Neural Bases Exam 1: SUPER DECK (Ch 1-5 LOs + Picture Labeling)

Subarachnoid space (the clear fluid-filled space containing cerebrospinal fluid)

Label structure A.

Label structure B, F, G

gray matter

Label structure C.

Epidural space (outermost region containing adipose tissue/fat and internal vertebral venous plexuses)

Label structure D.

Central canal (the narrow longitudinal channel in the center containing CSF)

Label structure E.

Dorsal (posterior) root ganglion (the sensory cell body swelling along the nerve pathway)

Label structure H.

Dura mater (the thick, tough outermost meningeal layer)

Label structure I.

Denticulate ligament (triangular extensions of the pia mater anchoring the cord laterally)

Label structure J.

dorsal funiculus

Label structure K.

Pia mater

Label structure L.

Gray commissure (the horizontal strip connecting the left and right gray matter halves)

Label structure M.

white mater

Label structure N.

Subdural space (the narrow potential space between the dura mater and arachnoid mater)

Label structure O.

Arachnoid mater (the delicate, web-like middle meningeal layer)

What is neurology?

The study of the anatomy, physiology, and pathology of the nervous system.

What does 'anatomy' mean, and what does neuroanatomy specifically study?

Anatomy = the study of structure; neuroanatomy studies the structure of the brain and spinal cord.

What does 'physiology' mean, and what does neurophysiology study?

Physiology = the study of function; neurophysiology studies how the nervous system works.

What does 'pathology' mean, and what does neuropathology study?

Pathology = the study of disease; neuropathology studies diseases of the nervous system.

What does a neurosurgeon do, in the simplest terms?

Removes or repairs structures that are impairing the nervous system - cutting into the system to fix it.

What does neuroradiology involve?

The diagnostic study of nervous system tumors and structures using radiation-based imaging techniques.

What does neuroembryology study?

Normal and pathological development of the nervous system.

What are the three major components of the nervous system, and which two make up the CNS?

Brain, spinal cord, and nerves; the brain and spinal cord together make up the CNS, while cranial and spinal nerves make up the PNS.

Give two of the professor's five reasons SLPs and audiologists need neurological training.

Any two of: speaking the neurologist's language; choosing the right tests based on the injury; predicting problems from a known etiology; documenting treatment change/efficacy; understanding neuroplasticity to plan treatment.

How does the professor define neuroplasticity?

The brain's ability to change, including in response to treatment.

Match each person to their neurological condition: Reagan, Fox, Reeve, Hawking, Horn.

Reagan = Alzheimer disease; Fox = Parkinson disease; Reeve = spinal cord injury (C2 separation); Hawking = ALS; Horn = stroke.

In the Medical model of disability, is the focus on the person's skill or on society's response?

The person's skill - what the person can't do, or a body structure that doesn't work.

In the Social model of disability, what is the focus?

How society interacts with the person, and how that barrier could be resolved.

Give the three Medical model terms and their Social model counterparts.

Impairment to function barriers; Disability to activity barriers; Handicap to participation barriers.

Under WHO ICD-10, which category do encephalitis and meningitis fall under?

Inflammatory diseases of the CNS.

Under WHO ICD-10, which category does Huntington disease fall under?

Systemic atrophies primarily affecting the CNS.

Under WHO ICD-10, which category does Parkinson disease fall under?

Extrapyramidal and movement disorders.

Under WHO ICD-10, which category does Alzheimer disease fall under, and what's happening at the cellular level?

Other degenerative diseases; involves neuron death and neuron disconnection, and is the most common degenerative disease.

Under WHO ICD-10, which category does multiple sclerosis fall under, and what's the underlying mechanism?

Demyelinating CNS diseases; the myelin covering that speeds motor neuron signals is what gets attacked.

Under WHO ICD-10, which category does epilepsy fall under?

Episodic and paroxysmal disorders.

Which ICD-10 category does Bell palsy fall under, and what does it look like clinically?

Nerve, nerve root, and plexus disorders; one side of the face droops.

Which ICD-10 category does Guillain-Barre syndrome fall under?

Polyneuropathies and other PNS disorders (demyelinating).

Which ICD-10 category does myasthenia gravis fall under, and what's the functional pattern?

Diseases of the myoneural junction and muscle; symptoms worsen with repeated muscle use.

Which ICD-10 category does anoxia fall under, and what does the brain need that anoxia disrupts?

Other disorders of the nervous system; the brain needs both oxygen and glucose, and anoxia is a lack-of-oxygen state from disrupted blood flow.

What are the two ends of the spectrum of belief about how the brain works?

Localization (specific functions in specific spots) at one end, holism (functions from the brain as an integrated whole) at the other.

Historically, what did belief about the seat of mental life shift from and to?

From cardio-centrism (mental life = the heart) to cerebro-centrism (mental life = the brain).

What is the difference between structural and functional imaging?

Structural imaging shows the brain's static structure/anatomy; functional imaging shows physiology - electrical activity and glucose metabolism.

Which imaging technique is most commonly used overall?

CT.

How does CT imaging work, and what is its biggest downside?

X-ray beams reflect off tissue (denser tissue reflects more); downsides are radiation exposure and showing structure only, missing new oxygen-loss damage.

How does MRI imaging work?

A magnetic field interacts with water in the body, flipping protons to create a clear, multi-dimensional image.

What are two limitations of MRI?

Cannot be used with metal in the body, and requires the patient to stay still in an enclosed space (a problem for claustrophobia).

How does angiography work, and what is it especially good at finding?

Iodine contrast is injected and X-ray images the vascular system; excellent at finding blood clots, with diagnosis and treatment possible in the same session.

How does PET imaging work?

A radioisotope tracks glucose metabolism; active brain areas need more energy, so PET shows activity by tracking where glucose use is highest.

What are the pros and cons of EEG/MEG?

Pro: low cost, widely available, excellent timing. Con: essentially no spatial resolution.

How does fMRI work, and what makes it unique?

Tracks blood oxygenation during a stimulus; unique because it gives structure and function at once, safely, with no injection needed.

Rank fMRI, PET, and EEG/MEG from best to worst spatial resolution.

fMRI greater than PET greater than EEG/MEG.

Rank EEG/MEG, fMRI, and PET from best to worst temporal resolution.

EEG/MEG greater than fMRI greater than PET.

What does 'spatial resolution' measure, versus 'temporal resolution'?

Spatial resolution = location; temporal resolution = timing (how quickly the brain responds to a stimulus).

Why is it a mistake to assume a brain area 'lighting up' on a scan is the sole area responsible for a function?

Functions typically involve networks of interacting areas - lighting up doesn't rule out other areas' involvement.

A patient has a pacemaker and cannot have an MRI. Which structural imaging option would you expect instead, and why?

CT (or angiography for vascular detail) - it doesn't rely on a magnetic field that would interact with implanted metal.

Describe anatomical position.

Body erect, arms forward, palms facing out, face forward.

Which plane splits the body into left and right, and what's an everyday image for it?

Sagittal (lateral) - like cutting an apple in half.

Which plane splits the body into front and back, and what's an everyday image for it?

Coronal (frontal) - like slicing a loaf of bread.

Which plane splits the body into top and bottom, and what's an everyday image for it?

Transverse (horizontal) - like hamburger layers.

What is a parasagittal cut?

An off-center sagittal-style cut, not exactly down the midline.

In an anatomical top-down view of the brain, does left stay left?

Yes - in anatomical orientation, left is left and right is right.

In clinical orientation, as used to read an MRI or CT slice, what happens to left and right?

They flip - left appears as right and right appears as left on the image.

Superior and inferior correspond to which two other directional terms?

Cranial (superior) and caudal (inferior).

Anterior and posterior correspond to which two other directional terms, and what do they mean?

Ventral (anterior, toward the stomach) and dorsal (posterior, toward the back).

What do lateral and medial mean?

Lateral = away from the midline; medial = toward the midline.

What do proximal and distal mean?

Proximal = nearest a limb's point of attachment; distal = farthest from it.

What do peripheral and central mean?

Peripheral = toward the outer surface; central = toward the center.

What do ipsilateral and contralateral mean?

Ipsilateral = same side; contralateral = opposite side.

Where do most motor pathways decussate, and what does that predict about brain-body control?

The medulla; this is why the right side of the brain generally controls the left side of the body.

What do supine and pronate mean?

Supine = lying with the ventral surface up (palms/face up); pronate = lying with the ventral surface down.

On the body, dorsal and caudal map straightforwardly. On the brain, why can these terms shift meaning?

Because of how the neural tube bends during development - on the brain, caudal can mean posterior or inferior, and dorsal can mean back or superior.

On the brain specifically, what do rostral, caudal, dorsal, and ventral mean?

Rostral = front; caudal = back; dorsal = top; ventral = underside.

Define abduct and adduct.

Abduct = moving structures apart; adduct = bringing structures together.

Define flexion and extension.

Flexion = bending a joint; extension = straightening a joint.

Do the vocal folds abduct or adduct during quiet breathing? During phonation?

They abduct during breathing and adduct during phonation.

What two structures must you know about the brain for the anatomical approach, per the professor's own emphasis?

The divisions and structures of the brain, plus the 12 cranial nerves.

In the anatomical approach, what makes up the CNS and the PNS?

CNS = brain plus spinal cord; PNS = cranial nerves plus spinal nerves.

In the functional approach, what's the mnemonic for efferent versus afferent?

Efferent = away from the brain (exit; motor, voluntary); afferent = to the brain (sensory).

In the functional approach's sensory branch, which subdivision is tied to 'rest and digest'?

Visceral sensory (versus somatosensory).

In the functional approach's motor branch, what are the two subdivisions?

The autonomic nervous system (involuntary) and the somatic nervous system (voluntary).

Is breathing controlled by the autonomic or somatic branch of the motor system?

The autonomic branch.

In the developmental approach, what are the three primary vesicles of the CNS?

Prosencephalon (forebrain), mesencephalon (midbrain), rhombencephalon (hindbrain).

The prosencephalon divides into which two secondary vesicles, and what does each become?

Telencephalon becomes the cerebral hemispheres; diencephalon becomes the thalamus and hypothalamus.

The rhombencephalon divides into which two secondary vesicles, and what does each become?

Metencephalon becomes the pons and cerebellum; myelencephalon becomes the medulla.

Does the mesencephalon divide into secondary vesicles?

No - it stays as the midbrain itself, a single structure.

Besides Chapter 3's developmental approach, which approach does the rest of the course follow, and in what order?

The anatomical approach, moving spinal cord to brainstem to cerebellum to diencephalon to cerebral hemispheres.

How many chromosome pairs does a normal somatic cell have, and how many total chromosomes?

23 pairs, totaling 46 chromosomes.

What is the difference between mitosis and meiosis?

Mitosis produces 2 identical daughter cells; meiosis produces 4 gametes with half the chromosome number.

Turner syndrome results from what kind of chromosomal defect?

A whole chromosome deletion (missing an X chromosome).

Cri du Chat syndrome results from what kind of defect, and what are its symptoms?

A partial chromosome deletion; round face, micrognathia, wide-spaced eyes, low tone, microcephaly, intellectual impairment, delayed speech/hearing.

Trisomy 21 (Down syndrome) results from what kind of defect, and what are its symptoms?

An extra chromosome; some intellectual disability, macroglossia, slanted eyes, growth failure.

Put these stages in order: Embryo, Zygote, Fetus, Morula, Blastocyst.

Zygote, Morula, Blastocyst, Embryo, Fetus.

What are the three germ layers, and what does each become?

Endoderm becomes gut/liver/lungs; mesoderm becomes skeleton/muscles/kidneys/blood/heart; ectoderm becomes skin and the nervous system.

Which organ system is the first to begin developing?

The central nervous system.

Put the six phases of CNS structural development in order.

Dorsal induction, ventral induction, neural proliferation, neuronal migration, cortical organization and synapse formation, myelination.

What happens during dorsal induction, and when?

GA 3-7 weeks; the neural plate forms and folds into the neural tube (neurulation), closing by about week 6.

What defect results if dorsal induction fails?

Neural tube defects.

What happens during ventral induction, and when?

GA 2-3 months; the face and brain develop from the tube's superior end, and the brain cleaves into two hemispheres.

What defect results if ventral induction fails?

Holoprosencephaly.

What happens during neural proliferation, and when?

GA 3-4 months; neurogenesis - new neurons form the gray/white matter of the cerebral hemispheres.

What defect results if neural proliferation fails?

Microcephaly.

What happens during neuronal migration, and what chemical guides it?

GA 3-5 months; neurons move to their proper location guided by reelin. By about 20 weeks, the six cortical layers are established.