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196 Cards in this Set
- Front
- Back
What is derived from neuroectoderm?
(4) |
- CNS neurons
- ependymal cells (inner lining of ventricles --> make CSF) - oligodendroglia - astrocytes |
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What is derived from neural crest?
(2) |
- Schwann cells
- PNS neurons |
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What is derived from mesoderm?
(2) |
- microglia
- macrophages "Microglia, like Macrophages, originate from Mesoderm" |
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General info on Neurons?
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- comprise nervous system
- permanent cells --> do not divide in adulthood - large cells with prominant nucleoli - Nissl substance (RER) in cell body - dendrites - NOT axon |
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General info on Astrocytes?
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- physical support
- repair K+ metabolism - removal of excess NT - maintenance of blood-brain barrier - reactive gliosis in response to injury |
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What is the astrocyte marker?
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GFAP
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General info on Microglia?
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- CNS phagocytes
- mesodermal origin - not readily discernible in Nissl stains - have small, irregular nuclei and relatively little cytoplasm - microglia --(tissue damage--> large ameboid phagocytic cells |
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What happens to HIV-infected microglia cells?
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- they fuse to from multinucleated giant cell in the CNS
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General info on Oligodendroglia?
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- each one myelinates multiple CNS axons (up to 30 each)
- in Nissl stains, they appear as small nuclei with dark chromatin and little cytoplasm - predominant type of glial cell in white matter |
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What cells are destroyed in Multiple Sclerosis?
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Oligodendrocytes
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What looks like a fried egg on a H&E stain?
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Oligodendrocytes
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General info on Schwann cells?
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- each one myelinates only 1 PNS axon
- also promote axonal regeneration - derived from neural crest |
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What cells are destroyed in Guillain-Barre syndrome?
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Schwann cells
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Acoustic Neuroma?
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- type of schwannoma
- typically located in internal acoustic meatuc (CN VIII) |
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Free Nerve Ending types?
(2) |
1. C -- slow, unmyelinated fibers
2. Aδ -- fast, myelinated fibers |
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Free nerve ending location?
(3) |
- all skin
- epidermis - some viscera |
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Free nerve ending senses?
(2) |
- pain
- temperature |
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Meissner's corpuscles general info?
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- large, myelinated fibers
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Meissner's corpuscles location?
(1) |
- glabrous (hairless) skin
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Meissner's corpuscles senses?
(3) |
- position sense
- dynamic touch (ie. manipulation) - adapt quickly |
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Pacinian corpuscles general info?
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- large, myelinated fibers
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Pacinian corpuscles location?
(3) |
- deep skin layers
- ligaments - joints |
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Pacinian corpuscles senses?
(2) |
- vibration
- pressure |
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Merkel's disks general info?
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- large, myelinated fibers
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Merkel's disks location?
(1) |
- hair follicles
|
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Merkel's disks senses?
(3) |
- position sense
- static touch (ie. shapes, edges, textures) - adapt slowly |
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Endoneurium
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- invest single nerve fiber
- inflammatory infiltrate in Guillain-Barre |
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Perineurium
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- Permeability barrier
- surrounds a fascicle of nerve fibers - must be rejoined in microsurgery for limb reattachment |
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Epineurium
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- dense connective tissue that surrounds entire nerve (fascicles and blood vessels)
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NE and anxiety?
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- NE is INCREASED in anxiety
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NE and depression?
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- NE is DECREASED in depression
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Dopamine and schizophrenia?
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- dopamine is INCREASED in schizophrenia
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Dopamine and Parkinson's?
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- dopamine is DECREASED in Parkinson's (and depression)
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Dopamine and depression?
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- dopamine is DECREASED in depression (and Parkinson's)
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5-HT and anxiety?
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- 5-HT is DECREASED in anxiety (and depression)
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5-HT and depression?
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- 5-HT is DECREASED in depression (and anxiety)
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ACh and Alzheimer's?
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- ACh is DECREASED in Alzheimer's (and Huntington's and REM sleep)
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ACh and Huntington's?
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- ACh is DECREASED in Huntington's (and Alzheimer's and REM sleeep)
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ACh and REM sleep?
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- ACh is DECREASED in REM sleep (and Alzheimer's and Huntington's)
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GABA and anxiety?
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- GABA is DECREASED in anxiety (and Huntington's)
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GABA and Huntington's?
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- GABA is DECREASED in Huntington's (and anxiety)
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Where is NE synthesized?
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Locus ceruleus
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Where is dopamine synthesized?
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Ventral tegmentum and SNc
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Where is 5-HT synthesized?
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Raphe nucleus
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Where is ACh synthesized?
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Basal nucleus of Meynert
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Where is GABA synthesized?
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Nucleus accumbens
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What area of the brain makes NT in response to stress and panic?
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- Locus ceruleus --> NE
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What is the reward center, pleasure, addiction, fear center of the brain?
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Nucleus accumbens and Septal nucleus
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What NT are INCREASED in anxiety?
(1) |
- NE
|
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What NT are DECREASED in anxiety?
(2) |
- 5-HT
- GABA |
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What NT are DECREASED in depression?
(3) |
- NE
- dopamine - 5-HT |
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What NT are DECREASED in Parkinson's?
(1) |
- dopamine
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What NT are DECREASED in Alzheimer's?
(1) |
- Ach
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What NT are DECREASED in Huntington's?
(2) |
- ACh
- GABA |
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What NT are DECREASED in REM sleep?
(1) |
- ACh
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What 3 structures form the blood-brain barrier (BBB)?
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1. Tight junctions between nonfenestrated capillary endothelial cells
2. Basement membrane 3. Astrocyte processes |
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What crosses the BBB slowly by carrier-mediated transport mechanism?
(2) |
- glucose
- amino acids |
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What crosses the BBB rapidly via diffusion?)
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- nonpolar/lipid-soluble substances
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A few specialized brain regions with fenestrated capillaries and no BBB allow what?
(2) |
1. they allow molecules in the blood to affect brain function (ie. area postrema --> vomiting after chemo; OVLT --> osmotic sensing)
2. they allow neurosecretory products to enter circulation (ie. neurohypophysis --> ADH release) |
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What are the 3 blood barriers?
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1. blood-brain barrier
2. blood-testis barrier 3. maternal-fetal blood barrier of placenta |
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What does a brain infarction destroy? And what does this lead to?
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- endothelial cell tight junctions
- leads to vasogenic edema |
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What does the Hypothalamus do?
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"TAN HATS"
- Thirst and water balance - Adenohypophysis control - Neurohypophysis releases hormones from hypothalamus - Hunger - Autonomic regulation - Temperature regulation - Sexual urges |
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Inputs to the hypothalamus?
(2) |
- OVLT (senses change in osmolarity)
- area postrema (responds to emetics) |
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What makes ADH?
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Supraoptic nucleus
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Where is the supraoptic nucleus found?
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Hypothalamus
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What makes oxytocin?
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Paraventricular nucleus
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Where is the paraventricular nucleus found?
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Hypothalamus
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What does the lateral area of the hypothalamus do?
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controls hunger
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Destruction of the lateral area of the hypothalamus leads to?
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- Anorexia
- failure to thrive (infants) "If you zap your LATERAL nucleus, you shrink LATERALLY" |
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What inhibits the lateral area of the hypothalamus?
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Leptin --> don't feel hungry
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What does the ventromedial area of the hypothalamus do?
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controls satiety
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Dextruction of the ventromedial area of the hypothalamus (ie. craniopharyngioma) causes what?
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Hyperphagia
"If you zap your VENTROMEDIAL nucleus, your grow VENTRALLY and MEDIALLY" |
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What stimulates the ventromedial area of the hypothalamus ?
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Leptin --> feel full
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What does the Anterior hypothalamus control? And is it controlled via sympathetics or parasympathetics?
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- cooling
- pArasympathetic "Anterior nucleus = Cool off" (A/C = Anterior Cooling) |
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What does the posterior hypothalamus control? And is it controlled via sympathetics or parasympathetics?
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- heating
- sympathetic "posterior nucleus = get fired up" "If you zap your Posterior hypothalamus, you become a Poikilotherm (cold-blooded, like a snake)" |
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What does the Septal nucleus control?
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Sexual urgers
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Where is the septal nucleus located?
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Hypothalamus
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What does the suprachiasmatic nucleus control?
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Circadian rhythm
"You need SLEEP to be CHARISMATIC (chiasmatic)" |
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Where is the suprachiasmatic nucleus located?
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Hypothalamus
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What are all the areas of the hypothalamus and what do they do?
(8) |
1. Supraoptic nucleus -- makes ADH
2. Paraventricular nucleus -- makes oxytocin 3. Lateral area -- hunger 4. Ventomedial area -- satiety 5. Anterior hypo -- cooling 6. Posterior hypo -- heating 7. Septal nucleus -- Sexual urges 8. Suprachiasmatic nucleus -- circadian rhythm |
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Posterior pituitary aka?
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Neurohypophysis
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What does the posterior pituitary do?
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- receives hypothalamic axonal projections from supraoptic (ADH) and paraventricular (oxytocin) nuclei
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Anterior pituitary aka?
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Adenohypophysis
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Oxytocin
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- made by paraventricular nuclei of hypothalamus
- oxys = quick - tocos = birth |
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What does the Thalamus do?
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- major relay for ascending sensory information that ultimately reaches the cortex
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What does the Lateral geniculate nucleus (LGN) control?
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- visual
- projects via optic radiations to occipital cortex "Lateral for Light" |
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Where is the lateral geniculate nucleus (LGN) located?
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Thalamus
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What does the Medial geniculate nucleus (MGN) control?
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- auditory
"Medial for Music" |
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Where is the medial geniculate nucleus (MGN) located?
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Thalamus
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What does the ventral posterior nucleus, lateral part (VPL) do?
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- body sensation (proprioception, pressure, pain, tough, vibration via dorsal columns, spinothalamic tract)
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Where is the ventral posterior nucleus, lateral part (VPL) located?
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Thalamus
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What does the ventral posterior nucleus, medial part (VPM) do?
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- facial sensation (via CNV)
"You put Makeup on your face, and the sensory info is relayed through the VPM" |
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Where is the ventral posterior nucleus, medial part (VPM) located?
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Thalamus
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What does the ventral anterior/lateral (VA/VL) nuclei do?
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- motor
"Motor is anterior to sensation in the thalamus, just like the cortex" |
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Where is the ventral anterior/lateral (VA/VL) nuclei located?
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Thalamus
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Blood supply to the thalamus?
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- posterior communicating artery
- posterior cerebral artery - ICA (anterior choroidal arteries) |
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What all does the LImbic system include?
(4) |
- cingulate gyrus
- hippocampus - fornix - mammillary bodies |
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What all is the Limbic system responsible for?
(5) |
"The Famous 5 F's"
- Feeding, Fighting, Fleeing, Feeling, and Fucking |
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What info does the cerebellum receive?
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- receives CONTRAlateral cortical input via middle cerebellar peduncle
- receives IPSIlateral proprioceptive info via inferior cerebellar peduncle |
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What are the input nerves to the cerebellum?
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- climbing and mossy fibers
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What does the cerebellum do?
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- provides stimulatory feedback to CONTRAlateral cortex to modulate movement
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What are the output nerves from the cerebellum?
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- Purkinje fibers output to deep nuclei of cerebellum --> which in turn output to cortex via superior cerebellar peduncle
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What are the deep nuclei of the cerebellum?
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Lateral to Medial:
- Dentate - Emboliform - Globose - Fastigial "Don't Eat Greasy Foods" |
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What does the lateral cerebellum control?
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- voluntary movement of extremities
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What does the medial cerebellum control?
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- balance
- truncal coordination - ataxia - propensity to fall toward injured (IPSIlateral) side |
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In what areas is the basal ganglia important?
(2) |
- voluntary movements
- making postural adjustments |
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SNc
|
- Substantia nigra pars compacta
- part of the basal ganglia |
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SNr
|
- Substantia nigra pars reticulata
- part of the basal ganglia |
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GPe
|
- Globus pallidus externus
- part of the basal ganglia |
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GPi
|
- Glubus pallidus internus
- part of the basal ganglia |
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STN
|
- Subthalamic nucleus
- part of the basal ganglia |
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D1
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- Dopamine D1 receptor
- excitatory "D1-R = D1Rect pathway" - part of the basal ganglia |
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D2
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- Dopamine D2 receptor
- inhibitory "Indirect = Inhibitory" - part of the basal ganglia |
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Excitatory pahtway of the basal ganglia?
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- SNc's dopamine binds to D1 receptors in thexcitatory pathway --> stimulating the excitatory pathway (increases motion)
- therefore, loss of dopamine in Parkinson's inhibits the excitatory pathway (decreased motion) |
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Inhibitory pathway of the basal ganglia?
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- SNc's dopamine binds to D2 receptors in the inhibitory pathway --> inhibiting the inhibitory pathway (double negative) (increased motion)
- therefore, losss of dapamine in Parkinson's excites (ie. disinhibits) the inhibitory pathway ( decreased motion) |
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What is Parkinson's disease?
|
- a degenerative disorder or CNS
|
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What is Parkinson's disease associated with (microscopically)?
(2) |
- Lewy bodies (composed of α-synuclein --> intacellular inclusion)
- depigmentation of the substantia nigra pars compacta (SNc) --> loss of dopaminergic neurons |
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Rare cases of Parkinson's disease have been linked to what?
|
- exposure to MPTP --> a contaminant in illicit street drugs
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What symptoms do you see in Parkinson's disease?
(4) |
"TRAP"
- Tremor (at rest -- ie. pill-rollong tremor) - cogwheel Rigidity - Akinesia - Postural instability "you are TRAPped in your body" |
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What is hemiballismus?
|
- sudden, wild flailing of 1 arm +/- leg
"Half ballistic (as in throwing a baseball)" |
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What is hemiballismus characteristic of?
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- contralateral subthalamic nucleus lesion (ie. lacunar stroke in pt. with a history of HTN)
- loss of inhibition of thalamus through globus pallidus |
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What is Huntington's disease?
|
- an autosomal dominant trinucleotide repeat disorder
- expansion of CAG repeats (anticipation) "CAG = Caudate loses Ach and Gaba" |
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On what chromosome is the trinucleotide repeat found in Huntington's disease?
|
Chromosome 4
|
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What happens in Huntington's disease?
|
Neuronal death via:
- NMDA-R binding - glutamate toxicity |
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What symptoms do you see in Huntington's disease?
(3) |
- Chorea (quick movements of feet of hands)
- Depression - Progressive Dementia |
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When do symptoms manifest in Huntington's disease?
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- between the ages of 20 and 50
|
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What do you see on MRI in Huntington's disease?
|
- atrophy of caudate nucleus (loss of GABA)
- atrophy of putamen - enlarged lateral ventricles - defined sulci - p. 397 |
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What is chorea?
|
- sudden, jerky, pruposeless movements (of hands and feet)
- Chorea = dancing (Greek) "Think choral dancing or choreography" |
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Chorea is characteristic of what?
|
- basal ganglia lesion (ie. Huntington's)
|
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What is athetosis?
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- slow, writhing movements, especially of fingers
- Athetos = not fixed (Greek) "Think snakelike" |
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Athetosis is characteristic of what?
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- basal ganglia lesion (ie. Huntington's)
|
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What is myoclonus?
|
- sudden, brief muscle contraction
- jerks, hiccups |
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What is dystonia?
|
- sustained, involuntary muscle contractions
- writer's cramp |
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What is an Essential/Postural tremor?
|
- action tremor (worsens when holding posture)
- autosomal dominant - essential trmor pts. often self-medicate with alcohol, which decreases tremor |
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What is the treatment for essential/postural tremor?
|
- β-blockers
|
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What is a Resting tremor?
|
- most noticeable distally
- seen in Parkinson's pts (pill-rolling tremor) |
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What is an Intention tremor?
|
- slow, zig-zag motion when pointing toward a target
- associated with cerebellar dysfunction |
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Cerebral Cortex functions:
Frontal Lobe (4) |
- Motor speech (Broca's area; dominant hemishpere)
- Frontal eye fields - Premotor area (part of extrapyramidal circuit) - Principle motor area |
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Cerebral Cortex functions:
Parietal Lobe (1) |
- Principal sensory areas
|
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Cerebral Cortex functions:
Occipital Lobe (1) |
- Prnicipal visual cortex
|
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Cerebral Cortex functions:
Temporal Lobe (2) |
- Primary auditory cortex (Heschl's gyrus)
- Associative auditory cortex (Wernicke's area; dominant hemisphere) |
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What does the arcuate fasciculus connect?
|
- Wernicke's area (associative auditory complex) and Broca's area (motor speech)
|
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Frontal Lobe functions
(9) |
"Executive Functions"
1. planning 2. inhibition 3. concentration 4. orientation 5. language 6. abstraction 7. judgement 8. motor regulation 9. mood |
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What is most noticible symptom in frontal lobe lesions?
|
- lack of social judgement
"Damage = Disinhibition (ie. Phineas Gage)" |
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What is the homunculus?
|
- a topographical representation of sensory and motor areas in the cerebral cortex
|
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What is the homunculus used for?
|
- used to localize lesions (ie. in blood supply) leading to specific defects
- for example, lower extremity deficit in sensation or movement may indicate involvement of the anterior cerebral artery |
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Brain Lesion Consequences:
Amygdala (bilateral) (3) |
Kluver-Bucy syndrome:
- hyperorality - hypersexuality - disinhibited behavior |
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Brain Lesion Consequences:
Frontal Lobe (5) |
- disinhibition
- deficits in concentration, orientation, and judgement - may have reemergence of primitive reflexes |
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Brain Lesion Consequences:
Right parietal lobe (1) |
- Spatial neglect syndrome (agnosia of the contralateral side of the world)
|
|
Brain Lesion Consequences:
Reticular activating system (midbrain) (1) |
- reduced levels of arousal and wakefulness (ie. coma)
|
|
Brain Lesion Consequences:
Mammillary bodies (bilateral) (6) |
Wernicke-Korsakoff syndrome
- Wernicke --> confusion, ophthalmoplegia, ataxia - Korsakoff --> memory loss, confabulation, personality changes |
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Brain Lesion Consequences:
Basal ganglia (3) |
- tremor at rest
- chorea - athetosis |
|
Brain Lesion Consequences:
Cerebellar hemisphere (2) |
- intention tremor
- limb ataxia - damage to the cerebemmum results in IPSI deficits - fall toward side of lesion - cerebellum --> SCP --> contralateral cortex --> corticospinal decussation = IPSI "Cerebellar hemispheres are LATERALLY located --> affect LATERAL limbs" |
|
Brain Lesion Consequences:
Cerebellar vermis (2) |
- truncal ataxia
- dysarthria "Vermis is CENTRALLY located --> affects CENTRAL body" |
|
Brain Lesion Consequences:
Subthalamic nucleus (1) |
- CONTRA hemiballismus
|
|
Brain Lesion Consequences:
Hippocampus (1) |
- anterograde amnesia (inability to make new memories)
|
|
Brain Lesion Consequences:
Paramedian pontine reticular formation (PPRF) (1) |
- eyes look AWAY from side of lesion
|
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Brain Lesion Consequences:
Frontal eye fields (1) |
- eyes look TOWARD lesion
|
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What symptoms do you see in Central Pontine Myelinolysis?
(5) |
- acute paralysis
- dysarthria - dysphagia - diplopia - loss of consciousness |
|
What commonly causes Central Pontine Myelinolysis?
|
- very rapid correction of hyponatremia
|
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What happens with a recurrent laryngeal nerve injury?
|
- loss of all laryngeal muscle except cricothyroid
|
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What symptom do you see in recurrent laryngeal nerve injury?
|
- hoarseness
|
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What is aphasia?
|
- higher-order inability to speak
|
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What is dysarthria?
|
- motor inability to speak
|
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What is Broca's aphasia?
|
- NONFLUENT aphasia with intact comprehension
"BROca's BROken BOCA" |
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Where is Broca's area?
|
- inferior frontal gyrus of frontal lobbe
|
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What is Wernicke's aphasia?
|
- FLUENT aphasia with impaired comprehension
"Wernicke's is Wordy but makes no sense!" "Wernicke's = What?" |
|
Where is Wernicke's area?
|
- superior temporal gyrus of temporal lobe
|
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What is global aphasia?
|
- NONFLUENT aphasi with impaird comprehension
- BOTH Broca's and Wernicke's areas affected |
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What is conduction aphasia?
|
- poor repetition but FLUENT speech
- intact comprehension - Arcuate fasciculus -- connects Broca's and Wernicke's areas |
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What does the anterior cerebral artery supply?
|
- supplies anteromedial surface
|
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What does the middle cerebral artery supply?
|
- supplies lateral surface
|
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What does the posterior cerebral artery supply?
|
- supplies posterior and inferior surfaces
|
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Associated area/deficit for:
Anterior spinal artery (3) |
Medial medullary syndrome
- CONTRA hemiparesis (lower extremities) - medial lemniscus (decreased CONTRA proprioception) - IPSI paralysis of hypoglossal nerve |
|
Associated area/deficit for:
PICA (12) |
Lateral medullay syndrome (aka Wallenberg's)
- CONTRA loss of pain and temperature - IPSI dysphagia - hoarseness - decreased gag reflex - vertigo - diplopia - nystagmus - vomiting - IPSI Horner's - IPSI facial pain and temperature - trigeminal nucleus (spinal tract and nucleus) - IPSI ataxia |
|
Associated area/deficit for:
AICA (5) |
Lateral inferior pontine syndrome
- IPSI facial paralysis - IPSI cochlear nucleus - vestibular (nystagmus) - IPSI facial pain and temperature - IPSI dystaxia (MCP, ICP) |
|
Associated area/deficit for:
Posterior cerebral artery (1) |
- CONTRA homonymous hemianopia with macular sparing
- supplies occipital cortex |
|
Associated area/deficit for:
Middle cerebral artery (3) |
- CONTRA face and arm paralysis and sensory loss
- aphasia (dominant sphere) - left-sided neglect |
|
Associated area/deficit for:
Anterior cerebral artery (2) |
- supplies medial surface of the brain
- leg-foot area of motor and sensory cortices |
|
Associated area/deficit for:
Anterior communicating artery (1) |
- lesion may cause visual field defects
|
|
What is the most common site of circle of Willis aneurysms?
|
Anterior communicating artery
|
|
Associated area/deficit for:
Posterior communicating artery (3) |
- common area of aneurysm
- causes CN III palsy |
|
Associated area/deficit for:
Lateral striate (4) |
- divisions of middle cerebral artery
Supplies: - internal capsule - caudate - putamen - globus pallidus "Arteries of Stroke" |
|
An infarct of the posterior limb of the internal capsule causes what?
|
- pure motor hemiparesis
|
|
Associated area/deficit for:
Watershed zones (2) |
Between:
- anterior cerebral / middle cerebral - posterior cerebral / middle cerebral |
|
Damage to watershed zones in severe hypotension leads to?
|
- upper leg / upper arm weakness
- defects in higher-order visual processing |
|
Associated area/deficit for:
Basilar artery (1) |
- infarct causees "locked-in syndrome"
- CN III is typically intact |
|
Associated area/deficit for:
in general, stroke of anterior circle (2) |
- general sensory and motor dysfunction
- aphasia |
|
Associated area/deficit for:
in general, stroke of posterior circle (4) |
Cranial nerve deficits
- vertigo - visual deficits - coma - cerebellar deficits (ataxia) - Dominant hemisphere --> ataxia - Nondominant hemisphere --> neglect |
|
Where do Berry aneurysms occur?
|
- at the bifurcations in the circle of Willis
|
|
Most common site of Berry aneurysms?
|
- the bifurcation of the anterior communicating artery
|
|
Most common complication of Berry aneurysms and what that leads to?
|
- Rupture --> leads to hemorrhagic stroke/subarachnoid hemorrhage
|
|
What diseases/syndromes are Berry aneurysms associated with?
(3) |
- adult polycystic kidney disease
- Ehlers-Danlos syndrome - Marfan's syndrome |
|
Other risk factors for Berry aneurysms?
(4) |
- advanced age
- HTN - smoking - race (higher risk in blacks) |
|
What are Charcot-Bouchard microaneurysms associated with?
|
- chronic HTN
|
|
What do Charcot-Bouchard microaneurysms affect?
|
- small vessels (ie. in basal ganglia, thalamus)
|