Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
140 Cards in this Set
- Front
- Back
|
Which nuclei are in the Corpus Striatum |
Caudate Putamen Globus Pallidus CPG Striatum as it is stripey in appearance due to being separated by the internal capsule and gaps between the GP internus and externus. |
|
|
Which nuclei make up the Basal Ganglina |
Caudate Putamen Globus Pallidus Nucleus Accumbens Subthalamic Nucleus |
|
|
What are the 4 Cardinal signs of Parkinson's disease? |
Tremor at rest Rigidity Bradykinesia Loss of postural reflexes |
|
|
What are the 3 types of tremor |
Intention Resting Essential |
|
|
Signs of Cerebellar stroke |
Very similar to being drunk Slurred speech Ataxic gait (staggering, uncoordinated walking) Diplopia Incoordination Intention Tremor |
|
|
Characteristics of Huntingtons disease |
Gait abnormilities Lack of coordination Cognitive impairment Psychiatric disturbances Sleep disturbance Weight loss Accumulation of huntingtin protein Huntington's- due to loss of GABA neurons |
|
|
Main neurological (histological) changes in Parkinson's disease |
There is a loss of doperginic receptors in the Substantia Nigra |
|
|
Which gene is associated with Parkinson's Disease? It is also what accumulates in the Lewy bodies in the substantia nigra. |
Alpha- Synuclein gene |
|
|
What kind of receptor does dopamine act on? |
G-protein coupled receptor |
|
|
What class of drug is Rotigotine? |
Dopamine agonist usually administered in a transdermal patch. |
|
|
Drugs Given for epilepsy |
Sodium Valporate Pregablin Carbamzepine |
|
|
Example, mechanism and side effects of NSAIDS |
Aspirin, Ibruprofen, Diclofenac COX 1/2 inhibitor Nausea and GI bleeding |
|
|
Examples of Opioids |
Morphine- Short half-life Fentanyl Methadone- Very long half-life Tramadol- longer half-life than morphine |
|
|
Side effects of Opioids |
Analgesia Respiratory depression Drowsiness Euphoria Miosis Nausea and Vomiting Hypotension Itching |
|
|
Name a local anaesthetic and give the mechanism of action and give side effects |
Lignocaine, Lidocaine Blockage of sodium channels Hypotension Respiratory depression Bradycardia |
|
|
What kind of stimuli do TRPV, TRPM, ASIC respond to? |
TRPV- thermal stimuli TRPM- Cold Stimuli ASIC- Acid Many- Mechanical pain |
|
|
What number of the cortex is the primary motor cortex? |
Area 4- just anterior to the central sulcus |
|
|
What is apraxia? |
An inability to perform some purposeful motor tasks |
|
|
What symptoms would a lesion of the frontal eye fields (FEF) cause? |
Inability to follow objects with their eyes- they turn their head to follow objects in their peripheral vision. Area 10 of the frontal cortex |
|
|
What is antreograde and retrograde amnesia |
Antrograde- loss of ability to make new memories Retrograde- loss of memories before then amnesia event |
|
|
What cells are lost in the demylinating disease Multiple Sclerosis? |
Oligodendrocytes |
|
|
What kind of receptor do Benzodiazepines affect? |
GABAa Cl- channels. |
|
|
What drugs do you give for: Mild to moderate AD? Severe AD? |
Mild to moderate- Acetylcholinesterase inhibitors. Severe- NMDA receptor blockers |
|
|
How'd you calculate the CPP? |
CPP =MAP-ICP CPP is cerebral perfusion pressure |
|
|
What is addiction? |
Addiction-a chronic disease characterized by drug seeking and use that is compulsive, ordifficult to control, despite harmful consequences. |
|
|
What are the actions of COMT and MAO (A/B)? |
They degrade dopamine to an inactive form |
|
|
Give examples of genetic abnormalities that cause Schizophrenia. |
BDNF DAOA COMT Dysbindin DISC1 |
|
|
Give examples of positive and negative symptoms. |
Positive- hallucinations, delusions, thought disorder, disorganized behaviour.- Thing normal people don't experience Negative- social withdrawal, apathy, emotional blunting, incongruous emotions,neglect of personal care.- Things a person with Schizophrenia looses. |
|
|
What's the function of the pontine olives? |
They are found on the anterior surface of the brainstem and are involved in motor learning (superior) and perception of sound (inferior). |
|
|
What are the functions of the colliculi (little hills)? |
They are involved in auditory and visual reflexes. |
|
|
Give the main excitatory and inhibitory neurotransmitters. |
Excitatory- Glutamate Inhibitory- GABA Pleasure- Dopamine |
|
|
What is the main neurotransmitter in the basal ganglia? |
Inhibitory GABA but the input is via glutamate. |
|
|
Which neuron inputs from the cortex into the basal ganglia? |
The medium spiny neuron is an inhibitory GABA releasing neuron. Input from the cortex is via dopamine. They innervate the globus pallidus and substantia nigra. |
|
|
Is the direct pathway excitatory or inhibitory? |
Direct- Excitatory- D1 receptors (Globus pallidus Interna) Indirect- Inhibitory- D2 receptors (Globus pallidus Externa) |
|
|
What happens in Parkinson's disease? |
There is loss of dopaminerguc input to the caudate and putamen nuclei which leads to lack of activation of the D1 receptors causing loss of substanita nigra cells. |
|
|
What do the frontal eye fields do? |
They control eye movements- if they're damaged bilaterally then when tracking objects they turn their head and overshoot. |
|
|
What is the function of the dorsolateral prefrontal cortex? |
It is involved in the planning of movement and future actions. Damage also usually affects personality and ability to plan tasks. |
|
|
What does the motor thalamus do? |
It is an important route for motor commands from the basal ganglia and the cerebellum to the corticospinal tract. |
|
|
Corticobulbar tract? |
Travels from the cortex to the brainstem where it innervates the cranial nerves the control head and neck movement. It travels through the internal capsule and becomes the corticospinal tract. |
|
|
What is the extrapyramidal tracts? |
They are tracts which originate in the brainstem and control posture, locomotion and gait. |
|
|
What does damage to the vermis cause?
|
Truncal ataxia
|
|
|
What is the difference between decorticate and decerebrate posturing? |
Decorticate- 2 c's= arms are c shaped and is more dangerous than decerebrate. Decorticate damage= corticospinal tract damage in the midbrain Decerebrate- damage to the corticospinal tract below the midbrain (red nucleus). |
|
|
What is hemiplegic dystonia?
|
It is where after a stroke persistent spascicity progresses to a state where the arms are permanently flexed and legs extended. |
|
|
What does the clasp knife reflex indicate? |
Chronic cerebral motor lesions. |
|
|
What is the function of the Dorsal and Ventral spinocerebellar tracts?
|
Dorsal- Totally ipsilateral and carries information from the proprioceptors (joints, muscle spindles). Ventral- Contralateral in the spinal cord then recrosses in the brainstem. State of reflexes and interneurones in spinal cord. |
|
|
What kind of inheritability is Huntington's disease? |
Autosomal dominant disease- huntingtons chromosome 4. Treat with tetrabenzine- synaptic vesicle amine transporter inhibitor. |
|
|
Multiple Sclerosis S+S |
MS is a CNS demyelinating disease (loss of oligodendrocytes) S+S: Fatigue Vision problems Numbness and tingling Muscle spasms, weakness and stiffness Mobility problems Pain |
|
|
What is Uhtoff's syndrome? |
It is the phenomenon where patients with demyelinating diseases experience a worsening of S+S during hot weather or conditions. |
|
|
Lhermitte's sign |
A sensation people with MS experience when they bend their neck forwards. Usually an electrical sensation that travels down the back of the neck into the arms, legs, fingers and toes. |
|
|
Give the side effects of local anesthesia. |
Local anesthesia- blocks sodium channels. Side effects: Hypotension respiratory depression Bradycardia |
|
|
What is trigeminal neuralgia? |
It is a common lancating facial pain caused by compression, stretching or distorsion of the CN V facial root. |
|
|
What are nociceptors? |
Nocioceptors are specilised sensory neurons that detect noxious (unpleasant stimuli). They are the free nerve endings of A delta (fast) and C (slow) fibres. |
|
|
Neuropathic pain? |
Pain relating to damage to peripheral or central nerves- lancating, prickling, electric shock. |
|
|
Somatic pain |
Arises from cutaneous or deep tissues, well localised, dull or achy- a-delta fibre activity
|
|
|
Visceral pain |
Arises from organ infiltration, compression or stretching. Poorly localised, ache, pressure or sharp- C-fibre activity. |
|
|
What is pain? |
An unpleasant sensory and emotional experience associated with actual or potential tissue damage. |
|
|
What type of fibre is mainly carried in the the anterior spinothalamic tract? |
Enters at lamina V and carries mainly A-delta fibres- Pain localisation. |
|
|
Where does the lateral spinothalamic tract enter and what type of fibre does it carry? |
It enters at lamina I and carries mainly slow C-fibres.- Emotional aspects of pain. |
|
|
How does inflammation cause peripheral sensitisation? |
Inflammatory mediators release arachidonic acid from Phospholipase A2 enzymes in cell membranes. This is used by COX 1+2 enzymes as a substrate to produce prostaglandins which activate and sensitise C-fibres. |
|
|
Allodynia |
Where there is an abnormal painful response to an normally innocuous stimuli. |
|
|
Hyperalgesia |
A heightened response to a stimulus that is usually painful. |
|
|
What is chronic pain? |
A continued state of experiencing pain where the pain persists past the healing phase. |
|
|
What is cognitive behavioral therapy? |
Cognitive behavioural therapy (CBT) is a talking therapy that can help manage problems by changing the way you think and behave. |
|
|
What is the function of limbic system? |
5 F's Feeding Forgetting (memory) Fighting Family F*cking- sexual arousal |
|
|
What is the functions of the cingulate gyrus? |
It is responsible for registering how severe the pain is and also what actions to take to avoid the pain. |
|
|
What is the function of the hippocampus? |
It is responsible for spatial and time awareness and labels new memories to be identified later. Long-term memory. |
|
|
What kind of cells are reduced in number in epilepsy? |
Chandilier cells- inhibitory interneurons. |
|
|
What is the role of the Fornix and what effect would damage have? |
The fornix is involved in memory relay and damage results in anterograde amnesia. |
|
|
What structure is found lateral to the 4th ventricle?
|
The thalamus |
|
|
What is the function of the flocculo-nodular lobe? |
It is involved in the vestibulocerebellum and co-ordinates head and eye movements. Flocculonodular lobe looks like a bow tie- worn on the neck control head + neck movements. |
|
|
How and where are peptide neurotransmitters produced? |
They are produced in the cell bodies via transcription and translation.
Somatostatin, Substance P, Cholecystokinin, Enkephalins. |
|
|
How and where are non-peptide neurotransmitter produced? |
They are produced presynaptically by active uptake of precursor molecules. |
|
|
What is the delay between pre-synaptic terminal depolarisation and onset of post-synaptic response. |
0.5msec. |
|
|
What are auto receptors? |
They are receptors found presynaptically which bind with the released products and regulate their own release. |
|
|
In the treatment of Parkinson's what is the target for DBS? |
In Parkinson's the target for deep brain stimulation is the GPi as this has an inhibitory effect on the motor cortex so blocks these inhibitory signals. |
|
|
How to diagnose Schizophrenia? |
Using the DSM IV criteria- two or more of the criteria present for a significant portion of time during a 1-month period. Criteria- Delusions, Hallucinations, Dis organised speech, negative symptoms. |
|
|
Name one side effect of mono-amine oxidase inhibitors. |
When taking monoamine oxidase inhibitors you cannot eat thiamine containing foods (cheese, yeast extract) as this causes critical hypertension episodes. |
|
|
Which two enzymes are responsible for production of pathogenic amyloid beta plaques? |
Beta-gamma secretase enzymes. |
|
|
What are the 3 types of headache? |
Primary- occurs with no cause Secondary- Occurs due to a cause- sinusitis Medication overdose |
|
|
What are the 3 types of primary headache? |
Migraine- pulsing head,photo and phonophobia. Tension- band like non-pulsating. Cluster- short episodes of severe pain. |
|
|
What are the S+S of Migraine? |
Unilateral Pulsating quality Nause/ vomiting Photophobia Phonophobia |
|
|
Which part of the brain is responsible for the level of consciousness? |
The Reticular formation in the pons.
|
|
|
What effects do orexins have on sleep? |
(Ghrelin) Keeps the person awake (inhibits sleep). |
|
|
Which enzyme converts DOPA to Dopamine and 5-Hydroxytryptophan to 5-HT?
|
DOPA decrboxylase |
|
|
What is tolerance? |
It is the phenomenon where the drug taker becomes desensitised to the effects of the drugs and takes larger and larger doses. |
|
|
What is the function of the Ventral and Lateral spinothalamic tracts? |
Ventral- transmits crude touch and firm pressure. Lateral- pain and temperature. |
|
|
Give 4 non-motor complications of Parkinson's |
Olfactory dysfunction Depression Dementia Sleep disturbance (insomnia) Autonomic system dysfunction |
|
|
What drug is L-DOPA usually given with? |
L-DOPA is usually given with a dopamine decarboxylase inhibitor (Benserazide) to prevent peripheral breakdown of L-DOPA. |
|
|
What is neuroleptic malignant syndrome? |
Is it where use of some neuroleptic drugs causes hyperpyrexia, rigidity, confusion, autonomic instability. |
|
|
What class of receptor is the dopamine auto-receptor? |
D2 Dopamine autoreceptor |
|
|
What is the precursor molecule to L-DOPA in Dopamine production? |
Tyrosine --> Tyrosine hydroxylase--> DOPA --> DOPA decarboxylase --> Dopamine.` |
|
|
What are the stages in 5-HT synthesis? |
Tryptophan--> Tryptophanhydroxylase--> 5-hydroxytryptophan--> DOPA decarboxylase--> 5-HT. |
|
|
What is the function of the Orbitofrontal cortex?
|
Controls motor responses associated with the limbic system (thirst, hunger, sex).
Area 11- sat on the roof of the orbit. Deficit- pseudopsychotic- impulsiveness, sexual disinhibition, lack of concern for others. |
|
|
Anhedonia |
Where normally pleasurable activities are no longer pleasurable.
|
|
|
What are the 4 types of depression? |
Major- intense feelings of sadness Bipolar- unpredictable shifts in mood Dysthymic- Less intense but persists for longer Post-partum- occurs after delivery |
|
|
What chromosomes encode for APP Presenilin 1 Presenilin 2 ApopE4 |
APP-CHROMOSOME 21 Presenilin 1- Chromosome 14 Presenilin 2- Chromosome 1 ApopE- Chromosome 19 |
|
|
Which ApopE is protective and harmful? |
Protective- ApopE2 Harmful- ApopE4 |
|
|
Where are these neurotransmitters produced? Noradrenaline Serotonin Dopamine Achetylcholine |
Noradrenaline- Locus Correleus Serotinin- Raphe nucleus Dopamine- Ventral tegmental area Acetycholine- pedunculopontine area |
|
|
Which area shows particular changes in depression? |
The left subgenual anterior cingulate cortex as it shows reduced metabolism and activity. This causes rummnation- continual circulating of thoughts as the cingulate cortex is part of Papetzes circuit. There is also reduced volume in the hippocampus. |
|
|
What substance can be used to asses dopamine levels in the brain? |
Homovanillic acid |
|
|
What is Ballismusand Athetosis? |
Ballismus- Uncontrolled sudden jerky movements. Athetosis- Involuntary smooth 'sinus' movements. |
|
|
Where do conscious and unconscious motor actions come from in the brain? |
Conscious- cortex Unconscious- Brain stem (extrapyramidal) |
|
|
What are the two divisions of the corticobulbospinal tract? |
Corticalbulbar component- supplies the cranial nerves supplying the head and neck. Corticospinal component- forms the corticospinal tract which controls the trunk and limbs.FP |
|
|
What area of the brain does the Wisconsin card sorting test assess? |
The dorsolateral prefrontal cortex. |
|
|
What is the function of the cerebellum? |
It recieves feedback from proprioception and other sensory organs and integrates this with commands coming from the motor cortex to make movements fluid and smooth. |
|
|
What is the structure of the vestibulocerebellum system in co-ordinating the head, neck, eyes and legs? |
Vestibular nuclei--> Medial longitudinal fasiculus--> Neck and eyes Vestibular nuclei--> Lateral vestibulospinal tract--> Legs These tracts help keep the head balanced on the body and body balanced on the legs on the ground. |
|
|
What is the most common cause of flocculonodular lobe syndrome? |
Medulloblastoma |
|
|
What is the function of the superior, middle and inferior peduncles? |
Superior- output Middle- Input- from cortex Inferior- input- from spinal cord |
|
|
What is the role of cannanaboids in the brain? |
They regulate synaptic neurotransmission. CB1 receptor stimulation can inhibit tremors and spasticity in MS. |
|
|
What substance can induce Parkinsons by damaging dopamine receptors and what enzyme is critical to this? |
MPTP is a prodrug of MPP+ which is produced during it's metabolism. This MPP+ causes increased oxidative stress on the mitochondrial respiratory chain 1. MAOB converts MPTP to MPP+. |
|
|
Why does L-DOPA cause nausea and vomiting and other unwanted side effects? |
L-DOPA is non-specifically converted to Dopamine which activates extra pyramidal tracts causing these unwanted side effects. |
|
|
Give all the receptors in the dopamine receptor families D1 and D2 |
D1- D1 + D5 D2- D2 + D3 + D4 |
|
|
What are the 3 dopaminergic pathways in the brain? |
Mesocortical Mesolimbic Nigrostriatal |
|
|
Contraindication and indicators for Deep Brain Stimulation |
Significant cognitive dysfunction Psychiatric symptoms Indicators: Increasing off periods Sever medication side effects Resistance to other medical therapies |
|
|
What is necessary for diagnosis of MS? |
Lesions in atleast two separate areas of the CNS that occurred at to different points in time. Juxta cortical Spinal Cord Intraventricular Periventricular Infratentortorial |
|
|
In MS what kind of MRI is used to image areas of inflammation? |
T1 weighted MRI scan. |
|
|
What level is a lumbar puncture taken? |
L3/4 The spinal cord ends at L1/2 |
|
|
What are the guidelines for NICE treatment of neuropathic pain? |
Give one of amitriptyline, duloxetine,gabapentin or pregabalin. Doesn't work--> Offer one of the 3 remaining drugs. Doesn't work --> Consider Tramadol Follow this except for trigeminal neuralgia |
|
|
What lamina is the inhibitory interneuron located? |
Lamina II. |
|
|
What are Otoconia? |
They are small rocks of calcium carbonate derived from the utricle. |
|
|
Which hair cells are responsible for vertical and horizontal encoding? Utricles or Saccules |
Utricles- Horizontal Saccules- Vertical (Saccules used when going up vertical stairs) |
|
|
What is Kulver-Bucy syndrome? |
It is loss of ability to detect fearful or dangerous situations due to loss of the Amygdala- loss of the tips of the temporal lobes. |
|
|
Which gene is involved in the Na+ channelopathy which causes increased excitability of neuronal cells which contributes to epilepsy? |
SCN1B gene |
|
|
Which gene is upregulated in chronic drug use? |
FosB Isoforms |
|
|
Criteria for migraines |
1.Unilateral location 2.Pulsating quality 3.Moderate or severe pain intensity 4.Aggravation by or causing avoidance of routine physical activity (e.g. walkingor climbing stairs) D.During headache, occurrence of at least one of following symptoms: 1.Nausea and/or vomiting 2.Photophobia and phonophobia |
|
|
What are the 5 stages of migraine development? |
Normal Premonitory- food craving, yawning, neckpain Aura- flashing light Headache- photophobia, Phonophobia Resolution- Vomiting, Medication Recovery- Tired, hungover, diuresis Normal |
|
|
What is an aura in migraine? |
Usually a whiteness spreading over the visual field. Due to cortical spreading depression. If it disappears when the eyes are closed then this is not a migraine and originates in the occipital lobe. |
|
|
Persistent vegetative state vs Permanent vegetative state? |
Persistent vegetative state- >1 month Permanent vegetative state- >12 months for traumatic injury or >6 months for anoxic injury |
|
|
Typically what are definitive signs of a left hemisphere stroke? |
The left hemisphere mostly does reading and speaking. |
|
|
What is the ABCD2 score? |
Used to assess risk of stroke- A- Age >60 B- BP >140/90 C- Clinical features- hemiparesis, speech alone D- Duration >1 hour D- Diabetes |
|
|
What is Tardive dyskinesia and what causes it? |
It is caused by prolonged use of typical antipsychotics. Involuntary movements of thelips, jaw, face; grimacing, constant chewing, tonguethrusting. |
|
|
What is neuroleptic malignant syndrome? |
It is a potentially lethal complication of antipsychotic drug use. Causes: hyperpyrexia, Muscle rigidity, Tremor, Confusion, Autonomic instability. |
|
|
Define dementia |
‘Dementia’ is a term used to describe asyndrome that may be caused by a number of illnesses in which there isprogressive decline in multiple areas of function, including; •Declinein memory and reasoning •Declinein communication skills •Inabilityto carry out daily activities. |
|
|
Which organ controls the sleep-wake cycle? |
The suprachiasmatic nucleus- has input from the retina and output to the tubermamillary body which controls release of Histamine. |
|
|
Stages of migraine onset |
Cortical spreading depression- swollen meningeal arteries and release of inflammatory mediators. Activates nerves to the trigeminal ganglion. Peripheral sensitisation- throbbing sensation. Trigeminal nerve transmits pain to the trigeminal nucelus caudalis. Pain impulses are transmitted to the thalamus and interpreted as pain (headache). |
|
|
Which nerve supplies all the muscles of the mouth and pharynx? |
The vagus- damage results in dysphagia |
|
|
Which hemisphere is responsible for the majority of speech, language and movement/ is the dominant hemisphere in most people? |
Left side- most people are right handed- contralateral sides therefore the left cortex is the dominant side. |
|
|
What are the 3 layers of the cerebellum? |
Molecular layer Purkinje layer Granular layer |
|
|
What is cortical spreading depression? |
A transient and local suppression (depression) of the spontaneous electrical activityin the cortex (cortical) which moves slowly across the brain (spreading). |
|
|
What 3 neurological signs would you get with these types of herniation? Tentorial (uncal) Subfalcine Tonsillar |
Tentorial- compression of cranial nerve III (occulomotor). Subfalcine- Leg weakness Tonsillar- Respiration depression |
