Neuro - Anatomy 3

Front 1

Important in voluntary movements and making postural adjustments

Back 1

basal ganglia

Front 2

Receives cortical input, provides negative feedback to cortex to modulate movement

Back 2

basal ganglia

Front 3

Which dopamine receptor is involved in the direct pathway?

Back 3

D1 receptor (excitatory)

D1rect pathway

Front 4

Which dopamine receptor is involved in the indirect pathway?

Back 4

D2 receptor (inhibitory)

indirect = inhibitory

Front 5

Steps in the direct pathway

Back 5

cortex --> (+) caudate / putamen --> (-) globus pallidus internus (GPi) --> (-) thalamus --> (+) cortex

net: activates movement

D1: activates this pathway

Front 6

Steps in the indirect pathway

Back 6

cortex --> (+) caudate / putamen --> (-) globus pallidus externa (GPe) --> (-) subthalamic nucleus --> (+) GP internus --> (-) thalamus --> (+) cortex

net: no movement

D2 receptors: DA inactivates pathway (promotes movement)

Front 7

Effect of dopamine on direct and indirect pathways

Back 7

Direct: D1 receptor --> stimulates --> movement

Indirect: D2 receptor --> inhibits --> movement

Promotes movement in both pathways

Front 8

Degenerative disorder of CNS associated with Lewy bodies and depigmentation of SNc

Back 8

Parkinson's disease

Front 9

What are Lewy bodies composed of?

Back 9

alpha-synuclein - intracellular inclusion

Front 10

Linked to the exposure of MPTP (contaminant in illicit drugs)

Back 10

Parkinson's

Front 11

Clinical presentation of Parkinson's

Back 11

TRAP

Tremor at rest (pill rolling)
cogwheel Rigidity
Akinesia
Postural instability

TRAPped in your body

Front 12

Sudden, wild flailing of 1 arm +/- leg

Back 12

hemiballismus

Front 13

What causes hemiballismus

Back 13

contralateral subthalamic nucleus lesion

e.g. lacunar stroke in patient with history of HTN

Front 14

Subthalamic nucleus lesion causes this

Back 14

contralateral hemiballismus

Front 15

Why does a lesion in the STN cause hemiballismus?

Back 15

loss of inhibition of thalamus through globus pallidus

indirect pathway goes through STN, thus preventing the inhibitory indirect pathway leads to hemiballismus

Front 16

Huntington's disease: mode of inheritance

Back 16

autosomal dominant trinucleotide repeat (CAG) disorder

displays anticipation (gets worse each generation)

Front 17

What chromosome is involved in Huntington's disease?

Back 17

chromosome 4

Front 18

What causes neuronal death in Huntington's disease?

Back 18

NMDA-R binding and glutamate toxicity

Front 19

What is the typical clinical presentation of Huntington's?

Back 19

Chorea, depression, progressive dementia

Front 20

When do symptoms usually manifest in Huntington's disease?

Back 20

20-50 yrs

Front 21

What is the genetic defect in Huntington's disease?

Back 21

trinucleotide repeat: CAG

(think: Caudate loses ACh and GABA)

Front 22

Atrophy of the caudate nucleus

Back 22

Huntington's disease

Front 23

Sudden, jerky, purposelessness movements

Back 23

chorea

characteristic of basal ganglia lesion

Front 24

Slow, writhing movements, esp of fingers

Back 24

athetosis

characteristic of basal ganglia lesion

Front 25

Movements characteristic of basal ganglia lesion

Back 25

athetosis (slow, writhing movements, esp of fingers)

chorea (sudden, jerky, purposelessness movements)

Front 26

Sudden, brief muscle contraction

Back 26

myoclonus (jerks, hiccoughs)

Front 27

Sustained involuntary muscle contactions

Back 27

dystonia (writer's cramp)

Front 28

Type of tremor that is worse when holding posture

Back 28

Essential/postural tremor

patients often medicate with alcohol

treatment: beta-blockers

autosomal dominant

Front 29

Essential / postural tremor

Back 29

action tremor (worsens when holding posture)

autosomal dominant

patients medicate with alcohol, treatment is beta-blockers

Front 30

Resting tremor

Back 30

most noticeable distally, seen in Parkinson's (pill rolling tremor)

Front 31

Type of tremor seen in Parkinson's

Back 31

resting tremor (pill rolling)

most noticeable distally

Front 32

Intention tremor

Back 32

slow, zigzag motion when pointing toward a target

associated with cerebellar dysfunction

Front 33

Tremor seen with cerebellar dysfunction

Back 33

Intention tremor

slow, zigzag motion when pointing toward a target

Front 34

slow, zigzag motion when pointing toward a target

Back 34

Intention tremor

seen with cerebellar dysfunction

Front 35

Prosencephalon consists of?

Back 35

Telencephalon (cerebral hemispheres)

Diencephalon (thalamus)

Front 36

Cavity associated with telencephalon (cerebral hemispheres)

Back 36

Lateral ventricles

Front 37

Cavity associated with diencephalon

Back 37

3rd ventricle

Front 38

Mesencephalon becomes?

Back 38

Midbrain

Front 39

Metencephalon becomes?

Back 39

Pons + Cerebellum

Front 40

Aqueduct associated with what embryological structures?

Back 40

Mesencephalon + Metencephalon

Front 41

Rhombencephalon consists of?

Back 41

Metencephalon (Pons), Myelencephalon (Medulla)

Front 42

Rhombencephalon associated with what cavity?

Back 42

4th ventricle

Front 43

Neural tube defects occur when?

Back 43

4th week (neuropores fail to fuse)

Persistent connection between amniotic cavity and spinal canal

Front 44

Persistent connection between amniotic cavity and spinal canal

Back 44

Neural tube defect - associated with low folic acid intake

Front 45

Lab values seen in neural tube defects

Back 45

High AFP in amniotic fluid and maternal serum

High AFP + acetylcholinesterase in CSF

Front 46

Failure of bony spinal canal to close; dura intact

Back 46

Spina bifida occulta - no structural herniation. Tuft of hair

Front 47

Meninges herniates through spinal canal defect

Back 47

Meningocele

Front 48

Meninges and spinal cord herniate through spinal canal defect

Back 48

Myelomeningocele

Front 49

Holoprosencephaly associated with?

Back 49

Patau's
Severe FAS
Cleft lip/palate