral Corticospinal Tract
-fiber caliber

Back 112

approximately 90% of the fibers lie between 1 and 4 micrometers and 4% lie above 20 micrometers (from the giant cells of Betz)

Front 113

Lateral Corticospinal Tract
-origin

Back 113

-arises from layer V of the cerebral cortex from three cortical areas in equal aliquots:
-the premotor cortex (Brodmann's area 6)
-The primary motor cortex (Brodmann's area 4)
-The primary sensory cortex (Brodmann's areas 3, 1, and 2)

-The arm and face areas of the motor homunculus arise from the lateral convexity; the foot region of the motor homunculus is found in the paracentral lobule

Front 114

Lateral Corticospinal Tract
-termination

Back 114

The lateral corticospinal tract terminates contralaterally, through interneurons, on ventral horn motor neurons

Front 115

Lateral Corticospinal Tract
-course
-Telencephalon

Back 115

-Telencephalon-the lateral coricospinal tract runs in the posterior limb of the internal capsule in the tlencephalon

Front 116

Lateral Corticospinal Tract
-course
-Midbrain

Back 116

-Midbrain-the lateral corticospinal tract runs in the middle 3/5 of the crus cerebri in the midbrain

Front 117

Lateral Corticospinal Tract
-course
-Pons

Back 117

the lateral corticospinal tract runs in the base of the pons

Front 118

Lateral Corticospinal Tract
-course
-medulla

Back 118

-The lateral corticospinal tract runs in the medullary pyramids.
-Between 85% and 90% of the corticospinal fibers decussate in the pyramidal decussation as the lateral corticospinal tract.
-The remaining 10% to 15% of the fibers continue as the anterior corticospinal tract

Front 119

Lateral Corticospinal Tract
-course
-spinal cord

Back 119

The lateral corticospinal tract runs in the dorsal quadrant of the lateral funiculus

Front 120

Lateral Corticospinal Tract
-transection of the lateral corticospinal tract
-above the motor decussation

Back 120

transection results in the contralateral spastic paresis and Babinski's sign (upgoing toe)

Front 121

Lateral Corticospinal Tract
-transection of the lateral corticospinal tract
-in the spinal cord

Back 121

-trasection results in ipsilateral spastic paresis and Babinski's sign

Front 122

Hypothalamospinal Tract
-anatomic location

Back 122

Projects without interruption from the hypothalamus to the ciliospinal center of the intermediolateral cell column at T1 to T2.
-It is found in the spinal cord at T1 or above in the dorsolateral quadrant of the lateral funiculus.
-It is also found in the lateral tegmentum of the medulla, pons, and midbrain.

Front 123

Hypothalamospinal Tract
-clinical features

Back 123

-Interruption of this tract at any level results in Horner's syndrome
-(miosis, ptosis, hemianhidrosis, and apparent enopthalmos)
-the signs are always ipsilateral

Front 124

Upper Motor Neuron Lesions
-caused by

Back 124

transection of the corticospinal tract or destrufction of the cortical cells of origin

Front 125

Upper Motor Neuron Lesions
-result in

Back 125

spastic paresis with pyramidal signs (Babinski's sign)

Front 126

Lower Motor Neuron Lesions
-caused by

Back 126

damage to the motor neurons

Front 127

Lower Motor Neuron Lesions
-result in

Back 127

-flaccid paralysis, areflexia, atrophy, fasciculations, and fibrillations
-Poliomyelitis or Werdnig-Hoffman disease results from damage to the motor neurons

Front 128

Amyotrophic Lateral Sclerosis
-aka
-is
-caused by
-have no

Back 128

-ALS, or Lou Gehrig's Disease
-is a combined UMN and LMN disease
-ALS is couased by damage to the corticospinal tracts, with pyramidal signs, and by damage to the LMNs, with LMN symptoms
-Patinets with ALS have no sensory deficits

Front 129

Patients with neurosyphilis
-get what
-characterized by

Back 129

-dorsal colum disease (tabes dorsalis)
-characterized by a loss of tactile discrimination and position and vibration sensation.
-Patients have a Romberg sign (subject stands with his feet together. when he closes his eyes, he loses his balance. This is a sign of dorsal column ataxia)

Front 130

Ventral Trigeminothalamic Tract
-mediates

Back 130

Pain and temperature sensation from the face and oral cavity

Front 131

Dorsal Trigeminothalamic Tract
-mediates

Back 131

Tactile discrimination and pressure sensation from the face and oral cavity. It receives input from Meissner's and Pacini's corpuscles

*This tract is both crossed and uncrossed

Front 132

Corneal Reflex
-Afferent Limb
-Efferent Limb

Back 132

-Opthalmic Nerve (V-1)
-Facial Nerve (VII)

Front 133

Jaw Jerk
-Afferent Limb
-Efferent Limb

Back 133

-Mandibular Nerve (V-3)
-Mandibular Nerve (V-3)

Front 134

Tearing (lacrimal) Reflex
-Afferent Limb
-Efferent Limb

Back 134

-Opthalmic Nerve (V-1)
-Facial Nerve (VII)

Front 135

Oculocardiac Reflex
-Afferent Limb
-Efferent Limb

Back 135

-Opthalmic Nerve (V-1)
-Vagal Nerve (X)

Front 136

Audiotry system
-derived from

Back 136

-The otic vesicle, which is a derivative fo the otic placode, a thickening of the surface ectoderm

Front 137

In Normal ears,
-Weber Test shows
-Rinne Test shows

Back 137

-no lateralization
-AC>BC, both ears

Front 138

In Conduction deafness of left ear
-Weber Test shows
-Rinne Test shows

Back 138

-lateralizes to left ear
-BC>AC on left
-AC>BC on right

Front 139

In Conduction deafness of right ear
-Weber Test shows
-Rinne Test shows

Back 139

-Lateralizes to right ear
-BC>AC on right
-AC>BC on left

Front 140

In Nerve deafnessof left ear
-Weber Test shows
-Rinne Test shows

Back 140

-lateralizes to right ear
-AC>BC, both ears

Front 141

In Nerve deafness of right ear
-Weber Test shows
-Rinne Test shows

Back 141

-lateralizes to left ear
-AC>BC, both ears

Front 142

Vestibular System
-function

Back 142

-Maintains posture and equilibrium and coordinates head and eye movements

Front 143

Vestibular (horizontal) Nystagmus
-Fast Phase-in direction of
-Slow Phase-in direction of

Back 143

-Direction of Rotation
-Opposite of Rotation

Front 144

Postrotatory (horizontal) Nystagmus
-Fast Phase-in direction of
-Slow Phase-in direction of

Back 144

-Oppostie of Rotation
-Direction of rotation
-The patient past-points and falls in the direction of previous rotation

Front 145

Caloric Nystagmus (stimulation of horizontal ducts) in Normal Patients
-Cold Water Irrigation-in direction of
-Warm Water Irrigation-in direction of

Back 145

-To opposite side
-To same side

Front 146

Test Results in Unconscious subjects

Back 146

-No nystagmus is seen
-When the brain stem is intact, there is deviation of the eyes to the side of the cold irrigation
-With bilateral MLF transection, there is deviation of the abducting eye to the side of cold irrigation
-With lower brain stem damage to the vestibular nuclei, there is no deviation of the eyes

Front 147

Lesions of the parahippocampal uncas

Back 147

may cuase olfactory hallucinations [uncinate fits (seizures) with deja vu]

Front 148

CN 3
-function

Back 148

-moves the eye, constricts the pupil, accomodates, and converges

Front 149

Eye muscles
-SIN mnemonic

Back 149

-Superior muscles are intorters of the globe

Front 150

Medial rectus muscle
-function

Back 150

adducts the eye

Front 151

Superior rectus muscle
-function

Back 151

elevates, intorts, and adducts the eye

Front 152

Inferior rectus muscle
-function

Back 152

depresses, extorts, and adducts the eye

Front 153

Inferior oblique muscle
-function

Back 153

elevates, extorts, and abducts the eye

Front 154

Levator palpebrae muscle
-function

Back 154

elevates the upper eyelid

Front 155

Edinger-Westphal nucleus
-projects

Back 155

preganglionic parasympathetic fibers to the ciliary ganglion of the orbit through CN III

Front 156

Ciliary Ganglion
-projects

Back 156

postganglionic parasympathetic fibers to the sphincter muscle of the iris (miosis) and the ciliary muscle (accomodation)

Front 157

Oculomotor paralysis (palsy)
-seen with

Back 157

transtentorial herneiation (tumor, subdural or epidural hematoma)

Front 158

Denervation of the levator palpebrae muscle
-causes

Back 158

pstosis-drooping of the upper eyelid

Front 159

Denervation of the extraocular muscles
-causes

Back 159

-the affected eye to look "down and out" as a result of the unopposed action of the lateral rectus and superior oblique muscles

Front 160

Superior Oblique Muscles
-innervated by

Back 160

CN IV

Front 161

Lateral Rectus Muscles
-innervated by

Back 161

CN VI

Front 162

Oculomotor Palsy
-causes

Back 162

diplopia (double vision) when the patient looks in the direction of the paretic muscle

Front 163

Interruption of parasympathetic innervation (internal opthalmoplegia)
-results in

Back 163

a dilated, fixed pupil and paralysis of accommodation (cycloplegia)

Front 164

Transtentorial (uncal) herniation
-what happens

Back 164

increased supratentorial pressure (from a tumor) forces the hippocampal uncus through the tentorial notch and compresses or stretches the oculomotor nerve

Front 165

Transtentorial (uncal) herniation
-results in

Back 165

-Pupilloconstricot fibers are affected first, resulting in a dilated, fixed pupil
-Somatic efferent fibers are affected later, resulting in external strabismus (extropia)

Front 166

Trochlear Nerve
-innervates

Back 166

Superior Oblique Muscle

Front 167

Superior Oblique Muscle
-function

Back 167

depresses, intorts, and abducts the eye

Front 168

CN IV paralysis
-results in

Back 168

-Extorsion of the eye and weakness of downward gaze
-vertical diplopia, which increases when looking down
-head tilting to compensate for extorsion (may be misdaignosed as idiopathic torticollis)

Front 169

Trigeminal nerve
-derived from
-divisions

Back 169

-Pharyngeal (brachial) arch 1
-Opthalmic, Maxillary, Mandibular

Front 170

CN VI paralysis
-is
-seen

Back 170

-The most common isolated palsy that results from the long peripheral course of the nerve
-Seen in patients with meningitis, subarachnoid hemorrhage, late-stage syphilis, and trauma

Front 171

Abducent nerve paralysis
-results in

Back 171

-Convergent (medial) strabismus (esotropia) with inability to abduct the eye
-Horizontal diplopia with maximum separation of the double images when looking toward the paretic lateral rectus muscle

Front 172

CN VII
-functions

Back 172

-mediates facial movements
-taste
-salivation
-lacrimation
-general sensation from the external ear

Front 173

CN VII
-derived from

Back 173

Pharyngeal (brachial) arch 2

Front 174

CN VII
-and taste

Back 174

-it innervates the taste buds from the anterior 2/3 of the tongue

Front 175

Solitary tract
-for
-what nerves

Back 175

-Tastes
-VII, IX, X

Front 176

Vestibulocochlear Nerve (CN VIII)
-2 divisions and their function

Back 176

-vestibular-maintains equilibrium and balance
-cochlear-mediates hearing

Front 177

Vestibular Nerve
-lesions-result in

Back 177

-disequilibrium
-vertigo
-nystagmus

Front 178

Cochlear Nerve
-lesions-result in

Back 178

-destructive lesions cause hearing loss (sensorineural deafness)
-irritative lesions can cuase tinnitus (ear ringing)
-an acoustic neuroma is a Schwann cell tumor of the cochliar nerve that cuases deafness

Front 179

CN IX
-function

Back 179

-Along with CN X, XI, and XII, it mediates taste, salivation, and swallowing
-it mediates input from the carotid sinus, whcih contains baroreceptors that monitor arterial blood pressure
-it also mediates input from he carotid body, which contains chemoreceptors that monitor the CO2 and O2 concentration of the blood

Front 180

CN IX
-derived from

Back 180

-pharyngeal (brachial) arch 3

Front 181

what nerve does taste from posterior 1/3 of tongue

Back 181

CN IX

Front 182

CN IX
-lesions-result in

Back 182

-loss of general sensation in the pharynx, tonsils, fauces, and the back of the tongue
-loss of afferent limb of gag reflex
-loss of taste from posterior 1/3 of tongue

Front 183

CN X
-mediates
-innervates

Back 183

-phonation, swallowing (with IX, XI, XII), elevation of the palate, taset, and cutaneous sensation from the ear
-viscera of the neck, thorax, and abdomen

Front 184

CN X
-derived from

Back 184

-the pharyngeal (brachial) arches of 4 and 6

Front 185

CN XI
-mediates

Back 185

-head and shoulder movement and innervates the laryngeal muscles

Front 186

Medial Medullary Syndrome (anterior spinal artery syndrome
-affected structures and resultant deficits include:

Back 186

-corticospinal tract (medullary pyramid)-lesions result in contralateral spastic hemiparesis
-medial lemniscus-lesions result in contralateral loss of tactile and vibration sensation from the trunk and extremities
-hypoglossal nucleus or intraaxial root fibers-lesion reults in ipsilateral flccid hemiparalysis of the tongue.

Front 187

Lateral Medullary Syndrome (PICA)
-things affected

Back 187

-vestibular nuclei
-inferior cerebellar peduncle
-nucleus ambiguus of CN IX, X, XI
-glossopharyngeal nerve roots
-vagal nerve roots
-spinothalamic tracts (spinal lemniscus)
-spinal trigeminal nucleus and tract
-descending sympathetic tract

Front 188

Lateral Medullary Syndrome (PICA)
-vestibular nuclei-see

Back 188

nystagmus, nausea, vomiting, and vertigo

Front 189

Lateral Medullary Syndrome (PICA)
-inferior cerebellar peduncle-see

Back 189

-ipsilateral cerebellar signs-dystaxia, dysmetria (past pointing), dysdiadochokinesia

Front 190

Lateral Medullary Syndrome (PICA)
-nucleus ambiguus of CN IX, X and XI-see

Back 190

ipsilateral laryngeal, pharyngeal, and palatal hemiparalysis (loss of gag reflex-efferent limb), dysarthria, dysphagia, and dysphonia (hoarseness)

Front 191

Lateral Medullary Syndrome (PICA)
-glossopharyngeal nerve roots-see

Back 191

-lesions result in loss of the gag reflex (afferent limb)

Front 192

Lateral Medullary Syndrome (PICA)
-vagal nerve roots-see

Back 192

-same deficits as seen in lesions involving the nuclesu ambiguus:
ipsilateral laryngeal, pharyngeal, and palatal hemiparalysis (loss of gag reflex-efferent limb), dysarthria, dysphagia, and dysphonia (hoarseness)

Front 193

Lateral Medullary Syndrome (PICA)
-spinothalmic tracts (spinal lemniscus)-see

Back 193

contralateral loss of pain and temperature sensation from the trunk and extremities

Front 194

Lateral Medullary Syndrome (PICA)
-spinal trigeminal nucleus and tract-see

Back 194

-ipsilateral loss of pain and temperature sensation from the face (facial hemianesthesia)

Front 195

Lateral Medullary Syndrome (PICA)
-descending sympathetic tract-see

Back 195

ipsilateral Horner's syndrome

Front 196

Medial Inferior Pontine Syndrome
-results from

Back 196

occlusion of the paramedian branches of the basilar artery

Front 197

Medial Inferior Pontine Syndrome
-structures affected and resultant deficits

Back 197

-cortiocpinal tract-contralateral spastic hemiparesis
-medial lemniscus-contralateral loss of tactile sensation from the trunk and extremities
-abducent nerve roots-ipsilateral lateral rectus palsies

Front 198

Lateral Inferior Pontine Syndrome (AICA syndrome)
-structures affected

Back 198

-facial nucleus
-cochlear nuclei
-vestibular nuclei
-spinal trigeminal nucleus and tract
-middle and inferior cerebellar peduncles
-spinothalamic tracts
-descending sympathetic tract

Front 199

Lateral Inferior Pontine Syndrome (AICA syndrome)
-facial nuclues
-deficit

Back 199

-ipsilateral facial nerve paralysis
-ipsilateral loss of taste from teh anterior 2/3 of tongue
-ipsilateral loss of lacrimation and reduced salivation
-loss of corneal and stapedial reflexes (efferent limbs)

Front 200

Lateral Inferior Pontine Syndrome (AICA syndrome)
-cochlear nuclie
-deficit

Back 200

-unilateral central deafness

Front 201

Lateral Inferior Pontine Syndrome (AICA syndrome)
-vestibular nuclei
-deficit

Back 201

nystagmus, nausea, vomiting, and vertigo

Front 202

Lateral Inferior Pontine Syndrome (AICA syndrome)
-spinal trigeminal nucleus and tract
-deficit

Back 202

-ipsilateral loss of pain and temperature sensation from the face

Front 203

Lateral Inferior Pontine Syndrome (AICA syndrome)
-middle and inferior cerebellar peduncles
-deficit

Back 203

-ipsilateral limb and gait dystaxia

Front 204

Lateral Inferior Pontine Syndrome (AICA syndrome)
-spinothalamic tracts (spinal lemniscus)
-deficit

Back 204

contralateral loss of pain and temperature sensatino from the trunk and extremities

Front 205

Lateral Inferior Pontine Syndrome (AICA syndrome)
-descending sympathetic tract
-deficit

Back 205

-ipsilateral Horner's syndrome

Front 206

Medial Longitudinal Fasciculus (MLF) syndrome
-aka

Back 206

internuclear ophthalmoplegia

Front 207

Medial Longitudinal Fasciculus (MLF) syndrome
-see

Back 207

interrupts fibers from the contralateral abducent nucleus that project through the MLF to the ipsilateral medial rectus subnucleus of CN III

Front 208

Medial Longitudinal Fasciculus (MLF) syndrome
-causes

Back 208

-medial rectus palsy on attempted lateral conjugate gaze
-nystagmus in the abducting eye
-convergence remains intact

Front 209

Medial Longitudinal Fasciculus (MLF) syndrome
-syndrome often seen in patients with

Back 209

multiple sclerosis

Front 210

Parinaud's Syndrome
-often resultant of

Back 210

a pinealoma or germinoma of the pineal region

Front 211

Parinaud's Syndrome
-affected structures and resultant deficits

Back 211

-superior colliculus and pretectal area-lesions cause paralysis of upward and downward gaze, pupillary disturbances, and absence of convergence
-cerebral aqueduct-compression causes noncommunicating hydrocephalus

Front 212

Acoustic Neuroma (Schwannoma)
-is

Back 212

-a benign tumor of Schwann cells that affects the vestibulocochlear nerve.
-it is a posterior fossa tumor of the internal auditory meatus and cerebellopontine angle

Front 213

Acoustic Neuroma (Schwannoma)
-often compresses

Back 213

-the facial nerve (CN VII), which accompanies CN VIII in the cerebellopontine angle and internal auditory meatus

Front 214

Acoustic Neuroma (Schwannoma)
-affected structures and deficits

Back 214

-cochlear of VIII-tinnitus and unilateral nerve deafness
-vestibular of VIII-vertigo, nystagmus, nausea, vomiting, unsteadiness of gain
-VII-facial weakness and loss of efferent limb of corneal reflex
-spinal trigeminal tract-paresthesia, anesthesia of ipsilateral face, loss of afferent limb of corneal reflex

Front 215

Acoustic Neuroma (Schwannoma)
-often accompanied by

Back 215

-Neurofibromatosis type 2 often occurs with bilateral neuromas

Front 216

Locked-In Syndrome
-is

Back 216

a lesion of the base of the pons as the result of infarction, trauma, tumor, or demyelination

Front 217

Locked-In Syndrome
-affected tracts

Back 217

-corticospinal and corticobulbar tracts are affected bilaterally
-oculomotor and trochlear nerves are not injured
-patients are conscious and may communicate through vertical eye movements

Front 218

Subclavian Steal Syndrome
-results from

Back 218

thrombosis of the left subclavian artery proximal to the vertebral artery

Front 219

Subclavian Steal Syndrome
-blood shunted

Back 219

-retrograde down the left vertebral artery and into the left subclavian artery

Front 220

Subclavian Steal Syndrome
-clinical signs

Back 220

-transient weakness and claudication of the left arm on exercise
-vertebrobasialar insufficiency

Front 221

3 main functions of the cerebellum

Back 221

-maintenance of posture and balance
-maintenance of muscle tone
-coordination of voluntary motor activity

Front 222

Cerebellar Cortex has 3 layers

Back 222

-molecular layer-contains stellate and basket cells, and the dendritic arbor of the Purkinje cells
-purkinje cell layer-lies between the molecular and granule layer
-granule layer-inner layer overlying the white matter. Contains granule cells, Golgi cells, and cerebellar glomeruli (consists of a mossy fiber roseete, granule cell dendrites, and a Golgi cell axon.

Front 223

Cerebellum
-purkinje cells

Back 223

-convey the only output from the cerebellar cortex.
-project inhibitory output to the cerebellar and vestibular nuclei

Front 224

Cerebellum
-excited by
-inhibited by

Back 224

-are excited by parallel and climbing fibers
-inhibited by GABA-ergic basket and stellate cells

Front 225

Cerebellum
-Granule cells
-excite

Back 225

-by way of glutamate-purkinje, basket, stellate, and golgi cell through parallel fibers

Front 226

Cerebellum
-Granule cells
-inhibited by
-excited by

Back 226

-inhibited by golgi cells
-excited by mossy fibers

Front 227

Cerebellum
-Parallel fibers
-are
-extend

Back 227

-the axons of granule cells
-extend into the molecular layer

Front 228

Cerebellum
-Mossy Fibers
-are

Back 228

-the afferent excitatory fibers of the spinocerebellar, pontocerebellar, and vestibulocerebellar tracts

Front 229

Cerebellum
-Mossy Fibers
-terminate

Back 229

-as mossy fiber rosettes on granule cell dendrites

Front 230

Cerebellum
-Mossy Fibers
-excite

Back 230

-granule cells to discharge through their parallel fibers

Front 231

Cerebellum
-Climbing Fibers
-are

Back 231

-the afferent excitatory (by way of aspartate) fibers of the olivocerebellar tract

Front 232

Cerebellum
-Climbing Fibers
-arise from

Back 232

-contralateral inferior olivary nucleus

Front 233

Cerebellum
-Climbing Fibers
-terminate

Back 233

-on neurons of the cerebellar nuclei and dendrites of Purkinje cells

Front 234

The Major Cerebellar Pathway

Back 234

-Purkinje cells of the cerebellar cortex project to the cerebellar nuclei
-Dentate nucleus gives rise to the dentatothalamic tract-projects through the superior cerebellar peduncel to the contralateral ventral lateral nucleus of the thalamus
-ventral lateral nucleus of the thalamus projects to the primary motor cortex of the precentral gyrus (area 4)
-motor cortex projects as the corticopontine tranct to the pontine nuclei
-pontine nuclei projects as the pontocerebellar tract to thte contralateral cerebellar cortex, where they terminate as mossy fibers

Front 235

Cerebellar Nuclei

Back 235

dentate, emboliform, globose and fastigial

Front 236

The major effector nucleus of he cerebellum

Back 236

dentate nucleus-gives rise to the dentatothalamic tract-projects through the superior cerebellar peduncel to the contralateral ventral lateral nucleus of the thalamus

Front 237

Anterior vermis syndrome
-results from
-causes

Back 237

-atrophy of the rostral vermis, most commonly caused by alcohol abuse
-causes gait, trunk, and leg dystaxia

Front 238

Posterior vermis syndrome
-involves
-result of
-most commonly caused by
-causes

Back 238

-flocculonodular lobe
-brain tumors in children
-medulloblastomas or ependymomas
-truncal dystaxia

Front 239

Thalamus
-is
-role

Back 239

-the largest division of the diencephalon
-important role in the integration of the sensory and motor systems

Front 240

Thalamus
-anterior nucleus

Back 240

-part of the Papez circuit of emotion of the limbic system

Front 241

Thalamus
-mediodorsal nucleus

Back 241

-when destroyed, memory loss occurs (Wernicke-Korsakoff syndrome)
-plays a role in the expression of affect, emotion, and behavior (limbic function)

Front 242

Thalamus
-pulvinar

Back 242

-largest thalamic nucleus
-it plays a role in the integration of visual, auditory, and somesthetic input
-destruction of the dominant pulvinar mya result in sensory dysphasia

Front 243

Thalamus
-Ventral anterior/Ventral Lateral

Back 243

-motor

Front 244

Thalamus
-VPL

Back 244

-receives fibers from spinothalamic tracts and the medial lemniscus
-it projects to the sensory cortex (Brodmann's 3, 1, 2)

Front 245

Thalamus
-VPM

Back 245

-receives fibers from the trigeminothalamic tracts
-projects to the sensory cortex (Brodmann's 3, 1, 2)
-The gustatory (taste pathway originates in the solitary nucleus and projects via the central tegmental tract to VPM, and thence to the gustatory cortex of the postcentral gyrus (Brodmann's 3b) of the frontal operculum and insular cortex
-the taste pathway is ipsilateral

Front 246

Thalamus
-Metathalamus
-Lateral Geniculate Nucleus
-Medial Geniculate Nucleus

Back 246

-LGN is a visual relay nucleus. It receives retinal input through the optic tract and projects to the primary visual cortex (Brodmann's 17)
-MGN-an auditory relay nucleus. It receives auditory input through the brachium of the inferior colliculus and projects to the primary auditory cortex (Brodmann's 41 and 42)

Front 247

Anterior limb of Internal Capsule
-located

Back 247

between caudate nucleus and the lentiform nucleus

Front 248

Genu of Internal Capsule
-contains

Back 248

corticobulbar fibers

Front 249

Posterior limb of Internal Capsule
-located

Back 249

between the thalamus and the lentiform nucleus.

Front 250

Posterior limb of Internal Capsule
-contains

Back 250

corticospinal (pyramid) fibers as well as sensory (pain, temperature, and touch), visual, and auditory radiations

Front 251

Anterior limb of Internal Capsule
-blood supply

Back 251

medial striate branches of the anterior cerebral artery and the lateral striate branches of the middle cerebral artery

Front 252

Genu of Internal Capsule
-blood supply

Back 252

direct branches from the internal carotid artery or by pallidal branches of the anterior choroidal artery

Front 253

Posterior limb of Internal Capsule
-blood suppy

Back 253

branches of the anterior choroidal artery and lenticulostriate branches of the middle cerebral arteries

Front 254

transection of left upper division of geniculocalcarine tract (visual radiation)
-gives

Back 254

right contralateral lower quadrantanopia

Front 255

transection of left lower division of geniculocalcarine tract (visual radiation)
-gives

Back 255

right contralateral upper quadrantanopia ("pie in the sky")

Front 256

Pupillary Light Reflex Pathway
-afferent limb
-efferent limb

Back 256

-afferent limb-CN II
-efferent limb-CN III

Front 257

Pupillary Light Reflex Pathway
-pathway

Back 257

-gaglion cells of the retina-project bilaterally to the pretectal nuclei
-the pretctal nucleus of the midbrain projects (through the posterior commisure) crossed and uncrossed fibers to the Edinger-Westphal nucleus
-Edinger-Westphal nucleus of CN III-gives rise to preganglionic parasympathetic fibers. These fibers exit the midbrain and synapse with postganglionic parasympathetic neurons of the ciliary ganglion
-Ciliary ganglion-gives rise to postganglionic parasympathetic fibers-innervate the sphincter muscle of the iris

Front 258

MLF syndrome/internuclear ophthalmoplegia
-damage to
-causes

Back 258

-damage (demyelination) to the MLF between the abducent and oculomotor nuclei
-cuases medial rectus palsy on attempted lateral gaze and monocular horizontal nystagmus in the abducting eye
-convergence is normal

Front 259

MLF syndrome/internuclear ophthalmoplegia
-most commonly seen in

Back 259

multiple sclerosis

Front 260

One-and-a-half Syndrome
-consists of
-whats messed up

Back 260

-bilateral lesions of the MLF and a unilateral lesion of the abducent nucleus
-on attempted lateral conjugate gaze, the only muscle that functions is the intact lateral rectus

Front 261

Argyll Robertson Pupil
-is
-occurs in

Back 261

-the absence of a miotic reaction to light, both direct and consensual, with the preservation of a miotic reaction to near stimulus (accommodation-convergence)
-occurs in syphilis and diabetes

Front 262

Transtentorial (uncal) herniation
-occurs

Back 262

-as a result of increased supratentorial pressure, which is commonly caused by a brain tumor or hematoma (subdural or epidural)

Front 263

Transtentorial (uncal) herniation
-pressure forces

Back 263

the parahippocampal uncus through the tentorial incisure

Front 264

Transtentorial (uncal) herniation
-impacted uncus forces

Back 264

-the contralateral crus cerebri against the tentorial edge (Kernohan's notch) and puts pressure on the ipsilateral CN III and posterior cerebral artery

Front 265

Transtentorial (uncal) herniation
-neurologic defects

Back 265

-Ipsilateral hemiparesis-occurs as a result of pressure on the corticospinal tract, which islocated in the contralateral crus cerebri
-a fixed and dilated pupil, ptosis, and a "down-and-out" eye are caused by pressure on the ipsilateral oculomotor nerve
-Contralateral homonymous hemianopia is caused by compression of the posterior cerebral artery, which irrigates the visual cortex

Front 266

Megacolon
-absence of
-occurs

Back 266

-ganglion cells in the myenteric plexus
-occurs when neural crest cells do not migrate into the colon

Front 267

Shy-Drager syndrome
-involves
-characterized by

Back 267

-preganglionic sympathetic neurons from the intermediolateral cell column
-characterized by orthostatic hypotension, anhidrosis, impotence, bladder atonicity

Front 268

Major Hypothalamic Nuclei and Their Functions
-Paraventricular Nucleus

Back 268

-synthesizes ADH, oxytocin, and CRH
-gives rise to the supraopticohypophyseal tract, which projects to the neurohypophysis
-regulates water balance (vonservation)
-destruction causes diabetes insipidus

Front 269

Major Hypothalamic Nuclei and Their Functions
-Medial Preoptic Nucleus

Back 269

-regulates the release of gonadotropic hormones from the adenohypophysis
-contains the sexually dimorphic nucleus, the development of which depends on testosterone levels

Front 270

Major Hypothalamic Nuclei and Their Functions
-Suprachiasmatic Nucleus

Back 270

-receives direct input from the retina
-plays a role in the reuglation of circadian rhythms

Front 271

Major Hypothalamic Nuclei and Their Functions
-Anterior Nucleus

Back 271

-plays a role in temperature regulation
-stimulates the parasympathetic nervous system
-destruction results in hyperthermia

Front 272

Major Hypothalamic Nuclei and Their Functions
-Supraoptic Nucleus

Back 272

-sythesizes ADH and oxytocin (similar to the paraventricular nucleus)

Front 273

Major Hypothalamic Nuclei and Their Functions
-Dorsomedial Nucleus

Back 273

-in animals, savage behavior results when this nucleus is stimulated
-obesity when stimulated

Front 274

Major Hypothalamic Nuclei and Their Functions
-Ventromedial Nucleus

Back 274

-Satiety Center
-when stimulated, it inhibits the urge to eat
-bilateral destrction results in hyperphagia, obesity, and savage behavior

Front 275

Hypothalamus
-is
-helps to

Back 275

a division of the diencephalon that subserves 3 systems: the autonomic nervous system, endocrine system, and limbic system
-helps to maintain homeostasis

Front 276

Major Hypothalamic Nuclei and Their Functions
-Arcuate (infundibular) nucleus

Back 276

-contains neurons that produce factors that stimulate or inhibit the action of the hypothalamus
-this nucleus gives rise to the tuberohypophyseal tract, which terminates in the hypophyseal portal system of the infundibulum.
-it contains neurons that produce dopamine (prolactin-inhibiting factor)

Front 277

Major Hypothalamic Nuclei and Their Functions
-Mamillary Nucleus

Back 277

-receives input from the hippocampla formation through the postcommissural fornix
-it projects to the anterior nucleus of the thalamus through the mamillothalamic tract
-patients with Wernicke's encephalopathy, which is a thiamine (b1) deficiency, have lesions in the mamillary nucleus
-lesions are also associated with alcoholism

Front 278

Major Hypothalamic Nuclei and Their Functions
-Posterior Hypothalamic Nucleus

Back 278

-Plays a role in thermal regulation (conservation and increased production of heat)
-lesions result in poikilothermia (inability to thermoregulate)

Front 279

Major Hypothalamic Nuclei and Their Functions
-Lateral Hypothalamic Nucleus

Back 279

-induces eating when stimulated
-lesions cause anorexia and starvation

Front 280

Major Fiber Systems of the Hypothalamus
-Fornix

Back 280

-the largest projection to the hypothalamus
-projects from the hippocampal formation to the mamillary nucleus, anterior nucleus of the thalamus, and septal area
-fornix then projects from the septal area to the hipocampal formation

Front 281

Major Fiber Systems of the Hypothalamus
-Medial Forebrain bundle

Back 281

-traverses the entire lateral hypothalmic area
-interconnects the orbitofrontal cortex, septal area, hypothalmus, and midbrain

Front 282

Major Fiber Systems of the Hypothalamus
-Mamillothalamic tract

Back 282

-projects from the mamillary nuclei to the anterior nucleus of the thalamus (part of the Papez circuit)

Front 283

Major Fiber Systems of the Hypothalamus
-Stria terminalis

Back 283

-the major pathway from the amygdala
-interconnects the septal area, hypothalamus, and amygdala

Front 284

Major Fiber Systems of the Hypothalamus
-Supraopticohypohysial Tract

Back 284

-conducts fibers from the supraoptic and paraventricular nuclei to the neurohypophysis, which is the release site for ADH and oxytocin

Front 285

Major Fiber Systems of the Hypothalamus
-Tuberohypophysial (tuberoinfundibular) tract

Back 285

-conducts fibers from the arcuate nucleus to the hypophyseal portal system

Front 286

Major Fiber Systems of the Hypothalamus
-Hypothalamospinal Tract

Back 286

-Contains direct descending autonomic fibers
-These fibers influence the preganglionic sympathetic neurons of the intermediolateral cell column and preganglionic neurons of the sacral parasympathetic nucleus
-Interruption above the first throacic segment (T1) causes Horner's syndrome

Front 287

Anterior Hypothalamus
-excitatory efect on

Back 287

-the parasympathetic nervous system

Front 288

Posterior hypothalamus
-excitatory effect on

Back 288

-the sympathetic nervous system

Front 289

Anterior Hypothalamus

Back 289

-regulates and maintains body temperature
-destruction cuases hyperthermia

Front 290

Posterior Hypothalams

Back 290

-Helps to produce and conserve heat
-destruction causes inability to thermoregulate

Front 291

Paraventricular Nucleus

Back 291

-synthesizes ADH, whcih controls water excretion by the kidneys

Front 292

Hypothalamus and Food Intake

Back 292

-Ventromedial Nucleus-when stimulated inhibits the urge to eat. Bilateral destruction results in hyperphagia, obesity, and savage behavior
-Lateral Hypothalamic Nucleus-when stimulated induces the uge to eat. Destruction causes starvation and emaciation

Front 293

Craniopharyngioma
-originates

Back 293

-a congenital tumor that originates from remnants of Rathke's puch

Front 294

Craniopharyngioma
-is usually
-is

Back 294

-calcified
-the most common supratentorial tumor in children and the most common cause of hypopituitarism in children

Front 295

Craniopharyngioma
-pressure on the chiasma
-pressure on the hypothalamus

Back 295

-causes bitemporal hemianopia
-causes hypothalamic syndrome (adiposity, diabetes insipidus, disturbance of temperature regulation, somnolence)

Front 296

Limbic System
-considered

Back 296

-the anatomic substrate that underlies behavioral and emotional expression
-it is expressed through the hypothalamus by way of the autonomic nervous system

Front 297

Limbic System
-orbiotfrontal cortex

Back 297

-mediates the conscious perception of smell
-has reciprocal connections with the mediodorsal nucleus of the thalamus
-it is interconnected through the medial forebrain bundle with the septal area and hypothalamic nuclei

Front 298

Limbic System
-mediodorsal nucleus of the thalamus

Back 298

-receives input from the amygdala and plays a role in affective behavior and memory

Front 299

Limbic System
-limbic lone

Back 299

-includes the subcallosal area, paraterminal gyrus, cingulate gyrus and isthmus, and parahippocampal gyrus, which includes the uncus
-it contains, buried in the parahippocampal gyrus, the hippocampal formation and amygdaloid nuclear complex

Front 300

Limbic System
-hipocampal formation

Back 300

-functions in leraning, memory, and recognition of novelty

Front 301

Limbic System
-hipocampal formation
-major structures

Back 301

-dentate gyrus-contains granule cells that receive hipocampal input and project output to the pyramidal cells of the hippocampus and subiculum
-hippocampus (cornu Ammonis)-has a 3-layered archicortex. It contains pyramidal cells that project through the fornix to the septal area and hypothalamus
-subiculum-receives input through the hippocampal pyramidal cells. It projects through the fornix to the mamillary nuclei and the anterior nucleus of the thalamus.

Front 302

Amygdaloid Complex

Back 302

-a basal ganglion that underlies the parahippocampal uncus

Front 303

Amygdaloid Complex
-stimulation causes
-lesions cause

Back 303

-fear and signs of sympathetic overactivity
-placidity and hypersexual behavior

Front 304

Limbic Midbrain Nuclei and Associated Neurotransmitters

Back 304

-Ventral Tegmental Area-dopamine
-Raphhe Nuclei-serotonin
-Locus Ceruleus-norepinephrine

Front 305

-Ventral Tegmental Area
-neurotransmitter

Back 305

-dopamine

Front 306

-Raphhe Nuclei
-neurotransmitter

Back 306

-serotonin

Front 307

-Locus Ceruleus
-neurotransmitter

Back 307

-norepinephrine

Front 308

Bilateral destruction or removal of the cingulate gyry causes

Back 308

-loss of initiative and inhibition as well as dulling of the emotions.
-memory is unaffected

Front 309

Lesions of the anterior cingulate gyri cause

Back 309

placidity

Front 310

Cingulectomy is used to treat

Back 310

severe anxiety and depression

Front 311

Basal Ganglia
-components

Back 311

-caudate nucleus
-putamen
-globus pallidus

Front 312

Grouping of the Basal Ganglia
-striatum
-consists of

Back 312

-caudate nucleus
-putamen

Front 313

Grouping of the Basal Ganglia
-lentiform nucleus
-consists of

Back 313

-globus pallidus
-putamen

Front 314

Grouping of the Basal Ganglia
-Corpus Striatum
-consists of

Back 314

-Lentiform Nucleus (putamen and globus pallidus)
-Caudate nucleus

Front 315

Grouping of the Basal Ganglia
-Clasustrum
-consists of

Back 315

-lies between the lentiform nucleus and the insular cortex
-it has recprocal connections between the sensory cortices

Front 316

The Striatal (extrapyramidal) Motor System
-plays a role in
-also involved in

Back 316

-the initiation and execution of somatic motor activity, especially willed movement
-it is also involved in automatic stereotyped postural and reflex motor activity (ex normal subjects swing their arms when they walk)

Front 317

The Striatal (extrapyramidal) Motor System
-structure

Back 317

-neocortex
-striatum (cuadatoputamen, or neostriatum)
-globus pallidus
-subthalamic nucleus
-substantia nigra (pars compacta and pars reticularis)
-Thalamus (ventral anterior, ventral lateral, and centromedian nuclei)

Front 318

Parkinson's Disease
-is

Back 318

-a degenerative diseas that affects the substantia nigra and its projections to the striatum

Front 319

Parkinson's Disease
-results

Back 319

-Parkinson's disease causes a depletion of dopamine in the substantia nigra nad striatum as well as a loss of melanin-containing dopaminergic neurons in the substantia nigra

Front 320

Parkinson's Disease
-clinical signs

Back 320

-bradykinesia
-stooped posture
-shuffling gait
-cogwheel rigidity
-pill-rolling tremor
-masked facies
-Lewy bodies are found in the melanin-containing neurons of the substatia nigra
-progressive supranuclear palsy is associated with Parkinson disease

Front 321

Parkinson's Disease
-treatment

Back 321

-L-dopa
-surgical intervention includes pallidotomy (rigidity) and ventral thalomotomy (tremor)

Front 322

Methylphenyltetrahydropyridine (MPTP)-induced parkonsonism

Back 322

-MPTP is an analog of meperidine (Demerol)
-it destroys dopaminergic neurons in the substantia nigra

Front 323

Huntington's disease
-is

Back 323

-an inherited autosomal dominant movement disorder that is traced to a single gene defect on chromosome 4

Front 324

Huntington's disease
-associated with

Back 324

-degeneration of the cholinergic and gama-aminobutyric acid-ergic neurons of the striatum.
-accompanied by gyral atrophy in the frontal and temporal lobes

Front 325

Huntington's disease
-get

Back 325

-glutamate excitotoxicity
-GLU is released in the striatum and binds to its receptors on straital neurons resulting in an action potential.

Front 326

Huntington's disease
-how is glutamate removed

Back 326

-GLU is removed from the extracellular space by astrocytes.

Front 327

Huntington's disease
-glutamate is bound
-results in
-this cascade of events

Back 327

-to the N-methyl-D-aspartate (NMDA) receptor
-results in an influx of calcium ions and subsequent cell death
-this cascade of events with neuronal death most likely occurs in cerebrovascular accidents (stroke)

Front 328

Hemiballism
-is

Back 328

-a movement disorder that usually results from a vascular lesion of the subthalamic nucleus

Front 329

Hemiballism
-lesion of what

Back 329

lesion of the subthalamic nucleus

Front 330

Hemiballism
-clinical signs

Back 330

-violent contralateral flinging (ballistic) movements of one or both extremities

Front 331

Hepatolenticular Degeneration
-aka

Back 331

Wilson's Disease

Front 332

Wilson's Disease
-is

Back 332

-an autosomal recessive disorder that is caused by a defect in the metabolism of copper
-gene locus is on chromosome 13

Front 333

Wilson's Disease
-clinical signs

Back 333

-choreiform or athetotic movements
-rigidity
-wing-beating tremor (tremor is the most common neurologic sign)
-deposition of copper in the cornea gives rise to the corneal Kayser-Fleischer ring
-deposition of copper in the liver leads to multilobar cirrhosis

Front 334

Wilson's Disease
-lesions

Back 334

-are found in the lentiform nucleus

Front 335

Wilson's Disease
-psychiatric symptms

Back 335

-psychosis
-personality disorders
-dementia

Front 336

Wilson's Disease
-diagnosis based on

Back 336

-low serum ceruloplasmin
-elevated urinary excretion of copper
-increased copper concentration in a liver biopsy specimen

Front 337

Wilson's Disease
-treatment

Back 337

-penicillamine, a chelator

Front 338

Tardive Dyskinesia
-is

Back 338

-a syndrome of repetitive choreic movement that affects the face and trunk

Front 339

Tardive Dyskinesia
-results from

Back 339

-phenothiazines
-butyrophenones
-metoclopramide

Front 340

Neurotransmitters
-Acetylcholine
-major transmittor of

Back 340

-peripheral nervous system
-neuromuscular junction
-parasympathetic nervous system
-preganglionic sympathetic fibers
-postaganglionic sympathetic fibers that innervate sweat glands and some blood vessels in the skeletal muscle

Front 341

Neurotransmitters
-ACh
-found in

Back 341

-the neurons of the somatic and visceral motor nuclei in the brain stem and spinal cord
-also found in the basal nucleus of Meynert, which degenerates in Alzheimer's disease

Front 342

What degenerates in Alzheimer's disease

Back 342

-basal nucleus of Meynert
-so get decreased ACh

Front 343

What NT is depleted in Alzheimer's disease

Back 343

Acetylcholine

Front 344

What NT is depleted in Parkinson's disease

Back 344

Dopamine

Front 345

What NT is increased in schizophrenia

Back 345

Dopamine

Front 346

Dopamine increased in...

Back 346

schizophrenia

Front 347

Dopamine decreased in...

Back 347

Parkinson's

Front 348

Acetylcholine decreased in...

Back 348

Alzheimer's

Front 349

Dopamine is found where in the CNS

Back 349

-arcuate nucleus of the hypothalamus

Front 350

Dopamine Receptors

Back 350

-D1-receptors are postsynaptic. They activate adenylate cyclase and are excitatory
-D2-receptors ar both postsynaptic and presynaptic. They inhibit adenylate cyclase and are inhibitory.
-Antipsychotic drugs block D2 receptors

Front 351

-Antipsychotic drugs block what receptors

Back 351

D2 receptors

Front 352

Norepinephrine
-is

Back 352

-the transmitter of most postganglionic sympathetic neurons
-Antidepressant drugs enhance its transmission

Front 353

Antidepressant drugs enhance the transmission of what NT

Back 353

norepinephrine

Front 354

Norepinephrine
-plays a role in

Back 354

-anxiety states
-panic attacts are believed to result from paroxysmal discharges from the locus ceruleus.

Front 355

Norepinephrine
-receptors

Back 355

-most postsynaptic receptors of the locus ceruleus pathway are beta-1 or beta-2 receptors that activate adenylate cyclase and are excitatory

Front 356

Norepinephrine
-found

Back 356

in locus ceruleus

Front 357

Reduced Norepinephrine activity
-related to

Back 357

depression

Front 358

Increased Norepinephrine activity
-related to

Back 358

mania

Front 359

Serotonin
-found where

Back 359

raphe nuclei of the brain stem

Front 360

when 5-HT activity is reduced,

Back 360

-decreased levels of catecholamines cause depression and insomnia

Front 361

when 5-HT activity is increased,

Back 361

elevated levels of catecholamines cause mania

Front 362

dysfunction of 5-HT may underlie

Back 362

obsessive-compulsive disorder

Front 363

Certain antidepressants work by
-doing what to 5-HT

Back 363

-increase 5-HT availability by reducing its reuptake
-5-HT agonists that bind 5-HT1A and those that block 5-HT2 have antiderpressant properties

Front 364

Fluoxetine
-is

Back 364

-a selective serotonin reuptake inhibitor (SSRI)

Front 365

Endorphins
-found

Back 365

exclusively in the hypothalamus

Front 366

Endorphins
-Beta-endorphin

Back 366

-the major endorphin found in the brain
-one of the most powerful analgesics known

Front 367

Enkephalins
-found

Back 367

-in the globus pallidus
-coexist with dopamine, GABA, NE, and ACh.
-are colocalized in GABA-ergic pallidal neurons

Front 368

Enkephalins
-role

Back 368

play a role in pain suppression

Front 369

Substance P
-role

Back 369

-plays a role in pain transmission

Front 370

Substance P
-concentrated in

Back 370

-substantia nigra (highly concentrated)
-also found in the dorsal root ganglion cells and substantia gelatinosa

Front 371

Substance P
-colocalized with

Back 371

GABA in the striatonigral tract and plays a role in movemnt disorders

Front 372

Substance P
-levels are reduced in

Back 372

-patients with Huntington's Disease

Front 373

Somatostatin
-regulates the release of

Back 373

-growth hormone and thyroid-stimulating hormone

Front 374

The concentration of somatostatin in the neocortex and hippocampus is significantly reduce in patients with

Back 374

-Alzheimer's disease

Front 375

somatostatin levels are increased in patients with

Back 375

-Huntington's disease

Front 376

Inhibitory amino acid transmitters

Back 376

-GABA
-Glycine

Front 377

GABA
-is

Back 377

-the major inhibitory neurotransmitter of the brain

Front 378

GABA
-receptors

Back 378

-GABA-A and GABA-B are intimately associated with bezodiazepine-binding sites

Front 379

GABA
-benzodiazepines

Back 379

-enhance GABA activity

Front 380

GABA
-GABA-A receptors

Back 380

-open chloride channels

Front 381

GABA
-GABA-B receptors

Back 381

-are found on the terminals of neurons that use another transmitter (ie NE, DA, 5HT)
-activation of GABA-B receptors decreases the release of the other transmitter

Front 382

Glycine
-is

Back 382

-the major inhibitory neurotransmitter of the spinal cord

Front 383

Glycine
-used by

Back 383

-used by the Renshaw cells of the spinal cord

Front 384

Excitatory Amino Acid Transmitters

Back 384

Glutamate and Aspartae

Front 385

Glutamate
-is

Back 385

the major excitatory transmitter of the brain

Front 386

Glutamate and NMDA receptors

Back 386

glutamate, through its NMDA receptors plays a role in long-term potentiation ( a memory process) of hippocampal neurons

Front 387

Glutamate plays a role in

Back 387

-kindling and subsequent seizure activity
-under certain conditions, glutamate and its analogs are neurotoxic

Front 388

Alzheimer's Disease
-characterized histologically by

Back 388

-neurofibrillary tangles
-senile (neuritic) plaques
-amyloid substance
-granulovacuolar degeneration
-Hirano bodies

Front 389

Myasthenia Gravis
-results from

Back 389

-autoantibodies against the nicotinic acetylcholine receptor on skeletal muscle
-these antiboides block the postganglionic acetylcholine bindgin site

Front 390

Myasthenia Gravis
-cardinal manifestation

Back 390

-fatigable weakness of the skeletal muscle

Front 391

Myasthenia Gravis
-diagnosis

Back 391

-edrophonium or neostigmine injection

Front 392

Lambert-Eaton Myasthenic Syndrome
-caused by

Back 392

-a presynaptic defect of acetylcholine release

Front 393

Lambert-Eaton Myasthenic Syndrome
-causes

Back 393

-weakness in the limb muscles, but not the bulbar muscles

Front 394

Lambert-Eaton Myasthenic Syndrome
-50% of cases are

Back 394

-associated with neoplams

Front 395

Lambert-Eaton Myasthenic Syndrome
-in these patients, muscle strength

Back 395

-improves with use (vs those in Myasthenia Gravis in which muscle use results in fatigue)

Front 396

Cerebral Cortex
-layers

Back 396

6 layers
-Layer 1-molecular
-Layer 2-external granular
-Layer 3-external pyramidal
-Layer 4-internal granular
-Layer 5-internal pyramidal
-Layer 6-multiform layer

Front 397

Broca's Speeach Area
-Brodmann's numbers
-located
-destruction results in

Back 397

-44 and 45
-the posterior part of the inferior frontal gyrus in the dominant hemisphere
-expressive, nonfluent aphasia (Broca's Aphasia)

Front 398

Sensory Cortex
-Brodmann's
-destruction

Back 398

-3, 1, 2
-destruction results in contralateral hemihypesthesia and astereognosis

Front 399

Hippocampal cortex
-bilateral lesions result in

Back 399

-the inability to consolidate short-term memory into long-term memory
-earlier memories are retrievable

Front 400

Construction apraxia

Back 400

the inability to draw or construct a geometric figure

Front 401

hemineglect

Back 401

-if the patient draws only the right half of the clock
-lesion is located in the right inferior parietal lobule

Front 402

Broca's Aphasia

Back 402

-lesion in the frontal lobe, in the inferior frontal gyrus (Brodmann 44, 45)
-good comprehension
-effortful speech
-dysarthric speech
-telegraphic speech
-nonfluent speech
-poor repetition
-contralateral lower facial and upper limb weakness

Front 403

Wernicke's Aphasia

Back 403

-lesion in the posterior temporal lobe, in the superior temporal gyrus (Brodmann 22)
-poor comprehension
-fluent speech
-poor repetition
-Quadrantanopia
-paraphasic errors-non sequiturs (L. does not follow) are statements irrelevant to the question askeed, neologism are words with no meaning, driveling speech

Front 404

Conduction Aphasia

Back 404

transection of the arcuate fasciculus; the arcuate fasciculus interconnects Brodmann's speech area with Wernicke's speech area
-poor repetion
-good comprehension
-fluent speech

Front 405

Transcortical Motor Aphasia

Back 405

-poor comprehension
-good repetition
-nonfluent speech

Front 406

Transcortical Mixed Aphasia

Back 406

-poor comprehension
-good repetition
-nonfluent speech

Front 407

Transcortical Sensory Aphasia

Back 407

-poor comprehension
-good repetition
-fluent speech

Front 408

Global aphasia

Back 408

-results from a lesion of the perisylvian area, which contains Broca's and Wernicke's areas.
-Global aphasia combines all of the symptoms of Broca's and Wernicke's aphasias

Front 409

Back 409

1-Conduction Aphasia
2-Wernicke's Aphasia
3-Transcortical Sensory Aphasia
4-Broca's Aphasia
5-Transcortical Motor Aphasia
6-Mixed Transcortical Aphasia