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495 Cards in this Set
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NEUROGLIA- Produce myelin sheath - provide structural framework
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Oligodendrocytes
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NEUROGLIA - provide metabolic support and protection
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Astrocytes
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NEUROGLIA - migratory cells that remove pathogens and cell debris by phagocytosis
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Microglia
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NEUROGLIA - line ventricles and central canal - involved in production and maintenance of CSF
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Ependymal cells
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Blood brain barrier excludes many substances from the brain for example _
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Fatty acids
Penicillin |
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Substances that DO PASS through BBB
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Caffeine
Nicotine Alcohol Cocaine |
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Name two glucose transporters that have low Km for glucose to ensure efficient uptake at all physiological levels
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GLUT1
GLUT3 |
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Seratonin and melatonin are made from _
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Tryptophan
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_ compete with tryptophan for the same transporter
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Branched chain amino acids
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INHIBIT production of seratonin and melatonin
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Branched chain amino acids
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In PHENYLKETONURIA which enzyme is defficient
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Phenylalanine hydroxylase
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High levels of phenylalanine results in _
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Mental retardation
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In PHENYLKETONURIA there is decreased synthesis of _ which results in defficiency of pigmentation
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MELANIN
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In PHENYLKETONURIA _ becomes essential amino acid to ensure normal NT production
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Tyrosine
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Phenylalanine competes with _ for uptake into brain - may contribute to mental retardation
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Tyrosine and tryptophan
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Normally brain uses only _ for energy, in starvation uses _
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Glucose
Ketone bodies |
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In brain energy is mainly required for _
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Transport process
Synthesis of NT |
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Gluconeogenesis depletes _ (in liver)
Depletion of _ inhibits _ _ accumulates |
Oxaloacetate
Oxaloacetate - inhibits TCA cycle Acetyl Co A |
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Ketone bodies are only produced in _
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Liver
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Ketone bodies can be oxidized for energy production in most tissues EXCEPT
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Liver
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In acute hypoglycemia brain uses _ as major energy source
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Glucose - degradation of liver glycogen first 24 hours, followed by gluconeogenesis using muscle protein
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In prolonged hypoglycemia (starvation) liver produces _ that take over from glucose as major energy source (thus sparing muscle)
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Ketone bodies
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Which NT is mage from glucose
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Glutamate
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Which NT is made from glutamate
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GABA
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This component of anti-oxidant system is made from glutamate which is very important in brain
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Glutathione
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Pentose phosphate pathway is essential for
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Anti-oxidant system (glutathione reductase)
Lipogenesis |
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Major processes in nervous system that require glucose
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Synthesis of glutamate and GABA
Synthesis of glutathione Pentose phosphate pathway (for provision of NADPH) Synthesis of acetyl choline |
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All sphingolipids are derived from _
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sphingosine
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Sulphatides accumulate in which disease
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Metachromatic leukodystrophy
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Gangliosides accumulate in which disease
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Tay-Sachs
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In GAUCHERS disease enzyme defficient is _
What accumulates |
Glucocerebrosidase
Glucocerebroside |
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In TAY SACHS enzyme defficient is _
What accumulates |
Hexosaminidase A
Ganglioside Gm2 |
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In FABRYS disease enzyme defficient is _
What accumulates |
Alpha-galactosidase A
Ceramide trihexoside |
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In KRABBES disease enzyme defficient is _
What accumulates |
Galactocerebrosidase
Galactocerebroside |
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In NIEMANN PICK disease types A and B enzyme defficient is _
What accumulates |
Sphingomyelinase
Sphingomyelin |
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In NIEMANN PICK disease types C and D enzyme defficient is _
What accumulates |
Cholesterol trafficking enzyme
Cholesterol |
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3 year old presents with hepatosplenomegaly (especially spleen), mental retardation (type 2) and "crumpled tissue paper" appearance of cells
DIAGNOSIS |
Gauchers
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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 |
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4 year old presents with mental retardation, hepatosplenomegaly and cholesterol accumulation
DIAGNOSIS WHAT POPULATION COMMON |
Niemann Pick
Ashkenazi Jews |
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Fabrys disease most commonly presents with _
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Skin rash
Kidney failure |
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Krabbes disease most commonly presents with _
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Mental retardation
Absense of myelin |
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The ONLY sphingolipidoses that is X LINKED is _
All others are _ |
Fabrys
Autosomal recessive |
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What type of anemia is in vitamin B12 defficiency
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Megaloblastic
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Glutamate is produced from _
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Alpha-ketoglutarate
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Ammonia is removed by _ reaction
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Glutamine synthetase - conversion of glutamate to glutamine
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Conversion of glutamate to glutamine depletes brain of _
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TCA cycle intermediates, reduces ATP production
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Accumulation of glutamine causes what condition
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Cerebral edema
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Acquired hyperammonemia is a consequence of _
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Liver disease
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Hereditary hyperammonemia is a consequence of _
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Genetic defficiency of urea cycle enzyme
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Which type of hereditary hyperammonemia is more common, what is defficient and what is the mechanism
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TYPE II - defficient ornithine transcarbamoylase - X LINKED
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Name NT's derived from tyrosine
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DOPAMINE
NOREPINEPHRINE EPINEPHRINE |
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NT derived from histidine
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HISTAMINE
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Name two purigenic neurotransmitters
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Adenosine
ATP |
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Dense core vesicles contain _
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Peptides
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Peptides are synthesized in _
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Rough ER
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Choline used in neurons comes from _
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Diet and turnover of membrane lipids
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Acetyl Co A is produced by _
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Metabolism
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Choline acetyl transferase (CHAT) synthesizes Ach in _
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Cytoplasm
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Ach is degraded by Ach esterase in _ into _
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Extracellular side of membrane
Acetic acid and choline |
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Excitatory ligand gated Na channels which are Ach receptors
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NICOTINIC
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Slow Ach receptors - can be excitatory or inhibitory, involved in parasympathetic neurons
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Muscarinic
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Parkinsons disease is caused by loss of _ cells in _
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Pigmented dopamine producing cells in SUBSTANTIA NIGRA
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Blocks reuptake of dopamine
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Cocaine
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Amino acid derived from phenylalanine
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Tyrosine
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Tyrosine is converted to _ by _
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L-DOPA by tyrosine hydroxylase
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L-DOPA is converted to _ by _ - requires vitamin B6, drug alpha-methyldopa inhibits this enzyme
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DOPAMINE by DOPA decarboxylase
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Dopamine is converted to _ by _ in special vesicles, requires vitamin C
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NOREPINEPHRINE by Dopamine beta-hydroxylase
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_ converts NE to EPI as part of epinephrine stress response induced by glucocorticoids
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PNMT
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_ is diagnostic for adrenal tumors ( pheochromocytomas)
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VMA - vanillylmandelic acid
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Excitatory dopamine receptors
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D1 and D5
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Inhibitory dopamine receptors
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D2, 3, 4
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Only classical ligand gated Na channel 5 HT receptor is _
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5HT 3
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NT that affects mood, sleep and behavior
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Serotonin
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NT produced in pineal gland, regulates endocrine rhythms
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Melatonin
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Serotonin producing cell bodies are located in _
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Raphe nuclei in midbrain
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2 types of glutamate receptors
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AMPA
NMDA |
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Requirements of NMDA receptors
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Glutamate or aspartate
Glycine Depolarization (so need AMPA receptors as well) |
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What kind of channeld is glycine receptor
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Ligand gated Cl channel
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NT important for memory
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Glutamate
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NT that can be toxic if too much released - can cause epilepsy, ischemic brain damage, excitotoxicity
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Glutamate
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Drugs that increase Cl current caused by GABA but do not cause a current by themselves
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Barbiturates and benzodiazepines
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In glia GABA is converted to _ which can cross back into neurons
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Glutamine
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GABA shunt converts unused GABA to _
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Glutamine and succinate
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Majority of glycine sites are found in _
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Spinal cord
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Immediate precursor of glycine is _
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Serine
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Action of glycine is terminated by its reuptake by _
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high-affinity transporter system
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Best known glycine antagonist is _
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Strichnine
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Putative neurotransmitter that is not stored in terminal vesicles and doesnt regulate ion channels - UNSTABLE GAS which can easily diffuse through membranes
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Nitric Oxide (NO)
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Prolonged wearing of contact lenses causes hypoxia which results in _
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Increased lactate production --> decreased corneal pH --> corneal swelling
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Aqueous humor of the eye is secreted by _ into _
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Ciliary processes
Posterior chamber |
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Aqueous humor of the eye drains out through _
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Canal of Schlemm
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Brings nutrients to cornea and lens and removes metabolic end products
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Aqueous humor
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Damage to optic nerve - usually due to increased intraocular pressure and leading cause of preventable blindness is _
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Glaucoma
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Glaucoma has higher incidence in _
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African Americans
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Common cause of glaucoma
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Decreased drainage of aqueous humor
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Glaucoma due to blockage in drainage canals is called _
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Primary open angle glaucoma
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Glaucoma when outer edge of iris blocks entrance to canals is called _
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Angle closure glaucoma (narrow angle glaucoma)
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Glaucoma with optic nerve damage despite normal intraocular pressure is called
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Normal tension glaucoma
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Glaucoma risk factors
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African ancestry
Family history Diabetes Severe myopia Age over 45 Prolonged use of steroids Previous eye injury |
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Treatment for glaucoma - reduce secretion
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Beta blockers (TIMOLOL)
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Treatment for glaucoma - restore outflow
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Cholinergic agonists (PILOCARPINE)
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Which illegal drug reduces intraocular pressure and can be treatment for glaucoma
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Marijuana
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Gelatinous mass- metabolic carrier for retina - support function
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Vitreous humor
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In vitreous humor _ are held apart by proteoglycan bridges
_ holds bridges apart, maintaining sparse meshwork |
Collagen fibrils
Hylauronic acid |
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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)
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Posterior vitreous detachment (PVD)
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Crucial to lens transparency
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Water content
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2 types of cataracts
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Diabetic and senile
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Loss of transparency of the lens to the extent that visual acuity is impaired is called
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Cataracts
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Cataracts are due to _
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Aggregation of lens proteins
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Risk factors for cataracts
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Diabetes
Galactosemia Radiation Smoking High fat diet Certain drugs (corticosteroids) Genetic |
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Increased glucose leads to increased production of _ in eye
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Sorbitol
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How do cataracts form in diabetics (or galactosemia in infants)
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Excessive glucose --> sorbitol --> osmotic uptake of water --> crystallins become hydrated and aggregate scattering light
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Location in brain where axis are changing orientation is _
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Midbrain-diencephalon junction
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Consists of cell bodies, proximal dendrites and glia
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Gray matter
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Consists of neuronal processes, axons and glia
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White matter (MYELINATED)
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_ layer is divided into alar and basal plates
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Mantle
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Extent of spinal cord
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L2
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_ anchors conus medullaris to vertebral column
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Filum terminale
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Lamina _ corresponds to substantia gelatinosa and is found at all cord levels
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II
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Lamina _ is intermediate zone - contains Dorsal Nucleus of Clarke, IML and sacral parasympathetic
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VII
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Lamina _ is present only in enlargements
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VI
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Consists of "large motor neurons " - lamina _ ?
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IX
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In ventral horn what is more posterior flexors or extensors
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FLEXORS - posterior
EXTENSORS - anterior |
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In ventral horn what is more medial - proximal or distal muscles
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PROXIMAL - medial
DISTAL - lateral |
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Posterior root entry zone electrode stimulation is a possible treatment for _
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Deafferentation pain
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Anterior median fissure can be found on
a) Anterior medulla b) Posterior medullar c) Anterior pons d) Posterior pons |
a) Anterior medulla
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Pyramids are found in
a) Anterior medulla b) Posterior medullar c) Anterior pons d) Posterior pons |
a) Anterior medulla
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Medulla is associated with what CN's
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XII
IX X |
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Spot in medulla where 4th ventricle is closing off - right between gracile tubercles
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OBEX
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Posterior columns - gracile and cuneate tubercles are located where
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Posterior medulla
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Pontomedullary junction is associated with what CN's
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VI
VII VIII |
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CN associated with pons
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V
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Midbrain is associated with two CN -
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III
IV |
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Posterior surface of midbrain is the exit for _
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CN IV
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_ runs length of brainstem and separates sensory nuclei from motor
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Sulcus limitans
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Direct continuation of spinal cord substantia gelatinosa in medulla is _
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Spinal trigeminal tract
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CN nucleus located under the decussation of pyramids in medulla
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Spinal accessory nucleus
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Brainstem tegmentum contains numerous loosely arranged cells and tracts - this is _
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Reticular formation
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Situated adjacent to midline and use 5HT and distribute to sensory centers, cerebral cortex, brainstem, cerebellum and autonomic centers
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Raphe nuclei
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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)
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Central group
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Damage to pontine reticular formation results in _
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coma
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Damage to medullary reticular formation results in _
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Insomnia
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Certain parts of reticular formation are active during waking cycles - those are _
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Locus ceruleus
Cholinergic neurons Central group |
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Certain parts of reticular formation are active in sleep - those are _
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Raphe nuclei
Cholinergic neurons |
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_ projects to thalamus as part of ascending pathway for poorly localized pain
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Reticular formation
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_ target sensory centers to prevent the relay of pain information
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Descending 5HT neurons
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Catecholaminergic neurons are located in _
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Locus ceruleus
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Parvocellular area of reticular formation is co-extensive with _
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"expiratory center"
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Parabrachial area of reticular formation is co-extensive with _
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"pneumotaxic center"
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Vomitting center of the brain is located in _
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Area postrema (reticular formation)
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Separates thalamus and hypothalamus
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Hypothalamic sulcus
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Separates right and left thalami
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massa intermedia
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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
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Hypothalamus
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Which part of hypothalamus is responsible for sexual behavior and is sexually dimorphic
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Preoptic
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This nucleus of hypothalamus is responsible for circadian rhythms
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Suprachiasmatic
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Correlation center of olfactory system - part of epithalamus
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Habenula
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Pineal gland is part of _
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Epithalamus
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_ releases melatonin in periods of darkness
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Pineal gland
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Organs that are outside of blood brain barrier are called _
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Circumventricular
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Forebrain is divided into _
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Telencephalon and diencephalon
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_ are ipsilateral cortical connections
_ are contralateral cortical connections |
ASSOCIATION FIBERS
COMMISSURAL FIBERS |
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Part of thalamus that is external (lateral) to globus pallidus
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PUTAMEN
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C shaped part of thalamus
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Caudate nucleus
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Located along inferior horn of lateral ventricle
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Hippocampus and amygdaloid complex
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_ gives rise to fornix
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Hippocampus
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Only openings between ventricles and subarachnoid space
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Foramina of Luschka
Foramen of Magendie |
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_ line ventricular system
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Ependymal cells
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Most ependymomas occur in _
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Posterior cranial fossa
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At what time choroid plexus is fully operational and producing CSF
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By end of first trimester
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Structure found in lateral, 3d and 4th ventricles - produces CSF
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Choroid plexus
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Blood-CSF barrier is located where
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Epithelial choroid cells - joined by tight junctions
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Flow of ions/metabolites into CSF tightly controlled by _
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Choroid epithelial layer
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_ is actively transported into CSF and water follows
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NaCl
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Large molecules are transported into CSF by _
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Pinocytosis/Exocytosis
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Average volume of CSF in adult
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120 mL
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Production rate of CSF
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450-500 mL /day
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Compared to blood plasma CSF is high in _ , low in _
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HIGH - Cl, Mg, Na
LOW - protein, glucose, Ca, P |
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2 types of choroid plexus tumors
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Papilloma
Carcinoma |
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How would patient present with choroid plexus tumor
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Signs/symptomps of increased intracranial pressure - headache, nausea, vomitting, lethargy, hydrocephalus, eye movements deficits due to pressure on CN's III, IV, VI
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When you do lumbar puncture what are you looking for
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Composition of CSF and pressure
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Where is LP done
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L3/L4 (L4/L5)
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Describe normal CSF
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Clear, colorless
Very little protein Little IgG 1-5 leukocytes/mL |
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Blockage of CSF movement or lack of absorption of CSF into venous system is called _
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Hydrocephalus
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In hydrocephalus where does CSF accumulate
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In ventricles and subarachnoid space
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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
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CSF movement is blocked- type of hydrocephalus
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OBSTRUCTIVE
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CSF flow is not impaired but movement into venous system is blocked - type of hydrocephalus
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COMMUNICATING
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Ventricles appear to be inordinately large due to brain atrophy - type of hydrocephalus
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EX VACUO HYDROCEPHALUS
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You order MRI and see enlargement of one lateral ventricle - what is blocked, type of hydrocephalus and where do you place shunt
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One intraventricular foramen is blocked
OBSTRUCTIVE HYDROCEPHALUS Ventriculo-peritoneal or ventriculo-atrial shunt |
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You order MRI and see that both lateral ventricles are enlarged - what is blocked, type of hydrocephalus and where do you place shunt
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Both intraventricular foramina are blocked
OBSTRUCTIVE HYDROCEPHALUS Ventricular shunt (ventriculo-peritoneal or ventriculo-atrial) |
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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
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STENOSIS OF CEREBRAL AQUEDUCT
OBSTRUCTIVE HYDROCEPHALUS VENTRICULAR SHUNT |
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You order MRI and all 4 ventricles are enlarged - what is blocked, type of hydrocephalus and what type of shunt
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Can be obstructive or communicating hydrocephalus
Lumbar-peritoneal shunt |
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2 layers of dura mater
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Meningeal and periosteal
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Covers brain but doesnt follow contours
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Arachnoid mater
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_ space in meninges contains CSF
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Subarachnoid
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Pachymeninx is another name for _
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Dura mater
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Leptomeninges are _
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Arachnoid + pia
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Channels between dural layers are called _
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Dural venous sinuses
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Who usually gets subdural hemorrhage and why
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Infants - shaken baby syndrome
Elderly - after minor injury/fall |
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How would patient with subdural hematoma present
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Loss of consciousness
Headache Nausea+vomitting Seizures |
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Subdural hematomas are due to _
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Rupture of bridging cerebral veins
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In extradural hematomas symptoms are due to _
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Increased pressure
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Patient with extradural/epidural hematomas will present how
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Headache
Confusion/disorientaiton Lethargy Unresponsiveness |
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What is the most common way of obtaining epidural/extradural hematoma
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Blow to pterion
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Cause of epidural hematoma
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Rupture of middle meningeal artery
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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 |
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2 most common causes of subarachnoid hemorrhage
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Trauma
Ruptured aneurysm |
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Bactrial meningitis usually involves which part of meninges
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Leptomeninx - arachnoid + pia
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What would LP in patient with bacterial meningitis show
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Cloudy with many WBC, high protein and bacteria, elevated CSF pressure
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Which meningitis is less sever and has better outcome
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Viral
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Area of skin supplied by any one CN or spinal nerve through dorsal and ventral rami
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DERMATOME
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For which CN there is absolutely no overlap in dermatomes
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CN V
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Is area of tactile loss greater or smaller then pain/temperature
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GREATER
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Dermatome of nipple
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T4
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Dermatome of umbilicus
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T10
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Dermatome of inguinal ligament
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L1
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Dermatome of pubis
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T12
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Dermatome of xiphoid process
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T6
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Which nerve innervates mid thigh
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L2
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Which nerve innervates lower and medial thigh
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L3
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Which nerve innervates patella, big toe and medial malleolus
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L4
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Which nerve innervates lateral leg and digits 2-4
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L5
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Which nerve innervates lateral malleolus and small toe
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S1
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Which nerve innervates posterior thigh and leg
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S2
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Which nerve innervates webspace between big toe and 2nd toe
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Deep peroneal nerve
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Upper eyelid, tip of nose and forehead is innervated by _
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V1
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Lower eyelid, skin around nostril and upper lip is innervated by _
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V2
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Part of ear, lower lip and chin are innervated by _
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V3
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Back of head is innervated by _
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C2
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Skin of ear lobe is innervated by _
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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
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Four nuclei of CN IX are found in close proximity to each other - they are_
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Inferior salivatory
Solitary Nucleus ambiguous Spinal trigeminal |
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Hyperacusis occurs from damage to _
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CN VII - stapedius muscle
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GAG reflex
Afferent - Efferent - |
IX
X |
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Cough reflex
Afferent Efferent |
X
X |
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Deviation of the tongue from the midline indicates _
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Paralysis of IPSILATERAL genioglossus
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Odorant molecules binds receptor -> receptor activates _ --> activates _ --> makes _ --> opens _ channels --> opens outward _ channels --> cell _
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G protein
Adenylate cyclase cAMP Ca channels Cl channels depolarizes |
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Olfactory receptor cells synapse in _ onto _
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GLOMERULUS
MITRAL AND TUFTED CELLS |
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Mitral and tufted cells synapses are _ and use which NT's
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EXCITATORY
Glutamate and carnosine |
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Periglomerular and granule cells use which NT
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GABA
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Major NT of olfactory system is _
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GLutamate
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Olfactory cortex consists of _
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Anterior olfactory nucleus
Olfactory tubercle Piriform cortex Amygdala Entorhinal cortex |
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CN's involved in taste are _
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VII, IX and X
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Taste molecules binds receptor --> receptor activates _ --> activates _ --> makes _ --> activates _ --> phosphorylates outward _ --> inside of the cell becomes _
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G protein
Adenylate cyclase cAMP PKA K channels Positive (depolarizes) |
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" Sweet chemical" binds to _ and activates _ via _
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G protein related receptor
K channel PKA |
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How is something salty identified
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Na ions directly flow through amiloride sensitive Na channel
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How is something sour identified
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H ions directly flow through amiloride sensitive Na channel but cause K channel to close
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How is bitter identified
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Bitter binds to ligand gated K channel
Also binds to G protein related receptor - activates release of internal Ca ions via phospholipase C |
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In identification of UMAMI taste _ binds to _
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GLUTAMATE
Ligand gated Ca Na channel |
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Innervates anteror 2/3 of tongue
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CN VII
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Cell bodies of primary fibers of CN VII are located in _
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Geniculate ganglion
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Innervates posterior 1/3 of tongue
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CN IX
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Cell bodies of CN IX taste fibers are located in _
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Inferior (petrosal) ganglion
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Innervates epiglottis and palate taste
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CN X
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Cell bodies of CN X taste fibers are in _
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Inferior ganglion of CN X
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In this potential type increase causes increased frequency of repetitive action potentials
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RECEPTOR POTENTIAL
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Constant stimulus decreases response - this is called _
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ADAPTATION
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Slowly adapting receptors are also called _
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TONIC RECEPTORS
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Rapidly adapting receptors are also called _
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PHASIC RECEPTORS
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Area consisting of all receptors for one nerve is called _
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RECEPTIVE FIELD
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In receptive field receptor number is large in _
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CENTER
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_ stimulation of receptive field gives greates sensation
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CENTER
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Sharpens sensations by inhibiting activity of sensory neurons coming from areas of skin adjacent to the area that is most stimulated
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LATERAL INHIBITION
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Mechanoreceptors in hairless skin are _
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Merkels disks
Meissners corpuscles Pacinian corpuscles Free nerve endings |
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Mechanoreceptors in hairy skin
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Hair follicles
Ruffini endings Tactile disks PACINIAN CORPUSCLES |
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Mechanoreceptor that is present in both hairy and hairless skin
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PACINIAN CORPUSCLES
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Flattened non-neural epithelial cell synapsed on nerve terminal, located at the border of epidermis and dermis - PARTIALLY ADAPTING, steady state signals
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MERKELS DISKS
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Mechanoreceptor - located between epidermis and dermis, VERY SENSITIVE (lips, fingertips), FAST ADAPTING - respond to vibrations and movement of objects over skin
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MEISSNERS CORPUSCLE - sense VIBRATION AND CHANGE
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_ 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
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PACINIAN CORPUSCLE
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Which mechanoreceptor has large receptive fields (poor sensitivity)
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PACINIAN
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These mechanoreceptors located in deep internal tissue, slowly adapting and signal continuous deformation
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Ruffini endings
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Found in hairy or hairless skin and other tissues - detect touch and pressure, tickle and itch - may be slowly or rapidly adapting
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FREE NERVE ENDINGS
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All but free nerve endings transmit _
Free nerve endings transmit via _ |
Abeta nerve
Adelta dibers and type C unmyelinated fibers |
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Cold receptors respond over 50 degrees - this is called _
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PARADOXICAL COLD
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_ is responsible for pain quality
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Somatosensory cortex
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_ main area for pain appreciation
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Reticular formation and thalamus
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Opioid peptides prevent release of _
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Substance P
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Infection of pain neurons in DRD is called _
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Herpes Zoster (Shingles)
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