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NeuroAnatomy ((BBB (tight junctions between nonfenestrated capillary…
NeuroAnatomy
BBB
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glucose, AA cross slowly via carrier-mediated transport
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fenestrated capillaries allow molecules to affect brain. [area postrema - vomiting after chemo; organum vasculosum lamina terminals - osmotic sensing; neurosecretory - ADH release]
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Cerebellum
movement, coordination, balance
input - contralateral cortex via middle cerebellar peduncle. ipsilateral proprioceptive info via inferior cerebellar peduncle from spinal cord
output - Purkinje cells [inhibitory] --> deep nuclei of cerebellum --> contralateral cortex via superior cerebellar peduncle .
deep nuclei [lateral to medial] - dentate, emboli form, globose, fastigial
Lateral lesions - Limbs; medial lesions -midline [truncal ataxia, wide-based cerebellar gait, nystagmus, head tilt]
meninges
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Pia mater 0 thin, inner layer adheres to brain and spinal cord
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Hypothalamus
lateral - hunger. stimulated by gherkin, inhibitors by leptin.
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anterior - cooling, parasympathetic
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supraoptic and paraventricular nucleus - synthesize ADH, oxytocin
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Limbic system - emotion, long term memory, olfaction, behavior modulation, ANS function.
Papez circuit - hippocampus, mammillary bodies, anterior thalamic nuclei, cingulate gyrus, entorhinal cortex.
Feeding, Fleeing, Fighting, Feeling, Fucking [sex]
Spinal Nerves
vertebral disc herniation - nucleus pulposus herniates through annulus fibrosus. usually posterolaterally L4-L5 or L5-S1. nerve usually affected is below herniation. S1 compression --> absent ankle reflex.
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Ascending - dorsal columns of corticospinal tract - arms outside, legs inside [fasciculus gracilis and cuneatus[upper arm]]
nerve ending --> bypass pseudo unipolar cell body in dorsal root ganglion --> enter spinal cord --> ascend IPSILATERALLY in dorsal column to synapse at nucleus gracilis/cuneatus in IPSILATERAL medulla
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REFLEXES
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Primitive
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Galant - stroking along one side of spine while newborn is in ventral suspension --> lateral flexion toward stimulated side
Sensory Receptors
free nerve endings - C [slow unmyelenated] + Adelta [fast, myelinated] PAIN/TEMP
Meissner corpuscles - fine/light touch, position sense [large myelinated]
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merkel discs - pressure, deep static touch, position sense [large myelinated, adapt slowly]
Ruffini corpuscles - pressure, slip objects along skin, joint angle change [dendritic endings with capsule, adapt slowly]
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Perfusion
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watershed zones - severe hypotension --> upper leg/arm weakness, defects in higher order visual processing
Venous run through dura. drain blood and received CSF from arachnoid granulations --> empty into internal jugular vein
venus sinus thrombosis - signs/sxs of high ICP --> may lead to venous hemorrhage. associated with hypercoagulable states [preggers, OCP use, factor 5 leiden]
Ventricles
lateral ventricles --> R and L inter ventricular foramina of Monro --> 3rd ventricle --> aqueduct of sylvius --> 4th ventricle --> foramina of Luschka [lateral] and Magendie [medial] --> subarachnoid space
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Brain Stem
pineal gland - melatonin secretion, circadian rhythms
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Cranial Nerves
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midbrain - nuclei of 3, 4; pons - nuclei of 5, 6, 7, 8; medulla - nuclei of 9, 10, 12; spinal cord - nucleus of 11
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Path
Neural tube defects
spina bifida occulta - failure of caudal neuropore closure without herniation. dura intact. tuft of hair/skin dimple
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holoprosencephaly - L and R hemispheres don't separate. Shh mutations. cleft lip/palate. cyclopia in most sever. [assc. trisomy 13, fetal alcohol syndrome]
anencephaly - failure to close neuropore. no forebrain. polyhydramnios - no swallowing center in brain