NEURO 210

clinical neuroscience consists of ___

neuroscience, neurology, psychiatry

neuroscience

SCIENTIFIC STUDY of brain and nervous system

neurology

MEDICAL SPECIALTY based around the nervous system and its abnormalities

psychiatry

MEDICAL SPECIALTY based around mental illness

when was the society for neuroscience formed?

1969

when did clinical neuroscience become widely recognized?

21st century

Aristotle

Before 300 BC; Heart is the body's control centre; the brain cools the heart

discovery around 300 BC

Brain is the controlling centre of the body

Galen

~100 BC; pneumata (spirits) circulate between the liver, brain, and heart

Al-Zahrawi

~1000; neurosurgeon who successfully treated hydrocephalus

Avicenna

~1000; Father of Modern Medicine, The Cannon of Medicine

Andreus Vesalius

~1500; dissected humans to disprove Galen

Rene Descartes

~1600; "Cogito ergo sum" (I think therefore I am), believed spirits use to nerves to travel to/from pineal gland, recognized reflexes

Descartes' 3 concepts

1. only humans have a thinking mind; 2. dualism; 3. mind and body (separately interact with the pineal gland

The Virtuosi

Oxford scholars lead by Thomas Willis during the Renaissance; belief that natural laws can explain the workings of the material world

Luigi Galvani

1700s; used frog legs to provide evidence for intrinsic electrical activity in the nervous system

Jean-Martin Charcot

1800s; father of modern neurology; examined nervous system postmortem to classify features of neurological disorders (ex. MS, ALS)

William James

late 1800s; coined the term "stream of consciousness"; wrote The Principles of Psychology

Sigmund Freud

~1900; psychoanalysis; id, ego, superego

Carl Jung

~1900; acrimonious split with Freud; analytical psychology; brought up evolutionary past with concepts such as archetypes and the collective unconscious

Charles Sherrington

~1900; neural networks can explain behaviour; discovered inhibition; introduced the term "synapse"

Santiago Ramon y Cajal

~1900; Golgi staining technique showed nerve cell structure; unidirectional flow of information

Ivan Pavlov

~1900; biopsychology, classical conditioning demonstrated brain:behaviour relationship

B.F. Skinner

1900s; operant conditioning; Skinner Box, reinforce desired response and punish undesired response

Rita Levi-Montalcini

1900s; identified NGF in "bedroom laboratory"

Eccles, Hodgkin, and Huxley

Nobel Prize in 1963 for ionic mechanisms of nerve cell membrane (action potentials)

Hubel, Wiesel, and Sperry

Nobel Prize in 1981 for visual processing and left vs. right hemispheres

Buck and Axelrod

Nobel Prize in 2004 for discoveries about olfactory system

Julius and Patapoutian

Nobel Prize in 2021 for temperature and touch receptors

Brenda Milner

1900s-present; patient HM; showed importance of the hippocampus

Donald Hebb

1900s; Hebbian learning; "neurons that fire together wire together"

Wilder Penfield

~1900s; neurosurgeon, cortical homunculus

Ben Barres

late 1900s; studied glia in the CNS

CNS components

brain, spinal cord

PNS components

nerves, NMJs

sulcus

groove in cerebral cortex

gyrus

crest in cerebral cortex

central sulcus

divides frontal and parietal lobes

precentral gyrus

primary motor cortex

postcentral gyrus

primary somatosensory cortex

corpus callosum

connects left and right hemispheres

left-handed people's brains are ___ hemispherically split

less

left brain processes ___ thought

rational

right brain processes ___ thought

emotional

___ creates diversity between brains

frontal lobe connectivity

frontal lobe functions

behavioural organization and planning, personality, short-term memory

Phineas Gage

tamping iron damaged his frontal lobe, highlighting the frontal lobe's role in personality

parietal lobe functions

somatosensation, attention, body awareness, visuomotor guidance

motor homunculus is located in the ___ lobe

frontal

somatosensory homunculus is located in the ___ lobe

parietal

hemineglect

attention error resulting from unilateral parietal lobe damage, neglect of half of visual field

occipital lobe functions

visual processing

hemianopsia

loss of half of the visual field

dorsal visual processing

"where"

optic ataxia

problem translating visual input into action

patient RV

damage to dorsal stream caused issues with reaching and grasping objects perceived visually

ventral visual processing

"what"

visual form agnosia

damage to inferior temporal lobe causes issues recognizing objects

patient DF

injury to medioventral temporal cortex allowed them to copy images, but not recognize them

temporal lobe functions

audition, long-term memory, language comprehension; near limbic structures

hippocampus functions

declarative memory, spatial navigation, associative memory (spatial and non-spatial)

amygdala functions

emotional expression, emotion:behviour associations, fear learning

anterograde amnesia

inability to form new memories, motor skills and old memories intact

diencephalon

contains thalamus and similar structures

thalamus

rely centre for senses except smell; generates activity towards cortex

brainstem (rhombencephalon)

mesencephalon (midbrain), pons, medulla

medulla

homeostatic functions (involuntary)

pons

rely centre between cerebrum and cerebellum

mesencephalon

processes visual and auditory info; arousal and wakefulness; pain modulation

cerebellum

coordination, balance, gait; connects to brainstem

spinal cord

connects brain and PNS, surrounded by meninges

spinal nerves

31 pairs, subdivided in levels

afferent nerve damage

problems with sensation, no motor follow-through

efferent nerve damage

motor problems, sensation intact

neruomuscular junction (NMJ)

point of contact between motor neuron and muscle

initial patient assessment

clinical history, physical examination

clinical history includes factors such as

age, sex, handedness, specifics of the problem/ symptoms, medications, relevant health conditions, genetic history

physical examination

mental status, language, cranial nerve exam, cerebellar exam, strength, tone, reflexes, gait

cranial nerves

olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, spinal accessory, hypoglossal

cranial nerve exam

test done in patients to assess brainstem, often tested in comatose patients

cranial nerve II and III exam

tests visual function (II) and eye movement/ symmetry (III)

cerebellar exam

tests for symptoms of cerebellar dysfunction such as ataxia, slurred speech, unsteady gait, dysdiadochokinesia, nystagmus

dysdiadochokinesia

inability to perform rapid, alternating muscle movements such as turning hands over repeatedly

nystagmus

quick, involuntary eye movement; causes blurriness, balance issues, shakiness

deep tendon reflex

spinal reflex triggered by tapping a tendon, such as the kneejerk reflex resulting from tapping the patellar tendon

stretch receptors

receptors involved in deep tendon reflexes

increased reflex suggests…

nerve damage above the level tested (UMN lesion in CNS)

decreased reflex suggests ___

nerve damage below the level tested (LMN lesion in PNS)

purpose of reflex tests

help localize lesion

clonus reflex

rhythmic, lower extremity reflex indicative of spinal injury above lumbar

Babinski test

stroking the sole of the foot to test for brain lesion

positive Babinski reflex

dorsiflexion of big toes and fanning of other toes (normal before age 2 but abnormal afterwards)

importance of clinical investigations (2 reasons)

help identify location of lesions; history of progression can INDICATE (not confirm) disease

Pathological post-mortem exam

anatomical brain examination following death

Tan's brain postmortem

left frontal cortex damage associated with problems speaking; presented by Broca

Phineas Gage postmortem

prefrontal cortex injury associated with personality changes and disinhibition

chronic traumatic encephalopathy

accumulation of Tau protein in the cerebral cortex following brain injury

Tau proteins

microtubular associated proteins involved in Alzheimer's and CTE

MRI

uses a magnet, radio frequency coil, and detector to image brain

pathology

examines types of cells to identify diseases based on prior imaging