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Step 1 First Aid - Neurology

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Step 1 First Aid - Neurology
CNS/PNS origins: Neuroectoderm (gives rise to what?) - answer:-CNS neurons
Ependymal cells (inner lining of ventricles, make CSF) Oligodendrocytes Astrocytes

CNS/PNS origins: Neural Crest (gives rise to what?) - answer:-Schwann cells PNS
neurons

CNS/PNS origins: Mesoderm (gives rise to what?) - answer:-M icroglia, like M
acrophages, originate from M esoderm

Neurons - answer:-Comprise nervous system. Permanent cells -- do not divide in
adulthood. Large cells w/ prominent nucleoli.

Nissl substance - answer:-RER found in cell body and dendrites, but not axon of
neurons.

Astrocytes - answer:-Physical support, repair, K+ metabolism, removal of excess NT.
Maintenance of BBB. Reactive gliosis in response to injury. <img src="392a
Astrocyte.JPG" />

Astrocyte marker? - answer:-GFAP

Microglia - answer:-CNS phagocytes. Mesodermal origin. Not readily discernible in
Nissle stains. Have small, irregular nuclei and relatively little cytoplasm. <img src="392b
Microglia.JPG" />

What happens to microglia in the presence of tissue damage? - answer:-Microglia --
(tissue damage)--< large ameboid phagocytic cells

What happens to HIV-infected microglia? - answer:-HIV-infected microglia fuse to form
multinucleated giant cells in the CNS

Oligodendria - answer:-Each oligodendrocyte myelinates multiple CNS axons (up to 30
each). In Nissle stains, they appear as small nuclei with dark chromatin and little
cytoplasm. <img src="392c oligodendroglia.JPG" />

What is the predominant type of glial cell in white matter? - answer:-Oligodendrocytes.

What cells are destroyed in multiple sclerosis? - answer:-Oligodendrocytes.

What do oligodendrocytes look like on H&amp;E? - answer:-"Fried Eggs" <img
src="555a oligodendrocytes.JPG" />

Schwann cells - answer:-Each Schwann cell myelinates only 1 PNS axon. Also promote
axonal regeneration. Derived from neural crest.

,Step 1 First Aid - Neurology
What are the cells that are destroyed in Guillain-Barré syndrome? - answer:-Schwann
cells.

An acoustic neuroma is a type of...? Where is it located? - answer:-Acoustic neuroma is
a type of Schwannoma. It is typically located in internal acoustic meatus (CN VIII)

Sensory receptors/corpuscles: Free nerve endings (C, A-delta fibers) Location?
Senses? - answer:-In all skin, epidermis, some viscera. Senses pain and temperature.
<img src="393a free nerve endings.JPG" />

Sensory receptors/corpuscles (location and senses): In all skin, epidermis, some
viscera. Senses pain and temperature. <img src="393a free nerve endings.JPG" />
Which is this? - answer:-Free nerve endings (C, A-delta fibers)

Sensory receptors/corpuscles: Meissner's corpuscles Location? Senses? - answer:-In
glabrous (hairless) skin. Senses dynamic fine touch (e.g., manipulation), adapt quickly.
<img src="393b Meissners Corpuscles.JPG" />

Sensory receptors/corpuscles (location and senses): In glabrous (hairless) skin. Senses
dynamic fine touch (e.g., manipulation), adapt quickly. <img src="393b Meissners
Corpuscles.JPG" /> Which is this? - answer:-Meissner's corpuscles

Sensory receptors/corpuscles: Pacinian corpuscles Location? Senses? - answer:-In
deep skin layers, ligaments, and joints. Sense vibration, pressure. <img src="393c
Pascinian corpuscle.JPG" />

Sensory receptors/corpuscles (location and senses): In deep skin layers, ligaments, and
joints. Sense vibration, pressure. <img src="393c Pascinian corpuscle.JPG" /> Which is
this? - answer:-Pacinian corpuscles

Sensory receptors/corpuscles: Merkel's disks Location? Senses? - answer:-(cup-
shaped, unencapsulated) In hair follicles. Sense static touch (e.g., shapes, edges,
textures), adapt slowly. <img src="393d Merkels disk.JPG" />

Sensory receptors/corpuscles (location and senses): (cup-shaped, unencapsulated) In
hair follicles. Sense static touch (e.g., shapes, edges, textures), adapt slowly. <img
src="393d Merkels disk.JPG" /> Which is this? - answer:-Merkel's disks

Peripheral nerve layers: Endoneurium - answer:-Invests a single nerve fiber (Endo =
inner) <img src="393e Peripheral nerve layers.JPG" />

Peripheral nerve layers: Perineurium - answer:-(P erineurium is the P ermeability
barrier) Surrounds a fascicle of nerve fibers. (Peri = around) Must be rejoined in
microsurgery for limb reattachment. <img src="393e Peripheral nerve layers.JPG" />

,Step 1 First Aid - Neurology
Peripheral nerve layers: Epineurium - answer:-Dense connective tissue that surrounds
entire nerve (fasicles and blood vessels) (Epi = outer) <img src="393e Peripheral nerve
layers.JPG" />

Neurotransmitters: NE Change in dz? Location of synthesis? - answer:-Increased in
anxiety, decreased in depression. Made in the locus ceruleus.

Increased in anxiety, decreased in depression. Made in the locus ceruleus. What NT is
this? - answer:-NE

Neurotransmitters: Dopamine Change in dz? Location of synthesis? - answer:-
Increased in schizophrenia, decreased in Parkinson's. Made in the ventral tegmentum
and SNc

Increased in schizophrenia, decreased in Parkinson's. Made in the ventral tegmentum
and SNc What NT is this? - answer:-Dopamine

Neurotransmitters: 5-HT Change in dz? Location of synthesis? - answer:-Decreased in
anxiety, depression. Made in the raphe nucleus

Decreased in anxiety, depression. Made in the raphe nucleus What NT is this? -
answer:-5-HT

Neurotransmitters: ACh Change in dz? Location of synthesis? - answer:-Decreased in
Alzheimer's, Huntington's. Made in the basal nucleus of Meynert.

Decreased in Alzheimer's, Huntington's. Made in the basal nucleus of Meynert. What
NT is this? - answer:-ACh

What 3 structures form the blood-brain barrier (BBB)? - answer:-1.) Tight junctions btw
nonfenestrated capillary endothelial cells 2.) Basement membrane 3.) Astrocyte
processes <img src="394a BBB.JPG" />

Besides the BBB, what are 2 similar barriers? - answer:-1.) Blood-testis barrier 2.)
Maternal-fetal blood barrier of placenta

What happens at the BBB w/ infarction? - answer:-Infarction destroys endothelial cell
tight junctions, leading to vasogenic edema

Glucose and amino acids at the BBB - answer:-Cross slowly by carrier-mediated
transport mechanism.

Nonpolar/lipid-soluble substances at the BBB - answer:-Cross rapidly via diffusion.

Specialized brain regions w/ fenestrated capillaries and no BBB - answer:-Allow
molecules in the blood to affect brain function (e.g., area postrema - vomiting center

, Step 1 First Aid - Neurology
after chemo, OVLT - osmotic sensing) or neurosecretory products to enter circulation
(e.g., neurohypophysis - ADH release)

Hypothalamus functions - answer:-The hypothalamus wears TAN HATS : T hirst and
water balance A denohypophysis control N eurohypophysis releases hormones from
hypothalamus H unger A utonomic regulation T emperature regulation S exual urges

Inputs to the hypothalamus - answer:-OVLT (senses change in osmolarity) Area
postrema (responds to emetics)

Supraoptic nucleus of the hypothalamus - answer:-Area that makes ADH.

Area that makes ADH. - answer:-Supraoptic nucleus of the hypothalamus

Paraventricular nucleus of the hypothalamus - answer:-Area that makes oxytocin.

Area that makes oxytocin. - answer:-Paraventricular nucleus of the hypothalamus

Lateral area of the hypothalamus - answer:-Controls hunger: destruction leads to
anorexia. ("If you zap the lateral nucleus, you shrink laterally ") Inhibited by leptin.

Ventromedial area of the hypothalamus - answer:-Controls satiety: destruction leads to
hyperphagia. ("If you zap your ventromedial nucleus, you grow ventrally and medially .")
Stimulated by leptin.

Anterior hypothalamus - answer:-Cooling (Anterior = cooling, or A/C). A nterior is pA
rasympathetic.

Posterior hypothalamus - answer:-Heating (posterior = get fired up / heating).
Sympathetic. If you zap your P osterior hypothalamus, you become a P oikilotherm
(cold-blooded, like a snake)

Septal nucleus of the hypothalamus - answer:-area responsible for sexual urges

area responsible for sexual urges - answer:-Septal nucleus of the hypothalamus

Suprachiasmatic nucleus of the hypothalamus - answer:-Circadian rhythm. ("You need
to sleep to be charismatic [chiasmatic]").

Posterior pituitary (neurohypophysis) - answer:-Receives hypothalamic axonal
projections from supraoptic (ADH) and paraventricular (oxytocin) nuclei. Oxytocin: oxys
= quick; tocos = birth.

Anterior pituitary aka...? - answer:-A nterior pituitary = A denohypophysis

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