Professional Documents
Culture Documents
I.MusclesofMouth,Throat,andDeepNeck...........2 XII.CerebellarNeurons................................................6
II.GrossExternalAnatomyoftheBrainstem.............2 XIII.DivisionsofCerebellum.........................................6
III.InternalAnatomyoftheBrainstem........................3 XIV.RetinalCellTypes...................................................7
IV.BrainstemTracts.....................................................4 XV.Phototransduction.................................................7
V.EyeMovementLesions...........................................4 XVI.LesionsoftheVisualPathway...............................7
VI.BrainstemLesions...................................................4 XVII.EyeandVisualDisorders.......................................8
VII.AreasoftheCerebralCortex..................................5 XVIII.TheAuditoryProcess.............................................8
VIII.WhiteMatteroftheCerebrum..............................5 XIX.TheVestibularSystem...........................................9
IX.SensoryReceptors..................................................6 XX.AudiovestibularDisorders.....................................9
X.SensoryNeurons.....................................................6 XXI.ClassificationofANSReceptors.............................9
XI.CorticalSomatosensoryAreas................................6 XXII.ComparisonofAutonomicNervousSystem.......10
Exclusions:CerebrovascularSystem(L30,Aschebnrenner),ReticularFormation(DSA10,Forster),BasalGanglia(L33b,Schetz),MotorSystems(L33c,Schetz),TasteandOlfaction
(DSA9,Schetz).Allwillbecompletedbytomorrowafternoon.
fromthisdaytotheendingoftheworld,
Butweinitshallberememberd;
Wefew,wehappyfew,webandofbrothers;
Forhetodaythatshedshisbloodwithme
Shallbemybrother;behene'ersovile,
Thisdayshallgentlehiscondition:
AndgentlemeninEnglandnowabed
Shallthinkthemselvesaccursedtheywerenothere,
Andholdtheirmanhoodscheapwhilesanyspeaks
ThatfoughtwithusuponSaintCrispin'sday.
WilliamShakespeare,HenryV,ActIV,Sceneiii
Page2of10 NervousSystemWrittenExamIITables byDMFA
Salpingopharyngeus Elevatespharynx
Palatopharyngeus PharyngealplexusofCNX Elevateswallofpharynx
Stylopharyngeus Glossopharyngealn.(CNIX) Elevateslarynxduringswallowing
Obliquearytenoid Recurrentlaryngealn. Narrowslaryngealinlet
Thyroepiglottic Recurrentlaryngealn. Widenslaryngealinlet
Cricothyroid Externallaryngealn. Tensesvocalcord
Larynx
Laterallyflexesvertebralcolumn,elevatessecond
Posteriorscalene Anteriorramiofcervicalnn.
rib
Longuscapitis C1C3spinalnerves Flexesheadanteriorly
Longuscolli C2C7spinalnerves Flexesneckanteriorly,slightlyrotatesneck
Corticospinaltractdecussations(a.k.a.,Decussationofthepyramids)(1),Lateralspinothalamictract(2),
Reticularformation(centralgraymatter)(3),Dorsalandventralspinocerebellartracts(4),Accessorynucleus(5),
Fasciculusgracilis(6A)Fasciculuscuneatus(6B),Nuc.gracilis(7),SpinalTractandunderlyingnucleusofCNV(8)
Fasciculusgracilis(1),Fasciculuscuneatus(2),Hypoglossalnuc.andn.(3),Dorsalmotornuc.ofvagusn.(4),
SensoryDecussn
CaudalMedulla
Nucleusambiguus(5),Spinaltractandnuc.ofCNV(6),Lateralspinothalamictract(7),
Internalarcuatefibers/mediallemniscus(8),Dorsalandventralspinocerebellartracts(9),Pyramids(10),
Mediallongitudinalfasciculus(MLF)(11)
Somatotopicarrangementofthefibersinthemediallemniscusisimportant!
Mostventralbankoffibersreceiveinputfromthefasc.gracilis(lowerlimb,foot/toessacralarea)
Mostdorsalbankoffibersreceiveinputfromthefasc.cuneatus(upperlimb,hand,fingers)
RostralMedulla@
Obex/Inf.Olive
ObexandIVVentricle(opens)(1),Hypoglossalnuc.(2),Dorsalmotornuc.ofCNX(3),Mediallemniscus(4),
Spinaltractandnuc.ofCNV(5),Lateralspinothalamictract(6),Inferiorcerebellarpeduncle(7),
Vestibularnuclearcomplex(8),Inferiorolivarynucleus(9),Nuc.ambiguus(SVE:CNIX,X,XI)(10),
Nucleusandtractussolitarius(11),Pyramids(12),Mediallongitudinalfasciculus(13)
CaudalPons
Abducensnuc.andnervefascicles(1),Facialnuc.andnerve(internalgenu)(2),Mediallemniscus(3),
Superiorolivarynucleus(4),Trapezoidbody/Laterallemniscus(5),Mediallongitudinalfasciculus(6),
Corticospinalandcorticobulbartracts(7),Spinalnuc.andtractofCNV(8),Lateralspinothalamictract(9),
Middlecerebellarpeduncle(brachiumpontis)(10)
Trigem.Complex
MidPons,
PrincipalsensorynucleusofCNV(1),MotornucleusofCNV(2),Mediallemniscus(3),
Lateralspinothalamictract(4),Mediallongitudinalfasciculus(5),Corticospinalandcorticobulbartracts(6),
Pontinenuclei(7)
RostralPons
Superiorcerebellarpeduncles(1),FasciclesofCNIVdecussatinginthesuperiormedullaryvelum(2),
Mediallemniscus(3),Laterallemniscus(4),Lateralspinothalamictract(5),Mediallongitudinalfasciculus(6),
Pontinenuclei(7),Corticospinalandcorticobulbartracts(8),Middlecerebellarpeduncle(9)
InferiorColliculus
CaudalMidbran,
Nuc.oftheinferiorcolliculus(1),Trochlearnuc.(2),Decussationofsup.cerebellarpeduncle(3),
Mediallongitudinalfasciculus(MLF)(4),Mediallemniscus(5),Laterallemniscus(6),Cerebralaqueduct(7),
Periaqueductalgray(8),Mesencephalicnuc.CNV(9),Cerebralpeduncle(10)
SuperiorColliculus
RostralMidbrain,
Nucleusofthesuperiorcolliculus(1),Cerebralaqueduct(2),Periaqueductalgray(3),Mesencephalicnuc.CNV(4),
Rednucleus(5),Oculomotornucleus(6),
EdingerWestphalnuc.(Accessoryoculomotornuc.)preganglionicparasymp.nuc.ofCNIII(7),Substantianigra(8)
Cerebralpeduncles(9),Oculomotornervefibers(10)
DiencephalonJct.
Midbrain/
Posteriorcommissure(1),Pretectalnucleus(region)(2),Medialgeniculatenucleus(3),
Lateralgeniculatenucleus(4),Oculomotornucleus(5),Rednucleus(6),Substantianigra(7),Cerebralpeduncle(8),
Medial&trigeminallemniscus(9)
Vestibulospinal Paraveterbralextensorsandproximallimbextensors(postureandbalance)
Reticulospinal ThroughgammaMNs,maintainingpostureandmodulatingmuscletone
Tectospinal Headmovementsfororientingreactions
onMNs(through interneurons)indorsolateralgraythatcontroldistallimbmuscles
Rubrospinal toMNsinnervatingproximallimbflexors(upperextremity)
(lateral) Specieslackcorticospinaltractandfinecontrolofdistalmusclesisthroughrubrospinaltract
Humansw/corticospinallesions,itprovidesremainingfunction
Inabilitytolookconjugatetothecontralateralside
FrontalEyeFields(Area8)
Eyes(atrest)deviateipsilaterallybecausethecontralateral
frontaleyefieldisunopposed
Inabilitytomakeconjugateshifttoipsilateralside
CenterforLateralGaze(Paramedian
PontineReticularFormation,PPRF) Eyesperformverticalandcontralateralgazesproperly,but
cannotprogressbeyondthemidline
MedianLongitudinalFasciculus(MLF) Seeinternuclearopthalmoplegia
InhibitsPurkinjecells
Basket (interneuron)
GABA
InhibitsPurkinjecells
Stellate (interneuron)
Inhibitsgranulecells
Golgi (interneuron)
Page7of10 NervousSystemWrittenExamIITables byDMFA
TableXIV RetinalCellTypes L36Dr.Sheedlo
CellType Location Components Functions
Tightandadherentjunctions Pigmentabsorbsstraylight
Betweensensoryretinaand
RPECells Apicalprocessesenvelopoutersegmentof Development&maintenanceofretina,esp.photoreceptors
choroid
photoreceptors Phagocytizeshedoutersegments,recycleretinoids
Ciliumconnectssegments (rods&cones) SeveralrodssynapseondendritesofonebipolarneuroninINL
Throughoutretinaexceptfovea
Rod Membranousdiscsshedevery10days Releaseglutamatetonicallyindark;respondtolightby
Bodyouternuclearlayer
photoreceptors Rhodopsin11cisretinalandopsin conformationalchangeinrhodopsin,resultingin
Axonouterplexiformlayer
Mitochondriaininnersegment(rods&cones) hyperpolarizationanddecreasedglutamaterelease
Outersegmentopentosubretinalspace
Foveacentralis,fewinperiphery 1:1or2:1ratioofsynapsesonbipolarneuronsinINL
Cone Membranousdiscsshedevery30days
Bodyouternuclearlayer Opsinsrespondtolightbyconformationalchange,resultingin
photoreceptors ConepediclesynapticendinginONL
Axonouterplexiformlayer hyperpolarization
1OpsinLong(red)Med(Green),orShort(blue)
Bodyinnernuclearlayer Interneuronbetweenphotoreceptorsandganglioncells
Bipolarcells
Axoninnerplexiformlayer Canreceiveinputfromasmanyas2050photoreceptors
Bodyinnernuclearlayer Receiveglutamatergicinputfromphotoreceptors
Horizontalcells
Axoninnerplexiformlayer Sharpenedgeofvisualfieldinhibitsurroundingphotoreceptors
Amacrinecells Bodyinnernuclearlayer Noobviousaxon,highlybrancheddendrite Appeartomodulatesignalsfromphotoreceptors
Bodyganglioncelllayer Unmyelinatedaxoninretina,becomes
Ganglioncells Outputcellsofretina,2:1ratiotoconesinfoveacentralis
Axonsexitretinaatopticn. myelinatedbyoligodendrocytesinopticn.
Mullerglial Processesspanfrominnertoouterlimiting
Bodyinnernuclearlayer Structureandtrophyoftheretinalcells
cells membraneoftheretina
Astrocytes Surroundingbloodvessels Formsbloodeyebarrier
Bothnasalretinas,canbe
2Opticchiasm Bitemporalhemianopsia
causedbypituitarytumor
Ipsilateraltemporalretinaand
3Optictractpost.toopticchiasm Homonymoushemianopsia(R)
contralateralnasalretina
4Temporalportionsofoptic
Contralateralinferiorretina Superiorquadrantanopsia(R)
radiation(MeyersLoop)
5Parietalportionsofoptic
Contralateralsuperiorretina Inferiorquadrantanopsia(R)
radiation(geniculocalcarinetract)
Allfibersfromoneeyeexcept Homonymoushemianopsiawith
6VisualCortex(Area17)
frommacula(macularsparing) macularnotch
Page8of10 NervousSystemWrittenExamIITables byDMFA
TableXVII EyeandVisualDisorders L36Dr.Sheedlo
Disease/Lesion Cause Description VisualDefect Treatment
ColorBlindness Xlinkedrecessive 812%ofmales,99%redgreen Lackofsensitivitytocertaincolors None
nearsightedness imagefocusesinfrontof
Myopia Refractingsystemistoopowerful Concavelenses
retina
Hyperopia Refractingsystemistooweak farsightedness imageappearsbeforefocusing Convexlenses
Occurswith Curvatureoflens/corneaisgreaterinone Pointsappearmorelikeovals Correctivelenses
Astigmatism
near/farsightedness axisfootballshapedeye Lightfocusesatmorethanonepointonretina Refractivesurgery
LossofRPEpigmentgranules,detachment
AgerelatedMacular Therapiestoslow
Age fromBruchsmembrane Lossofcentralandfinevision(cones)
Degeneration(ARMD) progression
Appearspatchywhiteonfundus
Mostcommonformofjuvenilemacular
Autosomalrecessive
StargardtsDisease degeneration;yellowflecksaround Lossofcolor,central,andfinevision(cones) None
(1/20,000)
maculacalledfundusflavimaculatus
Defectivephotoreceptorsduetomutation
RetinitisPigmentosa Lossofperipheralandnightvision(rods,most)
Unknown inopsin,peripherin,orrds/peripherin None
(RP) Lossofcolorandsharpcentralvision(cones)
Oftenperipheralroddegeneration
Increasedintraocularpressure
Excessaqueoushumor
Glaucoma Lossofaxonsofretinalganglionneurons Cuppingofopticdiskleadstoblindness None
(blockage,overproduction)
Secondleadingcauseofblindnessinworld
Proliferationofvessels leakingontoretina
DiabeticRetinopathy Diabetesmellitus,VEGF Sporadic,progressivevisionlossoverbotheyes
irregularcorkscrewappearance
Tears/holesorfluid
DetachedRetina RPEpullsawayfromphotoreceptors Completevisionlossindetachedareas Vitrectomy
accumulation
Lossofmacularvisionasinoptic/retrobulbar
Scotoma Unknown Blindsportsinvisualfields None
neuritis,colorvision,reading,highacuityfunctions
Increasedintracranial Chokeddisk,swellingofopticn.head Enlargesblindspot,noinitialaffectonvisual Reductionin
Papilledema
pressure,braintumor Usuallybilateralwithnopupildefect acuity;chronicmaycauseatrophyandvisualloss pressure
Developmental,
Blurredvision,abnormalperipheralvision,
inflammation,tumor,
OpticAtrophy Opticdiskappearspink,white,orgray abnormalcolorvision,poorpupilconstriction, Irreversible
glaucoma,toxins,vitamin
decreasedbrightnessinaffectedeyethanother
deficiency,MS,syphilis
InferiorColliculus Auditoryreflexes,multisensoryintegration
Complexfeaturedetection,movingstimuli,auditoryattention,multisensory
MedialGeniculateNucleus
integration
PrimaryAuditoryCortex
Frequencycolumnslowsoundsbylateralportion,highsoundsbymedial
(Area41)
SecondaryAuditoryCortex
Partofplanumtemporale,largeronleft
(Area42)
Partofplanumtemporale,posteriorportionofsuperiortemporalgyrus
Area22
WernickesArea
Speechcomprehension
(Areas39,40)
BrocasArea(44,45) Speechexpression
Arcuatefasciculus Connectsauditoryandspeechareas
Page9of10 NervousSystemWrittenExamIITables byDMFA
TableXIX TheVestibularSystem L38Dr.Routh
Structure Function Subunits Images
Detectstiltin Macula:containshaircells,depolarizewithtilttowards striola,
Utricle
lateralplane entryofvestibularn.
Detectstiltin Macula:containshaircells,depolarizewithtiltawayfrom striola,
Saccule
vertical(AP)plane entryofvestibularn.
Ampulla:enlargementatendofduct,entryofvestibularn.
Crista:neuroepithelialridgewithhaircells,movementof
Horizontal Detectsrotation
endolymphtowardsutricledepolarizes
SemicircularCanal inlateralplane
Atrest:firingonbothsidesissame,leftorrightheadturncauses
increaseinfiringtowardsideofturn&decreaseonoppositeside
Vertical Ampulla:enlargementatendofduct,entryofvestibularn.
Detectsrotationin
Semicircular Crista:neuroepithelialridgewithhaircells,movementof
vertical(AP)plane
Canals(A&P) endolymphawayfromutricledepolarizes
Vestibulocerebella
Reflexes Eye,neck,andheadmovements
rpath
Directionofnystagmusnamedforfastphase
Vestibuloocular Reflexes(e.g.
COWS:cold=opposite,warm=same;relationshipbetweentemp
path nystagmus)
andnystagmus(coldinLear,nystagmusonR)
VPL,VPM,andposteriorthalamicnuclei
Vestibulocortical Conscious
Area3a:integratesmotorcontrolofheadandbody
path integration
Area2v:stimulationinducessensationofspinning,moving