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495 Cards in this Set

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NEUROGLIA- Produce myelin sheath - provide structural framework
Oligodendrocytes
NEUROGLIA - provide metabolic support and protection
Astrocytes
NEUROGLIA - migratory cells that remove pathogens and cell debris by phagocytosis
Microglia
NEUROGLIA - line ventricles and central canal - involved in production and maintenance of CSF
Ependymal cells
Blood brain barrier excludes many substances from the brain for example _
Fatty acids
Penicillin
Substances that DO PASS through BBB
Caffeine
Nicotine
Alcohol
Cocaine
Name two glucose transporters that have low Km for glucose to ensure efficient uptake at all physiological levels
GLUT1
GLUT3
Seratonin and melatonin are made from _
Tryptophan
_ compete with tryptophan for the same transporter
Branched chain amino acids
INHIBIT production of seratonin and melatonin
Branched chain amino acids
In PHENYLKETONURIA which enzyme is defficient
Phenylalanine hydroxylase
High levels of phenylalanine results in _
Mental retardation
In PHENYLKETONURIA there is decreased synthesis of _ which results in defficiency of pigmentation
MELANIN
In PHENYLKETONURIA _ becomes essential amino acid to ensure normal NT production
Tyrosine
Phenylalanine competes with _ for uptake into brain - may contribute to mental retardation
Tyrosine and tryptophan
Normally brain uses only _ for energy, in starvation uses _
Glucose

Ketone bodies
In brain energy is mainly required for _
Transport process
Synthesis of NT
Gluconeogenesis depletes _ (in liver)

Depletion of _ inhibits _

_ accumulates
Oxaloacetate

Oxaloacetate - inhibits TCA cycle

Acetyl Co A
Ketone bodies are only produced in _
Liver
Ketone bodies can be oxidized for energy production in most tissues EXCEPT
Liver
In acute hypoglycemia brain uses _ as major energy source
Glucose - degradation of liver glycogen first 24 hours, followed by gluconeogenesis using muscle protein
In prolonged hypoglycemia (starvation) liver produces _ that take over from glucose as major energy source (thus sparing muscle)
Ketone bodies
Which NT is mage from glucose
Glutamate
Which NT is made from glutamate
GABA
This component of anti-oxidant system is made from glutamate which is very important in brain
Glutathione
Pentose phosphate pathway is essential for
Anti-oxidant system (glutathione reductase)

Lipogenesis
Major processes in nervous system that require glucose
Synthesis of glutamate and GABA

Synthesis of glutathione

Pentose phosphate pathway (for provision of NADPH)

Synthesis of acetyl choline
All sphingolipids are derived from _
sphingosine
Sulphatides accumulate in which disease
Metachromatic leukodystrophy
Gangliosides accumulate in which disease
Tay-Sachs
In GAUCHERS disease enzyme defficient is _

What accumulates
Glucocerebrosidase

Glucocerebroside
In TAY SACHS enzyme defficient is _

What accumulates
Hexosaminidase A

Ganglioside Gm2
In FABRYS disease enzyme defficient is _

What accumulates
Alpha-galactosidase A

Ceramide trihexoside
In KRABBES disease enzyme defficient is _

What accumulates
Galactocerebrosidase

Galactocerebroside
In NIEMANN PICK disease types A and B enzyme defficient is _

What accumulates
Sphingomyelinase

Sphingomyelin
In NIEMANN PICK disease types C and D enzyme defficient is _

What accumulates
Cholesterol trafficking enzyme

Cholesterol
3 year old presents with hepatosplenomegaly (especially spleen), mental retardation (type 2) and "crumpled tissue paper" appearance of cells

DIAGNOSIS
Gauchers
Newborn presents with mental retardation, blindness and characteristic cherry red spot on macula

DIAGNOSIS
PROGNOSIS ?
COMMON AMONG WHAT POPULATION
Tay Sachs

Death in infancy

Ashkenazi Jews
4 year old presents with mental retardation, hepatosplenomegaly and cholesterol accumulation

DIAGNOSIS
WHAT POPULATION COMMON
Niemann Pick

Ashkenazi Jews
Fabrys disease most commonly presents with _
Skin rash

Kidney failure
Krabbes disease most commonly presents with _
Mental retardation

Absense of myelin
The ONLY sphingolipidoses that is X LINKED is _

All others are _
Fabrys

Autosomal recessive
What type of anemia is in vitamin B12 defficiency
Megaloblastic
Glutamate is produced from _
Alpha-ketoglutarate
Ammonia is removed by _ reaction
Glutamine synthetase - conversion of glutamate to glutamine
Conversion of glutamate to glutamine depletes brain of _
TCA cycle intermediates, reduces ATP production
Accumulation of glutamine causes what condition
Cerebral edema
Acquired hyperammonemia is a consequence of _
Liver disease
Hereditary hyperammonemia is a consequence of _
Genetic defficiency of urea cycle enzyme
Which type of hereditary hyperammonemia is more common, what is defficient and what is the mechanism
TYPE II - defficient ornithine transcarbamoylase - X LINKED
Name NT's derived from tyrosine
DOPAMINE

NOREPINEPHRINE

EPINEPHRINE
NT derived from histidine
HISTAMINE
Name two purigenic neurotransmitters
Adenosine

ATP
Dense core vesicles contain _
Peptides
Peptides are synthesized in _
Rough ER
Choline used in neurons comes from _
Diet and turnover of membrane lipids
Acetyl Co A is produced by _
Metabolism
Choline acetyl transferase (CHAT) synthesizes Ach in _
Cytoplasm
Ach is degraded by Ach esterase in _ into _
Extracellular side of membrane

Acetic acid and choline
Excitatory ligand gated Na channels which are Ach receptors
NICOTINIC
Slow Ach receptors - can be excitatory or inhibitory, involved in parasympathetic neurons
Muscarinic
Parkinsons disease is caused by loss of _ cells in _
Pigmented dopamine producing cells in SUBSTANTIA NIGRA
Blocks reuptake of dopamine
Cocaine
Amino acid derived from phenylalanine
Tyrosine
Tyrosine is converted to _ by _
L-DOPA by tyrosine hydroxylase
L-DOPA is converted to _ by _ - requires vitamin B6, drug alpha-methyldopa inhibits this enzyme
DOPAMINE by DOPA decarboxylase
Dopamine is converted to _ by _ in special vesicles, requires vitamin C
NOREPINEPHRINE by Dopamine beta-hydroxylase
_ converts NE to EPI as part of epinephrine stress response induced by glucocorticoids
PNMT
_ is diagnostic for adrenal tumors ( pheochromocytomas)
VMA - vanillylmandelic acid
Excitatory dopamine receptors
D1 and D5
Inhibitory dopamine receptors
D2, 3, 4
Only classical ligand gated Na channel 5 HT receptor is _
5HT 3
NT that affects mood, sleep and behavior
Serotonin
NT produced in pineal gland, regulates endocrine rhythms
Melatonin
Serotonin producing cell bodies are located in _
Raphe nuclei in midbrain
2 types of glutamate receptors
AMPA

NMDA
Requirements of NMDA receptors
Glutamate or aspartate

Glycine

Depolarization (so need AMPA receptors as well)
What kind of channeld is glycine receptor
Ligand gated Cl channel
NT important for memory
Glutamate
NT that can be toxic if too much released - can cause epilepsy, ischemic brain damage, excitotoxicity
Glutamate
Drugs that increase Cl current caused by GABA but do not cause a current by themselves
Barbiturates and benzodiazepines
In glia GABA is converted to _ which can cross back into neurons
Glutamine
GABA shunt converts unused GABA to _
Glutamine and succinate
Majority of glycine sites are found in _
Spinal cord
Immediate precursor of glycine is _
Serine
Action of glycine is terminated by its reuptake by _
high-affinity transporter system
Best known glycine antagonist is _
Strichnine
Putative neurotransmitter that is not stored in terminal vesicles and doesnt regulate ion channels - UNSTABLE GAS which can easily diffuse through membranes
Nitric Oxide (NO)
Prolonged wearing of contact lenses causes hypoxia which results in _
Increased lactate production --> decreased corneal pH --> corneal swelling
Aqueous humor of the eye is secreted by _ into _
Ciliary processes

Posterior chamber
Aqueous humor of the eye drains out through _
Canal of Schlemm
Brings nutrients to cornea and lens and removes metabolic end products
Aqueous humor
Damage to optic nerve - usually due to increased intraocular pressure and leading cause of preventable blindness is _
Glaucoma
Glaucoma has higher incidence in _
African Americans
Common cause of glaucoma
Decreased drainage of aqueous humor
Glaucoma due to blockage in drainage canals is called _
Primary open angle glaucoma
Glaucoma when outer edge of iris blocks entrance to canals is called _
Angle closure glaucoma (narrow angle glaucoma)
Glaucoma with optic nerve damage despite normal intraocular pressure is called
Normal tension glaucoma
Glaucoma risk factors
African ancestry
Family history
Diabetes
Severe myopia
Age over 45
Prolonged use of steroids
Previous eye injury
Treatment for glaucoma - reduce secretion
Beta blockers (TIMOLOL)
Treatment for glaucoma - restore outflow
Cholinergic agonists (PILOCARPINE)
Which illegal drug reduces intraocular pressure and can be treatment for glaucoma
Marijuana
Gelatinous mass- metabolic carrier for retina - support function
Vitreous humor
In vitreous humor _ are held apart by proteoglycan bridges

_ holds bridges apart, maintaining sparse meshwork
Collagen fibrils

Hylauronic acid
This condition is common in elderly - flashing lights and floaters - due to shrinkage and collapse of vitreous humor (becomes more liquid and falls away from retina)
Posterior vitreous detachment (PVD)
Crucial to lens transparency
Water content
2 types of cataracts
Diabetic and senile
Loss of transparency of the lens to the extent that visual acuity is impaired is called
Cataracts
Cataracts are due to _
Aggregation of lens proteins
Risk factors for cataracts
Diabetes
Galactosemia
Radiation
Smoking
High fat diet
Certain drugs (corticosteroids)
Genetic
Increased glucose leads to increased production of _ in eye
Sorbitol
How do cataracts form in diabetics (or galactosemia in infants)
Excessive glucose --> sorbitol --> osmotic uptake of water --> crystallins become hydrated and aggregate scattering light
Location in brain where axis are changing orientation is _
Midbrain-diencephalon junction
Consists of cell bodies, proximal dendrites and glia
Gray matter
Consists of neuronal processes, axons and glia
White matter (MYELINATED)
_ layer is divided into alar and basal plates
Mantle
Extent of spinal cord
L2
_ anchors conus medullaris to vertebral column
Filum terminale
Lamina _ corresponds to substantia gelatinosa and is found at all cord levels
II
Lamina _ is intermediate zone - contains Dorsal Nucleus of Clarke, IML and sacral parasympathetic
VII
Lamina _ is present only in enlargements
VI
Consists of "large motor neurons " - lamina _ ?
IX
In ventral horn what is more posterior flexors or extensors
FLEXORS - posterior

EXTENSORS - anterior
In ventral horn what is more medial - proximal or distal muscles
PROXIMAL - medial

DISTAL - lateral
Posterior root entry zone electrode stimulation is a possible treatment for _
Deafferentation pain
Anterior median fissure can be found on

a) Anterior medulla
b) Posterior medullar
c) Anterior pons
d) Posterior pons
a) Anterior medulla
Pyramids are found in

a) Anterior medulla
b) Posterior medullar
c) Anterior pons
d) Posterior pons
a) Anterior medulla
Medulla is associated with what CN's
XII
IX
X
Spot in medulla where 4th ventricle is closing off - right between gracile tubercles
OBEX
Posterior columns - gracile and cuneate tubercles are located where
Posterior medulla
Pontomedullary junction is associated with what CN's
VI
VII
VIII
CN associated with pons
V
Midbrain is associated with two CN -
III
IV
Posterior surface of midbrain is the exit for _
CN IV
_ runs length of brainstem and separates sensory nuclei from motor
Sulcus limitans
Direct continuation of spinal cord substantia gelatinosa in medulla is _
Spinal trigeminal tract
CN nucleus located under the decussation of pyramids in medulla
Spinal accessory nucleus
Brainstem tegmentum contains numerous loosely arranged cells and tracts - this is _
Reticular formation
Situated adjacent to midline and use 5HT and distribute to sensory centers, cerebral cortex, brainstem, cerebellum and autonomic centers
Raphe nuclei
This part of reticular formation is located mainly in midbrain and includes paramedian pontine RF - contributes to reticulospinal tract (motor) and central tegmental tract (to thalamus)
Central group
Damage to pontine reticular formation results in _
coma
Damage to medullary reticular formation results in _
Insomnia
Certain parts of reticular formation are active during waking cycles - those are _
Locus ceruleus
Cholinergic neurons
Central group
Certain parts of reticular formation are active in sleep - those are _
Raphe nuclei
Cholinergic neurons
_ projects to thalamus as part of ascending pathway for poorly localized pain
Reticular formation
_ target sensory centers to prevent the relay of pain information
Descending 5HT neurons
Catecholaminergic neurons are located in _
Locus ceruleus
Parvocellular area of reticular formation is co-extensive with _
"expiratory center"
Parabrachial area of reticular formation is co-extensive with _
"pneumotaxic center"
Vomitting center of the brain is located in _
Area postrema (reticular formation)
Separates thalamus and hypothalamus
Hypothalamic sulcus
Separates right and left thalami
massa intermedia
This part of the brain occupies only 0.5% of it but controls temperature, hunger, thirst, sex drive, goal-seeking behavior, endocrine,affective emotional behavior and visceral activity
Hypothalamus
Which part of hypothalamus is responsible for sexual behavior and is sexually dimorphic
Preoptic
This nucleus of hypothalamus is responsible for circadian rhythms
Suprachiasmatic
Correlation center of olfactory system - part of epithalamus
Habenula
Pineal gland is part of _
Epithalamus
_ releases melatonin in periods of darkness
Pineal gland
Organs that are outside of blood brain barrier are called _
Circumventricular
Forebrain is divided into _
Telencephalon and diencephalon
_ are ipsilateral cortical connections

_ are contralateral cortical connections
ASSOCIATION FIBERS

COMMISSURAL FIBERS
Part of thalamus that is external (lateral) to globus pallidus
PUTAMEN
C shaped part of thalamus
Caudate nucleus
Located along inferior horn of lateral ventricle
Hippocampus and amygdaloid complex
_ gives rise to fornix
Hippocampus
Only openings between ventricles and subarachnoid space
Foramina of Luschka

Foramen of Magendie
_ line ventricular system
Ependymal cells
Most ependymomas occur in _
Posterior cranial fossa
At what time choroid plexus is fully operational and producing CSF
By end of first trimester
Structure found in lateral, 3d and 4th ventricles - produces CSF
Choroid plexus
Blood-CSF barrier is located where
Epithelial choroid cells - joined by tight junctions
Flow of ions/metabolites into CSF tightly controlled by _
Choroid epithelial layer
_ is actively transported into CSF and water follows
NaCl
Large molecules are transported into CSF by _
Pinocytosis/Exocytosis
Average volume of CSF in adult
120 mL
Production rate of CSF
450-500 mL /day
Compared to blood plasma CSF is high in _ , low in _
HIGH - Cl, Mg, Na

LOW - protein, glucose, Ca, P
2 types of choroid plexus tumors
Papilloma

Carcinoma
How would patient present with choroid plexus tumor
Signs/symptomps of increased intracranial pressure - headache, nausea, vomitting, lethargy, hydrocephalus, eye movements deficits due to pressure on CN's III, IV, VI
When you do lumbar puncture what are you looking for
Composition of CSF and pressure
Where is LP done
L3/L4 (L4/L5)
Describe normal CSF
Clear, colorless

Very little protein

Little IgG

1-5 leukocytes/mL
Blockage of CSF movement or lack of absorption of CSF into venous system is called _
Hydrocephalus
In hydrocephalus where does CSF accumulate
In ventricles and subarachnoid space
In hydrocephalus what is increased :

a) CSF volume
b) CSF pressure
c) Size of one or more ventricles
d) all of above
ALL OF ABOVE
CSF movement is blocked- type of hydrocephalus
OBSTRUCTIVE
CSF flow is not impaired but movement into venous system is blocked - type of hydrocephalus
COMMUNICATING
Ventricles appear to be inordinately large due to brain atrophy - type of hydrocephalus
EX VACUO HYDROCEPHALUS
You order MRI and see enlargement of one lateral ventricle - what is blocked, type of hydrocephalus and where do you place shunt
One intraventricular foramen is blocked

OBSTRUCTIVE HYDROCEPHALUS

Ventriculo-peritoneal or ventriculo-atrial shunt
You order MRI and see that both lateral ventricles are enlarged - what is blocked, type of hydrocephalus and where do you place shunt
Both intraventricular foramina are blocked

OBSTRUCTIVE HYDROCEPHALUS

Ventricular shunt (ventriculo-peritoneal or ventriculo-atrial)
You order MRI and see that both lateral and 3d ventricle are enlarged - what is blocked, type of hydrocephalus and where do you place shunt
STENOSIS OF CEREBRAL AQUEDUCT

OBSTRUCTIVE HYDROCEPHALUS

VENTRICULAR SHUNT
You order MRI and all 4 ventricles are enlarged - what is blocked, type of hydrocephalus and what type of shunt
Can be obstructive or communicating hydrocephalus

Lumbar-peritoneal shunt
2 layers of dura mater
Meningeal and periosteal
Covers brain but doesnt follow contours
Arachnoid mater
_ space in meninges contains CSF
Subarachnoid
Pachymeninx is another name for _
Dura mater
Leptomeninges are _
Arachnoid + pia
Channels between dural layers are called _
Dural venous sinuses
Who usually gets subdural hemorrhage and why
Infants - shaken baby syndrome

Elderly - after minor injury/fall
How would patient with subdural hematoma present
Loss of consciousness

Headache

Nausea+vomitting

Seizures
Subdural hematomas are due to _
Rupture of bridging cerebral veins
In extradural hematomas symptoms are due to _
Increased pressure
Patient with extradural/epidural hematomas will present how
Headache
Confusion/disorientaiton
Lethargy
Unresponsiveness
What is the most common way of obtaining epidural/extradural hematoma
Blow to pterion
Cause of epidural hematoma
Rupture of middle meningeal artery
What would be the most common complaint of patient with subarachnoid hemorrhage

Other symptoms?
Worst headache of lifetime

other symptoms- stiff neck, nausea + vomitting, loss of consciousness, photophobia, bloody CSF on LP or CT
2 most common causes of subarachnoid hemorrhage
Trauma

Ruptured aneurysm
Bactrial meningitis usually involves which part of meninges
Leptomeninx - arachnoid + pia
What would LP in patient with bacterial meningitis show
Cloudy with many WBC, high protein and bacteria, elevated CSF pressure
Which meningitis is less sever and has better outcome
Viral
Area of skin supplied by any one CN or spinal nerve through dorsal and ventral rami
DERMATOME
For which CN there is absolutely no overlap in dermatomes
CN V
Is area of tactile loss greater or smaller then pain/temperature
GREATER
Dermatome of nipple
T4
Dermatome of umbilicus
T10
Dermatome of inguinal ligament
L1
Dermatome of pubis
T12
Dermatome of xiphoid process
T6
Which nerve innervates mid thigh
L2
Which nerve innervates lower and medial thigh
L3
Which nerve innervates patella, big toe and medial malleolus
L4
Which nerve innervates lateral leg and digits 2-4
L5
Which nerve innervates lateral malleolus and small toe
S1
Which nerve innervates posterior thigh and leg
S2
Which nerve innervates webspace between big toe and 2nd toe
Deep peroneal nerve
Upper eyelid, tip of nose and forehead is innervated by _
V1
Lower eyelid, skin around nostril and upper lip is innervated by _
V2
Part of ear, lower lip and chin are innervated by _
V3
Back of head is innervated by _
C2
Skin of ear lobe is innervated by _
C3
Clavicle is innervated by _
C4
Thumb is innervated by _
C6
Middle finger is innervated by _
C7
Small finger is innervated by _
C8
Dermatome of lateral side of big toe
L5
Dermatome of medial side of big toe
L4
Skin around anus is innervated by _
S5
Conscious proprioception includes _
Discriminative touch
Flutter-vibration
Proprioception (position sense)
Kinesthesia ( motion sense)
Non-conscious prorioception is used for _
Motion coordination
Protopathic sensibility includes
Crude touch (non-discriminative)
Pain
Temperature
Which pathway transmits and analyzes mechanical stimuli and conscious proprioception from body
Posterior column - medial lemniscus pathway
Receptors that respond to application and removal of stimulus but not during maintained stimulation are called _
RAPIDLY ADAPTING
Receptors that are active as long as stimulus is present are called _
SLOWLY ADAPTING
Proprioceptors are _
MUSCLE SPINDLE + GOLGI TENDON ORGAN
In posterior column - medial lemniscus pathway where do primary afferent fibers travel
Fasciculus cuneatus - upper thoracic and cervical

Fasciculus gracilis - sacral, lumbar and lower thoracic
In posterior column - medial lemniscus pathway where is the first synapse occurs
Gracile and cuneate nuclei
In posterior column- medial lemniscus pathway where do fibers cross
AFTER synapse in cuneate and gracile nuclei and travel in medial lemniscus
Where in thalamus do fibers from posterior column- medial lemniscus pathway synapse
VPL of thalamus
Post-synaptic posterior column-medial lemniscus pathway is different in one additional synapse - where is the synapse
IN SPINAL CORD - LAMINA III, IV
Conscious proprioception from the head is carried by _
Anterior and posterior trigeminothalamic pathways
Which trigeminothalamic pathway is ipsilateral and which is contralateral
POSTERIOR - ipsilateral

ANTERIOR - contralateral
Where does the first synapse occur in trigeminothalamic pathways
Reticular formation
Where in thalamus do fibers from anterior and posterior trigeminothalamic pathways synapse
VPM of thalamus
Muscle spindle, Golgi tendon organ and joint receptors target what areas of primary sensory cortex
3a and 2
Cutaneous receptors target what areas of primary sensory cortex
3b and 1
Lesion of area 1 of primary sensory cortex will lead to _
Loss of texture discrimination
Lesion of area 2 of primary sensory cortex will lead to _
Loss of size and shape discrimiation (astereognosis)
Lesion of area 3b of primary sensory cortex would lead to _
both diminished texture discrimination and astereognosis
Somatotopic representation of body surface on primary sensory cortex is called
Homunculus
Secondary somatosensory cortex is located where
Inner face of upper bank of lateral sulcus
Secondary somatosensory cortex receives input from _
Ipsilateral primary somatosensory cortex and ventral postero-inferior nucleus of thalamus
Secondary somatosensory cortex is supplied by what artery
Middle cerebral
Which parietal areas receive input from ipsilateral primary somatosensory cortex and pulvinar thalami
Area 5 and lateral portion of 7 (7b)
Lesion of area 5 and area 7b would lead to _
Agnosia (contralateral part is lost from personal body map)
Primary somatosensory cortex is supplied by what arteries
Anterior and middle cerebral
Principal sensory and mesencephalic trigeminal nuclei are supplied by what blood vessels
Basilar and superior cerebellar arteries
Which pathways carry nonconscious proprioception information
Spinocerebellar ( from limbs and trunk)

Trigeminocerebellar ( from head)
Which spinocerebellar pathways carry information from lower limbs
Anterior and posterior spinocerebellar
Which spinocerebellar pathways carry information from upper limb
Rostral spinocerebellar and cuneocerebellar
Friedrich ataxia - how does it present and what causes it
- DEGENERATION OF MAJOR SPINOCEREBELLAR TRACTS

- Lack of coordination during walking or other movements ( no sensory feedback to cerebellum necessary to regulate movement)
Where does first synapse occur in anterior spinocerebellar pathway
SPINAL CORD ( lamina V, VII, spinal border cells of L3-L5)
Where do fibers CROSS in anterior spinocerebellar pathway
At the level of ANTERIOR COMMISSURE at the level of synapse
Fibers in anterior spinocerebellar tract go through _ and end up in _
Superior cerebellar peduncle

IPSILATERAL lateral cerebellar vermis ( fibers recross in cerebellum)
Where does first synapse occur in posterior spinocerebellar pathway
DORSAL NUCLEUS OF CLARKE (lamina VII, T1-L2)
Is posterior spinocerebellar tract ipsilateral or conralateral
IPSILATERAL
Fibers of posterior spinocerebellar tract go through _ and end up in _
Restiform body

Medial cerebellar vermis - IPSILATERAL
Which spinocerebellar pathway of upper limb has synapse in spinal cord
ROSTRAL SPINOCEREBELLAR ( synapse in lamina VII of cervical enlargement C4-C8)
Are rostral and cuneocerebellar tracts ipsilateral or contralateral
IPSILATERAL
After synapse fibers of rostral spinocerebellar tract go through _ and _ and end up in _
Superior cerebellar peduncle and restiform body

Lateral cerebellar vermis
In cuneocerebellar pathway where does the synapse occur
Lateral cuneate nucleus
In cuneocerebellar pathway fibers go through _ and end up in _
Restiform body

Medial cerebellar vermis
In trigeminocerebellar pathways which two nuclei are involved and in which one does synapse occur
Spinal trigeminal nucleus (pars interpolaris) and mesencephalic nucleus

SYNAPSE - spinal trigeminal nucleus (pars interpolaris)
Trigeminocerebellar pathway going through trigeminal nucleus passes through _ on its way to cerebellar hemispheres and cerebellar nuclei

Pathway going in mesencephalic nucleus passes through _ on its way to cerebellum
Restiform body

SCP
Nociceptors respond to what kind of stimuli
Intense stimuli that have potential to damage tissue
Nociceptors that have thinly myelinated fibers are called _
Adelta
Nociceptors that have nonmyelinated fibers are called _
C-polymodal nociceptors
2 parts of anterior lateral system are _
Spinothalamic and spinoreticular tracts
In spinothalamic tract where does a first synapse occur
SPINAL CORD - lamina I, V for Adelta fibers, lamina II for C fibers
Where do fibers CROSS in spinothalamic tract
At each segment in anterior commissure
Fibers of spinothalamic tract on their way to thalamus send collaterals to _
Reticular formation
Where in thalamus do fibers of spinothalalmic tract synapse
VPL of thalamus
In spinoreticular pathway where does first synapse occur
SPINAL CORD - lamina II, III for C fibers, lamina V, VIII for interneurons
In spinoreticular pathway where does second synapse occurs
RETICULAR FORMATION
Where do fibers cross in spinoreticular pathway
At each segment of anterior commissure
Where in thalamus do fibers of spinoreticular tract synapse
Intralaminar and posterior nuclei of thalamus
In spinocervicothalamic tract where does first synapse occur
SPINAL CORD (lamina III, IV)
Spinocervicothalamic tract - is it ipsilateral or contralateral
IPSILATERAL - travels in lateral funiculus
Where does second SYNAPSE occur in spinocervicothalamic tract
LATERAL CERVICAL NUCLEUS - C1-C2
When do fibers cross in spinocervicothalamic tract
AFTER SYNAPSE in lateral cervical nucleus and travel in medial lemniscus
Where in thalamus do fibers synapse in spinocervicothalamic tract
VPL
Which artery is damaged in Wallenberg syndrome
PICA = posterior inferior cerebellar artery
How would patient with Wallenberg syndrome present
CONTRALATERAL loss of pain, temperature and crude touch sensibility over body

IPSILATERAL loss over face
Which pathways are disrupted in Wallenberg syndrome
Anterior trigeminothalamic

ALS
In patient with Brown-Sequard syndrome what deficits would you see
IPSILATERAL LOSS at and below segmental level of injury of posterior column modalities ( discriminative touch, positional and vibratory sensations)

CONTRALATERAL loss of nociceptive, nondiscriminative (crude) touch and thermal sensations below segmental level of injury
What is the cause of deficits in patients with SYRINGOMYELIA
Cystic cavitation of spinal gray matter - destruction of decussating ALS fibers in anterior commissure
How would patient with SYRINGOMYELIA present
BILATERAL loss of nociceptive, non discriminative touch and thermal sensations beginning several segments below the segmental injury level
Where is pain perceived
Subcortical levels
Which pathway is necessary for suffering component of pain
Spinoreticular
Which pathway is necessary for localization of pain
Spinothalamic
Patient has phantom limb (deafferentation ) pain - thalamic lesioning is necessary - where is it done
MEDIAL THALAMIC LESIONING - long lasting pain relief - minimal side effects (transient confusion, somnolence but no apparent sensory loss)
Pain resulting from stimulus that is normally not painful is called
ALLODYNIA
Fibrous layer of the eye consists of _
Cornea, sclera and associated conjunctiva
This part of eye has high turnover - collagen is arranged in very regular manner making it transparent
CORNEA
This part of eye contains blood vessels and irregularly arranged collagen making it opaque
SCLERA
This part of eye is longitudinal and has radial and circular fibers
CILIARY BODY
2 layers of retina are _
Neural retina and retinal pigmented epithelium
2 parts of neural retina are _
Non-photosensitive part and photosensitive part
This layer of retina consists of single layer of cells on basal lamina - these cells have processes that surround the processes of rods and cones - functions in absorption of light, isolation of photoreceptors, metabolis support for photoreceptors and phagocytosis of spent discs
Pigmented epithelium
Are there more cones or rods
RODS
This layer of retina consists of tips of Muller cells connected by adherens
Outer limiting membrane
This layer of retina consists of cell bodies and nuclei of rods and cones
Outer nuclear layer
Contains processes of rods, cones, bipolar and horizontal cells - synapse between photoreceptors and bipolar/horizontal cells
Outer plexiform layer
This layer of retina contains nuclei of horizontal, amacrine, bipolar and Mullers cells
Inner nuclear layer
This layer contains processes of horizontal, amacrine, bipolar and Mullers cells
Inner plexiform layer
_ constricts the iris, reducing pupil
Parasympathetic CN III
_ increases pupil
Sympathetic (NE)
Rods and cones release _ on bipolar cells which activate _
Glutamate

Ganglion cells
Axons of ganglion cells make up the _
OPTIC NERVE
Rods and cones release glutamate _
IN DARK
Describe what happens when light hits retina
Light converts cis- Rodopsin to trans - Rodopsin --> activate G protein --> G protein activates PDE --> breaks down cGMP --> cell polarizes without cGMP and stops releasing glutamate
_ have excitatory glutamate activity and release GABA on surrounding rods and cones
Horizontal cells
On center bipolar interconnecting neuron dendrites have _ glutamate receptors
INHIBITORY
Off center bipolar cells have _ glutamate receptors
EXCITATORY
Which nuclei are involved in visual tracking
Superior colliculus --> Pulvinar
Visual acuity is best at _
FOVEA and binocular regions
Optic nerve is surrounded by _
Meninges
Increase in intracranial pressure will first show up in _
RETINA
Major projection of axons from retinal ganglion cells is to _
Lateral geniculate body
Magnocellular information is derived from _
RODS
Parvocellular information is derived from _
CONES
Which layer of LGB has large receptive fields and large axons
Magnocellular
Which layer of LGB has small receptive fields
Parvocellular
Loss of vision in left eye can be caused by _
Damage to either left optic nerve or damage to left eye
Patient has complete loss of vision in left eye and right upper portion of temporal field in right eye - what is the cause
Aneurysm pressing optic nerve and also affecting chiasm
What would the visual loss pattern look like if there was pituitary tumor pressing directly and symmetrically on chiasm
Loss of temporal visual field in both eyes
Loss of R visual field in both eyes is caused by lesion to _
Left optic tract
LGB has _ nuclear layers separated by bundles of axons
6
Layers 1 and 2 of LGB have _ cells
MAGNOCELLULAR (rods)
Layers 3-6 of LGB have _ cells
PARVOCELLULAR (cones)
Axons from temporal hemiretina (inner visual field) terminate in layers _ of _ LGB
2,3, 5 of IPSILATERAL LGB
Axons from nasal hemiretina (OUTER VISUAL FIELDS) terminate in layers _ of _ LGB
1, 4, 6 of CONTRALATERAL LGB
Binocular vision is formed in _
Cerebral cortex
Location of primary visual cortex
Either side of calcarine sulcus
Areas 18 and 19 of cortex get input from _
Area 17 (primary visual cortex) and pulvinar
_ are formed by axons arising from LGB neurons that target primary visual cortex
OPTIC RADIATIONS
Lower visual field quadrant arises from _ LGB and travel through _
DORSOMEDIAL

RETROLENTICULAR LIMB OF INTERNAL CAPSULE
Upper visual field quadrant arises from _ LGB and travels through _
VENTROLATERAL

MYERS LOOP
Lesion involving Meyers loop on R side would cause what deficit
Loss of vision in quarter of upper left visual field
Layer _ of visual cortex is wide and receives LGB input
4
Fovea on brain map is more posterior or anterior than peripheral regions
POSTERIOR
Takes up nearly half of primary visual cortex
FOVEA
Which lesion would knock out left visual field in both eyes
R optic tract lesion
Which lesion would cause tunnel vision in patient (bothe temporal fields are out)
Chiasm lesion
If patient has lazy eye what did not develop
Ocular dominance columns
If patient can describe but cant assign meaning to objects his condition is called
Associative agnosia
Inability to recognize faces is called _
Prosopagnosia
If patient after stroke can write but cant read - which part of the brain is damage
Splenium of corpus callosum
Inability to recognize colors is called
Achromotopsia
Loss of voluntary eye movements is called _
Balint syndrome
Inability to understand visual objects is called _
Asimultagnosia
Retinal projections to pretectum function in _
PUPILLARY LIGHT RESPONSE
_ coordinates visual, somatic and auditory information and directs head and eyes toward stimuli
SUPERIOR COLLICULUS
_ induces overlying ectoderm to form neural plate
NOTOCHORD
Sensory cell bodies (pseudounipolar) are situated in _ and derive from _
DRG

Neural crest cells
3 primary brain vesicles are _
RHOMBENCEPHALON
MESENCEPHALON
PROSENCEPHALON
PROSENCEPHALON consists of _
Telencephalon

Diencephalon
RHOMBENCEPHALON consists of _
Myelencephalon

Metencephalon
Name 3 brain flexures that put brain into mature configuration
MESENCEPHALON flexure - between mesencephalon and rhombencephalon
CERVICAL flexure - at junction of spinal cord and myelencephalon
PONTINE FLEXURE - between two halves of metencephalon
Anterior blind end of neural tube is called _ , it will form _
LAMINA TERMINALIS

Anterior wall of third ventricle
Myelencephalon is _
Medulla and lower part of 4th ventricle
Metencephalon is _
Pons, cerebellum and upper part of 4th ventricle
Mesencephalon is _
Midbrain and cerebral aqueduct
Diencephalon is _
Thalamus
Hypothalamus
Epithalamus
Subthalamus
Third ventricle
Telencephalon is _
Cerebral hemispheres + lateral ventricles
Posterior pituitary derives as outgrowth from _
DIENCEPHALON (neuroectoderm)
Anterior pituitary derives as outgrowth of _
ORAL ECTODERM = RATHKES POUCH
Craniopharyngioma can be caused by remnant of _
RATHKES POUCH
In spinal cord BASAL PLATE forms _
CN XI nucleus
Motor columns
IML
Sacral parasympathetic column
In spinal cord ALAR PLATE forms _
Substantia gelatinosa
Visceral receptive area
In medulla BASAL PLATE forms
Hypoglossal nucleus
Inferior salivatory nucleus (CN IX)
Dorsal vagal nucleus
Nucleus ambiguous ( CN IX and X)
In medulla ALAR PLATE forms _
Solitary nucleus ( CN VII, IXm X)
Spinal trigeminal nucleus ( V, VII, IX, X)
Vestibular and cochlear nuclei - CN VIII
In pons ALAR PLATE forms _
Chief sensory nucleus of V
Mesencephalic nucleus
In pons BASAL PLATE forms
Abducens nucleus
Superior salivatory nucleus ( CN VII)
Trigeminal motor nucleus (CN V)
Facial nucleus ( CN VII)
In midbrain BASAL PLATE forms _
Oculomotor nucleus
Edinger-Westphal nucleus
Trochlear nucleus
Failure of anterior pore to close is called
Meroanencephaly
Meroanencephaly is accompanied by _
Increase in alpha-fetoprotein and polyhydramnios (fetus lacks control for swallowiing)
2 parts of membranous labyrinth
Utricle and saccule
Where macular hair cells located
One in utricle and one in saccule
_ ganglion is related to cochlear duct and is involved in hearing
SPIRAL
Which muscle is attached to malleus
Innervation ?
Tensor tympani

CN V
Which muscle is attached to stapes

Innervation
STAPEDIUS

CN VII
Which parts of the eye develop from neuroectoderm
RETINA

POSTERIOR LAYERS OF IRIS

OPTIC NERVE
Which parts of the eye develop from surface ectoderm
LENS

CORNEAL EPITHELIUM
Which parts of the eye come from mesoderm
FIBROUS AND VASCULAR COATS
Which parts of the eye come from neural crest cells
CHOROID

SCLERA

CORNEAL ENDOTHELIUM
Neural retina and pigmented retina are separated by _
Intraretinal space
COLOBOMA involves improper closure of _ resulting in gap in iris or iris and retina
CHOROID FISSURE
Glaucoma can arise in relation to _ infection during pregnancy
RUBELLA
_ gives rise to membranous labyrinth of ear
OTIC PLACODE
Fluid in boney labyrinth of ear is called _
PERILYMPH
Scala media is _
COCHLEAR DUCT
Above scala media there is _ and below is _
SCALA VESTIBULI

SCALA TYMPANI
Tethers cochlear duct to surrounding cartilage
SPIRAL LIGAMENT
Tympanic membrane comes from what germ layers
Ectoderm
Endoderm
Mesoderm
External ear includes _
Auricle

External auditory meatus

Tympanic membrane
Auricle is made out of _
Elastic cartilage
Outer 1/3 of external auditory meatus is _ , inner 2/3 is _
Elastic cartilage

Bone
Tympanic membrane has 3 layers
- Cuticular - ECTODERM

- Fibrous - MESODERM

- Mucous - ENDODERM
Middle ear is lined with _ epithelium
Cuboidal or simple squamous
Perilymphatic duct of inner ear is continuous with _
SUBARACHNOID SPACE
3 types of ear hair cells
CRISTAE AMPULARIS

MACULAE (utricle, sacula)

ORGAN OF CORTI
What type of neurons are in spiral ganglion
BIPOLAR (all other ganglia - pseudounipolar)
What separates scala vestibuli from scala media
Vestibular membrane
_ hair cells are in single row while _ hair cells are in row of 3
Inner hair cells

Outer hair cells
What can cause hair cell damage
Loud noise

Aminoglycoside antibiotics

Chemo drugs (cisplatin)
Are middle ear ossicles amplifiers
NO - reduce amplitude of sound
If you cut auditory nerve - what is the effect
DEAFNESS in that ear
AUDITORY NERVE PROJECTS TO _
Dorsal and ventral cochlear nuclei
Axons take three pathways from cochlear nucleus _
Dorsal acoustic stria
Intermediate acoustic stria

TRAPEZOID BODY
What is a major target of cochlear nuclei axons
SUPERIOR OLIVARY COMPLEX
Vast majority of ascending auditory fibers travel in _
LATERAL LEMNISCUS
Fibers from lateral lemniscus innervate both ipsilateral and contralateral _
INFERIOR COLLICULI
Auditory neurons in inferior colliculus project to _ through
Medial geniculate body

BRACHIUM OF INFERIOR COLLICULUS
Neurons in _ project to auditory cortex through auditory radiations
MEDIAL GENICULATE BODY
Primary auditory cortex are areas _
41, 42 (Heschls gyrus, transverse temporal gyri)
Area _ gets most output of MGB
41
Descending auditory pathways have _ role

Main players _
Modulatory

Medial and lateral olivocochlear bundles
Describe acoustic startle reflex
Auditory nerve --> Cochlear nucleus + superior olivary complex --> RETICULAR FORMATION --> spinal motor neurons
Axons entering CNS are called _ and their cell bodies are in _
AFFERENT

Sensory ganglia
Visceral efferent pathways always involve _ neurons
2 - one in CNS and one in peripheral ganglia
GSA component transmits _
Sensation from body wall
GSE component transmits _
Motor information to skeletal muscle
GVE component transmits _
Motor information to viscera
GVA component transmits _
Sensation from viscera
SVA component transmits _
TASTE AND OLFACTION
SSA component transmits _
Vision
Balance
Hearing
SSE component transmits _
Efferent to hair cells (CN VIII)
SVE component transmits _
Motor information to skeletal muscle from branchial arches
Four nuclei of CN IX are found in close proximity to each other - they are_
Inferior salivatory
Solitary
Nucleus ambiguous
Spinal trigeminal
Hyperacusis occurs from damage to _
CN VII - stapedius muscle
GAG reflex

Afferent -

Efferent -
IX

X
Cough reflex

Afferent

Efferent
X

X
Deviation of the tongue from the midline indicates _
Paralysis of IPSILATERAL genioglossus
Odorant molecules binds receptor -> receptor activates _ --> activates _ --> makes _ --> opens _ channels --> opens outward _ channels --> cell _
G protein

Adenylate cyclase

cAMP

Ca channels

Cl channels

depolarizes
Olfactory receptor cells synapse in _ onto _
GLOMERULUS

MITRAL AND TUFTED CELLS
Mitral and tufted cells synapses are _ and use which NT's
EXCITATORY

Glutamate and carnosine
Periglomerular and granule cells use which NT
GABA
Major NT of olfactory system is _
GLutamate
Olfactory cortex consists of _
Anterior olfactory nucleus

Olfactory tubercle

Piriform cortex

Amygdala

Entorhinal cortex
CN's involved in taste are _
VII, IX and X
Taste molecules binds receptor --> receptor activates _ --> activates _ --> makes _ --> activates _ --> phosphorylates outward _ --> inside of the cell becomes _
G protein

Adenylate cyclase

cAMP

PKA

K channels

Positive (depolarizes)
" Sweet chemical" binds to _ and activates _ via _
G protein related receptor

K channel

PKA
How is something salty identified
Na ions directly flow through amiloride sensitive Na channel
How is something sour identified
H ions directly flow through amiloride sensitive Na channel but cause K channel to close
How is bitter identified
Bitter binds to ligand gated K channel

Also binds to G protein related receptor - activates release of internal Ca ions via phospholipase C
In identification of UMAMI taste _ binds to _
GLUTAMATE

Ligand gated Ca Na channel
Innervates anteror 2/3 of tongue
CN VII
Cell bodies of primary fibers of CN VII are located in _
Geniculate ganglion
Innervates posterior 1/3 of tongue
CN IX
Cell bodies of CN IX taste fibers are located in _
Inferior (petrosal) ganglion
Innervates epiglottis and palate taste
CN X
Cell bodies of CN X taste fibers are in _
Inferior ganglion of CN X
In this potential type increase causes increased frequency of repetitive action potentials
RECEPTOR POTENTIAL
Constant stimulus decreases response - this is called _
ADAPTATION
Slowly adapting receptors are also called _
TONIC RECEPTORS
Rapidly adapting receptors are also called _
PHASIC RECEPTORS
Area consisting of all receptors for one nerve is called _
RECEPTIVE FIELD
In receptive field receptor number is large in _
CENTER
_ stimulation of receptive field gives greates sensation
CENTER
Sharpens sensations by inhibiting activity of sensory neurons coming from areas of skin adjacent to the area that is most stimulated
LATERAL INHIBITION
Mechanoreceptors in hairless skin are _
Merkels disks

Meissners corpuscles

Pacinian corpuscles

Free nerve endings
Mechanoreceptors in hairy skin
Hair follicles

Ruffini endings

Tactile disks

PACINIAN CORPUSCLES
Mechanoreceptor that is present in both hairy and hairless skin
PACINIAN CORPUSCLES
Flattened non-neural epithelial cell synapsed on nerve terminal, located at the border of epidermis and dermis - PARTIALLY ADAPTING, steady state signals
MERKELS DISKS
Mechanoreceptor - located between epidermis and dermis, VERY SENSITIVE (lips, fingertips), FAST ADAPTING - respond to vibrations and movement of objects over skin
MEISSNERS CORPUSCLE - sense VIBRATION AND CHANGE
_ located in subcutaneous levels of hairy and hairless skin, RAPIDLY ADAPTING - sense vibration and rapid mechanical tissue changes, sensation is poorly localized - LARGE RECEPTOR FIELDS
PACINIAN CORPUSCLE
Which mechanoreceptor has large receptive fields (poor sensitivity)
PACINIAN
These mechanoreceptors located in deep internal tissue, slowly adapting and signal continuous deformation
Ruffini endings
Found in hairy or hairless skin and other tissues - detect touch and pressure, tickle and itch - may be slowly or rapidly adapting
FREE NERVE ENDINGS
All but free nerve endings transmit _
Free nerve endings transmit via _
Abeta nerve

Adelta dibers and type C unmyelinated fibers
Cold receptors respond over 50 degrees - this is called _
PARADOXICAL COLD
_ is responsible for pain quality
Somatosensory cortex
_ main area for pain appreciation
Reticular formation and thalamus
Opioid peptides prevent release of _
Substance P
Infection of pain neurons in DRD is called _
Herpes Zoster (Shingles)