Neuro Exam 2

98 flashcards · Other · by Jared Blackwell

1. Anterior commissure Optic chiasm Mamillary body

2. What is Meniere's disease?

   Endolymphatic hydrops endolymph swells in membranous labyrinth and activates hair cells making feel like you're spinning around. Vertigo, nausea, hearing loss, and tinnitus.

3. Spiral ganglia has primary affernets for hearing in cochlea. Sensory has cell bodies in periphery.

4. Rostral Medulla Cochlear nucleus - 2nd order neurons for auditory.

5. Caudal Pons Superior olivary nucleus does location of sound and reflex to CN 7.

6. Name the diseases for Norepinehprine, Dopamine, and acetylcholine.

   NE: Depression and ADHD. Incrased PTSD. Locus cereulus and Reticular formation and Decreased dopamine Parkinsons. Increase schinzophrenia. Substantia nigra. Decerase ACh dementia Basal nucleus and reticular formation. Raphe nucleus for seratonin.

7. Caudal Pons Superior Vestibular nuclei. Vesitibular ganglia->Vestibular nuceli ->Abducens nucleus--> Oculomotor nucleus.

8. Cingulate gyrus Corpus collosum Lateral Ventricle Caudate Internal capsule (top green) Thalamus (bottom green) Third ventricle **Globus pallidus is always on lateral part of internal capsule (can't see globus pallidus). Thalamus is medial to internal capsule.

9. Lateral ventricle Caudate Internal capsule (first green) Putamen **Globus pallidus is always on lateral part of internal capsule (can't see globus pallidus). Thalamus is medial to internal capsule. Insula far left.

10. Optic nerve Optic chiasm Optic tracts Pituitary stalk Mamillary bodies

11. Thalamus Anterior commisure Mamillary body Optic chiasm Hypothalamus

12. Corpus callosum Fornix Anterior commisure Optic chiasm Mamillary body

13. Hypothalamus lateral to third ventricle and medial to fornix.

14. Mamillary bodies.

15. Anterior pituitary gland.

16. Posterior pituitary gland.

17. Describe pathway of sound?

    Vibrations funneled to tympanic membrane which vibrates malleus, incus, and stapes. The stapes vibrates periplymph through oval window producing wave to move inner hair cells. Signal goes to CN 8 spiral ganglia then goes to Rostral Medulla cochlear nuclei. Then Caudal Pons at superior olivary nucleus and bifurcates. Goes to Caudal Midbrain inferior colliculs then to thalamus meidal geniculate finally to superior temporal gyrus.

18. Describe low frequency response?

    CN 8 in and CN 7 out.

19. What does Bone Conduction and Air Conduction test for?

    Bone Conduction: It tests the inner ear hair cells and cochlea - sensorineural. The vibrations on skull "giggle" the fluid in cochlea. Air Conduction: Tests middle ear.

20. What is the primary cortex for olfaction?

    Piriform cortex. Amygdala also involved in smell.

23. Describe the Anterior Nucleus of Thalamus

    Relay Nuclei: Info from Hippocampus enters thalamus Anterior Nucleus which goes through Anterior Limb and goes to Cingulate Gyrus.

24. Describe the VA & VL nucleus of Thalamus

    Relay Nuclei: Info comes from Basal Ganglia & Cerebellum enters Thalamus at VA & VL nucleus and goes through the Posterior Limb to the Precentreal gyrus-motor cortex.

25. Describe the VPL/VPM of Thalamus

    Info comes from STT & ML somatosensory and enters Thalamus at VPL/VPM and goes through posterior limb to the postcentral gyrus-insula.

26. Describe the Medial Geniculate Nucleus of Thalamus

    Gets info from cochlea and goes to medial geniculate nucleus and goes through Sublenticular part and ends at superior temporal gyrus. Does hearing

27. Describe the Lateral Geniculate Nucleus

    Info from optic tracts goes to thalamus at lateral geniculate and through the Retrolenticular limb to the occipital cortex. Does vision.

28. Describe the Pulvinar & Dorsomedial nucleus of Thalamus

    Pulvinar use retrolenticuar limb. Pulvinar & LP goes to parietal-occipital-temporal cortex. Dorsomedial goes to prefrontal cortex.

29. Where do the primary afferents for olfaction terminate?

    The piriform cortex ends at Mitral cell dendrites forming axodendritic synapse.

30. How does CN 1 depolorize?

    Through chloride efflux. Cilia has G-protein receptors which allow Ca2+ to enter which activates Cl- channel and chloride goes out. Nerve has high conc. of chloride inside.

31. Where does conscious perception of smell come from?

    Precentral gyrus, specifically Orbital cortex.

32. Rostral Pons Parabrachial Nucleus Taste and breathing. **Damage Superior Cerebellar Peduncle causes ipsilateral ataxia. Between Parabrachial Nucleus

33. What are the 3 functions of insula?

    Primary cortex for Pain, gustatory, vestibular.

34. Describe blood supply to the Anterior limb, Posterior limb, and Retrolenticular and Sublenticular limb of Internal Capsule.

    Anterior limb = ACA Posterior limb = MCA Retro/Sublenticular limb = PCA

35. What does the Reticular nucleus do?

    Sends inhibitory GABA to thalamus. Directs attention Sleep-wake cycle.

36. Centrum Semievale Corona Radiata Posterior limb of internal capsule.

37. Describe Osteogensis Imperfecta

    Genetic disorder in collagen. COL1A1 & COL1A2. "Brittle bone disease." Blue or Gray sclera.

38. Describe Horner Syndrome

    Disruption of sympathetic chain to face. Miosis (small pupil) Ptosis (lose superior tarsal muscle that assists levator palpebrae in raising eyelid) Anhidrosis Caused by: Apical lung tumor Aortic dissection Carotid dissection PICA stroke (lateral medullary syndrome)

39. Medial preoptic area Supraoptic nucelus Suprachiasmatic nucleus Optic chiasm

40. What has large neurons that contains oxytoncin & vasopressin in the hypothalamus?

    Supraoptic nucleus & Paraventricular nucelus. Send axons to posterior pituitary.

41. What is the function of the Supraoptic nucleus?

    Located in Thalamus that contains oxytoncin and vasopressin along with the paraventricular nucleus.

42. What does the medial preoptic area in hypothalamus do?

    Controls sleep, water balance, sexual behavior, reproductive capacity, and temperature. Inflammatory cytokins interleukin 1 and TNF stimulate prostaglandin synthesis in brain. PGE2 acts in medial preoptic area to allow body temp to be regualted at a higher level (fever).

43. What does the suprachiasmatic nucleus in hypothalamus do?

    Controls circadian rhythms.

44. What does the paraventricular nucleus in the hypothalamus do?

    Small neurons that control autonomic nervous system. Also large neurons send axons to posterior pituitary to secrete oxytocin and vasopressin with supraoptic nucleus.

45. What are the hormones of the anterior pituitary and posterior pituitary gland?

    Anterior pituitary gland: ACTH TSH LH & FSH Prolactin GH Posterior pituitary: Oxytocin ADH/vasopressin

48. Precentral gyrus -motor cortex Central sulcus Postcentral gyrus -sensory cortex. Blue is "hook" for motor of hand area of precentral gyrus.

49. Orbital cellulitis Infection behind septum May spread to cavernous sinus & brain through venous drainage.

50. The trochlear CN IV is outside septum and around orbit. Inside cone or septum is CN 3, 4, opthalmic artery.

51. Invasive Fungal Disease Mucor & Aspergillus are angioinvasive fungi that will occlude ophthalmic artery. Diabetes, immunosuppresion, metabolic acidosis. **Eyelid swelling, discharge, & on chemotrherapy with eye motility disorder is invasive fungal disease.

52. Seen in neurofibromatosis Optic nerve Glioma. Meningioma surrounds nerve going through. Orbital floor fracture can't feel check because CN V2

53. Neurofibromatous Decreased vision Proptosis (protrusion of eyeball). Afferent pupillary defect. Plexiform neurofriboma results in ptosis and may lose vision on that side.

54. Vertical conjugate movements. Superior Rectus -CN3 Neurons for upward eye movements are located near superior colliculi (rostral midbrain). Bilateral distribution. *These neurons go to CN 3.

55. What happens if pineal gland presses on top of midbrain

    Pineal gland tumors may press on top of midbrain (superior colliculi) causing a selective paralysis of upward gaze.

56. Describe damage to left abducens nerve and left abducens nucleus.

    Damage to left abducens nerve causes medial strabismus of left eye. Left eye cannot look left. Damage to left abducens nucleus causes medial strabismus of left eye AND right eye cannot look left. Damages MLF neurons. Right MLF damage: Left eye looks left but right eye cannot look left.

57. Describe horizontal conjugate movements

    Medial Rectus -CN3 Lateral Rectus -CN6 MLF Neurons for horizontal movements are located at paramedian pontine reticular formation PPRF (Caudal Pons). Unilateral distribution. Damage from one side will have deficit. Damage of PPRF effects same side. Receives input from contralateral cortex.

58. Glaucoma Lose the disc cupping.

59. What does premotor area and supplementary motor area do?

    Premotor area cortex PMA does external movements like catching dropped pen. Supplementary motor area SMA does interal guided movements. Bimanual activities like tying shoelaces.

60. Red arrow: Subthalamic Nucleus *2 o'clock to Red nucleus

61. Subthalamic Nucleus Signals GPi to inhibit movement.

62. 1) Caudate 2) Putamen 3) Globus pallidus externa 4) Globus pallidus interna 5) Subthalamic Nucleus 6) Substatia nigra

63. Striatum (putamen) Globus pallidus externa Globus pallidus interna Thalamus

64. Lenticular Nucleus GPi GPe Putamen

65. Substantia Nigra

66. Uncus Flocculus

67. Vermis (Cerebeullum) Nodulus red arrow.

68. Nodulus Flocculus Eye coordination.

69. Rostral Pons Parabrachial Nucleus Superior Cerebellar Peducle Pontine Nucleus (Mossy fibers).

70. Caudal Midbrain Superior Cerebellar Peduncle Decussation. Inferior colliculus for auditory.

71. Rostral Midbrain Superior Cerebellar Peduncle Near CN3 on way to Thalamus. Rostral Midbrain has Cerebral Peduncle (bottom sides). Corticospinal tract area around that is Cortical Pontine Fibers. Substantia nigra is light purple near Cerebral Peduncle.

72. Mammillothalmic tract Mammillary body Damage causes Anterograde amenesia. Mammillary body sends signal to Thalamus.

73. What is Wernicke-Korsakoff syndrome?

    Ataxia/nystagmus, amnesia, confabulation due to lack of thiamine (Vitamin B1). Common in alcoholics. Damage to mammillary bodies. Wernicke is confusion, nystagmus, ataxia. Korsakoff is amnesia, hallucination, confabulations. Mammillary bodies. Medial Thalamus.

74. Describe the NMDA receptor

    Glutamate binds AMPA and sodium enters cell. This creates voltage and magnesium block in NMDA is repelled. NMDA receptor allows calcium to come in allowing for LTP-long term potentiation.

75. Cerebral peduncle - Midbrain. Anterograde degeneration Loss of cerebeullum (red) Stroke lost motor cortex (upper left). *Cortical pontine, corticospinal tract, and corticobulbar tract run through Cerebral peduncle of Midbrain.

76. Describe difference in endolymph and perilymph

    Perilymph is BONY labyrinth, Na+. Endolymph is MEMBRANOUS labyringht, K+. Hair cells project to Endolymph.

77. Difference in Otolithic membrane, Basilar membrame, and Cupula.

    Otolithic membrane detects linear acceleration via saccule and utricle. Basilar membrane picks up sound. Cupula picks up angular acceleration.

78. Describe cranial nerve 3 lesion

    Eye will be down and out If pupil dilated, parasympathetic nerves impacted. Easily compressed by Pcomm aneurysm. NO dilation, ischemia common in diabetes. Adie's Tonic pupil: Parsympathetic block 1 eye dilated Tumor, inflammation, trauma, infection.

79. What causes anisocoria? What about light reflex?

    Anisocoria=Difference in pupil size. CN 3 palsy or Horner Syndrome. (parasym & symp). Light reflex tests optic nerve. If eye dilates common in optic neuritis. Demyelinating disorders. Multiple Sclerosis.

80. Describe a cranial nerve 4 palsy

    Eye tilted outward and cannot look down. Diplopia. Often will tilt head away from bad side.

81. Describe a cranial nerve 6 palsy

    Eye cannot move laterally. May see papilledema. Pseudotumor Cerebri High intracranial pressure. Woman, childbearing age Headaches.

82. Describe Anopia, Homonymous Hemianopsia, Bitemporal Hemiansopsia, and Quadrantic Anopia

    Anopsia Can't see out of one eye. Optic nerve or Retina lesion. Optic neuritis, MS TIA, embolus to retinal artery from carotid. Homonymous Hemianopsia Bilateral loss on SAME side. PCA Stroke Optic tract or Cortex damage. Bitemporal Hemianopsia Can't see out of both periphery. Optic chiasm, pituitary tumor/aneurysm. Quadrantic Anopia Meyer's loop, temporal lobe lose upper 1/4 bilaterally. Baum's loop, parietal lobe lose lower 1/4 bilaterally.

83. Retinitis Pigmentosa Vision loss in childhood. Lose photoreceptors.

84. Retinitis Retinal edema/necrosis Cytomegalovirus usually in HIV or transplant patients, immunocompromised.

85. Nonproliferative Diabetic Retinopathy May cause blindness. Degeneration of Pericytes which wrap capillaries. Microaneurysms Rupture-->hemorrhage. Yellow exudates of fatty lipids (1st picture).

86. Diabetic Retinopathy - Proliferative. Angiogenesis. Retinal ischemia b/c new vessels are friable and grow on retina. Retinal detachment. Macular edema-> Blindness.

87. Describe retinal detachment

    Often the posterior vitreous membrane detachment precedes this. Lose of connection to choroid which results in ischemia. Patient complains of flashy lights and black spots. Diabetic proliferative retinopathy, myopia, and eye surgery risk factors.

88. Retinal vein occlusion Branch retinal vein Arteriosclerosis compresses veins. Central retinal vein occlusion caused by thrombus.

89. What causes cherry red spots?

    Retinal Artery Occlusion, Tay-Sachs, or Niemann-Pick Disease. Thrombus from internal carotid artery to ophthalmic artery stuck in retinal artery. Outer parts photoreceptors are supplied by choriocapilliaris. Fovea is spared, retina degrades.

90. Papilledema Blurred margins of optic disc Due to increased intracranial pressure. May be seen in CN 6 palsy. Normal:

91. Describe macular degeneration

    Age related Macular degeneration also has two types like diabetics. Build up of metabolic by products which build up underneath retina. Dry macular degeneration accumulation of drusen formed between Bruch's membrane and Retinal pigment epithelium. Gradual vision loss. (Arrow is optic disc) Wet Macular degernation is break in Bruch's membrane resulting in hemorrhage. ANTI-VEGF treatment. Arrow is normal. **Macula has dual blood supply from MCA and PCA. Macular sparing if only PCA stroke.

92. 1,2,3 are Premotor Cortex 4 is Primary motor cortex. 5 is primary somatosensory cortex. 6 & 7 Posterior parietal cortex *Everything seen contributes to corticospinal and corticobulbar tracts.

93. What does the tectospinal tract do?

    Coordinates head/neck movements with eye movements. Hear something you turn. Medial pathway, goes to medial motor neurons. Begins in tectum (superior colliculus).

94. Describe the reticulospinal tract

    Does axial/proximal muscles and central pattern generator. Medial pathway, goes to medial motor neurons.

95. What does the vestibulospinal tract do?

    Does postural movements and balance. Medial pathway, goes to medial motor neurons.

96. Describe the premotor cortex (PMA) and supplementary motor area (SMA).

    Premotor area does external guided movements like grabbing a falling pen. SMA does internal guided movements like piano, tying shoelace.

97. Damage to STN results in what?

    Hyperkinetic movements, ballismus, chorea. Involuntary movements on opposite side.

98. Lower face only (contralateral)