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Lecture 18
Basal Ganglia
Function
Basal Ganglia Areas
o Caudate Nucleus
o Putamen
o Globus Pallidus
o Subthalamic Nucleus
o Substantia Nigra
pars compacta
pars reticulata
Basal Nuclei
o Corpus Striatum components
o Neostriatum components
o Lentiform Nucleus components
o Paleostriatum components
Inputs - arrive at striatum
Outputs - leave via internal globus pallidus and substantia nigra (pars
reticulata)
Pathways
o Direct -- double (-) = (+)
ACh won't inhibit = direct signal to thalamus
o Indirect -- single (-) = (-)
ACh WILL inhibit = indirect signal to thalamus via sub-
thalamus
Lesions
o caudate nucleus
o caudate nucleus (head of left)
Disorders
Movement
bradykinesia
hypokinesia
akinesia
Rigidity
Dystonia
Ballism
Athetosis
Chorea
Tics
o Parkinson's - Lead pipe- loss of pigmentation at substantia nigra-
dopa
o Huntington's – Chorea- degeneration of stritum at cudate-gaba
o Wilson's – Copper- degeneration of lentiform w/ liver cirrhosis
o Kernicterus - Indirect bilirubin- globus pallidus
Lecture 19
Cerebrum
https://radiopaedia.org/articles/cerebrum
Know the functions of each of the following and what happens if there is a lesion in that area!!! -- also important
to know brodmann areas + corresponding #
Central Sulcus
Pre-central Gyrus - Motor
Post-central Gyrus - Sensory
Corpus Callosum
Neocortex
Allocortex
Neuro - Lectures
main concepts to over in detail!
Attached are questions for lectures 20-24
Lecture 20
Higher Cortical Function
The first 11 pages are review from the lecture on Cerebrum!!!
Broca's area
Wernicke's area
Arcuate Fasciculus -- connects B + W
Aphasias:
o Broca's -- can't speak fluently
o Wernicke's -- can't comprehend
o Conductive -- repetition problems
o Global -- all the problems
o Gertsmann Syndrome -- alexia + agraphia
Learning
explicit (declarative)
o semantic - meaningful
o episodic - events/time related
implicit (non-declarative)
o priming -- apply new memory to previous memory
o procedural memory -- procedures (walking, biking, driving)
o learned emotion -- happy when good things happens, sad when bad things
happen
o conditioned reflexe
o s -- Pavlov (dog + salivation)
Memory Defects
Amnesia
o Retrograde
o Anterograde
Dementia
Alzheimers
o hippocampus
o amyloid plaques -- weaken vessel walls, causes hemorrhage
o neurofibrillary tangles
o cholinergic transmission impairment
o highest risk = down syndrome
Wernicke-Korsakoff Disease
o chronic alcohol abuse
o thiamine deficiency
o "Wernicke's encephalopathy" -- reversible
confusion, ataxia, nystagmus
o "Korsakoff's psychosis" -- irreversible
memory impairment
infarction occurs in
mammillary bodies/ thalamus/ limbic system
Lecture 21
Reticular Formation + EEG
sleep vs. awake
Lecture 22
Thalamus + Hypothalamus
Thalamus
Relay station for ALL sensory except smell
Hypothalamus
4 F's -- Fight, Feed, Fleed, Fornicate (F***)
REGULATION!
o internal environment, water, temperature, food intake, sleep/wakefulness
Temperature
o anterior nucleus = cool
o posterior nucleus = warm "hot booty"
o TSH - thyroid hormone
o set point
skin circulation, metabolic rate, sweating, behavior
o fever
phases
benefits
o hyperthermia
Eating
o lateral nucleus - eat! (when you eat, you grow laterally)
o ventromedial nucleus - satiety (tall and skinny)
o lesions??
Suprchiasmatic nucleus
o circadian rhythm
Mammillary nuclei -- memory consolidation
Paraventricular nuclei
o magnocell
o parvocell
supraoptic nuclei
o ADH - water reuptake
o oxytocin
Lesions
o genital dystrophy + abnormalities of sex development
o aggression
o rage
o sleep disorders
Lecture 23
Limbic System --> "extra limb"
Motivation, Addiction, Emotion, Sexual Activity, Autonomic Responses
Lecture 24
Autonomic Nervous System
Neuro - Lectures 25 + 26 + 27
main concepts to over in detail!
Lecture 25
Vision
fibrous tunic
o cornea + sclera
vascular tunic
o choroid + ciliary body + iris
lens
retina
o optic disc = blind spot (no rods or cones)
o macula lutea
o fovea centralis
o layers
pigmented layer
neural layer
photoreceptor layer
in dark = glutamate
bipolar neurons
amacrine + horizontal
ON/OFF cells
light on = on
light off = off
ganglion cell layer
glands
o melbonian glands
o sebaceous glands
o lacrimal glands -- dacryocystitis
PNS - CN VII
Image focusing
o accommodation = increase refractory power of lens!
ciliary muscle contracts to release tension
PNS - CN III
Refractive Error
o Hypermetropia = far sighted
image focused behind retina
fix convex lens
o Myopia = near sighted
image focused in front of retina
fix with concave lens
o Astigmatism = oblong corneal shape
fix with cylindrical lens
o Presbyopia
due to aging = loss of elasticity
old people can't read close print
Photopigments
o Rods
slow adaptation to dark (20 min)
fast adaptation in light (seconds)
light sensitive, more in #
loss of rods = night blindness + loss of periph vision
o Cones
day vision -- color vision!
3 types of cells (red, blue, green)
loss of cones = decreasd acuity (legal blindness)
Photoreceptor Mechanims
o light hits retina which causes photoisomerization of retinal
11-cis Retinal converted to all-trans retinal
regeneration of 11-cis retinal REQUIRES vitaminA
o Metarhodopsin II activates G protein transducin
o Na+ channels carry current in
o DARK = increased cGMP = Na+ influx (depol)
o LIGHT = less cGMP = Na+ channels close (hyperpol)
do NOT generate AP's . . . EPSP/IPSPs only
Visual Pathway Lesions
o monocular scotoma
o monocular visual loss
o bitemporal hemianopia - optic chiasm
o contralateral homonymous hemianopia
o contralateral superior quadrantanopia
o contralateral inferior quadrantanopia
Visual Reflexes
o Light Reflex - Midbrain
o Accommodation reflex - LGB
o Blink Reflex
Clinical Aspects
o Strabismic Amblyopia
o Night Blindness
o Retinitis Pigmentosa
o Color Blindness
blue = tri
red = pro
green = deu
o Argyll-Robertson Pupil
o Adie's Pupil
o Marcus-Gunn Pupil
o Weber Syndrome
o Parinaud Syndrome
o Cataracts
o Glaucoma
Lecture 26
Hearing (Auditory + Vestibular)
Auditory
Anatomy + Phys
o External Ear
pinna (auricle)
auditory meatus (external auditory canal)
tympanic membrane (ear drum)
o Middle Ear
ossicles
utricle
saccule
eustachian tube (auditory)
o Internal Ear
cochlea
organ of Corti (spiral) = organ of hearing
hair cells
CN VIII
Clinical
o tympanic reflex - both ear muscle contract pull malleus n stapes apart-->
lowers sounds
tensor tympani
stapedius
o eustachian tube dysfunction – pressure on either side of TM=TM stretch =
pain
o impedance matching -- middle ear sound amplification
ear drum - increased pressure oval window
middle ear - increase force + less velocity of stapes
Hearing Defects
o conduction deafness
obstruction -- wax
otosclerosis -- stapes is fixed due to bone formation oval
window
otitis media – inflammation of middle ear due to infection
o sensorineural deafness
presbycusis -- most common, degenerative w/ aging of corti
acoustic neuroma - tumor compression
Hearing Tests
o Rinne - determines if there is sensorineural deafness (AC>BC)
o Weber - determines "whether/weber" it's the L or R
o Schwabach - conduction test
o https://www.youtube.com/watch?v=cZYJL9Jg-3k
Vestibular
vestibular apparatus
o CN VIII
o semicircular ducts
o otolith crystals -- part of hair cells detecting position of head
utricle = horizontal
saccule = skinny, vertical
Vestibular nuclei
o MLF -- "MILF" --> route toward eye movment
vestibulo-ocular reflex
-- nuclei pass through MLF to get to eye muscles!
o oculocephalic reflex - dolls head
o vestibular nystagmus - fast component
o postrotational nystagmus - fast component
o caloric nystagmus -- tests for brainstem death
COWS test (fast)
cold opposite (slow, fast)
warm same (slow fast)
intact brainstem? cows works
lower brainstem lesion - NO movement at
all
bilateral MLF lesion - tricky one!!!
cold water will move eye to
same side SLOW
vestibular disorders
o motion sickness
o meniere disease -- CN8
o tinnitus
o vertigo
vestibular reflexes
https://www.youtube.com/watch?v=O_c0ohKc0qw
https://www.youtube.com/watch?v=5SPslYO1PT0 -- brain dead (min 4)
https://www.youtube.com/watch?v=Vjk1f99N13M -- awake
https://www.youtube.com/watch?v=ixySJdRxmdA -- awake
https://www.youtube.com/watch?v=j7EK6kV5Zx8 -- physiology of reflex
Remember:
creates currents based on temperature!
slow then fast in alive
nothing in lower brain stem lesion
Lecture 27
Smell (Olfactory + Gustatory)