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217 Cards in this Set
- Front
- Back
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Astrocytes
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Physical support, repair, K+ metabolism
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Microglia
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Phagocytosis
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Oligodendroglia
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Central myelin production
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Schwann cells
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Peripheral myelin production
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Ependymal cells
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Inner lining of ventricles
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The BBB is formed by what three structures
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BBB guarded by the CIA:
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1.
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Choroid plexus epithelium
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2.
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Intracerebral capillary epithelium
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3.
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Arachnoid
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How do glucose and AA’s cross
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Carrier-mediated transport
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Describe the fxns of the hypothalamus
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Thirst and water balance
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As for autonomic regulation, what part of hypothalamus regulates parasympathetic activity
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Anterior
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And what part regulates circadian rhythms
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Suprachiasmatic nucleus
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Which nucleus controls hunger?
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Lateral nucleus
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Which controls satiety?
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Ventromedial
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What nucleus controls water balance
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Supraoptic nucleus
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What section of hypothalamus coordinates cooling when hot
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Anterior (A/C = anterior cooling)
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Which nucleus controls sexual urges and emotions
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Septate nucleus
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The posterior pituitary is aka
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Neurohypophysis
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The neurohypophysis receives hypothalamic axonal projections from which 2 nuclei
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Supraoptic (ADH)
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Oxytocin: “oxys – tocos” means
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Quick birth
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Functions of the thalamic nuclei
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Lateral geniculate
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Visual
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Medial geniculate
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Auditory
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What is the pneumonic
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Lateral to look, medial for music
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1.
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lateral part
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2.
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medial part
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Ventral anterior / lateral nuclei
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Motor
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The limbic system is responsible for what famous 5-F’s
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Feed, fight, feel, flight….and sex!
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Mamillary body gives input to ____ which gives input to ____ gyrus, which gives input to entorhinal cortex, which gives input to ____
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Anterior nucleus of thalamus
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Which ganglia is important in mitigating voluntary mvmts and making postural adjustments
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Basal ganglia
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____ sudden jerky, purposeless mvmts
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Chorea
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Characteristic of lesion where
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In the basal ganglia
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Characteristic of what disease
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Huntington’s
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Slow writhing mvmts, esp. of fingers =
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Athetosis
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Characteristic of what disease
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Huntington’s
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Sudden, wild flailing of one arm
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Hemiballismus
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P eumonic?
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Hemi-ballistic, as in throwing a baseball
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Characteristic of
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Contralateral, subthalamic nucleus lesion
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____ tremor = intention tremor
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Cerebellar
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____ tremor = resting tremor
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Basal ganglion tremor
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Pneumonic?
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Basal = at rest, as in PARKed, as in PARKinson’s disease
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Brain lesions (given the area, state the consequence)
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Broca’s area
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Motor (expressive) aphasia with good comprehension
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Wernicke’s area
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Sensory (receptive) aphasia with poor comprehension
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Arcuate fasciculus
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Conduction aphasia; poor repetition with good comprehension, fluent speech
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Amygdala (bilateral)
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Kluever-Bucy syndrome – hyperorality, hypersexuality, disinhibited behavior
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Frontal lobe
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Frontal release signs – personality changes, difficulty in concentrating, judgement
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Right parietal lobe
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Spatial neglect (agnosia of the contralateral side of the world)
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Reticular activating system
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Coma
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Mamillary bodies (bilateral)
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Wernicke’s - Korsakoff encephalopathy (confabulations, anterograde amnesia like in Memento)
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What nerves pass through the cavernous sinus?
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The nerves that control EOM and V-1, V-2
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List them
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CN III, IV, VI, V-1, V-2
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Any of them “free-floating”
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CN VI
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Any arteries in there?
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Cavernous portion of internal carotid
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The foramina of the middle cranial fossa: who passes through each?
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Optic canal
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CN II, opth. Artery and central retinal vein
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Superior orbital fissure
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CN III, IV, V-1, VI and opth. Vein
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Foramen rotundum
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CN V-2
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Foramen ovale
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CN V-3
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Foramen spinosum
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Middle meningeal artery
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What’s the pneumonic for the branches of the trigeminal nerve and where they pass through
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Standing Room Only (V-1, V-2, V-3)
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Foramina of the posterior cranial fossa: list who passes through each:
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Internal auditory meatus
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CN VII, VIII
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Jugular foramen
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CN IX, X, XI and jugular vein
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Hypoglossal canal
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CN XII
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Foramen magnum
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Brain stem, vertebral arteries and spinal roots of CN XI
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LR6SO4R3 means
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Lateral rectus on CN VI
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How does the superior oblique AID us?
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Abducts, Introverts, Depresses
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Describe the flowpath of the pupillary reflex
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Light in either retina sends a signal to the PRETECTAL nuclei, which in turn activate both EDINGER-WESTPHAL nuclei, which send signals to constrict BOTH pupils
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Lesions in the medial longitudinal fasciculus (MLF) results in what presenting symptoms
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Medial rectus palsy on attempted lateral gaze
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This syndrome is aka
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Internuclear opthalmopplegia
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Commonly seen in which patients
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MS
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Left homonymous hemianopsia results from a lesion in the
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Right optic tract
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Right anopsia?
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Right optic nerve
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Bitemporal hemianopsia
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Optic chiasm
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Left upper quadrantic anopsia
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Right temporal lesion
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Left lower quadrantic anopsia
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Right parietal lesion
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Flowpath of visual signals
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Retina, optic nerve, optic chiasm, lateral geniculate body, optic radiations to calcarine fissure
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Are CN I-XII sensory, motor or both
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Some Say Marry Money But My Brother Says Big Boobs Matter Most
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Oculomotor nerve controls what 4 functions
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Eye mvmnt, pupil constriction, accommodation, eyelid opening
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Who controls muscles of mastication
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Trugeminal
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What else does trigeminal do
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Facial sensation
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Who controls lacrimation and salivation
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Facial
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Who controls taste
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Anterior 2/3 = facial
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Which nerve controls the parotid
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IX (even though facial runs right through it!)
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Who controls swallowing
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IX
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Tongue movements?
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XII
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Head turning?
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XI
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Who monitors carotid body and sinus
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IX
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Palate elevation and talking controlled by
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Vagus
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What viscera does vagus innervate
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Thoracoabdominal
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Cranial nerves and passageways
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Which CN passes through the cribiform plate
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CN I
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Where does CN II pass through
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Optic canal
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Which CNs pass through the superior orbital fissure
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III, IV, V-1, VI
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Through the jugular foramen
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IX, X, XI
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Foramen ovale
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V-3
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Hypoglossal canal
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XII
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Internal auditory meatus
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VII, VIII
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Foramen rotundum
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V-2
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Which cranial nerves lie ‘medially’ at the brainstem
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III, VI, XII (3x2=6x2=12)
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Homunculus: lower extremity deficit in sensation or movement indicates involvement of which artery
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Anterior cerebral
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Name the infarcted arteries which cause the following
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Leg-foot area of motor / sensory cortices
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Anterior cerebral
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What surface(s) does it supply
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Medial surface
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Damage to lateral aspects of brain, Broca’s and Wernicke’s areas
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Middle cerebral artery
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The most common Circle of Willis aneurysm
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Anterior communicating
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What are common indications
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Visual field defects
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An infarct here may cause CN III palsy
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Posterior communicating
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“arteries of stroke”, supply internal capsule, caudate, putamen, globus pallidus
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Lateral striate
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In general, stroke of the anterior circle causes
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General sensory / motor dysfunction
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Stroke of the posterior circle causes
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Vertigo, ataxia, visual deficits and coma
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What sounds test the following CN nerves
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VII
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mi-mi-mi (tests lips)
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X
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Kuh kuh kuh (tests palate elevation)
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XII
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La la la (tests the tongue)
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Name the three Vagal Nuclei
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Nucleus Solitarius
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Which nucleus is involved with Motor innervation of the larynx, pharynx and upper esophagus
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aMbiguous
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Which deals with visceral Sensory information
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Nucleus Solitarius
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So, what does the dorsal motor nucleus do?
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Send parasympathetic fibers to heart, lungs and upper GI
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CN XII – which way does the tongue deviate
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Towards the lesion side
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Jaw deviates toward side of which CN lesion
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CN – V
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Uvula deviates AWAY from side of ___ lesion
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CN – X
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Head deviates AWAY from side of ___ lesion
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CN – XI
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Spinal Cord Tracts and Lesions
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What section of the spinal cord is associated with pressure, vibration, touch, proprioception
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Dorsal columns
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Name the two ‘divisions’ of the dorsal columns
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Faciculus cuneatus and fasciculus gracilis
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How are these two division different
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FC – upper body, extremities
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Which tract is involved in pain and temperature
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Spinothalamic tract
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____ affects LMNs only and causes flaccid paralysis, symmetric lesions
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Poliomyelitis (Werndig-Hoffman disease)
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Lesions are in the ____ matter
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Gray
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_____: mostly white matter lesions of cervical region, random and asymmetric
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MS
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____: symmetric, NO sensory deficit, both upper and lower motor neurons
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ALS
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So, which matter are the lesions in?
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Both
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Describe the result of a complete occlusion of the vertebral artery
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Destroys everything in the spinal cord EXCEPT it spares the dorsal columns
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____: impaired proprioception and locomotor ataxia
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Tabes dorsalis
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Results from
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Tertiary syphilis
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Where is the cord affected?
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Both fasciculus gracilis only
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What disease affects the ventral white commissure and ventral horns
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Syringomyelia
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Describe the cord damage in B12 neuropathy / Friedreich’s ataxia
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Dorsal columns, lateral corticospinal tracts and spinocerebellar tracts
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Where are the tracts for the upper limbs / lower limbs inside the dorsal columns
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Lower limbs – inside
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FC=
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____ syndrome = hemisection of spinal cord
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Brown-Sequard
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What does the patient lose contralaterally
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Pain and temperature
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Why? What tract is affected
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Spinothalamic
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What are the ipsilateral losses
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1.
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2.
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ipsilateral loss of tactile, vibration, proprioception sense (dorsal column)
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3.
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ipsilateral motor paralysis and spasticity (pyramidal tract)
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If lesion occurs above T1, how does pt present
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With Horner’s syndrome
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Atrophy, flaccid paralysis and absent DTRs are indicative of
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LMN injury
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What else may / may not be present
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Fasciculations
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What are the signs of UMN damage
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Spastic paralysis (clonus)
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Facial Nerve / Lesions
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Describe the tract / path of the facial nerve
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Face area of motor cortex to facial nucleus (upper/lower divisions) to face
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A lesion where causes central facial palsy
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Lesion in the cortico-bulbar tract
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What causes Bell’s palsy
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Lesion post-nucleus
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Central facial palsy presents as
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Paralysis of the contralateral lower quadrant
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Explain how this is so
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Both cortices feed the upper division and this in turn feeds the upper quadrant
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Bell’s palsy presents as
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Peripheral ipsilateral facial paralysis with inability to close eye on affected side
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(ALexander BELL with STD)
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Aids
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Spindle muscle control: reflex arc
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What does the 1a intrafusal fiber regulate
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Length of muscle fiber(s)
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Describe the flowpath of the reflex arc
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Muscle stretch, intrafusal stretch, stimulates 1a afferent, stimulate alpha motor neuron, reflex extrafusal contraction
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How is the gamma loop different
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CNS stimulates gamma motor neuron, contracts intrafusal fiber, increases sensitivity of the reflex arc
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How does the Golgi tendon organ differ from the intrafusal fiber
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Golgi organ is in SERIES with the muscle fiber whereas intrafusal is in parallel
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Golgi organ sends signals via ___ fiber
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1b
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Function of Golgi organ
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Senses tension and provides inhibitory feedback to the alpha motor neurons
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What injury often causes injury to radial nerve
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Humerus fracture
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What deficits of motion occur
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1.
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2.
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loss of brachioradialis reflex
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3.
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loss of extensor carpi radialis longus (wrist drop)
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Loss of sensation?
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Posterior bracjial / antibrachial cutaneous
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Loss of musculocutaneous nerve results in
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Loss of function of coracobrachialis, biceps and brachialis mucles (biceps reflex)
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Loss of axillary nerve results in
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Loss of deltoid action
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Axillary nerve often damaged in what type of injuries
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Shoulder dislocation
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Damage to the medial epicondyle can damage the ____ nerve
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Ulnar
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Function lost?
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Impaired wrist flexion and adduction
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Loss of sensation felt where?
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Medial palm (and 1.5 fingers)
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What nerve damage results in loss of forearm pronation, wrist flexion, finger flexion and several thumb movements
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Median nerve damage
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What common injury causes this
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FX of the supracondyle of the humerus
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_____ palsy is the traction or tear of the superior trunk of the brachial plexus (C5 and C6 roots)
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Erb-Duchenne
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What type of injury causes this
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Falling on shoulder
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This condition is often referred to as
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Waiter’s Tip due to position of arm (?)
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Findings: limb hangs by side due to paralysis of
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Abductors
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Medially rotated due to
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Paralysis of lateral rotators
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Forearm is pronated due to loss of
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Biceps
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Which nerve is aka The Great Extensor Nerve
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Radial nerve
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What does it innervate
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Brachioradialis
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Maybe it should be called
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The BEST extensor nerve
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Recall that, to supinate is to carry a
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Bowl of soup
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What embryological defect can lead to compression of the subclavian artery and inferior trunk of the brachial plexus
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Cervical rib
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What is this syndrome called
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Thoracic outlet syndrome
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What does the inferior trunk consist of
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C8, T1
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What hand deficits are involved
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1.
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2.
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atrophy of the interosseus muscles
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Any pulses involved
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Disappearance of radial pulse on turning head to opposite side
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Name the nerve root involved in the following clinical reflexes:
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Biceps
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C5
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Triceps
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C7
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Patella
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L4
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Achilles
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S1
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Babinski
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Sign of UMN lesion as an adult
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