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223 Cards in this Set

  • Front
  • Back

a motor neuron that communicates directly with somatic muscle - arise from spinal cord or brain

lower motor neurons
motor neurons arising from motor centers in the brain that communicate

either directly with lower motor neurons or indirectly via interneurons

many undergo decussataion
upper motor neurons
what are the descending motor tracts lateral pathways?

what type of bias do they have
lateral pathways are:
lateral cotricospinal
rubrospinal
medullary reticulospinal

THERE IS A FLEXOR BIAS
what are the escending motor tracts Medial pathways?

what type of bias do they have
Medial Pathways are
Pontine Reticulospinal
Lateral Vestibulospinal
Medial vestiulospinal

THERE IS AN EXTENSOR BIAS
Why is the corticobulbar tract not in the spinal cord
it is responsible for the face and does not descend to the cord
where are the flexor bias areas

where are the extensor bias area
Flexor - lateral

extensor - medial
what motor pathways receive commands from the cortex

this means they are involved in...
corticospinal
rubrospinal
reticulospinal

involved in voluntary movement
progressively weakens then destroys LMN's
eventually effect parts of pyramidal tracts and precentral gyrus (primary motor area)
difficulty speaking / swallowing (bulbar nuclei)
tongue weakness / atrophy
muscle wasting / atrophy in hands
loss of respiratory function usually causes death
death after 3-5 years of diagnosis
Lou Gehrigs Disease
Amyotrophic Lateral Scelrosis
what tracts / cells are affected with anterior spinal artery syndrome

what are the symptoms

what are the causes
Tracts:
anterior corticospinal
lateral corticospinal
ALS
anterior horn cells

spastic paraparesis
bilateral extensor plantar response
bilateral loss of pain and temp below the lesion
*touch, vibration in tact
retention of urine
sexual function impaired

CAuses: infarction of ant spinal artery
usually affect motor and somatosensory tracts in white matter

can also affect motor neurons of anterior horn and sensory neurons of dorsal horn
spinal cord diseases
central medullary syndrome can affect what tracts? (aka)

what are the symptoms
ALS is affeted, and some of the anterior horn cells
AKA - Syringomyelia

symptoms include:
segmented muscle atrophy (usually hands and fingers)
loss of pain and temperature (no ALS)
describe the corticospinal pathway
Start
Route
End
Start: Pyramidal Cell layer 5 of Precetnral Gyrus

Route: Corona Radiata -> internal capsule -> crus cerebri -> basilar pons -> lateral corticospinal tract -> decussation at lower end of MEDULLA -> alpha/gamma lower motor neurons

End: contralateral anterior horn of the spinal cord where upper motor neurons synpase on alpha and gamma lower motor neurons that exit VENTRAL horn to innervate target muscle
Somatic Map of the corticospinal pathway:
medial to lateral
medial: foot, knee, hip, trucnk, arm, hand, thumb face, mouth, chin, tongue -- homonuclena!
Where?
production of motor programs
project to ____ cortex
have layer 5 pyrramidal cells that project via the corticospinal tract to excite motor neurons
medial aspect of this cortex contains the supplemental motor area which does the same thing
pre motor cortex

broddman 6
where? what?

lies in precentral gyrus
layer five pyramidal cells make excitatory synapses to LMN in the spinal cord directly and indirectly via interneurons
as a distinct somatotropic map
primary motor cortex

brodmann 4
where does motor cortex receive input from

where does premotor cortex receive info from
Primary Motor input from:
1. primary somatosensory B3 1 2
2. Posterior Parietal Area B 5, 7 - integrates sensory info for motor planning
3. Basal Ganglia and Cerebellum (via thalamus)

Premotor input from:
1. Posterior Parietal Area
2. Basal Ganglia
_______ Lesion results in:
1 PARALYSIS or paresis
2 AREFLEXIA - decrease/ loss in reflexes due to loss of efferents
3 muscle ATROPHY
4 denervation can cause FASICULATIONS and FIBRILLATIONS (fibs detected by EMG's)
5 all symptoms occur IPSILATERAL to the side of damage

2 examples of this disease
Lower Motor Neuron Lesions

amyotrophic lateral sclerosis
Peripheral nerve damage
_____ Lesion results in:
1 inital flaccidity and areflexia due to SPINAL SHOCK
2 (few weeks later) - SPASTIC PARALYSIS (increased muscle tone) -- NO WASTING OF MUSCLES
3 positive BABINSKI TEST aka Extensor plantar response (also found among babies bc tract hasnt matured)
4 Clonus- a series of involuntary muscular contractions due to sudden stretching of the muscle

Which sides are affected?
Upper Motor Neuron Lesion

If lesion is above the decussation - symptoms occur contrlateral to the lesion
*if lesion is below the decussation - symptoms occur ipsilateral to the lesion
If the Bernard Brown Syndrome affects the cortcospinal tract via:
-type of lesion
-contra / ipsilateral below the lesion
-patient exhibits:
UPPER MOTOR NEURON SYNDROME (BELOW LEVEL OF LESION)i
psilateral below the lesion

patient exhibits:
hyperrelfexia
clonus
extensor plantar reflex
spastic paralysis
If the Bernard Brown Syndrome affects the Spinothalamic tract via:

-contra / ipsilateral below the lesion
-patient exhibits:
contralateral below the lesion

patient exhibits
-no perception of pain and temperature
(unless leissure's tract (3 levels) can be used)
If the Bernard Brown Syndrome affects the Dorsal Column/Medial Lemniscus tract via:

-contra / ipsilateral below the lesion
-patient exhibits:
ipsilateral below the lesion

patient exhibits loss of perception of vibration and proprioception
If the Bernard Brown Syndrome affects the Corticospinal tract via:

where does an LMN lesion occur?

-contra / ipsilateral below the lesion
-patient exhibits:
LMN - at level of the lesion - in the ANTERIOR HORN OF THE SPINAL CORD

patient exhibits
hyporeflexia
wasting of muscles
flaccid paralysis
fasiculations
fibrillations
what is a bilateral spinal cord injury most cases due to a traumatic event that impairs the cells within the spinal cord or cuts and crushes fibers of the tracts
paraplegia
symptoms of paraplegia include
6
flaccid paralysis below the level of the lesion (due to spinal shock - after 4 weeks - spasticity)
increased deep tendon reflexes and clonus
extensor plantar response
urine retention - painless bladder distention (stretch receptors in bladder can be damaged)
paraplegia in flexion (physiotherapy warranted)
loss of all somatosensation below the lesion
____ fibers innervate motor cranial nerve nuclei where their route dependson the CN being severed
corticobulbar fibers
an UPPER lesion (central) of these fibers will cause a contralateral denervation of the tongue

LOWER lesion (peripheral) will cause an ipsilateral lesion of the tongue
central lesion / peripheral lesion of the corticobulbar tract to the HYPOGLOSSAL NERVE
1. Central lesion:
patient will have a gaze twaord the side of the lesion
fibers do not reach ?
lesion is in the frontal eye field (BA 8) or internal capsule
-what eyemovement is affected
2 Peripheral lesion - is where?
what muscles affected
Corticobulbar fibers lesion to PPRF - conjugate eye movement affected
-- fibers do not reach the PPRF

Peripheral lesion - fibers do not reach the oculomotor or abducens nucleus and the lateral rectus or medial rectus muscles will lose innervation
type of lesion?
1. loss of lower facial muscles, but still able to move forhead - due to partial innervation from other cortex
2. no loss because the majority of the innervation comes from the other cortex
3. total loss of muscle innervation on the ipsilateral side
type of lesion?
1 CONTRALATERAL CENTRAL FACIAL LESION. loss of lower facial muscles, but still able to move forhead - due to partial innervation from IPSILATERAL cortex
2. IPSILATERAL CENTRAL FACIAL LESION no loss because the majority of the innervation comes from the CONTRALATERAL cortex
3. PERIPHERAL FACIAL LESION total loss of muscle innervation on the ipsilateral side
Flexor Biased Pathway
Rubrospinal Tract
Start
Route
End
Function
Flexor Biased Pathway

Start: RED NUCLEUS in midbrain - receives cortical input from motor cortex hens voluntary activity

Route: Cortex -> Red Nucleus - > DECUSSATION IN ventral MIDBRAIN - > (red nuclues influences opposite side of the body) -> LATERAL BRAINSTEM & SPINAL CORD --> EXCITATORY synapses on ALPHA AND GAMMA motor neurons of PROXIMAL FLEXOR MUSCLES OF LIMPS (greater influence on arms)

End: ALPHA AND GAMMA motor neurons in anterior horn of the cervical spinal cord

Function: receives ipsilateral input from motor cortex and cerebellar nuclei
read red nucleus synapses in the cervical segments innervating the PROXIMAL muscles of the contralateral arms
Flexor Biased Pathway
MEDULLARY (lateral) Reticulospinal Tract
Start
Route
End
Function
Flexor Biased Pathway

Start: Medullary Reticular Nuclei in the midbrain - receives BILATERAL cortical input

Route: Cortex -> Medullary Reticular Nucleus -> descent ipsilateral OR decussate in medulla and descend in Reticuospinal Tract - > synapse on interneurons -> synapse on ALPHA or GAMMA motor neurons

End: Interneurons that excite ALPHA or GAMMA motor neurons
Extensor Biased Pathway
PONTINE (medial) RETICULOSPINAL Tract
Start
Route
End
FUNCTION
Extensor Biased Pathway

Start: Pontine Reticular Nucleus - Pons - receives BILATERAL cortical input

Route: Cortex -> pontine reticular nucleus -> descent ipsilateral in reticulospinal tract -> synapse on ipsilateral gamma motor neurons

End -> ipsilateral anterior honr on MAINLY gamma motor neurons to innervate axial and limb extensor muscles

Function: receive info from cortex BILATERALLY
receive STRONG input of sensory info from limbs and trunk
facilitate extensor activity of limb muscles
Extensor Biased Pathway
Lateral Vestibulospinal Tract
Start
Route
End
FUNCTION
Extensor Biased Pathway
Lateral Vestibulospinal Tract
Start Lateral Vestibulospinal Nucleus

Route ; vestibular organs and cerebellum -> Lat Vestibulo nucleus -> descened ipsilaterally in the medulla and spinal cord -> synapse on interneurons -> synapse on ALPHA motor neurons

End: synapse on EXCITATORY interneurons of the anterior horn which eventually synapse on ALPHA motor neurons

FUNCTION:
receive input from vestibular organs and cerebellum
eventual excitatory influence to contract axial and limb extensor muscles - the 'anti-gravity' muscles coordinating balance
Extensor Biased Pathway
Medial Vestibulospinal Tract
Start
Route
End
FUNCTION
Extensor Biased Pathway
Medial Vestibulospinal Tract

Start: Medial vestibulospinal Nucleus

Route: vestibular organs and cerebellum -> medial vestibular nucleus -> descend ipsilateral MLF of spinal cord-> synapse on ALPHA motor neurons (cervical and thoracic)

End: synapse on ALPHA motor neurons at the cervical and upper thoracic levels of the spinal cord

FUNCTION
receive input from vestibular organs and cerebelum
INHIBIT extensor muscles via Glycine release on ALPHA motor neurons of the neck and back
predominantly work toward stabilizing head position
Sensory Biased Pathway
Spinoreticular Tract
Start
Route
End
FUNCTION
Sensory Biased Pathway
Spinoreticular Tract

Start: peripheral pain and temp receptors

Route: TP receptor -> ascend via ALS (immediate decussation) -> synapse in BOTH reticular nuclei -> send efferent signals to respond to stimuli (leg lift after sharp object)

End: Pontine and Medullary Reticular Nuclei
FUNCTION
3 Lateral / Flexion Motor Pathways

3 Medial / Extensor Motor Pathways
3 Lateral / Flexion Motor Pathways
Lateral Corticospinal
Lateral/Medullary Reticulospinal
Rubrospinal

3 Medial / Extensor Motor Pathways
Medial/Pontine Reticulospinal
Lateral Vestibulospinal
Medial Vestibulospinal
Main characteristics of
Lower Motor Neuron Syndromes: (5)

Upper Motor Neuron Syndromes (5)
Main characteristics of
Lower Motor Neuron Syndromes:
1. NO muscle innervation
2. atrophy / hyporeflexia
3. fasiculations
4. fibrillations (EMG)
5. flaccid paralysis initially and throughout

Upper Motor Neuron Syndromes
1. NO cortical modulation of input
2. hyperreflexia
3. Flaccid Paralysis -> Spastic Paralysis
4. Spastic Paralysis
5. Extensor Plantar Reflex (positive Babinski test)
Describe the Gamma Loop
1. Extrafusal fibers are stimulated by Alpha motor neurons and the muscle contracts/ shortens
2. Muscle spindle loosens and decreases the 1a afferent firing rate
3. Decrease on 1a causes Gamma-motor neuron to stimulate intrafusal fiber& muscle spindle to contract and adapt to the new shortened length on the extrafusal fiber
what happens if there is stimulated on Gamma alone?

where does this occur (what tract)
Gamma alone:
1. stimulation will contract the intrafusal fiber which stimulates the 1a neuron
2. 1a axon stimulates the ALPHA motor axon to contract the muscle - indirect muscle contraction

- seen in Pontine Reticulospinal tract
What tracts do you see simultaneous stimulation of Alpha and Gamma stimulations?
Lateral Corticospinal
Medullary (Lateral) Reticulospinal
Rubrospinal
What is the function of the golgi tendon fiber 1b

where does it synapse?
1. synapses on INTERNEURONS which will inhibit ALPHA motor neurons
2. PROTECTIVE MECHANISM to ensure the muscle contraction does not reach the point of damage
3. the NEGATIVE FEEDBACK is also responsible for FINE MOTOR acts like handling delicate objects
_____Posture due to a lesion above the Red Nucleus, impairing Corticorubral and Corticospinal tracts
- Red Nucleus is active but there is NO cortical input

What type of Posture?
How are the arms and Legs positioned? (due to what?
Decorticate Posture (lesion ABOVE red nucleus)

- Arms are flexed - due to powerful rubrospinal influence
-Legs are extended due to unopposed Pontine Reticulospinal and Vestibulospinal
a lesion below the red nucleus would cause this type of posture

the working tracts are?
the impaired tracts are?
Decerebrate posturing

Working tracts are both
vestibulospinal tracts (extensor)
pontine reticulospinal (extensor)
medullary reticulospinal (flexor) <- overcome by extensor innervation of the pontine reticulo spinal and vestibulo tracts

NON working tracts are: corticospinal, rubrospinal, corticobulbar
Intrafusal fibers: name it

1. ____sensitive to length change and rate of change
2. ____ sensitive to length change only all nuclei lined up in a row
3. ____ sensitive to length change only - nuclei NOT all lined up in a row
Intrafusal fibers: name it

1. Dynamic Nuclear Bag sensitive to length change and rate of change
2. NUCLEAR CHAIN FIBERS sensitive to length change only all nuclei lined up in a row
3. STATIC NUCLEAR BAG FIBERS sensitive to length change only - nuclei NOT all lined up in a row
______lie within the spindle between/parallel to the extrafusal fibers and are attached to the muscle's tendons
-- when muscle contracts it shortens a there is a ____ in 1a firing rate
- when muscle stretches, there is an ___ in 1a firing rate
INTRAFUSAL FIBERS lie within the spindle between/parallel to the extrafusal fibers and are attached to the muscle's tendons
-- when muscle contracts it shortens a there is a DECREASE in 1a firing rate
- when muscle stretches, there is an INCREASE in 1a firing rate
What are the two types of sensory innervation for intrafusal fibers?
how do they differ?

What is the motor innervation for intrafusal fibers?
What are the two types of sensory innervation for intrafusal fibers?
how do they differ?
1. GROUP 1a - PRIMARY SENSORY ENDING CARRYING STATIC AND DYNAMIC (length and rate) AFFERENTS
2. GROUP II - CARRYING STATIC SENSORY INFO ONLY

What is the motor innervation for intrafusal fibers?
A-GAMMA - SMALL MYELINATED AND LOW VELOCITY AXONS CARRY MOTOR INNERVATION TO THE INTRAFUSAL FIBERS (**A-alpha responsible for motor innervation of extrafusal fibers)
____ a large myelinated axon with relatively high conductance
-fiber branches and LOSES its myelin sheath, leaving FREE sensory nerve endings to interweave among chains of collagen fibers
--- when stretched through muscular contraction, nerve endings are distorted which leads to opening of membrane cation channels - increase rate of action potential firing - which increases the fiber
1b FIBER
____ a large myelinated axon with relatively high conductance
-fiber branches and LOSES its myelin sheath, leaving FREE sensory nerve endings to interweave among chains of collagen fibers
--- when stretched through muscular contraction, nerve endings are distorted which leads to opening of membrane cation channels - increase rate of action potential firing - which increases the fiber
this fiber measures muscles tension

mediates inhibition of activity of alpha motor neurons whose extrafusal fibers are under greatest tension
-distributes tension among extrafusal fiber
-participates in a proctective 'inverse' mytatic reflex
golgi tendon 1b fiber
under very large tension this fiber is part of the reflex that relaxes the homonymous and synergistic muscles and excites the antagonist muslces
-this is called the protective reflex aka inverse myotatic reflex
golgi tendon 1b
3 main contributers of the motor control system

other subcortical systems that influence the motor control system

afferent input from
3 main contributers of the motor control system
CEREBRAL CORTEX
BRAIN STEM
SPINAL CORD

other subcortical systems that influence the motor control system
BASAL GANGLIA, CEREBELLUM

afferent input from
RECEPTORS RELAY INFO ABOUT HEAD, BODY, AND LIMB POSITION TO CORTICAL AND SUBCORTICAL COMPONENTS OF THE MOTOR SYSTEM
Motor Neurons:
____ large myelinated, high velocity passing via ventral horn to limb muscle EXTRAFUSAL fibers

_____small myelinated, lower velocity passing via ventral horn to limb muscle INTRAFUSAL fibers
Motor Neurons:
A-ALPHA large myelinated, high velocity passing via ventral horn to limb muscle EXTRAFUSAL fibers

A-GAMMA small myelinated, lower velocity passing via ventral horn to limb muscle INTRAFUSAL fibers
Where are the A-alpha and A-gamma located in the spinal cord?

What are renshaw cells and what are their function?
In the ventral horn of the cord

Renshaw cells are inhibitory interneurons of the anterior horn (ventral horn) that receive collaterals from alpha motor neurons and work to avoid damage in the event of excessive contraction (like golgi inverse myotatic)
Muscle Spindle role in stretch reflex:

1: muscle stretching causes _____
2: these impulses synapse on and stimulates the _____ to cause contraction
3: there is an inhibitory interneuron stimulus to inhibit the _____
4. this is called _____
Muscle Spindle role in stretch reflex:

1: muscle stretching causes 1a AXON STIMULATED AND SENDS IMPULSES TO VENTRAL HORN
2: these impulses synapse on and stimulates the ALPHA MOTOR NEURON to cause contraction OF THE STRETCHED MUSCLE
3: there is an inhibitory interneuron stimulus to inhibit the ALPHA MOTOR NEURON OF THE ANTAGONIST MUSCLE
4. this is called RECIPROCAL INNERVATION
During sustained stretch (contraction)- what happens to the muscle spindle?
There is conitnued action potential firing in the muscle spindle afferent
During simultaneous alpha and gamma stimulation what happens to the muscle spindle?
When alpha and gamma are stimulated, extrafusal and intrafusal fibers will CONTRACT TOGETHER

- intrafusal spindle consensually contracts, it continues to relay afferent info thus able to CONTINUALLY MEASURE/MONITOR MUSCLE LENGTH
what is a motor unit?

where do they congregate?
alpha motor neuron and the extrafusal muscle fibers that it directly innervates

congregate - about 100 motor neurons congregate in the ventral horn of he spinal cord
and the brainsem contains motor nuclei of the motor cranial nerves
a ____ brances at its muscle and each ____ only receives only one ending of the branching

the NMJ is located near the center of the ____ and that is where the action potentials are generated
a MOTOR AXON brances at its muscle and each FIBER only receives only one ending of the branching

the NMJ is located near the center of the FIBER and that is where the action potentials are generated
_____ slow twitch muscle fibers, low tension, fatigue resistant, aerobic, innervated by relatively small motor neuron and axons (cross country running)
____ fast fatigue resistant (almost); large tension; some aerobic capacity; innervated by relatively large motor neuron and axon
_____ fast fatiguable ; large tension, anaerobic, innervated by relatively large motor neurons (sprinting)
TYPE 1 slow twitch muscle fibers, low tension, fatigue resistant, aerobic, innervated by relatively small motor neuron and axons (cross country running)
TYPE IIA fast fatigue resistant (almost); large tension; some aerobic capacity; innervated by relatively large motor neuron and axon
TYPE IIB: fast fatiguable ; large tension, anaerobic, innervated by relatively large motor neurons
the 2 factors controlling contraction are:
1. force developed within the muscle fibers - it increases with increasing firing rate of motor neuron

2. force will increase as more motor units are recruited to the excited state
____reduced muscle tone (atrophy) due to damage to either the 1a afferent or the alpha motor neuron

___ caused by destruction of the motor neuron in the anterior horn, axons in the ventral roots or the peripheral nerves
-can cause: atrophy, loss of voluntary and reflex responses, hyporeflexia, fasiculation and fibrillations
HYPOTONIA ____reduced muscle tone (atrophy) due to damage to either the 1a afferent or the alpha motor neuron

LOWER MOTOR NEURON SYNDROME___ caused by destruction of the motor neuron in the anterior horn, axons in the ventral roots or the peripheral nerves
-can cause: atrophy, loss of voluntary and reflex responses, hyporeflexia, fasiculation and fibrillations
What are the 6 possible sites for lesions in the motor unit?
Soma
Axon,
Nerve Ending
Schwann Cells
Synaptic Cleft
End Plate
Muscle Fiber
Where are the lesions for the following diseases?

Lou Gehrig Disease(ALS)
Poliomyelitis

Botulism
Lambert-Eaton

Guillan Barre
Diptheria

Myasthenia

Myasthenia gravis
nAChR defects

Myotonias
Muscular Dystrophy
Where are the lesions for the following diseases?

SOMA
Lou Gehrig Disease(ALS)
Poliomyelitis

NERVE ENDING
Botulism
Lambert-Eaton

SCHWANN CELL
Guillan Barre
Diptheria

SYNAPTIC CLEFT
Myasthenia

END PLATE
Myasthenia gravis
nAChR defects

MUSCLE FIBER
Myotonias
Muscular Dystrophy
_____toxin that stops ACh vesicles from docking at the NMJ; inhibits ACh exocytosis (eating food, wound infected, ingesting spores)

____causes massive ACh release, travels via lymph to blood causing tetanus, painful muscle contraction and eventual paralysis

____ toxin in venom that reduces ACh release by acting on proteins in nerve terminals involved in exocytosis

____arrowhead poison, found in plants and is a reversible nAChR antagonist - temporary paraylsis
BOTULISM (COLOSTRIDIUM BOTULINIUM) toxin that stops ACh vesicles from docking at the NMJ; inhibits ACh exocytosis (eating food, wound infected, ingesting spores)

ALPHA-LATROTOXINcauses massive ACh release, travels via lymph to blood causing tetanus, painful muscle contraction and eventual paralysis

BETA-BUNGAROTOXIN toxin in venom that reduces ACh release by acting on proteins in nerve terminals involved in exocytosis (in snake venom)

CURARE (TUBOCURARIN) arrowhead poison, found in plants and is a reversible nAChR antagonist - temporary paraylsis
--- autoimmune against voltage gated ca2+ channels - causes insufficient release of ACh
-continued contractions will cause and increase in ACh until it reaches a concentration sufficient to elicit a proper contraction
--- waxing in EMG

WHAT IS THE TREATMENT
LAMBERT EATON SYNDROME autoimmune against voltage gated ca2+ channels - causes insufficient release of ACh
-continued contractions will cause and increase in ACh until it reaches a concentration sufficient to elicit a proper contraction
--- waxing in EMG

FOUND IN PATIENTS WITH SMALL CELL CANCERS OF THE LUNG

TREATMENT
REMOVE UNDERLYING TUMOR AND GIVE IMMUNOSUPRESSIVE DRUGS
2 CALCIUM GLUCONATE TO ENHANCE Ca2+ INFLUX
3 4-AMINOPYRIDINE TO PROLONG PRESYNAPTIC ACTION POTENTIAL AND IMPROVE TRANSMITTER RELEASE (block potassium channels to increase Ca2+)
Three types of Congenital Myasthenias can be

1____ caused by increased and prolonged EPP; temporal summation will easily cause desensitization known as depolarization block
2.____ binding of ACh to nAChR causes prolonged opening of the ACh receptor channel
-channels open for too long causes prolonged depolarization resulting in depolarization blcok
-results in muscle weakness, rapid fatigue and progressive atrophy
3._____ via abnormal binding of ACh with nAChR or ACh-gated channel have extremely brief opening times
Three types of Congenital Myasthenias can be

1 AChE Deficiency causes increased and prolonged EPP; temporal summation will easily cause desensitization known as depolarization block
2.SLOW CHANNEL SYNDROME binding of ACh to nAChR causes prolonged opening of the ACh receptor channel
-channels open for too long causes prolonged depolarization resulting in depolarization block
-results in muscle weakness, rapid fatigue and progressive atrophy
3.OTHER CONGENITAL MYASTHENIAS
via abnormal binding of ACh with nAChR or ACh-gated channel have extremely brief opening times
MYASTHENIA GRAVIS:

causes (3)

symptoms (6)

Signs and Tests (2)

Treatment (3)
MYASTHENIA GRAVIS:

Causes
1. AUTOIMMUNE ANTIBODIES AGAINST nAChR - block ACh ability to bind to receptor
2. STRUCTURAL CHANGES in end plate: fewer nAChR, Wider Cleft, Smaller Shallower junctional folds
3. sometimes associated with THYMUS TUMORS

symptoms
1. WEAKNESS of VOLUNTARY muscles which IMPROVE WITH REST and worsens with activity
2. DIFFICULT SWALLOWING (frequent choking)
3. LATE-DAY PARALYSIS
4. MYASTHENIC CRISIS -> difficulty breathing that may be life threatening
5. Diplopia
6. Ptosis

Signs and Tests
1. EMG - WANING pattern (decrease in strength)
2. AChE test is usually positive

Treatment
1. NEOSTIGMINE/Pyridostigmine - AChE inhibitor to increase ACh presence in the cleft
2. PREDNISONE - immune suppressors such as azathioprine or cyclosporine
3. SURGICAL REMOVAL of THYMUS - sometimes put patient into remission
MYOTONIA CONGENITA

1. Autosomal _____ -> ___ channels are decreased in number, causing SLOWER MUSCLE RELAXATION
2. ___ channels usually reset the Vm after an action potential, (usually set to the E(Cl) during recovery so there is and increase in _____ (smaller depolarizations is required to evoke action potential -- train of action potentials)
3______accumulation which leads to spontaneous ____after the end of the nerve stimulation

4. Patient suffers from _____ and____
MYOTONIA CONGENITA

1. Autosomal DOMINANT -> CHLORIDE channels are decreased in number, causing SLOWER MUSCLE RELAXATION
2. CHLORIDE channels usually reset the Vm after an action potential, (usually set to the E(Cl) during recovery so there is and increase in EXCITABILITY (smaller depolarizations is required to evoke action potential -- train of action potentials)
3 POTASSIUM accumulation which leads to spontaneous FIRING after the end of the nerve stimulation

4. Patient suffers from STIFFNESS and HYPERTROPHY
Myopathies -- DUCHENNE MUSCULAR DYSTROPHY
______recessive, absence of the ___ protein
onset is ______ when ___ develops
die of _______
Myopathies -- DUCHENNE MUSCULAR DYSTROPHY
X LINKED recessive, absence of the DYSTROPHIN protein
onset is EARLY CHILDHOOD 3-5 YEARS) when MUSCLE WEAKNESS develops
die of RESIPRATORY AND OR CARDIAC FAILURE
____second order neurons which stimulate the muscle are lost

lesion is either on the motor axon or the soma in the spinal cord or the brainstem
LOWER MOTOR NEURON SYNDROME
second order neurons which stimulate the muscle are lost

lesion is either on the motor axon or the soma in the spinal cord or the brainstem
what are the 3 caueses of LMN syndrome
viral infection - poliomyelitis
trauma
neuro-degeneration
-----
can effect the whole body but usually just motor neurons in the ventral horns
-severe cases causes permanent paralysis or death
-transmission - is person to person contact (nose mouth fecal)
-PREVENTiION - vaccine
POLIOMYELITIS
-----
can effect the whole body but usually just motor neurons in the ventral horns
-severe cases causes permanent paralysis or death
-transmission - is person to person contact (nose mouth fecal)
-PREVENTiION - vaccine
Four common (sometimes defining) features of disordered movement include:
1. impaired postural reflexes contributing to balance (during movement or stationary)

2. diminished or slow movements (hypokinesia/bradykinesia)

3. excessive involuntary movements (hyperkinesia)

4. uncoordinated or unsteady movements (ataxia)
Tremors:
____ reflects low amplitude cycles of flexion and extension of a bodily region

_____ common in Parkinsons, wanes during voluntary movement of affected body part -- basal gangliar dysfunction seondary to mesencephalic neural degeneration

____ arises with voluntary movement, particularly as the affected body part (arm) approaches a target (doorbell) CEREBELLAR lesions commonly yield these tremors
Tremors:
PHSYIOLOGICAL TREMOR reflects low amplitude cycles of flexion and extension of a bodily region

RESTING TREMOR common in Parkinsons, wanes during voluntary movement of affected body part -- basal gangliar dysfunction seCondary to mesencephalic neural degeneration

INTENTIONAL TREMOR arises with voluntary movement, particularly as the affected body part (arm) approaches a target (doorbell) CEREBELLAR lesions commonly yield these tremors
brief purposeless irregular jerky movements of the body parts, often stemming from BASAL GANGLIAR DISEASE
Chorea
movements are often described as 'flinging'. Rotation of joints may be expressed. Causal lesions often involve the SUBTHALAMIC NUCLEUS, which contribute to BASAL GANGLIAR function.
Ballismus
_____widely varied lesions can cause this; LMN or neuromuscular junction can be implicated arising in flaccid paralysis

____ - associated with lesion of the upper motor neurons, yielding increased muscular tone
hypokinetic disorders - widely varied lesions can cause this; LMN or neuromuscular junction can be implicated arising in flaccid paralysis

HYPOKENSIA- associated with lesion of the upper motor neurons, yielding increased muscular tone
-----reflects absence of movement or limited movement
in parkinsons - dirstubances are often tied to difficult initiating movement
-----refers to movements that are pathologically slower than normal
AKINESIA reflects absence of movement or limited movement
in parkinsons - dirstubances are often tied to difficult initiating movement
BRADYKINESIA-refers to movements that are pathologically slower than normal
Parkinson's symptoms
- Facial expression commonly diminishes early, resulting in a masked appearance

- exhibiting muscular stiffness of differing forms, revealed during assessment of passive movement --
Types:
1. --- refers to recurrent stepwise release and return of resistance to passive movement
2. --- resistance that is sustained throughout a range of passive movement

-- difficulties initiating movement - accompanied by---

-- markely affected, patients taking short shuffling steps, turning is difficult; many small steps replace smooth
Parkinson's symptoms
-FACIAL MASKING Facial expression commonly diminishes early, resulting in a masked appearance

RIGIDITY- exhibiting muscular stiffness of differing forms, revealed during assessment of passive movement --
Types:
1. COGWHEEL RIGIDITY- refers to recurrent stepwise release and return of resistance to passive movement
2. LEAD PIPE- resistance that is sustained throughout a range of passive movement

LOSS OF POSTURAL- difficulties initiating movement - accompanied by---

PARKINSONIAN GAIT- markedly affected, patients taking short shuffling steps, turning is difficult; many small steps replace smooth
noxious stimulus (firm tapping) between the eyes to elicit bilateral blinking
opthalmic branch of cranial nerve V serves as a sensory limb and temporal branches of CN VII are motor limb
-normal response causes weakened response with continued stimulation - does not occur with parkinsons
GLABELLAR RESPONSE
parkinsonian speech is like what?
quiet, hoarse and monotonous but with bursts of speed (fenstination speech)
What are the stages of parkinson disease
1. unilateral
2. bilateral but with preserved postural reflexes
3. bilateral with loss of postural reflexes (falls becoming more likely)
4. Severe disability but some movement
5. akinesia - no movement
Differential diagnosis for Parkinson Disease are:
Essential (postural) tremor - expressed only when a particular posture is maintained

Intention tremor - cerebellar disease rather than parkinson disease
---- is a hallmark feature of Huntington's Disease - inherited autosomal dominant condition

-- also prominant in SYDENHAM DISEASE autoimmune characteristics that are linked to childhood rheumatic fever.
CHOREA
writhing movements tied to basal gangliar disease - might be seen in ---- cerebral palsy
movements overlap with chorea,
*accompanied by hemiplegia, with a hemiplegic gait therefore being superimposed
ATHETOSIS
muscle spasms or sustained posture are involved
-generalized ___ produces abnormal postures involving the trunk and limbs
--may be partial or segmental
Dystonias
--- a specific dystonia involving the neck, neck muscles (sternocleidomastoid) contract involuntarily and may become hypertonic
SPASMODIC TORTICOLLIS
irregularly occuring streotyped movements that are usually transient and coordinated. range from simple (eye blinking, arm jerks) to complex (head shaking, spitting, floor licking)
Tic Syndromes
genetic disorder with an onset of seven years of age, a specific __ disorder

-multifocal __ are common and often accompany attention deficit hyperactivity disorder
-key to diagnosis is vocal compnonen (barking, grunting)
Tourette Syndrome
may occur in patients exposed to some antipsychotic drugs (dopamine receptor antagonists)
-can feature stereotypic oral movements
-advanced age of patients predicts greater vulnerability
____ can not necessarily abate with drug withdrawal, meaning it can be permanently expressed
TARDIVE DYSKINESIA

DYSKINESIA can not necessarily abate with drug withdrawal, meaning it can be permanently expressed
often arises during treatment of parkinson disease with precursor to dopamine.
Choreoform movements predominate, facial dystonias (grimacing or eye closure) are not uncommon
DOPA INDUCED DYSKINESIA
can arise with agents that block dopamine receptors or deplete dopaminergic cells of their transmitter
-symptoms dissipate within weeks of withdrawal of these agents
DRUG INDUCED PARKINSONISM
_____ reflect embryologically determined migration of neurons away from the cerebral paraventricular zone -- embeds subcortical islands of gray matter (basal ganglia) in the cerebral white matter, creating targets for cortical output.

the caudate and the putamen make up the _____

the putamen and the globus pallidus make up the _____
BASAL GANGLIA reflect embryologically determined migration of neurons away from the cerebral paraventricular zone -- embeds subcortical islands of gray matter (basal ganglia) in the cerebral white matter, creating targets for cortical output.

the caudate and the putamen make up the STRIATUM

the putamen and the globus pallidus make up the LENTIFORM NUCLEUS
Name the four parts of the Basal ganglia that modulated motor related activity of the frontal cortices

- they interact to render the basal nuclei as integral to the initiation and control of voluntary movement, owing to their regulation of the thalamus
Name the four parts of the Basal ganglia that modulated motor related activity of the frontal cortices

- they interact to render the basal nuclei as integral to the initiation and control of voluntary movement, owing to their regulation of the thalamus

1. Striatum: caudate and putamen and ventral striatum
2. Globus Pallidus: external (lateral) part - GPe and internal (medial) part GPi
3.Subthalamic Nucleus
4. Substantia Nigra: Pars Reticulata (SNr) and the Pars Compacta (SNc)
The principle product of the basal ganglia is ____-; it transmitted to the _____ and it suppresses an excitatory _____.
The principle product of the basal ganglia is INHIBITORY SIGNAL-; it transmitted to the THALAMUS and it suppresses an excitatory THALAMO-CORTICAL PROJECTION.
synaptic connections forming motor loops: direct and indirect gangliar motor loop similarities:

1. corticospinal fibers release ____ to excite ___

2. Striatal cells are either excited or inhiibited by dopamine arising from the ____

3 the substantia nigra receives ____ signals from the striatum

4 GABAergic output from the medial (internal) part of the globus palldus (GPi) inhibits cells of the _____

5. Thalamic cells excite the ____ via release of glutamate
synaptic connections forming motor loops: direct and indirect gangliar motor loop similarities:

1. corticospinal fibers release GLUTAMATE to excite STRIATAL NEURONS

2. Striatal cells are either excited or inhiibited by dopamine arising from the SUNSTANTIA NIGRA PARS COMPACTA (SNc)

3 the substantia nigra receives INHIBITORY GABAergic signals from the striatum

4 GABAergic output from the medial (internal) part of the globus palldus (GPi) inhibits cells of the VENTRAL LATERAL THALAMIC NUCLEI

5. Thalamic cells excite the MOTOR COTEX via release of glutamate
Draw out the indirect and direct motor pathways

what are the differnent receptors on neostriatum for substantia nigra?
Direct has D1 excitatory on striatum

Indirect has D2 inhibitory on stiratum
Parkinsons Disease: Hypokinesis

Due to a decrease in _____ from the substantia nigra.

Direct Pathway leads to a decrease in ___ causing a reduction in the ___ output, which leads to disinhibited ____ which causes ____ to be overactive and suppresses the ____ which eventually leads to _____

ndirect Pathway leads to an increase in ____which leads to disinhibited ____, increased acitivty of ____ inhibits ____ which causes a disinhibition of ____ The overexcitatory output of ___ leads to an increased activity of ____ which causes the suppression of ____ ____ which eventually leads to _____
Parkinsons Disease: Hypokinesis

Due to a decrease in DOPAMINE from the substantia nigra.

Direct Pathway leads to a decrease in D1 causing a reduction in the STRIATAL output, which leads to disinhibited GLOBUS PALLIDUS INTERNAL which causes GLOBUS PALLIDUS INTERNAL to be overactive and suppresses the THALAMUS which eventually leads to DECREASED CORTICAL INPUT - SLOWING OF MOVEMENT AND DIFFICULTY INITIATING MOVEMENT

Indirect Pathway leads to an increase in DOPAMINE ON D2 which leads to disinhibited STRIATAL CELLS , increased acitivty of STRIATAL CELLS inhibits GLOBUS PALLIDUS EXTERNAL which causes a disinhibition of SUBTHALAMUS. The overexcitatory output of SUBTHALAMUS leads to an increased activity of GLOBUS PALLIDUS INTERNAL which causes the suppression of THALAMUS which eventually leads to DECREASED CORTICAL INPUT - SLOWING OF MOVEMENT AND DIFFICULTY INITIATING MOVEMENT
Drug induced Parkinson's can be caused by _____ which block D2 receptors in the forbrain for treatment of psychosis -- inhibition of striatal neurons contributing to the ____ pathway

-drugs like ____ deplete dopamine stores and affect both pathways

- a metabolite ____ is a compound in syntheitc narcotics can causing parkinsonism by damaging neuronal mitochondria
Drug induced Parkinson's can be caused by PHENOTHIAZINES which block D2 receptors in the forbrain for treatment of psychosis -- inhibition of striatal neurons contributing to the INDIRECT pathway

-drugs like RESERPINE deplete dopamine stores and affect both pathways

- a metabolite MPTP is a compound in synthetic narcotics can causing parkinsonism by damaging neuronal mitochondria
---- is caused by midbrain flexes during trauma induced acceleration of the forebrain, which can tear small mesencephalic blood vessels and shear axons

- dura that forms the ____ may also interact unfavorably with the midbrain with excessive acceleration

-sufficient blows to the head can cause this syndrome
DEMENTIA PUGILISTICA
---- is caused by midbrain flexes during trauma induced acceleration of the forebrain, which can tear small mesencephalic blood vessels and shear axons

- dura that forms the TENTORIAL KNOTCH may also interact unfavorably with the midbrain with excessive acceleration

-sufficient blows to the head can cause this syndrome
parkinsonism can also be caused by viral _____ and a ____ can impact the substantia nigra or its output pathways
parkinsonism can also be caused by viral ENCEPHALITIS and a NEOPLASIA
can impact the substantia nigra or its output pathways
Huntingtons is caused by degeneration of striato-pallidal neurons that express ____ which functionally changes the ____ pathway

the end result is a _____ in thalamic output causing _____
Huntingtons is caused by degeneration of striato-pallidal neurons that express D2 which functionally changes the INDIRECT pathway

the end result is aN INCREASE in thalamic output causing HYPERKINESIS
In hemiballismus there is a unilateral stroke related injury to the ______ with ____ limbs affected

causes ____ of the arms and ____ of the legs
In hemiballismus there is a unilateral stroke related injury to the SUBTHALAMUS with CONTRALATERAL limbs affected

causes FLINGING of the arms and ROTATIONAL MOTION of the legs
What areas are degenerated in the brain due to Parkinsonism

____ which contains noradrenergic neurons that readily degenerates

___ with peripheral noradrenergic cells, those providing sympathetic inputs to the heart degenerate

___ is also common in stage II
What areas are degenerated in the brain due to Parkinsonism

PONTINE LOCUS COERULEUS which contains noradrenergic neurons that readily degenerates

ANS with peripheral noradrenergic cells, those providing sympathetic inputs to the heart degenerate

DEPRESSION is also common in stage II
Frontal line therapy for Parkinson's

___ is administered orally along with ___that reduces the peripheral metabolism
Frontal line therapy for Parkinson's

L-DOPA is administered orally along with CARBIDOPA that reduces the peripheral metabolism
Agonists of Striatal Dopamine Receptors

stimulates ___ or ___ and ___ to interact with the indirect and direct gangliar circuts
Agonists of Striatal Dopamine Receptors

stimulates D2 (BROMOCRIPTINE) or D1 and D2 (PERGOLIDE) to interact with the indirect and direct gangliar circuts
drugs that enhances striatal dopamine release

____ is an antiviral drug, may benefit some manifestations of parkinson's disease - may promot the release of dopamine and/or block acetylcholine receptors
drugs that enhances striatal dopamine release

AMANTADINE is an antiviral drug, may benefit some manifestations of parkinson's disease - may promot the release of dopamine and/or block acetylcholine receptors
Inhibitors of dopamine metabolizers also help with parkinsons

Inhibitors of ____ blocks the breakdown of dopamine in the CNS, irreversibly interacting with ____ - may improve responses or delay need for other therapies.

____inhibit ____ an enzyme that breaks down dopamine, prolonging the longevity of neurotransmitter
Inhibitors of dopamine metabolizers also help with parkinsons

Inhibitors of MAO-B blocks the breakdown of dopamine in the CNS, irreversibly interacting with MAOB - may improve responses or delay need for other therapies.

Entacapone and Tolcapone inhibit COMT an enzyme that breaks down dopamine, prolonging the longevity of neurotransmitter
___ excites striatal neurons that express D2 receptors - there for ___ antagonists supress the __ mediated excitation of striatal neurons.

- decreased output from GPe - causes an indirect decrease in output from ___ --> which increases the ability of the ____ to excite the cortex and normalize parkinson motor function
ACETYLCHOLINE excites striatal neurons that express D2 receptors - there for MUSCARINIC antagonists supress the ACh mediated excitation of striatal neurons.

- decreased output from GPe - causes an indirect decrease in output from GPI --> which increases the ability of the THALAMUS to excite the cortex and normalize parkinson motor function
Surgical treatments for Parkinsons include stereotaxic surgical lesions of :
1.
2.
One more therapy for Parkinson's involves electrical stimulation of the thalamic, pallidal and subthalamic sites - this is called:
Surgical treatments for Parkinsons include stereotaxic surgical lesions of :

1. Subthalamic Nuclei
2. Internal Globus Pallidus

One more therapy for Parkinson's involves electrical stimulation of the thalamic, pallidal and subthalamic sites - this is called: DEEP BRAIN STIMULATION
Therapies for Huntingtons Disease include:

1
2
Therapies for Huntingtons Disease include:

1 Antidepressants
2 antichorea drugs - antagonists for D2 receptors

*degeneartion of striatal cells and efferents tracts along with frontal cortices, lateral ventricular enlargement is common - BOXCAR VENTRICLES
the ___ is responsible for modulating movements to produce smooth, well timed muscular contractions of the Basal Ganglia,
the ____ and NO direct motor neuron connections but constantly influence movement in 3 ways:

1. _____ , the ____compares descending motor output with ascending info regarding posture and movement.
____ intervention coordinates movement to ensure it is smooth and accurate.

2. ____, modifies descending sequences of motor signals to ensure smooth muscular activity, this is also coordinated with the part concerned with maintaining balance and posture

3. ____there is ____ gives the cerebellum the ability to store and update motor info so that learned movements can be accurately initiated.
the CEREBELLUMis responsible for modulating movements to produce smooth, well timed muscular contractions of the Basal Ganglia,
the CEREBELLUM and NO direct motor neuron connections but constantly influence movement in 3 ways:

1. COMPARISON, the CEREBELLUM compares descending motor output with ascending info regarding posture and movement.
CEREBELLAR intervention coordinates movement to ensure it is smooth and accurate.

2. TIMING, modifies descending sequences of motor signals to ensure smooth muscular activity, this is also coordinated with the part concerned with maintaining balance and posture

3. INITIATION & STORAGE OF MOTOR INFO there is SPASTIC PLASTICITY that gives the cerebellum the ability to store and update motor info so that learned movements can be accurately initiated.
Cerebellar Function and Dysfunction:

1. Cerebellum regulates the _____ body

2. acute damage tends to yield ______ motor deficit

3. Substantial recovery often occurs with long-standing but non-progressive _____
Cerebellar Function and Dysfunction:

1. Cerebellum regulates the IPSILATERAL SIDE body

2. acute damage tends to yield PRONOUNCED motor deficit

3. Substantial recovery often occurs with long-standing but non-progressive CEREBELLAR DAMAGE
Cerebellar Anatomy:

1. the Vestibulo- Cerebellum receives afferent information about the _____ & helps regulate __ & _____

2. The Spino-Cerebellum receives afferent information from the _____ & helps regulate ______ & ____

3. The Cerebro-Cerebellum receives afferent connections from the _____ and is involved in ___ & _____
Cerebellar Anatomy:

1. the Vestibulo- Cerebellum receives afferent information about the VESTIBULAR SYSTEM & helps regulate EYE MOVEMENT & BALANCE

2. The Spino-Cerebellum receives afferent information from the SPINAL CORD & helps regulate BODY & LIMB MOVEMENT

3. The Cerebro-Cerebellum receives afferent connections from the DEEP PONTINE NUCLEI and is involved in PLANNING & MONITORING MOVEMENT
Cerebellar Peduncles: connections to the brainstem:

1. Superior Cerebellar Peduncle - from cerebellum to ______, __, &____

2. Middle Cerebellar Peduncle: from ___ to cerebellum

3. Inferior Cerebellar Peduncle: from ____ & _____ to cerebellum, from the the _____ to the cerebellum and from the cerebellum to the ____
Cerebellar Peduncles: connections to the brainstem:

1. Superior Cerebellar Peduncle - from cerebellum to DIENCEPHALON, MIDBRAIN, AND PONS

2. Middle Cerebellar Peduncle: from PONS to cerebellum

3. Inferior Cerebellar Peduncle: from SPINAL CORD & MEDULLA to cerebellum, from the the VESTIBULAR APPARATUS to the cerebellum and from the cerebellum to the LATERAL VESTIBULAR NUCLEUS
Inputs to the Cerebellum:

1. Cerebro-Ponto-Cerebellar Inputs:
- the the ____ & ______ of the frontal lobe emit large volumes of motor info as part of the corticospinal and corticobulbar tracts.
-Copies of Coritcospinal and Corticobulbar signals destined for motor neurons terminate in the ________
-the Ponto-Cerebellar (transverse) fibers then _____ in the middle cerebellar peduncle

2. RUBRO-OLIVE-CEREBELLAR INPUTS:
-Ruberal efferents that DO NOT cross as part of the rubrospinal tract may descend to the ______ and synapse on the _____
-Olive-Cerebellar Fibers then cross the midline of the medulla to enter the cerebellum at the ____

3. Reticulo-Cerebellar Inputs:
-Medullary and Pontine reticular formations receive comples array of inputs from higher centers in the ___ & _____
-reticular formation normally influences muscle tone and informs the cerebellum regarding ____&_____

4. Vestibulo Cerebellar Inputs:
-CN VIII traduces signals related to ORIENTATION & ACCELERATION OF THE HEAD, which may pass from CN VIII directly into the IPSILATERAL FLOCCULONODULAR LOBE
-Vestibular nuclei less directly relate additional signals arising from cranial nerve VIII

5. Tecto-Ponto Cerebellar Inputs: intregrate crude auditory and visual information that regulates movements of the ____ & ____ under sensory guidance
-copies of Tectal motor signals reach the _____ which transfer info the the cerebellum via the middle cerebellar peduncle
Inputs to the Cerebellum:

1. Cerebro-Ponto-Cerebellar Inputs:
- the the PREFRONT GYRUS & ANTERIOR PARACENTRAL LOBULE of the frontal lobe emit large volumes of motor info as part of the corticospinal and corticobulbar tracts.
-Copies of Coritcospinal and Corticobulbar signals destined for motor neurons terminate in the ipsilateral DEEP PONTINE NUCLEI
-the Ponto-Cerebellar (transverse) fibers then CROSS THE MIDLINE OF THE CEREBELLAR HEMISPHERE TO THE OPPOSITE CORTICAL SIDE in the middle cerebellar peduncle

2. RUBRO-OLIVE-CEREBELLAR INPUTS:
-Ruberal efferents that DO NOT cross as part of the rubrospinal tract may descend to the ROSTRAL MEDULLA and synapse on the INFERIOR OLIVARY NUCLEUS
-Olive-Cerebellar Fibers then cross the midline of the medulla to enter the cerebellum at the OPPOSITE INFERIOR CEREBELLAR PEDUNCLE

. Reticulo-Cerebellar Inputs:
-Medullary and Pontine reticular formations receive comples array of inputs from higher centers in the CORTEX & SPINAL SENSORY SYSTEMS
-reticular formation normally influences muscle tone and informs the cerebellum regarding POSTURE & REFLEXIVE RESPONSES

5. Tecto-Ponto Cerebellar Inputs: intregrate crude auditory and visual information that regulates movements of the EYE & HEAD under sensory guidance
-copies of Tectal motor signals reach the DEEP PONTINE NUCLEI which transfer info the the cerebellum via the middle cerebellar peduncle
CEREBELLAR INPUTS:

Spinal Inputs:
1. Dorsal-Cerebellar System:
-Neuromuscular spindles & the ____ transmit signals related to specific muscles of the lower body into the ___
-the dorsal spinocerebellar pathway ascends ______ to enter the cerebellum at the____
VENTRAL Spinocerebellar System
-Spinal neurons send axons across the spinal cord to ascend to the _____
-these fibers then _____ in the cerebellum

CUNEO Cerebellar System
-proprioceptors from the ____ contribute to the ipsilateral fasiculus ____ which terminates in the medullary nucleus ____.
- external arcuate fibers enter the cerebellum through the ipsilateral _______ as the cuneocerebellar pathway
CEREBELLAR INPUTS:

Spinal Inputs:
1. Dorsal-Cerebellar System:
-Neuromuscular spindles & the GOLGI TENDON ORGANS transmit signals related to specific muscles of the lower body into the SPINAL DORSAL HORN
-the dorsal spinocerebellar pathway ascends IPSILATERALLY to enter the cerebellum at the INFERIOR CEREBELLAR PEDUNCLE

VENTRAL Spinocerebellar System
-Spinal neurons send axons across the spinal cord to ascend to the SUPERIOR CEREBELLAR PEDUNCLE
-these fibers then CROSS A SECOND TIME in the cerebellum

CUNEO Cerebellar System
-proprioceptors from the UPPER LIMBS contribute to the ipsilateral fasiculus CUNEATUS which terminates in the medullary nucleus CUNEATUS.
- external arcuate fibers enter the cerebellum through the ipsilateral INFERIOR CEREBELLAR PEDUNCLE as the cuneocerebellar pathway
Similarities between Cerebral and Cerebellar Gross Histology:

In both the Cerebral Cortex and the Cerebellum the pattern from outward in is:
Similarities between Cerebral and Cerebellar Gross Histology:

In both the Cerebral Cortex and the Cerebellum the pattern from outward in is:
GREY MATTER, WHITE MATTER GREY MATTER (deep cerebellar nuclei / basal ganglia), VENTRICLES
LAYERS OF THE CEREBELLAR CORTEX:

1. Three layers consist of:

2. The two fiber inputs are:
___ input from the inferior Olivary Nucleus
___ carry all other inputs

3. One output fiber:
______ are the only output neurons, they are ____ fibers which end on the deep Cerebellar Nuclei.
-the neurons leaving the Deep Cerebellar Nuclei have _____ actions on motor systems
LAYERS OF THE CEREBELLAR CORTEX:

1. Three layers consist of:
Granule
Purkinje
Molecular

2. The two fiber inputs are:
CLIMBING FIBERS input from the inferior Olivary Nucleus
MOSSY FIBERS carry all other inputs

3. One output fiber:
GABAergic PURKINJE FIBERS are the only output neurons, they are INHIBITORY fibers which end on the deep Cerebellar Nuclei.
-the neurons leaving the Deep Cerebellar Nuclei have EXCITATORY actions on motor systems
3 major connections between the cerebellum and the motor sytems

1. Fastigial Nucleus
Efferents reach: the ______ via the superior cerebellar peduncle to influence reflexive movements of the eye, head and truck
And it reaches the _______ to influence movement of the limbs

2. Interposed Nucleus: Efferents communicate with the _______ to influence the output of the rubrospinal system.

3. Dentate Nucleus receives input from the _____ and communicates with the contralateral ventrolateral nucleus of the thalamus to influence cortical motor systems.
3 major connections between the cerebellum and the motor sytems

1. Fastigial Nucleus
Efferents reach: the MEDIAL VESTIBULAR NECLEUS via the superior cerebellar peduncle to influence reflexive movements of the eye, head and truck
And it reaches the LATERAL VESTIBULAR NUCLEUS to influence movement of the limbs

2. Interposed Nucleus: Efferents communicate with the CONTRALATERAL RED NUCLEUS to influence the output of the rubrospinal system.

3. Dentate Nucleus receives input from the LATERAL CEREBELLAR HEMISPHERES and communicates with the contralateral ventrolateral nucleus of the thalamus to influence cortical motor systems.
A lesion in the _______ will cause a disturbance in equilibrium related movements; nystagmus, tilted head, titubation, truncal ataxia.

A lesion of the ______ causes disturbances that affect posture and movement of limbs; ataxias of limbs (ipsilateral) and gait ataxia accompanies by lurching is common

a lesion of the ________ causes disturbances that affect accuracy and timing; ataxia, decomposition of movement, dysarthria (slurred monotonous speech), dyssynergia (uncoordination of the limbs), dysdiadokinesia, dysmetria, hypotonia, intention tremor, rebound phenomenon
A lesion in the VESTIBULO-CEREBELLUM will cause a disturbance in equilibrium related movements; nystagmus, tilted head, titubation, truncal ataxia.

A lesion of the SPINO-CEREBELLUM causes disturbances that affect posture and movement of limbs; ataxias of limbs (ipsilateral) and gait ataxia accompanies by lurching is common

a lesion of the CEREBRO-CEREBELLUM causes disturbances that affect accuracy and timing; ataxia, decomposition of movement, dysarthria (slurred monotonous speech), dyssynergia (uncoordination of the limbs), dysdiadokinesia, dysmetria, hypotonia, intention tremor, rebound phenomenon
Cerebellar lesions predict deficits:

a ____ more common in children, motor loss - broadbase stance, impaired tandem walking, hypotonia, nystagmus, truncal ataxia --- also headache, hydrocephalus, ICP, nausea vomiting

In a cerebellar stroke the ____ is usually implicated, motor signs include dysarthia, dyssnergia, dysmetria, dysdiaokinesia, intenion tremor (ipsilatateral), limb ataxia ipsi, truncal ataxia,

a ___ deficiency is linked to degeneration of the anterior vermis and remaining anterior cerebellar lobe. alcoholics are at risk
cortical purkinje fibers degenerate, motor signs of the ____ are dysmetria and truncal ataxia
Cerebellar lesions predict deficits:

a TUMOR more common in children, motor loss - broadbase stance, impaired tandem walking, hypotonia, nystagmus, truncal ataxia --- also headache, hydrocephalus, ICP, nausea vomiting

In a cerebellar stroke the VERTEBRAL ARTERIAL SYSTEM iis usually implicated, motor signs include dysarthia, dyssnergia, dysmetria, dysdiaokinesia, intenion tremor (ipsilatateral), limb ataxia ipsi, truncal ataxia,

a VITAMIN B 1 deficiency is linked to degeneration of the anterior vermis and remaining anterior cerebellar lobe. alcoholics are at risk
cortical purkinje fibers degenerate, motor signs of the LEGS AND TRUNK are dysmetria and truncal ataxia
autosomal recessive, widespread degernation of purkinje fibers of the cerebellum, compromised immune function, delayed motor skils, MILESTONES delayed - walking, talking, facial and ocular movements, skin and eyes espress small dilated blood vessels
LOUIS BAR SYNDROME
autosomal recessive, widespread degernation of purkinje fibers of the cerebellum, compromised immune function, delayed motor skils, MILESTONES delayed - walking, talking, facial and ocular movements, skin and eyes espress small dilated blood vessels
Lesions of the posterior lobe are thought to correlate with failures of cognitive and emotional systems, leading to emotional blunting and depression, disinhibition, psychotic features --- dysmetria of thought
CEREBELLAR COGNITIVE AFFECTIVE SYNDROME
CCAS
Lesions of the posterior lobe are thought to correlate with failures of cognitive and emotional systems, leading to emotional blunting and depression, disinhibition, psychotic features --- dysmetria of thought
Stretch Reflex:
1. in response to passive muscle ___ indicates ___
2. ___ fibers from the spindle directly stimulate alpha motor fiber to ___ the stretched muscle
3. __ fibers also stimulate inhibitory interneurons that eventually inhibit the alpha motor neuron on the ___ muscle
Negative Feedback loop:
The stretch reflex works as a negative feedback loop to maintain muscle ___ that is desired

___ are responsible for contracting the ends of the muscle spindle to keep its length identical to the muscle fibers in an effort to maintain monitoring of the muscle length at all times
Stretch Reflex:
1. in response to passive muscle STRETCHING indicate POSTURE
2. 1-A fibers from the spindle directly stimulate alpha motor fiber to CONTRACT the stretched muscle
3. 1-A fibers also stimulate inhibitory interneurons that eventually inhibit the alpha motor neuron on the ANTAGONIST muscle

Negative Feedback loop:
The stretch reflex works as a negative feedback loop to maintain muscle LENGTH that is desired
GAMMA MOTOR NEURONS are responsible for contracting the ends of the muscle spindle to keep its length identical to the muscle fibers in an effort to maintain monitoring of the muscle length at all times
SEGMENT ___ MUSCLE __ FUNCTION __

1. C 3,4,5
2. C 5
3. C 5,6
4. C 6,7
5. C 7,8
6. C 8
7. C 8, T1
8, L 2,3
9. L 2,3,4
10. L5, S1
11. S1,2
12, S 2,3,4
SEGMENT ___ MUSCLE __ FUNCTION __

1. C 3,4,5 DIAPHRAGM INSPIRATION
2. C 5 DELTOID SHOULDER ABBDUCTION
3. C 5,6 BICEPS BRACHII, BRACHIALIS, ELBOW FLEXION
4. C 6,7 extensor carpi, radialis longus, brevis WRIST EXTENSION
5. C 7,8 TRICEPS BRACHII, ELBOW EXTENSION
6. C 8 FLEXOR DIGITORUM SUPERFICIALIS, PROFUNDUS FINGER FLEXION
7. C 8, T1 INTEROSSI FINGER AB & ADDUCTION
8, L 2,3 ADDUCTOR LONGUS AND BREVIS THIGH ADDUCTION
9. L 2,3,4 quadirceps KNEE EXTENSION
10. L5, S1 EXTENSOR HALLICUS LONGUS GREAT TOE EXTENSION
11. S1,2 GASTROCENEMIUS, SOLEUS ANKLE PLANTAR FLEXION
12, S 2,3,4 SPHINCTER NUI EXTERNUS ANAL CONTRACTION
scale for reflex testing

__ very brisk, hyperactive, with clonus
__ brisker than average
__ average
__ somewhat diminished
__ no response
scale for reflex testing

4__ very brisk, hyperactive, with clonus
3__ brisker than average
2__ average
1__ somewhat diminished
0__ no response
GOLGI TENDON INVERSE STRETCH REFLEX

1. golgi tendon is located between ___ and ___ and is sensitive to ___
2. golgi tendon is innervate by a __ axon that is large mylinated with __ velocity. Only when the golgi tendon ___ does it lose it's mylination.
3. Compression of the _____ will increase firing rate of the axon
PHYSIOLOGICAL RESPONSE
1. increasing the ___ firing will increase inhibition on the ___
2. this will ensure even distribution of ____ and ____ and avoid excessive ___ to the point of damage
3. this is known as the ___
GOLGI TENDON INVERSE STRETCH REFLEX

1. golgi tendon is located between TENDON and EXTRAFUSAL FIBER and is sensitive to TENSION
2. golgi tendon is innervate by a 1B axon that is large mylinated with HIGH velocity. Only when the golgi tendon ENTERS THE MUSCLE FIBER does it lose it's mylination.
3. Compression of the FREE NON-MYELINATED ENDINGS will increase firing rate of the axon

PHYSIOLOGICAL RESPONSE
1. increasing the 1B AXON_ firing will increase inhibition on the _ALPHA MOTOR NEURON
2. this will ensure even distribution of TENSION____ and CONTRACTION____ and avoid excessive ___CONTRACTION to the point of damage
3. this is known as the INVERSE MYOTATIC REFLEX
PRIMARY FUNCTION OF GOLGI TENDON:
1.Posture - via the __ tendon and __ muscles.
When the muscle relaxes there is less tension and the ____ is removed. The muscle will then contract to maintain proper posture
PRIMARY FUNCTION OF GOLGI TENDON:
1.Posture - via the PATELLAR tendon and QUADRICEP muscles.
When the muscle relaxes there is less tension and the _INHIBITION is removed. The muscle will then contract to maintain proper posture
Flexion Reflex: aka the ____reflex
this is in response to ____ stimulii, causing rapid flexion as a ___ mechanism
-___ afferents (_ & _ fibers) will stimulate excitatory interneurons that will then synapse on ___ to flex the necessary muscle
Flexion Reflex: aka the WITHDRAW reflex
this is in response to _PAINFUL_ stimulii, causing rapid flexion as a PROTECTIVE_ mechanism
-__PAIN_ afferents (A DELTA & C fibers) will stimulate excitatory interneurons that will then synapse on _ALPHA MOTOR NEURONS_ to flex the necessary muscle
FLEXION CROSSED EXTENSION REFLEX
- associated with ___limb
-support the -- leg to maintain balance if flexion reflex causes -- leg to lift

Ipsilateral flexor--- and extensor ---
Contralateral flexor -- and extensor --
FLEXION CROSSED EXTENSION REFLEX
- associated with _CONTRALATERAL_limb
-support the CONTRALATERAL leg to maintain balance if flexion reflex causes -IPSITLATERAL- leg to lift

Ipsilateral flexor-STIMULATION- and extensor -INHIBITION-
Contralateral flexor -INHIBITION- and extensor -STIMULATION-
Plantar Response

External portion of the sole is stimulated from __ to __
__ = good
__ = bad

Positive Babinski indicates ___ damage to the spinal cord (thoracic or lumbar) or brain disease to the ____ tract
Newborns have immature tracts so they have non pathological plantar responses
Plantar Response

External portion of the sole is stimulated from _HEAL _ to _TOE_
_FLEXION_ = good
_FANNING_ = bad

Positive Babinski indicates _UPPER MOTOR NEURON LESION__ damage to the spinal cord (thoracic or lumbar) or brain disease to the _CORTICOSPINAL_ tract
Newborns have immature tracts so they have non pathological plantar responses
the Posterior spinal artery is a branch of ____

PICA is a branch of

Anterior Spinal is a branch of

SCA is a branch of ___ and supplies

AICA is a branch of near CN?

Labyrinth is a branch of -- near CN ? and travels near?

PCA is just rostal to CN ?
the Posterior spinal artery is a branch of PICA OR VERTEBRAL

PICA is a branch of VERTEBRAL

Anterior Spinal is a branch of VERTEBRAL

SCA is a branch of BASILAR and supplies superior cerebellar peduncles, caudal midbrain, superior vermis and cerebellar hemispheres

AICA is a branch of BASILAR near CN VI

Labyrinth is a branch of AICA or BASILAR near CN VII and VIII travells to INNER EAR


PCA is just rostal to CN III
Caudal Medulla:

VentroMedial portion receives blood from: ___ supplying the ___

Ventrolateral portion receives blood from __serving the __ system

Distal portion receives blood from - which has the __ and ___
Caudal Medulla:

VentroMedial portion receives blood from: ANTERIOR SPINAL supplying the PYRAMIDS

Ventrolateral portion receives blood from _VERTEBRAL AND PICA_serving the _ALS_ system

Distal portion receives blood from POSTERIOR SPINAL ARTERY which has the _NUCLEUS GRACILIS AND CUNATE_ and _DORSAL COLUMNS_
Rostral Medulla
Blood supply:

Ventromedial
Ventrolateral

*structural change - appearance of the ___ medial to CN __ __ __and lateral to __

Dorsolateral ___ which supplies the ___
Rostral Medulla
Blood supply:

Ventromedial - ANTERIOR SPINAL
Ventrolateral VERTEBRAL

*structural change - appearance of the _OLIVE_ medial to CN _IX_ _X_ _XI_and lateral to _XII_

Dorsolateral _PICA__ which supplies the _INFEREIOR CEREBELLAR PEDUNCLE_
PONS blood supply:

Midline:____ supplies the __ and ___ fibers

Lateral Tissue ___ & ___
with the __ supplying the middle cerebellar peduncle

Superior Cerebellar Peduncle receives most of its blood supply from ___ which supplies the dorsolateral part of the pons
PONS blood supply:

Midline:_PARAMEDIAN BRANCHES supplies the _CORTICOSPINAL_ and _CORTICOBULBAR_ fibers

Lateral Tissue _SHORT_ & _LONG CIRCUNFRENTIAL_
with the _LONGER BRANCHES_ supplying the middle cerebellar peduncle

Superior Cerebellar Peduncle receives most of its blood supply from _SUPERIOR CEREBELLAR ARTERY__ which supplies the dorsolateral part of the pons
MIDBRAIN blood supply

except for the most caudal portions of the midbrain which are supplied by the ___
the majority of the midbrain is supplied by ______

the ___ of the ___ supply the ventromedial midbrain

and the _____ supply the ventrolateral midbrain

___ supplies the dorsolateral midbrain
MIDBRAIN blood supply

except for the most caudal portions of the midbrain which are supplied by the _SUPERIOR CEREBELLAR ARTERY_
the majority of the midbrain is supplied by _POSTERIOR CEREBRAL ARTERY_

the _THALAMOPERFORATE BRANCHES_ of the _POSTERIOR CEREBRAL ARTERY__ supply the ventromedial midbrain

and the _POSTERIOR MEDIAL CHOROIDAL_ supply the ventrolateral midbrain

_QUADRIGEMINAL supplies the dorsolateral midbrain
MEDULLA - MEDIAL MEDULLARY SYNDROME

Artery Affected:
WHAT TYPE OF MOTOR NEURON SYNDROME?
Affected__ : cause__ (contralateral or ipsilateral)
Pyramids : ____
Medial Leminiscus: ____
Hypoglossal Nerve
MEDULLA - MEDIAL MEDULLARY SYNDROME

Artery Affected: ANTERIOR SPINAL ARTERY

UMN SYNDROME

Affected__ : cause__ (contralateral or ipsilateral)
Pyramids : CONTRALATERAL_PARESIS_
Medial Leminiscus: _CONTRALATERAL LOSS OF SOMATOSENSATION_
Hypoglossal Nerve: IPSILATERAL DEVIATION OF THE TONGUE (WEAKNESS)
MEDULLA - LATERAL MEDULLARY SYNDROME aka ___

Artery Affected:
WHAT TYPE OF MOTOR NEURON SYNDROME?
Affected__ : cause__ (contralateral or ipsilateral)

1. Spinal nucleus of Trigeminal Nerve:
2. ALS system
3. Efferents of Nucleus Ambiguous
4. Horner Syndrome
5. Ataxia
MEDULLA - LATERAL MEDULLARY SYNDROME aka _WALLENBERG SYNDROME_

Artery Affected: PICA
WHAT TYPE OF MOTOR NEURON SYNDROME?
UMN

Affected__ : cause__ (contralateral or ipsilateral)

1. Spinal nucleus of Trigeminal Nerve: IPSILATERAL FACIAL ANESTHESIA/ THERMANESTHESIA (mouth, eyes, nose)
2. ALS system : CONTRALATERAL ANESTHESIA / THERMANESTHESIA
3. Efferents of Nucleus Ambiguous: DYSPHAGIA/DYSARTHIA (mouth)
4. Horner Syndrome - IPSILATERAL
5. Ataxia IPSILATERAL
MIDBRAIN SYNDROME (VENTROMEDIAL) aka ___

Artery Affected:

WHAT TYPE OF MOTOR NEURON SYNDROME?
Affected__ : cause__ (contralateral or ipsilateral)

1. Corticospinal fibers:
2. Corticobulbar fibers
3. Corticobulbar fibers
4. Corticobulbar fibers
5. CN III
MIDBRAIN SYNDROME aka _WEBER SYNDROME__

Artery Affected: THALAMOPERFORATE BRANCHES OF POSTERIOR CEREBRAL

WHAT TYPE OF MOTOR NEURON SYNDROME? UMN
Affected__ : cause__ (contralateral or ipsilateral)

1. Corticospinal fibers: CONTRALATERAL PARESIS, MOSTLY UPPER BODY
2. Corticobulbar fibers: IPSISLATERAL DEVIATION OF EYES
3. Corticobulbar fibers: CONTRALATERAL FACIAL PARESIS
4. Corticobulbar fibers: CONTRALATERAL LINGUAL PARESIS
5. CN III : IPSILATERAL OPTHALMOPLEGIA (ptosis, dilation
PONS SYNDROME aka ___

Artery Affected:

WHAT TYPE OF MOTOR NEURON SYNDROME?
Affected__ : cause__ (contralateral or ipsilateral)

1. infra-mesencephalic corticospinal and corticobulbar fibers:
2. SECONDARY COMPLICATIONS:
PONS SYNDROME aka _LOCKED IN SYNDROME__

Artery Affected: VENTROMEDIAL BASILAR BRANCHES

WHAT TYPE OF MOTOR NEURON SYNDROME?
Affected__ : cause__ (contralateral or ipsilateral)

1. infra-mesencephalic corticospinal and corticobulbar fibers: BILATERAL PARALYSIS - ONLY PRESERVATION OF VERTICAL MOVEMENTS OF EYE, SENSORY AND COGNITION MAY BE ENTIRELY LOST

SECONDARY COMPLICATIONS: RESPIRATORY INFECTION AND DEEP VEIN THROMBOSIS CAUSE DEATH
MIDBRAIN SYNDROME MEDIAL

Artery Affected:

WHAT TYPE OF MOTOR NEURON SYNDROME?
Affected__ : cause__ (contralateral or ipsilateral)

1. Red Nucleus:
2. Substantia Nigra:
3. CN III
4. Medial Lemniscus
5. Crus Cerebri
MIDBRAIN SYNDROME MEDIAL

Artery Affected: THALAMOPERFORATE, POSTERIOR MEDIAL CHOROIDAL AND QUADRIGEMINAL OF PCA

WHAT TYPE OF MOTOR NEURON SYNDROME?
Affected__ : cause__ (contralateral or ipsilateral)

1. Red Nucleus: CONTRALATERAL CHOREA
2. Substantia Nigra: CONTRALATERAL TREMOR
3. CN III - IPSILATERAL
4. Medial Lemniscus : CONRALATERAL SOMATOSENSORY LOSS
5. Crus Cerebri - CONTRALATERAL PARESIS
___ used to measure the speed of electrical conduction through a nerve -
-to detect a deficit
-determine damage
-determine if destruction exists
NEVER CONDUCTION VELOCITY TEST_ used to measure the speed of electrical conduction through a nerve -
-to detect a deficit
-determine damage
-determine if destruction exists
In an NCV TEST for Motor:

The first stimulator is placed:__
The second stimulator is placed: __
the recorder is placed __

The __ nerve is tested for time it takes for the stimulus to go between T2 and T1
To find the Velocity the equation is:
In an NCV TEST for Motor:

The first stimulator is placed: AT THE CUBITA FOSSA
The second stimulator is placed: ON THE PALMAR ASPECT OF THE WRIST
the recorder is placed ON THE ABDUCTOR BREVIS MUSCLE

The _MEDIAN_ nerve is tested for time it takes for the stimulus to go between T2 and T1
To find the Velocity the equation is:
D/(T2-T1)
In an NCV TEST for Sensory:

The stimulator is placed:__
The first recorder is placed: __
the second recorder is placed __

The __ nerve is tested for time it takes for the stimulus to go between T2 and T1
To find the Velocity the equation is:
In an NCV TEST for Sensory:

The stimulator is placed:_ON THE INDEX FINGER_
The first recorder is placed: _PALMAR ASPECT OF THE WRIST_
the second recorder is placed _CUBITAL FOSSA_

The _MEIDAN_ nerve is tested for time it takes for the stimulus to go between T2 and T1
To find the Velocity the equation is:
D/(T2-T1)
Conduction Velocity Measurements:
options: change, not change, (motor or sense) slowing of motor, slowing of sensory

a. Motor Neuron Soma: (2)

b. Peripheral Nerve (3)

c. NMJ and or Muscle (1)
Conduction Velocity Measurements:
options: change, not change, slowing of motor, slowing of sensory

a. Motor Neuron Soma: (2)
1. little or no change in motor
2. no change in sensory

b. Peripheral Nerve (3)
Compression= slowing of motor and sensory
*Demylination = marked slowing of motor and sensory
Mild Axon degeneration slight/no change

c. NMJ and or Muscle (1)
NO CHANGE IN MOTOR OR SENSORY
Mechanical trauma to the nerve:
damage of peripheral nerves develops from the ___ to ___ structures

the ___ is the most vulnerable part of the peripheral nerve - and the ___ is the most resistant
Mechanical trauma to the nerve:
damage of peripheral nerves develops from the INNER to OUTER structures

the AXON is the most vulnerable part of the peripheral nerve - and the EPINEURIUM is the most resistant
Carpal Tunnel Syndrome:
The cause is a compression on the ___ nerve.
The Carpal Tunnel contains two tendons of __ & ___ and __ nerve

causes difficult in handling objects and muscular atrophy of the ___ this is a __ syndrome
Carpal Tunnel Syndrome:
The cause is a compression on the MEDIAN nerve.
The Carpal Tunnel contains two tendons of FLEXOR POLLICIUS LONGUS & LONG FINGER FLEXORS and MEDIAN nerve

causes difficult in handling objects and muscular atrophy of the THENAR EMINENCE this is a LMN syndrome
TYPES OF AXOTOMY:

1. ___ degeneration of the distal part of the axon
2. ___ degeneration of the distal nerves
3. ___ degeneration of the proximal nerves
TYPES OF AXOTOMY:

1.WALLERIAN degeneration of the distal part of the axon
2. ANTEROGRADE TRANSNEURAL degeneration of the distal nerves
3. RETROGRADE TRANSNEURAL degeneration of the proximal nerves
Regeneration and regrowth of ___ nerves
1. after dissection of a peripheral nerve the ___end sprouts
2. one of the sprouts will find the guide tube that is created by the ____ and the axon will continue to grow
3. this is facilitated by ____, __ and ___
4. The newly grown axon will then be re-myelinated by the new ___
Regeneration and regrowth of PNS nerves
1. after dissection of a peripheral nerve the TERMINAL end sprouts
2. one of the sprouts will find the guide tube that is created by the SCHWANN CELLS and the axon will continue to grow
3. this is facilitated by NERVE GROWTH FACTOR, LAMININ and ADHESION MOLECULES
4. The newly grown axon will then be re-myelinated by the new SCHWANN CELLS
3 REASONS REGENERATION OF NEURONS DOESNT OCCUR IN CNS

1. ____ do not release nerve growth factor
2. astrocytes multiply in regions of truama which create ____ and stop the development of axonal sprouts which is known as ____
3. inhibitor chemical messengers are released in the CNS that opposes ____
3 REASONS REGENERATION OF NEURONS DOESNT OCCUR IN CNS

1. OLIGODENDROCYTES do not release nerve growth factor
2. astrocytes multiply in regions of truama which create GLIAL SCARS and stop the development of axonal sprouts which is known as GLIOSIS
3. inhibitor chemical messengers are released in the CNS that opposes AXONAL REGENERATION IN ADULTS
REINNERVATION of Denervated Skeletal Muscle:
1. following nerve damage, motor axons regenerate and form new ___ usually at the same place as before
2. the ___ is responsible for differentiating the growth cone into the nerve terminal
3. ____ seen in synaptic basal lamina
4. ___ seen in extrasynaptic basal lamina
REINNERVATION of Denervated Skeletal Muscle:
1. following nerve damage, motor axons regenerate and form new NMJ'S usually at the same place as before
2. the BASAL LAMINA is responsible for differentiating the growth cone into the nerve terminal
3. LAMININ-11 seen in synaptic basal lamina
4. LAMNIN-2 seen in extrasynaptic basal lamina
PERIPHERAL NEUROPATHY

1. ____ acute idiopathic neuritis, caused by nerve inflammation and results in muscle weakness and paralysis.Increase in Protein content of CSF
Treatment ___ & _____
2. ____ is an infectious disease caused by ____; characterized by skin lesions and peripheral nerve damage, long incubation period. Sensory loss in the skin & muscle weakness. Also may reflect loss of protective nociception
Treatment:___

3. ______ caused by neurotoxic effect of alcohol or associated nutritional (thiamin) deficiencies; numbness, tingling, burning feet, and weakness. Sensory and motor losses are symmetric - starts distal to proximal (foot --> leg -> trunk)

4. ____ children more vulnerable to toxicity. May lead to encephalopathy with diminished IQ, attentional problems, and learning disabilities - high levels can result in mental retardation, coma or death. In adults - may cause memory and concentration problems and peripheral motor neuropathy

5. ____ functional losses include sensation, motor and autonomic - begin in legs and ascend - reflect abnormalities of unmyelinated axons carrying pain and temperature in a 'stocking distribution'.... complicated with ___ vasculopathies
PERIPHERAL NEUROPATHY

1. GUILLIAN BARRE acute idiopathic neuritis, caused by nerve inflammation and results in muscle weakness and paralysis.Increase in Protein content of CSF
Treatment IMMUNO GLOBULIN IV & PLASMAPHORESIS
2. LEPROSY is an infectious disease caused by MYOBACTERIUM LEPRAE; characterized by skin lesions and peripheral nerve damage, long incubation period. Sensory loss in the skin & muscle weakness. Also may reflect loss of protective nociception
Treatment:ANTIBIOTICS

3. ALCOHOL POLYNEUROPATHY caused by neurotoxic effect of alcohol or associated nutritional (thiamin) deficiencies; numbness, tingling, burning feet, and weakness. Sensory and motor losses are symmetric - starts distal to proximal (foot --> leg -> trunk)

4. LEAD POISONING children more vulnerable to toxicity. May lead to encephalopathy with diminished IQ, attentional problems, and learning disabilities - high levels can result in mental retardation, coma or death. In adults - may cause memory and concentration problems and peripheral motor neuropathy

5. DIABETES MELLITUS functional losses include sensation, motor and autonomic - begin in legs and ascend - reflect abnormalities of unmyelinated axons carrying pain and temperature in a 'stocking distribution'.... complicated with DIABETIC vasculopathies
_____ contributes to homeostasis; maintaining internal environment WITHOUT voluntary control.

Hypothalamus - is the control center for most basic life processes aka the ____
Neuronal input containing visceral sensory info about the ____ enters the CNS via spinal nerves or cranial nerves. First they hit the __ nucleus before reaching the hypothalamus

Humoral input is receives through the ____which have fenestrated capillaries and lack a blood brain barrier, can detect chemical changes in blood and relay info to internal regulating system
ANS contributes to homeostasis; maintaining internal environment WITHOUT voluntary control.

Hypothalamus - is the control center for most basic life processes aka the COMPARATOR
Neuronal input containing visceral sensory info about the CONTROLLED VARIABLE enters the CNS via spinal nerves or cranial nerves. First they hit the SOLITARY nucleus before reaching the hypothalamus

Humoral input is receives through the CIRCUMVENTRICULAR ORGANS which have fenestrated capillaries and lack a blood brain barrier, can detect chemical changes in blood and relay info to internal regulating system
DIVISIONS OF ANS:
1. ____ concerned with fight or flight
2. _____ concerned with rest and digest
3. ___ formed by 2 layers of ganglia in the GIT; each plexus receives sensory info from the ___ and modulate their respective task
- may work with PNS and SNS
-____ between longitudinal and circular smooth muscle, responsible for gut motility
-____ adjacent to mucosal epithelium; responsible for water/ion transport and digestive juice secretion
DIVISIONS OF ANS:
1. SNS concerned with fight or flight
2. PNS concerned with rest and digest
3. ENTERIC formed by 2 layers of ganglia in the GIT; each plexus receives sensory info from the GUT WALL and modulate their respective task
- may work with PNS and SNS
-MYENTERIC (AUERBACH) between longitudinal and circular smooth muscle, responsible for gut motility
-SUBMUCOSAL adjacent to mucosal epithelium; responsible for water/ion transport and digestive juice secretion
EFFERENTS -- WHICH:

The ___ neuron is the output element of the somatic efferent's - cell bodies are located in___ in either ____ or ____. Axons are ___ and run in peripheral nerves. They uses ___ as an NT which binds to receptors called___.

Sympathetic First order neuron cell bodies are located in the ___ the axons are ___ and run in the peripheral nervous system, the NT is ___ and target receptors are ___ these are ___ sized neurons. Second order neurons (postganglionic) are ___ in length, they use ___ as a NT and their final targets are smooth muscle, cardiac muscle, and gland cells that have ___ receptors

Paraympathetic First order neuron cell bodies are located in the ___ the axons are ___ and run in the peripheral nervous system, the NT is ___ and target receptors are ___ these are ___ sized neurons. Second order neurons (postganglionic) are ___ in length, they use ___ as a NT and their final targets are smooth muscle, cardiac muscle, and gland cells that have ___ receptors
EFFERENTS -- WHICH:

The MOTOR neuron is the output element of the somatic efferent's - cell bodies are located in CNS in either MOTOR NUCLEI OF CRANIAL NERVES or ANTERIOR HORN OF GRAY MATTER OF SPINAL CORD. Axons are MYELINATED and run in peripheral nerves. They uses ACETYLCHOLINE as an NT which binds to receptors called NICOTINIC RECEPTORS.

Sympathetic First order neuron cell bodies are located in the CNS the axons are MYELINATED and run in the peripheral nervous system, the NT is ACETYLCHOLINE and target receptors are NICOTNIC these are SHORT sized neurons. Second order neurons (postganglionic) are LONGER in length, they use NOREPINEPHRINE as a NT and their final targets are smooth muscle, cardiac muscle, and gland cells that have _ADRENERGIC_ receptors

Parasympathetic First order neuron cell bodies are located in the CNS the axons are MYELINATED and run in the peripheral nervous system, the NT is ACETYLCHOLINE and target receptors are NICOTINC these are LONG sized neurons. Second order neurons (postganglionic) are SHORTER in length, they use ACETYLCHOLINE as a NT and their final targets are smooth muscle, cardiac muscle, and gland cells that have MUSCARINIC receptors
Sympathetic Pathways:
Preganglionic fibers leave the ____ column of the spinal grey matter via ___. Fibers enter either the ____ or the _____.
Postganglionic fibers leave their ganglia to their target tissue.
One exception is when preganglionics leave the spinal cord and synapse directly on the ____; it acts as a second order enuron and releases ___ into the blood. This makes any adrenergic receptor in the entire body reactable to the sympathetic nervous system
Sympathetic Pathways:
Preganglionic fibers leave the INTERMEDIOLATERAL column of the spinal grey matter via _VENTRAL ROOTS_. Fibers enter either the _PARAVERTEBRAL_ or the _PREVERTEBRAL_.
Postganglionic fibers leave their ganglia to their target tissue.
One exception is when preganglionics leave the spinal cord and synapse directly on the _ADRENAL MEDULLA_; it acts as a second order neuron and releases EPINEPHRINE into the blood. This makes any adrenergic receptor in the entire body reactable to the sympathetic nervous system
Parasympathetic Pathways:
preganglionic fibers originiate in ____ or ___; there are distinct parasympathetic ganglia: ___, __, __,___.
Other than these four ganglia post ganglionic fibers originate in terminal ganglia that are found _____
Parasympathetic Pathways:
preganglionic fibers originiate in BRAINSTEM CRANIAL NERVES or IN THE SPINAL CORD; there are distinct parasympathetic ganglia: , CILIARY, PTERYGOPALATINE, OTIC, SUBMANDIBULAR GANGLIA
Other than these four ganglia post ganglionic fibers originate in terminal ganglia that are found ON THE WALL OF THE TARGET ORGAN
CNS ORIGIN, Paravertebral Sympathetic Gangli OR Prevertebral - target

T1-T2 --PARAvertebral ___ Target ___

T2-T6: Para____ Target ____
T6-L1 Pre___ Target____
T9-L1 Para ___ Target____
T10-T11 Para ___ Target ____
T11-L1 Pre ___ Target ___
L1-L2 Pre ___ Target ___
CNS ORIGIN, Paravertebral Sympathetic Gangli OR Prevertebral - target

T1-T2 --PARAvertebral _SUPERIOR CERVICAL GANGLION_ Target DILATOR PUPILAE, FACE_

T2-T6: Para INFERIOR CERVICAL GANGLION_ Target UPPER EXTREMITIY, BRONCHIAL TREE MUSCLES, HEART_
T6-L1 Pre: CELIAC GANGLION Target_ LIVER, GI
T9-L1 Para _LUMBOSACRAL GANGLION_ Target_LOWER EXTREMEITIES_
T10-T11 Para _ADRENAL GLAND_ Target _ADRENAL GLAND
T11-L1 Pre _SUPERIOR MESENTERIC PLEXUS_ Target _GI_
L1-L2 Pre _INFERIOR MESENTERIC PLEXUS_ Target _RECTUM, BLADDER, REPRODUCTIVE ORGANS_
The Edinger Westphal Nucleus of CN __ has a distinct parasympathetic ganglion called ____ and the target organs are ____.

The Superior Salivatory Nucleus of CN __ has a distinct parasympathetic ganglion called __&__ and the target organs are ____

The inferior salivatory Nucleus of CN __ has a distinct parasympathetic ganglion called ____ and the target organs are ____

The Dorsal motor nucleus Nucleus of CN __ has a terminal parasympathetic ganglion called ____ and the target organs are ____

The S2-S4 __ has a terminal parasympathetic ganglion called ____ and the target organs are ____
The Edinger Westphal Nucleus of CN _III_ has a distinct parasympathetic ganglion called _CILIARY_ and the target organs are _CONSTRICTOR PUPILAE, CILIARY MUSCLE_.

The Superior Salivatory Nucleus of CN _VII_ has a distinct parasympathetic ganglion called _SUBMANDIBULAR_& _PTERYGOPALATINE_ and the target organs are _LACRIMAL GLAND, SUBLINGUAL GLAND AND SUBMANDIBULAR GLAND

The inferior salivatory Nucleus of CN _IX_ has a distinct parasympathetic ganglion called _OTIC_ and the target organs are _PAROTID GLAND_

The Dorsal motor nucleus Nucleus of CN _X_ has a terminal parasympathetic ganglion called _INTRAMURAL GANGLIA (INSIDE ORGAN WALLS)_ and the target organs are _BRONCHIAL TREE, HEART GI

The S2-S4 __ has a terminal parasympathetic ganglion called _INTRAMURAL GANGLIA_ and the target organs are _RECTUM, BLADDER, REPRODUCTIVE ORGANS
The dilator pupilae has a ___ receptor and responds to adrenergic impulses from the ___.
The constrictor pupilae responds to ____ impulses from the parasympathetic system
The dilator pupilae has a ALPHA 1 receptor and responds to adrenergic impulses from the __SYMPATHETICS_.
The constrictor pupilae responds to _CHOLINERGIC_ impulses from the parasympathetic system
Ciliary muscle has a ___ receptor and responds to ___ impulses from the __ system. (contraction for near vision)
The SA node has __ receptors that respond to adrenergic impulses that cause an _______; and cholinergic responses that cause a _____

The Atria/Ventricles have a___ receptor and respond to adrenergic impulses by ___ and cholinergic impulses by ____
Ciliary muscle has a _BETA 2__ receptor and responds to _CHOLINERGIC_ impulses from the _PARASYMPATHETIC_ system. (contraction for near vision)


The SA node has _BETA ONE_ receptors that respond to adrenergic impulses that cause an _INCREASE HEART RATE_; and cholinergic responses that cause a _DECREASE IN HEART RATE_

The Atria/Ventricles have a_BETA ONE__ receptor and respond to adrenergic impulses by _INCREASE IN CONTRACTILITY__ and cholinergic impulses by _DECREASE IN CONTRACTILITY_
The detrusor muscle has a ___ receptor and in response to adrenergic impulses it ___ and in response to cholinergic impulses it ____

The trigone and sphincter muscle has a ___ receptor and in response to adrenergic impulses it ___ and in response to cholinergic impulses it ____

The trachea and bronchial muscle has a ___ receptor and in response to adrenergic impulses it ___ and in response to cholinergic impulses it ____
The detrusor muscle has a _BETA TWO__ receptor and in response to adrenergic impulses it __RELAXES_ and in response to cholinergic impulses it _CONTRACTION_

The trigone and sphincter muscle has a _ALPHA ONE_ receptor and in response to adrenergic impulses it _CONTRACTS_ and in response to cholinergic impulses it _RELAXES_

SYMPATHETICS - RETAIN URINE, PARASYMPATHETICS - UNIRATE

The trachea and bronchial muscle has a _BETA 2__ receptor and in response to adrenergic impulses it _RELAXES_ and in response to cholinergic impulses it _CONTRACTS_
Atenolol has a ___ receptor and is an ____ and is used clinically for ___.

Salbutamol has a ___ receptor and is an ____ and is used clinically for ___.

Atropine has a ___ receptor and is an ____ and is used clinically for ___.
Atenolol has a _BETA1_ receptor and is an _ANTAGONIST_ and is used clinically for HYPERTENSION_.

Salbutamol has a _BETA 2_ receptor and is an _AGONIST_ and is used clinically for _ASTHMA (BRONCHODILATOR)_.

Atropine has a _MUSCARINIC_ receptor and is an ___ANTAGONIST_ and is used clinically for _MYDRIATIC, REDUCTION OF DROOLING IN PARKINSONS.
____ is a congenital disease characterized by deficiency of motility and peristalsis of the distal part of the colon due to lack of parasympathetic terminal ganglia - feces get trapped in large intestine causing abnormal dilation (megacolon)
_HIRSCHSPRUNG'S DISEASE (MEGACOLON)_ is a congenital disease characterized by deficiency of motility and peristalsis of the distal part of the colon due to lack of parasympathetic terminal ganglia - feces get trapped in large intestine causing abnormal dilation (megacolon)
___is a chronic neuropathic pain syndrome following injury of bone, soft tissue or nervous tissue; pain persists after apparent healing - sympathetic activity is likely to play a role in maintaining pain by an increase in activity or sensitization of nociceptors to NE, (postganglionic NT) increase in sympathetic activity can also lead to an increase in sweating.
_COMPLEX REGIONAL PAIN SYNDROME CRPS_is a chronic neuropathic pain syndrome following injury of bone, soft tissue or nervous tissue; pain persists after apparent healing - sympathetic activity is likely to play a role in maintaining pain by an increase in activity or sensitization of nociceptors to NE, (postganglionic NT) increase in sympathetic activity can also lead to an increase in sweating.
Hypothalamic Functions - there are 5 basic life processes
BBEER

Integration of three output pathways
Hypothalamic Functions - there are 5 basic life processes
BBEER
1. Blood Pressure and electrolyte composition
2. Body Temperature
3. Energy Metabolism
4. Reproduction
5. Emergency responses

Integration of three output pathways
1. autonomic function
2. endocrine function
3. motivation and behavior
Example of BP modulation via three hypothalamic pathways:
1. hypothalamus can influence the ___ to change BP via HR and contractility
2. ___ out put of they hypothalamus can modulate ADH release from the posterior pituitary to change BP via kidney reabsorption
3. Hypothalamus can influence ___ to either sit and rest or engage in exercise
Example of BP modulation via three hypothalamic pathways:
1. hypothalamus can influence the AUTONOMIC NS_ to change BP via HR and contractility
2. _ENDOCRINE OUTPUT_ out put of they hypothalamus can modulate ADH release from the posterior pituitary to change BP via kidney reabsorption
3. Hypothalamus can influence _MOTIVATIONAL SYSTEM_ to either sit and rest or engage in exercise
ENDOCRINE Function and chemical signalling:
1. ____ release by a species and travel through the air to reach their target cell on another individual of that species
2. ___ provide feedback to the releasing cell itself or its neighbors
3. ___ release hormone into the blood to reach their target
4. ___ transmitter released on target to elicit action
5. ___ a hybrid which releases their neurohormone into the blood, these are found in the hypothalamus and are connected to the anterior and posteirior pituitary
ENDOCRINE Function and chemical signalling:
1. _PHERMONES_ release by a species and travel through the air to reach their target cell on another individual of that species
2. _PARACRINE/ AUTOCRINE_ provide feedback to the releasing cell itself or its neighbors
3. _ENDOCRINE_ release hormone into the blood to reach their target
4. _NEURONS_ transmitter released on target to elicit action
5. _NEUROENDOCRINE_ a hybrid which releases their neurohormone into the blood, these are found in the hypothalamus and are connected to the anterior and posteirior pituitary
Structure of the hypothalamus:
1. the ____ zone is adjacent to the 3rd ventricle
2. the ___ zone contains most of the distinct nuclei of the hypothalamus
3. the ___ zone contains less defined nuclei but is rich in fiber tracts which connect the hypothalamus to other areas of the brain.
Structure of the hypothalamus:
1. the _PARAVENTRICULAR_ zone is adjacent to the 3rd ventricle
2. the _MEDIAL_ zone contains most of the distinct nuclei of the hypothalamus
3. the _LATERAL_ zone contains less defined nuclei but is rich in fiber tracts which connect the hypothalamus to other areas of the brain.
HYPOTHALAMO-ADENOHYPOPHYSEAL PATHWAY
Hypothalamic Control of the Anterior Pituitary
1. ____ neuroendocrine cells from the Parvoventricular and Arcuate nuclei terminate in the primary capillary plexus of the ____ which is in the ____
2. Neuroendocrine substances are released into the ____ which drains into the portal vein
3. The portal vein leads the blood flow toward the anterior pituitary and into a ______
4. Neurohormones controlling the anterior pituitary will either __ or ___ hormone release from the anterior pituitary.
HYPOTHALAMO-ADENOHYPOPHYSEAL PATHWAY
Hypothalamic Control of the Anterior Pituitary
1. _PARVOCELLULAR_ neuroendocrine cells from the Parvoventricular and Arcuate nuclei terminate in the primary capillary plexus of the _SUPERIOR HYPOPHYSEAL ARTERY_ which is in the _INFUNDIBULUM_
2. Neuroendocrine substances are released into the _PRIMARY CAPILLARY PLEXUS_ which drains into the portal vein
3. The portal vein leads the blood flow toward the anterior pituitary and into a _SECONDARY CAPILLARY PLEXUS_
4. Neurohormones controlling the anterior pituitary will either _INDUCE_ or _INHIBIT_ hormone release from the anterior pituitary.
HYPOTHALAMO-ADENOHYPOPHYSEAL PATHWAY
REGULATORY HYPOTHALAMIC HORMONES Anterior Pituitary

1. After hypothalamic stimulation the AP may release ___ (6) hormones
2. release dpeends on the hormone released by the hypothalamus
3. the more important is the response to ___ where __ causes a release of __- that acts on the adrenal cortex to release ___ into the blood which acts on various target cells
HYPOTHALAMO-ADENOHYPOPHYSEAL PATHWAY
REGULATORY HYPOTHALAMIC HORMONES Anterior Pituitary

1. After hypothalamic stimulation the AP may release _LH, FSH, ACTH, GH, PROLACTIN, TSH_ (6) hormones
2. release dpeends on the hormone released by the hypothalamus
3. the more important is the response to _STRESS_ where _CRH_ causes a release of _ACTH_- that acts on the adrenal cortex to release _CORTISOL_ into the blood which acts on various target cells
Hypothalamo-Neurohypopphyseal Pathway

Hypothalamic Control of the Posterior Pituitary
1. ____ neuroendocrine cells from the paraventricular and supraoptic nucleus send axons directly to the posterior pituitary so called the ____ tract
2. These neuroendocrine cells release their neurohormone into capillaries of the _____ thus entering circulation
3. Neurohomones now in the blood can reach their target tissues via circulation
Hypothalamo-Neurohypopphyseal Pathway

Hypothalamic Control of the Posterior Pituitary
1. _MAGNOCELLULAR neuroendocrine cells from the paraventricular and supraoptic nucleus send axons directly to the posterior pituitary so called the _SUPRAIOPTICO-HYPOPHYSEAL_ tract
2. These neuroendocrine cells release their neurohormone into capillaries of the _INFERIOR HYPOPHYSEAL ARTERY_ thus entering circulation
3. Neurohomones now in the blood can reach their target tissues via circulation
Hormones of the Posterior Pituitary

1. there are NO regulatroy hormones from hypothalamus as the Posterior Pituitary is controlled under direct ____
2. Two neurohormones of the posterior pituitary are:
___ that is a vasoconstrictor, and functions to ___ water in the kidney
___, helps with __ contraction and __ ejection
Hormones of the Posterior Pituitary

1. there are NO regulatroy hormones from hypothalamus as the Posterior Pituitary is controlled under direct _NEUROLOGIC CONNECTIONS_
2. Two neurohormones of the posterior pituitary are:
ADH_ that is a vasoconstrictor, and functions to _REABSORB_ water in the kidney
_OXYTOCIN_, helps with _UTERINE_ contraction and _EJECTION OF MILK_
Hypothalamus Regulation of feeding behavior:
1. the ___ decreases feeding behavior
2. the ___ increases feeding behavior

Feedback Mechanisms to control feeding behavior are:
1. Short term -
2. Long term -
Hypothalamus Regulation of feeding behavior:
1. the _VENTROMEDIAL NUCLEUS_ decreases feeding behavior
2. the _LATERAL HYPOTHALAMUS_ increases feeding behavior

Feedback Mechanisms to control feeding behavior are:
1. Short term - BLOOD GLUCOSE LEVELS
2. Long term - LEPTIN RELEASED FROM ADIPOSE WILL REACH THE ARCUATE NUCLEUS WHICH SENDS INHIBITORY INTERNEURONS TO THE LATERAL HYPOTHALAMUS TO SUPPRESS EATING.
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

1. Thyrotropin releasing hormone - ____ - _____
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

1. Thyrotropin releasing hormone - TSH - THYROID GLAND T3, T4 SECRETION
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

Corticotropin Releasing Hormone - ___ - ____
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

Corticotropin Releasing Hormone - ACTH - STEROID PRODUCTION IN THE ADRENAL CORTEX
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

Gonadotropin Releasing Hormone - __ & __ - ___& ___
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

Gonadotropin Releasing Hormone - LH & FSH - GAMETOGENESIS & SEX STEROID PRODUCTION IN GONADS
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

GHRH & Inhibiting hormone Somatostatin - __ - ___
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

GHRH & Inhibiting hormone Somatostatin - GROWTH HORMONE - LINEAR GROWTH
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

Prolactin Inhibiting Hormone (Dopamine) - __ - __
Hypothalamic Regulatory Hormone - Anterior Pituitary Hormone - Function

Prolactin Inhibiting Hormone (Dopamine) - PROLACTIN - LACTOGENESIS
Stress Response, fill-in

Hypothalamus -release __ --> ___ - release ACTH --> __ --> __ --> Physiological Stress Response --> ___
Stress Response, fill-in

Hypothalamus -release CRH--> ANTERIOR PITUITARY - release ACTH --> ADRENAL CORTEX --> CORTISOL --> Physiological Stress Response --> INSULIN
WATER BALANCE regulation via Hypothalamus

1. Information is received by the brain via two major inputs:
---- passes the BBB at the subfornical organ (circumventricular organs)
---sends BP info via mechanisenstive endings in the heart

Mechanism for Modulation:
-hypothalamus influences water conservation by eliciting __ to release __ as a neuroendocrine signal on the kidney.
-hypothalamus also sends neuronal input to our ----system to control the consumption of ---
WATER BALANCE regulation via Hypothalamus

1. Information is received by the brain via two major inputs:
ANGIOTENSIN- passes the BBB at the subfornical organ (circumventricular organs)
VAGUS NERVE--sends BP info via mechanisenstive endings in the heart

Mechanism for Modulation:
-hypothalamus influences water conservation by eliciting POSTERIOR PITUITARY to release ADH as a neuroendocrine signal on the kidney.
-hypothalamus also sends neuronal input to our -MOTIVATIONAL-system to control the consumption of WATER
Hypothalamic Regulation of Body Temperature:

Anterior Hypothalamus -___ body temperature; has temperature sensitive cells to detect body temp changes which is integrated with somatosensory temperature information.

Posterior Hypothalamus - ___ body temperature

Mechanism for Modulation
1. Temperature changes can be induced via the ___ which ___
2. Use signals to the ___ system to seek __
Hypothalamic Regulation of Body Temperature:

Anterior Hypothalamus -DECREASES body temperature; has temperature sensitive cells to detect body temp changes which is integrated with somatosensory temperature information.

Posterior Hypothalamus - INCREASES body temperature

Mechanism for Modulation
1. Temperature changes can be induced via the AUTONOMIC NERVOUS SYSTEM which CONTRICTS OR DILATES VESSELS
2. Use signals to the MOTIVATIONAL SYSTEM system to seek WARMER/COOLER PLACES
___ is a disorder of caloric balance causing obesity attributed to damage of the ventromedial nucleus

__ absence of ADH causes excessive thirst and urination (10 L/day) this may be due to a lesion of the SUPRAOPTIC or PARAVENTRICULAR Nuclei in the posterior Pituitary Tract

__ may be due to lesions of the posterior hypothalamus leaving the anterior hypothalamus unopposed; causes a decrease in metabolism and vasodilation causing a decrease in body temp

__ may be due to lesions of the anterior hypothalamus leaving the posterior hypothalamus unopposed - causes an increase in metabolism, shivering and vasoconstriction resulting in an increase in body temperature
VENTROMEDIAL HYPOTHALAMIC SYNDROME (FROHLICH SYNDROME) is a disorder of caloric balance causing obesity attributed to damage of the ventromedial nucleus

DIABETES INSIPIDUS absence of ADH causes excessive thirst and urination (10 L/day) this may be due to a lesion of the SUPRAOPTIC or PARAVENTRICULAR Nuclei in the posterior Pituitary Tract

HYPOTHERMIA may be due to lesions of the posterior hypothalamus leaving the anterior hypothalamus unopposed; causes a decrease in metabolism and vasodilation causing a decrease in body temp

HYPERTHERMIA may be due to lesions of the anterior hypothalamus leaving the posterior hypothalamus unopposed - causes an increase in metabolism, shivering and vasoconstriction resulting in an increase in body temperature
Autonomic Control of the Pupil:

1. Parasympathetics cause the pupil to ____
pathway: Midbrain --> ___ --->

2. Sympathetics cause the pupil to ___
* the ___ fibers from the ___ descend to the upper thoracic level of the spinal cord --> ___ ganglion and postganglionics to the pupil
Autonomic Control of the Pupil:

1. Parasympathetics cause the pupil to _CONSTRICT_
pathway: Midbrain --> _CILIARY GANGLION_ ---> SHORT CILIARY FIBERS

2. Sympathetics cause the pupil to _DILATE_
* the _HYPOTHALAMO-SPINAL_ fibers from the _HYPOTHALAMUS_ descend to the upper thoracic level of the spinal cord --> _SUPERIOR CERVICAL GANGLION_ ganglion and postganglionics to the pupil
Three levels of control of the urinary bladder:
1. __ above the tentorium cerebelli, bladder control originates in the frontal cortex (motor strip) and the hypothalamus
2. __ below the tentorium cerebelli, locations of the PONTINE MICTURITION CENTER, coordination of inhibition of symp and stimulation of parasympathetic to begin voiding
3. __, bladder is innervated by sympathetic efferents in lower thoracic and upper lumbar, and parasympathetics S2-4 and somatic efferents in sacral spinal cord segments
Three levels of control of the urinary bladder:
1. _SUPRATENTORIAL LEVEL_ above the tentorium cerebelli, bladder control originates in the frontal cortex (motor strip) and the hypothalamus
2. _POSTERIOR FOSSA_ below the tentorium cerebelli, locations of the PONTINE MICTURITION CENTER, coordination of inhibition of symp and stimulation of parasympathetic to begin voiding
3. _SPINAL CORD_, bladder is innervated by sympathetic efferents in lower thoracic and upper lumbar, and parasympathetics S2-4 and somatic efferents in sacral spinal cord segments
Sympathetic efferents are responsible for the relaxation of the __muscle and the constriction of the __ during the __ stage.

Parasympathetic efferents are responsible for __bladder phase by inducing a constriction of the __ and relaxation of the __.

Somatic Efferents (alpha motor neurons) control the __ muscle

** the influence of the __ is far more relevant for bladder control that the __
Sympathetic efferents are responsible for the relaxation of the _DETRUSOR_muscle and the constriction of the _INTERNAL SPINCTER_ during the _FILLING_ stage.

Parasympathetic efferents are responsible for _VOIDING_bladder phase by inducing a constriction of the _DETRUSOR_ and relaxation of the _INTERNAL SPHINCTER_.

Somatic Efferents (alpha motor neurons) control the _EXTERNAL SPHINCTER_ muscle

** the influence of the _PARASYMPATHETICS_ is far more relevant for bladder control that the __
once the bladder is full, sensory fibers innervating the bladder wall report the increase in pressure back to the spinal cord, and the higher centers such as the __

Afferent fibers synapse on the ___ _-ganglionic neurons in the spinal cord and activate them. __ output constricts the detrusor muscle and relaxes the internal sphincter
once the bladder is full, sensory fibers innervating the bladder wall report the increase in pressure back to the spinal cord, and the higher centers such as the _PONTINE MICTURITION CENTER & CEREBRAL CORTEX_

Afferent fibers synapse on the _PARASYMPATHETIC_ PRE_-ganglionic neurons in the spinal cord and activate them. _PARASYMPATHETIC_ output constricts the detrusor muscle and relaxes the internal sphincter
Reproductive organ control:

Male: preganglionic fibers pass through the __ and synapse in the __ ganglion; postganglionic reach their target and cause ejaculation -- in females it causes ___

__innervation of male and female reproductive organs originate in the sacral cord, preganlionic fibers run in the __ nerves, pass thorugh the __ plexus and synapse on postganglionic neurons in __ -> causing erection
Reproductive organ control:

Male: preganglionic fibers pass through the _SYMPATHETIC CHAIN_ and synapse in the _INFERIOR MESENTERIC_ ganglion; postganglionic reach their target and cause ejaculation -- in females it causes _CONTRACTION OF THE UTERUS_

_PARASYMPATHETIC_innervation of male and female reproductive organs originate in the sacral cord, preganlionic fibers run in the _PELVIC_ nerves, pass thorugh the _HYPOGASTRIC_ plexus and synapse on postganglionic neurons in _ORGAN WALL_ -> causing erection
__ changes in a circadian patter, with higher __ during the __ and lower during __

The circadian clock is __ , with an average of roughly __ hrs per day if the __ cues are not available
_BODY TEMPERATURE_ changes in a circadian patter, with higher _TEMPERATURES_ during the _DAY_ and lower during _SLEEP_

The circadian clock is _SLOW_ , with an average of roughly _25_ hrs per day if the _ZEITGEBER_ cues are not available
the reseting mechanism of the circadian clock involves the __cells of the __. These cells send their signals along the axons of the ___ via the __ tract to the __ nucleus of the hypothalamus.

under normal conditions the circadian clock is reset every morning at the onset of light through the activity of the ___ tract fibers
the reseting mechanism of the circadian clock involves the _LIGHT SENSITIVE_cells of the _RETINA_. These cells send their signals along the axons of the _RENTINAL GANGLION CELLS_ via the _RETINO-HYPOTHALAMIC_ tract to the _SUPRACHIASMATIC_ nucleus of the hypothalamus

under normal conditions the circadian clock is reset every morning at the onset of light through the activity of the __RETINOHYPOTHALAMIC_ tract fibers
Output pathway of the circadian clock system includes neuronal and humoral pathways
Neuronal signals that originate in the __ nucleus control the synthesis and release of __, the dark hormone - produced by the __ gland

Humoral output may also include a rhythmic secretion pattern of ADH from the __ nucleus of the hypothalamus
Output pathway of the circadian clock system includes neuronal and humoral pathways
Neuronal signals that originate in the _SUPRACHIASMATIC_ nucleus control the synthesis and release of _MELATONIN_, the dark hormone - produced by the _PINEAL_ gland

Humoral output may also include a rhythmic secretion pattern of ADH from the _SUPRACHIASMATIC_ nucleus of the hypothalamus
Horner's Syndrome:
unilateral __, with __ and facial __

the three types of fibers that can be affected are:
1. central lesions that affect the __ pathway
2. __ lesions - compression of the sympathetic chain by a ___ tumor
3. __ lesions at the level of the __ (or tumor in the __ sinus)
Horner's Syndrome:
unilateral __, with __ and facial __

the three types of fibers that can be affected are:
1. central lesions that affect the _HYPO-THALAMOSPINAL_ pathway
2. _PREGANGLIONIC_ lesions - compression of the sympathetic chain by a _PANCOST_ tumor
3. _POSTGANGLIONIC_ lesions at the level of the _INTERNAL CAROTID ARTERY_ (or tumor in the _CAVERNOUS_ sinus)
__ Bladder - afferent activity is not sensed at the level of the spinal cord.
Lesion that the __ levels will cause this because the __ afferents are lost, there are no __
_ATONIC_ Bladder - afferent activity is not sensed at the level of the spinal cord.
Lesion that the _L1 AND LOWER_ levels will cause this because the _S2-4_ afferents are lost, there are no _PARASYMPATHETICS_
___ conscious memory for facts, places and events, involves the hippocampal formation and diencephalon

__ subconscious memory for skills, habits, emotional responses and some reflexes; involve the striatum, cerebellum, and amygdala - sometimes called "__ memory"
_DECLARATIVE_ conscious memory for facts, places and events, involves the hippocampal formation and diencephalon

_NON-DECLARATIVE MEMORY_ subconscious memory for skills, habits, emotional responses and some reflexes; involve the striatum, cerebellum, and amygdala - sometimes called "_PROCEDURAL_ memory"
___ is where new sensory info is processed to initially for a few seconds
__ this is where new sensory information goes second about facts, events or places that are not yet consolidated
__ after consolidation, info storage that is relatively stable and does not require continual refreshment
__IMMEDIATE MEMORY_ is where new sensory info is processed to initially for a few seconds
_SHORT TERM MEMORY_ this is where new sensory information goes second about facts, events or places that are not yet consolidated
_LONG TERM MEMORY_ after consolidation, info storage that is relatively stable and does not require continual refreshment
__ loss of memory of past events before trauma

__ inability to form new memories following trauma and remember only the past
_RETROGRADE AMNESIA_ loss of memory of past events before trauma

_ANTERGRADE AMNESIA_ inability to form new memories following trauma and remember only the past
__ can result from a variety of causes, stemming from cerebral ischemia - brief retrograde aiwht sudden anterograde amnesia lasting minutes to days
TRANSIENT GLOBAL AMNESIA
can result from a variety of causes, stemming from cerebral ischemia - brief retrograde aiwht sudden anterograde amnesia lasting minutes to days
__ are how memories are encoded in the brain - a pattern of neuronal firing

- collection of some neurons connect togethr having a possibility to activate at the same time

--> location is distributed in the __ grouped into associated areas which receive input from the primary visual, auditory, and somatosensory cortices.
_ENGRAM_ are how memories are encoded in the brain - a pattern of neuronal firing

- collection of some neurons connect togethr having a possibility to activate at the same time

--> location is distributed in the _NEOCROTEX_ grouped into associated areas which receive input from the primary visual, auditory, and somatosensory cortices.
Pathway of Engrams:

1. Begin in the Neocortex "association areas" -> new sensory info then send to medial temporal lobes in the ___, that relays it right back to the association area to consolidate into memory
2. Info for emotional content is sent to ___ whereas info concerning emotional working memory is sent to ___
Pathway of Engrams:

1. Begin in the Neocortex "association areas" -> new sensory info then send to medial temporal lobes in the _HIPPOCAMPAL FORMATION__, that relays it right back to the association area to consolidate into memory
2. Info for emotional content is sent to _ASSOCIATION AREAS OF CORTEX_ whereas info concerning emotional working memory is sent to _PREFRONTAL CORTEX__
Hippocampal Formation Consists of:
1. __ gyrus
2. fields __
3. __ aka __ gyrus
4. __
Hippocampal Formation Consists of:
1. _DENTATE_ gyrus
2. fields _CA1-CA3_
3. _SUBICULUM_ aka _PARAHIPPOCAMPAL_ gyrus
4. __
Information passes through Hippocampal formation in this pathway:

1. Cortical association areas -> __ -> Dentate Gyrus --> __ -> __-> Subiculum -> returns back to __

This loops induces SYNAPTIC PLASTICITY at synapses on cells of the __ GYRUS, __ and __
Information passes through Hippocampal formation in this pathway:

1. Cortical association areas -> _ENTROHINAL CORTICAL AREAS_ -> Dentate Gyrus --> _CA3_ -> _CA1_-> Subiculum -> returns back to _ENTORHINAL CORTICAL AREAS_

This loops induces SYNAPTIC PLASTICITY at synapses on cells of the _DENTATE_ GYRUS, _HIPPOCAMPUS_ and _SUBICULUM_
Long Term Plasticity
1. Hippocampus and Synaptic Plasticity
When CA1 is excited by CA3 impulse trains at __ frequency, the excitatory synapse undergoes a long lasting __ in synaptic efficiency called ___
Long Term Plasticity
1. Hippocampus and Synaptic Plasticity
When CA1 is excited by CA3 impulse trains at _HIGH_ frequency, the excitatory synapse undergoes a long lasting _INCREASE_ in synaptic efficiency called _LONG TERM POTENTIATION_
Long Term Potentiation
2. LTP caused by postsynaptic changes in CA1 neurons
-LTP is caused by an __ in sensitivity to glutamate via insertion of new ___ receptors
-ALSO, due to the formation of new dendritic spines between CA3 and CA1, the __ number of synapses facilitates an increased responsiveness to synpases from CA3 to CA1
Long Term Potentiation
2. LTP caused by postsynaptic changes in CA1 neurons
-LTP is caused by an _INCREASED_ in sensitivity to glutamate via insertion of new _AMPA__ receptors
-ALSO, due to the formation of new dendritic spines between CA3 and CA1, the _INCREASED_ number of synapses facilitates an increased responsiveness to synpases from CA3 to CA1
___ conscious memory for facts, places and events, involves the hippocampal formation and diencephalon

__ subconscious memory for skills, habits, emotional responses and some reflexes; involve the striatum, cerebellum, and amygdala - sometimes called "__ memory"
_DECLARATIVE_ conscious memory for facts, places and events, involves the hippocampal formation and diencephalon

_NON-DECLARATIVE MEMORY_ subconscious memory for skills, habits, emotional responses and some reflexes; involve the striatum, cerebellum, and amygdala - sometimes called "_PROCEDURAL_ memory"
___ is where new sensory info is processed to initially for a few seconds
__ this is where new sensory information goes second about facts, events or places that are not yet consolidated
__ after consolidation, info storage that is relatively stable and does not require continual refreshment
__IMMEDIATE MEMORY_ is where new sensory info is processed to initially for a few seconds
_SHORT TERM MEMORY_ this is where new sensory information goes second about facts, events or places that are not yet consolidated
_LONG TERM MEMORY_ after consolidation, info storage that is relatively stable and does not require continual refreshment
__ loss of memory of past events before trauma

__ inability to form new memories following trauma and remember only the past
_RETROGRADE AMNESIA_ loss of memory of past events before trauma

_ANTERGRADE AMNESIA_ inability to form new memories following trauma and remember only the past
__ can result from a variety of causes, stemming from cerebral ischemia - brief retrograde aiwht sudden anterograde amnesia lasting minutes to days
TRANSIENT GLOBAL AMNESIA
can result from a variety of causes, stemming from cerebral ischemia - brief retrograde aiwht sudden anterograde amnesia lasting minutes to days
__ are how memories are encoded in the brain - a pattern of neuronal firing

- collection of some neurons connect togethr having a possibility to activate at the same time

--> location is distributed in the __ grouped into associated areas which receive input from the primary visual, auditory, and somatosensory cortices.
_ENGRAM_ are how memories are encoded in the brain - a pattern of neuronal firing

- collection of some neurons connect togethr having a possibility to activate at the same time

--> location is distributed in the _NEOCROTEX_ grouped into associated areas which receive input from the primary visual, auditory, and somatosensory cortices.
Pathway of Engrams:

1. Begin in the Neocortex "association areas" -> new sensory info then send to medial temporal lobes in the ___, that relays it right back to the association area to consolidate into memory
2. Info for emotional content is sent to ___ whereas info concerning emotional working memory is sent to ___
Pathway of Engrams:

1. Begin in the Neocortex "association areas" -> new sensory info then send to medial temporal lobes in the _HIPPOCAMPAL FORMATION__, that relays it right back to the association area to consolidate into memory
2. Info for emotional content is sent to _ASSOCIATION AREAS OF CORTEX_ whereas info concerning emotional working memory is sent to _PREFRONTAL CORTEX__
Hippocampal Formation Consists of:
1. __ gyrus
2. fields __
3. __ aka __ gyrus
4. __
Hippocampal Formation Consists of:
1. _DENTATE_ gyrus
2. fields _CA1-CA3_
3. _SUBICULUM_ aka _PARAHIPPOCAMPAL_ gyrus
4. __
Information passes through Hippocampal formation in this pathway:

1. Cortical association areas -> __ -> Dentate Gyrus --> __ -> __-> Subiculum -> returns back to __

This loops induces SYNAPTIC PLASTICITY at synapses on cells of the __ GYRUS, __ and __
Information passes through Hippocampal formation in this pathway:

1. Cortical association areas -> _ENTROHINAL CORTICAL AREAS_ -> Dentate Gyrus --> _CA3_ -> _CA1_-> Subiculum -> returns back to _ENTORHINAL CORTICAL AREAS_

This loops induces SYNAPTIC PLASTICITY at synapses on cells of the _DENTATE_ GYRUS, _HIPPOCAMPUS_ and _SUBICULUM_
Long Term Plasticity
1. Hippocampus and Synaptic Plasticity
When CA1 is excited by CA3 impulse trains at __ frequency, the excitatory synapse undergoes a long lasting __ in synaptic efficiency called ___
Long Term Plasticity
1. Hippocampus and Synaptic Plasticity
When CA1 is excited by CA3 impulse trains at _HIGH_ frequency, the excitatory synapse undergoes a long lasting _INCREASE_ in synaptic efficiency called _LONG TERM POTENTIATION_
Long Term Potentiation
2. LTP caused by postsynaptic changes in CA1 neurons
-LTP is caused by an __ in sensitivity to glutamate via insertion of new ___ receptors
-ALSO, due to the formation of new dendritic spines between CA3 and CA1, the __ number of synapses facilitates an increased responsiveness to synpases from CA3 to CA1
--A single presynaptic impulse can reopen the __ receptors but the NMDA's remain blocked by the resident __ion, but when a train of impulses arrive, it can open the NMDA channel and allow Ca2+ to enter
---The Ca2+ ions leads to activation of __ which leads to an increase in AMPA receptors and eventual LONG TERM POTENTIATION
Long Term Potentiation
2. LTP caused by postsynaptic changes in CA1 neurons
-LTP is caused by an _INCREASED_ in sensitivity to glutamate via insertion of new _AMPA__ receptors
-ALSO, due to the formation of new dendritic spines between CA3 and CA1, the _INCREASED_ number of synapses facilitates an increased responsiveness to synpases from CA3 to CA1
--A single presynaptic impulse can reopen the _AMPA_ receptors but the NMDA's remain blocked by the resident _Mg2+_ion, but when a train of impulses arrive, it can open the NMDA channel and allow Ca2+ to enter
---The Ca2+ ions leads to activation of _KINASES_ which leads to an increase in AMPA receptors and eventual LONG TERM POTENTIATION
LONG TERM POTENTIATION SUMMARY

1. Increase in __ channel conduction (early)
2. increase in the number of __ channels (early)
3. Increase in the number of synapses via __ formation (late)
LONG TERM POTENTIATION SUMMARY

1. Increase in _AMPA_ channel conduction (early)
2. increase in the number of _AMPA_ channels (early)
3. Increase in the number of synapses via _DENDRITIC SPINE_ formation (late)
Long Term Depression
1 Hippocampus and Synaptic Plasticity
-When CA1 is excited by CA3 impulse trains run at __ frequencies, excitatory synapse undergoes a large persistent __ in synaptic efficiency called __
--the same synapses showing LTP under intense stimulation will exhibit __ under weak stimulation

---the use of __ receptors is ncesary for both LTP and LTD, the difference is in the __ concentration --> the amount of NMDA activation dictates the amount of __ concentration thus a direct influence on synaptic strength
Long Term Depression
1 Hippocampus and Synaptic Plasticity
-When CA1 is excited by CA3 impulse trains run at _LOW_ frequencies, excitatory synapse undergoes a large persistent _FALL_ in synaptic efficiency called _LONG TERM DEPRESSION_
--the same synapses showing LTP under intense stimulation will exhibit _LTD_ under weak stimulation

---the use of _NMDA_ receptors is necessary for both LTP and LTD, the difference is in the _Ca2+_ concentration --> the amount of NMDA activation dictates the amount of _Ca2+_ concentration thus a direct influence on synaptic strength
Calcium Concentrations Regulates Synaptic Plasticity
1. High Frequency Stimulation --> __ induces a large rise in Ca which activates protein __ that __ synaptic proteins (including __ receptors) leading to LTP
2.Low frequency stimulation -> __ induces very small rises in Ca2+ concentration which activates protein __ which __ synaptic proteins (including __ receptors) leading to LTD
Calcium Concentrations Regulates Synaptic Plasticity
1. High Frequency Stimulation --> _LTP_ induces a large rise in Ca which activates protein _KINASES_ that _PHOSPHORYLATE_ synaptic proteins (including _AMPA_ receptors) leading to LTP
2.Low frequency stimulation -> _LTD_ induces very small rises in Ca2+ concentration which activates protein _PHOSPHATASES_ which DEPHOSPHORYLATE__ synaptic proteins (including _AMPA_ receptors) leading to LTD
Location of Procedural/ Non Declarative Memory , three major anatomical sites with functional synaptic connections are:
1. __ & __ cortex
2. __ (in basal ganglia)
3. __
Location of Procedural/ Non Declarative Memory , three major anatomical sites with functional synaptic connections are:
1. _SUPPLEMENTAL_ & _PREMOTOR_ cortex
2. _STRIATUM_ (in basal ganglia)
3. _CEREBELLUM_
Synaptic Plasticity in Cerebellum - LTD
1. Purkinje Cells - are the sole __ cells of the cerebellar cortex, each purkinje cell receives two major excitatory inputs
a. __ fiber - found in traversing the outer molecular layer and sends an input
b. __ fiber - makes several hundred synapses on the Purkinjes dendrites
2. LTD - only occurs in __ fibers that are activated at thes ame time as the __ fibers;
----if the __ fiber is stimulated alone, this will not exhibit this LTD plasticity
Synaptic Plasticity in Cerebellum - LTD
1. Purkinje Cells - are the sole _OUTPUT_ cells of the cerebellar cortex, each purkinje cell receives two major excitatory inputs
a. _PARALELL_ fiber - found in traversing the outer molecular layer and sends an input
b. _CLIMBING_ fiber - makes several hundred synapses on the Purkinjes dendrites
2. LTD - only occurs in _PARALLEL_ fibers that are activated at thes ame time as the _CLIMBING_ fibers;
----if the _PARALLEL_ fiber is stimulated alone, this will not exhibit this LTD plasticity
MECHANISM OF LTD IN CEREBELLUM
1. __ fiber activation strongly depolarized the the purkinje cell dendrite which leads to activation of the voltage gated __ channel
2. __ fiber activation leads to AMPA activation and subsequent __ influx
3. __ fiber activation also leads to stimulation of metabotropic receptors to eventually generate Protein Kinase C
-- Protein Kinase C then phosphorylates the __ receptors and causes them to be internalized where it is this reduction of __ channels that cause the decreased sensitivity to glutamate and consequently cause LTD
MECHANISM OF LTD IN CEREBELLUM
1. _CLIMBING_ fiber activation strongly depolarized the the purkinje cell dendrite which leads to activation of the voltage gated _Ca2+_ channel
2. _PARALLEL_ fiber activation leads to AMPA activation and subsequent _Na_ influx
3. _PARALLEL_ fiber activation also leads to stimulation of metabotropic receptors to eventually generate Protein Kinase C
-- Protein Kinase C then phosphorylates the _AMPA_ receptors and causes them to be internalized where it is this reduction of _AMPA_ channels that cause the decreased sensitivity to glutamate and consequently cause LTD
LTD SUMMARY:
1. A rise in intracellular __ arising from the climbing fiber stimulation
2. A rise in intracellular __ from the AMPA channel opening
3. An activation of __ from glutamate metabotropic receptor activation
LTD SUMMARY:
1. A rise in intracellular _CALCIUM_ arising from the climbing fiber stimulation
2. A rise in intracellular _SODIUM_ from the AMPA channel opening
3. An activation of _PROTEIN KINASE C_ from glutamate metabotropic receptor activation
__ Syndrome - occurs in chronic alcoholics from a thiamine deficiency, atrophy of __ thalamus and mammillary bodies
- exhibit confusion, confabulaiton, and severe memory impairment
-- anterograde amnesia and severe retrograde amnesia prob due to damage to the thalamus and hippocampus
-may also have lesions in the neocortex, cerebellum and brainstem
_KORSAKOFF'S_ Syndrome - occurs in chronic alcoholics from a thiamine deficiency, atrophy of _DORSOMEDIAL_ thalamus and mammillary bodies
- exhibit confusion, confabulaiton, and severe memory impairment
-- anterograde amnesia and severe retrograde amnesia prob due to damage to the thalamus and hippocampus
-may also have lesions in the neocortex, cerebellum and brainstem
___ is employed to treat severe cases of clinical depression which electrically induce seizure
- based on __ who are depressed and showed marked improvement in depression following a seizure
- may cause __ amnesia but usually subsides a in a few months post-treatment
_ELECTROCONVULSIVE THERAPY__ is employed to treat severe cases of clinical depression which electrically induce seizure
- based on _EPILEPTICS_ who are depressed and showed marked improvement in depression following a seizure
- may cause _RETROGRADE OR ANTEROGRADE_ amnesia but usually subsides a in a few months post-treatment
__ Disease & __ have problems remembering and memorizing immediate past and current incidents, names and locations is an early sign of __ disease
_ALZHEIMERS_ Disease & _DEMENTIAS_ have problems remembering and memorizing immediate past and current incidents, names and locations is an early sign of _ALZHEIMERS_ disease
__ released by Dinoglagellate Pfiesteria piscicida can cause confusion, poor concentration, disorientation and severe memory loss - when it is in __ or __ by humans
_NEUROTOXINS_ released by Dinoglagellate Pfiesteria piscicida can cause confusion, poor concentration, disorientation and severe memory loss - when it is in _CONTACT WITH SKIN_ or _INHALED_ by humans