Neuro Review

Front 1

CSF is primarily secreted into ventricles through the

Back 1

CHOROID PLEXUS

Front 2

What are the primary functions of the CSF?

Back 2

Suspension of the CNS,

nutrient/hormonal/ waste management,

intracranial volume regulation.

Front 3

The lateral ventricles lie within the _____ and are separated by the _____

Back 3

cerebral hemispheres

Septum Pellucidum

Front 4

The third ventricle lies between the_______

The fourth between the ___ and the ____

Back 4

3rd: Halves of the diencephalon

4th: Brainstem and Cerebellum

Front 5

The lateral ventricles are attached to the third ventricles via _____and the third with the fourth ventricle via _____

Back 5

the foramen of Monro

The cerebral aqueduct.

Front 6

The lateral ventricles have how many parts? What are they?

Back 6

5 parts:
an anterior horn, body, atrium, posterior horn and inferior horn.

Front 7

What is the passage of flow of CSF?

Back 7

Cerebrospinal fluid is produced largely (but not exclusively) in the lateral ventricles, flows through the formen of Monro, into the third ventricle, through the cerebral aqueduct to the fourth ventricle and into the subarachnoid space through the foramina of Magendie, and Luschka.

Front 8

Larger areas of subarachnoid space are called ____.

Name the major ones

Back 8

cisterns.

Some of the primary cisterns include the cisterna magna, interpedunclular cistern, prepontine cistern and the quadrigeminal cistern and the ambient cistern.

Front 9

An increase in CSF can cause what condition of the eye?

Why does this occur?

Back 9

Papilledema (dilation).

This is because the CSF lies very close to the optic nerve

Front 10

CSF turns over about _x per day.

There (is/is no) direct lymphatic drainage for the brain

Back 10

4.

Is NO...therefore the CSF acts as the route for drainage of the extracellular space

Front 11

Ventricles are lined by what kind of cells?

Back 11

Ependymal

Front 12

The rate of passage of CSF into venous sinuses is dependent upon what?

Back 12

The relative pressures of CSF and the venous sinuses.

In fact, the CSF pulses with arterial circulation

Front 13

What are tanicytes?

Back 13

Specialized ependyma that contact blood vessels. They form specialized areas of the ventricles circumventricular organs, that have interactions with substances in the blood.

Front 14

If CSF is cloudy, what does that mean?

Back 14

There is leukocytes present in the CSF, and it is indicative of patholgy.

Front 15

Yellow CSF is indicative of what?

Back 15

Blood in the CSF. This is consistent with an older intracranial or spinal bleed. It can take up to 2-4 weeks to clear the CSF of blood after a hemorrage. If it was a new bleed it would be red.

Front 16

What is hygroma?

Back 16

CSF creating a subdural space

Front 17

Increased protein in CSF may occur with what conditions?

Back 17

Brain tumors and multiple sclerosis.

Front 18

What changes to CSF occur in Parkinson's disease?

Back 18

A reduction in catecholamine metabolites in CSF

Front 19

What are some signs of increased CSF?

Back 19

pappilledema, changes in mental status, and vomiting.

Front 20

What are the two types of hydrocephalus?

Back 20

Congenital and Acquired.

Further divisions include noncommunicating hydrocephalus, communicating hydrocephalus, normal pressure hydrocephalus, and hydrocephalus ex vacuo.

Front 21

Communicating hydrocephalus occurs (with/without) an obstruction of CSF flow through the ventricles

Back 21

WITHOUT.

Disruption of the arachnoid villi return of the CSF into the sinuses is the most common cause.

Front 22

What is normal pressure hydrocephalus?

Back 22

expansion of the ventricles that occurs in the absence of a consistent increase in CSF pressure. It is often confused with Alzheimer’s disease and/or Parkinson’s disease

Front 23

What is hydrocephalus ex vacuo?

Back 23

is ventricular enlargement as a result of atrophy or degeneration due to pathological processes (stroke, etc.) that is not related to an increase in CSF pressure.

Front 24

A crescent shaped image on the lateral side of the brain that appears in a CT scan would be what?

Back 24

An epidural hematoma

Front 25

What are the typical sites of a noncommunicating hydrocephalus?

Back 25

Interventricular foramina, cerebral aqueduct, fourth ventricle

Which ventricles enlarge determine where the obstruction is. Ie. If the lateral ventricles enlarge with no enlargment of the 3rd and 4th, then the obstruction is in the interventricular foramen.

Front 26

Meningitis will cause communicating or non communicating hydrocephalus?

Back 26

Communicating

Front 27

Electrotonic synapses, ephaptic connections, and connexions are what type of synapse?

Back 27

Electrical

These synapses are membrane junctions between cells that don't use chemical neurotransmitters. They occur in the nervous system primarily in neuroglia.

Front 28

Cellular differentiation in embryonic tissues uses which type of synapse?

Back 28

electrical

Front 29

What are the two types of chemical synapses?

Back 29

ionotropic (small molecule, fast, single messenger)

Metabotropic (neuropeptide synapses, slow, second messenger)

Front 30

Most ____ receptors use a guanosin nucleotide - binding protein as part of signal transduction using a second messenger.

Back 30

metabotropic

Front 31

Retrograde regulation is produced by (post/pre)synaptic terminal and includes substances such as ___and ___

Back 31

POST

trophic, transmitters (ie.NO)

Front 32

What is denervation supersensitivity?

Back 32

Upregulation of receptor numbers on a postsynaptic cell after loss of synaptic connections

Front 33

What are the major types of neurotransmitters?

Back 33

Amino acids, biogenic amine, and neuropeptides.

Front 34

What are the major amino acid nuerotransmitters?

Back 34

glutamate, GABA, glycine

Front 35

Glutamate and GABA are derived from what?

With what enzyme?

Back 35

alpha ketoglutarate via GABA transaminase.

Glutamate is formed first and GABA is formed from glutamate via GABA decarboxylase

Front 36

GABA is the major ____ NT in the brain, while Glutamate is the major ____

Back 36

inhibitory, excitatory

Front 37

GABA and glutamate are degraded to ____, and recycled through what cells?

Back 37

glutamine

astrocytes

Front 38

What is the major inhibitory amino acid transporter in the spinal cord?

Back 38

Glycine

Front 39

Acetylcholine is synthesized from choline by what enzyme?

Back 39

Choline acetylase

Front 40

What enzymes inactivate catecholamines?

Back 40

monoamine oxidase and catechol-O-methyltransferase

Front 41

Serotonin is a(n) _______ synthesized from ____ by a process of hydroxylation and decarboxylation.

Back 41

indoleamine

tryptophan

Front 42

____ such as substance P, VIP, endorphins, and enkephalins are synthesized in the cell body, and typically broken down and not reutilized.

Back 42

Neuropeptides

Front 43

What type of nerve damage causes a stocking glove type of sensorimotor loss?

Back 43

Diabetic and toxic neuropathies

Front 44

Lower motor neuron deficits are characterized by what?

Back 44

enduring flaccid paralysis
Rapid muscle atrophy
Fasciculations of affected muscles
hypotonia
Hyporeflexia or arefelxia

Example of lower motor neuron diseases include polio and amyotrophic lateral sclerosis

Front 45

Upper motor neuron lesions cause the loss of control of lower motor neurons and denervations problems that include what?

Back 45

Spasticity, Hypertonia, hyperflexia, clonus, clasp knife response, altered cutaneous reflexes (babinski/hoffman), slow atrophy of muscle, autonomic dysreflexia

Front 46

What is the typical upper motor neuron lesion?

Back 46

a lesion of the pyramidal system either in the cerebral cortex or along its pathway

Front 47

Lesions of the ______ tracts contribute to autonomic dysreflexia

Back 47

hypothalamospinal

Front 48

Lesions of what will produce a loss of reduction of epicritic touch, vibration, and position sense

Back 48

Lesions of the Dorsal Column

Front 49

If there is a lesion in the dorsal column, the functional loss will be on what side of the injury?

Back 49

Ipsilateral in the spinal cord, and contralateral for the medial meniscus

Front 50

What does neurosyphillis affect?

Back 50

(aka tabes dorsalis) produces degeneration in the dorsal column system.

Front 51

lesions of the anterolateral systems will produce what?

Back 51

Contralateral loss of pain, temperature and protopathic touch sensation usually 1-2 segments below the lesion.

Front 52

Give an example of an anterolatral system lesion

Back 52

Syringomyelia

It is usually bilateral and affects cervical segments first

Front 53

Lesions of the ____ tracts in the spinal cord do not generally produces isolated, clinically distinguishable symptoms

Back 53

Spinocerebellar

Front 54

After interruption of the axon, a neuronal cell body undergoes a reaction called what, that is related to an effort to stimulate regeneration

Back 54

Chromatolysis

Front 55

In the axon distal to the injury, the axon degenerates, and Schwann cells form what in preparation for receiving regenerating axons

Back 55

Bands of Bungner

Front 56

What are the classifications of peripheral nerve injury?

Back 56

Neurpraxia, axonotmesis, neurotmesis

Front 57

What happens to a muscle after denervation?

Back 57

Flaccid paralysis, denervation supersensitivity, spread of extrajunctional receptors, fasciculations, and rapid atrophy

Front 58

How long before muscle degeration becomes irreversible?

Back 58

1-2 years

Front 59

Nerve regeneration can be monitored with ___ sign

Back 59

Tinels

Front 60

Sensory recovery is what?

Back 60

Protopathic (nonspecific) sensation, then incomplete recovery of epicritic sensation

Front 61

What occurs after CNS injury?

Back 61

astrocytes react to isolate intact tissue from injured tissue.

Microglial cells and peripheral macrophages infiltrate areas of injured CNS tissue and remove necrotic tissue

After Axonal injury, CNS neurons are generally incapable of generating a regenerative response and usually undergo a SLOW atrophy and cell death

Front 62

(T/F) Oligodendrocytes form an equivalent to bands of Bugner in the CNS

Back 62

False!

Front 63

What is transneuronal degeneration?

Back 63

Sequential loss of neurons in a pathway after one neuron is lost.

Front 64

Tyrosine is an important precursor, as it makes most ____

Back 64

Neurotransmitters

Front 65

Botulinum Toxin aims at preventing which step in neuronal transmission?

Back 65

synaptic vesicle fusion

Tetanus does the same

Front 66

Glutamate and Asparate are (excitatory/inhibitory) amino acids

Back 66

Excitatory

Front 67

GABA and Glycine are (excitatory/inhibitory)

Back 67

inhibitory

Front 68

Overstimulation of what receptors is thought to cause degeneration of neurons?

Back 68

NMDA receptors (Ionotropic)

Front 69

A positive Babinski sign would be most likely to be associated with

Back 69

A lesion of the corticospinal tract (Upper Motor Neuron)

Front 70

The superior colliculus functions to coordinate what?

Back 70

reflexes to visual stimuli and contributes to the control of eye movements

Front 71

The inferior colliculus functions

Back 71

Forms a relay station of the auditory pathways to the cerebral cortex

Coordinates reflexes to auditory stimuli

Front 72

CNs III and IV come off what part of the brainstem (be specific)

Back 72

Midbrain, more specifically the Tegmentum (Floor).

CN III emerges from the interpeduncular fossa,
CNIV just dorsal to the inferior colliculus.
Both of these nerves modulate contraction of extraoccular muscles.

Front 73

Which CN emerges dorsal to the inferior colliculus?

Back 73

CN IV

Front 74

Which CN emerges from the interpeduncular fossa?

Back 74

CN III

Front 75

CN V emerges from what part of the brainstem?

Back 75

Pons. (Along with CN VI, VII and part of VIII)

Specifically the dorsal portion of the pontine tegmentum

Front 76

CN VI, VII, and VIII emerge from what

Back 76

Pons

Specifically the pontomedullary junction...ie inferior pontine sulcus

Front 77

The medulla is responsible for what?

Back 77

autonomic control of respiration, heart rate. blood pressure

Front 78

The reticular formation has to do with what

Back 78

consciousness

Front 79

The medulla contains nuclei for what cranial nerves?

Back 79

IX, X, XI, XII

Front 80

What cranial nerves emerge from the postolivary sulcus?

Back 80

IX, and X

Front 81

What cranial nerve emerges from the preolivary sulcus?

Back 81

CN XII

Front 82

CN XII emerges from where?

Back 82

preolivary sulcus of the medulla

Front 83

CNs IX and X emerge from where?

Back 83

postolivary sulcus of the medulla

Front 84

The anterior clinoid process serves as an attachment for what

Back 84

the free edge of the tentorium cerebelli

The fixed edge attaches to the posterior clinoid process

Front 85

The lesser petrosal nerve exits what foramen?

Back 85

Foramen ovale ( with V3)

Front 86

The anterior wall for which foramen contains the opening for the pterygoid canal?

Back 86

foramen lacerum

Front 87

What is the clivus

Back 87

A "shelf" for the pons and medulla

Front 88

What are tanicytes?

Back 88

Specialized ependymal cells found in the third ventricle that connect to blood vessels

Front 89

The primary structures adjacent to the lateral ventricle include...

Back 89

Caudate Nucleus
Corpus Callosum
Septum Pellucidum
Fornix
Thalamus

Front 90

The body of the lateral ventricle Lies under the ___ ___ and over the ___

Back 90

corpus callosum

thalamus

Front 91

What CN exits at the interpeduncular cistern?

Back 91

CN III

Front 92

What are the three structures that make up the choroid plexus?

Back 92

Pia mater
Ependymal Cells
Artery

Front 93

What is the glomus choroideum?

Back 93

It is a large clump of choroid plexuses in the lateral ventricle.

It may become calcified and is easily identifiable in CT scans

Front 94

CSF has (higher/Lower) in comparison to blood :

Potassium
Sodium
Chloride
Calcium
Glucose
Magnesium
Proteins

Back 94

Lower - potassium
Higher - sodium
Higher - chloride
Lower - calcium
Lower - glucose
Higher - magnesium
Lower - proteins

Front 95

Tanycytes have (tight junctions or zona adherens) between them?

Back 95

Tight junctions

Most ependymal cells are connected to each other via zona adherens

Front 96

The subfornical organ, the orgnm vasculosum of lamina terminalis, the pineal gland and the area postrema are all examples of what?

Back 96

Circumventricular organs, which contain fenestrated capillaries and no BBB. This allows these areas to be exposed to the chemical environment of blood

Front 97

An increase in Immunoglobulin G in CSF (as in MS patients) will show up as what in electrophoresis

Back 97

Oligoclonal bands

Front 98

What is a hygroma?

Back 98

A collection of CSF in the subdural space, resulting from a disruption of the arachnoid membrane.

Front 99

What are clinical signs of increased intracranial pressure?

Back 99

headache, forced downward gaze (setting sun sign), seizures, projectile vomiting, Cushing's triad

Front 100

What is cushing's triad

Back 100

Hypertension, bradycardia, irregular respiration.

This occurs when there is an increase in intracranial pressure

Front 101

What is a positive Queckenstedt's sign?

Back 101

Blocking the internal jugular veins should normally raise CSF pressure. If it does not, this is a positive Queckenstedt's sign

Front 102

If increased intracranial pressure is suspected, the next thing you should do is a lumbar puncture in order to decrease the pressure (T/F)

Back 102

FALSE! A lumbar puncture should not be performed. The resulting decrease in CSF pressure of the vertebral column may cause a herniation into the spinal column.

Front 103

What occurs in communicating hydrocephalus?

Back 103

The movement of CSF into the venous system is blocked.


This can be congenital, or due to a large amount of protein in the CSF

Front 104

What are some disorders that can lead to normal pressure hydrocephalus

Back 104

subarachnoid hemorrhage, paget disease, meningitis...anything that is related to preventing CSF passage through arachnoid granulations

Front 105

What are some symptoms of normal pressure hydrocephalus?

Back 105

impaired gait, incontinence, and dementia

Front 106

What is hydrocephalus ex Vacuo?

Back 106

Its the result of general atrophy of the brain, the ventricles are larger but there is no increase in ICP, and any deficits are due to the brain atrophy.

Front 107

What are the 6 layers of the neocortex?

Back 107

I - molecular
II - outer granular
III - outer pyramidal
IV - Inner granular
V - inner pyramidal
VI - multiform

Front 108

The primary motor cortex is dominated by ___ ___ neurons

Back 108

Pyramidal Projection

This is referred to as the agranular cortex

Front 109

The primary sensory cortex is dominated by ___

Back 109

small cells, especially stellate cells

This is a granular cortex

Front 110

Pyramidal neurons are present in all layers of the cortex except

Back 110

Layer I (Molecular Layer)

Front 111

The giant pyramidal neurons of Betz are found where

Back 111

Only in the motor cortex (layer 5)

Front 112

Spiny Stellate Cells are (inhibitory/excitatory) interneurons

Back 112

Excitatory (Glu)

Front 113

Basket cells are found in which layers

Back 113

III and V

Front 114

Area 4 is AKA

Back 114

Primary Motor Cortex

Front 115

Areas 3,1,2 is AKA

Back 115

Primary Somatosensory Cortex

Front 116

Area 17 is AKA

Back 116

Primary Visual Cortex

Front 117

Areas 41,42 is AKA

Back 117

Primary Auditory Cortex

Front 118

Which lobe has motor and cognitive functions?

Back 118

Frontal

Front 119

The body of the lateral ventrical lies under the ___ ___ and over the ____

Back 119

corpus callosum

Thalamus

Front 120

The inferior horn of the lateral ventrical extends into the ___ lobe

Back 120

temporal

Front 121

The fornix is the major tract between ...

Back 121

the hippocampus and the mammilary bodies

Front 122

The "eye" or hole in pictures where the halves of the thalamus join together is known as what?

Back 122

massa intermedia

Front 123

Masses of white matter (axons) that connect the two hemispheres are called what

Back 123

commissures.

They establish pathways of communication between cerebral hemispheres (interhemisperic white matter)