Flashcards
HNN Block 1
Cards in this deck (123)
- 1Eg. Right sided weakness affecting most of the body but sparing the legHemiparesis
- 2Gives rise to descending pathways that control voluntary movementMotor Cortex
- 3One of the main motor pathways involved in voluntary movementPyramidal tract
- 4One of the main motor pathways; passes from motor cortex through brainstem, crosses the midine and activates motoneurons in the spinal cordPyramidal tract
- 5Left motor cortex controls muscles on which side of the body?Right
- 6Lesion on left side of brain, involves both motor cortex and language areas, likely diagnosisStroke affecting left middle cerebral artery
- 7Caused by discrete lesions affecting myelin surrounding many CNS axons, seen as plaque in white matter of brain and spinal cordMultiple sclerosis
- 8Example of sensory changes in multiple sclerosisNumbness
- 92 examples of motor symptoms in multiple sclerosisWeakness, Ataxia
- 10Distinguish between partial loss of vision and double visionVision loss = sensory impairment - results from optic nerve damage. Double vision = motor impairment - results from altered eye movements
- 11Lesions affecting the cerebellum can result in thisAtaxia
- 12Lesions affecting the spinal cord result in this sensation and motor impairmentNumbness, muscle weakness
- 13Neuron whose cell body is located in the CNS but whose axon enters the PNSPreganglionic neuron
- 14Neuron whose cell body and axon are located in the PNS and its axon innervates a target organPostganglionic neuron
- 15Postganglionic cell located in which type of structure?Ganglion
- 16In the sympathetic division of the ANS where are the preganglionic neurons?In thoracic and upper lumbar spinal cord T1-L3
- 17In the parasympathetic division of the ANS where are the preganglionic neurons?In brainstem and sacral spinal cord
- 18Preganglionic sympathetic neurons are located in which structures?Sympathetic ganglia
- 19Where are sympathetic ganglia found?Sympathetic chain next to vertebral column
- 20Where are the parasympathetic ganglia found?In the walls of the viscera that they innervate
- 21Explain the sequence of events which sensitises nociceptors (tip: stimulus; reaction; result; effect)Tissue damage. Damaged cells release ATP and H+, contributes to sensitisation.
Inflammatory mediators released -activating inflammatory cells. Iinflammatory cells release cytokines - forming inflammatory soup that bathes and sensitises nociceptive neurons. - 22Explain the significance of the cascade effect of mediators induced by inflammation in relation to nociceptor sensitisation?The process of nociceptor sensitisation continues after the initial stimulus to ensure that pain stimuli are perceived and we are able to initiate protective responses.
- 23Distinguish between nociceptive and sensory components of the primary afferent pathwayNociceptors are receptors of stimuli - thermoreceptors, mechanoreceptors, chemoreceptors.
Whereas, sensory axons are the Ad and C fibres that transmit the action potentials transduced by nociceptors. - 24What is the principle underlying the gate control theory of pain?Perceived pain is driven and damped. Driven so that appropriate protective responses can be made. Damped so that we are not overwhelmed by the sensation.
- 25Gate control theory of pain. When there is no pain stimulus what happens?There is no signal transduction by C fibres. The brain doesn't perceive pain.
- 26Gate control theory of pain. When there is a painful stimulus what happens? (5 Points)Nociceptor sensitisation and activation. Signal transduction by C fibres.
Deactivation of inhibitory interneuron. Activation of pain pathway.
Brain perceives pain. - 27Gate control theory of pain. When there is a pain stimulus plus nonpain stimulus what happens?Nociceptor sensitisation and activation. Signal transduction by C fibre.
Non-pain receptor activation. Touch stimulus activates Ad fibre.
C fibre inhibits inhibitory interneuron whilst Ad fibres stimulate inhibitory interneuron.
Pain is perceived by the brain but intensity is damped by the input of the Ad fibre. - 28Precisely where do the pairs of spinal nerves exit the VERTEBRAL COLUMN?Via intervertebral foramen.
C1-C7 nerve pairs exit through foramen located above their corresponding vertebrae.
C8-Co1 nerve pairs exit through the foramen below their corresponding vertebrae. - 29What is spina bifida?Congenital malformation results from failure of closure of the neural tube.
- 30Name some types of spina bifidaOcculta, lipomeningocoele, meningocoele, myelomeningocoele
- 31Which 2 factors determine the severity of spina bifida?Site at which neural tube fails to close. Tissue types which are exposed to the outside.
- 32How is tissue organised in a transverse section of the spinal cord?White matter in columns surrounding grey matter which look like horns in transverse section
- 33Identify the types of white matter in the transverse section of spinal cordDorsal, lateral and ventral funiculae (columns)
- 34Identifiy the types of grey matter in the transverse section of spinal cordDorsal, intermediate, ventral horns
- 356 bones of skullFrontal, parietal x2, occipital, temporal x2
- 363 gross components of brainNeocortex, cerebellum, brainstem
- 37Location of Broca's areaInferior frontal gyrus (pars opercularis, pars triangularis)
- 38Broca's area most commonly found in which hemisphere?Left
- 39Results of damage to Broca's areaExpressive aphasia; non-fluent; slow speech
- 40Specialisation of Wernicke's areaAuditory association cortex
- 41What does the auditory association cortex do?Sensory language area, lexical processing
- 42Wernicke's areas found predominantly in which hemisphere?90% in left hemisphere
- 43Damage to Wernicke's area results in these effectsReceptive aphasia; extremely poor comprehension
- 443 groups of nuclei of basal gangliaCorpus striatum; Sub-thalamic nuclei; Substantia nigra
- 45Corpus striatum comrpises which 3 nuclei?Caudate; putamen; globus pallidus
- 46Name the 4 sections of the corpus callosum seen in sagittal sectionRostrum; genu; body; splenium
- 47Filtrate of blood in subarachnoid spaceCSF
- 48Location of the choroid plexusLateral ventricles
- 493 key functions of CSFCSF protects brain and spinal cord from trauma.
CSF supplies nutrients to nervous system tissue.
CSF removes waste products from cerebral metabolism - 50Fluid reabsorbed into the venous drainage system of the headCSF
- 51Course of CSFLateral ventricles to third ventricle to fourth ventricle to brainstem and spinal cord
- 52Connects third and fourth ventricleAqueduct of midbrain
- 53Connects lateral and third ventriclesInterventricular foramen
- 542 nuclei that lie medial to the lentiform nucleusHead of caudate nucleus and thalamus
- 55Name the 4 boundaries of the lentiform nucleusAnterior, posterior limb, and Claustrum. Genu at junction of anterior and posterior limbs.
- 56Capsule composed of lentiform nucleusInsular capsule
- 57Major components of circle of WillisAnterior x2, middle x2 and posterior x2 cerebral arteries
- 58Distinguishing features of Alzheimer's diseased brainCortical atrophy, enlarged ventricles.
- 593 Components of brainstem, caudal to cranialMedulla oblongata, pons, midbrain
- 60Origin of all motor cranial nerve nucleiBrainstem
- 61What is a sensory unit?Single sensory nerve fibre and receptors associated with it
- 62Type of quadrantic hemianopia produced by a lesion in Baum's loop (Rt parietal radiation)Left lower quadrantic hemianopia
- 63Type of quadrantic hemianopia produced by a lesion in Meyer's loop in the Rt Temporal lobe?Left upper quadrantic hemianopia
- 64Which type of quadrantic hemianopia results from lesions of the temporal lobes?Right or left upper
- 65Controls more vital functions than any other equivalent volume of nervous systemBrainstem
- 66Interaction between the brainstem and cerebral cortex is essential for what?Consciousness
- 674 Functions of CNIII - Oculomotor1. Extrinsic eye muscles except superior oblique and lateral rectus
2. Skeletal muscle of eyelid
3. Pupillary constriction
4. Accommodation for near vision - 68Sensory, special sensory, motor and secretomotor functions of Facial nerve CNVIISensory to skin of external ear
Special sensory - taste (anterior 2/3 tongue)
Motor to muscles of facial expression, Secretomotor to lacrimal and salivary glands - 69Motor, secretomotor, sensory, and special sensory functions of CNIX - GlossopharyngealMotor - swallowing;
Secretomotor - parotid salivary gland
Sensory - carotid body, palate and posterior 1/3 tongue
Special sensory - taste - posterior 1/3 tongue including taste - 70When testing reflexes in limb muscles how is the limb positioned?So that muscle being tested is under slight tension but not bearing weight
- 71When testing reflexes of the limbs what should happen when the tendon is struck with the patellar hammer?The muscle gives a brief twitch
- 72Knee-jerk reflex tests which muscle?Quadriceps femoris
- 73Ankle-jerk reflex tests which muscle?Gastrocnemius
- 74Reflex contraction induced in masseter muscle in response to brisk stretchJaw-jerk reflex
- 75How to elicit the Jaw-jerk reflexSubject allows lower jaw to sag. Examiner places thumb or forefinger over tip of subject's mandible and taps the thumb downwards with the tendon hammer
- 76Jendrassic manoeuvreSubject pulls on opposed fingers for a reinforced jaw-jerk reflex test
- 77Reflex test that assesses the integrity of pyramidal tractPlantar response aka Babinski reflex
- 78How to elicit the Babinski reflexWith blunt instrument firmly stroke outer edge of sole, from heel towards big toe. Normal aka Babinski negative response in adult is downward curling of toes. In neonates and adults with cortico-spinal lesion toes fan out - Babinski-positive.
- 79What is the effect of a lesion that damages the optic chiasm?Medial, crossed bundles of fibres are damaged producing a bitemporal hemianopia
- 80Define 'visual field'Everything that can be seen with one eye without changing its point of fixation
- 81What response may be elicited by shining a light into one eye? When may this be useful clinically?Direct and consensual pupillary responses Screening for brain injury in neuro examination - absent responses indicate a lesion at the level of the upper brainstem
- 82What symptoms are likely to result from infarction of the region of the post. limb of the Rt internal capsule?Contralateral hemiparesis
- 83What pass through the blind spot to make it blind?Axons of retinal ganglion cells that become the optic nerve
- 844 examples of anaesthetic agentsHalothane, desflurane, esflourane, propofol
- 85In a superior view of the retina what relation is the fovea to the optic disc?Fovea is lateral and optic disc is medial
- 86What is the difference in the content of nerve fibres between the left optic nerve and the left optic tract?Left optic nerve - fibres from retinal ganglion cells of the left eye only.
Left optic tract - fibres from: (i) retinal ganglion cells of temporal retina (central VF) of left eye
(ii) retinal ganglion cells of nasal retina (periph VF) of right eye - 872 exampes of sedativesBarbiturates, benzodiazepines
- 88What is the role of the fovea centralis and why is it so-called?'central pit' represents deepest part of the retina, is the area of highest visual acuity and is densely packed with cones
- 893 examples of antipsychotic drugsClozapine, chlorpromaine, haloperidol
- 903 examples of analgesic drugsNSAIDs, opiates, carbamazepine
- 91Papilloedema of the retina is a clinical sign of what? Give 3 possible causesRaised ICP
Head injury
Subarachnoid haemorrhage
Tumour - 922 examples of psychomotor stimulant drugsMethylphenidate, amphetamine
- 93Differentiate between moderate and severe papilloedema of the retina at the optic discModerate - crescent
Severe - halo - 94Define psychotomimetic drugsDrugs that cause disturbance of perception and of behaviour that cannot be simply characterised as sedative or stimulant effects
- 95State three functions of lacrimal fluidLubricant for eyelid movement
Moisten cornea for comfort
Bactericidal action stimulated by irritants (tears) - 964 examples of psychotomimetic drugsLSD, mescaline, phencyclidine, THC
- 97Define consensual pupillary responseWhat happens to other eye when light shone directly into one pupil. Normal = constriction
- 982 examples of cognition enhancing drugsTacrine, donepizil
- 99Define the accommodation reflexConstriction of pupils when eyes focus on close object - improves depth of focus
- 1003 main dopamine pathways in CNSNigrostriatal, mesolimbic/cortical, and tuberhypophyseal
- 101Define direct pupillary responseWhat happens to the pupil when light shone straight into that eye. Normal = constriction
- 102What is the significance of the pupil?Defines the area over which light can enter the eye and reach the retina
- 103What maintains intraocular pressure?Rate of production of aqueous humour = rate of absorption of aqueous humour
- 104What is the canal of Schlemm?Canal into which aqueous humour drains, from here fluid returned to venous blood.
- 105What is the effect on sight of a lesion after the optic chiasm?Pt blind in the visual field contralateral to side of lesion. Homonymous hemianopia.
- 106Optic radiations pass through the cerebral hemisphere in which part of the internal capsule?Posterior
- 107Which 2 lobes do the optic radiations pass through?parietal, temporal
- 108Which lobe marks the terminus of the optic radiations?Occipital
- 109Which 2 types of visual defects are produced when the occipital lobe is damaged?Homonymous hemianopia
Scotoma - 110Which cerebral aa supply the occipital lobes?middle and posterior cerebral aa
- 111Which cerebral aa supply the posterior tip of the occipital lobe?middle
- 112A lesion affecting only the posterior tip of the occipital lobe produces which type of homonymous hemianopia?Central homonymous hemianopia sparing the peripheral vision
- 113A lesion affecting the anterior of the occipital lobe will produce which type of homonymous hemianopia?Peripheral homonymous hemianopia - sparing the central vision sensed by the macula.
- 114Trochlear nerves innervate superior oblique muscles on the X sidecontralateral
- 115How do you differentiate between retinal arterial and venous vessels?Central retinal artery located nasal to central vein. At given distance from optic disc ration vv:aa is 1.3:1
- 116Axons of lateral geniculate cell bodies run as optic radiations to reach the visual cortex on which surface of the occipital lobe?medial
- 117Visual cortex is a layer of grey matter on the surface of the occipital lobe alongside which fissure?Calcarine
- 118State the examination sequence for direct pupillary reflexAsk Pt to fix eyes on distant point straight ahead. Bring torchlight from side to shine on left pupil. Look for constriction of left pupil. Repeat for right pupil.
- 119State the examination sequence for the consensual pupillary reflexAsk the Pt to fix eyes on distant point straight ahead. Bring bight torchlight from side to shine on left pupil. Look for constriction of right pupil. Repeat for Left pupil.
- 120State the examination sequence for accommodation reflexAsk Pt to fix eyes on distant point straight ahead. Present object 15cms in front of eyes and ask Pt to focus on it (demonstrates convergence). Look for pupillary constriction.
- 121Explain the swinging light reflexTests for relative afferent pupillary defect which is a decreased direct response caused by unilateral decreased visual function. The torchlight is moved back and forth between the eyes every 2 secs. Abnormal response is affected pupil dilation when light shining in it.
- 122Explain how knowledge of CNS anatomy enables the site of a lesion to be identified based on observed signs and symptomsIt is not the case that all bits of CNS controls all sensory and motor functions. Rather distinct parts of the CNS are responsible for certain functions. So if we know which parts of CNS control which functions, when these functions become altered or impaired we can conclude that there is damage in that part of the CNS.
- 123Explain why damage affecting different parts of the peripheral nervous system produces alterations in sensory and motor functionPeripheral nerves contain both motor and sensory fibres.
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- Bachelors Degree Medicine (Neurology) Flashcards on HNN Block 1, created by Rebecca Norton on 29/02/2016.
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