Neuro 1 pt 1

*Mastication Networks* 1. what is a central pattern generator? 2. What functions of mastication does #1 work on? 3. Does it also evaluate proprioceptive afferents coming in? If so, what does that accomplish?

1. "Its like having a mini brain that is talking to different nuclei and coordinating them" 2. Both opening and closing of the mouth. 3. yes, making sure that we dont bite our lip or our cheek

*Sites of Drug Action in the CNS:* 1. SSRI's work at what site? 2. What are #1's used for? 3. acytlcholine esterase inhibitor act on what site?

1. (#6) reuptake into the nerve ending or uptake into a glial cell. 2. anti depressants 3. (#7) Degradation

*Thalamus-Nuclear Groups & Functions* - *Anterior* 1. The *Anterior* nuclear group is at the {front or back} of the thalamus? 2. It in part borders what? 3. It can be seen in the {anterior or posterior) horn of the {medial or lateral} ventricle?

1. *Front of Thalamus* 2. Borders the *ventricles* 3. It can be seen in the *anterior* horn of the *lateral* ventricle (anterior thalamic tubercle).

1. What branches does the infraorbital a. supply as it passes through the infraorbital canal? (2) 2. What do these branches supply? (3)

1. *Middle superior alveolar branch* *Anterior superior* alveolar branch 2. *maxillary sinus*, *maxillary bicuspid* *incisor teeth*

Explain to me the unique constellation of symptoms associated w/ Wallenberg Syndrome

-*Ipsilateral* loss of pain and temp on face (Descending portion of spinal trigeminal tract) -*Contralateral* loss of pain and temp in body (Ascending portion of spinal thalamic tract) -lose vestibular nuclei (ataxia and dizziness) -lose sympathetic fibers (Horners syndrome: ptosis meiosis, anhidrosis) -Lose nucleus ambiguus (difficulty swallowing and speaking)

What landmark of the temporal bone will assist in the opening of the mouth?

---ARTICULAR TUBERCLE *this is a ramp utilized by head of mandible

What are 2 important landmarks found on the PARIETAL bone?

---Superior Temporal Line: marks attachment of temporalis fascia ---Inferior Temporal Line: marks perimeter attachment of temporalis muscle

What are the foramina/canals (6) associated with the sphenoid bone?

---Superior orbital fissure ---Foramen Rotundum ---Foramen Ovale ---Foramen Spinosum ---Pterygoid canal ---Pharyngeal canal

What is the cause of Alzheimer's Disease (AD)? How is it treated?

--> Reduced cerebral production of choline acetyl transferase, which leads to a decrease in ACh synthesis & impaired cortical cholinergic function. *Acetylcholinesterase (AChE) Inhibitors are used to treat AD

Activation of mAChRs will lead to what kind of intracellular events?

--> Triggers the mobilization of second messengers within the cell.

What are the components of the Zygomatic arch?

--> Zygomatic process of the Temporal bone. --> Temporal process of the Zygomatic bone.

What are the four bones that the Zygomatic bone articulates with?

--Frontal --Maxillary --SPhenoid --Temporal

What are the bones that the maxilla will articulate with? (9)

--Frontal --Nasal --Lacrimal --Ethmoid --Zygomaticc --Inferior concha --Palatine --Vomer --Sphenoid

What are 3 common co-transmitters that are co-released with adrenergic vesicles? What is their function?

--NE (norepinephrine) --ATP --neuropeptide Y (NPY) These cotransmitters will have feedback on prejunctional receptors to INHIBIT the release of each other.

Which bones of the skull will be paired (one on each side of skull)?

--Nasal --Zygomatic --Parietal --Temporal --Palatine --Lacrimal --Inferior concha

Where does the parietal bone articulate with the sphenoid bone?

--Pterion --Middle cranial fossa

What are the 3 regions of the occipital bone? Describe each.

--SQUAMOUS: largest portion, with a saucer-like appearance posterior to foramen magnum. --BASILAR: Trapezoidal portion anterior to foramen magnum --LATERAL: Portions lateral to the foramen magnum

What are the co-transmitters that found in the vesicles of BOTH adrenergic and cholinergic nerves?

-ATP -Neuropeptide Y -Vasoactive intestinal peptide (VIP) -Substance P

*Organization of Primary Auditory Pathways* What is the pathway from the cochlea to the primary auditory cortex?

-Cochlea -Dorsal and Ventral cochlear nuclei -Superior olivary nuclei -Inferior colliculus -Medial geniculate body of the thalamus -primary auditory cortex

What are the bones (4) of the skull that contain air cells or sinuses?

-Frontal -Maxilla -Ethmoid -Sphenoid

Flip the card

-Make an assessment -When testing the jaw jerk reflex, what would it look like if there was some type of cortical issue (no longer getting UMN involvement)? -What is there was an issue in the LMN pool? -Can you test this on an unconscious person? -Motor nucleus of V -The reflex would by hyper-reactive -Hypo-reflexive, wasting away of jaw musculature. -Yes you can

The Frontal bone will articulate with which other bones (7) of the skull?

-Nasal -Maxillla -Zygomatic -Parietals -Lacrimal -Ethmoid -Sphenoid (greater & lesser wing)

What are the catecholamines (small-molecule neurotransmitters) used in the autonomic nervous system (ANS)?

-Norepinephrine (NE) -Epinephrine (Epi) -Dopamine (DA)

What are the structures found in the Oral region of the body?

-Oral cavity -Cheeks & Lips -Teeth & Gingivae -Tongue -Tonsils -Salivary glands -Palate

precommissural fornex connects what?

-connects subcortical structures (septal area, hypothalamus) associated with olfaction emotion and basic behaviors such as feeding and the emotional components of memories

Its like they gave up for test 3, there is nothing from the class before us

.

Should we practice drawing these?

.... nah

What are the non cortical components?

1 Amygdaloid complex 2 Substantia innominata 3 septal nuclei 4 nucleus accumbens 5 hypothalamus- mammillary bodies 6 thalamic nuclei- anterior thalamic and dorsomedial nuclei of the thalamus Remember this by Non cortical is N-Stash (nucleus accumbens, substantia innominata, thalamic nuclei, amygdaloid body, septal nuclei, hypothalamus)

What are the two white matter tracts in the hippo(campal) formation?

1 alveus - on hippocampal ventricular surface comprised of afferents and efferents 2 fimbria- collection of nerves from alveus along medial border of hippo upon leaving the hippo it turns into the fornix (about 10^6 axons!)

where are the other hippocampal formation afferents?

1 contralateral hippocampus (via hippocampal commissure in fimbria fornix) 2. septal area, substantia innominata (basal cholinergic nuclei of forebrain) 3. thalamus (anterior group and medioventral) 4. ventral tegmental area (dopaminergic basal ganglia pathway) 5. reticular formation

Here is an overview of the branches of V2

1 question: What is the importance of the communicating branch shown here? (scroll down) (hint: you might see this picture at the end of the slide show) The communicating branch is important for parasympathetic innervation to the lacrimal gland

What are the cortical structures of the limbic system?

1 subcallosal area (parolfactory and parateminal gyri) 2 cingulate gyrus 3 parahippocampal gyrus (uncus, entorhinal cortex) 4 parts of hippocampal formation

*Middle Ear* - Medial Wall (flip)

1) A-C 2) What is covering all of these structures? Answers hiding ↓ 1. A: Base of Stapes (in oval window) B: Round window C: Promotory w/tympanic nerve & plexus 2. Mucous Membrane

What are the pathophysiologic effects of Dopamine (DA)?

1) DA neurons in the striatum degenerate in Parkinson's Disease 2) Psychosis (Schizophrenia): increased DA activity 3) cocaine abuse will produce DA uptake blockade and amphetamines increase DA release ("reward pathway")

What are the pathophysiologic effects of Serotonin (5-HT)?

1) Depression is associated w/ decreased 5-HT. 2) Mediates effective processes such as aggressive behavior & arousal 3) Ecstasy (MDMA), LSD & other hallucinogens probably act in part by interacting w/ 5-HT receptors 4) antiemetics are 5-HT receptor antagonists 5) Atypical antipsychotics are partial agonists at 5-HT

What are the pathophysiologica effects of acetylcholine?

1) NT in the CNS, PNS, and NMJ 2) In CNS: midbrain reticular formation (wakefulness), basal ganglia (motor control), basal forebrain (connects hippocampus & cortex: memory and motor skills) 3) Alzheimer's (decreased ACh synth.) 4) NMJ disorders 5) BLockage of ACh receptors can cause drowsiness, sedation and memory loss.

What are the pathophysiologic effects of Norepinephrine (NE)?

1) Noradrenergic neurons have cell bodies in the locus coeruleus & diffuse projections throughout the brain. 2) Modulates sleep, wakefulness, attention and feeding behavious 3) Role in mood disorders (depression)

What are the pathophysiologic effects of Glutamate?

1) Synaptic plasticity -- Learning and Memory 2) Migraine -- excessive glutamate release contributes to cortical spread in Aura of headache. 3) Excitotoxicity & Cell Death

y u here?

1-12. ID 1. Frontal sinus 2. Crista gali 3. lacrimal bone 4. maxilla, frontal process 5. Anterior nasal aperture 6. Inferior concha 7. Maxilla, palatine process 8. Middle concha (ethmoid bone) 9. Palatine bone, horizontal plate 10. Choana 11. Pterygoid process, both the medial and lateral plate 12. superior concha (ethmoid bone.)

hey check out what is on the other side of this card....

1-2 -Where are we in the brainstem? -#2 sits (ventrolateral/ventromedial) in pontine tegmentum in caudal pons 1. CN VII 2. Facial motor nucleus -Caudal pons -ventrolateral

1. What makes up the Waldeyer's ring of tonsillar tissue? 2. Where are the adenoids and when are they considered adenoids?

1-2. Pharyngeal tonsils (knowns as the adenoids of the nasopharynx, only considered adenoids when they are inflammed), tubal tonsil, palatine tonsils, lingual tonsils.

flip for pic

1-3. ID 4. what is # 2 made up of? 1. dentate nucleus 2. interposed nucleus 3. fastigial nucleus 4. #2 is made up of globose and emboliform

Flip the card.........

1-4 Also, what type if fibers would you find in 1, 2, and 3? (Scroll down) 1. Hypoglossal nucleus (GSE fibers) 2. nucleus solitarius (Visceral afferent) 3. nucleus ambiguus (SVE fibers) 4. CN XII

Flip for ?

1-6. What NT? 7-12. What Receptor? 13-16. What NT and What Receptor? 17. what NT? 18-21. Sympathetic or Parasympathetic? 1. ACh 2. ACh 3. ACh 4. ACh 5. ACh 6. ACh 7. N 8. N 9. N 10. N 11. N 12. N 13. ACh, M 14. ACh, M 15. NE, alpha/beta 16. D, D1 17. EPI and NE 18. Parasympathetic 19. Sympathetic 20. Sympathetic 21. Sympathetic

Check the other side again

1-7 1. Incisive fossa 2. Greater palatine foramen 3. Lesser palatine forament 4. Transverse palatine folds 5. Palatine raphe 6. Palatine process of maxilla 7. Palatine glands 8. Horizontal plate of palatine bone

Flip for the pic

1-8 ID 1. Hemisphere 2. Vermis 3. Anterior lobe 4. Posterior lobe 5. Flocculonodular lobe 6. Vermis 7. Intermediate zone of hemisphere OR paravermis 8. Lateral zone of hemisphere 9. Posterior fissure

See the other side for the question

1-9 -What is the importance of #4-6? -Will you see #6 in association with both #1 and #2? Just about there dont give up Woooooow you made it!!!! 1. Rods 2. Cones 3. Horizontal cells 4. Rod bipolar cells (ON) 5. Cone bipolar cells (ON) 6. Cone bipolar cells (OFF) 7. Amacrine cells 8. RCG 9. CN II -ON bipolar cells will be active when there is light and OFF bipolar cells will be active when there is no light. -NO! only see them in association with cones, not rods.

Recap: Which cell in the olfactory bulb... 1. Are 1° output cells. Their dendrites synapse w/olfactory neurons in Glomeruli, which leave cell to 1° olfactory cortex 2. Are inhibitory Cells. Influence which cells leave the cell. 3. Are synapse spheres where olfactory neuron axons interact w/output cells of bulb. 4. Are 2° output cells. Just like mitral but go to different places.

1. *Mitral Cells* 2. *Granule Cells* 3. *Glomeruli* 4. *Tufted Cells*

1. What branch of V3 will branch from V3 near the *Otic ganglion*? 2. What muscle will this nerve penetrate? 3. which nerves branch from it?

1. *Nerve to the medial pterygoid* 2. This will penetrate the medial pterygoid m. which it innervates. 3. *Nerve to Tensor Veli Palatini* *Nerve to Tensor Tympani*

What is the term for rhythmic, INVOLUNTARY eye movements (drifting)? What is this caused by?

1. *Nystagmus* (becomes pathological when not controlled. there is a normal amount of nystagmus) 2. -Vestibulo-ocular reflex (VOR) -Optokinetic reflex

*Vestibular Damage - Nystagmus:* 1. What is *Nystagmus*? 2. Nystagmus is usually in what direction? (horizontal or vertical or rotary?) 3. The movements of the eyes are as though the head were WHAT and trying to keep the eyes tracking objects in the visual field.

1. *Nystagmus* is a slow, rhythmic oscillation of the eyes to one side followed by a fast or corrective phase. 2. Nystagmus is usually horizontal, but vertical and rotary nystagmus may also occur. 3. head were turning

*Blood Supply* to Eye and Orbit 1. Major Vessel that dives in & branches? 2. Which vessel feeds the Retina? 3. Which vessels feed the Vascular Tunic (2)? 4. Which vessel feeds the Lateral Eyelid & Lacrimal Gland?

1. *Ophthalmic* Artery (off ICA) 2. *Central Retinal* A 3. *Short & Long Posterior Ciliary* aa 4. *Lacrimal* A

1. What are the anterior boundaries (2) of the hypothalamus? 2. What is the posterior boundary of the hypothalamus? 3. 3 more structures located midline (from anterior to posterior if you please)?

1. *Optic Chiasm* (inferior view) & *Lamina Terminalis* (sagittal view) 2. Caudal extent of *Mammillary Bodies* 3. Infundibulum → 3rd Ventricle → Tuber Cinereum

*Sensory* Innervation 1. What nerve allows for special sense in the eye? 2. What nerve allows you to feel when someone pokes you in the eye?

1. *Optic nerve (II)* - SSA (sight) 2. *Trigeminal nerve (V)* (Ophthalmic division) - GSA (general sensation)

1. 1° Gustatory Cortex projects where? 2. Recall what else projected here?

1. *Orbitofrontal Cortex* 2. Olfaction Info

*The Static Labyrinth:* 1. The macula consists of an area of hair cells embedding in a gelatinous membrane called WHAT? 2. This membrane from #1 contains particles of what molecule? 3. #2 gives the membrane a higher density than WHAT in the membranous labyrinth?

1. *Otolithic membrane* 2. Calcium carbonate (*otoconia*) 3. Endolymph

1. Which Nucleus is the *Master Regulator of the ANS*? 2. Efferents from 1 travel in what 2 tracts to directly connect w/Preganglionic Sympathetic & Parasympathetic Neurons?

1. *Paraventricular Nucleus* 2. *Medial Forebrain Bundle (MFB)* & *Dorsal Longitudinal Fasciculus (DLF)*

1. What's the name of the fascia outmost in the orbit + what's it made of? 2. What's the name of the fascia just around the eye ball + where exactly is it found? 3. What's found b/w these two fascial layers & what are it's to divisions?

1. *Periorbita*: orbit periosteum continuous w/dura (Depicted in blue in the image) 2. *Bulbar fascia*: surrounds globe directly & attached to sclera (not over cornea) (red in image) 3. *Periorbital fat*: *intra*conal (inside extrinsic eye muscles) & *extra*conal (outside extrinsic eye muscles)

1. What branch arises from the maxillary a. as it enters the pterygomaxillary fissure? 2. What is the course of this branch? 3. What does it supply? (3)

1. *Posterior Superior Alveolar a.* 2. this a. passes forward & downward to enter a foramen on the posterior surface of the maxilla (sphenomaxillary fissure) 3. where it provides branches to the *maxillary molars* & *bicuspid teeth* & *the maxillary sinus.*

*Sensory Innervation of the Nasal Cavity:* 1. What branch emerges from the sphenopalatine foramen to innervate the middle nasal cavity? 2. #1 is a branch of what CN 3. Which nerve is a branch from Greater palatine nerve as it descends and helps innervate the middle nasal cavity? 4. #3 is a branch from what CN

1. *Posterior Superior Lateral Nasal Nerves* 2. CN V2 3. *Posterior Inferior Lateral Nasal Nerves* 4. CN V2

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 1. [pre or post] ganglionic parasympathetic fibers from WHAT nucleus course within WHAT CN?

1. *Preganglionic parasympathetic fibers* from the superior salivatory nucleus · course within the *Facial N. (CN VII)*.

1. What is another name for the meningeal branch of V3? 2. Where does this branch travel? 3. This does sensory to what structure in the cranium?

1. *Recurrent branch of V3* 2. returns to the cranium via *foramen spinosum* 3. *dura* w/ a distribution similar to that of the middle meningeal a.

*Accommodation:* -DISTANCE VISION 1. In the absence of nerve stimulation the ciliary muscle is [flexed or relaxed?] 2. the zonular fibers are under tension or are they relaxed? 3. Lens is beings stretched or is it not stretched?

1. *Relaxed* 2. UNDER TENSION 3. lens is being stretched thin

Globe: *Neural* Tunic 1. 3 major parts to it?

1. *Retina*, *Optic disc*, & *Macula lutea*

1. What sort of map can we make along the Calcarine sulcus? With this in mind: 2. What part of the retina maps onto the very back of the Calcarine sulcus? 3. As you move more anteriorly along the Calcarine sulcus, where in the retina are you moving?

1. *Retinotopic* map (this is the thing where different parts of the retinal field map on different parts of the visual cortex) 2. Macula 3. Think bullseye fashion medial → lateral

1. What other fibers from the CN VII are carried on V3 aside from GVE-P fibers? 2. What is the function of these fibers?

1. *SVA from CN VII* 2. which will *provide taste* to the *anterior 2/3* of the tongue.

*The Static Labyrinth:* 1. The *static labyrinth* includes what 2 things and the specialized sensory receptor apparati, (which make up the *otolith organs* (*otoconia*)) 2. The otolith organs are located in specific areas of the saccule and utricle called what?

1. *Saccule* and *Utricle* 2. *maculae* (spots)

1. Day 22: _____ _______ form on sides of forebrain. 2. When neural tube closes, Q1 form outpockets called _____ ________. 3. As Q2 come in to contact w/surface ectoderm they induce changes in ectoderm forming ____ ________. 4. Q3 will invaginate & close off to form?

1. *optic grooves* 2. *optic vesicles* 3. *lens placodes* 4. lens of the eye

1. What is the vestibule portion of the oral cavity? 2. Where does it open externally? 3. What is its function (with help of muscle of facial epression)?

1. *space b/w the lips/cheeks and teeth.* 2. Opens externally at the oral fissure b/w the lips. 3. the vestibule *controls shape/size of oral fissure*.

*Sensory Detectors: Hair Cells* 1. Hair Cells have what type of cilia? 2. There are 60-100 'hairs' (#1) project from each cell, progressively increasing in length as they progress towards WHAT? 3. What do they arise from?

1. *stereocilia* 2. long cilium (Kinocilium) 3. a centriole.

-Salivary Glands *Submandibular and sublingual glands- sympathetics* 1. Postganglionic sympathetic fibers originating from WHAT ganglion? 2. They provide what branches which form a plexus on the facial artery? 3. these accompany its branches tow what 2 glands?

1. *superior cervical ganglion* 2. External carotid branches which form a plexus on the Facial artery 3. to the submandibular and sublingual salivary glands.

*Autonomic Innervation of the Head:* -Salivary Glands *Parotid gland-sympathetics* 1. Postganglionic sympathetic fibers from WHAT ganglion form the *external carotid plexus* which courses on what vessel? 2. Fibers from this plexus distribute to the parotid gland as WHAT artery courses through its substance? 3. Fibers are mainly what?

1. *superior cervical ganglion* forms the *external carotid plexus* which is on the external carotid artery 2. external carotid artery 3. Vasomotor

1. The pre-ganglionic parasympathetic fibers in the chorda tympani (CN VII) will arise from what part of the brainstem? 2. What will the parasympathetic fibers in chorda tympani innervate? (2) 3. Via what ganglion?

1. *superior salivatory nucleus* 2. these fibers will innervate the *lingual, submandibular and sublingual salivary glands* 3. via the submandibular ganglion.

*Kinetic Labyrinth:* 1. The hair cells are aligned in a ridge within the *ampulla* Called the WHAT? 2. with the stereocilia embedded in a gelatinous cap called the WHAT? 3. that is attached to the roof and walls of the WHAT, forming a fluid-tight partition. 4. Rotation of the head will cause the endolymph to push against the WHAT, producing deflection of the stereocilia of the hair cells.

1. *the crista* 2. * the cupula* 3. *Ampulla* 4. *Cupula*

*Parasympathetics* 1. Leave cortical control ("Limbic" in image) & go to which 3 possible nuclei? 2. After leaving NST, what nuclei will Parasympathetic info go to (2)?

1. - *Paraventricular nucleus (PVN)* - Nucleus of Solitary Tract (NST) - Nucleus Ambiguus (NA) 2. - Dorsal Motor Nucleus of X (DMX) (vagus) - Nucleus Ambiguus (NA) (all the while there is feedback communication b/w PVN & NST)

*Inferior cerebellar peduncle:* 1. What are the 3 tracts that run thru it? 2. Are the tracts ipsilateral, contralateral, or bilateral, or laterally? 3. There is also efferents to what nuclei?

1. - *vestibulo*cerebellar tracts -*spino*cerebellar tracts - Olivocerebellar tracts 2. Ipsilateral info 3. Vestibular nuclei note- also called restiform or juxtarestiform body

*Sympathetics* 1. Leave cortical control ("Limbic" in image) & go to which 2 nuclei? 2. After leaving NST, what nuclei will Sympathetic info go to (2)? 3. Theme: Both PVN and NST are modulated by what 2 things.

1. - Nucleus of Solitary Tract (NST) - *Paraventricular nucleus (PVN)* (via NST) 2. - Locus Coeruleus (LC) - Ventral Lateral Medulla (VLM) (A5) 3. Limbic system & other hypothalamic nuclei

1. What is the characteristic triad for pheochromocytomas? 2. What is a pheochromocytoma?

1. - headaches, - perspiration, and - palpitations 2. Pheochromocytoma is a chromaffin cell tumor secreting excessive catecholamines resulting in increased peripheral vascular resistance and hypertension. it is a tumor of the adrenal gland. the tumor secretes increased amounts of catecholamines, usually epinephrine, and norepinephrine. if there is increased dopamine secretion it suggest malignant tumor. vasoconsriction increaseds peripheral resistance and blood pressure and hypertension may be episodic or sustained.

*Accommodation:* 1. What are the 3 actions of accommodation? 2. All three of those actions are mediated by what CN? 3. The accommodation reflex is in by what CN and out by what CN?

1. -Convergence -Thickening of lens - Pupillary constriction 2. CN III 3. in by CN II and out by CN III "remember it has to happen by light! haha, a blind person cannot accommodate" -Dr. buck - Michael Scott

1. The vermis (medial zone) of the cerebellum gets input from what 3 tracts? 2. The paravermis (intermediate zone) of the cerebellum gets input from what 4 tracts?

1. -Dorsal Spinocerebellar tract (DCST) -Cuneocerebellar tract (CCT) -Olivocerebellar tract (OCT) 2. -Dorsal Spinocerebellar tract (DCST) -Cuneocerebellar tract (CCT) -Olivocerebellar tract (OCT) -Pontocerebellar tract (PCT) From primary motor cortex

*Glutamate: The Primary Excitatory NT:* 1. What are the 4 pathophysiology problems glutamate can cause? 2. which one are we most concerned with this year?

1. -Ischemic injury, stroke -Migraine -Alzheimer's disease -Lou Gehrig's disease 2. Ischemic injury, stroke

*Clinical Comments:* Caloric testing 1. Warm water will produce conjugate gaze to the [Same or Opposite?] side of the applied water ([slow or fast?] phase), 2. In the conscious patient, the eyes will rapidly reposition to the central position ([slow or fast?] phase, [same or opposite?] side).

1. -OPPOSITE side - Slow phase 2. - FAST phase - SAME side

1. The lateral zone of the cerebellum gets input from what 2 tracts? 2. The flocculomodular lobe gets input from what 2 tracts?

1. -Olivocerebellar tract (OCT) -Pontocerebellar tract (PCT) From primary motor cortex 2. -Olivocerebellar tract (OCT) - Vestibulocerebellar tract (VCT)

*Adrenergic Transmission:* 1. What are the 4 steps? (hint starts with it being made)

1. -Synthesis -Storage -Release -Reuptake

*Clinical Comments:* Caloric testing 1. Nystagmus is classified based on the direction of the [fast or slow?] return phase such that with coloric nystagmus can be remembered with COWS. What does COWS stand for? 2. In the comatose patient, the [fast or slow?] phase (driven by the cortex) is absent?

1. -fast return phase - C O W S -(Cold Opposite, Warm-same) 2. In the comatose patient, the fast phase (driven by the cortex) is absent.

*Vestibular Damage - Nystagmus:* 1. Nystagmus can be produced behaviorally by the same mechanism as vertigo. After spinning in a circle and stopping, WHAT within the semicircular ducts continues to move, creating the illusion of movement (vertigo) and nystagmus. 2. This will result in reflex eye movements, as though WHAT was occurring?

1. -the Endolymph 2. actual movement was occuring

*Planning movements:* 1. Afferents from what motor cortex? 2. is #1 from the ipsilateral or contralateral side? 3. Efferents goes to what 2 things?

1. Afferents from Premotor/supplementary motor ctx 2. (Contra) 3. to the Thalamus, to cortex

*Cerebellum functions:* Planning movements 1. the afferents are from what 2 things? ipsilateral or contralateral? 2. The efferents go to what 2 things?

1. Afferents from premotor/supplementary motor ctx (contra) 2. Efferents to the thalamus, to cortex

*Cerebellum functions:* Limb and Postural adjustments 1. Afferents from what tracts and what ctx? 2. Efferents to what 2 things?

1. Afferents from spinocerebellar tracts and motor ctx 2. Efferents to the thalamus, cortex

*FACIAL NERVE* 1. Facial is kind of a weird nerve, what happens if there is a cortical lesion (i.e. how would it present)? 2. How would it present with a cranial nerve nuclei lesion?

1. Again, there is a bilateral projection, so you would see slacking of the face below the eyes but the forehead would just show weakness. Additionally, you would see a *contralateral* deficiency (due to nerve decussation). 2. Lesions of nucleus causes ipsilateral deficiency.

*Serotonin (5-Hydroxytryptamine, 5-HT):* 1. Serotonin mediates affective processes such as what 2 things? 2. it is in descending WHAT pathways? 3. What does serotonin do to sensory?

1. Aggressive behavior and arousal. yin yang kinda schtuff 2. Descending pain pathways 3. Sensory enhancement!

Ear Review: The middle ear 1. The middle ear is filled with {fluid or air} 2. Has connections to the pharynx through what structure (+ function)? 3. Static pressure differences on either side of the tympanic membrane can interfere with? 4. Connection of ossicles to oval window of vestibule provide which mechanical transduction system?

1. Air filled space (relatively enclosed) 2. Eustachian tube (some pressure balance) 3. Its motion (and hearing) 4. Convert motion of ossicles to sound waves in the fluid filled inner ear

*Autonomic Innervation of the Head:* -Eye *Ciliary Ganglion* 1. Carries what CN and what fibers? 2. Located *BETWEEN* what 2 things? 3. it is approximately how man mm in diameter? 4. it communicates with the eyeball via what nerves? 5. It has how many roots? 6. What are the names of the roots?

1. CN III, GVE-P 2. b/w lateral rectus and optic nerve 3. 2mm 4. via short ciliary nn 5. 3 roots 6. sensory root, sympathetic root, and oculomotor root

*SUMMARY:* -Parasympathetic Innervation of the Head 1. WHAT CN is the great sensory nerve to structures of the head and provides ready-made routes to all structures which need autonomic innervation. 2. Four parasympathetic ganglia are "associated" with CN V. What are their names. AND. What division of CN V are they from?

1. CN V 2. CN V: V1 (ciliary), V2 (pterygopalatine), and V3 (otic & submandibular).

*Auditory Reflexes - Sound Dampening* 1. What is the other CN that isnt as important? 2. What is its main function? 3. Is it activated as readily as CN VII with loud sounds? 4. Does damage to this CN cause hyperacusis? 5. Over activity of this could cause what though?

1. CN V 2. Reflex involves *tensor tympani,* dampens sounds of internal origin (your speech). 3. You would think, but no it does not. 4. NOPE! 5. can produce objective tinnitus and can interfere with hearing at low frequencies.

*Deglutition Networks - Afferent Fibers* 1. What CN's are taking care of the afferent fibers again? 2. What nucleus would proprioceptive information travel back to?

1. CN V, VII, IX, X 2. Via CN V back to the mesencephalic nucleus

*Deglutition Networks - Efferent Fibers* 1. What CN are taking care of the efferent information again? 2. What nuclei do each of them project out from? 3. What is the "mini-brain" that is governing all of these actions again?

1. CN V, VII, IX, X, XII 2. CN V - Motor Nuc of V CN VII - Motor Nuc of VII CN IX/X - Nucleus Ambiguus CN XII - Hypoglossal Nuc 3. Central Pattern Generator (CPG)

*Auditory Reflexes - Sound Dampening* 1. What is the really important CN that we should remember for this pathway and what does it innervate? 2. Contraction of #1 causes what? 3. What happens if you damage it?

1. CN VII, innervates the stapedius muscle. 2. Contraction of the stapedius will increase the resistance of the ossicular chain and dampen particularly low frequency sound transmission. 3. Get sensitivity to loud sounds (hyperacusis)

*Motor learning:* 1. It has afferents from what CN, and what nucleus? 2. It has Efferents to what, to what, controling what muscles?

1. CN VIII and the inferior olivary nucleus 2. Efferents to reticular formation, cranial nerve nuclei controlling extraocular muscles This is the muscle memory. helps remember them. when you have done something alot you don't have to think about it because the cerebellum does it. Try brushing your teeth with the hand you usually don't brush with......

1. Which CN's are parasympathetic CN? 2. Which CN's are sympathetic CN?

1. CNs III, VII, IX, X 2. There are NO SYMPATHETIC CRANIAL NERVES

*Transduction by Hair Cells:* 1. The release of neurotransmitter is dependent on what ion? 2. Even at rest, there is a substantial level of of what activity?

1. Ca2+ 2. spontaneous activity (90 spikes/sec).

*Internal Ear* 1. What are *Otolith/Otoconium*? 2. Function?

1. Calcium carbonate crystals in saccule & utricle 2. Detect gravity & linear acceleration (movement of fluid)

*Clinical Note: Damage to Hair Cells* 1. The sound induced depolarization of hair cells can be measured, but where in the cochlea? 2. By what means can this be measured? 3. Does it vary with the sound stimulating the hair cells?

1. Can be measured anywhere within the cochlea 2. by electrophysiological means. 3. Yes, it does vary based on the sound.

*Superior cervical ganglion:* -internal carotid nerve 1. The caroticotympanic plexus is located where? 2. It is in conjunction with what 2 CNs?

1. Caroticotympanic plexus on the promontory of the middle ear 2. in conjunction with CNs VII and IX

*Superior cervical ganglion:* -internal carotid nerve 1. The cavernous plexus is located on what? 2. It provides fibers to what CN? 3. once it joins #2 what nerve does it form? 4. These fibers then continue [synapsing or without synapsing?] coursing thru what nerves to gain access to the globe (eyeball)? 5. This nerve will innervate what muscle and what other thing in the eye?

1. Cavernous plexus, located on the carotid siphon, 2. provides fibers to CN Ill 3. which forms the sympathetic root of the ciliary ganglion. 4. These fibers continue without synapsing, course with the short ciliary nerves to gain the globe (eyeball) 5. where they innervate the dilator pupillae muscle and blood vessels of the eye.

*Blood Supply* to Eye and Orbit 1. Recall: What A & V travel down the center of the Optic Nerve? 2. What 2 other arteries feed the Globe (vascular tunic)? 3. What A & V feed the extra ocular eye muscles?

1. Central Retinal A & V 2. Long & Short Posterior Ciliary aa 3. Anterior Ciliary A & V

The chorda tympani n. (CN VII) will merge with the lingual n. (Branch of V3) to reach the oral cavity --- how does this nerve reach the lingual n.? 1. Where is it formed? 2. How does it exit the middle ear? 3. Where does it enter after it goes through #2? 4. What does it merge with in the *infratemporal fossa*?

1. Chorda tympani is *formed in the MIDDLE* ear and 2. exits this region *via the petrotympanic fissure* to 3. enter the *INFRATEMPORAL fossa.* 4. the Lingual n.

Guess who's baaaack... *CVOs* 1. What are those again? 2. These areas play what role?. 3. Which CVO participates in osmotic/fluid homeostasis?

1. Circumventricular organs (specialized ventricular structures in which the BBB appears absent) 2. Regulation of some physiologic functions 3. Subfornical organ (SFO) (best example)

*Inner Ear* 1. Which part of the inner ear is deigned for hearing? 2. Which part of the inner ear is designed for balance? 3. These structures sit within what bone?

1. Cochlea 2. Semicircular canals 3. Under petrous part of temporal bone (membranous parts w/in boney parts)

*Properties of Sound* 1. When you pluck a guitar string, what influence does it have on the air? 2. What is frequency? 3. What is volume? 4. Sound waves are represented by what shape wave?

1. Creates sound waves in the air (sounds are complex combos of sound waves) 2. Cycles per second, Hertz (Hz) - pitch 3. Hight of peaks - decibels (dB) 4. Sine wave [having peaks (compression of air) & troughs (rarification) that constitute a wavelength with an amplitude]

*Dopamine Pathophysiology:* 1. Schizophrenia involves increased WHAT activity? 2. Classical antipsychotics work (in part) by blocking what receptors? 3. So why don't we use dopamine to treat depression (MOOD)

1. Dopamine 2. Dopamine D2 receptors 3. cuz we can cause mania and psychiatric disorders which would be bad news bears home boy. also run risk of movement issues I guess as well was found that if you give dopamine in parkinsons they do show different mood changes.

1. What nucleus does the monaural pathway usually come from? 2. What pathway does most of the hearing information go through?

1. Dorsal cochlear nucleus 2. Monaural pathway

1. What are the veins that drain the tongue/mouth? (4) 2. Where do all of these eventually end up draining in to?

1. Dorsal lingual v- post tongue, tonsils, soft palate and epiglottis Sublingual v- floor of mouth Deep lingual v- inferior surface of tongue Venae comitantes hypoglossi --> Drain floor of oral cavity & parallel course of hypoglossal nerve to end in the common facial v. 2. Internal jugular vein

1. What two conditions have a smooth or indistict philtrum and thin upper lip?

1. Down's syndrome and Fetal alcohol syndrome

Now, how about a LMN palsy.. 1. How would it present? 2. What causes it?

1. Drooping of ENTIRE face on Ipsilateral side 2. By damage to facial neuron or nerve -can be viral, Autoimmune, unknown (Bells)) looks worse, *less dangerous*

*Localizing cerebellar lesions:* 1. what type of disturbances would you see with a flocculonodular lobe lesion? 2. What type of disturbances would you see with a anterior lobe lesion? 3. what type of disturbances would you see with a lateral lobes lesion?

1. Disturbed equilibrium, *truncal* ataxia, *nystagmus* 2. *Gait ataxia*, inability to do tandem walking 3. Limb ataxia (esp. *upper*), hypotonia, *dysdiadochokinesia*

*Acetylcholine in the CNS* 1. When our Central ACh receptors are blocked what 3 things can occur? 2. Why do lots of drugs cause drowsiness? 3. Many CNS drugs have significant affinity for what receptors?

1. Drowsiness, sedation, and memory loss 2. the drug can get into the CNS and cause ACh receptors to be blocked causing the drowsiness lots of times 3. Many CNS drugs have significant affinity for *muscarinic ACh receptors*

1. During an annual physical exam, an internist notes that a 65 y/o woman appears depressed. She admits to persistent feelings of hopelessness. She feels she is nothing but a burden to her husband. She doesn't seem to enjoy anything anymore. She sleeps poorly, tending to wake up at 3-4 am. Her appetite is diminished and she has lost 10 lb over the past 2 months. She has frequent crying spells. She denies suicidal ideation but wishes she could just quietly die. Which of the following neurotransmitter systems could be modulated pharmacologically to address her psychological symptoms? A. Acetylcholine B. Dopamine C. Glutamate D. Norepinephrine E. Serotonin

1. E. Serotonin *AND* D. Norepinephrine for PRIMARILY pharmacologically addressing her psychological symptoms. I hate when there are 2 answers....

*Internal Ear*: Membranous Labyrinth 1. Function? 2. Lateral/Horizontal semicircular duct helps with what movement? 3. Anterior/Superior semicircular duct helps with what movement? 4. Posterior semicircular duct helps with what movement?

1. Help with position 2. Rotation of head on *transverse* plane (shaking head no) 3. Rotation of head on *saggital* plane (nodding head yes) 4. Rotation of head on *coronal* plane (ear to shoulder)

1. The internal branch of the Superior laryngeal n. (Vagus n., CN X) will provide what types of fibers to the epiglottic region of the tongue? 2. The CN X will provide the SVE fibers to what structure in the oral cavity?

1. GVA fibers. SVA fibers (taste) 2. SVE fibers to the PALATOGLOSSAL m. >palatoglossal is odd man out for ext. tongue muscles

1. Where do CNs VII, IX, X synapse with their taste info?

1. Nucleus of Solitary Tract (*NST*) [aka: Gustatory Nucleus] {share common PW after synapse}

Hyoglossus m.? 1. Origin 2. Insertion 3. Action 4. Innervation

1. O: *Hyoid bone* 2. I: *Inferolateral side of tongue* 3. A: *Retracts; depresses tongue* 4. N: Hypoglossal n. (GSE)

*Middle Ear*: Muscles - *Tensor tympani* 1. Origin? 2. Insertion? 3. Function? 4. Innervation?

1. O: cartilaginous bit of auditory tube 2. I: Malleus 3. F: dampen movements of ossicles 4. N: CN V3

*Middle Ear*: Muscles - *Stapedius* 1. Origin? 2. Insertion? 3. Function? 4. Innervation?

1. O: pyramidal eminence 2. I: stapes 3. F: dampen movements of ossicles 4. N: CN VII

*Genioglossus m.* 1. Origin 2. Insertion 3. Action 4. Innervation

1. ORIGIN: mental spine of mandible 2. INSERTION: Dorsum of tongue (from apex to hyoid) 3. Bilaterally- *Protrudes the tongue* Unilateral- *pushes tongue to opposite side.* 4. Hypoglossal n. (GSE)

What 2 main muscles are found in the eye lid

1. Obicularis Oculi 2. Levator palpebrae superioris

1. If a patient snores, wakes up gasping for air, is chronically tired, and never has enough energy, what might your patient have? 2. How is #1 related to our conversation about the tongue? 3. What are two main treatment options?

1. Obstructive sleep apnea 2. *Relaxation of tongue muscles* allow tongue to fall posteriorly into oropharynx obstructing airflow in *both nasal and oral cavity* 3. *CPAP* (continuous positive airway pressure) -implantable neuromodulator device (stimulates hypoglossal n at night)

*Olfactory Neuron Signaling Cascade* 1. 1st step? 2. Effect Q1 has?

1. Odorant binds GPCR 2. Changes conformation of GPCR to interact with G-protein

1. What is *Flavor*? 2. How can food your eating get to olfactory ET? 3. What is the response of the Orbital Frontal Cortex to Olfaction & Gustation

1. Olfaction + Gustation 2. Orthonasal & Retronasal 3. Different response to taste alone, smell alone & smell + taste

1. What is the name of the area just proximal to the Olfactory Bulb? 2. What is the name of the area proximal to Q1? 3. What are the 3 PWs that emerge from Q2?

1. Olfactory Tract 2. Olfactory Trigone 3. i: Lateral Olfactory Stria ii: Olfactory Tubercle iii: Medial Olfactory Stria

1. On which part of the olfactory neuron are the odorant receptors found? 2. Are they also found on the cell body? 3. Are they also found on the distal axon? 4. What is the function of Q3?

1. On the dendrites 2. ...no. Why would you think that? 3. YES! (Isn't that weird?) 4. Involved in axon pathfinding (which is used to sort out scent info in the olfactory bulb)

1. How do we test the muscles of the palate? 2. If CN X was lesioned, what would present?

1. Open up and say "AH!" 2. The uvula would deviate away from the side that has the lesion.

*Trigeminal Nerve Fiber Types* What are the 4 different fibers that make up the trigeminal nerve (afferent and efferent)

1. Ophthalmic division (V1) 2. Maxillary division (V2) 3. Mandibular division (V3) 4. Pharyngeal motor to muscles of mastication

*Pupillary* PW 1. If we're sending info to our Eddinger-Westphal nucleus, what is it's PW? 2. About where is the Eddinger-Westphal nucleus found?

1. Optic nerve → chiasm → tract → *Pretectal area (midbrain)* → [synapse] → interneurons to both Eddinger-Westphal nuclei 2. Just next to the CN III nucleus in the midbrain

*Deglutition Networks* What are the 4 phases of deglutition?

1. Oral preparatory phase 2. Oral transport phase 3. Pharyngeal phase 4. Esophageal phase

*Salpingopharyngeus Muscle* 1. Where does it originate? 2. Where does it insert? 3. What innervates it? 4. What is its function? 5. If covered in mucosa, what is it called?

1. Origin- inferior portion of cartilage of auditory tube 2. Insertion- blends with palatopharyngeus to attach with stylopharyngeus to thyroid cartilage 3. Innervation- pharyngeal branch of vagus n. 4. Function- elevate pharynx and larynx during swallowing 5. Salpingopharyngeus fold

*Tensor Veli Palatini* 1. Where does it originate? 2. Where does it insert? 3. What innervates it? 4. What is its function?

1. Origin: lateral side of cartilaginous auditory tube 2. Insertion: attach to palatine aponeurosis via tendon that passes inferior to hook of pterygoid Hamulus 3. Innervation: Trigeminal n (V3), only palate muscle not from CN X 4. Function: tenses palate, functions during mastication and swallowing, *opens membranes portion of auditory tube to equilibrate pressure of middle ear* (suggest feeding babies as you take off and land on a plane, that will help pop their ears; have kids chew gum).

*Levator Veli Palatini* 1. Where does it originate? 2. Where does it insert? 3. What innervates it? 4. What is its function?

1. Origin: medial side of cartilaginous auditory tube, petrous portion of temporal bone 2. Insertion: passes between skull and superior constrictor to attach to palatine aponeurosis 3. Innervation: CN X 4. Function: elevate palate, pull against roof of pharynx

*Arterial supply of the thalamus* 1. Comes from what major arteries? 2. What branches of Q1? 3. What else is important to know about perfusion?

1. Posterior cerebral arteries 2. - paramedian branches - posterior choroidal arteries - thalamogeniculate arteries. [also the tuberothalamic branch of the posterior communicating artery] (he made it seem like the branches are not super important to know) 3 Can be discreet (meaning an occlusion can kill a certain part of the thalamus)

*Vestibular Peripheral Transduction:* 1. the [endolymph or perilymph?] is (high Na+, Low K+) 2. The [endolymph or perilymph?] is (Low Na+, High K+) 3. Is Perilymph or endolymph found at the apex of the hair cells?

1. Perilymph 2. Endolymph 4. Endolymph (check out sweet pic)

1. When light enters the eye and hits the retina, what are the first cells that it hits? 2. What are the two different types of integration mechanisms that these photoreceptors use to process the information?

1. Photoreceptors (either rods or cones) 2. Horizontal and vertical

1. Axons traveling through the Lateral Olfactory Stria enter what specific part of the cortex? 2. In what part of the brain is this found? 3. What is weird about this sensory system compared to other sensory systems?

1. Piriform & Periamygdaloid Cortex 2. Medial, Anterior tip of *Temporal Lobe* (1° olfactory cortex) 3. Does *not* go through the Thalamus (only system that connects directly to Cortex)

1. What are the branches (6) from the Pterygopalatine portion of the maxillary a.?

1. Posterior superior alveolar a. 2. Infraorbital a. 3. Descending palatine a. 4. Artery of the pterygoid canal. 5. Pharyngeal a. 6. Sphenopalatine a.

1. What structure is partially an outgrowth of the hypothalamus? 2. What are the 2 divisions of Q1 + where do each grow out from?

1. Pituitary Gland 2. *Neurohypophysis* (down from brain) [yellow in image] & *Adenohypophysis* (up from oral cavity) [red in image] {Adeno bit grows up, pinches off & grows around neuro bit}

How do the sympathetic fibers which innervates the submandibular & sublingual salivary glands reach their targets: 1. Where do *post-ganglionic sympathetic fibers* originate? 2. What branches form a plexus on the facial a? 3. Fibers accompany facial a branches to the submandibular and sublingual salivary glands. What does it synapse on in the submandibular ganglion?

1. Post-ganglionic sympathetic fibers which originate in *SUPERIOR CERVICAL GANGLION* 2. will provide *External Carotid Branches* that form a plexus on the facial a. 3. Fibers will pass through the *SUBMANDIBULAR GANGLION without synapsing*.

*Innervation of Maxillary Sinus:* 1. CN V2 branches form the superior Dental Plexus. What 3 nerves make up this plexus? 2. Which nerve of #1 do we care about because it innervates the maxillary sinus?

1. Posterior Superior Alveolar Nerve Middle Superior Alveolar nerve Anterior Superior Alveolar Nerve 2. Middle Superior Alveolar Nerve

*Subthalamus (Ventral Thalamus)* 1. Location in thalamus? 2. What does it *NOT* border? 3. What 2 nuclei form the 1° nuclei in subthalamus?

1. Posterior/Ventral bit (caudal & lateral to hypothalamus near border w/brainstem) 2. Does not border a ventricle 3. Subthalamic nucleus & zona incerta

*Facial Nerve - Corneal Blink Reflex* 1. So, as a review, what nerve is brining in the sensory information? 2. and which one sends out the muscle efferent information? 3. What nuclei are involved through this whole pathway?

1. In through CN V and 2. out through CN VII 3. Main sensory nucleus for CN V, Spinal Trigeminal Nucleus (on ipsilateral side of the eye being poked), and then activating bilateral facial nuclei to elicit a blink (182).

*Horner's Syndrome:* 1. What is Incomplete Horner's? Where is the damage? 2. What symptoms are different and what symptoms are the same compared to complete horner's syndrome?

1. Incomplete Horner's: implies injury *CRANIAL* to SCSG, i.e., internal carotid plexus 2. ONLY Ptosis, Miosis;. SO NO anydrosis b/c that has already jumped onto the face.

*CC* 1. During normal development, what forms over the lens & the iris? 2. Over what area does this membrane normally degrade? 3. What if it doesnt? 4. What symptoms?

1. Iridopupillary Membrane 2. Over the lens 3. You have *Persistent Iridopupillary Membrane* 4. Can't really see

1. What affect would increased intracranial pressure have on the eye? 2. How?

1. Vision impairment (directly from compression of optic nerve *or* indirectly from compression of central retinal artery) & *papilledema* (swelling in retina due to compression of central retinal vein) 2. b/c the eye is derived from neural ectoderm & meninges surround the optic nerve & pressure can be transmitted to the eye

Flip for pic

1. What kind of cancer? 2. What LNs will this drain to? 1. Squamous cell carcinoma 2. Ipsilateral submental

Flip for question

1. What kind of cancer? 2. Where will this drain lymph? 1. Basal cell carcinoma 2. Ipsilateral submandibular

1. *Oculomotor (III)* nerve palsy: 2 symptoms & why? 2. *Trochlear (IV)* nerve palsy: 1 symptoms & why? 3. *Abducens (VI)* nerve palsy: 1 symptoms & why?

1. eye lid closed (LPS) & eye down/out (only lateral rectus & superior oblique work) 2. eye up & in (down & out muscle (SO) not working) 3. eye medial (LR not working)

1. What kind of papilla is decreased in geographic tongue? 2. Geographic tongue also has hyper keratotic area.

1. filiform 2. That was not a question. Geographic tongue

*Medial Boundary & Foramen* 1. What is the medial wall formed by? 2. What does it separate the PPF from? 3. How does the PPF communicate with #2? 4. What does #4 transmit?

1. formed by the palatine bone 2. separates the PPF from the nasal cavity 3. they communicate via the sphenopalatine foramen 4. sphenopalatine a.v., nasopalatine n, posterior superior lateral nasal n.

*Superior cervical ganglion:* 1. The internal carotid nerve forms a plexus on what artery? 2. Fibers leave the internal carotid nerve and go to what 3 places?

1. forms a plexus on the internal carotid artery 2. -Caroticotympanic plexus - Deep petrosal nerve - Cavernous plexus

1. Where do optic radiations originate? 2. What are the 2 divisions of the optic radiations?

1. from LGN of thalamus (headed to cortex) 2. *Baum's loop* (medial/superior) & *Meyer's loop* (inferior/lateral)

*SUMMARY:* -Sympathetic Innervation 1. Preganglionic sympathetic fibers arise from what? 2. All postganglionic fibers destined to innervate visceral structures of the head *MUST* synapse in what ganglion? 3. Therefore, WHAT are the pre-ganglionic sympathetic fibers are in the head?

1. from the IMLCC (I don't know what that stands for?) at T1 - T4. 2. Superior cervical sympathetic ganglion (SCSG) 3. Therefore, *THERE ARE NO PRE-GANGLIONIC SYMPATHETIC FIBERS IN THE HEAD.*

1. The GSA fibers get info from what parts of the body? (5ish) 2. What other sensation does it do?

1. general sensation from the *face, scalp, teeth, inside and outside of the cheek* 2. *proprioceptive fibers* from the muscles of mastication

1. What is the Clonidine suppression test? 2. What will the results of this test be if you have a pheochromocytoma?

1. give Clonidine to see if it activates central pre-synaptic alpha-2 receptors and suppresses the release of catecholamines from neurons 2. Clonidine has no effect on catecholamine secretion from a pheochromocytoma. So there will be no suppression of the release of catecholamiens if there is a pheochromocytoma.

*Localizing cerebellar lesions:* 1. if you have limb ataxia (esp. upper) hypotonia, and dysdiadochokinesia where in the cerebellum would the damage be localized? 2. If you have Disturbed equilibrium, truncal ataxia, and nystagmus where in the cerebellum would the damage be localized? 3. if you have Gait ataxia, and the inability to do tandem walking where in the cerebellum would the damage be localized?

1. lateral lobes 2. flocculonodular lobe 3. anterior lobe

1. HOW do we get vasodilation in the sympathetic system then? 2. epinephrine has high affinity for what receptors?

1. it is when epinephrine gets released from the adrenal medulla. basically when epi is around. think about the affects of an epi pen. 2. epinephrine has a high affinity for all adrenergic receptors

*Vestibulospinal pathways:* tell me which on is medial and which one is the lateral vesitbulospinal tract 1. ipsilateral? 2. Bilateral? 3. Cervical cord only? 4. Full length of spinal cord? 5. Medial nucleus 6. lateral nucleus 7. MLF

1. lateral 2. medial 3. medial 4. lateral 5. medial 6. lateral 7. medial

*Autonomic Innervation of the Head:* -General Consideration 1. The Vagus (CN X) has already been considered in the rest of the body and only innervates a small area of the head via what branch and where?

1. the internal laryngeal branch (base of tongue).

*Vestibulo ocular reflex (VOR):* 1. Horizontal movement of the head activates what fasciculus? RULE OF THUMBS: 2. if the head moves to the right the eyes will move to the [right or left?] 3. The VOR also affects gaze in the upward/downward direction, uses the MLF across what 3 ocular muscles?

1. the medial longitudinal fasciculus (MLF) 2. LEFT 3. -superior rectus - superior oblique -inferior oblique (thru CN VI and CNIII)

1. Lesser petrosal nerve then *exits* the petrous portion of the temporal bone via its own foramen, the *hiatus of the lesser petrosal nerve*, which opens into which fossa? 2. It then crosses the floor of the middle cranial fossa to exit the skull via its own foramen or which foramen?

1. the middle cranial fossa. 2. Foramen Ovale

*middle cerebellar peduncle:* 1. When and where do the neurons decussate?

1. the neurons are ipsilateral from cortex to pontine nuclei. then decussation occurs from the pontine nuclei to the cerebellum. (He says it makes a V, I guess it does but its stupid)

*Dopamine Pathophysiology:* 1. The VTA (ventral tegmental area) projects to what 2 things? 2. All drugs with abuse potential increase dopamine where? 3. Cocaine blocks what uptake? 4. Amphetamines increase what release?

1. the prefrontal cortex and the nucleus accumbens 2. in the nucleus accumbens 3. Dopamine uptake 4. dopamine release

*The Vestibulospinal Network:* 1. The medial vestibulospinal tract arises from nuclei that receive most (but not all) of their information from WHAT? 2. It acts to stabilize the head in space during body movements and as a part of WHAT?

1. the semicircular canals. 2. visual orientation.

*Vestibular Damage - Nystagmus:* 1. What is The slow phase of nystagmus? 2. What is the Fast phase of nystagmus?

1. the slow phase of nystagmus is essentially a reflex compensatory eye movement for the rotation of the head. 2. When the slow phase has reached its maximum, the eyes spring back to a central position. This is the fast phase.

*Dopamine Pathophysiology:* 1. The substantia nigra projects to what other part of the brain and does what? 2. The substantia nigra dopamine (DA) deurons degenerate in what disease?

1. the striatum (caudate nucleus and putamen) part of the part of the basal ganglia. envolved 2. Parkinson's disease

*Vestibular Ganglion and Nuclei:* 1. The afferent axons from the vestibular apparatus have their cell bodies located in WHAT ganglion? 2. These cells send axons into the brainstem to innervate WHAT nuclei? (4)

1. the vestibular ganglion (Scarpa's Ganglion). 2. The vestibular nuclei (superior, medial, lateral and inferior nuclei).

*Central Vestibular Pathways- Cerebellum:* 1. The cerebellum also sends reciprocal connections to WHAT? Some directly from what cells in the cerebellum? 2. Connections between the cerebellum and vestibular nuclei run through WHAT body?, 3. #3 a part of the what cerebellar peduncle?>

1. the vestibular nuclei, some directly from Purkinje cells. 2. *the juxtarestiform body* 3. a part of the inferior cerebellar peduncle

1. From the case in the previous slide how do antihistamines cause that problem?

1. they are a "dirty drug" aka not very specific. They cross the blood brain barrier and INHIBIT parasympathetics or mAChR. Delirium is showing there was a CNS problem

GABA is the primary inhibitory NT and Glutamate is the primary excitatory NT in the FAST neurotransmission. 1. A FAST neurotransmission has what type of receptors? 2. when a NT binds to #1 what happens?

1. they have receptors that are ionotropic have ion channels 2. very fast changes in membrane potential in postsynaptic cell

*Pathways from the Superior Olive* 1. Where do axons of the superior olive go to next? 2. What is the next stop for the axons?

1. they join the monaural projections that bypassed the superior olive to form the *lateral lemniscus.* 2. From *lateral lemniscus* it ascends to form connections with the *inferior colliculus.*

*Head and Eye Movements - The Vestibulo-Ocular network:* 1. The connections between the vestibular and visuomotor network serve what purpose? 2. These movements of the eyes are called WHAT? WHY?

1. to help keep the eyes fixated upon an object in conjunction with movements of the head 2. compensatory, because they are equal and opposite to the movement of the head.

*Sensorineural Hearing loss* What are the 4 common causes of sensorineural hearing loss (ok... so even MORE specific from the last two cards)

1. trauma from high intensity sounds 2. presbyacusis (age related hearing loss) 3. infections 4. DRUGS

1. What is conjunctiva? 2. What are the 2 parts to the conjunctiva? 3. Together, what do these form?

1. vascularized mucous membrane over eye (keeps things moist) 2. i: *Palpebral* conjunctiva: lining inner *eyelid* ii: *Bulbar* conjunctiva: covering anterior globe to periphery of cornea. 3. Both layers continuous w/one another, forming *mucosal bursa* for eyelids to move freely over globe.

1. Neurons in thalamic circuitry (including reticular nucleus) contains what particular type of channels? 2. Under normal circumstances of activation, these channels are part of what kind of firing patterns as part of thalamic function? 3. What other kind of patterns may also be produced as regulatory activity on the reticular nucleus diminish. 4. Both Q2 & Q3 are part of the normal electrical pattern of brain which can be measured by? 5. Disruptions of Q1 channel are associated with?

1. voltage gated calcium channels (*T type* VGCa++) 2. tonic discharge 3. Burst patterns 4. Electroencephalography 5. Absence seizures (tune out epilepsy)

*Neural Processing in the Cochlea* 1. Together, spiral ganglion cells code for what 2 characteristics? 2. At what level do they perform this? 3. Where is this information then conducted to?

1. volume and frequency 2. At the level of the cochlea 3. Conducted centrally to the dorsal and ventral cochlear nuclei of the brainstem.

*Submandibular and Sublingual parasympathetics* 1. Where are the preganlionic cell bodies? 2. What CN will these travel with? And then which branch of this CN? 3. Where will we find the postganglionic cell bodies? 4. Postganglionic parasymp cell fibers will travel with what nerve? Then it will innervate sublingual and submandibular glands

1. Salivatory nucleus (brainstem) 2. CN VII. Chorda tympani 3. Submandibular ganglion 4. Lingual n (V3)

Review: Which layer of embryonic tissue does each come from... 1. Lens Placode 2. Optic Stalk 3. Sclera 4. Cornea 5. Choroid 6. Rods/Cones & all that junk 7. Eye Lids

1. Surface Ectoderm 2. Neural Tube Ectoderm 3. Neural Crest Cells + mesenchyme 4. Surface Ectoderm 5. Neural Crest Cells + mesenchyme 6. Surface Ectoderm 7. Surface Ectoderm

1. What tissue layer forms the cornea & eye lids? 2. When the eyelid tissue grows over the cornea, what happens when the two eyelids meet? 3. Later on what happens?

1. Surface Ectoderm 2. They fuse 3. Later on they separate again

*Bony and Membranous Labyrinths:* 1. The [bony or membranous ?] labyrinth of the vestibular system is suspended in the [bony or membranous?] labyrinth by connective tissue what? 2. The sensory receptors of the vestibular system are located in the [bony or membranous?] labyrinth. 3. B/c of one this means that [endolymph or perilymph?] has an easier time moving around?

1. The membranous labyrinth of the vestibular system is suspended in the bony labyrinth by connective tissue trabeculae. 2. The sensory receptors of the vestibular system are located in the membranous labyrinth. 3. Endolymph easier time moving around

*Deep cerebellar nuclei* 1. What deep cerebellar nuclei is most medial? 2. what 2 tracts are from here? 3. outputs of all the deep cerebellar nuclei are generally [GABAergic or glutamatergic?]

1. The *Fastigial* nuclei 2. Vestibulocerebelar and spinocerebellar 3. Glutamatergic (excitatory)

1. The danger triangle of the face also includes what? 2. Venous drainage can access the crainal vault directly via what 2 veins? and indirectly thru what?

1. The Nasal Cavity 2. directly via the Ophthalmic vein and nasal emissary vein (in some people), and indirectly thru the Pterygoid Plexus

1. CN VII gets every gland but WHAT? 2. CN VII gets the rest of the glands thru what nerve and what fiber type?

1. The PAROTID!! 2. Greater petrosal N. GVE-P

*Clinical Correlation* 1. What are we accessing with a transantral access technique? 2. What bone do we need to cut through to access this structure? 3. What is this technique used for?

1. The PPF 2. cut through maxilla (the anterior boney boarder of PPF) 3. From there enter the maxillary sinus, this is used to remove tumors or ligate the sphenopalatine artery (which usually ligated if you have an uncontrolled nose bleed).

*AChE (organophosphate) Inhibitor Toxicity:* 1. What is the antidote

1. The antidote includes multiple drugs: A muscarinic antagonist reverses the effects at parasympathetic effector organs Pralidoxime is a cholinesterase regenerator, this treat the muscle paralysis (a slow recovery process) Benzodiazepines may be required for convulsions/seizures Patients require supportive care (ventilation, etc.)

*Vestibular Peripheral Structure:* 1. The apparatus consists of receptors located in WHAT three canals, and what 2 otolith organs? 2. Sensory neurons innervating hair cells are in the WHAT ganglion?

1. The apparatus consists of receptors located in three *semicircular* canals, and two otolith organs in the *saccule* and *utricle*. 2. Sensory neurons innervating hair cells are in the *vestibular ganglion*. IMPORTANT *NOT* the spinal ganglion

*Basic Cerebellar circuitry:* 1. The circuit in the cerebellum allows for what? 2. What does the cerebellum measure?

1. The circuit allows for the comparison of ongoing movement and sensory feedback derived from it 2. The cerebellum measures expectation vs. outcome

*Morphological Orientation of Hair Cells:* 1. The hair cells of the kinetic labyrinth are oriented in particular directions so that the flow of WHAT toward or away from the WHAT will either depolarize (activate) or hyperpolarize (deactivate) the hair cells of the WHAT. 2. Is toward [ampullofugal or ampullopetal?] 3. Is away [ampullofugal or ampullopetal?]

1. The hair cells of the kinetic labyrinth are oriented in particular directions so that the flow of *endolymph* toward or away from the *utricle* will either depolarize (activate) or hyperpolarize (deactivate) the hair cells of the *cristae* 2. ampullopetal 3. ampullofugal

*Inferior Boundary & Foramen* 1. The inferior wall (floor) is open via what canal? 2. What does it separate the PPF from? 3. What are the two things that it divides into? 4. What does #3 transmit?

1. The inferior wall (floor) of the PPF is open via the pterygopalatine canal. 2. Communicates with oral cavity. 3. Greater and lesser palatine foramen 4. Pterygopalatine canal transmits: Descending palatine a.; greater/lesser palatine nn.

*Acoustic Startle Reflex* 1. What is this and what does it contribute to? 2. What does the reflex consist of? 3. What are the primary connections in this reflex?

1. The integration of auditory information and motor information in the reticular formation contributes to the auditory startle and orienting reflexes. 2. These reflexes consist of the turning of the head and eyes and body toward a sound. 3. deep layers of the superior colliculus, reticular formation and cervical spinal cord (for neck muscles though *tectospinalbulbuar system*)

*Kinetic Labyrinth:* 1. The kinetic labyrinth detects what motion of the head? 2. The hair cells for #1 are located within an enlargement where? WHAT is it called?

1. The kinetic labyrinth detects angular motion (acceleration) of the head rather than static position. 2. The hair cells are located within an enlargement at the base of the semicircular canal at its junction with the utricle, *the ampulla*.

*Vestibular Damage - Nystagmus:* 1. Nystagmus may result from lesions of the nerve or nuclei? 2. Nystagmus may also result from what other 3 things?

1. The labyrinth, vestibular nerve, or nuclei 2. a metabolic disease, a lesion of the cerebellum, visual system (usually reflex centers and their connections) or lesions of cerebral cortex.

1. What does the palate divide? 2. What portion of the palate does the boney portion make up? the soft postion? 3. What bones make up the hard palate?

1. The nasal and oral cavities 2. Anterior 2/3; posterior 1/3 3. Palatine process of maxilla and palatine bone (horizontal portion)

1. What will be anterior to the PPF? 2. What will be medial to the PPF? Through what foramen does it communicate with it?

1. The orbit and the maxillary sinus 2. The nasal cavity. through the sphenopalatine foramen.

question on the flip side

1. what level of the brain stem are we? 2. What is this? 3. how many of the 4 ascending information goes thru #2 to get to the cerebellum? 4. What pathway's efferents leave thru #2? 1. Middle Medulla (Mid-Olivary level) 2. Inferior Cerebellar Peduncle (separated into a Restiform body + Juxtarestiform body) 3. 3 of the 4 4. Vestibulocerebellar pathway

1.What input does the nucleus accumbens recieve? 2.What receptors does the nucleus accumbens contain?

1.It receives input from the amygdaloid complex the hippocampal formation, and the substantial nigra and ventral tegmental area (dopaminergic) via the medial forebrain bundle. 2.It contains receptors for a variety of neurotransmitters including endogenous opioids.

*IMPORTANT:* transduction by Hair Cells: 1. Deflection [toward or away?] the kinocilium causes the hair cell to depolarize and release neurotransmitters to generate action potentials in the vestibular afferents. 2. Deflection [toward or away?] from the kinocilium produces hyperpolarization (relative to resting state) and reduced firing

1.TOWARD 2. AWAY

1What part of the hippocampus is sensitive to anoxia? 2What is a situation where this could occur?

1.The CA 1 area of the hippocampus is particularly sensitive to anoxia. 2.cases where general body oxygen levels drop as in heart attacks or cardiac surgery.

There are also 2 layers to the brain outpouching that becomes the optic cup/stalk... 10. What is the name of the space between the 2 layers? 11. What will that space form?

10. *Intraretinal space* 11. Forms the *retina*

*Internal ear* 10. How many layers to the Cochlear duct? 11. What are the inner 2 layers derived from? 12. What is the outer layer made from? 13. What does the outer layer go on to form?

10. 3 11. Otic vesicle 12. Mesenchyme 13. The bony labyrinth

*Autonomic Innervation of the Head:* -Salivary Glands *Parotid gland-parasympathetics* 10. The parasympathetics cross the middle cranial fossa which it then exits inferiority via WHAT foramen or via its own foramen immediately [anterior or posterior?] to that foramen. 11. They then enter WHAT ganglion where they synpase on postganglionic parasympathetic neurons. 12. Postganglionic p.s. fibers then exit that ganglion and course with WHAT nerve of WHAT CN to the parotid gland. 13. Parasympathetics will do what to the parotid gland?

10. Foramen ovale or immediately Posterior to it via its own foramen 11. *Otic Ganglion* 12. *Auriculotemporal n.* of V3 13. increase secretion of parotid gland

Hypothalamic Functions *Temperature* In case it wasn't clear before... 17. Posterior temperature center is temperature blind, what does that mean? 18. What if you lose the preoptic center?

17. No temperature sensitive neurons (activity dictated by Preoptic center) 18. Lose ability to regulate temperature

Hypothalamic Functions *Temperature* 19. Immune response generates what in the blood to signal the preoptic center? 20. What does Q19 cause?

19. Pyrogens (via local endothelial signal) 20. Inhibits temp sensitive neurons & ∴ wont fire at temps like they normally would = retain heat = *fever* (temp 37+°)

Rapid Recall: 1: Rods Detect? 2: Cones Detect?

1: Form & Movement 2: Detail & Color

What are the vessels found within the infratemporal fossa?

1st & 2nd portions of the MAXILLARY a. and its branches. Pterygoid plexus of veins

2. What is another name for the ii: Anterior Region? 3. What is another name for the iii: Middle Region? 4. What is another name for the iv: Poserior Region?

2. Supraoptic (found above optic chiasm/tratcs) 3. Tuberal (found above Tuber Cinereum) 4. Mammillary (found above Mammillary Bodies)

Globe: *Ciliary Body* 2. What are *Zonular fibers*?

2. a ring of fibrous strands that connects the ciliary body with the lens of the eye

Globe: *Fibrous* Tunic 2. 2 parts to the fibrous tunic & where each are found

2. i: *Sclera*- posterior 5/6th's; outermost layer of eye (site of internal & external muscle attachment) ii: *Cornea*- anterior 1/6th; transparent; (ciliary nerves via CN V1 ; avascular)

Globe: *Neural* Tunic 2. Function of the *Retina*? 3. Made of what layers? 4. Extends from where to where?

2. photoreceptive layer 3. comprised of pigmented & neural layers. 4. From ora serrata to choroid (& continues to pupil as non-photoreceptive retina)

Hypothalamic Functions *Temperature* 21. The temp center is closely associated to what other center we've talked about so far? 22. What happens to body temp while you sleep? 23. ∴ damage to the preoptic region would have what 2 effects?

21. Sleep Center! 22. It drops (low temp at 3am) 23. Insomnia & Hyperthermia

3. Efferents from mammillary bodies target what? 4. Q4 via what tract? 5. This is an important relay to which system? 6. 1 other random, unknown tract?

3. *Anterior Nucleus of Thalamus* 4. *Mammillothalamic Tract* 5. *Limbic System* 6. *Mammillotegmental Tract*

*External Ear* 3. 2 Major arteries to the tympanic membrane? 4. From which artery do these 2 branch?

3. *Anterior Tympanic* & *Deep Auricular* 4. 1st 2 branches of Maxillary (of External Carotid)

Hypothalamic Functions *Arousal & Sleep/Wake* 3. What happens if you get a lesion in the Tubulomammillary Nucleus? 4. It may be a surprise that histamine is an arousal hormone, but what happens when you take an antihistamine?

3. *Hypersomnolence* (feel sleepy all the time and fall asleep in the middle of the day) 4. You get the sleepys

*Thalamocortical Projections* 3. Projections to thalamus from body are called? 4. Projections to thalamus from cortex are called?

3. *Specific Inputs* 4. *Regulatory inputs*

*Middle Ear*: Pharyngotympanic tube 3. What 2 muscles are associated with the Cartilaginous part (+ what nerve innervates each)? 4. What 2 structures do these muscles connect? 5. What is the function of each muscle?

3. *Tensor Veli Palatini* (CN V3) *Levator Veli Palatini* (CN X) 4. Connects tympanic cavity with nasopharynx 5. *Levator* contracts while *Tensor* pulls opening cartilaginous part of tube to equalize pressure b/t middle ear & surrounding atmosphere.

*Thalamus-Nuclear Groups & Functions* - *Lateral* - VA 3. Ventral anterior nuclear group (VA) is part of several nuclei in the thalamus that have connections with what? 4. Depending upon classification method used, VA can have two parts, they are? [We probably don't need to know this question]

3. *The Basal Ganglia* (Putamen, Caudate, Striatum) 4. *Magnocellular & Parvocellular parts*

*Thalamic Nuclei* - iii: *Internal Medullary Lamina* 3. {1° OR 2°} anatomical divider 4. Separates thalamus into what 4 grossly identifiable groups of nuclei? 5. These groups are subdivided into what 3 areas?

3. 1° anatomical divider 4. i: Anterior ii: Medial iii: Lateral iv: intralaminar 5. Dorsal, ventral & posterior areas (usually on basis of histo exam)

*Nasal Air Flow:* 1. Laminar air flow enters the nose during inhalation and hits the turbinates and becomes what type of flow? 2. Most of that inhalated air is channeled down into the lungs but a separate stream does not travel with them. Where does it go? What for? 3. Does #2 continue into the Nasopharynx?

1. Turbulent Flow 2. Separate stream that travels superiorly toward the *Olfactory Mucosa* 3. Does not continue into Nasopharynx

1. What is the Internal border of the *External Ear*? 2. Within what structure is the *Middle Ear* found? 3. What separates the Middle Ear from *Inner Ear*?

1. Tympanic Membrane 2. Pharyngotympanic Tube 3. Oval Window (in which our Stapes runs)

*External Ear* 1. What happens when sound waves hi the tympanic membrane? 2. What aspects of Q1 help us differentiate different sounds? 3. eg: Characteristics of high pitched noises? 4. eg: Characteristics of loud noises?

1. Tympanic Membrane *vibrates* 2. Rate & intensity w/which it vibrates 3. Faster Vibrations 4. Bigger Vibrations

*External Ear* 1. What nerve innervates the inside of *Tympanic Membrane*? 2. From which nerve does this branch? 3. What type of fibers? 4. Through what "hole in the skull" does this nerve travel?

1. Tympanic N 2. CN IX 3. GVA 4. Tympanic Canaliculus

*Middle Ear*: Innervation 1. What nerve is found on the promontory? 2. How does Q1 get into the skull? 3. How does Q1 get out of the middle ear (& what nerve is it now)?

1. Tympanic N (plexus) 2. Tympanic Canaliculus 3. Hiatus for Lesser Petrosal N (as LPN of VII)

1. The tympanic branch of the CN IX will reenter the skull via what hole? 2. The tympanic branch participates in what plexus? 3. Where is #2 located? 4. What are all of the components that make up the tympanic plexus? (3)

1. Tympanic canaliculus 2. Tympanic plexus 3. on the *promontory* of the medial wall of the middle ear 4. VII, IX, sympathetics

*Thalamic Nuclei*... again 1. Thalamic nuclei themselves are *categorized* (not named) according to what? 2. Eamples of Q1?

1. Type of function 2. i: *Relay* ii: *Association* iii: *Nonspecific nuclei*

*Pseudobulbar palsy vs. Bulbar palsy* 1. So, after PE the patient has hyper-reflexive reflexes, what would you assume UMN or LMN issue? 2. Which one is an UMN issue, Pseudobulbar palsy or Bulbar palsy? 3. If after PE the patient has hypo-reflexive reflexes, would you assume UMN or LMN issue? 4. Which one is an LMN issue, Pseudobulbar palsy or Bulbar palsy?

1. UMN issue 2. Pseudobulbar palsy 3. LMN issue 4. Bulbar palsy

1. What the hell is Hemiballismus?? 2. What causes it?

1. Uncontrollable flailing ballistic movements in *contralateral* limbs 2. Stroke affecting subthalamic nucleus (can't stimulate globus palidus interna and thus inhibit movement)

*The Cochlear Nuclei* 1. Where are the dorsal and ventral cochlear nuclei located? 2. Where is the only area centrally where you can have a lesion and have mono hearing loss?

1. Upper medulla, near restiform body, just above the exit of CN IX. 2. Right at the cochlear nuclei in the upper medulla.

If you had *Homonymous hemianopia*: 1. in which part of your visual field would you be impaired? 2. In which part of your PW might you have damage?

1. Use your eyes to look at # 4, 6, 7 2. Break in optic tract OR optic radiation OR visual cortex

If you had an *Ipsilateral Scotoma*: 1. in which part of your visual field would you be impaired? 2. In which part of your PW might you have damage?

1. Use your eyes to look at the picture #1 2. Single part of the retina (like macular degeneration)

If you had *Unilateral Blindness*: 1. in which part of your visual field would you be impaired? 2. In which part of your PW might you have damage?

1. Use your eyes to look at the picture #2 2. 1 whole optic nerve broked

If you had *Bitemporal hemianopia*: 1. in which part of your visual field would you be impaired? 2. In which part of your PW might you have damage?

1. Use your eyes to look at the picture #3 2. Break right through the optic chiam (eg pituitary tumor)

If you had *Quadrantanopia*: 1. in which part of your visual field would you be impaired? 2. In which part of your PW might you have damage?

1. Use your eyes to look at the picture #5 2. Break in either Meyer's loop (pie in sky) or Baum's loop (pie on ground)

If you had *Bilateral scotoma*: 1. in which part of your visual field would you be impaired? 2. In which part of your PW might you have damage?

1. Use your eyes to look at the picture #8 2. Break in posterior bit of visual cortex/occipital lobe (like when you slip & smack the back of your head super hard)

*SUMMARY:* -Parasympathetic Innervation of the Head 1. The Submandibular & Sublingual SG receive parasympathetic innervation via what CN? 2. #1 is via WHAT Ganglion? 3. #1 is via what Carrier Nerve?

1. VII-Chorda Tympani 2. Submandibular gland 3. Lingual N. (V3)

*SUMMARY:* -Parasympathetic Innervation of the Head 1. the Lacrimal gland receive parasympathetic innervation via what CN? 2. #1 is via WHAT Ganglion? 3. #1 is via what 3 Carrier Nerve?

1. VII-Greater Petrosal N 2. PPG Ganglion 3. Zygomatic n. (V2) to lacrimal anastomatica to lacrimal n. (V1)

*SUMMARY:* -Parasympathetic Innervation of the Head 1. The Mucous glands (N, O, P, Ph) receive parasympathetic innervation via what CN? 2. #1 is via WHAT Ganglion? 3. #1 is via what Carrier Nerve?

1. VII-Greater Petrosal N. 2. PPG ganglion 3. Various branches of V2

GABA-mimetic drugs are benzodiazepines and barbiturates. 1. What are 2 common names for benzodiazepines? 2. Are GABA recepors downregulated with the overuse of alcohol? why?

1. Valium xanax 2. YUP, bodys trying to fix the problem with upregulated inhibition by getting rid of GABA receptors PAUL. and thats why when alcohol is gone you can't inhibit your neurons as well because the GABA receptors are bye Felicia

*Middle Ear*: Blood Supply 1. Pattern of venous drainage? 2. What 3 places do these drain to?

1. Venous drainage follow arteries 2. Drain to *transverse sinus, superior petrosal sinus*, & *pterygoid plexus*

*Thalamus-Nuclear Groups & Functions* - *Lateral* 1. Subdivided into which tiers? 2. 3 parts to the *Ventral* tier?

1. Ventral & Dorsal Teirs 2. i: Ventral anterior (VA) ii: Ventral lateral (VL) iii: Ventral posterior-(VPL & VPM)

*Sympathetic innervation of the head:* 1. The preganglionics leaving the spinal cord will traverse what root? 2. it will then follow a spinal nerve to then enter the sympathetic chain thru what? 3. Once in the sympathetic chain it will descend or ascend to what?

1. Ventral Root 2. White ramus communicans 3. *Ascend*, to the superior cervical sympathetic ganglion

*Clinical Comments:* Damage to the vestibular system is associated with what clinical signs? Also tell me what each one means. (Hint: I live in a VANN down by the river!)

1. Vertigo - sensation or hallucination of rotation 2. Ataxia - truncal ataxia where body position is difficult to maintain 3. Nystagmus - involuntary eye movement; may result in reduced or limited vision 4. Nausea and Vomiting; other autonomic signs may include palor (extreme paleness) and sweating

*Vestibular Damage - Nystagmus:* 1. Vertigo and nystagmus are usually worse with [central or peripheral?] lesions and milder with [central or peripheral?] ones.

1. Vertigo and nystagmus are usually worse with peripheral lesions and milder with central ones.

VOR 1. Sensory input first goes through which ganglion? 2. Where is the first synapse? 3. What nucleus does it go to next?

1. Vestibular ganglion (Scarpa's ganglion) 2. To one of the vestibular nuclei ( this pic has medial vestibular nucleus) 3. Abducens nucleus (contralateral side) *picture is on next slide

*Rotational Vestibulo-Ocular Reflex:* 1. Corresponding inhibitory circuits to the opposing eye muscle motor neurons are also sent from the WHAT nuclei. 2. Similar circuitry is used for WHAT other 2 types of responses?

1. Vestibular nuclei 2. vertical and torsional responses

*Thalamus-Nuclear Groups & Functions* - *Lateral* - VA 9. Projects to wide regions of _______ cortex including which 3 areas? 10. It contributes to which 2 functions? 11. Its connections suggest which 2 body functions?

9. *Frontal* cortex including: i: *orbitofrontal cortex* ii: *supplementary motor* iii: *premotor areas* 10 *Somatic motor* & some *visceromotor* 11. Basic motor planning & behavior

Hypothalamic Functions *Water Balance* 9. What 2 other areas receive direct projections from SFO? 10. Response of this direct stimulation?

9. *Supraoptic & Paraventricular Nuclei* 10. AVP release (when dehydrated)(independent of MPN)

Hypothalamic Functions *Arousal & Sleep/Wake* 9. Preoptic area is active during {wake or sleep}? 10. What NT does the preoptic area primarily utilize? 11. Preoptic area has connections to each of the arousal nuclei, but which nucleus gets the largest affect? 12. Damage to the Preoptic Area =? 13. Damage to the Tubulomammillary Nucleus =?

9. Active during sleep 10. GABA (for inhibition of arousal) 11. Tubulomammillary nucleus 12. Insomnia (can't sleep) 13. Somnolence (can't wake very well) (see the upper right hand part of the image for a fun story about zapping cat brains)

Architecture of the olfactory bulb (2nd look)...

A - E? =scroll for answers= A: Glomeruli B, C, D: Mitral, Tufted, Granule (G = most abundant) E: Axons leaving olfactory bulb (forming Olfactory Tracts)

What bone contains a body which holds the sigmoid sinus?

SPHENOID bone -- this is on the midline portion of the sphenoid.

What extends from the spine of the sphenoid to the lingula of the mandible?

SPHENOMANDIBULAR Ligament One of the accessory ligaments of TMJ *May support the axis rotation of mandible.

The upper portion of the Lateral Pterygoid muscle is also known as what?

SPHENOMENISCUS

What drugs are used to treat depression?

SSRIs = Selective Serotonin Reuptake Inhibitors *inhibits the re-uptake of serotonin by decreasing its rapid re-uptake into the nerve terminal. *also treated with SNRIs (serotonin and NE inhibition) and TCAs

*SUMMARY:* this is a great chart boiiiiiiiiiiiiiii

STRAIGHT FYYYYYIIIIIAAAAAA🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥

What is a fast method of drug absorption within the oral cavity?

SUBLINGUAL absorption of drugs. -- certain drugs (nitroglycerin) need rapid absorption, lingual v drain directly to the IJV, drugs can be placed in the sublingual region & rapidly absorbed into the bloodstream

Which ganglion will transmit the parasympathetic fibers which innervate the sublingual & submandibular glands? Where is this found?

SUBMANDIBULAR Ganglion *this ganglion is w/n the posterior floor of oral cavity and is suspended from the LINGUAL n.

Which foramen in the sphenoid bone is a gap found between the greater & lesser wings? What is the purpose of this foramen?

SUPERIOR ORBITAL FISSURE > This foramen will communicate the middle cranial fossa with the orbit.

What fibers are found in the mandibular portion of the trigeminal n. (V3)?

SVE GSA = GVE-P fibers from CN IX GVE-P and SVA fibers from CN VII

What is the result from parasympathetic stimulation to the submandibular gland & sublingual n.?

Secretomotor *stimulates salivation.

Check out this picture that Dr. Woodbury didn't want to say anything about other then for you to see all the paranasal sinuses and their connections with the nasal cavity

Thank you Dr. Woodbury you have done it again good sir

Why do people get motion sickness?

All the ear stuff feels/senses movement =BUT= our eyes don't see the movement as much → that disconnect makes you sick

corticomedial group sends connections via?

The coticomedial group sends connections primarily via the Stria terminalis- this is a direct pathway from the corticomedial groups that connects to the septal area (nuclei).

What type of cartilage covers the articular surfaces of the temporomandibular joint (TMJ)?

FIBROCARTILAGE ---this is *NOT hyaline* which is found in other synovial joints

What type of bone compose the Calvaria (roof of the cranial vault)? Describe these bones?

FLAT bones ---> these bones are structured so that they hace internal portion of Trabecular bone (diploe) sandwiched b/w two layers of Compact bone (outer & inner tables)

How many muscle of mastication are there? List them.

FOUR 1. Masseter m. 2. Temporalis m. 3. Lateral pterygoid m. 4. Medial pterygoid m.

What are the two bones that the nasal bone will articulate with?

FRONTAL MAXILLA

What is located in the frontal bone DEEP to the glabella & Superciliary arches?

FRONTAL AIR SINUS

Which mAChR subtypes are predominantly found in smooth muscle? cardiac muscle?

M2 and M3 --> smooth muscle M2 = CARDIAC muscle

All of the muscles of mastication are innervated by what?

MANDIBULAR division of the Trigeminal n. (V3)

What feature of the maxilla bone provides an attachment for the medial pterygoid m.?

MAXILLAY TUBEROSTIY *this is located posterior to 3rd maxillary molar.

Pt presents w/: -Sensory and motor deficits Contralateral UE & Face -Parietal/Temporal deficits -Possible BG deficits Where is the stroke?

MCA

What nerve innervates the mucous membrane of the lower lip?

MENTAL n. (this will also innervate the skin of the chin. --from the inferior alveolar n.

What are two enzymes that aid in the metabolic transformation to terminate adrenergic neurotransmission? Include where these enzymes are found.

MONOAMINE OXIDASE (MAO) --Metabolizes catecholamines released w/n nerve terminal --Outer surface of MITOCHONDRIA CATECHOL-O-METHYLTRANSFERASE (COMT) --metabolizes endogenous circulating catecholamines --Cytoplasmic enzyme.

Hey guys (and Val)....

MORE PATHWAYS!!!

Which landmark of the temporal bone will articulate with the condyle (head) of the mandible?

Mandibular Fossa

What are the nerves found within the infratemporal fossa?

Mandibular division of the Trigeminal n. (V3) & its branches. AUTONOMICS: *chorda tympani (CN VII) *lesser petrosal n. (CN IX) parasympathetic fibers to salivary glands

39

Parietal lobe Inferior parietal lobule aka *Angular gyrus*

40

Parietal lobe Inferior parietal lobule aka *Supramarginal gyrus*

3, 1, 2

Parietal lobe Postcentral gyrus, posterior paracentral lobule aka Primary somatosensory area; S1

5, 7

Parietal lobe Superior parietal lobule aka Somatosensory association area

What 2 structures will you see if you look through the cornea?

Pupil & Iris

Basic Identification

Quite an enjoyable time =Scroll for Answers= A: Optic Chiasm B: Infundibulum C: 3rd Ventricle D: Tuber Cinereum E: Mammillary Bodies

What is the action of the Medial Pterygoid m.?

RAISES the mandible; ASSISTS in protrusion & rotary movements during chewing

What muscle of facial expression will aide in the stretching of the lips laterally for forming a wide smile?

RISORIUS m.

What are saccades?

Rapid, *ballistic* eye movements to move image into the fovea (may be voluntary or involuntary) *try not to look at that

How does the olfactory cortex analyze odor information?

Responds to which odorant receptors are stimulated AND which are not (see in the image how one receptor responded to all 3 scents, another to 2, and another to 1)

How is norepinephrine (NE) inactivated after it has been release into the synapse?

Reuptake into the pre-synaptic cell is mediated by the norepinephrine transporter (NET).

How is dopamine (DA) inactivated after it has been released in the synapse?

Reuptake into the presynaptic cell is mediated by the high-affinity dopamine transporter (DAT) or the low-affinity plasma membrane monoamine transporter (PMAT)

Time out: what 3 things make up the Neural layer of retina?

Rods/cones bipolar cells ganglion cells (this is the bit that will send its projections back through the optic nerve)

What are the two fossa associated with the sphenoid bone?

SCAPHOID fossa = depression at base of medial pterygoid plate. PTERYGOID fossa = area b/w the pterygoid plates

What is the function of the parasympathetic stimulus on the Parotid gland?

SECRETOMOTOR: stimulates gland secretion

WHat landmark of the sphenoid bone is known as the Turkish Saddle? What are the 3 components of this landmark?

SELLA TUCICA: ---superior surface of body of the sphenoid b/w anterior & posterior clinoid processes (bed posts) 1. Tuberculum sellae = elevation posterior to prechiasmatic groove. 2. Hypophyseal fossa = depression in body which houses the pituitary gland 3. Dorsum sellae = elevation on posterior portion of sphenoid

MS and Spastic Cerebral Palsy are considered examples of which type of disease?

UMN Disease

What is the innervation of the upper lip and lower lip?

UPPER lip - V2 via infraorbital branches (INFRAORBITAL n.) LOWER lip - V3 via mental (medial) & buccal (lateral) branches (MENTAL & BUCCAL nn.)

*Deglutition Networks* When can you swallow more, if you are working under cortical control (no food or anything) or if it is under reflexive control (swallowing water, food, etc.)?

Under reflexive control! When swallowing food and such you have unconscious afferent information coming back that is lighting up the reflexive pathway to drive the swallowing apparatus.

All symptoms related to a major vessel stroke will be _________ signs

Upper Motor Neuron

Look on the other side...

Welcome: 1. What would A & B be called? 2. What causes C&D? 3. Auricle defects are often associated with what? (scroll for answers) 1. Preauricular fistula/cyst ("continuation of a tube") 2. Failure of *auricular hillocks* to regress or extra *auricular hillocks* 3. Chromosomal defects (congenital anomalies resulting from neural crest issues can affect auricle formation)

- Jugular foramen - Hypoglossal canal - Foramen lacerum (This hole isn't the Post meningeal br, just the Meningeal br of AP)

What 3 holes does the Posterior meningeal br of Ascending pharyngeal a pass through?

Zygomaticofacial - Zygomaticofacial foramen Zygomaticotemporal - Zygomaticotemporal foramen Supraorbital a - Supraorbital notch/foramen Ant/Post ethmoidal a - Ant/Post ethmoidal foramina

What are branches of opthalamic a? What foramina do they use?

flip for ?

What are the 3 reasons for him showing us this? 1. confirmation that nasal passages are continuous with lacrimal ducts 2. The valves can be overwhelmed by increased pressure 3. Even though we are busy this is what people do with spare time so its not bad to be busy

Brachial Plexus

What are the yellow circles highlighting?

You might want to ID this thing

What do ya think? Where does it sit? The LMN projects to what? If we have a lesion here what happens? 1. Hypoglossal nucleus -Dorsal medially -to the tongue and the tongue musculature -tongue will deviate to the side of the lesion

Petrotympanic fissure - Transmits nothing else! Chorda tympani - Branch of CN VII - Carries taste (SVA) info from the front 2/3 of tongue - Carries parasympathetics (GVE-P) to Submandibular/Sublingual glands - It travels through the middle ear to get back to the brain

What landmark transmits the chorda tympani? What is a "chorda tympani"? What else is transmitted by this landmark?

This pathway is similar to the corticobulbar system... that being said can you name the general pathway? (4) Hint: lower motor is the 3rd thing

pre-motor... upper motor... lower motor... effector *although no corticobulbar fibers

The fornix splits across anterior commissure into what 2 branches?

precommissural and postcommissural branches

FLIPPPPPP ITTTTTTT NOOOOWWWWWW

push the #2

She said not to memorize this chart but I think it will be helpful to know so I am putting the info from it into slides to help us take a look at it. just know the trends.

questions are coming in the following slides. you can star this card for the table

To make an Eye Ball

requires great focus

Parasymp PW

scroll A: Edinger-Westphal nucleus (pre-ganglionic parasympathetics) B: Oculomotor root of ciliary ganglion C: Ciliary ganglion D: Short Ciliary Nerves E: Ciliary Muscle F: Sphincter Pupillae Muscle

Symp PW

scroll down A: Preganglionic sympathetic cell bodies are located in the lateral horn from T1-T2. B: Superior Cervical Sympathetic Ganglion C: Internal Carotid Plexus D: Symp. root of ciliary ganglion E: Long Ciliary N F: Short Ciliary N G: Dilator Pupillae Muscle

ID time...

scroll down A: Frontal B: Lacrimal C: Ethmoid D: Sphenoid E: Zygomatic F: Maxilla G: Palatine

*Orbital Foramina* can you flip it and name them all?

scroll down A: Optic Canal/Foramen B: Anterior Ethmoidal Foramen C: Lacrimal canal D: Infra-orbital foramen E: Posterior ethmoidal foramen F: Infra-orbital groove G: Inferior orbital fissure H: Superior orbital fissure I: Zygomaticoorbital (facial) foramen

Buccal nerve sends sensory to the skin and inside of what? (2)

sends sensory to *skin of cheek and inside of the cheek (oral cavity)*

septal nuclei do what?

septal nuclei relate visceral reactions with behaviors.

What does Neuropharmacology capstone mean?

she doesn't know. she just named it that Just think about how we can manipulate the normal to be able to help fix diseases. Second hour is more capstone for autonomic pharmacology. Which we already learned. Apparently. I still don't buy it. But for real she said autonomic pharmacology is like the most important pharmacology ever "hopefully that is coming thru loud and clear"

SVE fibers will innervate (smooth/skeletal) muscle derived from (pharyngeal/palatine) arches.

skeletal; pharyngeal

How does the VOR and superior colliculus help us do different things?

sup colliculus helps us adjust our head according to *visual input* (reflexive control), where as the VOR helps us adjust according to *head position* (also reflexive)

What are the two major areas controlling the MLF?

superior colliculus and PPRF PPRF = paramedian pontine reticular formation

VOR also affects gaze in the upward/downward direction. This uses the MLF across what three eye muscles?

superior rectus superior oblique inferior oblique

What if synapses are not active often?

synapses that are not active are more likely to be lost. The same principle may apply to postsynaptic neurons. This process has been used to explain some processes of memory and neural activity related development as well (ocular dominance) fields.

Where is the Fornix?

the fornicator

what is the stria medullaris thalami?

the major efferent pathway from the septal nuclei. It connects to the habenular nuclei and then to the interpeduncular nucleus (via fasciculus retroflexus, a.k.a.habenulointerpeduncular tract )

dendritic spines and potentiation?

the primary modifications of potentiation are related to modifications within spines of dendrites

*Vestibulocerebellar tract:* 1. originates where? 2. terminates where? 3. thru which peduncle?

there are 2 here

okay okay okay

there is nothing from the DSA's in this deck. It is a lot of in depth information that I feel like is somewhat review and she will only teach what she has taught. But read thru them because it is good info.

check out pic of how they are fixed.

they run a catheter up to it and put in a coiled mass that is about the cost of a BMW. about 50% is still treated with open brain surgery.

Time for a bit of eye anatomy...

this guy gets it

*Superior Olivary Nuclei* T or F: Sound intensity, the phase of sound waves, and the timing of signal arrival in each ear can all be used for localization.

this is a true statement

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 3. After traversing the floor of the middle cranial fossa, the WHAT nerve crosses the opening of the carotid canal and, passing superior to the foramen lacerum, enters the WHAT canal.

3. After traversing the floor of the middle cranial fossa, the greater petrosal nerve crosses the opening of the carotid canal and, passing superior to the foramen lacerum, enters the *pterygoid canal.*

VOR continued 4. from abducens nucleus you will have two pathways. One directly activates which muscle? 5. The second pathway is from an interneuron to where? 6. Interneuron in #6 climbs up which pathway? 7. From there what other muscle will be activated?

4. Lateral rectus 5. Decussates to opposite side to occulomotor nucleus 6. MLF 7. Medial rectus

*Facial Nerve - Corneal Blink Reflex* 4. What two nuclei does this information travel through? 5. From the 2 nuclei in #4, how do they communicate with CN VII? 6. In the corneal blink reflex, do you end up blinking both eyes? If so, why?

4. Main sensory nucleus of CN V (two point discrimination/touch) AND Spinal Trigeminal Nucleus (nociceptive information) 5. Main sensory sends down an axon on the ipsilateral side. Spinal trigeminal tract sends up axons that bifurcate (ascend bilaterally) to both facial motor nuclei. 6. Yes, explained by #5.

*Middle ear* 4. What random structure, that Hurst mentioned in passing, is the beginning of middle ear bone formation? 5. What is Q4 made of? 6. What layer grows over these bones after they're formed?

4. Mesenchymal Condensation 5. Neural Crest (even though it's called *mesenchymal* condensation... seems suspect to me) 6. Endoderm from auditory tube (which is attached to the nasopharynx

*CN IX in Deglutition* 4. What is the branch that is under efferent control? 5. What muscle does it control? 6. What nucleus would the efferent info be projecting from?

4. Muscular branch 5. Stylopharyngeus m 6. Nucleus ambiguus

*Thalamus* 4. What will you find a lot of in the Thalamus (hint: there was a butt ton in the hypothalamus too)? 5. Most are named according to what?

4. Nuclei! (divided by both anatomical & functional characteristics) 5. Their anatomical positions

4. What are the different types of bipolar cells? 5. Where is the visual stimuli then passed on to? 6. Where is the point of convergence where properties are coded by bipolar cells?

4. On (if they are detecting light coming in) and Off (if there is an absence of light) bipolar cells 5. The retinal ganglion cells 6. Retinal ganglion cells

4. What is the posterior boarder of the PPF? 5. Inferior boarder?

4. Posterior: pterygoid process of sphenoid 5. Inferior: open via pterygopalatine canal

*Extraocular Eye Muscles* 4. Which muscles need to fire to look to the *Right*? 5. Which muscles need to fire to look to the *Left*?

4. R Lateral Rectus & L Medial Rectus 5. R Medial Rectus & L Lateral Rectus

*Metathalamus* 4. Are the Geniculate Bodies Relay or Association? 5. Medial Geniculate has what function? 6. Lateral Geniculate has what function?

4. Relay! 5. Auditory 6. Vision

4. How long is the refractory period for the ribbon synapses? 5. What is the NT that is released at the ribbon synapse? 6. Which bipolar cells will be active when there is light? What about when there is no light?

4. THERE IS NO REFRACTORY PERIOD! Thats why they are important. 5. Glutamate is the NT 6. ON will be active with light and OFF will be active in the absence of light.

*Deglutition Networks* 5. What nerves are in charge of afferent fibers? Which one is not like the others? 6. Which ones are involved in efferent information? 7. Each one is involved in what function?

5. CN V, VII, IX, and X; CN V (more proprioceptive info instead of taste) 6-7. CN V: primary mastication, also sound dampening while you are chewing CN VII: makes sure you dont have food dribbling out of your mouth; also sound dampening while you are chewing CN IX: Swallowing CN X: Swallowing CN XII: Movement of the tounge

-Salivary Glands *Submandibular and sublingual glands- parasympathetics* 4. after exiting the stylomastoid foramen they pass through an upward arching canal which opens into the cavity of what? 5. they then quickly exit #4 to enter WHAT fossa via WHAT fissure?

4. the middle ear 5. infratemporal fossa via the petrotympanic fissure

5. 3 Actions of *Superior Oblique*? 6. 3 Actions of *Inferior Oblique*?

5. Depression, Abduction, Intorsion (down & out) 6. Elevation, Abduction, Extorsion (up & out)

*Glutamate: The Primary Excitatory NT:* 4. The way the glutamate signal is terminated is thru what? 5. Once Glutamate is in #4 what happens? 6. after #5 where does it go? 7. What happens in #6?

4. through uptake to the glial cells 5. it is converted to glutamine 6. transported to the presynaptic neuron 7. It is converted back to Glutamine and put back in vesicles ready to be released again

Globe: *Vascular* Tunic 4. The *Choroid is continuous anteriorly with what other layer? 5. What is the *Ciliary body* made of? 6. Function of *Ciliary body* (2) + by what fibers?

4. w/*ciliary body* 5. Circularly arranged CT & smooth m. 6. lens accommodation via *zonular fibers* & production of aqueous humor.

*Acquired Hearing Loss - Damage from Sound* 4. Can loss be over particular frequencies or broadbands? 5. What is a possible cause? 6. Can you grow extra hair cells?

4. yes. 5. result from hearing sensitivity loss and may be part of the reason for old age hearing loss 6. yes but not on your own, gotta put them bad Jackson's in there!

4.5: Lens placodes begin to invaginate with optic vesicles to become? 5. What artery feeds the eye during development? 6. Where does the artery live?

4.5: *lens vesicles* (which lose contact w/ectoderm @ wk5 to lie in optic cup) 5. *Hyaloid* Artery (see it's position) 6. Dives into *Optic Stalk* w/in *Choroid Fissure*

When looking for MLF what ventricle should it be right by?

4th

*Pituitary* - Neurohypophysis 5. Tell us about a unique adaptation at the distal end of the Magnocellular Neurons? 6. Action of Q5?

5. *Herring Bodies*: swellings that store hormones 6. AP releases hormone directly into bloodstream via intimately associated capillaries

*Lateral medullary syndrome* 5. *Spinocerebellar fibers disrupted* causes what symptoms? 6. *Sensory trigeminal damage* causes what symptoms? 7. *Sympathetic pathway damage* causes what condition?

5. *Ipsilateral* ataxia 6. *Ipsilateral* loss of nociceptivity and thermosensitivity 7. Horner's syndrome

*A PATHWAY* 5. Where do optic tracts synapse? 6. What do the 2nd order neurons project through? 7. Where do the 2nd order neurons terminate? 8. How many axons in each optic nerve ? 9. How many axons in the in dorsal root somatosensory systems?

5. *Lateral Geniculate Nucleus* in Thalamus 6. Optic Radiations 7. Primary Visual Cortex (occipital lobe calcarine sulcus) 8. 1 million axons 9. only 40,000 (butt load more info from eye)

*Blood Supply* to Eye and Orbit 5. Which vessels feed the Ethmoid paranasal sinuses (2)? 6. Which vessel feeds the Medial Eyelid? 7. Which vessels feed the Scalp & Forehead (2)? 8. Which vessel feeds the Nose?

5. *Posterior & Anterior* Ethmoidal aa 6. *Medial Palpebral* A 7. *Supratrochlear* & *Supraorbital* aa 8. *Dorsal Nasal* A

*Afferent Signals* 5. 2nd order neurons {cross over OR remain uncrossed}? 6. 2nd order neurons access which nucleus of Thalamus? & via which tract?

5. *Remain Uncrossed* 6. Access *Ventral Posteromedial (VPM) Nucleus* of Thalamus via ipsilateral *Central Tegmental Tract*

5. *CN II* provides input to what nucleus? 6. *Medial Forebrain Bundle* provodes input to what on its way to/from what other 2 structures? 7. Each of the PWs here are bidirectional except for which?

5. *Suprachiasmatic Nucleus* 6. Input to *Lateral Hypothalamic Area (LHA)* on it's way to/from Ventral Tegmental Area & Basal Forebrain 7. All but retina (afferent only) [also get widespread input from Cortex]

*Tastant Receptors* - Sweet, Bitter, Umami 5. Receptor type for *Bitter*? 6. How many receptor subtypes for bitter? Why? 7. Receptor type for *Sweet*? 8. Receptor type for *Umami*?

5. *T2R* 6. 40+ subtypes (survival - bitter things can be poisonous) 7. *T1R3 + T1R2* dimer 8. 7. *T1R3 + T1R1* dimer

*Autonomic Innervation of the Head:* -Salivary Glands *Parotid gland-parasympathetics* 5. Parasympathetics emerge through the floor of the middle ear to course on the WHAT of the medial wall of the tympanic cavity? 6. This is where it participates (with twigs of WHAT CN and WHAT nerves of the internal carotid plexus (sympathetic)) in forming WHAT plexux?

5. *promontory* 6. where it participates (with twigs of CN VII and the *caroticotympanic nerves* of the internal carotid plexus [sympathetic]) in forming the *tympanic* plexus.

*Properties of Sound* 5. Normal hearing frequency range for human hearing is? 6. In children the range is? 7. Greatest sensitivity is in what range?

5. 50 to 16,000 Hz 6. 20 to 20,000 Hz 7. 2000 to 4000 Hz (conversational speech range - more hair cells in this range)

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 5. After traversing the pterygoid canal within the floor of the WHAT sinus, the nerve of the pterygoid canal enters the WHAT fossa to join the WHAT ganglion.

5. After traversing the pterygoid canal within the floor of the .sphenoid sinus, the nerve of the pterygoid canal enters the pterygopalatine fossa to join the *pterygopalatine ganglion*.

*Thalamus-Nuclear Groups & Functions* - *Lateral* - *Lateral Dorsal* 5. It has connections similar to what? 6. It may contribute to what function?

5. Anterior Nuclear Group 6. Autonomic component of emotional processing in memory (relating hypothalamic responses to sensations or experiences)

*CN VII in Deglutition - SVE* 5. For the efferent information of CN VII, there are two specific branches. What are they? 6. Which one is responsible for posterior belly of digastric and stylohyoid muscle? 7. So what nucleus would this sending out this information again?

5. Digastric branch and Buccal branch 6. Digastric branch 7. Again, since it is SVE information it will be coming from the motor nuc of CN VII

*Drainage of the Nasal Cavity:* 5. The superior nasal cavity usually drains to what veins? 6. #5 then drains to what vein? 7. #6 then drains to what?

5. Ethmoidal veins 6. Superior ophthalmic veins 7. Cavernous Sinus

*External Ear* 5. 1st pharyngeal cleft form what again? 6. What 3 layers make up the tympanic membrane?

5. External acoustic meatus 6. 1st pharyngeal cleft (*ectoderm*) + *mesoderm* + 1st pharyngeal pouch (*endoderm*)

*SUMMARY:* -Sympathetic Innervation 5. What nerve is located on the surface of the external carotid and its branches through which it will distribute to more superficial visceral structures of the head (face)? 6. What nerve is located on the internal carotid a. which forms a plexus?

5. External carotid n 6. Internal carotid n.

Hypothalamic Functions *Arousal & Sleep/Wake* 5. Neurons in the {medial OR lateral} Hypothalamus use what NT to hit those arousal nuclei to wake us? 6. What is Belsomra?

5. Lateral HT → (*Orexin*) → nuclei 6. Insomnia med that's an Orexin antagonist (so you can fall asleep) (check out the image for more clarification if necessary)

*Thalamic Nuclei* - * Association nuclei* 5. *Association nuclei* receive information from what? 6. Project to {one OR more than one} area? (Typically where)? 7. A list of nuclei that are examples of *Association nuclei*? 8. Although they form links b/w different areas of cerebral cortex, they don't have what?

5. Many structures *or* cortical regions 6. More than 1 area (mostly other association areas of cortex) 7. Mediodorsal (dorsomedial), Lateral dorsal Lateral posterior 8. Don't have broad projections of non-specific nuclei

cont. *course of CN XII* 5. It then goes superficial to to which muscle to get into oral cavity? 6. In oral cavity it runs on superficial and lateral part of which muscle?

5. Mylohyoid m 6. Hyoglossal m

6. If there is damage in the afferent PW (CN II), what will be the pupillary response? 7. If there is damage in the R efferent PW (CN III), what will be the pupillary response?

6. Bottom line of panel B 7. Panel C

*SUMMARY:* -Parasympathetic Innervation of the Head 6. Greater petrosal nerve gets parasympathetics via what CN? 7. #6 sends parasympathetics to what glands? via what ganglion? via what branches of what CN?

6. CN VII 7. Mucous glands of nasal cavity, oral cavity, pharynx, and palate via pterygopalatine ganglion and branches of V2 (and V1 to lacrimal gland)

*Sensory Afferent Coding of Intensity (Volume)* 6. What if the sound is beyond the dynamic range of the spiral ganglion cells? 7. How do we make up for this then? (i.e. are all spiral ganglion cells the same?)

6. Cell response saturates and will not respond with a greater frequency of action potentials. 7. Using neurons with different thresholds, the cochlea uses a typical cell recruitment pattern (low thresholds first, higher threshold neurons responding in sequence).

6. The *temporal* part of our *left* visual field hits what part of our retina? 7. The *nasal* part of our left *visual* field hits what part of our retina? 8. The *nasal* part of our right *visual* field hits what part of our retina? 9. The *temporal* part of our *right* visual field hits what part of our retina?

6. Hits our *nasal* part of our *left* retina 7. Hits our *temporal* part of our *right* retina 8. Hits our *temporal* part of our *left* retina 9. Hits our *nasal* part of our *right* retina

*Extraocular Eye Muscles* 6. Which muscles need to fire to look *straight down*? 7. Which muscles need to fire to look *down to the Right*? 8. Which muscles need to fire to look *down to the Left*?

6. L&R Superior Oblique & Inferior Rectus 7. R Superior Oblique & L Inferior Rectus 8. L Superior Oblique & R Inferior Rectus

*CN V in Deglutition* 6. via Efferent control, there are two branches of CN V. What are they? 7. Which one is responsible for temporalis muscle, masseter, medial and lateral pterygoid muscles? 8. Which one is responsible for mylohyoid and the anterior belly of digastric muscle?

6. Mandibular branch and Alveolar branch 7. Mandibular branch 8. Alveolar branch

*Neural processing in the Cochlea* 6. Are there more inner or outer hair cells? 7. How much of the afferent innervation do they receive? 8. What about efferent? Where do they receive it from? 9. Out hair cells may detect what intensity of sound and what type of discrimination?

6. Outer hair cells! (outer = 15,000; inner = 3,500) 7. 5% 8. Lots more!! from efferent cochlear bundle (olivocochlear bundle) of the brainstem. 9. Low intensity sound with reduced frequency discrimination (the rustling of a predator behind you in the leaves....watch out, here comes the scranton strangler!).

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 6. Postganglionic sympathetic fibers destined to innervate the lacrimal gland, nasal, palatal, oral and pharyngeal mucosa! glands, either distribute with branches of the pterygopalatine portion of the WHAT artery and/or follow the path of the WHAT division of WHAT CN. These fibers [increase or decrease?] secretion?

6. Postganglionic sympathetic fibers destined to innervate the lacrimal gland, nasal, palatal, oral and pharyngeal mucosa! glands, either distrib.ute with branches of the pterygopalatine portion of the maxillary artery *and/or* follow the path of the maxillary division of cranial nerve V2. *These fibers decrease secretion*

*Sensory Innervation of the Nasal Cavity:* 6. V 2 goes to what ganglia? 7. Branches of CN V 2 goes to the nasal cavity and innervates what structure?

6. Pterygopalatine Ganglia 7. the SEPTUM

*Thalamic Nuclei* 6. Most nuclei are named according to what? 7. In most cases _______ are used instead of full length name. 8. A few other nuclei have been ______ named (not like the others)

6. Their position (e.g. ventral anterior, ventral posterior lateral) 7. abbreviations (e.g. VA, VPL) 8. independently (e.g. pulvinar, geniculates)

*Venous Drainage* of Eye and Orbit 6. Pathway from eyeball out (4)?

6. Tributaries of vorticose veins (posterior & anterior) → Vorticose veins: → Superior Ophthalmic Vein → Cavernous Sinus =OR= → Inferior Ophthalmic Vein → Pterygoid venous plexus

Hypothalamic Functions *Temperature* 6. Heat Gain center (Posterior Hypothalamus) is under control of what other system & via what? 7. It's heat generating functions only act when? 8. Responses to deviation in set point are primarily through what system? and mediated by what?

6. Under control of Preoptic Nuclei via inhibition 7. Only when allowed (after body drops below a certain temp - but has no inherent ability to establish its own set point) 8. ANS & mediated by *Paraventricular Nucleus* (also augmented by stereotypical heat seeking/avoiding behaviors)

6. How do you test for *Superior oblique* 7. How do you test for *Inferior oblique*

6. have pt *ad*duct & then *depress* 7. have pt *ad*duct & then *elevate*

*Thalamus-Nuclear Groups & Functions* - *Medial* - DM 6. Bilateral lesion of DM or its connections w/prefrontal cortex (leukotomy,) can treat what (2)? 7. What will such lesions not help? 8. These lesions may also be followed by what behaviors?

6. i: Relieve *severe anxiety* (similar to prefrontal lobotomy) & *distress* 7. Wont help prevent detection of *intractable pain* (ie it hurts, but you don't care) 8. Inappropriate behavior Impairment of judgement & foresight.

*Effects of mAChR stimulation on smooth muscle:* 6. What will be the effect on GI Sphincters? 7. What will it do the the GI secretion? 8. What will it do to the Detrusor muscle in the bladder? 9. What will it do to the Trigone and sphincter in the bladder? 10. What will it cause in sweat, salivary, lacrimal, and nasopharyngeal glands?

6. relaxation 7. stimulation 8. contraction 9. relaxation 10. secretion

*Endolymph vs. Perilymph* 6. What type of junctions are between hair cells and supporting cells? 7. What does this maintain?

6. tight junctions 7. ensures that the endolymph and perilymph dont mix, keeps them separate.

What type of receptors are mAChRs? How may receptor subtypes are there?

7 transmembrane-spanning G-PROTEIN COUPLED Receptors (GPCRs, METABOTROPIC) > M1 - M5 subtypes

[We probably don't need to know the info on this card] *Thalamus-Nuclear Groups & Functions* - *Lateral* - VA 7. *Parvocellular part* receives afferents largely from (1)? 8. This part is sometimes classified as part of which nucleus?

7. *Medial globus pallidus* 8. Part of *Ventral Lateral nucleus* (VLo or VLa).

*Afferent Signals* Recap: 7. 2nd order neuron cell bodies where? 8. Axons ascend {Ipsilateral OR Contralaterally) & in which tract? 9. Synapse Where? New: 10. 3rd order neuron cell bodies where? 11. Synapse where?

7. *Nucleus of Solitary tract* 8. Ipsilaterally in *Central Tegmental Tract* 9. VPM of Thalamus 10. VPM of Thalamus 11. *Insula & Frontal Operculum* (*1° Gustatory Cortex*) - this is where taste sorting goes down

7. What does the Optic Stalk become? 8. When should the Choroid Fissure fuse? 9. What will the mouth of the cup surround & what will it become?

7. *Optic Nerve* 8. Week 7 (inner lips of choroid fissure fuse) 9. Will surround Lens Vesicle & becomes *Primitive Pupil*

Hypothalamic Functions *Arousal & Sleep/Wake* 7. Neurons in what region inhibit Orexin system & Arousal Nuclei to allow for sleep? 8. Recap: which bit of the hypothalamus is considered the *Sleep Center*? Which bit of the hypothalamus is considered the *Wake Center*?

7. *Preoptic Region* 8. *Sleep Center*: Anterior HT (Preoptic Region) *Wake Center*: Posterior HT (Tubulomammillary)

*SUMMARY:* -Sympathetic Innervation 7. The internal Cartoid Nerve contributes 3 branches what are their names?

7. - caroticotympanic branches - deep petrosal n - cavernous plexus

*Autonomic Innervation of the Head:* -Salivary Glands *Parotid gland-parasympathetics* 7. The parasympathetics "reforms" and is joined by fibers of WHAT CN? 8. then they leave the middle ear as WHAT nerve? 9. Via what Hiatus?

7. CN 7 8. *Lesser Petrosal Nerve* 9. Hiatus of lesser petrosal n. (lateral to the hiatus of greater petrosal nerve)

7. What is *Iris* made of? 8. Function of *Iris*?

7. CT & smooth muscle 8. aperture that changes shape to regulate amount light to retina

*Olfactory Neuron Signaling Cascade*.. 7. What happens after depolarization has begun?

7. Ca++ gated Cl- channels open & Cl- *leaves* the cell (augments depolarization)

*Thalamus-Nuclear Groups & Functions* - *Intralaminar Group* 7. Intralaminar nuclei may help with what functions? 8. Surgical lesions have been placed here to control what?

7. Control levels of consciousness & arousal, nonspecific awareness of stimuli. 8. Control intractable pain (probs due to interruption of anterolateral afferents) but the relief is only temporary

*Middle ear* 7. What is a *Congenital cholesteatoma*?

7. Keratin-filled cyst medial to tympanic membrane

7. Which of the 3 PWs from Q3 is the most poorly developed in humans (but under study)? 8. This PW (Q7) is located close to what part of the brain? 9. b/c of Q8, what lobe might this PW be considered a part of?

7. Olfactory Tubercle 8. close to *reward centers* (shares features w/em) 9. Part of *Limbic Lobe*

Globe: *Neural* Tunic 7. What is the *Macula lutea* + what is it used for? 8. What does it contain? 9. What does it provide?

7. Small, oval-shaped area lateral to optic disc used for central vision (what light hits when you look straight on at something) 8. Contains *fovea centralis*, a retinal depression w/high density of cones 9. Providing high acuity vision

7. Where does the Superior Oblique insert on the eyeball? 8. Where does the Inferior Oblique insert on the eyeball?

7. Superior/Lateral 8. Inferior/Lateral

7. What 3 types of cells are found in a taste bud? 8. A *Taste Cells* is just a specialized ____ cell? 9. Apical portion function? 10. Basal portion function? 11. What is crazy about this process?

7. Taste Cells, Sustentacular Cells, Basal Cells 8. Specialized *ET* cell (*Polarized*) 9. Recognizes tastants 10. releases NT 11. Taste cell depolarizes and releases NT =BUT= *they are not neurons*

check the back side of this card

#1? #2? (scroll down to find out) 1. Palatine process of maxilla 2. Palate bone (horizontal plate)

The basal ganglia limbic circuit in reward-related behavior uses VTA dopamine. (1) What part(s) of the basal ganglia circuit does the *hypothalamus* modulate? (2) The hypothalamus modulates the basal limbic circuit based on what need?

(1) *The Cortex* (Hippocampus, Amygdala, OFC, Insula, Cingulate), Nucleus accumbens (ventral striatum), and *Ventral Tegmental Area* (2) homeostatic need (i.e. hunger, thirst, etc.)

What are the 10 sites drugs can act on in the CNS? (sorry it has to be done)

(1) Action potential in presynaptic fiber; (2) synthesis of transmitter; (3) storage; (4) metabolism; (5) release; (6) reuptake into the nerve ending or uptake into a glial cell; (7) degradation; (8) receptor for the transmitter; (9) receptor-induced increase or decrease in ionic conductance; (10) retrograde signaling. This is the big picture and really important and she wants us to know this and put back what drugs act where.

(1) What is the *consummatory phase* of motivated behavior? (2) Is the nucleus accumbens dopamine dependent or independent?

(1) Defined by the interaction with the reward stimulus (2) In this phase the nucleus accumbens is dopamine independent.

(1) Where in the brain is dopamine manufactured? (2) Where is it released as part of the reward pathway?

(1) Dopamine is manufactured in nerve cell bodies located within the *ventral tegmental area (VTA)*. (2) Dopamine is *released* in the *nucleus accumbens* and the *prefrontal cortex.*

(1) What is the *instrumental phase* of motivated behavior? (2) Is the nucleus accumbens dopamine dependent or independent?

(1) In the instrumental phase you are invigorated by the very thought of the reward which motivates you to move toward the reward. (2) In this phase the nucleus accumbens is dopamine dependent. Phase in which you have obtained the reward.

The *nucleus accumbens* is involved in processing of positive and negative motivational stimuli in the basal ganglia limbic circuit. (1) What structure does it act on once it is stimulated by dopamine? (2) Will it inhibit, disinhibit, or stimulate this structure? (3) What will happen after this structure (1) is acted upon by the nucleus accumbens, and what was it doing initially?

(1) Ventral Pallidum (2) the accumbens will inhibit the ventral pallidum (3) Initially, the ventral pallidum was *inhibiting* the medial dorsal thalamus (MD thalamus). Once ventral pallidum is inhibited, this will then disinhibit the MD thalamus. Now free to do what it likes, the MD thalamus will stimulate the cortex to act on the nucleus accumbens.

*Retinal Ganglion Cells* How do we identify whether specific areas of the retinal ganglion cells an ON Center or an OFF Center?

(This is a long explanation; give them a shot at the answer then flip the card) Based off of their response to certain *patterns* of light (not just if light is present or not). These ON Centers and OFF centers will have a mixture of ON and OFF ganglion surrounding each other. These are scattered and arranged across the retina, these help us create an "edge" to visual information (i.e. do a contrast between a light and a dark).

What part of the basal ganglia limbic circuit represents *"Learning and Memory"*?

*Nucleus accumbens* (dendritic spine in the nucleus accumbens are increased) after +/- motivational stimulus *Long term potentiation happens here*

What is the origin of the Lateral Pterygoid m.?

Lateral surface of Lateral Pterygoid plate Infratemporal surface of the greater wing of the sphenoid.

What is the insertion of the Masseter m.?

Lateral surface of ramus & angle of Mandible.

Now things are really heating up... For the following Layers tell us {ipsilateral or contralateral} visual fields & {Magnocellular (Rods) or Parvocellular (Cones)}: Layer *1*? Layer *2*? Layer *3*? Layer *4*? Layer *5*? Layer *6*?

Layer *1*: Contralateral, Magnocellular Layer *2*: Ipsilateral, Magnocellular Layer *3*: Ipsilateral, Parvocellular Layer *4*: Contralateral, Parvocellular Layer *5*: Ipsilateral, Parvocellular Layer *6*: Contralateral, Parvocellular [Guess what? Each layer of LGN has its own column in the primary visual cortex. Crazy, huh?]

What 3 aspects of reward describe why we do what we do?

Learning and memory Motivation (wanting) Pleasure (liking)

After the tympanic plexus, fibers of IX re-coelesce and are joined by a branch· of VII (geniculotympanic branch) to form what nerve?

Lesser Petrosal Nerve

Can I see some ID?

Let's Split this up... (Just ID *A - G*) A: Fovea Centralis in Macula Lutea B: Sclera C: Choroid D: Ciliary bit of retina E: Ciliary Body & Ciliary Muscle F: Scleral venous sinus G: Zonular Fibers

*ID*entify

Let's Split this up... (Just ID *H - N*) H: Iris I: Lens J: Cornea K: Anterior Chamber L: Posterior Chamber M: Iridiocorneal junction/angle N: Ciliary Process

More *ID*

Let's Split this up... (Just ID *O - U*) O: Bulbar Conjunctiva P: Ora Serrata Q: Vitreous Body R: Hyaloid Canal S: Lamina Cribrosa of Sclera T: Optic Nerve (CN II) U: Central Retinal A & V

What type of receptors are nAChRs? How are they activates?

Ligand-gates ion channels that will allow Na+ to pass through the ion channel port when activated (IONOTROPIC Receptor) > activated by ACh and Nicotine

*Pupillary Light Reflex (bilateral)* How does it work (incl. what afferent N & what efferent N)

Light shine in pupil → afferent info thru CN II → Pretectal nucleus & bilaterally to Edinger-Westphal → bilaterally to ciliary gang → pupillary constrictors (consensual)

What 3 circuits are activated when decisions are made?

Limbic Cognitive Motor

Which probe would be considered "proper" to use when performing US scans of the neck and orbit? Which orientation should we begin with when scanning the neck?

Linear Transducer Transverse, then we can rotate to linear

The lingual n. (branch of V3) is used to distribute what nerve from another cranial nerve? (include fibers types)

Lingual n. (branch of V3) will distribute the CHORDA TYMPANI n. (from the CN VII) --SVA (ant. 2/3rds of tongue) --GVE-P (to submandibular ganglion)

Where is the Inion located?

Located at the EXTERNAL OCCIPITAL PROTUBERANCE.

How the hearing thing works...

Look at each number and tell us what happens here (don't worry about 6 & 7) *1*: Sound waves hit the tympanic membrane *2*: Vibrations make the bones shake *3*: Stapes moves against the oval window (air → water: bones have to amplify the waves) *4*: Waves travel into the *scala vestibuli* *5*: Scala vestibuli → hit the membrane at different portions along the *Tectorial Membrane* depending on *pitch*. The *louder* the sound the more hair cells are activated

How does one differentiate between Facial Palsy? What 2 groups do the symptoms fall into?

Look at the symptoms UMN and LMN

Which muscles are found in the infratemporal fossa?

Lower portion of TEMPORALIS m. PTERYGOID m. (lateral & medial?)

Occipital - Foramen magnum - Spinal cord - Spinal roots of CN XI - Vertebral a's - Ant + 2 Post Spinal a's - Ant + Post Meningeal branches (Vertebral a's) - Dural v's

Name of landmark? What travels through?

Optic canal (Sphenoid) - CN II - Ophthalmic a

Name of landmark? What travels through?

Petrotympanic fissure - Chorda tympani (CN VII)

Name of landmark? What travels through?

Pharyngeal canal (spheno-vomer suture) - Pharyngeal a + n ??? this needs a better picture

Name of landmark? What travels through?

Posterior Ethmoidal foramen - Posterior ethmoidal a.v.n.

Name of landmark? What travels through?

Posterior ethmoidal foramen - Posterior ethmoidal a.v.n. (CN V₁)

Name of landmark? What travels through?

Pterygoid canal - N + A of the pterygoid canal ??? needs a better picture

Name of landmark? What travels through?

Sphenomaxillary fissure - Maxillary a (3rd division) - Posterior superior alveolar n

Name of landmark? What travels through?

Stylomastoid foramen - SVE of CN VII

Name of landmark? What travels through?

Superior orbital fissure - CN III - CN IV - CN V₁ - CN VI - Superior ophthalmic v

Name of landmark? What travels through?

Supraorbital notch/foramen - Supraorbital a.v.n. (CN V₁)

Name of landmark? What travels through?

Tympanic canaliculus (crest between jugular foramen/carotid canal) - Tympanic br (CN IX)

Name of landmark? What travels through?

Zygomaticofacial foramen - Zygomaticofacial a.v.n.

Name of landmark? What travels through?

Zygomaticotemporal foramen - Zygomaticotemporal a.v.n.

Name of landmark? What travels through?

Sphenopalatine foramen (Deep to Pterygopalatine fossa) - Sphenopalatine a - Nasopalatine n - Post sup lat nasal n

Name of landmark? (the hole in the back) What travels through?

Pterygopalatine fossa - Maxillary a (3rd portion) - Pterygopalatine ganglion (V2)

Name of landmark? (the room) What travels through?

Time to ID again again

Name that Structure =Scroll for Answers= A: 1° olfactory cortex B: Anterior Entorhinal cortex C: Orbitofrontal Olfactory Area

Time to ID

Name that Structure =Scroll for Answers= A: Olfactory Bulb B: Olfactory Tract C: Olfactory Trigone D: Lateral Olfactory Stria E: Olfactory Tubercle F: Medial Olfactory Stria

Time to ID again

Name that Structure =Scroll for Answers= A: Olfactory Trigone B: Lateral Olfactory Stria C: to ipsilateral 1° olfactory cortex (piriform cortex) & Amygdala (periamygdaloid cortex) D: Medial Olfactory Stria

1. 3rd portion of Maxillary artery 2. Posterior superior alveolar a. 3. Infraorbital a. 4. Middle superior alveolar a. 5. Anterior superior alveolar a.

Name the blue boxes (1-5)

Attempt some ID

Name the nuclei A: Edinger-Westfall Nucleus B: Salivatory Nucleus C: Dorsal Motor Nucleus of X D: Nucleus Ambiguus

6. Descending palatine a. --> spleits into greater & lesser palatine aa. 7. Arteyr of pterygoid canal 8. Pharyngeal a. 9. Sphenopalatine a.

Name the yellow boxes (6-9)

Let's do this again..

Name them and, for those involved, name if Symp or Parasymp is found in them A: Hypoglossal Nucleus B: Dorsal Motor of X (Parasympathetic) C: NST (Symp & Parasymp) D: Vestibular Nucleus E: Nucleus Ambiguus (Parasympathetic) F: Spinal Trigeminal Nucleus (STN)

What is the insertion of the Lateral Pterygoid m.?

Neck of the mandible Capsule of TMJ at level of articular disc (*SPHENOMENISCUS*, upper portion of muscle)

What is the innervation of the Lateral Pterygoid m.?

Nerve to lateral pterygoid (V3)

What will acetylcholine (ACh) bind to and activate?

Nicotinic ACh receptors (nAChR) Muscarinic ACh receptors (mAChR)

What I was told the key to pharmacology is.

No I didn't edit this. He really said this. And it is still true. for all.

Nondeclarative memory

Nondeclarative (procedural) memory are memories that largely cannot be retrieved at a conscious level, how to perform tasks - riding a bicycle, gymnastic maneuver.

Through what foramen does the nasopalatine nerve exit?

None, it doesnt exit a foramen. It exits a canal. And that canal is the incisive canal. (Also, this gif is too good not to use twice in one set, so, get used to it)

Why do we care about the cortical components of these guys?

cortical structure corresponds to function

dorsal spinocerebellar tract

d

fasciculus cuneatus

d

substantia gelatinosa

d

Ptosis can be caused by which of the following? a. Loss of levator palpebrae b. Loss of superior tarsal muscle c. Loss of orbital orbicularis occuli d. A. and B. e. A. and C.

d. A. and B. a. Loss of levator palpebrae b. Loss of superior tarsal muscle

Quiz Time! A blow-out fracture will result in all of the following except: a. Dipolpia b. Enophthalmos c. Edema d. Aphakia e. Ecchymosis

d. Aphakia

Quiz Time: A disconnection of the Pigmented and the Neural retinal layer will result in _________. a. Leber's congenital amaurosis b. Congenital Aphakia c. Congenital Aniridia d. Congenital Retinal Detachment e. Coloboma

d. Congenital Retinal Detachment

1. A 50 year old man presents with a complaint of hyperacusis primarily in his right ear. You also observe that his right eye that appears red and irritated, and he says it has been feeling dry and sore. Both of these symptoms could be explained by damage to parts of the: a. Abducens nerve b. Trigeminal nerve c. Glossopharyngeal nerve d. Facial Nerve e. Vagus Nerves

d. Facial Nerve

5. After surgery in a recovery room, one of your patients appears alert and talks to you as you describe his postsurgical instructions. However, later in the afternoon, he can't remember that you visited him. A residual effect of the anesthesia suppressing activity in which of the followings structures would most readily explain this? a. Amygdala b. Ventromedial hypothalamus c. Orbitofrontal cortex d. Hippocampus e. Pyriform cortex

d. Hippocampus

3. You have a patient experiencing vertigo. You wish to test vestibular function by irrigating the patient's left external auditory meatus with warm water. Under normal circumstances, you would expect the results of this test to be: a. a nystagmus with a slow component to the left b. both eyes to drift slowly to the right c. the left eye drift slowly to the right d. a nystagmus with a quick component to the left e. both eyes drift to an upward position

d. a nystagmus with a quick component to the left

Crushing of what structure would impinge on V2? a. Lacrimal canal b. Anterior ethmoidal foramen c. Posterior ethmoidal foramen d. zygomaticooribital foramen e. infra-orbital foramen

d. zygomaticooribital foramen e. infra-orbital foramen maybe?

dorsal spinocerebellar tract lesion results in lack of coordination to the ipsilateral side

d? what if there was damage?

Parahippocampal cortex afferents?

depends on area includes visual and sensory association and interconnections with other areas of cerebral cortex

also I spell purkinje wrong a lot so there's that.

double screwed

lateral corticospinal tract

e

spinal tract of CN V

e

Congenital blindness can be caused by ________. a. Leber's congenital amaurosis b. Congenital Aniridia c. Congenital Retinal Detachment d. A. and B. e. A. and C.

e. A. and C. = a. Leber's congenital amaurosis = c. Congenital Retinal Detachment

Blockage of the trabecular meshwork can result in _______. a. Glaucoma b. Increased posterior segment pressure c. Blindness d. A. and B. e. All of the above

e. All of the above

A 36 y/o male presents with the inability of his left eye to look down and out, which muscle is most likely affected? a. Inferior oblique b. Lateral rectus c. Inferior rectus d. Superior rectus e. Superior oblique

e. Superior oblique

lateral corticospinal tract lack of voluntary movement on the contralateral side (this would be after pyramidal dessucation)

e? lesion here results in?

Simple pathway Circuit of papez

entorhinal cortex to hippocampal formation (subiculum) → fornix → mammillary bodies → med mammilary nuclei→ anterior thalamic nucleus → cingulum → entorhinal cortex → hippocampal formation.

Where do the primary afferents to the hippocampus come from?

entorhinal cortex, parahippocampal gyrus and multiple areas of the forebrain (septal area, hypothalamus, and amygdala)

Epidural hematomas

etiology: usually trauma to middle meningeal artery symptoms: lucid interval Imaging: non contrast CT. Calvarial fracture is typical. strips dura from skull unilateral. mass effect from bleed

Spinal nucleus of CN V

f

lateral corticospinal tract

f

substantia gelatinosa

f

postcommisural fornix comprises a pathway for what?

for cortical elements associated with memory and memory based behaviors

Why is it important for us to forget?

forgetting is an important process in the selectivity of information that is incorporated.

Dorsal spinocerebellar tract

g

nucleus dorsalis ( Clarke's nucleus) posterior spinocerebellar. first synapse is in clarkes nucleus

g? lesion here would affect which pathway?

Sorry. He very briefly mentioned this slide but I cannot make sense of it

good luck

lateral gray horn

h

spinothalamic tract

h

other limbic system components

habenular nuclei (MOTIVATION BABY!) INTERPEDUNCULAR NUCLEUS ventral tegmental area periaquaductal gray prefrontal cortex (according to some people)

tutor review for test 3

https://www.facebook.com/groups/rvucom2020/407569709600341/

Here is a link to a video to help us understand

https://www.youtube.com/watch?v=46aNGGNPm7s =I don't know how much she will test on this information?=

spinothalamic tract

i

ventral spinal rootlets

i

*Middle Ear*: Innervation What are the 3 branches of the *Facial nerve* in the middle ear + what fiber types in each?

i: *Greater petrosal nerve* (GVE-P) ii: *Nerve to stapedius* (SVE) iii: *Chorda tympani* (GVE-P; SVA)

*Internal Ear*: Vestibular Apparatus What are the 2 parts to the vestibular ganglion + each receive info from what?

i: *Superior* part: Anterior & Lateral semicircular canals & Utricle ii: *Inferior* part: Posterior semicircular canals & Saccule

Globe: *Ciliary Body* 1. Two main functions?

i: Accommodation (changing shape of lens in order to see far away things vs close up things) ii: Aqueous humor production

What are the 4 players in the *Olfactory Neuron Signaling Cascade*?

i: GPCR (odorant receptor) ii: Adenylate Cyclase III iii: cAMP gated ion channel iv: Ca++ gated Cl- channel

What are the two muscles that control diameter of pupil + which is sympathetically controlled & which parasympathetically?

i: Sphincter pupillae mm. (parasympathetic) ii: Dilator pupillae mm. (sympathetic)

What is declarative memory

is storage and retrieval that is available to consciousness and can be expressed by language - remembering a telephone number or images of events that have happened

where is long term potentiation produced?

its produced in Schaffer collaterals of pyramidal neurons in the hippocampus and in mossy fiber terminals of the dentate gyrus.

question, question, question, where is the question?

its right here! 1-3 ID 4. What is all the blue arrows and blue asterisks pointing to? 1. White matter 2. Granular cell layer 3. Molecular layer 4. Purkinje cell layer

ventral gray horn

j

ventral white commissure

j

The pterygoid branches from the pterygoid portion of the maxillary artery will supply blood to where?

lateral & medial pterygoid mm.

afferents from reticular formation going to the hippocampus are from what structures? PRL

locus coeruleus (NE), raphe nuclei (seritonin), and parabrachial region

check out pic

look at these herniations

Where are the post commissural projections going?

major hippocampal efferent is to the medial mammillary nucleus (connects to Papez circuit-memory). Other projections" the ventromedial nucleus of hypothalamus (feeding behavior) lateral dorsal nucleus of the thalamus (parietal association with cingulate gyrus) and anterior nucleus.

What connects the cranial nerves and integrates movements directed by gaze?

medial longitudnal fasciculus

In what area of the brain is the superior colliculus?

midbrain tectum

Where are mAChRs found within the ANS?

muscarinic ACh receptors -- are found in smooth & cardiac muscle, gland cells and nerve terminals.

What does the pterygoid plexus of veins communicate with posteriorly?

pharyngeal plexus

What are the twin inferior extensions form the body of the sphenoid bone?

LATERAL & MEDIAL pterygoid plates

What is the ONLY muscle of mastication that aids in OPENING the mandible?

LATERAL PTERYGOID muscle

Which branches of the maxillary a. supply blood to the Temporalis m.?

*Anterior & posterior Deep Temporal aa.* from the Pterygoid portion of maxillary a.

Globe: *Eye Chambers* What are the 2 segments + what chambers are found in each + type of humor in each?

*Anterior segment*: - Anterior chamber in front of iris (aqueous humor) - Posterior chamber behind iris (aqueous humor) *Posterior segment*: - Vitreous chamber (vitreous humor)

What are the aspects underlying reward-related behaviors? (fill in the blanks) 1. ____________ and _______________: Based on sensory and emotional experience 2. _____________: Based on internal states 3. _____________ : Based on experiencing a reward

*Aspects underlying reward-related behaviors* 1. *Learning* and *memory*: Based on sensory and emotional experience 2. *Motivation (wanting)*: Based on internal states 3. *Pleasure (liking)*: Based on experiencing a reward

What innervates the temporomandibular joint (TMJ)? (2)

*Auriculotemporal n.* (from V3, mandibular div.) *Masseteric branches* of V3 (mandibular div.)

When is *dopamine* in the *ventral tegmental area* (VTA) released? When is dopamine release inhibited?

*Dopamine in the ventral tegmental area VTA is released when*: (1) Reward is unexpected <-dopamine surge (unconditioned stimulus) (2) Reward is cued (i.e. getting your favorite jelly bean) ****Even anticipation of an award will increase dopamine**** *Dopamine release is inhibited* when expected reward is *not* present (i.e. getting a disgusting jelly bean) In the graph here you can actually see a plummeting of dopamine when no reward is present. :( https://www.youtube.com/watch?v=meiU6TxysCg

TRUE or FALSE: Learning and memory alone can affect behavior and is the answer to why we do what we do.

*FALSE* Learning and memory alone *cannot* affect behavior. You have to have a motivation. "But knowledge by itself, no matter what kind, is never motivation. Something else is required to translate remembered knowledge into motivation that can actually generate and control behavior." ~KC Berridge

What are the osseous elemends (6) of the cranial base (floor of the cranial vault)?

*Frontal *Ethmoidal *Parietals *Occipital *Temporals *Sphenoid

What bones of the skull are individual (lacking a pair)?

*Frontal *Maxilla *Occipital *Sphenoid *Ethmoid *Vomer *Mandible

HM was a patient who underwent surgery for epilepsy. His hippocampus was removed. What did he teach us?

*HM taught us the hippocampus is important for learning and making new memories* Every time an experimenter met with HM she shook his hand with a thumb tac and he hurt himself. He never tied shaking her hand to being hurt and shook her hand every time.

What is the main driver controlling our ANS?

*Hypothalamus*

What part of our brain controls the ANS?

*Hypothalamus*

Here's one: ANS is controlled by what region in the brain?

*Hypothalamus* (he must have said this 10 times, so I'm just driving the point home)

What is the job of the dorsolateral prefrontal cortex relative to FEF and PEF?

*Inhibiting saccades* So we don't look at things that our FEF and PEF want to look at

What are the different tonsils (4) found within the nasopharynx, ororpharynx & oral cavity?

*LINGUAL tonsils* -- located deep to mucosa of posterior 1/3 of tongue. *PHARYNGEAL tonsils* -- located w/n *pharyngeal recess* of nasopharynx. *PALATINE tonsils* - *b/w palatoglossal & palatopharyngeal* folds *TUBAL tonsils* - located at opening of auditory tube.

Certain cells in the Hippocampus code for "Place" by firing whenever they are in a particular area or spatial context. _______ and ______ Between the Parallel Fibers and Purkinje Cells are thought to Underlie Motor Learning in the Cerebellum.

*LTP* and *LTD* Between the Parallel Fibers and Purkinje Cells are thought to Underlie Motor Learning in the Cerebellum He said not to worry so much about the wiring of the schematic, but to remember that memory formation is not just about hippocampal and cortical thing (papez circuit and perforant pathway), but the cerebellum is involved as well. Very important for cognitive modulation of places and of learning and memory.

Why are *long-term potentiation* and *long-term depression* important in memory formation?

*LTP*: is a the long-lasting strengthening of synapses between nerve cells. *LTD*: allows us to ignore unimportant details of our lives (i.e. being aware of new watch touching skin -> ignoring new watch) Our hippocampus has regional, physical changes as a result of use ("Use-dependent plasticity")

What are the osseous elements (7) of the viscerocranium?

*Maxilla *Vomer *Zygomatic *Inferior nasal concha *Palatine *Lacrimal *Mandible *nasal

What is the gingivae?

*Mucous membrane & fibrous tissue* attached to the alveolar processes of the mandible & maxilla bones. *also attached to neck of teeth

1. What does the pterygoid plexus of veins communicate with medially?

*Nasal cavity* via the *Sphenopalatine v.*

PCA stroke symptoms

Pt presents w/: - Contralateral homonymous hemianopsia - Possible thalamic deficits

Fliiiiiiiip the card

*Nucleus of Different Fiber Types* 1. What information would be in this nucleus? 2. What information would be in this nucleus? 3. What information would be in this nucleus? Where are the cell bodies of these fibers located? 4. What information would be in this nucleus? Where are the cell bodies of these fibers located? 1. Pharyngeal motor information 2. Parasympathetic information (CN VII spits and cries) 3. Visceral sensory information (with the Solitary nucleus); geniculate ganglion 4. Somatic sensory; geniculate ganglion

*OLIVOCEREBELLAR tract:* 1. Goes through what cerebellar peduncle? 2. does if have ascending or descending fibers? 3. When does it have Tonic Oscillations? 4. What is this tract necessary for? 5. What part(s) of the cerebellum do they go to?

*OLIVOCEREBELLAR TRACT:* 1. Inferior cerebellar peduncle 2. Neither its Climbing fibers 3. Tonic oscillations for complex activity 4. *Necessary for motor learning* 5. all over, everywhere, they be important my friends

Define dentate gyrus

*PROCESSESSES OLFACTORY INFO specialized region of original hippocampal precursor between hippocampus and subiculum. It forms interlocking C's with distal end of hippocampus. *RECIEVES info from entorhinal cortex (olfactory associated cortex)

Hypothalamic info (PVN) down to many nuclei in the tegmentum? *Parabrachial nuclei* 2. What sensation does this info give? 3. Where are Q1 located?

*Parabrachial nuclei* 2. Sense of *Well Being* (RR, HR, etc) 3. Just medial to superior cerebellar peduncles

Which branch of the vagus n. (CN X) will enter the oral cavity? What muscles does this nerve pass through?

*SUPERIOR LARYNGEAL n.* (specifically the *internal laryngeal n.* to the epiglottic region) *Enters pharyngeal region posteriorly and passes b/w the MIDDLE & INFERIOR pharyngeal constrictors mm. and ascends to the epiglottic region of tongue.

If your patient presents with Xerostomia (dry mouth), Deep red tongue, Dental carries, Keratoconjunctivitis sicca (dry red eyes), Yeast infections 1. What disease might your patient have?

*Sjorgen syndrome* (autoimmune distruction of glands in the body)

1. Which branch of the maxillary a. will pass through the sphenopalatine foramen? 2. What cavity does this artery enter? 2. This provides branches to what? (2)

*Sphenopalatine a.* 2. *nasal cavity* 3. provides branches to the *lateral and medial nasal walls.*

1. What are the INTRINSIC muscles of the tongue? Include their functions.

*Superior and Inferior LONGITUDINAL*: responsible for shortening and retracting the tongue. *VERTICAL and TRANSVERSE mm.*: responsible for flattening the tongue and making it longer

1. How does the Temporalis m. insert onto the Buccinator m.? 2. Why is this insertion important?

*TEMPOROBUCCINATOR BAND*. 2. this band is important because it *pulls the Buccinator LATERALLY* which *prevents it from being trapped between the teeth.*

TRUE/FALSE: When an axon of cell A is near enough to excite cell B and repeatedly or persistently takes part in firing it, some growth process or metabolic change takes place in one or both cells such that A's efficiency, as one of the cells firing B, is increased.

*TRUE* Hebbian Learning - This is how we learn things! "Neurons that fire together, wire together" The *aplysia*/sea slug taught us that Hebbian learning is right! (slug sensitized to touch via pairing touch with shock: gill reflex increased as slug became conditioned to touch paired with shock)

What part of the basal ganglia limbic circuit represents *"Sensory Experience"*?

*The Cortex* (Hippocampus, Amygdala, OFC, Insula, Cingulate), Nucleus accumbens (ventral striatum), and Ventral Tegmental Area

According to Behavioralism theories: we only know our actions, we will never fully understand "why"? In essence the answer to *why* we do what we do all boils down to what *4 basic things*?

*We make decisions based on*: 1. Prediction 2. Reward 3. Outcome 4. ...and what motivates us

1. What does the pterygoid plexus of vein communicate with superiorly via what?

*cavernous sinus* via the *sphenoid emissary vv.*

Where does the LPN synapse on the postganglionic parasympathetic neurons?

*otic ganglion* (medial to the root of the nerve to the medial pterygoid)

*External Ear* - Recall: - What were the 2 main nerves that innervate the *external acoustic meatus*?

- *Auriculotemporal* off V3 - *Auricular br. of Vagus*

3 part question: What cranial nerves carry taste info to brain + what location each carry taste from + What taste buds for each?

- *CN VII*: Ant 2/3 of tongue (Fungiform & Filiform Papillae) - *CN IX*: Posterior 1/3 of tongue (Circumvallate Papillae) - *CN X*: Epiglottis (?)

More CCs she will address in the CIS?

- Ear Infections - Cochlear implant - Correlation of hearing loss & facial paralysis - Cerebellopontine angle tumors - Deafness (sensorineural vs conductive) - Tinnitus - Hyperacusis - Vertigo (balance disorders)

Cochlea CC: - What do they do for the cochlear implant?

- Put an electrode through the round window into the cochlea

The Cochlea (weird new stuff) - 2 primary components related to transduction along with its structure: → Sensory ganglion cells within the spiral ganglia, which innervate a detector, → Organ of Corti. - Dendrites of spiral ganglion cells distribute radially from the from the modiolus. - Axons of spiral ganglion cells form cochlear or auditory nerve which projects to cochlear nuclei of upper medulla.

- Wells Business

-Salivary Glands *Submandibular and sublingual glands- parasympathetics* 1. These receive parasympathetics via what CN? 2. Pacifically what nerve via that CN? 3. #2 arises from #1 just prior to its exiting of what foramen?

1. *Facial N. (CN VII) 2. *Chorda tympani* 3. Stylomastoid foramen

*Cochlear Labyrinths and Resonance* 1. Sound pressure waves generated at the oval [office/window] in the scala vestibuli by the foot of the stapes (or sound waves within the temporal bone) will be separated _____________ ____________ that vibrate the basilar membrane where? 2. A high pitched sound wave will push out a [small/large] wave through the cochlear perilymph fluid. 3. A low pitched sound wave will push out a [small/large] wave through the cochlear perilymph fluid. 4. 2 and 3 accomplish what with the cochlea?

1. (this is a terrible question, i am so sorry) Sound pressure waves generated at the oval *window* in the scala vestibuli by the foot of the stapes (or sound waves within the temporal bone) *will be separated into frequency components* that vibrate the basilar membrane in *different places in the cochlear spiral*. 2. Small 3. Large 4. This is how it separates out the sounds! Quote: "A sound wave that is short or long, [tends] to push a column of water related to its length up and down between the oval and the round window."

1. 1° olfactory cortex is made up of how many layers? 2. Is this Neocortex or Paleocortex? 3. Most neurons in 1° olfactory cortex respond to {single or range of} odorant(s)?

1. *3 layers* (Not 6 like other places) 2. Paleocortex (olfaction considered the oldest sensory system - older than thalamus, which is why it bypasses thalamus) 3. Range of odorants (unlike bulb) (the 1st step in *integration* of olfactory info in 1° olfactory cortex)

Hypothalamic info (PVN) down to many nuclei in the tegmentum? *Ventrolateral Medulla * 1. Another name for these? 2. Function of this region?

1. *A5 cells* (Reticular Formation) 2. Central Pattern Generators (CPG) for respiration, cardiovascular (so kinda important)

1. Which branch of the maxillary a. arises from the pterygopalatine fossa and will course posteriorly through the *pterygoid canal*? 2. Provides branches that supply what? (3)

1. *ARTERY of the PTERYGOID CANAL*. travels with nerve of the pterygoid canal. 2. Provides branches: *upper pharyngeal wall* *auditory tube* *tympanic cavity*

1. Which branch of the maxillary artery (mandibular portion) will enter the skull via the FORAMEN OVALE? 2. What other artery can this branch arise from?

1. *Accessory meningeal a.* 2. sometimes this can arise from the *Middle Meningeal a.* rather than directly off maxillary a. *This one is variable in existence and origin

1. What 2 structures in the *Temporal Lobe* send afferents to *&* receive efferents from the Hypothalamus? 2. What structure go directly to hypothalamus & is involved in circadian rhythm?

1. *Amygdala & Hippocampus* 2. *CN II*

1. What's the name for the decreased ability to smell? 2. How can you test for it clinically? 3. When using these tests what must you account for?

1. *Anosmia* 2. UPenn Smell Identification Test (UPSIT) = scratch & sniff test 3. Age of the individual (as we know, olfaction diminishes with age - just ask Andy)

1. What's the name of the 2° olfactory cortex? 2. Q1 receives projections from where? 3. Q1 is associated with what brain structure? 4. Function of Q3? 5. When is the bulk of odor memories formed?

1. *Anterior Entorhinal Cortex* 2. from 1° olfactory cortex 3. *Hippocampus* 4. Memory Formation (smells associated w/positive & negative memories) 5. 0-10 yo = long lasting (most visual memories not retrievable from this time period) [odor memories often more intense than visual *&* have more emotional content]

*Sensory Innervation of the Nasal Cavity:* 1. Which nerve innervates the anterior inferior nasal septum? 2. #1 is a branch from what CN? 3. Which nerve is the major innervator of the Nasal septum? 4. #3 is a branch from what CN?

1. *Anterior Ethmoid Septal branch* 2. CN V 1 3. Nasopalatine nerve 4. V2

*Autonomic Innervation of the Head:* -Salivary Glands *Parotid gland-parasympathetics* 1. Parasympathetic fibers innervate the parotid gland via what CN and what fibers? 2. They exit the medulla at what angle? 3. They exit the skull via what foramen? 4. They re-enter the skull via what?

1. *CN IX (GVE)* 2. Exits medulla at ponto-cerebellar-medullary angle 3. Exits skull via *jugular foramen* 4. Re-enters skull via *tympanic canaliculus*

1. The GSE nuclei (CN III, IV, VI, & XII) are responsible for what type of movements? 2. Where in the brainstem are these nuclei found? from what plate?

1. *CONJUGATE & VERGENCE* movements of paired organs & muscles. 2. nuclei are found in the *dorsomedial region* of the brainstem (from *basal plate origin*)

What are the 4 types of papilae we are interested in with the tongue?

1. *Circumvallate*. -Ant. to terminal sulcus -taste buds in depressions 2. *foliate* (Not developed much in humans) 3. *filiform* 4. *Fungiform*

*CC* 1. What's it called when the lens fails to develop? 2. What causes it?

1. *Congenital aphakia* (very rare) 2. Lack induction or signaling or surface ectoderm issue

1. What is the first branch to arise from the maxillary artery? 2. What is the course of this artery? 3. what does it supply? (2)

1. *Deep auricular a.* 2. Ascends through the *superior portion of the deepest part of the parotid gland* to pierce the cartilage (or bony part) of the external acoustic meatus 3. where it supplies branches to: *skin of the meatus* *external surface of the tympanic membrane*

1. The descending palatine a. descends from the maxillary a. in which canal? 2. What is it in company with? 3. What are the divisions? and where do those division go?

1. *Descends in the pterygopalatine canal* 2. in company with the *greater palatine n.* (V2) 3. *GREATER & LESSER palatine aa.* to the *hard & soft palate*.

1. The Hypothalamus is considered to be part of what other brain structure? 2. Q1 is true except for what bit of the Hypothalamus (2)? What are these derived from? 3. If Q2 aren't derived like the rest of the Hypothalamus, then why is it considered Hypothalamus?

1. *Diencephalon* 2. *Lateral & Medial Preoptic Nucleus* are derived from *Telencephalon* 3. b/c of it's function

*Paranasal Sinuses development*: 1. In the adult the *Maxillary Sinus* drains into WHAT? 2. What is the problem with #1? 3. How Is #1 accomplished?

1. *Drains into Middle Meatus* 2. has to drain 'uphill' 3. 100% reliant on the cilia and respiratory epithelium to move the mucus up and into the nasal cavity

*Vestibulo ocular reflex (VOR)* 1. Horizontal movement of head activates what? 2. if the head moves right where will the eyes move?

1. *medial longitudinal fasciculus (MLF)* 2. Rule of thumb: Head moves to the right, *eyes move to the left*

Lingual Nerve 1. What kind of fibers does it provide? 2. #1 to what part of the oral cavity? (3) 3. In addition to GSA, lingual nerve helps distribute what fibers to the anterior 2/3rds of the tongue? 4. What fibers does Lingual n. distribute to submandibular and sublingual glands?

1. *GSA* to the 2. anterior 2/3rds (body) of the tongue, floor of the oral cavity, and gingivae 3. *DISTRIBUTES SVA* to the anterior 2/3rds (body) of the tongue (*via chorda tympani branch of CN VII*) 4. Lingual Nerve *DISTRIBUTES GVE-P* to the submandibular and sublingual glands (*via chorda tympani branch of CN VII*)

*Autonomic Innervation of the Head:* -Eye *Ciliary Ganglion* 1. The *Oculomotor root* is what type of fibers? 2. It has [pre or post?] ganglionic [sympathetic or parasympathetic?] fibers from the oculomotor nuclear complex (Which is WHAT nucleus?) and travel with WHAT nerve to WHAT ganglion where they synapse on [pre or post?] ganglionic [sympathetic or parasympathetic?] nerve cell bodies? 3. The postganglionic p.s. fibers leave the ciliary ganglion and travel to the glob in WHAT nerves? 4. These innervate what Muscles that control WHAT?

1. *GVE-P* 2. *Preganglionic parasympathetic fibers* from the. oculomotor nuclear complex (*Edinger-Westphal nucleus*) travel with the oculomotor nerve (*CN Ill*) to the *ciliary ganglion* where they *synapse* on *postganglionic parasympathetic nerve cell bodies.* 3. *Short Ciliary nn.* 4. *sphincter pupilae muscle* and the muscles of the *ciliary body* that control *accommodation* (thickening of the lens for near Vision).

*Types of cells in Cerebellum:* 1. What are the 2 main cell types in the cerebellum? 2. What are the 3 circuit modifier cell types in the cerebellum?

1. *Granule cells* and *Purkinje cells* 2. stellate cells, basket cells, and Golgi II cells

*Afferent Signals* - *Solitary Tract* 1. Taste from *Hard/Soft Palate* travel in what nerve? To which ganglion? 2. Taste from *Anterior 2/3 of tongue* travel in what nerve*s*? To which ganglion? 3. Taste from *Posterior 1/3 of tongue + Circumvallate Papillae* travel in what nerve? To which ganglion? 4. Taste from *Epiglottis* travel in what nerve? To which ganglion?

1. *Greater Petrosal* (VII) to *Geniculate Ganglia* 2. w/*Lingual* (V) & branches to *Chorda Tympani* (VII) to *Geniculate Ganglia* 3. *Lingual* br of (IX) to *Inferior Glossopharyngeal Ganglia* 4. *CN X* to *Inferior Ganglia of Vagus (Nodose)*

Describe the two movements of the TMJ joint and when they occur.

1. *HINGE* - movements are allowed b/w the condyle & the disk. - Occurs when mouth is being opened and closed. 2. *GLIDING* -allowed *b/w the mandibular fossa & the disk* - occurs *when jaw is slack and teeth are not in contact*. Combination of these happen during chewing.

1. Fascicles that make up CN I are {homogeneous or heterogeneous}? What dat mean? 2. Glomeruli are {homogeneous or heterogeneous}? What dat mean? 3. 1 Mitral or Tufted carry info of {one or many} odorant(s) to 1° olfactory cortex?

1. *Heterogeneous* (have axons from many different odorant specific neurons) 2. *Homogeneous* (all neurons targeting a glomerulus respond to same odorant) 3. *1 single odorant* per mitral/tufted

1. What region of the brain is considered the *King* of Autonomic control? 2. Must have what information to be able to control the ANS well? 3. The vast majority of autonomic information from the body passes through what *specific nucleus*?

1. *Hypothalamus* 2. Must know what is going on out in the body 3. *Nucleus of Solitary Tract* (dark blue in image)

1. In what part of the brainstem do the *Pre-ganglionic parasympathetic* fibers which will innervate the parotid gland arise? 2. In what CN do these run? 3. Where does the CN from #2 exit the skull?

1. *INFERIOR SALIVATORY nucleus* and then the fibers 2. leave the brainstem in *CN IX*. 3. Jugular foramen

*Thalamus-Nuclear Groups & Functions* - Non-specific *Intralaminar Group* 1. Partially delineated by a division of what structure around them? 2. 2 nuclei found in this group?

1. *Internal medullary lamina* around them. 2. i: Centromedian Nucleus ii: Parafascicular Nucleus Also, iii: Several smaller nuclei [but dont need to remember this]

*Anastamoses:* 1. Arteries perfusing the nasal septum form extensive anastomotic connections in a region known as what or what? 2. Which artery is the primary contributor to nose bleeds? 3. What is the most frequent site of Epistaxis (nose bleeds)?

1. *Little's Area* and *Kiesselbach's Area* 2. Sphenopalatine artery 3. *little's Area*

Hypothalamic Functions *Arousal & Sleep/Wake* 1. What 2 Extra-hypothalamic (outside hypothalamus) structures feed into the hypothalamus & cortex to help with *arousal* (wakeful focus) *&* what hormone do each release? 2. What is the intra-hypothalamic structure that helps with *arousal* *&* what hormone does it release?

1. *Locus Coeruleus* (NE) & Dorsal Raphe (Serotonin) 2. *Tubulomammillary Nucleus* (Histamine) [other areas of hypothalamus can either enhance or inhibit activity of the nuclei above]

*Pituitary* - Neurohypophysis 1. {Parvocellular or Magnocellular} Neurons in which 2 Nuclei in the Pituitary? 2. Axons from Q1 travel into Neurohypophysis via which tract? 3. These deliver what 2 hormones to capillary bed? 4. Functions of Q3?

1. *Magnocellular* in *Supraoptic & Paraventricular Nuclei* 2. *Hypothalamohypophyseal* Tract 3. AVP & Oxytocin 4. *AVP*: Water reabsorption (distal Nephron) *Oxytocin*: Uterine Contractions & Milk Secretion

What are the three section of the maxillary artery?

1. *Mandibular portion*: behind the mandible. 2. *Pterygoid portion*: crosses the lateral pterygoid 3. *Pterygopalatine portion*: w/n the pterygopalatine fossa.

During the 1890s, Russian physiologist, Ivan Pavlov was looking at salivation in dogs in response to being fed. Eventually the dogs began to salivate upon hearing the sound of a bell (bell rang every time meat was brought to the dogs).*This experiment is a classic example of classical conditioning*. *In Pavalov's experiment*: 1. What was the *unconditioned stimulus (UCS)*? 2. What was the *conditioned stimulus (CS)*? 3. What was the *unconditioned response (UCR)*? 4. What was the *conditioned response (CR)*?

1. *Meat* = UCS 2. *Bell* = CS: dogs associated the sound of the bell with meat and eventually began to salivate after hearing the bell 3. *Salivation stimulated by meat* = UCR: dogs unconditionally salivated when they smelled/ saw meat. 4. *Salivation stimulated by the sound of the bell* = CR

1. What are the 2 walls of the orbit + Orientation of each? 2. Which extends more anteriorly? 3. Which side of the eye is more exposed?

1. *Medial*: Parallel (A-P) *Lateral*: Angled back so they meet at 70°-90° 2. Medial wall extends more anteriorly 3. Lateral side

Now Details of *submandibular and sublingual parasympathetics* 1. Preganglionic parasympathetic cell bodies? 2. preganglionics travel on Facial nerve via what branch? 3. Chorda tympni exits through which opening? 4. The fibers then join what nerve? 5. Where will postganglionics cell bodies be? 6. postsynaptic fibers are distributed out via what nerve?

1. *Salivatory nucleus* in brainstem 2. Chorda tympani 3. Petrotympanic hiatus 4. Lingual n. 5. Submandibular ganglion 6. branches of lingual n.

*Facial Never Fiber Types* What are the 4 different fiber types that make up the facial nerve?

1. *Somatic sensory* from the outer ear (geniculate ganglion) 2. *Visceral sensory* from taste buds on anterior 2/3 of the tongue (geniculate ganglion) 3. *Pharyngeal motor* to muscles of facial expression and stapedius 4. *Visceral motor* to salivary, nasal, palatine and lacrimal glands (via submandibular and pterygopalatine ganglion)

* Perfusion of the Nasal Cavity:* 1. Maxillary artery gives rise to what 2 branches? 2. Which artery of the main 3 is the biggest player a.k.a. brings in the most blood?

1. *Sphenopalatine* and *Descending Palatine*, they perfuse the nasal cavity 2. The maxillary artery

*Thalamocortical Projections* 1. Generally thalamic nuclei receive from where? 2. All thalamic nuclei project to where? *TestQ Alert*: One exception to Q2? 3. What does the thalamus get from Q2? 4. Q3 is an important part of? 5. Lesions to thalamus can, in some cases, mimic lesions where?

1. *Subcortical projections* (eg. sensory PWs) 2. Cerebral cortex (*EXCEPT reticular nucleus*) 3. Reciprocal projection from same cortical area 4. Information processing 5. cortical lesions.

*External Ear* 1. 2 major arteries to the external ear? 2. Drainage of the external ear through which vein?

1. *Superficial Temporal A.* & *Posterior Auricular A.* 2. Venae comitantes to external jugular v.

* Perfusion of the Nasal Cavity:* 1. The facial artery gives off what 2 branches? 2. #1 travel [medially or laterally] towards the [ear or nose?] 3. Small branches come from the two in #1 to supply what part of the nasal cavity? 4. The facial artery is a branch from what artery?

1. *Superior labial* and *Lateral Nasal* branches 2. travel medially toward the nose 3. Inferior Nasal cavity 4. External carotid

*Internal ear* 1. From which tissue layer is it derived? 2. What structure is formed initially (hint: similar to what we saw in the eye)?

1. *Surface Ectoderm* 2. *Otic Placode*

*Morphological Orientation of Hair Cells:* 1. The horizontal canal hair cells are oriented such that fluid movement [toward or away?] from the utricle will activate hair cells. 2. The anterior and posterior canals are oriented so that fluid movement [in or out?] of the utricle will activate hair cells.

1. *TOWARD* 2. *Fluid Movement OUT*

1. All fibers on the *temporal* aspect of the *retina* will {decussate at or remain ipsilateral after} the optic chiasm? 2. All fibers on the *nasal* aspect of the *retina* will {decussate at or remain ipsilateral after} the optic chiasm? 3. Neurons carrying info related to the *Left* Visual Space will Travel to the {Left or Right} Cortex? 4. Neurons carrying info related to the Right Visual Space will Travel to the {Left or Right} Cortex?

1. *Temporal* aspect of *retina* → *remain ipsilateral* after optic chiasm 2. *Nasal* aspect of *retina* → *decussate* at optic chiasm 3. *Left* Visual Space → *Right Cortex* 4. *Right* Visual Space → *Left Cortex*

1. The buccal a. & n. have a close relationship to what? 2. How do they course related to #1?

1. *Temporobuccinator band* (TBB) 2. These structures pass *posteromedial to the TBB* (remember TBB is extension of the Temporalis m.)

*IMPORTANT* The Vestibulospinal Network: 1. *The medial vestibulospinal tract* arises primarily from WHAT vestibular nuclei and descends [bilaterally or contralaterally or ipsilaterally or laterally?] in the WHAT fasciculous? 2. The goal of this is to influence [flexors or exensors or both?] motor neurons where?

1. *The medial vestibular nuclei* and decends BILATERALLY in the medial longitudinal fasciculus 2. to influence both flexor and extensor motor neurons in the neck.

1. What is the frontal eye field important for? 2. What is the broadman's area for frontal eye fields?

1. *Voluntary eye movements* you see something and choose to focus on it. 2. 8, roughly in the premotor area

1. Postganglionic sympathetic axons leave the internal carotid as what nerve? 2.#1 then contributes to what nerve? 3. Sympaathetic postganglionic axons pass thru [and synapse or do not synapse?] in the pterygopalatine ganglion?

1. *deep Petrosal Nerve* 2. Nerve of pterygoid canal 3. *pass thru but do not synapse in* the pterygopalatine ganglion

*Kinetic Labyrinth Function:* 1. The kinetic labyrinth functions on the basis of the WHAT of fluid inside the semicircular canals relative to the movement of the head in What motion? 2. How will the direction of flow through the ampulla be different for either side of the head? 3. While one side is being hyperpolarized what is the other side of the head doing? 4. 1. This creates opposing receptor signals on each side of the head that are sensitive to what?

1. *inertia*, rotation (head rotates, fluid lags behind). 2. The direction of flow through the ampulla will be different for either side of the head, so that the hair cells of one crista will be depolarized, while the other is hyperpolarized relative to a resting position. 3. being depolarized 4. Directionally sensitive

Here's something... 1. The *inferior* part of your visual field is received by what part of your *retina*? (+ what radiation loop is this in)? 2. The *superior* part of your visual field is received by what part of your *retina*? (+ what radiation loop is this in)?

1. *inferior* visual field = *superior* retina = *Baum's loop* 2. *superior* visual field = *inferior* retina = *Meyer's loop*

*Motion and the Static Labyrith:* 1. Although conscious perception of head position is perceived as a summary of activity of all maculae, WHICH macula is most sensitive to head tilt, and horizontal acceleration. 2. Forward and backward (pitch) positions are most effectively coded by WHICH macula.

1. *macula of the Utricle* 2. *macula of the saccule*

1. Which branch of the maxillary artery will pass through the mandibular notch? 2. What travels with this artery through the mandibular notch? 3. Where does this branch go?

1. *masseteric a.* (pterygoid portion of maxillary a.) 2.in company with *Masseteric n. (V3) and v.* 3. Passes through notch to reach the *deep* surface of the masseter m.

*The Vestibulo-Thalamo-Cortical Network-Conscious Vestibular Perception:* 1. The conscious perception of motion and spatial orientation arise through a convergence of information from WHAT 3 systems through WHAT pathway. 2. Nuclei of what 3 vestibular nuclei project to 3 thalamic areas, what are they? 3. *Stimulation of these areas of the thalamus can produce sensations of what 2 things?*

1. -the vestibular, visual and somatosensory systems. - a thalamocortical pathway. 2. the superior, lateral and inferior nuclei 3. the ventral posterolateral and posteroinferior nuclei (VPL + VPI) and a posterior nuclear group near the medial geniculate (basically near VPM). 4. *movement and dizziness.*

1. How many identified nuclei are found in the Hypothalamus? 2. How many major tracts travel through the Hypothalamus?

1. 11 identified nuclei 2. 5 major tracts

1. Mice have how many odorant receptors do mice have? 2. Humans have how many again? 3. What is anosmia? 4. Are these (Q3) people totally screwed?

1. 1200 2. 400 3. Altered expression of an odorant receptor causing difficulty in identifying 1+ odorants 4. Nah, likely can still detect due to cross-talk (but still altered a bit)

1. Do you remember what structure forms the *external ear compartment* (external auditory meatus)? 2. How about the *middle ear compartment*? 3. The meeting of these 2 structures forms what?

1. 1st pharyngeal *cleft* invagination 2. 1st pharyngeal pouch 3. Meeting of cleft & pouch separates tympanic membrane (non-specific mesodermal layer)

1. Orbitofrontal Olfactory Area receive input directly from what two areas? 2. Orbitofrontal Olfactory Area actually receives input from all sensory systems, but what are the two most important for our discussion today? Why?

1. 1° olfactory cortex *&* Entorhinal Cortex 2. *Taste + Olfaction = Flavor*

*Conscious Vestibular Perception:* 1. Thalamic projections provide HOW MANY separate pathways for vestibular information to reach at least HOW MANY separate areas of cerebral cortex (some controversy here). 2. The first area is where? 3. It is probably involved in what 2 sensations?

1. 2 he says 2. At the base of the postcentral sulcus, near the hand and mouth regions (posterior nucleus). 3. motion perception and spatial orientation

1. How many layers does the cerebellum have? 2. What is the name of each layer? 3. What cell is found in each layer?

1. 3 2. -Molecular layer (Top) - Purkinjie cell layer (middle) - Granular layer (bottom) 3. Granule cells are found in the granular layer Purkinje cells are found in the purkinje cell layer parallel fibers are in the molecular layer

1. How many layers are in the cerebellar cortex? 2. is there the same amount of layers across the whole cerebellar cortex? if yes, where is it different?

1. 3 2. NOPE

*Cerebellar Peduncles:* 1. How many cerebellar peduncles attach cerebellum to brainstem? 2. white or grey matter? 3. Afferents or efferents?

1. 3 cerebellar peduncles 2. White matter connections of cerebellum to brainstem. 3. both

*Maxillary Artery* 1. What portion of the maxillary artery enters in the pterygopalatine fossa? 2. What is the first branch off of #1? 3. What is the next branch off of #1?

1. 3rd division of the maxillary artery 2. Posterior superior alveolar artery 3. Infraorbital artery

1. How many incisor teeth are there? 2. How many canine teeth? 3. How many premolars are there? 4. How many molars?

1. 8 incicors total (4 top, 4 bottom) 2. 4 canines total 3. 8 premolars total 4. 12 molars total -posterior most are what are removed if get wisdom teeth out

*Middle Ear* - Lateral Wall (flip)

1. A & B? 2. Where does B insert? Answers hiding ↓ 1. A: Tympanic Membrane B: Tensor Tympani Muscle 2. Handle of the Malleus

*TEST QUESTION 3* 1. What is a TIA (Transient ischemic attack) HERE IS THE QUESTION: 2. What is the initial imaging study in the work up of a TIA?

1. A transient ischemic attack (TIA) is like a stroke, producing similar symptoms, but usually lasts less the 24 hours 2. *MRI Brain with MRA head and Neck* (can't do CT because you are looking for clots and if it was a struck and other such areas and because it already happened if it was a TIA)

*Middle Ear* - Posterior Wall (flip)

1. A-C 2. Function of A? Answers hiding ↓ 1. A: Aditus (to mastoid antrum) B: Pyramidal eminence C: Prominence of facial canal 2. PW to Mastoid air cells which assist in preventing pressure buildup (& they can also contain bone marrow)

*Middle Ear* - Medial Wall (a 2nd look) (flip)

1. A-C 2. What 2 things have been removed? Answers hiding ↓ 1. A: Oval window B: Promotory C: Round window 2. Mucosa & Stapes

Turn this guy over...

1. A-E 2. What is the function of these structures? 3. What is the image on the right depicting? 1. A: Helix B: Concha C: Cymba Conchae D: External Auditory Meatus E: Tragus 2. Collects sound & conducts it toward tympanic membrane 3. Shows which part of the ear is cartilage vs just skin

*Middle Ear*: Innervation - 2nd look (flip)

1. A-F 2. Where is C, E, F heading? Answers hiding ↓ 1. A: Facial N B: Prominence of Facial Canal C: Chorda Tympani D: Facial N E: Chorda Tympani F: Chorda Tympani 2. Headed to the anterior bit of the tongue for taste

1. A 66 y/o woman is diagnosed with Alzheimer disease, with symptoms being described as mild-to-moderate. Studies suggest that impaired cortical cholinergic function may contribute to the pathophysiology of disease. Which pharmacologic approach is most likely to restore cortical cholinergic function and alleviate her symptoms? A. Inhibit acetylcholinesterase B. Inhibit choline acetyltransferase C. Inhibit monoamine oxidase D. Prescribe acetylcholine E. Prescribe succinylcholine

1. A. Inhibit acetylcholinesterase All other answers have the opposite affect

1. What did the Phenytoin (Na+ channel blocker) that you gave do? (what site did it work at)

1. ACTION POTENTIALS! it will stop the action potential propagation

*General Circuitry of the ANS:* 1. parasympathetics use what neurotransmitter? 2. Parasympathetics have what two receptors?

1. ACh 2. nAChR, and mAChR

What are the 4 steps of ACh in the neuromuscular junction (hint the first step is ACh being born)

1. ACh synthesis 2. ACh storage 3. ACh release 4. ACh destruction

*Monoamine Transporters:* 1. What are the 2 drugs used to treat ADHD? 2. How do they work? 3. What type of NT does it effect usually? 4. How are they different from meth? 5. What NT does meth effect?

1. ADHD: methylphenidate, amphetamine 2. Amphetamine enters the norepinephrine transporter retrogradely on the presynaptic terminal and causes norepinephrine to come out of the vesicles and to leave the presynaptic cell into the synaptic cleft without a synapse happening by going thru a norepinephrine transporter backward. 3. usually pretty selective for norepinephrine because of low dose but can effect dopamine and serotonin in high doses. Not addictive in these low doses when only effecting norepinephrine sites. 4. Meth is a way higher dose so it effects the dopamine and serotonin cells as well 5. yup its dopamine, serotonin and norepinephrine neurons in CNS and PNS b/c such a high dose.

1. What would be anesthetized if you did a Inf. alveolar n block? 2. Where do you stick them to numb inf. alveolar?

1. ALL bottom teeth anterior bottom gingiva 2. Aim to ramus of mandible and a little superior toward cornoid process.

1. In general, the function of the extrinsic muscle of the tongue are to? 2. What are these muscles (4)? 3. All of these are innervated by CN XII, except for which one?

1. ALTER the *POSITION* of the tongue. 2. *Genioglossus m.* *Hyoglossus m. * *Styloglossus m. * *Palatoglossus m.* 3. Palatoglossus m (CN X)

What provides the *general sensory innervation* to the tongue? Be specific about fiber type and branches 1. Anterior 2. Posterior 3. Epiglottic region

1. ANTERIOR 2/3 = *GSA fibers* from *Lingual branch of V3* 2. POSTERIOR 1/3 = *GVA fibers* from *glossopharyngeal n.* (CN IX) 3. EPIGLOTTIC REGION = *GVA fibers* from the *internal laryngeal branch of vagus n.* (CN X)

*Digastric Muscle* 1. Origin (anterior and posterior belly)? 2. insertion 3. Innervation (Ant and post) 4. Action

1. ANTERIOR belly -- digastric fossa of mandible. POSTERIOR belly --mastoid process 2. I: Hyoid bone 3. N: Anterior= V3 Posterior= VII 4. Depresses mandible, elevates hyoid

1. Compensatory eye movements can be made in WHAT direction or be [excited or suppressed?] as in tracking an object with head movement.

1. ANY direction, Suppressed

1. Where does the Middle Meningeal a. arise from? 2. Where does this artery go? 3. What does this artery feed?

1. ARISES from the Maxillary a. (mandibular portion) 2. ascends *b/w the two roots of the auriculotemporal n.* Traverses *foramen spinosum* to divide into branches 3. which feed the *dura & inner table of a major portion of the cranial vault*.

*Drainage of the Nasal Cavity:* 1. The veins mostly parallel the WHAT? 2. The anterior inferior nasal cavity drains to what vein? 3. The middle nasal cavity drain to what veins? 4. #3 then drains to what?

1. ARTERIES 2. Drainage to facial vein 3. Sphenopalatine veins 4. Drain to Pterygoid plexus

1. 2/3 of the spinal cord are perfused by a single ________ 2. This artery is most commonly disrupted by damage or ischemia to the artery of ____________ 3. What are some common causes? 4. Where does #2 come from? 5. What regions would be damaged?

1. ASA 2. A. of Adamkiewicz 3. Aortic aneurysm, Aortic dissection, Trauma, Surgical error 4. large artery branching posteriorly from aorta (low tspine/high lspine) to supply ASA 5. spinothalamic, motor horn & corticospinal

1. Action of *Lateral Rectus*? 2. Action of *Medial Rectus*?

1. Abduction 2. Adduction

*CC* 1. What is *Leber's congenital amaurosis*? 2. Cause? 3. LCA characterized by (3)? Fun Fact: Tx?

1. Abnormal development of photoreceptor cells (1 in 40,000 newborns) 2. Different gene mutations (18 types discovered so far) 3. i: Nystagmus ii: Absent or sluggish pupillary response iii: Severe vision loss/blindness [Tx: Gene therapy with Adeno-associated virus in the eye]

*CC* 1. What is *Congenital aniridia*? 2. What is there instead?

1. Absence of iris 2. Gigantic pupil

1. What is *Anotia & Microtia*? 2. What % of babies w/this have additional defects 3. 3 examples of syndromes in which these are common? 4. What is the cause when there is no associated conitions (isolated Anotia or Microtia)?

1. Absent or Small Outer ear 2. 20-40% have additional defects 3. i: Treacher-Collins ii: Goldenhar iii: Konigsmark 4. Isolated anotia/microtia = *unknown* cause

*Monoamine Regulation of Major Depressive Disorder Symptoms:* Mood is regulated by Dopamine, serotonin, and norepinephrine. 1. Although DA plays a key role in depression, antidepressants, in general, do not target DA (exception is bupropion, also sertraline) Why?

1. Abuse potential, addictive; can precipitate psychosis. we will talk about it more as well

*General Circuitry of the ANS:* 1. What neurotransmitters are used at all ganglionic synapses, both sympathetic and parasympathetic? 2. What receptors are used at all post ganglionic neurons, both sympathetic and parasympathetic? 3. Are these fast or slow neural transmission? why is it that?

1. Acetylchline 2. nicotinic (nAChR) 3. FAST because nicotinic receptors are ion channels that depolarize the cell fast

1. What are the 2 neurotransmitters that balance eachother in the autonomic nervous system? 2. is this what is going on in the CNS? 3. What are the 2 NT that balance eachother in the CNS? 4. ALL other NT in the CNS are causing what function?

1. Acetylcholine and norepinephrine 2. NOPE 3. Glutamate (excitatory) and GABA (inhibitory) 4. neuromodulary function. she will explain later, so be on the look out.

From the previous question: 1. What is the drug doing, what receptors will be activated? 2. stimulation of sympathetic or parasympathetic?

1. Activation of nAChRs is desired effect 2. parasympathetic

*Motor Learning:* otra vez 1. What are the 2 Afferents inputs coming for motor learning in the cerebellum? 2. What are the 2 efferents outputs leaving for the motor learning in the cerebellum? 3. what happens if this is damaged?

1. Afferents from CN VIII, inferior olivary nucleus 2. Efferents to reticular formation, cranial nerve nuclei controlling extraocular muscles 3. you won't have muscle memory and you won't be able to make any more muscle memory. everything will be as if it was your first time doing it, and you will have to concentrate while doing it. wooph

Jugular foramen - CN IX - CN X - CN XI - Sigmoid sinus - Inf petrosal sinus - Internal jugular v - Posterior meningeal br's of Occipital a + Ascending pharyngeal a

Name of landmark? What travels through?

*Perfusion of the Nasal Cavity: lateral* 1. WHAT branch of the lateral nasal and superior labial arteries provides blood supply to the anterior inferior nasal cavity? 2. lateral nasal and superior labial branch off what artery? 3. WHAT 2 arteries provide blood to the superior lateral nasal cavity? 4. #3 are branches off what artery?

1. Alar branch of lateral nasal and Alar branch of Superior labial 2. branches of Facial artery 3. Anterior ethmoidal and Posterior ethmoidal arteries 4. branches of Ophthalmic artery

*Inferior Colliculus* 1. What does it receive? 2. Is this a highly organized area for sound frequencies? 3. The inferior colliculus has sections for both the binaural and monaural info, what does it do for each?

1. All ascending auditory pathways/information. 2. Yes 3. has sections for both binaural processing of sound localization and monaural frequency information, and

*Deglutition Networks* 1. So, we have to move the food through all of these different phases, what is coordinating this effort? 2. As a system gets more complex it tends to break down easier. Does this make it easier to detect what part of the system is broken then (i.e. where a lesion might be at)? 3. So can we use break downs in this system as early warning sings of nerve degeneration?

1. All the CN nuclei that we discussed (CN V, VII, IX, X, and XII) 2. Yes! If a certain part of this pathway breaks down we can nail it down to a specific CN nuclei. 3. you betcha......

*Deglutition Networks* 1. What is involved with the oral preparatory phase? 2. What is involved with the oral transport phase? 3. What is involved with the pharyngeal phase? 4. What is involved with the esophagel phase?

1. All the chewing and movement of the tongue 2. Moving food from anterior oral cavity back to oral pharynx 3. "now we are back in the pharynx and starting to move more inferior" 4. Food moves down the esophagus.

1. What is the benefits of the vestibule-ocular reflex? 2. How is this different than the optokinetic reflex?

1. Allows for the movement of the eyes to compensate for movement of the head. (input from vestibular apparatus) 2. The optokinetic reflex is used to cause nystagmus during movement of visual stimuli (NOT head, i.e. scenery in train window) - You're eyes will follow the tree and then snap back to follow the next target

*Sound Deconstruction in the Cochlea* 1. The structure of the cochlea and basilar membrane allows for what of complex sounds? What does this do for the analysis of sound? 2. What if damage occurs at a specific spot in the basilar membrane? 3. How is the actual transduction of sound into action potentials accomplished?

1. Allows the *separation* of complex sounds into vibrations at different points along the basilar membrane. This *establishes a spatial basis for the analysis of a sound by its component frequencies*. 2. We wont be able to hear the frequencies along those portions of the basilar membrane. 3. Through the hair cells of the organ of Corti.

Innervation of gingiva around upper teeth. 1. What innervates gingiva of upper anterior gingiva? (2) 2. What innervates the middle part of upper gingiva?

1. Ant. Sup alveolar n. & Infraorbital 2. Infraorbital & Middle Sup alveolar n 3. Post. Sup alveolar n

*External Ear* 3 sets of nodes around your ear... 1. Which set just anterior to your ear? 2. Which set just posterior to your ear? 3. Which set just under your ear? 4. To which nodes do all of these drain?

1. Anterior Auricular (Parotid) 2. Posterior Auricular (Mastoid) 3. Superficial Parotid 4. Deep cervical nodes

*Sensory Innervation of the Nasal Cavity:* 1. Which branch emerges onto the anterior nose? 2. This is from what CN? 3. What is this branch called?

1. Anterior Ethmoid 2. branch of CN V 1. 3. *External Nasal Branch* This is why we get the weird sensation pattern for V1 look at pic

What are the branches (5) of the pterygoid portion of the maxillary a.?

1. Anterior deep temporal a. 2. Posterior deep temporal a. 3. Pterygoid branches 4. Masseteric a. 5. Buccal a.

Lymph drainage: include Bilateral, contralateral, ipsilateral Anterior 2/3rds: 1. Which lymph nodes drain the anterior middle (not tip) tongue? 2. lateral anterior tongue? 3. Anterior tip? 2. Posterior tongue?

1. Anterior middle: *Contralateral* to Inferior deep cervical 2. anterior lateral: Ipsilateral submandibular 3. anteiror tip: bilaterally to submental LN 2. POSTERIOR: drains to *superior Deep cervical LNs* (bilateral)

1. What are the 4 *regions* of the Hypothalamus?

1. Anterior to Posterior: i: Preoptic Region ii: Anterior Region iii: Middle Region iv: Poserior Region

1. Which branch of the maxillary artery (mandibular portion) will enter the *petrotympanic fissure* with chorda tympani (CN VII)? 2. What artery does this run parallel to? 3. What does it supply? (2)

1. Anterior tympanic a. 2. parallel to the deep aruicular a. 3. Supplies blood to: *mucous membrane of the tympanic cavity* *internal surface of tympanic membrane*

1. What does the pterygoid plexus of veins communicate with anteriorly? via what? 2. & inferiorly? via what?

1. Anteriorly ---> *facial v.* via *inferior ophthalmic v.* 2. Inferiorly ---> *facial v.* via the *Deep facial v.*

Globe: *Eye Chambers* - *Anterior segment* 1. We mentioned that the cornea is fed by tears trapping O2... what feeds the anterior segment? 2. Where is Q1 made? 3. Direction of flow of Q1? 4. What does Q1 supply?

1. Aqueous humor 2. Made by ET of ciliary procecesses (in posterior chamber) 3. Flows anteriorly → absorbed by iridiocorneal junction → scleral venus sinus. 4. Provides ions/nutrients to avascular cornea & lens.

1. The masseteric n. will commonly arise in common with what other branch of the anterior division of V3? 2. The masseteric n. travels with masseteric vessels through which notch? 3. ... to get to what surface of the masseter m?

1. Arises in common with the posterior deep temporal n. 2. pass through the *mandibular notch* 3. ...to gain the *deep surface* of the masseter.

1. Does the medial longitudnal fasciculus have ascending or descending axons? 2. Neurons in this fasciculus arise from what nucleus? 3. Ascending fibers travel ipsilateral, contralateral or bilaterally?

1. Both 2. medial vestibular nucleus 3. Ipsilateral

1. What innervates the *Levator palpebrae superioris*? 2. What does it attach to? 3. What happens if you have a CN III or sympathetic lesion?

1. GSE via CN III 2. Superior Tarsal Plate & Muscle 3. Ptosis (Andy Eye Lid via loss of levator palpebrae superioris)

*Vestibular Peripheral Transduction:* 1. As in the auditory system, the hair cells in the semicircular canals, utricle and saccule are exposed [perilymph or endolymph?] (high Na+, Low K+) and [perilymph or endolymph?] (High K+, low Na+) across the cell. 2. The electrical potential between the endolymph and perilymph contributes to the WHAT functions of the vestibular apparatus.

1. As in the auditory system, the hair cells in the semicircular canals, utricle and saccule are exposed perilymph (high Na+, Low K+) and endolymph (High K+, low Na+) across the cell. 2. The electrical potential between the endolymph and perilymph contributes to the *transduction* functions of the vestibular apparatus.

Atrophic Glossitis 1. How will the tongue appear? (3) 2. What causes it?

1. Atrophied, red, smooth 2. Vitamin deficiency (like B9 B12)

*Example of an antidiarrheal:* diphenoxylate and atropine (Lomotil) Diphenoxylate - weak opioid receptor agonist (schedule V narcotic); inhibits excessive GI motility with added Atropine. 1. Why is Atropine added

1. Atropine- added to discourage abuse

1. Where is the capsule of the temporomandibular joint attached? 2. Where is the capsule loose and where is it tight?

1. Attached to the margins of the mandibular fossa above and to the neck of the mandible below. 2. Capsule is LOOSE b/w the mandibular fossa and the disk, but TIGHT b/w the disk and the condyle of the mandible.

What are the branches off of the posterior division of V3? (3)

1. Auriculotemporal n. 2. Lingual n. 3. Infeiror alveolar n.

1. What in the blazes is a *Centrifugal Fiber*? 2. Function of *Centrifugal Fiber*?

1. Axons that enter the bulb *from the Olfactory Cortex* (& other higher brain centers) 2. Synapse on Granule Cells & modulate their activity

*Case #4:* 1. He is prescribed an agent that will decrease both the force and rate of cardiac contraction. Which class of agents is described? A. Alpha-1 receptor selective agonist B. Beta-1 receptor selective antagonist C. Beta-2 receptor selective agonist D. Muscarinic ACh receptor agonist E. Nicotinic ACh receptor agonist 2. Which receptor in the heart is primarily responsible for force and rate of contraction?

1. B. Beta-1 receptor selective antagonist 2. Beta-1

*Case #5:* 1. A 29 y/o male presents to the emergency department unconscious with nonreactive, pinpoint-sized pupils, massive oral foaming, and muscle fasciculations. His pants are wet with urine and feces. Information provided by his wife reveals that he has a history of depression and attempted suicide 3 years ago. He is not taking any current medications. What receptor family is most likely involved in his presenting symptoms? A. Adrenergic B. Cholinergic C. GABA D. Glutamate E.Opioid

1. B. Cholinergic

1. Where in the mouth would you look to see a clue if a person has bulimia? 2. What will be wrong with #1?

1. Back of teeth. 2. Erosion of enamle

Recall: 1. What are the 3 layers to olfactory ET? 2. On which of these 3 layers do odorants bind?

1. Basal (stem) Cells, Sustentacular (support) Cells, Olfactory Neurons 2. dendrites of (*Olfactory Neurons*)

*Summary of Transduction in the Cochela* 1. Sound waves in cochlear fluid causes what to vibrate? 2. What then rubs against the stereocilia of the hair cells? Does it depolarize them? What type of transduction is this (chemical, mechanical, etc)?

1. Basilar membrane 2. The tectorial membrane rubs against the stereocilia, depolarizes them through mechanical transduction ion channels.

*TEST QUESTION 2* A 43 year-old woman with polycystic kidney disease who presents to ED with worst headache of life. 1. What should you be most worried about? 2. What test do you order?

1. Berry aneurysms: 5-10% of people who have polycystic kidney disease will have a berry aneurysm. worried about aneurysm rupture 2. NON CONTRAST head CT very limited indications for contrast in head CT (do give contrast for looking at vessels)

1. When talking about the heart epinephrine binds on what receptor on the heart for sympathetics? 2. ACh binds on what receptor in the heart for parasympathetics? 3. what does #1 and #2 cause?

1. Beta 1 2. M2 3. sympathetics cause increased HR parasympathetics cause decreased HR

1. epinephrine also binds to what receptor at the presynaptic terminal? 2. What does #1 cause? 3. Norepinephrine binds to what receptor at the presynaptic terminal? 4. what does it cause? 5. is #3 on sypmathetics or parasympathetics?

1. Beta 2 receptors 2. increased in norepinephrine release which goes to bind to beta 1 on the heart as well. check out pic 3. Alpha 2. 4. it puts the break on the release of NT so there is not so much that it is causing unwanted things. negative feedback loop 5. BOTH parasympathetics and sympathetics. again check out pic.

*Rules of Thumb for Smooth Muscle and Autonomic Receptors:* In the following list match the activity to either the Alpha 1 (α1) receptors, Beta2 (β2) receptors. 1. Relax Smooth Muscle - Vasodilation 2. Stimulate contraction of all smooth muscle 3. Vascular smooth muscle - vasoconstriction

1. Beta2 (β2) receptors 2. Alpha1 (α1) receptors 3. Alpha1 (α1) receptors

1. Where are the palatine tonsils located? 2. What cavity are they in?

1. Between the palatoglossal arch and the palatophyrngeal arch 2. In the oral cavity

1. Where will the lateral lower lip drain? 2. Where do middle lower lip drain?

1. Bilateral submandibular lymph nodes 2. Ipsilateral submental lymph nodes

1. WHAT DA EFF is cocaine and how it work? 2. Is it used therapeutically?

1. Blocks norepinephrine channel and is a local anesthetic (check out sic pic) 2. Not used therapeutically as much anymore

1. The majority of the brain is isolated from components of *systemic circulation* by what? 2. Exception to Q1 where? 3. Function of Q2?

1. Blood:Brain Barrier (BBB) 2. *Circumventricular Organ (CVO)* 3. modified BBB to allow assessment of systemic conditions (nutrition status, blood osmolality, hormone levels)

What would you see if you had a complete knockout of CN III? Cause?

1. Blown pupil and disrupted EOM. 2. Trauma, Autoimmune, intracranial bleed

*Middle Ear*: Pharyngotympanic tube 1. What are the 2 parts to the tube? 2. What runs along next to the tube?

1. Bony part: Posterolateral 1/3rd Cartilaginous part: Anteromedial 2/3rds 2. Tensor Tympani

There are 3-4 major cell groups in the pons & medulla controlling *Respiration* 1. Which group is important for rhythmic respiration? 2. Which nucleus is part of our Ventral Respiratory Group? 3. Which nucleus is part of our Dorsal Respiratory Group? 4. What sort of info is processed by Q2 & Q3?

1. Botzinger-PreBotzinger Complex (superior ventral group) [breathing you don't have to think about - ie when sleeping] 2. Nucleus Ambiguus (GSE & GVE) 3. Nucleus of Solitary Tract 4. *NST*: Blood Gas info, How inflated are our lungs, Diaphrgam & intercostal position *NA*: Efferent to affect motor response to NST info (to diaphragm, larynx, etc)

*The Nervous System:* 1. What 2 things make up the Central Nervous System? 2. What 3 systems make up the peripheral nervous system? 3. What are the 2 divisions of the Autonomic nervous system.

1. Brain and Spinal Cord. 2. *Peripheral Nervous System*: Autonomic Nervous System Somatic Nervous System Enteric Nervous System 3. Parasympathetic Division Sympathetic Division

1. Brainstem nuclei are named to how many categories? 2. How is that different from the nerves? 3. Where are our branchial nuclei going to be in the brainstem?

1. Brainstem nuclei are named to 1 category 2. Nerves can have 3-4; easier to name the nucleus than the nerve 3. These are where the exception to the Bell-Magendie organization take place; they are going to migrate ventral and lateral, but still on the more medial portion of the sulcus limitans line (see photo)

*Sensory* Innervation: Trigeminal Nerve 1. General Sensation Nerves on the face from which nerves?

1. Branches of Ophthalmic N.

*Sensory Innervation of the Nasal Cavity:* 1. Branches of what cranial nerve does the sensory of the Nasal Cavity? 2. What are the 2 divisions of #1 that provides sensory to the nasal cavity?

1. Branches of Trigeminal nerve (CN V) 2. Ophthalmic division (V1) and the Maxillary Division (V2)

*CC* 1. What is an orbital *blow out fracture*? 2. What can result? 3. Symptoms that present if this happens?

1. Break of the maxillary bone 2. Fat & Fascia can leak into the sinus 3. Diplopia, Infraorbital Nerve Paresthesia, Enophthalmos, Edema, Ecchymosis, limited gaze due to entrapment

Innervation of gingiva of lower jaw 1. What innervates the back parts of gingiva? 2. Whaat innervates the front parts of gingiva? 3. What innervates the floor of the mouth?

1. Buccal branch 2. Mental branch of Inf. Alveolar 3. Lingual n. (form V3)

What are the branches of V3 from the Anterior Division? (4)

1. Buccal n. 2. Nerve to the lateral pterygoid (direct branches no more cards made about this one) 3. Deep temporal nn. (anterior and posterior) 4. Masseteric n.

1. Which agent may be used in this patient to differentiate between a diagnosis of pheochromocytoma and false-positive increases in plasma catecholamines and fractionated metanephrines? (i.e., which agent will reduce catecholamine release in a patient without pheochromocytoma but will produce little-to-no physiological effects in a patient with a pheochromocytoma?) A. Beta-1 selective agonist B. Beta-2 selective antagonist C. Centrally-acting alpha-2 receptor agonist D. mAChR antagonist E. Monoamine oxidase inhibitor 2. Again, what's going on in pheo? 3. How are catecholamines like NE normally released? 4. How can you block sympathetic nerve stimulation?

1. C. Centrally-acting alpha-2 receptor agonist - So if you give clonidine (answer C) and nothing happens, the catecholamines must be coming from a pheochromocytoma Beta-1 agonist would make it worse by increasing heart rate Beta-2 antagonist would make HTN worse by blocking vasodilation mAChR antagonist would cause problems by increasing sympathetic tone even further MAO inhibitor would also make it worse by preventing breakdown of catecholamines (intracellular after reuptake) 2. Release of NE and epi from a neuroendocrine tumor 3. In response to sympathetic nerve stimulation 4. C. Centrally-acting alpha-2 receptor agonist

1. A 35 yo chronic alcoholic, after consuming up to 2 quarts of vodka a day for several weeks, runs out of money and alcohol and presents to the ED in acute alcohol withdrawal. He is extremely agitated, trembling violently, and an hour after arriving at the ED, experiences the first of several grand mal seizures. Phenytoin, a Na+ channel blocker, is given as a loading dose to control his seizures. A drug acting at which of the following receptors is indicated as additional treatment in this EtOH-withdrawal case? A. α2 adrenergic B. D2 dopaminergic C. GABAA GABAergic D. 5-HT3 serotoninergic E. M1 muscarinic cholinergic 2. Whats going on with this patient? 3. Whats going on with his neurons? 4. #3 is due to what? 5. So a drug acting at which type of receptor could counter-balance this?

1. C. GABAa GABAergic (all other options are excitatory, this is inhibitory, apparently, I didn't know that) 2. What's going on with this patient? Obviously we know he's having a seizure. 3. What's going on with his neurons? *Hyperactive or overexcited* 4. due to what NT? Glutamate. 5. So a drug acting at which type of receptor could counter-balance this hyperstimulation? GABAa GABAergic you will want to inhibit the hyperactive or overexcited neurons

*Superior cervical ganglion:* 1. Represents the *fused* cervical ganglia of what spinal levels? 2.Located on the anterior surface of WHAT muscle? 3. Provides only [pre or post?] -ganglionic sympathetic fibers to the head; therefore, there are no [pre or post?] -ganglionic sympathetic fibers in the head.

1. C1 - C4 2. longus capitis muscle 3. Provides *only* post-ganglionic sympathetic fibers to the head; *therefore, there are no pre-ganglionic sympathetic fibers in the head.*

(probs wont be tested by her...) 1. What type of info in CN II? 2. What type of info in CN III? 3. What type of info in CN IV? 4. What type of info in CN V1? 5. What type of info in CN VI? 6. What type of info in CN VII?

1. CN II - SSA 2. CN III - GSE; GVE-P 3. CN IV - GSE 4. CN V1 - GSA 5. CN VI - GSE 6. CN VII - SVE to orbicularis oculi

1. What does the *Optic canal (or foramen)* transmit (2)? 2. What does the *Superior orbital fissure* transmit (6)?

1. CN II; ophthalmic a. 2. CN's III, IV, V1, VI, sup. ophth. v. (also, this picture kind of looks like a duck smoking a cigar)

*SUMMARY:* -Parasympathetic Innervation of the Head 1. the Ciliary body & sphincter pupillae m. receive parasympathetic innervation via what CN? 2. #1 is via WHAT Ganglion? 3. #1 is via what Carrier Nerve?

1. CN III 2. Ciliary ganglion 3. Short Ciliary NN.

*Metathalamus* 1. What's it look like/where is it? 2. 2 parts? 3. When have we talked about these before?

1. Finger- like structure on posterior thalamus, part of which extends around the crus cerebri. 2. i: Lateral Geniculate Body ii: Medial Geniculate Body 3. Auditory & visual systems (?)

*Superior Olivary Complex - Coding by Volume Differences* 1. As opposed to spacial summation, what else can the olivary nucleus compare? Which specific part of it? 2. What type of frequency sounds is this most effective for? 3. What frequency do the hair cells tap out at? So what mechanism does this provide to us for high frequency sounds?

1. Compares sound intensity from each ear, specifically the lateral part of it. 2. High frequency signals (since the head may shield one ear). 3. 3000 Hz (or 3 kHz); this then provides a mechanism for localization of higher frequency sounds.

*S, M, L Cones* 1. How do we detect different color information? 2. When a wavelength of light is closer to the preferred wavelength of light we will have a [more/less] active neuron. 3. What does the retina do two cones are stimulated by a photon?

1. Comparison information from 2 of our 3 possible cones 2. A less active neuron. Tonic signaling will go down or be shut off. 3. Compares the output of the two adjacent cones to determine exactly what that wavelength looks like. For example, would compare an M cone to and L cone.

1. What is the interarticular disk of the TMJ joint composed of? 2. What does the disk divide the joint into what?

1. Composed of *DENSE FIBROUS CONNECTIVE TISSUE.* 2. Interarticular disk divides articular space into *TWO joint cavities*.

1. Which photoreceptor will be most active in a photopic environment? 2. Which photoreceptors will be most active in a scotopic environment? 3. Do rods have a direct line to the ganglion cells to send their information? 4. How do the nerve impulses change when someone is in a mesopic (moonlight) setting?

1. Cones 2. Rods 3. Nope, they have to patch in via an amacrine cell first to then talk to a retinal ganglion cell. 4. There is additional activity with the different cell types. when you get more light the rods will communicate through amacrine cells AS WELL AS the horizontal integration via the horizontal cells which allows them access to the bipolar cells (which usually only communicate with the cones).

*Rules of Thumb for Smooth Muscle and Autonomic Receptors:* 1. Muscarinic receptors contract [smooth or skeletal?] muscle? Does it use the same or different intracellular signal than α1 receptors. 2. There an apparent discrepancy when ACh and muscarinic agonists given IV cause vasodilation. WHY dis happen?

1. Contract smooth muscle (different intracellular signal than α1 receptors) 2. Apparent discrepancy - ACh & muscarinic agonists given IV cause vasodilation *due to release of nitric oxide (NO)*

*Effects of mAChR stimulation on smooth muscle:* 1. What will it do to the Sphincter muscle of the iris? 2. What will it do to the cilliary muscle? 3. What will it do to bronchial muscle? 4. What will it do to Bronchial glands? 5. What will it do to GI motility?

1. Contraction (Miosis) 2. Contraction for near vision 3. Contraction (bronchoconstriction) 4. Stimulation 5. increased

What is the parasympathetic action and ACh receptor(s) on the following lung muscles/glands 1. Tracheal and bronchial smooth muscle 2. Bronchial glands

1. Contraction, via M2=M3 2. stimulation via M3, M2

*Rotational Vestibulo-Ocular Reflex:* 1 .Using the horizontal (rotational) vestibulo-ocular reflex as an example, rotation of the head produces activation of the hair cells in one horizontal canal and deactivation of the [contralateral or ipsilateral?] side. 2. Accordingly, through connections with WHAT formation, the [ipsilateral or contralateral?] oculomotor nucleus will be activated to contract the WHAT muscle and the [ipsilateral or contralateral?] WHAT muscle will be activated to move the eyes in the opposite direction.

1. Contralateral 2. the paramedian pontine reticular formation (PPRF), the ipsilateral will be activated, Medial rectus Contralateral, Lateral Rectus all together now- Accordingly, through connections with the paramedian pontine reticular formation (PPRF), the ipsilateral oculomotor nucleus will be activated to contract the medial rectus muscle and the contralateral lateral rectus muscle will be activated to move the eyes in the opposite direction.

1. Do we have a convex or concave lens in our eye? 2. With this orientation, what happens to an image of Rob playing baseball?

1. Convex 2. He gets flipped

*Facial Nerve* 1. What reflex pathway is CN VII involved in? 2. What portion of the reflex is it involved in? 3. Where does the sensory information travel in this reflex pathway?

1. Corneal blink reflex 2. The motor portion of the reflex pathway 3. V1 of trigeminal takes care of the sensation to the cornea

What are the primary amygdala nuclear groups (2)?

1. Corticomedial group (aka centromedial group)- has primary connections with the olfactory bulb and is part of the lateral olfactory area. 2. basolateral group has no direct input from olfactory area, but connects with the corticomedial group, entorhinal area, septal area and cortical and subcortical regions.

MS is a *Autoimmune Demyelinating* disease of the CNS. 1. What tract is most often affected? 2. Is there another tract/pathway that is commonly affected? What is it called?

1. Corticospinal tracts are most often affected causing the UMN symptoms. 2. Yes. Eye pathways = painful vision loss, Optic neuritis

*Deglutition Networks* 1. Successful feeding also requires effective what (2)? 2. What is included in #1 (the second answer)?

1. Coughing and intact upper airway reflexes. 2. Upper airway reflexes: -gagging -vomiting -chewing

1. In which direction is your R eye rolling during *extorsion*? 2. In which direction is your R eye rolling during *intorsion*?

1. Counter-clockwise 2. clockwise

*Vestibulo-Ocular Network:* 1. The basic anatomy of this system involves connections of the vestibular nuclei with the oculomotor nuclei of WHAT cranial nerves? 2. #1 is through the WHAT fasciculus. 3. Efferent axons from the vestibular nuclei, under the influence of WHAT apparatus, produce eye movements that balance the perceived movements of the WHAT. 3. These eye movements are basically combinations of what three directions?

1. Cranial nerves III, IV and VI, 2. medial longitudinal fasciculus. 3. the peripheral vestibular apparatus, The head 3. horizontal, vertical, and torsional.

*Autonomic Innervation of the Head:* -General Considerations 1. Parasympathetic innervation of the visceral structures of the head is accomplished by WHAT portion of the cranio-sacral subdivision of the ANS? 2. #1 involves what 3 CN?

1. Cranial portion (I really don't know what he means) 2. CN III, VII, and IX

Lesser palatine canal - Lesser palatine a + n

Name of landmark? What travels through?

1. A 2 y/o female presents to the ED after an accidental overdose of antihistamines. Her temperature is 102.5° F and pupils are fixed and dilated. Heart rate is 160 bpm (normal 120 bpm). She shows signs of delirium and is noted to have marked cutaneous vasodilation upon physical exam. Stimulation of which receptor will most likely correct her symptoms? A. Alpha-1 receptor B. Beta-1 receptor C. Beta-2 receptor D. Muscarinic acetylcholine receptor (mAChR) E. Nicotinic acetylcholine receptor (nAChR)

1. D. Muscarinic acetylcholine receptor (mAChR)

*Case #3:* 1. A 32 y/o female presents with intermittent attacks of headache, perspiration, palpitations, and anxiety. During these attacks, she reports having feelings of impending doom and tremors. She notes that the attacks often occur after exercise or drinking coffee. Laboratory values are unremarkable. A plasma fractionated free metanephrine test is positive and a 24-hour urine specimen supports a diagnosis of: A. chronic hypertension B. hyperthyroidism C. Parkinson disease D. pheochromocytoma E. psychosis 2. What is metanephrine?

1. D. pheochromocytoma 2. This is a breakdown product of epinephrine and norepinephrine. so it means there is alot of epi in her blood.

1. Ethanol is a CNS [stimulant or depressant? 2. So it up regulates the [inhibitory or excitatory?] part of the brain and down regulates the [inhibitory or excitatory?] 3. So what happens when you take away the ethanol?

1. DEPRESSANT 2. Up regulates the inhibitory part of the brain and down regulates the excitatory part o the brain 3. you get rebound phenomenon that can results in seizures. So basically your body tries to overcome the inhibition by making more excitation so it can function but when the inhibition is gone you got way to much excitation and you can't function brucey

*Auditory Neural Damage* 1. What is sensorinueral hearing loss a result of? 2. Would someone with sensorineural hearing loss be able to hear vibrations through bone?

1. Damage to the neural apparatus and/or peripheral and central pathways of hearing. 2. Nope, its lost and gone forever.

*Auditory System Peripheral Damage* 1. What is conductive hearing loss? 2. What is sensorineural hearing loss/central deafness? 3. Conductive hearing loss may arise from what? 4. What do a lot of old people suffer from (that is technically conductive hearing loss)?

1. Damage to the transduction system 2. Damage to the neural component of the auditory system. 3. Damage to the tympanic membrane or any of the bones of the middle ear and/or obstruction of the external meatus. 4. Osteosclerosis of the ossicles. This is where the stapes will fuse with the oval window which dampens conduction.

What is the Sympathetic action and Adrenergic receptor(s) on the following Stomach muscles and secretion 1. Motility and tone 2. Sphincters 3. Secretion

1. Decrease (usually), Alpha 1, Alpha 2, Beta 1, Beta 2 2. Contraction (usually), Alpha 1 3. Inhibition, Alpha 2

*Horner's Syndrome:* 1. What is Horner's Syndrome? 2. How is it caused? 3. What are 3 of the symptoms?

1. Decreased sympathetic innervation due to interruption of sympathetic pathway from spinal cord to superior cervical sympathetic ganglion (SCSG) 2. contusion to side of head. someone comes and hits you with a pipe to the side of the head. *pancoast tumor!* coming up from the lung. You can have any spinal tumor as well. 3. Ptosis, Miosis, Anhydrosis

What are the branches (5) from the mandibular portion of the Maxillary a.?

1. Deep auricular a. 2. Anterior tympanic a. 3. Middle meningeal a. 4. Accessory meningeal a. 5. Inferior alveolar a.

*Basic Cerebellar circuitry:* 1. The purkinje cell synapses on what? is it excitatory or inhibatory? 2. The Granule cell synapses on what? is it excitatory or inhibatory?

1. Deep cerebellar nuclear cell- *inhibitory* 2. Synapses -on the Purkinjecell (excitatory)

Ventral part of tongue: 1. What artery and vein do you find on inferior tongue? 2. What nerve do you find on inferior surface of tongue? 3. What is the midline fold that attaches to inferior tongue? 4. What are the openings for the submandibular duct called?

1. Deep lingual artery and vein 2. Lingual nerve 3. Frenulum (holds anterior part of tongue but allows for motion of tongue) 4. Sublingual caruncle

*Superior cervical ganglion:* -internal carotid nerve 1. The Deep petrosal nerve joins which nerve? 2. these 2 nerves from #1 form what nerve? 3. The sympathetic portion of #2 then passes thru what ganglion? 4. Does it synapse on #3? 5. It then distributes via branches of what CN? 6. It innervates the mucosal glands of what 4 things?

1. Deep petrosal nerve which, with the greater petrosal nerve 2. forms the nerve of the pterygoid canal (Vidian). 3. The sympathetic portion of the nerve, after passing through the pterygopalatine ganglion 4. *'without synapsing,* 5. distributes via branches of *V2* 6. to the mucosa! glands of the nasal cavities, oral cavity, palate and upper pharynx.

Innervation of the bottom teeth 1. What innervates the back five teeth? 2. What innervates the front 3 teeth

1. Dental branches of inf. alveolar 2. Incisive branch of Inf. Alveolar

1. What region of the brain is the Thalamus a part of? 2. What are the 4 adult divisions of Q1? 3. Which of Q2 is the only division that is grossly visible externally ?

1. Diencephalon 2. i: Dorsal thalamus (thalamus) ii: Hypothalamus (covered elsewhere) iii: Epithalamus iv: Subthalamus 3. Hypothalamus (ventral view)

1. What types of cells encode the duration of a light stimulus? 2. Why is there a need to determine the length of a light pulse? 3. What about a short term determination of light pulses?

1. Different types of bipolar cells! 2. Within our retina we can detect the duration of the light we have (i.e. thinking of seasons). SAD, hibernation, undergoing seasonal changes in plants, etc. all respond to the duration of light that we experience in the world. 3. Helps to determine the movement of objects through space/3D environment.

1. Some olfactory tract axons go to what other structure (other than cortex)? 2. Q1 is an important component in *what system* & plays a major role in *what response*? 3. Electrical stim. of Q1 causes what?

1. Direct to *Amygdala* 2. *Limbic System* in *Fear Response* 3. Feelings of fear *&* Autonomic reactions of fear (better at detecting predators b/c you can pick up scent trail before they're close enough to hear or see)

1. CN III (Oculomotor Nerve) carries what type of info? 2. Superior division innervates what muscles? 3. Inferior division innervates what muscles?

1. GSE & GVE-P 2. Superior rectus & Levator Palpebrae Superioris (LPS) 3. Medial rectus, Inferior rectus, & Inferior oblique

1. A 32 y/o female presents with intermittent attacks of headache, perspiration, palpitations, and anxiety. During these attacks, she reports having feelings of impending doom and tremors. She notes that the attacks often occur after exercise or drinking coffee. Laboratory values are unremarkable. A plasma fractionated free metanephrine test is positive and a 24-hour urine specimen supports a diagnosis of pheochromocytoma. If a beta-receptor selective antagonist (propranolol) is administered, which of the following is most likely to occur? A. Bronchial smooth muscle constriction B. Diarrhea C. Increase in heart rate D. Uncontrollable urination E. Worsening of hypertension 2. Does the beta-receptor selective antagonist (propranolol) more selective at beta 1 or beta 2 or alpha 1 or alpha 2 receptors?

1. E. Worsening of hypertension (possible death) - Answer is not C because Beta 1 is the predominant receptor in the heart and so this would not cause an increased heart rate or contractility. - you would have worsening hypertension because you would take out the vasodilation part of the vasculature and the epi and norepi would cause more vasoconstriction in the vessels. 2. Beta 1 AND Beta 2 receptors. just not selective for alphas.

*Vestibular Output - The Vestibulospinal Network:* 1. The lateral vestibulospinal tract is [extensor or flexor?] muscle biased meaning WHAT?

1. EXTENSOR muscles biased. has most of its influence on extensor muscle motor neurons.

*Autonomic Innervation of the Head:* -General Consideration 1. Each of the three aforementioned cranial nerves which innervate structures of the head is associated with one or more parasympathetic ganglia, which, unlike the rest of the body, [are or are not?] housed in the wall of the organ to be innervated?

1. Each of the three aforementioned cranial nerves which innervate structures of the head is associated with one or more parasympathetic ganglia, which, unlike the rest of the body, are *NOT* housed in the wall of the organ to be innervated.

PW for Parasympathetics of Orbit/Eye (intraocular) 1. Preganglionic cell bodies where? 2. Preganglionic cell fibers travel with what nerve? 3. Postganglionic cell bodies where? 4. Postganglionic cell fibers distribute via which nerve?

1. Edinger-Westphal nucleus in brainstem 2. CN III 3. Ciliary ganglion 4. Short ciliary branches of V1

*CC* 1. What is *Coloboma*? 2. What causes *Coloboma*?

1. Elongation of the Pupill 2. Failure of choroid fissure to close

1. What is the outer part of the teeth called? 2. Where is the dentine? 3. What 3 regions can the tooth be split into? 4. What part sits in the alveolar socket? 5. where does the gingiva attach?

1. Enamel 2. Just inferior to enamel 3. Crown, neck, root 4. root 5. neck

*External Ear* 1. What is the *Umbo*? 2. What happens to the tympanic membrane when you get an infection in your middle ear?

1. End of the malleus pushes on the tympanic membrane 2. Swelling will caused the tympanic membrane to protrude out

*Vestibular Peripheral Structure:* 1. Where is the Endolymph fluid? 2. Where is the Perilymph fluid?

1. Endolymph is the fluid contained in the membranous labyrinth of the inner ear. 2. Perilymph the fluid between the membranous labyrinth of the ear and the bone that encloses it.

1. What is Syringomyelia? 2. What is the first key structure affected in Syringomyelia? what would this cause? 3. Most common location and result?

1. Enlargement of Central Canal of Spinal Cord (via cyst, cavity, etc.) genetic or acquired most often whiplash, tumor and meningitis. 2. Anterior White Commissure affected first = loss of Bilateral pain and temp in the region of the damage and 1-3 SC levels above 3. Lower cervical/upper thoracic region = *cape-like distribution* loss of pain and temp

*Superior cervical ganglion:* 1. The external carotid nerve forms a plexus on what artery and its branches? 2. The external carotid nerve delivers postganglionic sympathetic innervation to what 5 things?

1. External carotid nerve forms a plexus on the external carotid artery and its branches 2. thereby delivering postganglionic sympathetic innervation to blood vessels, salivary, oral and labial glands and the carotid body.

1. What type of ET covers lips externally? 2. Internally?

1. Externally: covered by thin skin (stratified squamous epithelium) 2. Internally: covered by mucus membrane

*Frequency Coding in the Cochlea* 1. T or F: the frequency of action potentials generated in afferents to hair cells is used directly for frequency discrimination. 2. What is the primary mechanism for coding frequency in the cochela? 3. What is tonotopic organization?

1. FALSE! It is NOT used for frequency discrimination. 2. *The position of hair cells int he cochlear spiral and which spiral ganglion cell it is innervating!* (This is the place theory) 3. The place theory is the basis for this organization, the particular spiral ganglion cells represent different frequencies and respond better to particular frequencies (i.e. where the nerve's threshold is lowest)

*Answer if this is intentional or a reflex and if it works of the ipsilateral or contralateral side* 1. Frontal eye fields 2. Parietal eye fields

1. FEF *Intentional* saccades [Area 8] - *contralateral* 2. PEF: *Reflexive* saccades [angular/supramarginal gyrus] - *contralateral*

*Mix and Match* 1. Muscles of facial expression 2. Anterior belly of diagastric 3. Pharynx 4. Stylopharyngeus 5. Trapezius

1. Facial Motor Nucleus (caudal pons?) 2. Motor Nucleus of V (mid-pons) 3. Nucleus Ambiguus (rostral medulla) 4. Nucleus Ambiguus (rostral medulla) 5. Spinal Accessory Nucleus (upper cervical)

* Perfusion of the Nasal Cavity:* What are the 3 primary sources of blood to the nasal cavity?

1. Facial artery 2. Ophthalmic artery 3. Maxillary artery

*Electrical Potentials between Compartments* 1. T or F: Disruption of the perilymph is more likely than to have a disruption with the endolymph. 2. What can happen if there is a disruption of the ion composition balance on either side of the hair cells?

1. False. The perilymph is continuous with CSF where endolymph is not (small detail that he mentioned). 2. can produce auditory and vestibular disturbances.

*Orbital Septum* 1. Type of tissue? 2. Connects what to what?

1. Fibrous membrane 2. Connecting tarsal plate to inferior & superior brim of orbit periosteum

*Case #4:* 1. From above case what is the diagnosis?

1. Heart failure "There is a lot of information here. Basically I wanted to expose you to a complicated case of heart failure."

1. *Orbital Frontal Cortex* response to glucose ingestion when your *hungry*? 2. *Orbital Frontal Cortex* response to glucose ingestion when your *getting full*? 3. *1° Gustatory Cortex* response to glucose ingestion when your *hungry*? 4. *1° Gustatory Cortex* response to glucose ingestion when your *getting full*?

1. Firing rate is high (make you want to eat more) 2. Lower & lower firing rate (start to avoid it) 3. Firing rate is high 4. Firing rate remains high (does not change) (please see the image for more details that are too hard for me to put into question format)

*Nasal Air Flow:* 1. How is the air in the olfactory region exhaled? 2. When expiration what do the turbinates do to it?

1. Flow in Olfactory region is like a Cul-de-sac. Stale air pushed out by next influx 2. Shape of turbinates doesn't disrupt flow very much. Channels air toward nares in mostly laminar flow

*Openings of Pterygopalatine Fossa* Posterior Openings: 1. What is the superior-lateral opening? 2. What is the middle opening? 3. What is the inferior-medial opening?

1. Foramen rotundum 2. Pterygoid canal 3. Pharyngeal canal

*Middle Ear*: Auditory Ossicles 1. What tissue(s) form(s) the footplate of the stapes? 2. These bones form a mobile osseous chain connecting _____ to ______. 3. Ear ossicles are {first or last} bones to ossify during development? 4. They are connected by?

1. Formed by *neural crest & paraxial mesoderm* 2. tympanic membrane to oval window 3. First! 4. Connected by synovial joints

1. The ethmoidal bulla forms the superior margin of what? 2. check out the ethmoidal infundibulum which is a small triangular shape.

1. Forms superior margin of Hiatus Semilunaris (check out pic) 2. seriously check it out

1. Where are the sublingual glands? what are they covered with? 2. Where do their ducts open?

1. Found on *anterior portion of the Floor* of the oral cavity. and are *covered w/ oral mucosa* which form *sublingual fold.* 2. OPEN into oral cavity via several small ducts on sublingual fold (not named ducts).

*Vestibular Peripheral Structure:* 1. What is the endolymphatic sac and duct? 2. What is the utriculosaccular duct? 3. What is the ductus reuniens?

1. From the posterior wall of the saccule a canal, the endolymphatic duct, is given off; this duct is joined by the utriculosaccular duct, and then passes along the vestibular aqueduct and ends in a blind pouch, the endolymphatic sac, on the posterior surface of the petrous portion of the temporal bone, where it is in contact with the dura mater. Studies suggest that the endolymphatic duct and endolymphatic sac perform both absorptive and secretory, as well as phagocytic and immunodefensive, functions. 2. part of the membranous labyrinth of the inner ear which connects the two parts of the vestibule, the utricle and the saccule. The utriculosaccular duct continues to the endolymphatic duct and ends in the endolymphatic sac. 3. ductus reuniens. the joining channel between the cochlea and sacculus of the membranous labyrinth of the inner ear

What are the 5 processes of the Maxilla bone?

1. Frontal 2. Orbital 3. Zygomatic 4. Alveolar (sockets for upper teeth) 5. Palatine (forms anterior 2/3 of hard palate)

*Paranasal Sinuses*: 1. What are the 4 paired paranasal sinuses? 2. Which one is the largest?

1. Frontal Sinuses Ethmoid sinuses (Ethmoid Air Cells) Maxillary sinus Sphenoid sinus 2. Maxillary sinus NOTE: This image gives the impression that ethmoid sinus surrounds the orbit. IT DOES NOT! it lies medial to the orbit

What are the 4 processes of the zygomatic bone?

1. Frontal process 2. Maxillary process 3. Temporal process (aids in formation of zygomatic arch) 4. Orbital surface

1. What are the functions of the teeth? 2. How many teeth are there (permanent & deciduous)?

1. Function: MASTICATION & ARTICULATION (speaking) 2. *32 permanent teeth* (4 incisors, 2 canine, 4 premolars, 6 molars) *16 deciduous* ("baby" teeth)

1. Which papila gives the tongue the majority of it's color? 2. Where are the taste buds of the circumvallate papilla? 3. What are filiform papilla for? 4. Which papilla is not developed very well in humans?

1. Fungiform (ET covered vascular tissue) 2. In the depressions 3. Sensation ("feel"iform) 4. foliate

1. What neurotransmitter do basal ganglia structures release?

1. GABA (inhibitory)

*GABA:* 1. GABA is the [primary or secondary?] [excitatory or inhibitory?] Neurotransmitter? 2. Is it localized throughout the PNS or CNS 3. it is the principal Neurotransmitter in what neurons? 4. it is found in Neurons at what 3 locations?

1. GABA: The Primary Inhibitory NT 2. CNS 3. Interneurons 4. Neurons in *striatum, globus pallidus, and Purkinje cells of cerebellum*

1. Which nerve enters the oral cavity posterior from the pharyngeal region and passes b/w the superior & middle pharyngeal constrictor m.? What gap is that? 2. What fibers does this nerve provide? 3. what more does it run with?

1. GLOSSOPHARYNGEAL n. (CN IX) > This n. will pierce the tongue posteriorly. > Gap 2 2. GVA (post. 1/3 of tongue) > SVA (post. 1/3 of tongue) 3. Styloglossus

*CN V in Deglutition* 1. What type of fiber information is CN V carrying in this pathway? 2. What are the three nuclei that are being utilized in this pathway and what fiber types do they have (from #1)?

1. GSA and SVE 2. GSA: Mesencephalic Nuc of V Main sensory Nuc of V (via semilunar ganglion) SVE: Motor Nuc of V

*Autonomic Innervation of the Head:* -Eye *Ciliary Ganglion* 1. The sensory root has what fibers of what CN from what in it??

1. GSA's of V1 from intraocular structures

*Hypoglossal nerve* 1. What functional fibers does it provide? 2. What muscles does it innervate?

1. GSE 2. All Intrinsic tongue muscles - All Extrinsic tongue muscles (*except palatoglossus m*)

*CN XII in Deglutition* 1. What fiber types does CN XII in reference to deglutition? 2. What are some muscles that CN XII innervates that are important for deglutition?

1. GSE 2. Check out the photo (everything with glossus in its name except for one thing)

1. CN VI (Abducens Nerve) carries what type of info? 2. Innervates what muscle?

1. GSE 2. Lateral Rectus

1. CN IV (Trochlear Nerve) carries what type of info? 2. Innervates what muscle?

1. GSE 2. Superior Oblique

*Autonomic Innervation of the Head:* -Eye *Ciliary Ganglion* 1. The Sympathetic root has what fibers? 2. These are [pre or post?] ganglionic [sympathetic or parasympathetic?] fibers from what ganglion via what plexus? 3. They enter the orbit on the surface with WHAT artery or they travel with WHAT nerve? 4. This passes through what ganglion [with or without?] synapsing? 5. This course withing what nerves to they eye? 6. Innervates what muscle and what blood vessels 7. Other sympathetic fibers follow unsubscribed routes to reach the smooth muscle fibers that compose the deep portion of what eyelid muscle?

1. GVE 2. *Postganglionic sympathetic fibers* from the *superior cervical ganglion* via the *internal carotid plexus* 3. ophthalmic artery or oculomotor nerve 4. *Ciliary Ganglion*, *without* synapsing 5. *Short Ciliary nn.* 6. *dilator pupilae muscle* and bulbar blood vessels 7. Levator Palpebrae superioris

1. The mandibular branch of the trigeminal n. (V3) contains GVE-P fibers from which nerves? What is the function of these fibers?

1. GVE-P from *CN IX* will innervate the *Parotid gland.* 2. GVE-P from *CN VII* will innervate the *submandibular, sublingual & lingual salivary glands.*

*Middle Ear*: Innervation Pathway 1. The Tympanic N begins as what N? 2. After *LPN* enters the middle cranial fossa, where does it exit again? 3. *What fibers* of LPN synapse & *on what*? 4. Postsynaptic fibers pass *to what* via *what* 5. What implications can Q4 have if you have inflammation of the inner ear?

1. Glossopharyngeal n (CN IX) 2. Foramen Ovale 3. *Parasympathetic* on *Otic Ganglion* 4. To *parotid gland* via *CN V3* 5. Can reduce innervation of the parotid gland

*Glutamate:* 1. Glutamate is the [primary or secondary?] [excitatory or inhibitory?] Neurotransmitter? 2. Where is it localized in the CNS? 3. Glutamate accounts for most [slow or fast?] synaptic transmission in the CNS and spinal cord

1. Glutamate: The Primary Excitatory NT 2. Localized throughout the CNS, its everywhere bruh 3. Glutamate accounts for most *fast* synaptic transmission in the CNS and spinal cord almost or more then 50% brah

1. RIP (OPN) is tonically releasing what molecule? 2. And #1 is released onto what?

1. Glycine 2. PPRF

*Pseudobulbar palsy vs. Bulbar palsy* You have a patient that presents with dysarthria and dysphagia: 1. What are the first things you want to check? 2. What will #1 help you identify?

1. Go through cranial nerve tests! (jaw jerk reflex, corneal blink reflex) 2. These will help you ID whether it is an UMN issue or LMN issue.

*Types of cells in Cerebellum:* 1. Golgi II cells are found in what layer? 2. They have input from what cells? 3. Golgi II cells inhibit what cells? 4. is #3 positive or negative feedback?

1. Granular layer 2. input from parallel fibers 3. inhibit granule cells 4. negative feedback

1. What artery feeds into the greater and lesser palatine artery to perfuse the palate? 2. What does it branch off of? 3. Where does venous drainage go to?

1. Greater (descending) palatine artery 2. Maxillary artery 3. to the pterygoid plexus of veins

*Perfusion of the Nasal Cavity: lateral* 1. What artery perfuses primarily the floor of the nasal cavity? 2. This is a branch off which artery? 3. Which is a branch off what artery?

1. Greater Palatine artery 2. Descending Palatine artery 3. Maxillary artery

1. What two arteries supply the palate? 2. Which specifically supplies the hard palate? 3. Which specifically supplies the soft palate?

1. Greater and lesser palatine arteries 2. Greater palatine artery 3. Lesser palatine artery

1. What innervates most of the palate? 2. What innervates the very front of palate?

1. Greater palatine n. 2. Nasopalatine n.

*Pterygopalatine Ganglion Autonomics* 1. Which nerve brings the parasympathetic information to the pterygopalatine ganglion? 2. Which nerve brings the sympathetic information to the pterygopalatine ganglion? 3. Which one will have cell bodies located in the pterygopalatine ganglion?

1. Greater petrosal n 2. Deep petrosal n 3. The greater petrosal n, because sympathetics dont have cell postganglionic cell bodies located in the head (thank you Dr. Buck)

1. What are the two nerves the come together to form the nerve to pterygoid canal? 2. What was important about the nerve to pterygoid canal and the pterygopalatine ganglion?

1. Greater petrosal nerve and deep petrosal nerve 2. It brings autonomic info to the pterygopalatine ganglion.

*Tastant Receptors* - Sour 1. What ion comes in through channel? 2. Effect this has on cell? 3. Might activate what? 4. What is released?

1. H+ 2. Depolarization 3. Might activate V-gated Na+ channels 4. NTs: *Serotonin & ATP*

1. How do you test for the integrity of each eye muscle? 2. How do you test for *Lateral rectus* 3. How do you test for *Medial rectus*

1. H-test 2. have pt *ab*duct their eye 3. have pt *ad*duct their eye

*Motion and the Static Labyrith:* 1. Because of their high density relative to the endolymph, the otoconia can also be moved by [high or low?] intensity, [high or low?] frequency sound. This can also stimulate the maculae and produce what 2 symptoms?

1. HIGH intensity, LOW frequency sound, can cause Nausea and dizziness

*Inner Ear* 1. What is found within the membranous part of the cochlea? 2. What are these for? 3. Where do the nerves from the vestibular canal portion meet up?

1. Hair cells 2. Transfer sound information to cochlear part of Vestibulocochlear N 3. Vestibular ganglion

1. What is mechanoelectrical transduction? 2. The movement of the basilar membrane and shearing action of the tectorial membrane provide the mechanical displacement of what structure?

1. Hair cells form a mechanical-to- electric transduction mechanism whereby movement of the stereocilia will produce either depolarization or hyper- polarization of the cell membrane ion channels. 2. Stereocilia

1. Coxsackie B is commony called what diseas? 2. What symptoms will you have related to mouth?

1. Hand foot mouth disease 2. Bad sore throat Ulcers like appearances

*Central Vestibular Pathways- Cerebellum:* 1. connections b/w the cerebellum and vestibular body thru the juxtarestiform body are involved in the control and coordination of WHAT 2 things, movements and posture. 2. The cerebellum is a primary influence over WHAT tract?

1. Head and eye 2. the vestibulospinal tracts (see cerebellum lecture later).

1. Horizontal cells are [depolarized/hyperpolarized] by light and accentuate [contrast/colors]. 2. T or F: Bipolar cells either hyperpolarize or depolarize to light 3. If there is an ON bipolar cell attached to a specific Retinal ganglion cell (RGC), what type of RGC cell would it be? 4. Do we see the world in absolutes in terms of lights and colors?

1. Hyperpolarize; contrast; this helps us put our visual information together. 2. True: Bipolar cells either hyperpolarize or depolarize to light 3. an ON RGC 4. NO!! Our vision is based off of contrasts; we dont see a specific color code, we will relate it to specific colors that are around it. This allows us to cut down on the overall machinery we would need to tell us what color we are looking at; we can use what we see to compare to other things around it.

Course of the Hypoglossal nerve. 1. exits which foramen? 2. Goes to posterior pharynx (medial or lateral) to vagus n? 3. It dives lateral and inferiorly to which branch off ext. carotid? 4. It dives into submandibular region by passing on which side of the *posterior digastric belly*?

1. Hypoglossal canal 2. *Lateral* to vagus n 3. *occipital* 4. Posterior 5. Mylohyoid

1. An ophthalmologic phenomenon caused by disruption of MLF is referred to as what? 2. What is happening in this pt? 3. what Causes this? 4. Is the adductor palsy on the ipsilateral contralateral to the MLF lesion? 5. Is convergence intact?

1. INO (Internuclear Ophthalmoplegia) 2. CN VI can no longer communicate w/ CN III to coordinate lateral eye movement. (Adductor Palsy in the eye *Ipsilateral* to MLF lesion) Isolated (non-coordinated) eye movement will be preserved. Can put an eye patch on the good eye and it will allow the bad eye to work normally. 3. MS (demyelination) or stroke 4. Ipsilateral. Adductor palsy ipsilateral to MLF lesion 5. Convergence is intact

*SUMMARY:* -Parasympathetic Innervation of the Head 1. The Parotid Gland receive parasympathetic innervation via what CN? 2. #1 is via WHAT Ganglion? 3. #1 is via what Carrier Nerve?

1. IX (Tympanic Branch & Lesser Petrosal) 2. Otic 3. Auriculotemporal n. (V3)

Globe: *Lens* 1. Where is the lens found? 2. What is it enclosed within? 3. Two main functions of lens?

1. In *Anterior segment* (anterior to vitreous body & posterior to iris) 2. w/in transparent & elastic capsule. 3. Refraction (focusing light) & Accommodation

*Bony and Membranous Labyrinths:* 1. In both receptor systems the information is converted to action potentials by WHAT cell receptors.

1. In both systems this information is converted to action potentials by hair cell receptors.

*Gag Reflex* 1. In by [IX/X] out by [IX/X] 2. Where will these afferent fibers of #1 be synapsing?

1. In by IX and out by X. 2. In the nucleus of the solitary tract

*Cough Reflex* 1. In by [IX/X] out by [IX/X] 2. Afferents of what nerve will bring in the sensory information and will synapse onto what nucleus?

1. In by X and out by X 2. Afferent sensory from CN X will come in and synapse on nucleus ambiguus.

*Deep cerebellar nuclei* 1. How are they organized? 2. lateral cortex goes to [medial or lateral?] deep cerebellar nuclei? 3. What is the name of the most lateral deep cerebellar nuclei?

1. In columns, from a medial to lateral standpoint, 2. lateral cortex goes to lateral deep cerebellar nuclei, and medial cortex goes to medial deep cerebellar nuclei 3. *Dentate* nucleus (feast yer eyes at the pic)

1. From the question before why is Bronchial smooth muscle constriction incorrect? 2. What causes frank bronchoconstriction of bronchioles?

1. In pheo, you have extremely high levels of NE and epi. What are the effects of NE and epi on bronchioles? NE not much effect on beta2 receptors; but epi will cause relaxtion/bronchodilation Yes, beta blocker may prevent this, but probably won't get bronchoconstriction unless there is pathology such as asthma or COPD 2. Stimulation of muscarinic receptors (M2 = M3)

*Lacrimal Apparatus:* 1. Where are tears produced? 2. Where do they go when you blink? 3. What do they collect in? 4. Then they are carried down to WHAT meatus of the nasal cavity by WHAT duct? 5. why does your nose run when you cry? 6. What theoretically prevents the reflux of tears back up #4?

1. In the *Lacrimal Gland* 2. Swept across eyes medially when you blink 3. collect in *lacrimal sac* 4. carried to inferior meatus of nasal cavity by *Lacrimal duct* 5. b/c of #4 6. Multiple valves (he says they aren't all that they are cracked up to be and will talk more about them later)

1. When are the receptors cells in the eye tonically releasing neurotransmitter? 2. What happens when light hits the photoreceptor? What type of synapses are they using?

1. In the absence of light 2. It will hyperpolarize and will stop sending the tonic signal (i.e. stop sending neurotransmitter) via ribbon synpases.

*Primary Divisions of the Vestibular System:* The primary parts of the vestibular system consist of: 1. The peripheral receptor apparatus which is where? 2. The central vestibular nuclei which is where? 3. 3 functional networks, What are they? Each of these divisions and collections of nuclei plays a vital role in vestibular function

1. In the inner ear 2. in the Brainstem 3. - The Vestibulo-ocular network (eye movements) - the vestibulospinal network (vestibular info into motor) - the Vestibulo-thalamo-cortical network (how you perceive vestibular info)

1. With regard to *Blood Supply*, whereabouts is the hypothalamus sitting? 2. Which part of Q1 is the only bit to NOT contribute to hypothalamic perfusion?

1. In the middle of the *circle of willis* (killin it with the perfusion) 2. All *CoW* contributes except *Middle Cerebral Arteries* (interestingly: many of these branches *ascend* to perfuse more dorsal regions of the hypothalamus)

1. What is the Bell-Magendie Law? 2. What is the sulcus limitans?

1. In the spinal cord, most of the posterior (dorsal) aspects are sites of the sensory information entering the spinal cord where the anterior (ventral) portions are responsible for more motor activity. 2. This is the "boarder" between the ventral and dorsal portions of the spinal cord; acts as a divider between them.

1. Where are the cell bodies for the sensory nerve fibers of the trigeminal tract? 2. Where is the proprioceptive cell body for the fibers of the trigeminal tract located? 3. When eliciting a reflex response, and the information has gone through the sensory and then up to the proprioceptive center, where does it synapse after that to complete the arch?

1. In the trigeminal ganglion (or the semilunar ganglion, same thing) 2. In the mesenchephalic nucleus 3. Down on the motor nucleus of CN V in order to excite the muscles

What is the Sympathetic action and adrenergic receptor on the following Heart 1. Sinoatrial node 2. Atria 3. Atrioventricular node 4. His-Purkinje system 5. Ventricle 6. what adrenergic receptors are used for all of these above?

1. Increased Heart rate, via Β1 > β2 2. increased contractility and conduction velocity via Β1 > β2 3. increased automaticity and conduction velocity via Β1 > β2 4. increased automaticity and conduction velocity via Β1 > β2 5. increased contractility, conduction velocity, automaticity, and rate of idioventricular pacemakers via Β1 > β2 6. Β1 > β2

What is the Parasympathetic action and ACh receptor(s) on the following Stomach muscles and secretion 1. Motility and tone 2. Sphincters 3. Secretion

1. Increased, M2=M3 2. Relaxation (usually) M3, M2 3. Stimulation, M3, M2

Quick side note: She mentioned later in the lecture that she forget to mention the following... 1. Joint b/w incus & malleus? 2. Joint b.w incus & stapes? 3. What holds them in place?

1. Incudo-malleolar Joint 2. Incudo-stapedal Joint 3. Ligament on each of the bones (around which is the axis of movement)

Innervation 1. Where in the brainstem does the vestibulocochlear nerve insert (she says synapse)?

1. Inferior Cerebellar Peduncle

1. What branch from the posterior division of V3 will travel with the lingual n. (b/w the lateral and medial pterygoid mm.)? 2. What does this nerve innervate? 3. What branches off of this immediately before it enters the mandibular foramen? 4. What nerve does the inf. alveolar terminate as?

1. Inferior alveolar n. 2innervation to the mandibular teeth 3. this will provide the MYLOHYOID n. before it enters the mandibular foramen. 4. terminates as the MENTAL n. (the n. will exit via the mental foramen)

*Lacrimal Duct:* 1. The lacrimal duct drains where?

1. Inferior meatus

1. Which branch of the maxillary a. (pterygopalatine portion) will course anterior & superior through the inferior orbital fissure? 2. What does it supply?

1. Infraorbital a. -- This enters the infraorbital groove and canal with the infraorbital branch of V2. 2. Terminates as it exits the infraorbital foramen by providing branches to the *lower eye lid (lateral surface of the nose & upper lip)*

What are the 4 foramina associated with the maxilla bone?

1. Infraorbital foramen 2. Incisive canal (fossa or foramina) 3. Posterior superior alveolar foramen 4. Provides anterior border of pterygo/sphenomaxillary fissure

*Lateral Boundary & Foramen* 1. The lateral boundary of the PPF is open to what fossa? 2. What fissure allows the PPF to be open to #1? 3. What does #2 transmit (think of foramen practical last test)?

1. Infratemproal fossa 2. Pterygomaxillary fissure (we called it the sphenomaxillary fissure, same thing) 3. 3rd portion of the maxillary artery and the posterior superior alveolar n.

*Basic Cerebellar circuitry:* Which is an excitatory neurotransmitter which is an inhibitory? 1. GABA 2. Glutamate

1. Inhibitory 2. Excitatory

*Vestibular Peripheral Structure:* From the list below tell me if it is part of the outer bony labyrinth or the inner membranous labyrinth? 1. utricle & saccule 2. semicircular ducts 3. Cochlea (auditory app.) 4. cochlear duct 5. endolymphatic sac and duct 6. utriculosaccular duct 7. semicircular canals & ampullae 8. ductus reuniens 9. vestibule & oval window

1. Inner Membranous labyrinth 2. Inner Membranous labyrinth 3. Outer bony labyrinth 4. Inner Membranous labyrinth 5. Inner Membranous labyrinth 6. Inner Membranous labyrinth 7. Outer Bony Labyrinth 8. Inner Membranous labyrinth 9. Outer Bony Labyrinth

*Neural processing in the Cochlea* 4. How much of the afferent innervation is going to the inner hair cells? 5. What are they responsible for (based on #1)?

1. Inner hair cells receive 95% of the afferent innervation from the spiral ganglion 2. Responsible for frequency discrimination

*Trunk and limb postural adjustments:* 1. input through what peduncle as what fibers? 2. From what tracts, which is why it is called spinocerebellum? 3. Input to what 2 regions of the cerebellum?

1. Input through inferior peduncle as mossy fibers 2. From spinocerebellar tracts (hence "spinocerebellum") 3. Input to *vermis, paravermal region*

*Vestibular:* 1. Input through which peduncle as what fibers? 2. These can be axons direct from what ganglia? or after first synapse in what nuclei? 3. What lobe are they going towards which gives them the vestibulocerebellum name?

1. Input through inferior peduncle as mossy fibers 2. These can be axons direct from *Scarpa's ganglia* (vestibular ganglion) or after first synapse in *vestibular nuclei* 3. To *flocculonodular lobe* (hence "vestibulocerebellum")

*Cortical input, "processed" and coordinated info:* 1. input is thru which peduncle as what fibers? 2. Thru what tract? (which is where it gets its name cerebrocerebellum) 3. Affects what 2 things? 4. Is #2 contralateral or ipislateral from cortex to cerebellum?

1. Input through middle peduncle as mossy fibers 2. Cerebro-ponto-cerebellar (hence "cerebrocerebellum") 3. Affects planning and programming of voluntary movements, motor learning (extremely important) 4. contralateral decussates at the middle peduncle

Occulomotor movements use the basal ganglia direct and indirect pathways. 1. What gets switched out with this pathway? 2. #1 inhibits or excites? and targets what structure?

1. Instead of globus pallidus internal it goes to *substantia nigra pars reticulata* 2. Inhibits VA/VL Thalamus

Hypothalamic Functions *Circadian Rhythm* 1. What are the 2 factors influence your sleep wake cycle? 2. What happens if you remove the 2nd influence in Q1? 3. What happens with blind people (with regard to cycle)?

1. Internal Clock *+* External Cues (ie light) = 24 hrs 2. Run off internal clock only = 26 hr cycle (sleep/wake cycle drifts) 3. *Non-24*: Circadian Drift (no light cues)

*Thalamocortical Projections* 1. The thalamus projects to & receives connections from cerebral cortex & sub cortical structures through what structure? 2. These PWs are called what?

1. Internal capsule 2. Thalamic Peduncles (not really something we need to worry about I think)

*Superior cervical ganglion:* 1. Postganglionic fibers that exit this ganglion goes into 2 nerves initially. What are they?

1. Internal carotid nerve and external carotid nerve

Mandibular foramen - Inferior alveolar a.v.n.

Name of landmark? What travels through?

*Paranasal Sinuses development*: 1. How do they form and why do they form? 2. Why must we have them then? 3. Most development occurs when? 4. The exception of #2 is to which sinus?

1. It is largely unknown. haha sorry not sorry. 2. (no olfactory epithelium, no air flow, now they think it is just to make the skull lighter, but anatomist don't really agree. SO best answer is that we have them b/c our ancestors had them.) sorry not sorry again suckah! 3. Postnatally 4. Ethmoid Air Cells, these form early on

1. Nerve to tensor tympani penetrates which cartilage in order to reach the tensor tympani muscle? 2. Nerve to Tensor Veli Palatini enters the muscle near it's origin or insertion?

1. It must penetrate the *cartilage of the auditory tube*. 2. *Origin*

*Paranasal Sinuses development*: 1. What is the Ethmoid bulla? 2. Where is it? 3. The ethmoid air cell growth is proportionate to what? 4. Does the maxillary sinus have the same proportionate growth like #3?

1. Just another air cell, but important landmark in adults 2. component of the middle meatus 3. proportionate to the face growth 4. Maxillary sinus expands disproportionately

*Transduction by Hair Cells:* 1. The response of hair cells to deflection depends upon the orientation of the deflection relative to the WHAT?

1. Kinocilium - (A kinocilium is a special type of cilium on the apex of hair cells located in the sensory epithelium of the vertebrate inner ear)

*Extraocular Eye Muscles* 1. Which muscles need to fire in order to look *straight up*? 2. Which muscles need to fire to look *up to the Right*? 3. Which muscles need to fire to look *up to the Left*?

1. L&R Inferior Oblique & Superior Rectus 2. R Inferior Oblique & L Superior Rectus 3. L Inferior Oblique & R Superior Rectus

1. What provides the blood supply to the tongue? 2. What are the specific branches to this artery? (3) - What do they supply

1. LINGUAL a. (branch of ECA) 2. *Dorsal lingual a.* to the posterior tongue, palatine tonsil, epiglottis and soft palate -*Sublingual a.* to floor of the mouth -*Deep lingual a.* to anterior tongue -- two sides of deep lingual will anastomose near apex

1. What nerve will wrap around the submandibular duct? 2. Which way is the lingual nerve coursing?

1. LINGUAL n. 2. More medially than anteriorly

1. What are the musculofascial skin folds found at the proximal-most part of GI tract? 2. What is between the two lips?

1. LIPS 2. Oral fissure

*Vestibular Peripheral Structure:* Blood Supply: 1. What artery divides into cochlear and vestibular branches? 2. #1 branches from what artery?

1. Labyrinthine artery 2. From basilar or AICA

Recap: the pathway of a tear (8)

1. Lacrimal *gland* (in lacrimal fossa) → 2. Lacrimal *ducts* → 3. Superior palpebral conjunctiva → 4. Lacrimal *punctum* (on lacrimal papilla) → 5. Lacrimal *canaliculi* → 6. Lacrimal *sac* → 7. Nasolacrimal duct → 8. Inferior nasal meatus

Eyelid: *Lacrimal Apparatus* 1. *Lacrimal gland*: located where? 2. Ducts empty where? 3. Tears drain where?

1. Lacrimal fossa of frontal bone 2. Into superior palpebral conjunctiva (& tears are distributed over globe by lids) 3. drain inferomedially into *lacrimal punctum* (opening) on lacrimal papilla.

*Turbulent air flow:* Match the following with laminar air flow or turbulent air flow; 1. Doesn't get cleaned 2. More gets humidified 3. Doesn't get warmed 4. More gets warmed 5. Doesn't get humidified 6. More gets cleaned

1. Laminar flow 2. Turbulent Air Flow 3. Laminar flow 4. Turbulent Air Flow 5. Laminar flow 6. Turbulent Air Flow I know this is a dumb card I'm sorry, but what's done is done

1. Recall: in which part of the thalamus do our optic nerves/tracts synapse? - It turns out, different types of Retinal ganglion cells project to different parts of Q1, for example: 2. What do Rods detect? 3. On what part of Q1 do Rods synapse? 4. What do Cones detect? 5. On what part of Q1 do Cones synapse?

1. Lateral Geniculate Nucleus (*LGN*) 2. Basic Form & Motion 3. Magnocellular (M ganglion) layers (1 & 2) 4. Color & Fine detail 5. Parvocellular (P ganglion) layers (3 - 6)

*Sympathetic innervation to the Parotid gland* 1. Where do presynaptic sympathetic cell bodies live? 2. preganglionic fibers ascend via what? 3. Where are the postganglionic cell bodies? 4. Where do they travel after synapsation?

1. Lateral horn T1-T4 2. Sympathetic chain 3. Superior cervical ganglion (SCG) 4. External carotid artery in *external carotid plexus* in order to reach sublingual, submadibular and parotid glands

1. What is the lateral boundary of the PPF? 2. Superior boarder? 3. Anterior?

1. Lateral: pterygomaxillary fissue (sphenomaxillary is also ok) 2. Superior: greater wing of sphenoid 3. Anterior: maxilla

1. What provides GSA fibers to both the palatoglossal and palatopharyngeal muscles? 2. What provides the GVA fibers to both of these muscles?

1. Lesser palatine nerve from the lesser palatine foramen 2. Glossopharyngeal nerve (specifically the tonsilar branch)

Which muscles of facial expression are responsible for elevating the upper lip (5)?

1. Levator labii superioris m. 2. Levator anguli oris = elevates upper lip & widens mouth 3. zygomaticus major (main smile muscle) 4. zygomaticus minor (main smile muscle) 5. Risorius

1. Where are the submandibular glands found? 2. Which direction does the duct of this gland go? 3. Where does the duct open up?

1. Lie within the submandibular triangle AND oral cavity (deep to the mandible, has a part superficial to mylohyoid m.) 2. Submandibular duct will course *anteriorly* from deep part of gland (b/w mylohyoid & hypoglossus) to 3. opens in floor of the mouth on the sublingual caruncle.

*Optogenetics* 1. What are *Opsins*? 2. Where are these utilized in humans? 3. Some microbes are *light activated ion channels*, which we utilize in what treatment?

1. Light responsive proteins found in many diff organisms 2. Visual System 3. Optogenetics

*Superior Olivary Complex - Sound Localization by Signal Phase* 1. Will sounds that undergo spatial summation at the olivary nucleus be in the same phase as one another (for low frequencies)? 2. What does this mean for the olivary nucleus?

1. No, they will be slightly out of phase. 2. This will create a differential signal in the superior olive that one arrive before the other.

1. What are the 4 things that the retina is discriminate? 2. Does the retina do any of the deconstruction of the visual information? 3. The retina receptive fields have to balance between two specific elements, what are they?

1. Light vs. dark (racist) Color discrimination (very racist) Motion Duration (ex. how long we are seeing the light) 2. Yes! 3. Balance between *acuity* and *sensitivity ***(Understanding how the circuitry in the retina both allows us to see details while simultaneously able to detect very low levels of light are major themes in this presentation)

*Ocular Reflexes: Accommodation* 1. What is it? 2. Afferent through what n? 3. Efferent through what n?

1. Looking from a distant object to a near object & Ciliary muscles/sphincter pupillae contract & eye adducts 2. CN II 3. CN III

Brown Sequard Syndrome 1. What is it? 2. How is it caused? 3. Symptoms?

1. Lose half of the spinal cord (left or right) 2. Stab wound or gunshot 3. Contralateral loss of Pain and Temp. BELOW Ipsilateral loss of everything else BELOW (Incl. vibration, prop and motor)

*Sensorineural Hearing loss* 1. What does this typically result from (more specific than last card)? 2. What is it called when children can hear the sounds made by the world but cannot process the information? 3. When is Sensorineural Hearing Loss typically identified in people?

1. Loss or damage to hair cells in cochlea, lesion to the cochlear part of CN VIII, or lesion of CNS auditory structures. 2. Auditory processing disorders 3. In childhood.

General contents What is everything in the infratemporal fossa?

1. Lower portion of the temporalis muscle, pterygoid muscles 2. Masticatory (buccal) fat pad 3. 1st & 2nd portions of the maxillary artery and its branches, pterygoid plexus of veins 4. Mandibular division of the trigeminal nerve (V3) and its branches 5. Autonomics: chorda tympani (CN VII) & lesser petrosal n. (CN IX) parasympathetic fibers to salivary glands

*Anterior lobe syndrome:* 1. What is anterior lobe syndrome? 2. predominantly around what cerebellum region? 3. what part of the body is most strongly affected? 4. What are the symptoms? (what type of gate, 1 speech, and one other)

1. Malnutrition from chronic alcoholism (vitamin deficiency) 2. Predominantly around the *vermis* 3. Legs most strongly affected Broad, staggering gate, dysarthria(sounds like hiccup while saying word) AND *ataxia*

What are the foramen associated with the temporal bone?

1. Mastoid foramen: post. to groove for post. belly of digastrics. 2. Jugular fossa: point of non-union of temporal & occipital medial to styloid process 3. Mastoid canaliculus: tiny foramen/canal on the lateral wall of the jugular fossa. 4. Tympanic canaliculus: tiny foramen/canal opening onto ridge b/w the jugular foramen & carotid canal. 5. Carotid canal: ant.. to jugular fossa.

What are the 5 paired bones and 4 single bones that make up the nasal cavity?

1. Maxilla bones 2. Nasal bones 3. Lacrimal bones 4. Palatine bones 5. Inferior concha bones 6. Vomer bone 7. Sphenoid bone 8. Ethmoid bone 9. Frontal bone YOU ARE responsible for knowing these. Refer back to earlier lecture for review if needed

*Anterior Boarder & Foramen* 1. What is the anterior boarder of the PPF? 2. What does #1 separate the PPF from? (what is on the other side of the #1) 3. What fissure is created in #1 so that the PPF can communicate with the orbit? 4. What are the contents of #3?

1. Maxillary bone 2. Maxillary sinus and the orbital floor 3. Inferior orbital fissure 4. Infraorbital a.v.n.; zygomatic a.v.n.; inferior opthalmic v.

*Electroencephalography (EEG)* 1. The measurement of what? 2. Electrodes (up to 20) are placed where? 3. What exactly is measured b/w electrodes?

1. Measurement of average electrical activity of certain parts of the brain relative to a neutral point, (mastoid process or auricle), or b/w 2 measuring electrodes (bipolar) 2. Standard locations on the scalp (International System of Electrode Placement) 3. *Electrical potential b/w electordes is measured through sensitive amplifiers*

On the other side is an intimidating table... He said that what he wants us to take away from this is: 1. Most nuclei are found in what shell? 2. What tract runs trough the entire *Lateral Shell of Thalamus*?

1. Medial Shell 2. *Medial Forebrain Bundle (MFB)*

*Central Vestibular Pathways - Spinal Cord and Reticular Formation:* 1. As part of the control of balance, the vestibular nuclei (mostly what 2 nuclei?) also receive afferent proprioceptive information from WHAT levels of the spinal cord, and processed information from WHAT formation. 2. This is information used as a WHAT type of feedback to those functions involved in WHAT connections.

1. Medial and lateral nuclei ALL levels of the spinal cord the reticular formation 2. Direct feedback to those functions involved in vestibulospinal connections

*Projections of Inferior Colliculus* 1. Where are the majority of the projections going? 2. Where are some other fibers going?

1. Medial geniculate nucleus of the thalamus via the inferior brachium. 2. Some commissural connections between the colliculu

1. The anterior division of V3 provides branches to all the muscles of mastication except which one? 2. Where trunk does the one that innervates #1 come from?

1. Medial pterygoid 2. undivided trunk of V3

*Accommodation:* 1. Convergence is the bilateral contraction of what muscle? 2. The thickening of the lens is accomplished by what muscles? 3. The pupillary constriction is accomplished by parasympathetics or sympathetics thru which muscle?

1. Medial rectus 2. Constriction of ciliary muscles 3. Parasympathetic stimulation of iris (sphincter pupillae m.)

1. What are the 3 *shells* of the Hypothalamus?

1. Medial to Lateral: i: *Periventricular Shell* ii: *Medial Shell* iii: *Lateral Shell*

Should be review.... Which vestibulospinal pathway is bilateral and only in the cervical region? Which vestibulospinal pathway is ipsilateral and runs full length of cord?

1. Medial vestibulospinal 2. Lateral vestibulospinal

Hypothalamic Functions *Water Balance* 1. Is there a reward with thirst PW? 2. In fact, do we like being thirsty? 3. What happens to SFO firing as you drink?

1. Nope 2. Nope, avoid it like pain 3. firing rate decreases (animal stops drinking when firing slows/stops) [review each part of the slide attached and ask Rob if you have any questions]

Mastoid canaliculus (inside jugular foramen laterally) - Auricular br (CN X)

Name of landmark? What travels through?

Tongue stuff 1. What are the folds that connect the epiglotis to the tongue? 2. What is the area between the folds in #1? 3. What separates the anterior (body) and posterior (root) tongue? 4. What structure found at the posterior part of terminal sulcus? 5. What separates the toungue into two halves? 6. Which side of the tongue is the ventral side?

1. Median and lateral glossoepiglottic folds 2. Epiglotic valleculae 3. Terminal sulcus (sight of oropharyngeal membrane during development) 4. Foramen cecum (Remnant of where thyroid developed and descended) 5. Midline groove 6. Inferior part

Hypothalamus *circadian entrainment* 1. What other kind of cells do we have in our retina besides Rods & Cones? 2. Where do these send information? 3. What tract does it follow to get there? 4. To which nucleus in Q2? 5. What is this system important for?

1. Melanaopsin 2. Hypothalamus (NOT thalamus/cortex) 3. Retinohypothalamic Tract 4. Suprachiasmatic Nucleus 5. Regulating day/night cycle

1. What is the "new" opsin that was found almost 20 years ago that is involved with unconscious light visualization? 2. What is its preferential color of light? (between what other two opsins that we have already talked about?) 3. What condition is this important in? Dont be too sad if you dont get it correct... 4. Where does this opsin sit? 5. What will the melanopsin communicate with?

1. Melanopsin 2. Between the Rods and S Cones 3. Seasonal Affective Disorder (SAD); shinning blue light on people will help them feel that they are getting more light then they are during the day and help them feel better. 4. This is found down with the RGC's, its a second layer of photoreceptors we didnt know we had. 5. The hypothalamus for the circadian rhythm!

*Thalamus-Nuclear Groups & Functions* - *Medial* 1. Degenerative changes of the medial group of nuclei are associated with what conditions? 2. These changes may also be more associated with the concurrent destruction of what? 3. Some divisions of the medial group near the lamina may also participate in what function?

1. Memory loss (e.g. Korsakoff's syndrome -EtOH & thymine deficiency) 2. Concurrent destruction of the *mammilothalamic tract* (and sometimes mammillary bodies) 3. Control of eye movements [dont worry about this one]

1. What are the branches of V3 from the *undivided trunk*? (2)

1. Meningeal branch (recurrent) 2. Nerve to the Medial pterygoid

*Pterygoid Canal* 1. What is its orientation out of the 3 openings in the posterior wall? 2. What does it allow the PPF to communicate with? 3. What does it transmit?

1. Middle 2. opens within foramen lacerum 3. nerve and artery of pterygoid canal

*Middle ear* is a hodgepodge of arches & pouches... 1. *1st pharyngeal pouch* goes on to form what part of middle earth (2)? 2. *1st pharyngeal arch* goes on to form what part of middle earth (3)? 3. *2nd pharyngeal arch* goes on to form what part of middle earth (2)?

1. Middle ear cavity & Auditory tube 2. Malleus, Incus, Tensor tympani 3. Stapes, Stapedius

*Modulatory Synapses:* 1. The NT systems in the brain that act primary through the matabotrobic receptors those G protein coupled receptors are WHAT in nature? 2. Would the modulatory synapse use GABA, Norepinephrine, or Glutamate? 3. a increase in norepinephrine will cause [more or less?] action potentials? 4. What are the 4 main modulatory NT? 5. What is there job as modulatory synapses acting in the brain?

1. Modulatory! 2. Norepinephrine 3. MORE check out dope pic 4. norepinephrine, acetylcholine, serotonin, and dopamine 5. modulating the way the neurons respond to other excitatory or inhibitory inputs.

*Types of cells in Cerebellum:* 1. What layer are the stellate cells found? 2. Stellate cells have input from what? 3. stellate cells inhibit what cells?

1. Molecular layer 2. input from parallel fibers 3. inhibit purkinje cells

*Organization of Primary Auditory Pathways* 1. What are the two types of parallel pathways? 2. What pathways is routed to the contralateral side, from one ear on one side? 3. What pathway is used to compare differences in sounds that reach both ears?

1. Monaural information and binaural information 2. Monaural pathway 3. Binaural pathway

*Neocerebellar syndrome:* 1. More common where? 2. What are the 5 symptoms? What is dysmetria again? 3. which one is the early warning sign of cerebellum damage?

1. More common in upper limbs 2. -Hypotonia -Ataxia -Dysmetria (Overshooting and undershooting targets) -Intention tremor -Dysdiadochokinesia (Rapid, alternating movements) -impaired 3. Hypotonia -note: rubarspinal reticulospinal system brain stem to spinal cord tone means cerebellum damage. it is early warning sine.

*Brainstem* 1. Where would special sensory nuclei be found in the brainstem (in terms of ventral/dorsal and medial/lateral placement)? 2. What type of special senses would this account for? 3. But, if you are given a histo slide and asked where a certain sensory innervation would go, would this help get us to the right place?

1. More often they are found more dorsally (posterior to the sulcus limitans) 2. Taste, smell, hearing (granted, they can target different nuclei in the brainstem so its not necessarily hard and fast). 3. More often than not yes. Let it guide you

*Pharyngeal Canal* 1. What is its orientation out of the 3 openings in the posterior wall? 2. What does it allow the PPF to communicate with? 3. What does it transmit?

1. Most medial/inferior 2. Opens on base of skull and communicates with nasopharynx 3. Transmits the pharyngeal a.v.n.

*Mix and Match* Ok, I want you to identify what nucleus each of these muscles is innervated by: 1. Muscles of mastication 2. Larynx 3. Stapedius 4. Sternocleidomastoid (SCM) 5. Tensor tympani

1. Motor Nucleus of V (mid-pons) 2. Nucleus Ambiguus (rostral medulla) 3. Facial Motor Nucleus (caudal pons?) 4. Spinal Accessory Nucleus (upper cervical) 5. Motor nucleus of V

*Mix and Match* 1. Mylohyoid 2. Upper esophagus 3. Tensor veli palatini

1. Motor Nucleus of V (mid-pons) 2. Nucleus Ambiguus (rostral medulla) 3. Motor Nucleus of V (mid-pons)

What are the 4 main functions (and associated circuits) of the Cerebellum?

1. Motor learning 2. Equilibrium and eye movements 3. Planning movements 4. Limb and postural adjustments

1. Does all light based visual information go to the occipital lobe? 2. If not, tell us 2 other locations light info might reach (+ what response these might have)?

1. Nope (this is just the conscious info, we have others...) 2. Hypothalamus (*circadian entrainment*) and Pretectal nuclei & Nucleus of Eddinger-Westphal: (*autonomic responses*: pupillary & accomodation)

*Mastication Networks* 1. With the CPG in the mastication network, what are the nuclei that are being coordinated? 2. Besides these motor nuclei, what other fibers are being coordinated at this center? 3. What if there is a lesion in the pontine reticular formation (what presentations would you see)? 4. Where are the "generator"/coordinator centers found in the brainstem?

1. Motor nucleus of V Motor nucleus of VII Hypoglossal nucleus 2. Proprioceptive information from the teeth (so you can modify your bite) 3. People biting their tongue or their cheeks a lot! 4. They are found in the reticular formation

*Turbulent air flow:* 1. Why is it bad to have Laminar flow of air in the nasal cavity? 2. Why is it good to have turbulent flow of air in the nasal cavity?

1. Much o the air stream avoids contact with the respiratory mucosa 2. Most of the air stream contacts the respiratory mucosa

*Nasal Cavity: Air Flow* 1. What takes up a lot of space in the nasal cavity, which lies on bones? 2. Inspired air flow is laminar until it hits the WHAT? then the air is redirected throughout the nasal cavity, so that the nasal cavity and perform its job on the air.

1. Mucosa 2. Concha (Turbinates)

*The Vestibulospinal Network:* 1. As with other central tracts controlling postural muscles, these axons may send collaterals to [multiple or one?] level(s) of the spinal cord. 2. This system is involved in reflex postural control through primarily [flexor or extensor?] musculature.

1. Multiple 2. extensor

1. What condition is caused by a virus and presents as parotitis, fever, Headache, muscle aches, tiredness, loss of appetite? 2. The above sounds like the flu... but why do we vaccinate for mumps? What are the complications that the mumps can cause?

1. Mumps 2. pancreatitis, meningitis, inflamed testicles

1. What is the diagnosis of the case #2 above? 2. What did the ice pack inhibit in the ice-pack test?

1. Myasthenia gravis 2. Ice pack inhibits activity of local acetylcholinesterase

1. Sympathetic innervation to dilator pupillae results in what? 2. Sympathetic innervation to superior tarsal muscle assists with what? 3. Loss of sympathetic tone results in what?

1. Mydriasis (pupillary dilation) 2. Elevation of upper eyelid 3. pupillary dilation; constricted pupil. Loss to superior tarsal = *ptosis* (eyelid droop).

What are the branches of the Inferior alveolar a. (other than dental)? Where does each branch

1. Mylohyoid a. ---> branches *immediately before the mandibular foramen*. travel in mylohyoid groove to *distribute in submental area.* 2. Mental a. ---> branches *while in the mandibular canal*, *exits the mental foramen* to distribute to the chin.

*Gaining Access to the Nasal Cavity:* 1. Branches of the facial artery enter through what? 2. Those of #1 headed for the lateral wall hug what cartilage? 3. Those of #1 headed for the septum hug what?

1. NARES 2. Alar Cartilage 3. Septum

*Sympathetics & Parasympathetics* 1. LC produced what NT? To go where? 2. VLM produced what NT? To go where? 3. NA is important for muscles in what region?

1. NE (to ascending reticular activating system) 2. NE (to Heart & Lungs) 3. Larynx

*Tastant Receptors* - Salt 1. What ion comes in through channel? 2. Effect this has on cell? 3. Might activate what? 4. What is released?

1. Na+ (duh) 2. Depolarization 3. Might activate V-gated Na+ channels 4. NTs: *Serotonin & ATP*

*Paranasal Sinuses development*: 1. Paranasal sinuses are outgrowths of what? 2. Each paranasal sinus has a WHAT that allows drainage? 3. They are lined with what type of epithelium?

1. Nasal Cavity 2. Ostium 3. Respiratory Epithelium

1. What are the 3 nerves that give innervation to the palate? 2. Which one gives innervation to the vast majority of the palate?

1. Nasopalatine nerve (via incisive canal) Greater palatine nerve (via greater palatine foramen) Lesser palatine nerve (via lesser palatine foramen) 2. Greater palatine nerve.

*Thalamic Nuclei* The thalamus also receives direct & indirect input from subcortical structures & supplies output to them... 1. What is the primary noncortical structure which receives significant thalamic projections? 2. Other areas include (3)?

1. Neostriatum 2. Amygdala, hippocampus & hypothalamus

*Electrical Potentials between Compartments* 1. The differing ionic composition between endolymph and perilymph supports a net [positive/negative] potential across the hair cell. 2. What is the resting membrane potential of the hair cells? 3. At these potentials, what happens tot he hair cell when K+ enters it? 4. T or F: endolymph/perilymph potential is a necessary part of the electrochemical driving force for depolarization of nerve terminals for transduction.

1. Net positive (+80 mV). 2. -70 mV 3. It will act to depolarize it. 4. True. He makes a big deal about this, specifically that potassium is used rather than sodium, and that exposing the cell to equal concentrations of potassium on either side of the membrane so there is no longer a potential for potassium to flow over the membrane. (if someone else can explain the importance with more gusto that would be fantastic).

1. Review: The Optic cup & Optic stalk form from {neural tube ectoderm OR surface ectoderm) 2. What other cells contribute to eye development? 3. Where does Q2 play a role (ie what tissue that we mentioned briefly before) + What does it form (2)?

1. Neural Tube Ectoderm 2. *Neural Crest Cells* 3. Influences *undifferentiated mesenchyme* to form *Choroid* (vascular) tunic & *Sclera* (white of eye)

*General Circuitry of the ANS:* 1. Sympathetics use what neurotransmitters? 2. Sympathetics have what 5 receptors? 3. Is norepinephrine or epinephrine used more?

1. Neurotransmitters: NE, Epi, (DA), and ACh 2. Receptors:(adrenergic) α, β, (D); nAChR, mAChR 3. Norepinephrine

*Swallowing* 1. In swallowing, does the esophagus contract all at once? 2. What specific nucleus helps the esophagus accomplish what is outlined in #1? 3. What specific part of the esophagus does #2 coordinate with?

1. No, its a parasaltic movement that is heavily coordinated 2. the nucleus ambiguus. 3. The striated muscle in the upper 1/2 of the esophagus

*Random Stuff from the slide that he didnt talk about* 1. Do people with schizophrenia have a gag reflex? 2. What other important action is CN IX also involved in? With what specific muscle?

1. No, often they do not have a gag reflex (no idea why) 2. Also involved in earlier swallowing, using stylopharyngeus

1. What is the Otolith organs? What 2 things make up the Otolith organ 2. What is the saccule? 3. What is the utricle? 4. Out of #2 and #3 which is larger?

1. Otolithic organs. While the semicircular canals respond to rotations, the otolithic organs sense linear accelerations. Humans have two otolithic organs on each side, one called the utricle (horizontal position- head tilt), the other called the saccule (forward and backward positions) 2. the smaller of the two fluid-filled sacs forming part of the labyrinth of the inner ear (the other being the utriculus). It contains a region of hair cells and otoliths that send signals to the brain concerning the orientation of the head. 3. the larger of the two fluid-filled cavities forming part of the labyrinth of the inner ear (the other being the sacculus). It contains hair cells and otoliths that send signals to the brain concerning the orientation of the head. 4. Utricle

Recall: 1. Mitral and tufted cells are the {input or output} cells of the bulb? 2. If they were left to their own devices, how would they act? 3. What controls this response?

1. Output cells of bulb 2. Fire all over the place telling cortex of every little odor all the time 3. Granule cells chill them out (filter for important stuff)

*Internal Ear*: Bony Labyrinth 1. 2 important landmarks in the bony part that has been brought up a butt ton of times this entire lecture? 2. What lies over them? 3. What if bone were over them?

1. Oval window & Round window 2. membrane 3. you wouldn't be able to transfer movement of fluid to the inner from middle (= no hear)

*Pterygopalatine Ganglion* 1. What type of autonomic cell bodies are located here? 2. Where does it get those autonomic fibers?

1. PPG contains the cell bodies of postganglionic parasympathetic neurons. 2. Receives it from nerve of pterygoid canal

What are the articulations (6) of the palatine bone?

1. Palatal shelves of the MAXILLA 2. Inferior nasal concha 3. Maxilla near Tuberosity 4. Lateral Pterygoid Plate opposite tuberosity of maxilla. 5. Medial Pterygoid Plate 6. Body of sphenoid near optic foramen

What is the soft palate made up of?

1. Palatine aponeurosis (from the tensor veli palatini muscle) 2. Uvula muscle 3. Palatoglossal arch 4. Palatophyrngeal arch

1. Taste bud found on what structures? 2. What are the massive Q1s on the back of the tongue? 3. How many Q2s? 4. Organization of Q2s?

1. Papillae (raised bits on tongue mucosa) 2. Circumvallate Papillae 3. 8-12 4. inverted V, just anterior to Sulcus Terminalis

Let's get more detailed... 1. What specific part of the Hypothalamus controls the ANS? 2. Hypothalamus sends/receives info to/from which regions in the cerebral cortex?

1. Par*a*ventricular Nucleus (PVN) 2. *Limbic* (Amygdala, Hippocampus, Septal Nucleus, cingulate, orbitofrontal, insular, rhinal)

*Accommodation:* -NEAR VISION 1. Sympathetic or parasympathetic stiumlation causes contraction or relaxation? 2. #1 to what muscle? 3. the zonular fibers are under tension or are they relaxed? 4. Lens is beings stretched or is it not stretched?

1. Parasympathetic 2. Ciliary muscle 3. relax 4. absense of stretching

1. Urinary incontinence is the inability to control urination. Is increased urination a function of the sympathetic division or the parasympathetic division? 2. Which receptor effect would increase the patient's ability to control urination? (Hint: refer to the table in section (8) of the ANS DSA.)

1. Parasympathetic divison 2. A beta 2 agonist would be expected to produce detrusor relaxation, which promotes bladder filling but does not really prevent evacuation. The best way to prevent evacuation is to prevent contraction of the detrusor.

*AChE inhibitor acute intoxication:* 1. This will cause sympathetic or parasympathetic effects? 2. what the SLUDGE is the SLUDGE acronym and how does it help? (hint: SLUDGE)

1. Parasympathetic effects 2. Parasympathetic effects cause these problems SLUDGE acronym - Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis

*Autonomics to nasal mucosa:* 1. Seromucus glands are innervated by [sympathetics or parasympathetics?] 2. Venous plexus and other vasculature innervated by [sympathetics or parasympathetics?] 3. The cycle of engorgement and non engorgement of the nasal cavity is caused by [sympathetics or parasympathetics?]

1. Parasympathetics 2. Sympathetics 3. Sympathetics

*Extraocular Eye Muscles* 1. From what embryonic tissue do these develop?

1. Paraxial mesoderm (GSE)

1. What are the 3 main salivary glands? 2. Why are these glands important?

1. Parotid glands Sublingual glands Submandibular glands 2. Help *moisten the mouth*. Helps prevent dental carries and cavities by promoting healthy bacterial environment *Enzymes help initiate digestion* Lubricate food to *help with swallowing*

*Pituitary* - Adenohypophysis 1. {Parvocellular or Magnocellular} Neurons in which Nucleus in the Pituitary? 2. Axons descend in which tract? 3. Secrete releasing *&* inhibiting factors where? 4. Releasing *&* Inhibiting factors enter which vein? 5. Stimulates release of which hormones?

1. Parvocellular- Arcuate (+ some Periventricular) 2. Tuberoinfundibular Tract 3. in 1° Plexus of Median Eminance 4. Enters portal vein & carried to *secondary plexus* 5. FLAT PiG (FSH, LH, ACTH, TSH, Prolactin, GH)

1. How does the *maxillary artery* reach the infratemporal fossa? 2. What accompanies the maxillary a. here?

1. Passes *medial to the neck of the mandible* (b/w it and the sphenomandibular ligament) 2. in company with the maxillary vein & auriculotemporal n. to enter the infratemporal fossa.

1. The Lingual n. (from posterior division of V3) passses behind the lateral pterygoid m. and then b/w which two muscles? 2. Lingual n. then runs inferiorly and passes out of the infratemporal fossa through what geometrically named space? 3. After passing through #2, it enters the tongue on what surface? 4. What will it innervate and via which fibers?

1. Passes BEHIND lateral pterygoid m. and then b/w *lateral and medial pterygoid m.* 2. runs inferiorly and out of the infratemporal fossa, *through the submandibular triangle* 3. *Inferior* surface 4. it provides *general sensation* (*GSA to anterior 2/3 of tongue*.

1. *Periventricular Nucleus* is a continuation of what? 2. What runs through it?

1. Periaquaductal Gray 2. Dorsal Longitudinal Fasciculus [black dot in bottom of image]

Mastoid foramen - Mastoid emissary v

Name of landmark? What travels through?

Course of the *parasympathetic fibers* to the *Parotid gland* 1. Where are the pre-ganglionic cell bodies? 2. What cranial nerve will the fibers travel? 3. What specific nerves will preganglionics travel with? (2) 4. Where are the cell bodies of postganglionics? 5. With what nerve will the postganglionics travel with? Then it innervates parotid gland

1. Pre-ganglionic cell bodies are in the *SALIVATORY NUCLEUS* w/n brainstem. 2. fibers travel w/ the *glossopharyngeal n. (CN IX)* which exits at *jugular foramen* 3. *Tympanic n.* and *lesser petrosal nerve* 4. *Otic ganglion* 5. CN V3 (auriculotemporal n)

1. [Preganglionic or postganglionic] Parasympathetiscs are carried in what nerve? 2. #1 is a branch of what CN? 3. Preganglionic parasympathetics in #1 join with [Preganglionic or Postganglionic?] Sympathetics in WHAT NERVE? 4. #1 and #3 form a "mixed" nerve called WHAT? and why is it "mixed"?

1. Preganglionic *Greater Petrosal Nerve* 2. Branch of CN VII 3. Postganglionic sympathetics in *Deep Petrosal Nerve* 4. *Nerve of Pterygoid Canal*, mixed b/c it has preganglionic parasympathetics and postganglionic sympathetics

Lets go over the route of the sympathetic fibers from origin to where it terminates. 1. Where do they start? 2. Through what route do they begin their journey? 3. Does it synapse? If so, where? 4. Where do the fibers then go?

1. Preganglionic cell bodies - T1-T4 lateral horn 2. Preganglionic cell fibers - travel within sympathetic chain 3. Postganglionic cell bodies - superior cervical ganglion. 4. Postganglionic cell fibers distribute via internal carotid nerve.

Lets go over the route of the parasympathetic fibers from origin to where it terminates. 1. Where do they start? 2. What CN do they travel with to get to where they need to go? 3. Does is synapse? If so where? 4. Where do these fibers then go?

1. Preganglionic cell bodies - salivatory nucleus in brainstem 2. Preganglionic cell fibers - travel with CN VII (greater petrosal branch) 3. Postganglionic cell bodies - pterygopalatine ganglion 4. Postganglionic cell fibers distribute the various branches of V2

*Presbyacusis* 1. What is this? 2. What is the average loss of Hz/year? 3. What are some sources it can arise from?

1. Presbyacusis (also, presbycusis) is hearing loss associated with aging. 2. 300 Hz/year 3. *Gradual irreversible loss of hair cells*, or more *acute loss from atherosclerotic damage*, especially to the fine microvasculature of the inner ear.

*Auditory Cortex* 1. What does the auditory cortex consist of? 2. Where is it located? 3. How do the left and right auditory cortex communicate? 4. How is it organized? 5. Where are high frequency sounds projecting? Low frequency sound?

1. Primary auditory (A1; area 41, medial gyrus) and secondary auditory cortex (A2; area 42, lateral gyrus). 2. transverse gyri of Heschl, in the depths of the lateral fissure. 3. Through the corpus callosum 4. Tonotopically organized 5. High frequency-medial portion, low frequency-lateral portion

*Accommodation* PW 1. Image must first reach what location? 2. Efferents sent to which location next? 3. Q2 innervates which structure? 4. Q3 innervates which muscles?

1. Primary visual cortex 2. Edinger-Westphal nucleus 3. ciliary ganglion 4. ciliary muscles & Medial/Lateral Rectus

*Auditory Reflexes - Sound Dampening* 1. What does this do for the ear holes and such? 2. What is the pathway called? 3. What mediates incoming signals and starts the reflex contracting muscles if the sound volume is excessive? 4. What motor nuclei does #3 act on?

1. Protective reflex for the auditory system are mediated via the brainstem through the motor nuclei of CN VII and V. 2. via middle ear reflex or acoustic reflex. 3. Via *superior olive* and reticular formation. 4. motor nuclei of CN V and VII.

1. What is the function of the SVA fibers in the chorda tympani (CN VII)?

1. Provides sense of TASTE to the *anterior 2/3 of the TONGUE.*

*The Inferior Olivary Nucleus:* 1. What type of input does it provide to the cerebellum? excitation or inhibition? to what cells? What is this input good for? 2. Inferior olive sends [ipsilateral or lateral or contralateral?] projections to the cerebellum? 3. The olivary neurons use what type of synapses and junctions?

1. Provides tonic input to cerebellum (like heart beat), excitation, to purkinje cells, This is thought to help motor learning b/c without it you cannot. It is believed that the timing is what sets the whole system up, they are unsure how it really works 2. Inferior olive sends *contralateral* projections to cerebellum 3. Olivary neurons use electrical synapses/gap junctions

*Posterior Boundaries & Foramen* 1. What is the posterior wall formed by? And what portion of that bone? 2. What are the 3 foramen that open up the posterior wall and what is their orientation?

1. Pterygoid portion of the sphenoid bone 2. Foramen rotundum (most lateral/superior) Pterygoid canal (middle) Pharyngeal canal (most medial/inferior)

1. Pupillary (Light)Reflex: pupil to do what? 2. What is the Afferent CN and fiber type? 3. What is the Efferent CN and fiber type? 4. So in by what CN and out by what CN?

1. Pupillary (Light)Reflex: Pupillary Constriction 2. Afferent limb: CN II (SSA) 3. Efferent Limb: CN III (GVE-P) 4. (In by II; out by III)

*Types of cells in Cerebellum:* 1. Basket cells are found in what layer? 2. Basket cells are local inhibitory internuerons on what cell?

1. Purkinje layer 2. local inhibitory interneurons on purkinje cells

from the case above: 1. Why not prescribe ACh?

1. Rapidly degraded, not used clinically; also charged and therefore does not cross blood brain barrier

1. What is ludwig's angina? 2. What complications can it lead to? 3. How to treat?

1. Rapidly developing cellulitis of submandibular region often caused by untreated dental infection 2. Airway compromise, hot potato voice, pain, drooling, dysphagia 3. Antibiotics

1. Where do the fibers of the chorda tympani (CN VII) travel after they join the Lingual n. (v3) in the infratemporal fossa? 2. What end effect would these fibers have?

1. Reach the *Submandibular GANGLION* and will then synapse on POST-ganglionic parasympathetic neurons 2. which distribute to submandibular, sublingual & lingual salivary gland to INCREASE secretion.

1. What is sialolithiasis? 2. Most often found in what two glands/ducts? 3. How can you get them out? (3) 4. Symptoms?

1. Salivary stones 2. Submandibular and parotid 3. Surgery, manually, or sour foods (increase salivation) 4. Mealtime syndrome (pain, worse before eating)

1. (quick review) what are the horizontal cells really good for? 2. How many different types of amacrine cells are there? 3. What NT do they release? 4. In terms of the center-surround response of RGC's, what do they contribute to in this response? 5. Do they co-release other neuropeptides? 6. Are they necessary to detect motion in the retina?

1. Really good at contrasting between dark and light. 2. ~ 30 different types 3. Release GABA or glycine onto bipolar cells and RGCs 4. Also contribute to the "surround" response of the center-surround RGC (this is pretty minor) 5. Co-release other neuropeptides 6. *Necessary to detect motion in the retina* (main purpose here)

*Tastant Receptors* - Sweet, Bitter, Umami 1. Tastant binds what? 2 & 3. Q1 has what effect? 4a. Q2/3 causes what to go up in cell? 4b. Q4a effect?

1. Receptor on GPCR 2 & 3. GPCR cascade & Phospholipase C activated IP3 levels ↑ 4a. *Ca++* levels go up 4b. TRPM channels lets more Ca++ in → depolarization

*CN X in Deglutition - SVE* 1. What are the two main branches of the SVE fibers from CN X? 2. What is the main job of these muscles?

1. Recurrent branch Superior laryngeal external branch 2. Get a successful passage of food from our larynx down to our esophagus

(REVIEW) 1. How do we check the integrity of the spinal tracks (whether there is a brain lesion or a lesion in the spinal cord)? 2. How do we test the SVE fibers in the head an neck? 3. What are some examples of #2 that we test? 4. What are we evaluating by using #2 then?

1. Reflex pathways! 2. REFLEX PATHWAYS! 3. Jaw jerk, corneal blink, gag, mastication and deglutition (swallowing) 4. Main points: -we are *evaluating the lower motor neuron and the afferent fibers coming back through them* - *checking to see if there is an issue with the voluntary pathways* (i.e. a cortical issue). -You can also use this info to *localize where the damage is*

Hypothalamic Functions *Water Balance* 1. Which system regulates water balance? 2. What influence does Q1 have? 3. What comes from lung and has it's influence on the brain?

1. Renin/Angiotensin/Aldosterone 2. Have kidneys retain water 3. Ang II

*Cochlea Overview* 1. What principle does the cochlea work through in order to split up sound spatially? 2. The sound waves are changed to action potentials via what system? What Organ (hint hint) does it use to accomplish this? 3. what structures distribute radially from the modiolus to contact hair cells of the Organ of Corti? 4. What do the cells from #3 form? Where does it project to?

1. Resonance principles 2. neural transduction system and this is accomplished through the Organ of Corti (the hair cells). 3. the dendrites of spiral ganglion cells distribute radially from the modiolus to contact hair cells of the Organ of Corti. 4. the cochlear or auditory nerve portion of CN VIII. Projects to the cochlear neuclei of the upper medulla.

1. What are the different types of photoreceptor again? 2. What does each sense? 3. What are the different types of Cones? 4. What do each of these sense?

1. Rods and Cones 2. Rods are good for detecting light or dark with a most responsive wavelength at 500 nm Cones respond to different wavelengths of light 3. L cones, M cones, and S cones. 4. S senses SHORT wavelengths of light M senses MEDIUM wavelengths of light L sense LONG wavelengths of light

1. What are the two types of photoreceptors? 2. What are 3 different stimuli they are receiving? 3. Where does the visual stimuli move to next?

1. Rods and cones 2. Color (cones) Sensitivity (Rods are sensitive to light and dark light) Acuity 3. The bipolar cells

1. The *Lateral Hypothalamic Area* is a continuation of what? 2. The *Lateral Hypothalamic Area* is part of what function? 3. What runs through it?

1. Rostral Reticular Formation 2. Arousal 3. MFB (Medial Forebrain Bundle) [black arrow in image]

*AChE (organophosphate) Inhibitor Toxicity:* 1. What does SLUDGE stand for? 2. What does DUMBELS stand for? 3. What organ do symptoms occur first in ingestion?

1. SLUDGE- Salivation, Lacrimation, Urination, Defecation, Gastrointestinal pain & gas, Emesis 2. DUMBELS - Defecation, Urination, Miosis, Bronchorrhea/ Bronchospasm/Bradycardia, Emesis, Lacrimation, Salivation 3. Ingestion: GI symptoms occur first

1. What delivers a greater volume of air to the olfactory mucosa with minimal increase in velocity? 2. How does it do this?

1. SNIFFING! (more volume not more velocity) 2. More of the Olfactory Mucosa is engaged

*Monoamine Transporters:* 1. What are 3 drugs used for Depression?

1. SSRIs, SNRIs (serotonin and norepinephrin re-uptake inhibitors), and TCAs (tri-cyclic antidepressants)((dirty drugs (((less selective)))))((((reputake inhibitors and direct receptor agonist or antagonist))))

1. The submental LNs will drain the medial part of the lower lip; what lymph nodes are responsible for draining all other parts of the lips? 2. Where will the lymph go after that?

1. SUBMANDIBULAR lymph nodes. 2. to the superior deep cervical LNs.

*CN VII in Deglutition* 1. What are the two fiber types found in CN VII for deglutition? What nuclei do they communicate with? 2. What does the afferent information from #1 control? 3. Through what specific nerve? 4. What does it innervate?

1. SVA (Nucleus of the Solitary Tract) and SVE (Motor Nuc of VII) 2. Taste 3. Chorda tympani 4. anterior 2/3 of the tongue

*CN IX in Deglutition* 1. What are the two fiber types that we see in CN IX for deglutition? Via what nuclei? 2. Afferent control gets information from what two sources? 3. Of the two, which would contain sensory info from mucous membrane of the oropharynx, palatine tonsils, faucial pillars and posterior 1/3 of the tongue?

1. SVA (Nucleus of the solitary tract) and SVE (Nucleus Ambiguus) 2. Sensation as well as taste (from posterior 1/3 of tongue) 3. Sensory branch under afferent control

*CN X in Deglutition* 1. What are the two fiber types we focus on for CN X in deglutition? What are their associated nuclei? 2. Does CN X have taste information? Where is it from? 3. What are the main branches relay sensory information via SVA fibers back to the associated nucleus? 4. What nucleus does the afferent information project back to?

1. SVA (nucleus of the solitary tract) and SVE (nucleus ambiguus) 2. Yes, from the epiglottis 3. The pharyngeal branch, superior laryngeal internal branch, recurrent laryngeal branch, esophageal branch. 4. Nucleus of the solitary tract

1. How does *disinhibition* happen? 2. What molecule is used to directly inhibit RIP OPN?

1. Superior colliculus activates mesencephalic reticular formation Mesen ret form then inhibits RIP OPN. 2. GABA

Now details Parasympathetics to Parotid 1. Where does it all start? 2. fibers travel with CN IX, which exits skull via what opening? 3. CN IX Gives a tympanic branch which enters middle ear through what opening? 4. It then exits the middle ear into the middle cranial fossa as what nerve? 5. It leaves the middle cranial fossa through what foramen? 6. Where does it synapse on the postsynaptic cell bodies? 7. It then travels with what nerve to get to parotid?

1. Salivatory nucleus in brainstem 2. Jugular foramen 3. tympanic canaliculus 4. Lesser petrosal n. 5. Foramen ovale 6. Otic ganglion 7. Auriculotemporal nerve (CN V3)

*Internal Ear*: Cochlear Duct 1. What are the 3 divisions within the membranous tube? 2. Waves of sound get amplified by what (earlier in ear)? 3. This amplified waves is sent through which of Q1? 4. These waves move what to cause what?

1. Scala Vestibuli, Cochlear duct, Scala tympani 2. Ossciles 3. Scala Vestibuli 4. Move vestibular membrane to cause changes of inner hair cells (cells of Hensen) on the *spiral organ*

*Ear Wax (cerumen)* 1. The upper skin of the meatus contains what structures that create the wax? 2. What is cerumen made up of? 3. Buildup of wax can cause?

1. Sebaceous & modified apocrine sweat glands (ceruminous glands) 2. Combo of secretions these glands + shed ET skin cells 3. Block External Auditory Meatus (conductive hearing loss, tinnitus, interference w/hearing aids)

Basal Ganglia Infarct facts: 1. Generally (primary or secondary) to stroke w/in perforating vessels of MCA or ACA 2. Depending on area hit, can cause vascular (Huntington's/Parkinsonism)

1. Secondary 2. Parkinsonism (Huntington's do not occur)

1. Where is the sensory distribution for the maxillary branch of trigeminal (V2)? 2. What are the terminal branches of V2 that provide this sensory information?

1. See photo 2. Zygomaticotemporal, zygomaticofacial, and infraorbital nn of maxillary

(the following are numbered to match the numbering in the image) 1. How do the *Olfactory Neurons* access the Olfactory bulb? Inside the bulb olfactory neuron axons access discrete areas that become what? 2. *Mitral Cell* dendrites in glomeruli receive input from what? These send out collaterals that interact with what? Axons here target what?

1. Send axons *thru Cribriform plate*. - Axons become *Glomeruli* 2. Input from *Olfactory Neurons*. - Interaction w/ *Tufted & Granule Cells*. - Axons target *1° olfactory cortex*

*Perfusion of the Nasal Cavity: Septal* 1. What branch of What artery provides blood to the anterior and inferior portions of he septal nasal cavity? 2. #1's artery is a branch off which artery? 3. Which 2 arteries provide branches to to the superior septal area of the nasal cavity? 4. What are the branches in #3 called? 5. What artery do the arteries in #3 come from?

1. Septal Branch of Superior Labial Artery 2. Facial Artery 3. Anterior and Posterior Ethmoidal arteries 4. Septal Branches 5. Ophthalmic artery

*Monoamine Regulation of Major Depressive Disorder Symptoms:* Tell me if the following is caused by Dopamine, Norepinephrine, or Serotonin. 1. Obsessions 2. Energy 3. Compulstions 4. Motivation 5. Reward 6. Alertness 7. Pleasure 8. Attention 9. Anxiety 10. Mood

1. Serotonin 2. Norepinephrine 3. Serotonin 4. Dopamine 5. Dopamine 6. Norepinephrine 7. Dopamine 8. Dopamine 9. Serotonin AND Norepinephrine 10. Dopamine AND Norepinephrine AND Serotonin

*Thalamic Nuclei* 1. Divided into regions by what? 2. The white matter sheets consist of what 3 bits?

1. Sheets of nerve fibers entering & leaving thalamus 2. i: *Stratum Zonale* (red): thin layer on dorsal thalamus ii: *External Medullary Lamina* (green): covers lateral surface (under reticular nucleus & internal capsule) iii: *Internal Medullary Lamina* (purple): divides thalamus into collections of nuclei

*Clinical Comments:* 1. are the VANN signs associated with peripheral or centeral or both pathology connections?

1. Signs associated with pathology of *both* peripheral and central connections.

1. In reference to ribbon synapses, what needs to happen for the ON bipolar cells to send off their visual signals? 2. Do rods bipolar cells communicate directly with ganglion cells? 3. What receptor type is present on the ON bipolar cells that cause the hyperpolarization in response to glutamate? What happens when the glutamate is no longer being secreted to bind this receptor?

1. Since ON bipolar cells are *hyperpolarized* in the presence of glutamate, the ribbon synapses need to stop or decrease the amount of glutamate that they are secreting in order for the ON bipolar cell to depolarize and send its info. 2. No; they came late to the evolution party and got left out. 3. mGluR6. When glutamate is not present, it will allow the cell to depolarize.

What are the 5 layers of the eye lid?

1. Skin 2. Loose CT (cont. w/scalp layer 4) 3. Muscle 4. Tarsal Plate: dense fibrous CT (eyelid support) 5. Palpebral conjunctiva (mucus production)

*Glossopharyngeal Nerve Fiber Types* What are the 5 fiber types that are being carried in CN IX?

1. Somatic sensory --> outer ear (superior ganglion of IX) 2. Visceral sensory --> from taste buds, posterior 1/3 tongue (inferior ganglion of IX) 3. Visceral sensory --> from carotid body and sinus, mucus of pharygnx, posterior tongue, middle ear (inferior ganglion of IX) 4. Pharyngeal motor, to stylopharyngeus m 5. Visceral motor --> to parotid gland (via otic ganglion)

*Thalamus-Nuclear Groups & Functions* - *Lateral* - *Lateral Posterior Nucleus* 1. Has reciprocal connections with what area? 2. Its subcortical afferents include those similar to what? 3. Its connections suggest what function?

1. Somatosensory association area of *parietal lobe* (esp visual areas) 2. *Pulvinar* (may be classified with it)- Superior colliculus, pretectal nuclei, & visual cortex 3. Visual/motor associations (e.g. cortical areas 5&7 - reaching for a target)

*Nasal Air Flow:* 1. Does expired air enter into the olfactory region? if so what is it important for? Is this in the main stream? 2. What are the 2 reasons why you don't want a lot of #1?

1. Some expired air enters into the olfactory region (important for flavor detection) but not in the main stream 2. Because if you'd have alot of exhaled air go to the olfactory mucosa you could not Minimizes dilution and masking of external-derived odorants

1. Do Olfactory cells regrow/replace themselves? 2. What happens on day 0 of neurogenesis of olfactory ET? 3. What happens on day 1 of neurogenesis of olfactory ET?

1. Sure do (unlike many other neural tissues, these turn over on the regular) 2. Day 0: Basal Cell divides 3. Day 1: 1 daughter = Basal Cell 1 daughter = Neuron (which sends processes to ET surface & cribriform)

1. The structure of the ear focuses [sound/water] waves into what structure? 2. What is then displaced by the pressure changes of sound wave? This then converts sound waves into what? 3. This process constitutes the first mode of what? What is being converted? 4. The ossicles translate ([with/without] some amplification) their [what?] into sound waves in the _______ of the inner ear (cochlea).

1. Sound, into the external acoustic meatus. 2. Tympanic membrane, converts sound waves into mechanical motion of the middle ear ossicles. 3. Constitutes first mode of transduction, from air waves to motion of the ossicles. 4. The ossicles translate (with some amplification) their motion into sound waves in the fluid of the inner ear (cochlea).

1. What about if we have CN III Ischemia? 2. Most common cause? 3. Symptoms?

1. Spared Pupil 2. Small vessel Ischemia due to Diabetes or smoking 3. CN III muscles Will Not fxn. Eye held Down and Out, Eyelid droop but PUPIL is Spared.

*Superior Olivary Nuclei - Comparison by Synaptic Summation* 1. What is one mechanism the superior olivary nucleus uses to compare signals from each ear? 2. Can it code for temporal differences in the time of arrival from each ear? 3. What happens if two different AP's arrive at different times?

1. Spatial summation 2. Yes 3. Each will produce a separate EPSP on the dendrites of superior olive neurons.

1. What are ribbon synapses? (very general) 2. Where are the three systems that use these synapses? 3. Where do we specifically find ribbon synapses in the visual pathway?

1. Specialized neurons 2. Visual, auditory, and vestibular 3. found in photoreceptors and bipolar cells.

1. The sphenoid sinus is drains to what? 2. The Frontal sinus drains to what? which is in what meatus?

1. Sphenoethmoidal recess 2. infundibulum of the middle meatus

1. What empties into the sphenoethmoidal recess? 2. What empties into the Superior meatus? 3. What empties into the Bulla which may open elsewhere in middle meatus? (2) 4. What empites into the Hiatus? 5. What empties into the inferior meatus? 6. What is the only thing that empties into the infundibulum?

1. Sphenoid sinus 2. Posterior Ethmoidal 3. Middle/anterior ethmoidal 4. Maxillary sinus 5. Lacrimal duct 6. Frontal sinus

*Where do Paranasal sinuses drain?!?!* 1. What does the sphenoid sinus drain into? 2. What does the Posterior Ethmoid air cells drain into? 3. What does the middle and anterior Ethmoid air cells drain into? 4. What does the frontal sinus drain into? 5. What does the maxillary sinus drain into? 6. What does the lacrimal duct drain into?

1. Sphenoidethmoidal recess 2. Superior meatus 3. Middle meatus 4. Middle meatus 5. Middle Meatus 6. Inferior meatus

*Perfusion of the Nasal Cavity: lateral* 1. branches of What artery provides the blood supply to the middle lateral nasal cavity? 2. the branches in #1 are called what? 3. #1 is a branch off what?

1. Sphenopalatine artery 2. Lateral Branches 3. Maxillary artery

*Perfusion of the Nasal Cavity: Septal* 1. What artery gives branches that supplies the middle septal area of the nasal cavity? 2. What are the branches in #1 called? 3. #1 comes off what artery? 4. Greater Palatine anastamoses with a septal branch of what artery? 5. #4 often occurs in what canal? 6. greater palatine comes from what artery? 7. #6 comes from what artery?

1. Sphenopalatine artery 2. Septal branches 3. Maxillary artery 4. Sphenopalatine artery 5. Incisive canal 6. Descending palatine artery 7. Maxillary artery

*Intraocular Eye Muscles* 1. GVE-P to which 2 muscles? 2. GVE-S to which 2 muscles?

1. Sphincter pupillae & ciliary muscle 2. Dilator pupillae & superior tarsal muscle

*Glossopharyngeal Nerve Fiber Types* 1. What nucleus does the somatic sensory information of CN IX go into? 2. What nucleus does the visceral sensory information (both tracks) synapse in?

1. Spinal Trigeminal nucelus 2. Solitary nucleus

*Limb and postural adjustments:* 1. Afferents from what tracts and motor ctx? 2. Efferents to what 2 things?

1. Spinocerebellar tracts and motor ctx 2. To the thalamus, cortex

What are the 4 regions of the Temporal bone?

1. Squamous part 2. Mastoid part 3. Tympanic part 4. Petrous part

*Neural processing in the Cochlea* 1. When hair cells release NT, what do they stimulate? 2. Do inner and outer hair cells differ in their innervation by spiral ganglion neurons? 3. What is the efferent portion that innervates them from the brainstem?

1. Stimulate nerve endings of spiral ganglion cells 2. Yes they do! 3. Efferent innervation from the brainstem from olivocochlear bundle (they regulate the hair cells)

1. Kawasaki disease and toxic shock syndrome can cause what of the tongue? 2. What organism is the culprit? (2)

1. Strawberry tongue 2. Staph aureus Strep pyogenese (can cuase strep throat or scarlet fever if left untreated)

What are the general contents (4) of the submandibular region?

1. Submandibular gland 2. Facial a. 3. Lingual a. 3. CN XII (hypoglossal n.) 4. Suprahyoid mm. (digastric, stylohyoid, mylohyoid, and geniohyoid)

1. What lymph nodes are responsible for draining the upper lip? 2. Where will lymph go from there?

1. Submandibular lymph nodes. ipsilateral 2. these will drain to the superior deep cervical LNs.

*Lymphatic Drainage:* 1. Lymphatics from Anterior regions of the nasal cavity drain to what nodes? 2. #1 then drains to what nodes?

1. Submandibular nodes 2. Deep cervical nodes

*Dopamine Pathophysiology:* 1. Dopamine comes from 2 places in the brain. What are those 2 places? 2. Which one in #1 helps regulate voluntary movement? 3. Which one in #1 mediates the "reward pathway"?

1. Substantia nigra and the Ventral Tegmental Area 2. Substantia nigra 3. Ventral Tegmental area

What are the foramina (6) which are associated with the sphenoid bone?

1. Superior Orbital Fissure (gap b/w greater & lesser wings) 2. Foramen Rotundum (opens into pterygopalatine fossa) 3. Foramen Ovale (opens into infratemporal fossa) 4. Foramen Spinosum (opens into infratemporal fossa) 5. Pterygoid canal (

1. What is the superior boarder of the PPF? 2. What foramen does it have? Contents that it transmits?

1. Superior boarder is formed by the sphenoid bone 2. NONE! Got ya!

Nasolacrimal canal - Nasolacrimal duct

Name of landmark? What travels through?

*Pheochromocytoma Treatment:* 1. What is the ultimate treatment? 2. What happens if you use a selective beta-blocker in a pt with a pheochromocytoma? 3. What if you use a nonselective beta-blocker which blocks both alpha and beta receptors? 4. The referred agent for controlling blood pressure is an irreversible, long-acting, nonspecific WHAT?

1. Surgical resection of the pheochromocytoma following medical preparation to control hypertension and volume expansion 2. will result in symptoms of 'unopposed alpha' stimulation (i.e., vasoconstriction) 3. use as the initial antihypertensive agent may cause paradoxical hypertension 3. *irreversible, long-acting, nonspecific alpha adrenergic antagonist (phenoxybenzamine)*

*Sympathetic vs. Parasympathetic Tone:* 1. Sympathetic or parasympathetic is adrenergic (anticholinergic)? 2. Sympathetic or parasympathetic is cholinergic? 3. Effects of sympathetics and parasympathetics are generally, but not always, what? 4. in the resting state does the sympathetic or parasympathetic tone dominate?

1. Sympathetic 2. Parasympathetic 3. Opposite 4. parasympathetic

1. Nerve of Pterygoid canal Preganglionic Parasympathetics will synapse on what ganglion? 2. Postganglionics from #1 will travel in association with WHAT CN branches and will do what?

1. Synapse in Pterygopalatine ganglion 2. travel in association with V2 branches and regulate secretion in *Nasal Mucosa*

*Basic Cerebellar circuitry:* 1. The mossy fibers coming in from the pontine nuclei (cerebral cortex), spinal cord, and vestibular system will synapse on what 2 things? tell me if they are inhibitory or excitatory? 2. The neurons from the inferior olive synapse on what 2 things? tell me if they are inhibitory or excitatory?

1. Synapses -on the granule cell (excitatory) - on the Deep cerebellar nuclear cell (excitatory) 2. Synapses -on the Purkinjecell (excitatory) - on the Deep cerebellar nuclear cell (excitatory)

1. Preganglionic sympathetics arise from what spinal level? 2. They will synapse on what ganglia? 3. Postganglionic axons hop on to what artery as what nerve/plexus?

1. T1 2. Superior cervical ganglia 3. internal carotid artery as *internal carotid nerve/plexus*

PW for Sympathetics of Orbit/Eye (intraocular) 1. Preganglionic cell bodies where? 2. Preganglionic cell fibers travel with what nerve? 3. Postganglionic cell bodies where? 4. Postganglionic cell fibers distribute via which nerve? 5. To which muscles?

1. T1-T2 lateral horn 2. travel within sympathetic chain 3. superior cervical ganglion 4. internal carotid nerve 5. Superior tarsal and dilator pupillae mm

*Sympathetic innervation of the head:* 1. Preganglionics to the had come from what spinal levels? 2. All postganglionics to the head come from what? 3. are there sympathetic ganglia in the head? 4. They come from what horn of the spinal cord?

1. T1-T4 2. the superior cervical sympathetic ganglion 3. heck no we won't go 4. lateral horn.

1. What is the main ligament of the temporomandibular joint (TMJ)? 2. Where is this located relative to the TMJ?

1. TEMPOROMANDIBULAR LIGAMENT (Lateral Ligament) 2. this is located on the *lateral surface of the TMJ*.

1. What is very important for muscle memory?

1. THE CEREBELLUM Don't remember what it is but you remember the movements

*The Cochlear Nuclei* 1. Which of the cochlear nuclei (dorsal/ventral) appear to contribute to *BOTH* pathways? 2. Is it even, though? 3. Monaural pathways from both nuclei are also called what?

1. THEY BOTH CONTRIBUTE TO BOTH PATHWAYS! 2. Nope... 3. Direct and indirect

What does the auriculotemporal n. innervate? 1. What joint? 2. What gland? 3. How many goosen (Some say geese, no judgment here)? 4. What part of the pinna? 5. what canal? 6. Which membrane? 7. skin of what area?

1. TMJ 2. parotid gland 3. Three, "Tre" goose *tragus* 4. anterior portion of the pinna 5. external auditory canal 6. tympanic membrane 7. skin *anterior and superior to the ear.*

Temporomandibular joint 1. What type of joint is this? 2. What are the components of the Temporomandibular Joint (TMJ)?

1. TMJ = True Synovial Modified Hinge Joint 2. B/w the condyle of the mandible, mandibular fossa & articular tubercle of the temporal bone.

*Middle Ear* - Grand Overview (this is an important, but difficult card) 1. What forms the *Roof*? 2. What forms the *Floor*? 3. What forms the *Lateral Wall*? 4. What forms the *Medial Wall*? 5. What forms the *Posterior Wall*? 6. What is found on the *Anterior Wall*?

1. Tegmen tympani 2. Bone separating tympanic cavity from carotid canal & jugular fossa 3. tympanic membrane 4. oval window, round window, promontory 5. aditus to mastoid antrum, pyramidal eminence, facial canal prominence 6. Auditory Tube, Tubal Artery, Tensor tympani

What are the muscles of the palate?

1. Tensor veli palatini 2. Levator veli palatini 3. Salpingopharyngeus muscle 4. Palatoglossus muscle

1. Of the muscles of the palate, what is the only muscle that is not innervated by CN X? 2. What is the nerve the innervates it?

1. Tensor veli palatini 2. Trigeminal Nerve (V3)

1. Which type of stroke is the ONLY type of stroke that will cause prolonged neuropathic pain? 2. What is this syndrome called?

1. Thalamic Stroke 2. Thalamic pain syndrome = Excruciating pain syndrome with no cure Inability of thalamus to act as gatekeeper and turn down any pain sensation entering the brain

1. Which one came first, the chicken or the egg? 2. Which one came first, the rods or the cones? 3. Which type of photoreceptor is stronger in terms of convergence? Would that make them more or less sensitive? Acute?

1. That is a mystery that only God knows. 2. Well it looks like the cones did and mammals developed the ability to see at night later on. 3. Makes the rods more sensitive (light and dark) but less acute

*Deep cerebellar nuclei* 1. Most fibers in the superior peduncle going to the cerebrum originate from what? 2. Again what is the most lateral cerebellar nucleus? What part of the cerebellum mostly feeds into this deep cerebellar nuclei? 3. Where are the interposed nucleus? 4. What are the 2 parts of the interposed nucleus? 5. What part of the cerebellum feeds into these deep cerebellar nuclei usually?

1. The *Dentate* nucleus 2. The *Dentate* nucleus , lateral cerebellum 3. just medial to the dentate nucleus at the paravermis(look yer eyes at that there pic) 4. *interposed* =*globose and emboliform* 5. paravermis

Infraorbital artery usually arises from the maxillary artery in what space?

Pterygopalatine fossa

*General Orientation:* 1. The plane of horizontal (lateral) canal and utricle is how many degrees from the nasooccipital plane? 2. Why is #1 the way it is? 3. The planes of the anterior canal and posterior canal are how many degrees apart? 4. Semicircular canals are oriented in a manner that allows WHAT of input from corresponding sides of the head

1. The plane of horizontal (lateral) canal and utricle is *~30 degrees* from the nasooccipital plane. 2. This becomes horizontal when the head is pitched forward 30o in a position that allows the line of site to be in front of the feet in normal ambulation. 3. The planes of the anterior canal and posterior canal are *~90 degrees* apart. 4. Semicircular canals are oriented in a manner that allows *comparisons* of input from corresponding sides of the head

1. What is the final common pathway of decomposed images as it will be carried into the brain via the optic nerve? 2. What are some of the jobs of the retina that are not specifically involved with the image forming function? 3. If you blind fold a rat, will he still be able to run the gambit during is usual nocturnal run?

1. The retinal ganglion cells. 2. Recognizing the day and night cycles. 3. Ok, so this is lame but the experiment he mentions is that when the rat was blind folded and didnt have the visual info for the day/night cycle, their usual night time running would start to drift into day-time hours.

1. What are the cells that will be releasing glutamate that act on the bipolar cells? 2. What are the cells that will be releasing glutamate that act on the retinal ganglion cells? 3. What type of receptor does the OFF bipolar cell have? What does glutamate do to this receptor? 4. What type of receptor does the ON bipolar cell have?

1. The rods and cones 2. The bipolar cells 3. AMPA, causes the cell to be depolarized. 4. mGluR6. This will hyperpolarize the cell (like we talked about before).

*Cochlea - Organ of Corti* 1. What does the organ of Corti sit between? 2. Is it an epithelium on the basilar membrane? 3. T or F: it is not continuous along the spiral of the cochela. 4. How many rows of hair cells and what is the distribution of these cells? 5. Are the hair cells specialized neurons? Are they continuous throughout the length of the spiral? 6. What is their job again?

1. The scala vestibuli and tempani and in the endocochelar duct (guys i have no idea where this is but he assumes that we already know this....?) 2. Yes 3. False, it is continuous along the spiral of the cochlea! 4. 4 rows (3 outer and 1 inner layer) 5. Yes, YES! 6. Transduce the mechanical waves into (mechanotransduction) into action potentials.

1. What is the mallampati score? 2. Which is more difficult to work with, a mallampati score of I or IV?

1. The score you will grade a patient when they open and say "AAHHH" to tell how difficult it will be to intubate them. 2. Mos def IV... check it out

1. What is the size of the hypothalamus? 2. Whereabouts in your brain is this "bad Jackson" located?

1. The size of the prostate (aka the size of a walnut (4cm2)) 2. Inferior bit o'*diencephalon*

*Openings of Pterygopalatine Fossa* 1. What is the lateral opening of the PPF? 2. What is the medial opening of the PPF?

1. The sphenomaxillary fissure (the door to the room) 2. The sphenopalatine foramen (the window of the room)

*Bony and Membranous Labyrinths:* What are the 2 receptors? and what are their primary functions?

1. The three semicircular canals (a.k.a. kinetic labyrinth - horizontal, anterior and posterior) transduce rotational head movements (angular accelerations), and 2. the otolith organs respond to translational movements and the orientation of the head relative to gravity.

*Central Vestibular Pathways- Cerebellum:* 1. WHAT is the only sensory organ in the body that sends direct primary afferents to the cerebellar nuclei and cortex (primary vestibular afferents). 2. T/F: There are also extensive secondary afferents from the vestibular nuclei to the cerebellum. 3. Although the projections are broad, the highest density is to structures of what part of the cerebellum?

1. The vestibular labyrinth 2. TRUE there are! 3. vestibulocerebellum (flocculonodular lobe, fastigial nucleus).

*Vestibular Peripheral Structure:* 1. The vestibular peripheral apparatus converts head orientation relative to gravity and kinetic head movements into WHAT codes in the vestibular portion of WHAT CN? 2. The apparatus is located in conjunction with the WHAT? apparatus in the petros of WHAT bone.

1. The vestibular peripheral apparatus converts head orientation relative to gravity and kinetic head movements into *action potential* codes in the vestibular portion of *CN VIII*. 2. The apparatus is located in conjunction with the *auditory* apparatus in the petros *temporal* bone.

1. non declarative memory substrates circuits involve what structures? 2. What structures do they not impact?

1. These circuits involve the basal ganlia, prefrontal cortex amygdala, sensory association cortex and cerebellum, 2. temporal lobe or midline thalamic nuclei

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 1. The mucous glands of the head also include what 5 glands? (just look at the answer)

1. These include mucous glands of the pharynx, nasal cavity, palate, oral cavity and the lacrimal gland

1. What is horizontal integration and what cells accomplish this? 2. Does this also happen at the level of the bipolar cells? What cell type accomplishes this and what are they doing? What do they feed into? 3. What can be considered the start of the optic nerve?

1. They are called horizontal cells. They are really good at linking that synaptic information that the photoreceptor information is receiving and relating what one photoreceptor is doing to the photoreceptor next to it. 2. Yes! The amacrine cells are relating the info of a bipolar cell to bipolar cells next to it. They transmit that info into the ganglion cells. 3. The ganglion cells. Its the axons projecting out of the ganglion cells through the optic nerve that will be synapsing in the LGN of the thamaus

*Motion and the Static Labyrith:* 1. The tilt of the head will produce [increased or decreased?] activity of hair cells within each macula? 2. Orientation shifts will also create differences in activity in the macula on [each side or one side?] of the head.

1. Trick question BOTH The tilt of the head will produce increased activity of some hair cells and reduce others within each macula. - remember that the hair cells are not all pointing the same direction in each macula 2. Orientation shifts will also create differences in activity in the macula on *each side* of the head.

ACA stroke symptoms

Pt presents w/: - Sensory and Motor deficits in Contralateral LE - Possible frontal deficits (mood/behavior) - Possible BG deficits

*Hair Cells of Organ of Corti* 1. With the efferent innervation of outer hair cells, and their contractile nature, what do they work as? 2. What is Henson's stripe and when is it used? 3. What does the loss of outer hair cells cause? 4. What is Otoacoustic emissions?

1. They may act as selective amplifiers (helping us to focus on the sound we want and drowned out the sound we dont). 2. When the outer hair cell contracts, it changes the basilar membrane relative to the tectorial membrane, which then allows Henson's stripe to cause a greater stimulation to the inner hair cell when the out hair cell contracts. 3. Selectively increases auditory threshold and reduces frequency discrimination. 4. Tests the neural pathway of the cochlea; used to see if neural pathway is intact and if cochlear implant would be viable (difference between mechanical and neural issue)

*Superior Olivary Nuclei* 1. What happens if AP's arrive at the same/similar times? 2. How does this then affect the cells and how they are coded?

1. They will summate 2. Cells can be coded to be responsive to different time separations of signals.

*Reticular Nucleus* 1. What's it look like/where is it?

1. Thin sheet of grey matter surrounding thalamus beyond the external medullary lamina (best defined anteriorly & laterally)

What are the contents of the pterygopalatine fossa? (5)

1. Third part of maxillary artery (pterygopalatine portion) 2. Maxillary portion of the trigeminal nerve (V2) 3. Pterygopalatine ganglion 4. Greater petrosal n. (CN VII via pterygoid canal) 5. Deep petrosal n. (Sympathetics via pterygoid canal)

*General Orientation:* 1. What is so important about posterior and anterior canal planes being 90 degrees apart?

1. This allows fluid to be flowing in one or the other and activating one side and inhibiting the other for a particular movement. This is so we can figure out what direction we are going

*Sympathetic innervation of the head:* 1. The Superior cervical sympathetic ganglion provides what to the head? 2. A small compliment of postganglionic sympathetic fibers follow the route of the WHAT artery into WHAT cranial fossa?

1. This ganglion will provide the majority of the postganglionic innervation to the visceral structures of the head 2. A small compliment of postganglionic sympathetic fibers follow the route of the vertebral artery into the posterior cranial fossa.

*Buccal Nerve* 1. This n. branches from ___________ ___________ of V3. 2. It passes b/w the two heads of what muscle? and a portion of what other close muscle?

1. This n. branches from *anterior division* of V3 2. b/w the two heads of the *lateral pterygoid m.* & crosses the lower head of this m. & a portion of the *medial pterygoid* to ramify on the surface of the buccinator m.

1. What is the course of the maxillary vein in relation to the mandible? (Hint: it passes with maxillary a and auricotemporal n.) 2. What does this vein join with and what vein do they form?

1. This vein passes out of the pterygoid plexus to *course behind the neck of the mandible* in the company w/ the maxillary a. & the auriculotemporal n. 2. maxillary v. joins the *superficial temporal v.* to form the *retromandibular v.* *retromandibular is one of the primary tributaries to the external jugular vein.

And finally: *Lateral medullary syndrome* 1. What causes this? 2. What 6 bits of the medulla are lost?

1. Thrombosis of vertebral or posterior inferior cerebellar artery (PICA) 2. Please see image for answer to you query

*Vestibular:* 1. It goes to what nucleus in the cerebellum? 2. Output to what nuclei and what formation? 3. Affects equilibrium, and movements of what?? 4. Exits what peduncle?

1. To *Fastigial nucleus* 2. Output to *vestibular nuclei* and *reticular formation* (can affect reticular spinal tracts) 3. Affects eye movements and equilibrium 4. inferior cerebellar peduncle -note this is the most medial system in the cerebellum

Cardiac control: 1. Baroreceptor info feeds into brain to what to nucleus & via what nerves? 2. Q1 send info up to hypothalamus & what response comes down?

1. To *Nucleus of Solitary Tract* via X & IX (mostly X) 2. Parasympathetic & Sympathetic output to heart & to cell column (*Hypothalamus decides which to shut off*)

*Cortical input, "processed" and coordinated info:* 1. Goes to what 2 zones of the cerebellum? 2. Goes to what 2 nuclei? which one is for which zone from #1? 3. Output goes to [ipsilateral or contralateral?] what 2 nuclei, and what other structure? Which one is from which nuclei from #2?

1. To *lateral zones* and *intermediate zones* 2. To *dentate* (Lateral zones) and *interposed nuclei* (intermediate zones) 3. Output to contralateral *red nucleus* (Interposed nuclei from intermediate zones) and *inferior olivary nucleus* (Interposed nuclei from intermediate zones) , also to the *VA/VL Thalamus* (dentate from lateral zones -> back to the cortex)

1. What would Post. Superior alveolar nerve block anesthetize? 2. Middle Sup alveolar nerve block does what?

1. Top back 2 1/2 teeth 2. Middle 2 1/2 teeth

*Vestibulo-Ocular Reflexes:* 1. Torsional responses also occur as a result of activation of the WHAT of the What 2 things of WHAT labyrinth, more directly through influences on WHAT 2 nerves?

1. Torsional responses also occur as a result of activation of the *maculae* of the *saccule and utricle* of the static labyrinth, more directly through influences on *the oculomotor and trochlear nerves*.

1. How do the SVA fibers from anterior 2/3 of tongue travel back to brain? 2. Where are the cell bodies of these fibers? 3. What is the nervous intermedius portion of CN VII?

1. Travel via Chorda Tympani (CN VII) 2. cell bodies will form the *GENICULATE GANGLION* 3. the *central processes of fibers which arise in the geniculate ganglion* form the Nervous Intermedius portion of CN VII

*Motion and the Static Labyrith:* 1. The maculae code the static orientation of the head using hair cell activity, by comparing hair cell activity [between sides of the head or within each macula?]? 2. Can the hair cells respond to gravity or linear acceleration? 3. How can the brain know what is going on, is it just by the activity of the maculae itself or is it because of the comparison b/w the sides of each maculae?

1. Trick again its both suckahs The maculae code the static orientation of the head using hair cell activity, by comparing hair cell activity *both* between sides of the head and within each macula. 2. Either one! The hair cells can respond to gravity or linear acceleration. 3. Comparison b/w the sides of each maculae. not just b/c they are activated Why do I keep making questions and answers like that? I guess I just want to see the world burn.

question is on the flipity flop. Good luck....

1. What level of the brain stem are we? 2. What is this? 3. What is this? 4. What is this? 5. What nerve emerges just posterior to #3 in this histo slide? 6. What is this? 7. What is this? 8. what is this? 9. what nucleus is this? 10. What nucleus is this? 11. What is this? 12. Fibers from #4 will head to the the cerebellar peduncle on the ipsilateral or contralateral side? 13. #2 is the major afferent or efferent pathway of the cerebellum? 1. Mid- Pons 2. Superior cerebellar peduncle 3. Middle Cerebellar Peduncle 4. Pontine Nuclei & Transverse Pontine fibers 5. Trigeminal nerve 6. corticospinal tract fibers 7. medial lemniscus 8. spinothalamic tract 9. Chief or main sensory nucleus of Trigeminal 10. Motor nucleus of Trigeminal 11. MLF 12. Contralateral 13. Efferents of the cerebellum

*Middle Ear*: Innervation (flip)

1. What other nerve travels through the middle ear (A in image)? 2. B: What ganglion is found within the middle ear? Answers hiding ↓ 1. *Facial* Nerve (runs along next to CN VIII) 2. B: Geniculate Ganglion

flip for ?

1. What type of GABA receptor is this? 2. What ion does it let thru this ionotropic receptor? 3. what happens when #2 enters the cell? 1. GABAa 2. Cl- 3. hyperpolarize (IPSP) harder to fire Action Potential

1. What is the job of a *wide filed amacrine cell*? 2. What is the job of a *starburst amacrine cell*?

1. Wide field amacrine cells subtract background noise from moving objects 2. Starburst amacrine cells respond to signals only in light movement across dendritic fields in a particular direction

*Vestibular Testing:* 1. A lesion WHERE will cause the slow phase to only involve the lateral rectus. 2. With a lesion WHERE the response may not be present, due to damage of the vestibular nuclei.

1. With lesions of the *MLF*, where the conjugate reflex pathways are disturbed, the slow phase may only involve the lateral rectus. 2. With *lower brainstem* lesions, the response may not be present, due to damage of the vestibular nuclei.

1. Where is the pterygopalatine fossa located? 2. What is just inferior to the PPF?

1. Within the infratemporal fossa, more medial and deep 2. The palate

Let's start w/ *External Ear* 1. What's the name of the outter part of your ear? 2. What 6 proliferations form Q1? 3. What tissue is Q2 made of? 4. From whic arch(es) do these proliferations form?

1. Wrong, it's *auricle* 2. 6 *Auricular hillocks* 3. Neural crest mesenchyme (ectomesenchyme) 4. 1st & 2nd pharyngeal arches surrounding 1st cleft (so the ear starts in the neck area)

*Medial Geniculate Nucleus* 1. As you ascend, does complexity increase? 2. What is one major projection of the medial geniculate nucleus? 3. How is the medial geniculate nucleus organized? 4. What other parts of the medial geniculate nucleus could be important?

1. Yes 2. Has a major projections to primary auditory cortex, as well as others. 3. Tonotopically organized 4. It has sub nuclei that process different types of information in a more complex way (it allows you to blend information together). He didnt mention anything in the last two bullet points really, but we should read them and make sure it isnt important.

*Sound Transduction in the Cochlea* 1. Do filaments and stereocilia maintain some tension on channels such that they are partially open at rest? 2. What does this allow for in terms of the channels? 3. What happens to the cell when the channels close?

1. Yes 2. This allows for both K+ and Ca2+ channels to *be open more or less* depending upon the direction of movement. 3. It hyper-polarizes the cells relative to rest.

1. In the brainstem, is the Bell-Magendie Law consistent with what we see in the spinal cord as well? 2. What is the dividing portion between these important divisions in the brainstem? 3. In the brainstem, where would we most likely find somatosensory nuclei of specific tracts?

1. Yes (though there is some modifications that takes place, more to come) 2. the sulcus limitans! 3. In a dorsal-lateral postion (see photo)

1. Can the hypoglossal nuclei be seen from the dorsal surface of brainstem in the hypoglossal nucleus?

1. Yes it can be

1. In conduction loss, are the neural components still intact? 2. Would someone with conduction loss be able to detect vibrations through bone? 3. What are two tests that could be used to test it?

1. Yes they are 2. Yes they would be 3. Rinne and Weber tests

1. Are these muscles that we have talked about so far paired across the mid-line? 2. Are they getting bilateral control? 3. If there is a deficiency at the cortex, what happens?

1. Yes they are 2. yes 3. Lesion of cortex causes bilateral deficiency (but minor)

*Deglutition Networks* 1. During a normal swallow, is respiration halted? 2. What is that called? 3. What portion of the respiration cycle occurs immediately before and after the swallow? 4. What is it preventing? 5. How is all of this coordinated?

1. Yes, it is temporarily halted 2. Deglutition apena 3. exhalation 4. Prevents accidental inhalation of any bolus remnants. 5. By the cranial nerves that we talked about!

*Descending Auditory Pathways* 1. Are there such things as descending auditory pathways? 2. What is the biggest one of these that is important? 3. Where does it start and where does it go to? 4. What does this provide for our auditory system?

1. Yes, thats why there is a card for it. 2. The olivocochlear system 3. Starts in the superior olivary complex out to the organ of corti and the outer hair cells mainly (but also some inner ones). 4. Auditory sharpening (amplify or reduce certain tones)!

*Deglutition Networks* 1. This network coordinates what action? 2. How many different cranial nerves are involved? 3. What are those 5 cranial nerves? 4. How many phases of deglutition are there?

1. Yes, you guessed it, swallowing 2. 5 different cranial nerves 3. CN V, VII, IX, X, and XII 4. There are 4

*Sensory Afferent Neuron Tuning and Intensity (Frequency)* 1. Is the tonotopic organization maintained throughout the auditory system? 2. In terms of spiral ganglion neurons, how is tonotopic organization associated with them? 3. Will neurons in spiral ganglion respond to a wide range of frequencies at high intensity sound levels?

1. Yes. 2. The position and properties of spiral ganglion neurons is also part of the coding frequency and intensity (volume) of sounds. 3. Yes (if you have a loud enough sound and high intensity it will stimulate the cochlea all over)

1. How does this circuit work with the expectation vs. outcome?

1. You have motor information and sensory information coming in and synapsing on the granule cell and prukinje cell. If the sensory and motor from the cortex match up the deep cerebellar nuclear cell will be inhibited and not fire. But if the motor and sensory are out of sync (i.e. you are walking but your foot is not in the right location for the next step) your deep cerebellar nuclear cell will be excited and it will fire and cause you to fix the position of your foot so that the motion you want will be accomplished! REMEMBER that the basket cells, Golgi II cells, and stelate cells internurons. will still be involved. this is just a basic diagram. OMG WOOOOWOWOWOWW

What are the bones (7) which articulate with the sphenoid bone?

1. Zygomatic 2. Frontal 3. Parietal 4. Temporal 5. Occipital 6. Maxilla 7. Vomer

1. What are the boarders of the tonsillar fossa? 2. What do you find in the fossa?

1. a. Superior constrictor muscle b. Hyoglossus c. Middle constrictor muscle (which makes up the bed of the fossa) 2. CN IX (Glossopharyngeal nerve)

1. What does the *buccal a.* travel with? 2. What is the path of the *buccal a.* (from pterygoid portion of maxillary a.)? 2. what does this artery supply? (3)

1. accompanies the *buccal n. (V3)* 2. travels *inferiorly across the lateral & medial pterygoid mm.* to reach the buccinator 2. *buccinators m.* *oral cavity* *cheek.*

1. What drink impairs the cerebellum? 2. What helps with sports, dance, and sports with motor control? 3. What helps you not fall over? 4. does the cerebellum have some cognitive control and cognitive modulation?

1. alcohol 2. the Cerebellum coordinating all motor movements 3. Cerebellum 4. Cerebellum. I mean yes.

*Vestibular Ganglion and Nuclei:* 1. There are also extensive *commissural (vestibulovestibular)* connections between the vestibular nuclei, allowing for what? 2. What is the recovery of postural reflexes after unilateral vestibular receptor loss due to trauma or disease called? 3. how fast does #2 occur? 4. Which pathway is important for #3 and #2

1. allowing for comparison of information between sides. 2. *vestibular compensation*. 3. This occurs gradually. 4. *commissural (vestibulovestibular)*

*Cholinergic Neurotransmission:* 1. So inhibiting acetylcholinesterase causes what? 2. it has been found in recent studies that a loss of WHAT causes the loss of cholinergic transmission in alzheimer's?

1. alot more acetylcholine in the synaptic cleft 2. Choline acetyltransferase (no drugs available clinically yet)

1. The root of the tongue is anchored to what? (3) 2. Why is this important?

1. anchored to the Mandible, Hyoid and Styloid process 2. this is the non-mobile portion which *provides support to the mobile portion (body)*

1. The pharyngeal a. arises superiorly w/n which fossa? 2. What is the course of the pharyngeal a. from the maxillary a.? 3. Provides branches to what? (3)

1. arises superiorly w/n the *pterygopalatine fossa* 2. & courses through the pharyngeal canal with the pharyngeal branch of V2. 3. *pharyngeal vault* *sphenoid sinus* *auditory tube*.

*Autonomic Innervation of the Head:* -General Consideration 1. Postganglionic sympathetic fibers are most often distributed to their target organs by traveling on the surface of WHAT? 2. Sometimes they may leave an arterial plexus to join parasympathetic elements which are following the path of what CN to reach their target organs?

1. arteries. 2. CN V (V1, V2, V3) t

*Conscious Vestibular Perception:* 1. The second area is WHERE? 2. This area receives inputs from the WHAT system (muscle spindle afferents, etc.) as well. 3. and appears to be involved in the integration of WHAT control of the head and body.

1. at the base of the central sulcus, adjacent to motor cortex (VPL and VPI) 2. -somatosensory system 3. motor control

1. What is the circuit modifier in the purkinjie layer? 2. What are the circuit modifier in the molecular layer? 3. Which cell in the cerebellum gets all the information from the body and cerebrum that converge on it. 4. What cells are then activated to then leave the cerebellum to provide something? 5. What cells modify the circuit and what layer are they in? 6. are the same layers and cell types found throughout the whole cerebellum? in no, where is it different?

1. basket cell 2. stellate cells 3. Granular cells 4. purkinje cells? 5. Gogli cells (granular layer) Basket cells (purkinjie layer) Stellate cells (molecular layer) 6. yes

1. Why do we not depend on the parasympathetic division for vasodilation? 2. But there are muscarinic receptors in what layer of the vasculature? 3. So what if we remove the layer we talked about in #2?

1. because most vasculature beds don't receive parasympathetic innervation. 2. endothelium 3. vasculature loses ability to respond to the ACh and muscarinic agonists (next card will describe it more)

*Organization of Primary Auditory Pathways* 1. Where does the primary central auditory pathways begin? 2. Where does it enter the brainstem? 3. What are the NT that are most likely present here? 4. Is tonotopic organization maintained throughout the auditory system? Does this mean the auditory cortex is tonotopically organized?

1. begin as the choclear portion of CN VIII. 2. enters the brainstem in the upper medulla. 3. NT = glutamate or aspartate 4. You betcha... Yes indeed that is the case.

*Motion and the Static Labyrith:* 1. b/c of the high density of the *otoconia*, a tilt of the head will cause the movement of the otolith membrane and do what to the hair cells? 2. Hair cells are also oriented in both the macula of the utricle and saccule relative to a depression called the WHAT? 3. such that some hair cells will be [depolarized (activated) or hyperpolarized (inactivated) or both?] in each macula 4. Do you need all of the macula together to compare and know what direction you are going?

1. bend the stereocillia hair cells either toward or away from the kinocilium. 2. *Striola* (the arch type continuous line in the green and blue circlely things in the picture)(( I added an arrow for greater understanding)) 3. BOTH. such that some hair cells will be depolarized (activated) and some hyperpolarized (inactivated) in each macula. 4. NOPE. because of the striola they have hair cells facing multiple directions so they can function independently from others even though your brain does use multiple to get information, but it could do it on one if it wanted to... what a loser...

*Blood Supply* to Eye and Orbit - funduscopic view 4. What 6 As & Vs to you see when looking in through a persons pupil?

4. - Superior & Inferior Temporal Retinal A/V - Superior & Inferior Macular A/V - Superior & Inferior Nasal Retinal A/V

*Thalamus* 1. Thalamus is a {mono-lobular OR bi-lobular OR tri-lobular} egg shaped structure that's divided medially by what? 2. Although only about ____% of brain weight, almost all info reaching cerebral cortex goes thru thalamus (________ is a primary exception) 3. Accordingly, almost all regions of cerebral cortex have ______ connections w/ thalamus.

1. bi-lobular thingy divided by 3rd ventricle 2. 2% brain weight (most except olfaction go through thalamus) 3. Reciprocal connections

*Vestibular Testing:* 1. The caloric test can also be used to evaluate some aspects of WHAT lesions and their extent in [conscious or comatose?] patients. 2. In normal conscious individuals, WHICH phases will be present. 3. In unconscious patients, only WHICH phases will be present. WHY?

1. brainstem lesions, in comatose patients but I guess it could be both 2. In normal conscious individuals, *both fast and slow phases* will be present. 3. In unconscious patients, only the *slow phase* will be present, since the fast phase is a *cortically mediated* response.

*Autonomic Innervation of the Head:* -General Consideration 1. These parasympathetic ganglia are suspended from what 3 branches of what CN? 2. Branches of the trigeminal nerve are used by WHAT other 3 CN to distribute postganglionic parasympathetic elements to viscera located along the path of CN v. 4. In some cases, postganglionic sympathetic fibers pass through these same ganglia ([with or without?] synapsing) en route to the same structures.

1. branches of V1, V2, and V3. 2. Branches of the trigeminal nerve are used by *CN Ill, VII, and IX* to distribute postganglionic parasympathetic elements to viscera located along the path of CN v. 4. in some cases Without synapsing.

*Deep cerebellar nuclei:* 1. How are they organized? 2. What are the 3 deep cerebellar nuclei again? 3. Which one has the most fibers going in the superior peduncle? 4. Which one is the most lateral cerebellar nucleus? 5. Which one is the most medial cerebellar nucleus? 6. what type of neurotransmitter outputs do they generally have?

1. columns 2. Dentate, Interposed (globaose and emboliform), and Fastigial 3. Dentate 4. dentate 5. Fastigial 6. outputs are generally glutamatergic

*Thalamus-Nuclear Groups & Functions* - *Lateral* - VP 1. *Ventral Posterior Nucleus (VP)* part of PW for what sensation? 2. Divided into what 2 primary parts? 3. Which nucleus is sometimes also included?

1. conscious appreciation of somatic sensation 2. i: *Ventral posterolateral (VPl)* ii: *Ventral posteromedial (VPm)* 3. *Ventral posterior inferior nucleus*

What is the Sympathetic action and adrenergic receptor on the following eye muscles 1. Radial Muscle, Iris. (also called the pupil dilator muscle) 2. Sphincter muscle ,iris. 3. Ciliary muscle

1. contraction (mydriasis) aka dilated pupil, Alpha 1 receptor 2. none, none, 3. Relaxation for far vision, Beta 2 receptor

1. Frontal eye field starts in the cortex and talks to what first? 2. What is the next stop? 3. What does #2 then talk to?

1. contralatera superior colliculus 2. PPRF 3. Ipsilateral abducens nucleus and contralateral occulomotor nucleus ( through interneuron) Same as sup colliculus pathway but have information starting in cortex so it's voluntary

*Complex Sound Deconstruction in the Cochlea* 1. What is the job of the basilar membrane? 2. It is [narrower/wider] and [looser/stiffer] near the base of the cochlea, compared to the apex. What is the helicotrema? 3. The hair cells are [longer/shorter] near the base as well. 4. With all of this in mind, higher frequency sound waves will resonate nearer to the [base/apex] and lower frequency sounds near the [base/apex].

1. contributes resonance properties over the length of the cochlear spiral as a variation from the physical structure of the membrane 2. Narrower and stiffer near the base of the cochlea. Helicotrema is the apex of the cochlea. 3. shorter near the base 4. Higher frequency = base Lower frequency = apex

*Doll's Eye Phenomenon -Oculocephalic Reflex:* 1. In a comatose patient, the brainstem vestibulo-ocular reflex is isolated from WHAT influences? 2. Stimulation of the vestibular system by turning the head will produce compensatory WHAT movements and this is called what reflex? 3 .Different degrees of WHAT damage are suggested by disruption of this reflex? 4. What is a normal oculocephalic reflex (doll's eye phenomenon)? 5. What is a abnormal oculocephalic reflex (doll's eye phenomenon)?

1. cortical influences 2. eye movemnets the (oculocephalic reflex). 3. brainstem damage 4. A normal response , turn head and eyes turn together to side opposite from turn of head. 5. Abnormal response, turn head and eyes do not turn in conjugate manner.

What is the Sympathetic action and Adrenergic receptor(s) on the following Intestine muscles and secretion 1. Motility and tone 2. Sphincters 3. Secretion

1. decrease, α1, α2, β1, β2 2. contraction, alpha 1 3. inhibition, alpha 2

What is the Parasympathetic action and ACh receptor(s) on the following heat things; 1. Sinoatrial node 2. Atria 3. Atrioventricular node 4. His-Purkinje system 5. Ventricle 6. what ACh receptors are used for all of these above?

1. decreased heart rate via M2 >> M3 2. decreased contractility via M2 >> M3 3. decreased Conduction velocity; AV block via M2 >> M3 4. Little effect via M2 >> M3 5. Slight decreased contractility via M2 >> M3 6. M2 >> M3

*Serotonin (5-Hydroxytryptamine, 5-HT):* 1. Depression is associated with [increased or decreased?] 5-HT function. 2. What is it usually treated with? 3. Ectasy (MDMA), LSD and other hallucinogens probably act in part by interacting with WHAT receptors?

1. decreased serotonin 2. SSRIs 3. 5-HT receptors

1. The *Inferior alveolar a.* (from the maxillary a, mandibular portion) will descend along the lateral surface of what? 2. It will enter which foramen? 3. What branches does it provide to teeth?

1. descend on the *lateral surface of the sphenomandibular ligament* to 2. *enter the mandibular foramen* in company with the inferior alveolar n. & v. 3. provides *DENTAL branches* to the mandibular teeth

1. When lesions are particularly diffuse or severe, may also show what?

1. dysarthria (Difficult or unclear articulation of speech that is otherwise linguistically normal.)

The pupillary reflex goes thru what nucleus?

1. edinger westphal nucleus

1. What causes oral hairy leukoplakia? 2. What causes oral thrush? 3. In order to tell the difference you scrape a tongue depressor against the white stuff on tongue. If the white stuff *does not* scrape off, which disease is it? 4. Both of these diseases common happen in people with what?

1. epstein barr virus 2. Candida ( a patogenic yeast) 3. oral hairy leukoplakia 4. Immunocompromised patients

1. other then granular cells in the granular layer what other cell is found there? 2. what type of fibers synapse on the granular cell? 3. After #2 the granular cell will pass its axons where? 4. after #3 they are going to interact with what dendrites? 5. What are golgi cells doing? 6. What is the circuit with the major players?

1. golgi cell (type 2) 2. mossy fibers 3. thru the purkinjie layer and out into the molecular layer to become parallel fibers 4. dendrites from the purkinjie cells 5. circuit modifiers 6. mossy fibers to granular cells to parallel fibers to purkinjie cells which then go to deep cerebellar nuclei

*Types of cells in Cerebellum:* 1. Granular cells are found in what layer? 2. granular cells become what fibers in what layer? 3. Purkinje cells are found in what layer? 4. Purkinje cells have dendrites that go where? 5. Purkinje cells have 2 targets what are they?

1. granular layer 2. parallel fibers in the molecular layer pushes through the purkinje layer 3. purkinje layer 4. to molecular layer communicate with parallel fibers 5. pass through the granular layer and goes to mostly the DCN (deep cerebellar nuclei - last stop before leaving the cerebellum) and some directly to vestibular nuclei

*Acquired Hearing Loss - Damage from Sound* 1. The auditory system is most sensitive to loss of what? why? 2. Acute loss can result from what? 3. Is lower intensities lost over a shorter or longer period of time? Can it damage bundles of hair cells?

1. hair cell loss because of its highly tonotopic organization. 2. a loud bang... 3. longer period of time. Yes.

*Sensory Detectors:* 1. The sensory detectors for both the static and kinetic motion detection of the vestibular portions of the vestibular system are what type of cells? 2. do Hair cells in the vestibular system lose their true cilium like those in the auditory system? 3. do the hair cells in the vestibular system have the same orientation of the stereocilia as those in the auditory system?

1. hair cells (neurons). 2. N.O.P.E. They have TRUE cilium on them unlike auditory hair cells which lose it during development. 3. YUP

1 Major pathways in the fornix are from where? 2 Go to where?

1. hippocampus, subiculum 2. to septal area, hypothalamus(precommissural), and mammillary bodies (postcommissural) it includes the direct and ID pathways. (precommissural=anterior to anterior commissure)

*Middle Ear*: Muscles 1. Paralysis of Stapedius or Tensor tympani can lead to what?

1. hyperacusis (difficulty tolerating everyday sounds, some of which may seem unpleasantly or painfully loud to that person but not to others)

*Globe* 1. What are the 3 tunics?

1. i: *Fibrous* Tunic ii: *Vascular* Tunic iii: *Neural* Tunic

Hypothalamic Functions *Control Eating* 1. What 2 areas of HT are eating centers & function of each? 2. What happens if you get b/l lesions at each? 3. How can you counteract *i* in Q2?

1. i: *Ventromedial HT (VMH)*: satiety center ii: *Lateral HT*: Apetite 2. i: VMH: Overeating/Obesity ii: Lat HT: Anorexia 3. just go lesion the Lateral HT!

*Thalamus-Nuclear Groups & Functions* - *Medial* 1. What are the 2 nuclei of the medial nuclear group?

1. i: Dorsomedial Nucleus (AKA mediodorsal nucleus) ii: Smaller medioventral nucleus

Hypothalamic Functions *Temperature* 1. What are the 2 primary body temp control centers on the hypothalamus?

1. i: Heat Loss center (Preoptic Thermoregulatory Center) ii: Heat Gain center (Posterior Hypothalamus)

*Thalamus-Nuclear Groups & Functions* - *Lateral* 1. 3 parts to the *Dorsal* Tier?

1. i: Lateral dorsal ii: Lateral posterior iii: Pulvinar

1. 3 parts to the *Obicularis Oculi*? 2. What innervates this muscle?

1. i: Orbital Bit ii: Palpebral Bit iii: Lacrimal Bit 2. (CN VII)

Lets start with the *Epithalamus* 1. Includes what 3 structures?

1. i: Pineal gland ii: habenular nuclei iii: Stria medullaris thalami.

*Vestibular Damage - Nystagmus:* 1. In the reverse direction, vertigo and nystagmus can also be produced opticokinetically. HOW?

1. if the visual surroundings are revolved while the body is stationary. see http://www.youtube.com/watch?v=U3KHgkZHuzc

*Sensory Innervation of the Nasal Cavity:* 1. Nasopalatine continues thru what canal to innervate the oral cavity? 2. Medial and lateral nares innervated by What CN? via what branches 3. most of the nasal cavity is the domain of what CN?

1. incisive canal 2. CN V 1 via Anterior Ethmoid 3. CN V 2

What is the Parasympathetic action and ACh receptor(s) on the following intestine muscles and secretion 1. Motility and tone 2. Sphincters 3. Secretion

1. increase; M3, M2 2. relaxation (usually); M3, M2 3. Stimulation; M3, M2

*Clinical Comments:* Caloric testing can be used to evaluate vestibular pathways: 1. How do you perform caloric testing? 2. To perform the test WHAT semicircular canal is positioned on/in vertical plane and convection currents?

1. induced by irrigating the external acoustic meatus with warm (40 degrees C) or Cold (30 degree C) water (usually about 50 cc. 2. The lateral (check out pic)

1. What is sialadenitis? 2. What causes it?

1. inflammation or infection of salivary gland (most commonly in submandibular) 2. infection, chronic inflammation, or blockage of duct by stone

1. What do the SVE fibers of V3 do? 2. In what nucles are these cell bodies? located?

1. innervate mm of pharyngeal arch origin 1 (muscles of mastication) 2. motor nucleus of V (medulla)

*Tinnitus* 1. What is objective tinnitus? 2. What is subjective tinnitus?

1. is *an actual sound that can be detected,* as a result of vibrations within the head (arteriovenous malformations, TMJ problems, constriction of blood flow at a point). 2. *associated with auditory system neural disturbance.* It can arise as a result of direct trauma, noise damage, an other nonspecific causes such as food allergies, ear infections, external ear material build up etc.

*Auditory Cortex - Belt Regions and Wernike's Area* 1. What is the auditory association cortex? 2. Where is this located? 3. What auditory sounds are more often than not processed in the left hemisphere? 4. What about the right?

1. it is the secondary auditory cortex (A2) 2. It surrounds the primary auditory cortex. 3. Speech (i.e. Wernike's area) 4. Belts region = music

Explanation: *Superior oblique* can depress and abduct the eye. 1. Abduction can also be accomplished by what muscle? 2. depression in the abducted eye can also be accomplished by what muscle?. [Thus, if the superior oblique is impaired, these functions will still exist.] 3. However, when the eye is fully_______, the superior oblique is the only muscle capable of______ the pupil. 4. In this position, the _____ loses its mechanical advantage. 5. Thus, if there is weakness or loss of depression in the fully adducted eye, ______ is impaired.

1. lateral rectus 2. inferior rectus 3. adducted, depressing 4. inferior rectus 5. superior oblique Superior oblique can depress and abduct the eye. Abduction can also be accomplished by lateral rectus; depression in the abducted eye can also be accomplished by inferior rectus. Thus, if the superior oblique is impaired, these functions will still exist. However, when the eye is fully adducted, the superior oblique is the only muscle capable of depressing the pupil. In this position, the inferior rectus loses its mechanical advantage. Thus, if there is weakness or loss of depression in the fully adducted eye, superior oblique is impaired.

Repeat: This will prob. be a test question.. 1. Abducent nerve (CN VI) innervates which eye muscle? 2. Trochlear nerve (CN IV) innervates which eye muscle? 3. Oculomotor nerve (CN III) innervates which eye muscles?

1. lateral rectus 2. superior oblique 3. levator palpebrae superioris, medial, superior, inferior rectus and inferior oblique LR6SO4R3

Explanation: *Inferior oblique* can elevate and abduct the eye. 1. Abduction can also be accomplished by what muscle? 2. elevation in the abducted eye can also be accomplished by what muscle? [Thus, if the inferior oblique is impaired, these functions will still exist.] 3. However, when the eye is fully______, the inferior oblique is the only muscle capable of______ the pupil. 4. In this position, the _______ loses its mechanical advantage. 5. Thus, if there is weakness or loss of elevation in the fully adducted eye, _______ is impaired.

1. lateral rectus 2. superior rectus 3. adducted, elevating 4. superior rectus 5. inferior oblique Inferior oblique can elevate and abduct the eye. Abduction can also be accomplished by lateral rectus; elevation in the abducted eye can also be accomplished by superior rectus. Thus, if the inferior oblique is impaired, these functions will still exist. However, when the eye is fully adducted, the inferior oblique is the only muscle capable of elevating the pupil. In this position, the superior rectus loses its mechanical advantage. Thus, if there is weakness or loss of elevation in the fully adducted eye, inferior oblique is impaired.

1. What is the fractured somatotpy? 2. the vermis gets input from what parts of the body? 3. the paravermis gets input from what parts of the body

1. like a homunculus just not continuous. look at the pic? 2. axial 3. para axial

*Anastamoses:* 1. Why should we call it *little's area* and not kiesselbach's area? 2. How do you tell the difference b/w a sphenopalatine nosebleed from littles area and a nosebleed from a deeper artery?

1. little was AMERICAN #freedom. also little described it first 2. if it is from little's area it will be more oozing and easier to stop. if it is deeper it will be more pulsatile and harder to stop.

*AChE (organophosphate) Inhibitor Toxicity:* 1. With Percutaneous absorption what are the 2 main symptoms? 2. What type of agents have CNS involvement following rapidly?

1. localized sweating and muscle fasciculations 2. Lipid-soluble agents: CNS involvement follows rapidly

1. Where is the hippocampal formation located? 2. What is the hippocampual formation? 3. What is its function?

1. located In the temporal lobe under the parahippocampal gyrus with which it is continueous with 2 A collection of structures that are defined by position and cellular architecture that include 1 dentate gyrus 2 hippocampus proper 3 subiculum This structure borders the inferior horn of the lateral ventricle. 3. important in memory and learning

Explanation: *Superior rectus* can elevate & adduct the eye. 1. Adduction can also be accomplished by which muscle? 2. elevation in the adducted eye can also be accomplished by what muscle? [Thus, if the superior rectus is impaired, these functions will still exist.] 3. However, when the eye is fully __________, the superior rectus is the only muscle capable of__________ the pupil. 4. In this position, the _______ loses its mechanical advantage. 5. Thus, if there is weakness or loss of elevation in the fully abducted eye, ________ is impaired

1. medial rectus 2. inferior oblique 3. abducted, elevating 4. inferior oblique 5. superior rectus Superior rectus can elevate and adduct the eye. Adduction can also be accomplished by medial rectus; elevation in the adducted eye can also be accomplished by inferior oblique. Thus, if the superior rectus is impaired, these functions will still exist. However, when the eye is fully abducted, the superior rectus is the only muscle capable of elevating the pupil. In this position, the inferior oblique loses its mechanical advantage. Thus, if there is weakness or loss of elevation in the fully abducted eye, superior rectus is impaired.

Explanation: *Inferior rectus* can depress and adduct the eye. 1. Adduction can also be accomplished by which muscle? 2. depression in the adducted eye can also be accomplished by which muscle? [Thus, if the inferior rectus is impaired, these functions will still exist.] 3. However, when the eye is fully______, the inferior rectus is the only muscle capable of ________ the pupil. 4. In this position, the ________ loses its mechanical advantage. 5. Thus, if there is weakness or loss of depression in the fully abducted eye, _____ is impaired.

1. medial rectus 2. superior oblique 3. abducted, depressing 4. superior oblique 5. inferior rectus Inferior rectus can depress and adduct the eye. Adduction can also be accomplished by medial rectus; depression in the adducted eye can also be accomplished by superior oblique. Thus, if the inferior rectus is impaired, these functions will still exist. However, when the eye is fully abducted, the inferior rectus is the only muscle capable of depressing the pupil. In this position, the superior oblique loses its mechanical advantage. Thus, if there is weakness or loss of depression in the fully abducted eye, inferior rectus is impaired.

Recap of last card: 1. the medial parts of your visual field are found on what part of the retina? 2. the lateral parts of your visual field are found on what part of the retina?

1. medial visual field = lateral parts of retina 2. lateral visual field = medial parts of retina

1. How can we have the sympathetic nervous system controlling both vasoconstriction (alpha 1) and vasodilation (Beta 2)? 2. Norepinephrine has a higher affinity for what receptors? 3. What receptor has relatively low affinity for Norepinephrine? 4. the dominant affect of the sympathetic nervous system is vasoconstriction or vasodilation?

1. preferential binding of norepinephrine and epinephrine. 2. Alpha1, Alpha2, and Beta1. 3. Beta2 4. Vasoconstriction

*Sensory Detectors: Hair Cells* 1. Supporting cells contain what type of "cilia" (it isn't cilia but kinda like cilia) 2. Hair cells release what 2 excitatory neurotransmitters? 3. Efferent nerve originating in the reticular formation release what 2 neurotransmitters? 4. The neurotransmitters in #3 do what?

1. microvilli 2. glutamate/aspartate - excitatory 3. acetylcholine and CGRP - (calcitonin gene related peptide) 4. modulate activity of hair cell or vestibular afferent.

More pathway of chorda tympani 1. It passes through an upward arching canal which opens up into the what part of the ear? 2. It exits the middle ear cavity to enter the which fossa via the petrotympanic fissure? 3. What nerve will chorda tympani join high in the infratemporal fossa?

1. middle ear 2. Infratemporal fossa 3. Lingual n.

1. Parasympathetic innervation to sphincter pupillae results in what? 2. Parasympathetic innervation to ciliary muscle results in what? 3. Decreased parasympathetic innervation to sphincter pupillae can result in what? 4. Decreased parasympathetic innervation to ciliary muscle results in what?

1. miosis (constriction of pupil) in bright light. 2. accommodation 3. loss of pupillary constriction; pupil will be dilated. 4. inability to focus on near objects (presbyopia)

*General Circuitry of the ANS:* 1. The adrenal medulla is like a modified what? 2. does parasympathetics or sympathetics synapse on the adrenal medulla? 3. what neurotransmitter is used? 4. What is the receptor on the adrenal medulla? 5. What does the adrenal medulla release generally when sympathetics activate it?

1. modified ganglion 2. Sympathetics 3. ACh 4. nAChR 5. systemic epi and NE because it goes straight into the blood stream from the adrenal medulla

*Foramen Rotundum* 1. What is its orientation out of the 3 openings in the posterior wall? 2. What does it allow the PPF to communicate with? 3. What does it transmit?

1. most lateral/superior 2. Middle cranial fossa 3. Maxillary nerve (CN V2)

*Thalamus-Nuclear Groups & Functions* - *Lateral* - VL 1. *Ventral Lateral nucleus (VL)* functions mostly associated with its {anterior OR posterior} part that receives projections from where?

1. mostly associated with its *posterior* part that receives projections from the *cerebellum*

*Middle Ear* 1. What covers all contents of the middle ear? 2. This means that what major structures in the middle ear are covered?

1. mucous membrane 2. Mucosa covers the bones of the middle ear!

*Superior Olivary Nuclei* 1. Where is this located? 2. Which is the first nucelus in which binaural information converges? 3. Where is the first level of processing for the localization of sound in auditory fields? 4. T or F: processing for the localization of sound is done soley through a single ear at a time.

1. near facial motor nucleus in the brainstem ( mid-pons) 2. The superior olivary nuclei 3. The superior olivary nuclei 4. False; this localization of sound is done through comparisons of the signal from each ear.

1. What is the weirdly named thing that is soluble in saliva & detected in the Gustatory System? 2. What are the 5 recognized tastes?

1. non-volatile *Tastants* 2. Sweet (Rob) Sour (Garrett) Bitter (Jamon) Salty (Cam) Umami (Savory - Andy)

What is the Parasympathetic action and ACh receptor(s) on the following eye muscles 1. Radial Muscle, Iris. (also called the pupil dilator muscle) 2. Sphincter muscle ,iris. 3. Ciliary muscle

1. none, none 2. Contraction (miosis) aka constricted pupil, M3, M2 3. Contraction for near vision, M3, M2

*Vestibular Ganglion and Nuclei:* 1. The afferents of vestibular fibers on the vestibular nuclei are highly ordered, with most neurons receiving information from how many otolith organ and how many pair of semicircular canals (horizontal or vertical). 2. This arrangement allows for what? (3) 3. Information is subsequently distributed how broadly across the CNS?

1. one otolith organ and one pair of semicircular canals (horizontal or vertical). 2. This arrangement allows for the distribution of information about the direction and speed of head movement as well as the position of the head with respect to gravity. 3. Information is subsequently distributed more broadly across the CNS than any other sensory system.

*A PATHWAY* 1. After light/image has hit the retina & info is being sent, what is the first thing it travels through? 2. What's the structure called at which Q1 converge? 3. What are the structures called after Q2 4. Q3 travel just lateral to what?

1. optic nerve 2. optic chiasm 3. optic tracts 4. Lateral to cerebral peduncles.

1. Superior colliculus has an *ipsilateral* projection down to the pons to the next nucleus, which is??? 2. It then realays through what tract to get to it's next destination? 3. What are the two nuclei that it's headed towards? 4. For which in #3 does it have to ascend through an interneuron to get to?

1. paramedian pontine reticular formation (PPRF) 2. relay in MLF 3. Abducens and occulomotor 4. ascends to occulomotor

*Sympathetic vs. Parasympathetic Tone:* Match the following to either sympathetic or parasympathetic: 1. Smooth muscle contraction 2. rest and digest 3. Smooth muscle relaxation 4. Fight or flight 5. decreased secretion and motility 6. increased secretion and motility 7. urination, defecation

1. parasympathetic 2. parasympathetic 3. sympathetic 4. sympathetic 5. sympathetic 6. parasympathetic 7. parasympathetic

1. What is the function of the parasympathetics that travel to the through this pathway? 2. What are some of the dysfunctions that are caused by these pathways are knocked out??

1. parasympathetic innervation to mucous glands results in increased mucus production 2. Keratoconjunctivitis sicca: dry, red eye Dry, irritated nasal passages (makes them at increased risk for infections)

*Endolymph vs. Perilymph* 1. Which is in the bony labyrinth? what about the membranous? 2. Which has high Na+? What about high K+? 3. What are both of these important for?

1. perilymph, endolymph 2. perilymph, endolymph 3. important in establishing membrane potentials as part of sound transduction into action potentials.

Innervation of the top teeth 1. What innervates the back 2 1/2 teeth? 2. What innervates the middle 2 1/2 teeth up top? 3. What innervates the incicors and canine teeth up top?

1. post superior alveolar n. 2. Middle superior alveolar n. 3. Anterior superior alveolar n.

1. Fibers of chorda tympani pass imperceptibly within the lingual nerve to reach the submandibular ganglion where they synapse ·on what type of neurons?

1. postganglionic parasympathetic neurons

*Vestibular Output - The Vestibulospinal Network:* 1. The *medial and lateral vestibulospinal tracts* produce WHAT? 2. The vestibular nuclei also have a large input into the WHAT system? 3. The lateral vestibulospinal tract arises from WHAT 2 vestibular nuclei? primarily innervated from what organ? 4. #3 It travels [ipsilaterally or contralaterally?] in WHAT funiculus. 5. It does so in a WHAT type of organized fashion 6. to end on what motor neurons? 7. as well as interneurons in WHAT Lamina?

1. reflex postural adjustments to the head and body. 2. The reticulospinal System 3. the lateral and inferior vestibular nuclei (primarily otolith organ innervated). 4. *Ipsilaterally* in the *Anterior* funiculus 5. topographically organized fashion 6. alpha and (to some extent) gamma motor neurons 7. Lamina VII to IX.

*Ocular Reflexes: Corneal reflex* 1. What is it? 2. Afferent through what n? 3. Efferent through what n?

1. reflex to blink when something's about to touch your eye 2. CN V1 3. CN VII

What is the Sympathetic action and Adrenergic receptor(s) on the following lung muscles/glands 1. Tracheal and bronchial smooth muscle 2. Bronchial glands (hint: there are 2 actions and 2 receptors for this one)

1. relaxation, Beta 2 2. -decreased secretion, via alpha 1 -increased secretion, via beta 2

*General Circuitry of the ANS:* 1. Where in the sympathetic system is there a tissue that has dopamine receptors? 2. What NT does the postganglionic sympathetic neuron release there?

1. renal vascular smooth muscle has dopamine receptors. don't worry we will learn lots more about this in renal next year #yay 2. DOPAMINE

*Tinnitus* 1. What is this? 2. Where does it come from? 3. What % of population has this? 4. What are the 2 forms? 5. What accompanies it?

1. ringing in the ears 2. unclear origins, appears to be associated with hearing damage (loud noises, infections). 3. 20% 4. Objective tinnitus and Subjective tinnitus 5. hyepracusis (sensitivity to loud sounds)

*Kinetic Labyrinth Function:* 1. The anterior and posterior canals are sensitive in the same manner to what 2 movements. 2. This opposing set of signals from the semicircular canals of each ear is detected and compared within WHAT system for differences in activity and frequency of action potentials. 3. The comparison of activity forms the basis for the transduction of WHAT movement to action potentials that can be interpreted by the brain.

1. roll and pitch movements 2. The Central Nervous system 3. ANGULAR movement

Micturition control: 1. When bladder is full you get parasymp from which part of spinal cord, telling you to do what? 2. BUT you also get info sent up to where? 3. What does Q2 control?

1. sacral spinal cord letting your detrusor know to contract & void (you also get sympathetics saying to fill the bladder & not let anything out) - reflex portion 2. *Pontine Micturition Center* 3. If it's an appropriate time to void

Eye Embryology: *Retinal Detachment* (CC) 1. What is it? 2. Why can this lead to blindness??

1. separation of internal & external layer of optic cup (separating pigmented ET from rods/cones) 2. Our photoreceptors don't work as well w/o the pigmented layer (even though it still works in cats... turns out we're different than cats)

*Acetylcholine in the CNS* 1. Where are the acetylcholine neurons in the brain 2. What are the 3 functions of Acetylcholine in the CNS?

1. single course divergent pathway- originate in one location within the neuronal nucleus and then they connect all over the brain. check out dope pic. 2. Functions -Wakefulness -Motor control -Memory

*Palatoglossus* 1. Where does it originate? 2. Where does it insert? 3. What innervates it? 4. What is its function? 5. What is it called when its covered in mucosa?

1. soft palate via palatine aponeurosis 2. side of the tongue 3. pharyngeal branch of vagus n 4. pulls tongue and soft palate together during swallowing. 5. ITS KNOWN AS THE PALATOGLOSSUS FOLD! DONT FORGET THIS!

*Palatopharyngeus* 1. Where does it originate? 2. Where does it insert? 3. What is its innervation? 4. What is its function? 5. What is it called when it is covered in mucosa?

1. soft palate via palatine aponeurosis 2. thyroid cartilage 3. pharygneal branch of vagus n 4. swallowing 5. palatopharyngeus fold

Auriculotemporal n. 1. passes posteriorly within the infratemporal fossa between the neck of the mandible and *what ligament*? 2. during #1 it runs in company with what artery and vein? 3. What part of the parotid gland does the auriculotemporal n. ascend through? 4. When the auriculo temporal n crosses the zygomatic arch to run in the scalp anterior to the ear what a. and v. is it now in company with?

1. sphenomandibular ligament 2. *maxillary a and v.* 3. *superior portion* of the parotid gland 4. in company with the *superficial temporal artery and vein*. Innervates the

1. Chorda tympani arises from CN VII just prior to it which foramen? clarification before CN VII exits 2. Does Chorda tympani house post or pre ganglionic parasympathetics?

1. stylomastoid foramen 2. Preganglionic parasympathetics

1. What is the function of the sympathetic fibers in this region? 2. If dysfunctional, what happens?

1. sympathetic innervation to lacrimal and mucous glands modifies gland secretion (makes it more watery) 2. Its usually pretty minimal, nothing crazy.

the Cuneocerebellar tract, Rostral spinocerebellar tract, Dorsal spinocerebellar tract, and the ventral spinocerebellar tract all input to the trunk and limb postural adjustments that we just went over. 1. all of them but one go thru which peduncle? 2. which one is the odd one that goes through the other peduncle? which peduncle is it?

1. the Cuneocerebellar tract, Rostral spinocerebellar tract, and Dorsal spinocerebellar tract go thru the inferior peduncle 2. The Ventral spinocerebellar tract goes thru the superior peduncle

*Paranasal Sinuses*: 1. These are outgrowths of what? 2. what type of epithelium are they lined with?

1. the Nasal cavity and intimately associated to it 2. Respiratory epithelium

*Thalamus-Nuclear Groups & Functions* - *Lateral* *Pulvinar* (pillow) 1. Can be seen from what area? 2. How many subnuclei?

1. the back of the thalamus dorsally & laterally from the brainstem. 2. 4 subnuclei

*Vestibular Damage - Nystagmus:* 1. The direction of the nystagmus is named for the fast or the slow phase? 2. which phase is saccade and cortically mediated 3. Which phase a brainstem mediated response?

1. the fast phase. 2. The FAST phase 3. The SLOW phase

flip the dec for the pic

1. what level of the brainstem we be at? 2. What be the arrow on the right? 3. What be the arrow on yer left? 4. What is happening to the olivarycerebellar tract b/w #2 and #3? yo ho yo ho a pirates life fer me 1. Middle Medulla (mid-Olivary level) 2. Inferior olivary nucleus 3. Inferior cerebellar peduncle 4. decussation of the fibers from the inferior olivary nucleus to the inferior cerebellar peduncle to enter the cerebellum

there is a trilobite on the flipside check that issh out

1. what part of the brainstem is this? 2-5. ID 6. #4 and #5 make up what? 7-9. ID 1. Middle medulla 2. Flocculus 3. Dentatne nucleus 4. Emboliform nucleus 5. Globose nucleus 6. interposed nucleus 7. Fastigial Nucleus 8. Vermis 9. 4th Ventricle

*Spinocerebellar ataxias:* 1. What is a intention tremor 2. What is dysmetria 3. what is ataxia 4. What is Dysdiadochokinesia?

1. when you are still you don't have a tremor but when you move or "intend" to do something you tremble issue with the cerebellum 2. When you ask them to touch the pen and then touch the nose they can't do it they miss, usually overshoot, are uncoordinated. happens in eyes as well, it overshoots the target. 3. the loss of full control of bodily movements. different types all b/c of problems with the cerebellum 4. Can switch actions quickly. impaired ability to perform rapid, alternating movements

1. Postganglionic sympathetics distribute to nasal mucosa with branches of what CN and what do they regulate?

1. with branches of V2 and regulate the vasculature

* Perfusion of the Nasal Cavity:* 1. The Ophthalmic artery within the WHAT gives off what 2 branches? 2. #1 branches supply what part of the nasal cavity?

1. within the ORBIT gives off the *Posterior and Anterior Ethmodial* branches 2. Superior Nasal cavity

*General Circuitry of the ANS:* 1. What does it mean if she says a neuron is cholinergic? 2. So what does the "-ergic" mean for a neuron?

1. yeah I don't know either. jk it means it synthesizes and releases ACh as its NT (neurotransmitter) 2. It means what ever "-ergic" it is it will synthesize and release that NT what type of information that cell is giving to the cell on the other side of that synapse (CNS has lots of

*Cholinergic Neurotransmission:* 1. Is there Cholinergic Neurotransmission in the brain? 2. What is "uptook" into the cell to make Acetylcholine? 3. What enzyme makes acetylcholine? 4. After it is made where does it go? 5. what causes it to be released into the synaptic cleft?

1. yeah buddy 2. choline 3. Choline acetyltransferase 4. pumped into the vesicles 5. once the action potential arrives Ca2+ is pumped into the cell which causes the release of the vesicles into the synaptic cleft.

*Sensory Afferent Coding of Intensity (Volume)* 1. Can it be similar in some ways to somatosensory systems? 2. Is the volume encoded by action potential numbers from threshold to saturation? 3. And the number of neurons responding to the stimulus? 4. What is the range of spiral ganglion cells in terms of dB? 5. What is the relationship to frequency and intensity of sound?

1. yes 2. Yes 3. YES 4. rang of about 40 dB 5. A neuron responds with greater frequency of firing to a greater intensity of sound.

*quick summary:* 1. So is the hair cell always firing? 2. When fluid flows away from the kinocilium does the hair cell fire more or turn off? 3. When the fluid flows toward the kinocilium does the hair cell fire more or turn off?

1. yes 2. hyperpolarize so turns off 3. Depolarizes so fires more

1. So does CN XI then get bilateral distribution from the cortex then? 2. If you see a discrepancy of the shrug test, where would you expect the lesion to be? 3. Torticollis will only occur if what part of the tract is lesioned?

1. yes it does! 2. The spinal accessory nucleus or the spinal accessory nerve as it is going out. 3. The spinal accessory nucleus or the nerve on its way out (will not occur in a cortical lesion).

*Corticobulbuar Projections* 1. Are corticobulbar projections different for SVE nuclei than for GSE nuclei? 2. So which of these, SVE or GSE fibers, will have bilateral projections? 3. If there is a lesion in #2, what will it look like?

1. yes they are 2. The SVE fibers have bilateral projections. 3. Since there is bilateral projections things will still look like they are intact and everything looks like it is ok

*Trigeminal Nerve Fiber Types* 1. Is there both a motor and a sensory nucleus for the trigeminal nerve? 2. With the machinery of the trigeminal nerve in mind, what would a reflex arch look like here? 3. From the other reflexes we just named (3 cards ago) what reflex pathway did we just describe?

1. yes, its just medial to it (look at the artist rendition... simply stunning. I think ill use it in my next film [the man says with a snobbish grin]). 2. Afferent information coming in through one of the divisions (V1, V2, V3) to the mesencephalic nucleus (i.e. proprioceptive info), the info then synapses in the motor nucleus, sends out info from the motor through the fibers out to the musculature. 3. the jaw jerk reflex

*General Circuitry of the ANS:* 1. does the sympathetic system use any muscarinic receptors at the tissue level? 2. Where? 3. At #2 what NT does the postganglionic sympathetic neuron release?

1. yup 2. Main place we have to know is at the sweat glands 3. ACh! crazy right.

1. What is Clonidine? 2. This decreases [sympathetic or parasympathetic tone?] 3. Net result is similar to a [beta or alpha1?] blocker?

1. α2-Selective Receptor Agonist 2. BOTH. 3. Net result is similar to that of a combined beta and alpha1 blocker

1. How many odorant receptors do humans have? 2. How many different odorant receptor genes per olfactory neuron? 3. How many odorants are detected per odorant receptor? 4. How many different odorant can humans detect overall?

1. ≈400 2. Just 1 odorant receptor gene per olfactory neuron 3. Some receptors detect 1 unique odorant, while others detect a class of odorants. 4. a *tri*llion!!

*GABA: The Primary Inhibitory NT:* ROLES of GABA 1. GABA balances [excitatory in inhibitory?] activity of what NT? 2. GABA dysfunction leads to [hyperexcited or hypoexcited?] states? 3. GABA-mimetic drugs are used to induce WHAT and control what 2 things?

1.Balances excitatory activity of glutamate 2. GABA dysfunction leads to hyperexcited states 3. GABA-mimetic drugs are used to induce sleep and control anxiety and seizures

MCA stroke symptoms

Pt presents w/: -Sensory and motor deficits Contralateral UE & Face -Parietal/Temporal deficits -Possible BG deficits

*Epithalamus* 10. The habenular nuclei are paired nuclei connected through what? Near what? 11. They receive info through what other brain structure 12. Q11 sends info via what PW? 13. Habenular nucleii send a tract (*Name of Tract*?) back to a nucleus (*Name of Nucleus*?) located *b/w what structures*?

10. Habenular commissure near cerebral aqueduct. 11. Basal ganglia 12. Via stria medullaris 13. *habenulointerpeduncular* tract to *interpeduncular nucleus* (b/w cerebral peduncles)

10. Which of the 3 PWs from Q3 was once thought to carry crossing afferents (but we now know that is bunk)? 11. So, if this PW doesn't take axons to the contralateral olfactory bulb, what does?

10. Medial Olfactory Stria (No axons to contralateral bulb) 11. Axons from AON cross over via *Anterior Commissure*

*Neural processing in the Cochlea* 10. We mentioned the outer hair cells receive a lot of efferent info, from what olivary nucleus specifically does it come? 11. What role does #1 play? 12. What is it also associated with?

10. Olivocochelar bundle from the superior olive in the brainstem (his words). 11. Origin of auditory sharpening; being able to concentrate on pacific sounds in a busy room (i.e. ignoring annoying people) 12. Associated with contractile properties of outer hair cells.

*SUMMARY:* -Parasympathetic Innervation of the Head 10. The Lesser Petrosal Nerve has parasympathetics from what CN? 11. #10 sends parasympathetics to WHAT gland via WHAT nerve(from what CN) and WHAT ganglion?

11. Parotid gland via lesser petrosal n. to otic ganglion and auriculotemporal n. (V3) to parotid gland

*SUMMARY:* -Sympathetic Innervation 11. The deep petrosal nerve gets to the Lacrimal gland and mucous glands of the nasal cavity, oral cavity, pharynx, and palate via what other nerve and branches of what CN? 12. The cavernous plexus feeds the Dilator pupillae muscle via the sympathetic root of what ganglion? then thru what nerves? or directly via what what nerves?

11. n. of the pterygoid canal, and branches of V2. 12. sympathetic root of the ciliary ganglion and short ciliary nerves or directly via the nasociliary and long ciliary nn.

*Glutamate: The Primary Excitatory NT:* 12. What are the 3 main glutamatergic receptors in the postsynaptic neuron in the CNS? 13. which receptor from #1 can allow extra calcium in the cell? 14. What does the extra Calcium do? 15. excitotoxicity leads to what?

12. AMPA and NMDA receptors, and mGLuR (metabatrophic glutamate receptors) 13. NMDA receptor 14. all the extra CA2+ essentially causes apoptosis 15. neuronal cell death. :`(

Ear Review: 12. Function of the external portion of the ear (pinna, auricle)? 13. Auricle & meatus are designed to collect and focus sound waves to what structure? 14. Tympanic membrane is displaced by what? 15. Thru Q14 converts sound waves into what?

12. Focuses sound waves into external acoustic meatus 13. tympanic membrane 14. Pressure changes of sound waves 15. Mechanical motion of middle ear ossicles

12. What is the name of the tissue surrounding the Optic Stalk/Cup & all that crap? 13. What does this tissue form?

12. Mesenchyme 13. Forms the Dura, Arachnoid & Pia Matters (this means that the meninges surround the optic nerve)

*Tastant Receptors* 12. Isolated 1st order neurons fire AP in response to how many tastants? 13. Only exception to Q12? 14. So if 1 neuron is carrying all this taste info, where does it all get sorted out again?

12. More than 1 13. Only *bitter* taste cells are innervated to exclusion of all others (bitter neurons only bitter info) 14. Gustatory Cortices (analyze pattern & generate sensation of taste)

Hypothalamic Functions *Temperature* So let's review... "I'm *too cold*" 13. What area is now inhibited? 14. What area takes over? 15. What system does it recruit? 16. What are body responses?

13. Preoptic Area 14. Posterior (Heat Gain) 15. Paraventricular (ANS) 16. Vasoconstriction, ↓ Panting/Sweating, ↑ HR, Brown fat thermogenesis, shivering, nest building

Hypothalamic Functions *Arousal & Sleep/Wake* 14. What happens when you have a mutation in orexin system & you get too excited? 15. It is believed that Q14 is an intrusion of what sleep interval on wakeful state. Why do they think this?

14. Arousal nuclei need stimuli but aren't getting it, so they can't keep up and you fall asleep in Benihana. 15. REM (loss of muscle tone & paralysis seen in these people (or dogs) but wakeful neural activity in brain)

(she's all over the place)... We talked about how our optic cup has 2 layers... 14. Outer layer of optic cup becomes what? 15. Inner layer of optic cup becomes what?

14. Pigmented ET layer of retina 15. Neural layer of retina

*Internal ear* 14. The Otic vesicle forms what 3 tubes w/in the otic duct? 15. Which of these tubes does the sensing?

14. Scala Vestibuli, Scala Tympani, Cochlear Duct 15. The Cochlear Duct (aka Scala Media)

*Epithalamus* 14. The habenular nuclei have been implicated in a number of functions including what 3?

14. i: Negative reward signal & inhibition of midbrain dopamine neurons ii: Negative emotions iii: Depression & schizophrenia

How many branches come off of the maxillary a.? How many in each section?

16 Mandibular: 5 Pterygoid: 5 Pterygopalatine: 6

16. As the weeks drag on, what fills in around the *Hyaloid* Artery? 17. what is found in the middle of the optic stalk/nerve? 18. About when does the choroid fissure close?

16. *Neural layer* of retina 17. Optic Artery/Vein 18. Wk 7

Ear Review: 16. What is the 1st mode of transduction in the ear? 17. What is it that creates resonance properties that enhance some frequencies more than others? 18. Is the enhancement of sound is direction dependent. 19. Localization of sound with one ear (monaural localization) is dependent on what?

16. Air waves to mechanical motion of ossicles 17. Design of external ear 18. Yes (easier to hear in front you you than behind) 19. Upon directional dependent cues (requires that auricle is intact)

*Internal ear* 16. What is *Cochleosaccular dysplasia*?

16. Collapse of cochlear duct and saccule (leads to non-formation of the 3 tubes within the tube)

The Amygdala has Bi-Directional Connections with Brainstem, Limbic and Cortical Structures. It has 2 major pathways: (1) The ______________ ________________ which contains efferents from corticomedian nucleus, and (2) The ______________ ________________ which contains efferents from basolateral and central nuclei

2 Pathways : (1) *Stria Terminalis* - efferents from corticomedian nucleus (2) *Amygdalofugal Tract* - efferents from basolateral and central nuclei

*Middle Ear*: Blood Supply (flip)

2 main vessels + what they supply? Answers hiding ↓ A: *Anterior Tympanic A* (Tympanic membrane; ossicles) B: *Stylomastoid A* (Posterior tympanic cavity)

*Thalamus-Nuclear Groups & Functions* - *Lateral* - VL 2. VL Receives afferents from what nuclei? 3. It projects (reciprocally) to where? 4. Function of VL?

2. *Deep cerebellar nuclei* (esp *dentate* & some pallidal) 3. 1° motor area (precentral gyrus) 4. Participates in cerebellar related regulation of motor activity.

2. Which shell contains the majority of the nuclei? 3. What separates the *Medial & Lateral Shells*?

2. *Medial Shell* 3. Columns of the Fornix

2. A 29 y/o male presents to the emergency department unconscious with nonreactive, pinpoint-sized pupils, massive oral foaming, and muscle fasciculations. His pants are wet with urine and feces. Information provided by his wife reveals that he has a history of depression and attempted suicide 3 years ago. He is not taking any current medications. An agent from which drug class was most likely ingested? A. AChE inhibitors B. Beta-blockers C. Centrally acting alpha-2 receptor agonists D. Local anesthetics E. mAChR antagonists 3. Do the patient's symptoms indicate increased or decreased activity of cholinergic receptors? Which type of drug could explain ALL of the patients symptoms?

2. A. AChE inhibitors 3. Symptoms indicate overactivation of parasympathetic division (muscarinic) What about fasciculations? These are due to stimulation of nicotinic receptors Remember that AChE inhibitors will increase levels of endogenous ACh and thus stimulate both muscarinic and nicotinic AChRs. organophosphate

1. The choroid (vascular) tunic is going to be continuous with what?

2. Ciliary process & bodies (form *intra*ocular muscles) ∴ Intraocular muscles develop from neural crest cells

*Reticular Nucleus* 2. Receives connections from where? 3. The nucleus is rich in what kind of neurons? (suggesting which function?) 4. Sends reciprocal projections where? 5. Function?

2. Collaterals of thalamic projections 3. GABAergic (inhibitory function) 4. Same nuclei (*Does NOT project to cortex*) 5. Appears to modulate (gate) or integrate activity of the nuclei (focuses a stimulus PW - lateral or surround inhibition). [This may relate to saliency or focusing on a sensory or motor modality]

2. So this means, if you're looking at a scary wombat in the wild & you freak out (sympathetic response) what muscle (in eye) fires & what happens to your pupil? 3. So this means, if you're looking at a a nice grandma that made you roast beef & Yorkshire puddings your mouth waters (parasympathetic response) what muscle fires (in eye) & what happens to your pupil?

2. Dilator pupillae mm - dilate pupil 3. Sphincter pupillae mm - constrict pupil

2. What will substantia niagra pars compact release?

2. Dopamine targeting D1 receptors

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 2. Fibers destined to form the Greater petrosal nerve branch within WHAT portion of WHAT bone and exit the WHAT hiatus?

2. Fibers destined to form the *greater petrosal nerve* branch within the petrous portion of the temporal bone and exit the hiatus of the greater petrosal nerve (hiatus canalis facialis).

Hypothalamic info (PVN) down to many nuclei in the tegmentum? *Nucleus Solitarius* 2. Type of info here? 3. Function of this center?

2. GVA center 3. Regulates baroreceptor reflex (BP, CO2 content, etc)

Hypothalamic info (PVN) down to many nuclei in the tegmentum? *Periaqueductal Gray* 2. Functions of this region (3)? 3. Using which tract, will the hypothalamus coordinates with the PAG 4. Some examples of drive-related behaviors (skeletomotor) via PAG?

2. Info related to pain (modulation), regulates physiology & behaviors to threats (amygdala) 3. *Dorsal longitudinal Fasciculus (DLF)* (skeletal muscle activation for drive-related behaviors) 4. Defensive reactions Vocalization Mating (oo la la)

Hypothalamic info (PVN) down to many nuclei in the tegmentum? *Pontine Micturition Center* 2. Function of this region?

2. Inhibits pre-ganglionic sympathetics & activates pre-ganglionic parasympathetics involved in urination (of course, this is when you're ready to go)

*Norepinephrine:* Norepinephrine plays roles in what in the CNS from the list below? 1. reward 2. learning and memory 3. anxiety 4. pain 5. motor 6. mood 7. your mom

2. Learning and memory 3. anxiety 4. pain 6. mood

*Thalamus-Nuclear Groups & Functions* - *Lateral* - *Lateral Dorsal* 2. Part of which system 3. Receives afferents from(2)? 4. It projects (reciprocal) to where?

2. Limbic System 3. From *hippocampus (via fornix) & hypothalamus* 4. *Cingulate Gyrus*

*Thalamus-Nuclear Groups & Functions* - *Medial* - DM 2. Dorsomedial Nucleus (DM) is also called what, again? 3. Associated connections & functions with what system?

2. Mediodorsal nucleus 3. Limbic System

*Mastication Networks* What 3 nuclei do we need for mastication?

2. Motor nucleus of V Motor nucleus of VII Hypoglossal nucleus

*Epithalamus* 2. *Pineal gland* has cells (pinealocytes) that are related to what structure in amphibians and reptiles. 3. In humans, these pinealocytes receive what input via what mechanisms (2)? 4. Pinealocytes synthesize what from what?.

2. Photoreceptors 3. Indirect light information thru sympathetic innervation & hypothalamus 4. *Melatonin from serotonin*

Hypothalamic Functions *Temperature* 2. Heat Loss center (Preoptic Thermoregulatory Center) is the {primary OR secondary} control center of temp? 3. What does it contain to monitor core temp? 4. It determines set point at what temp? 5. When it's active what does it cause & via what mechanism?

2. Primary temp control 3. Thermosensitive neuron populations 4. 37° 5. Causes heat loss via autonomics (vasodilation, sweating, panting)

What are the eye muscles which are innervated by the oculomotor nerve (III)?

Superior rectus Inferior rectus Medial rectus Inferior oblique

*SUMMARY:* -Parasympathetic Innervation of the Head 3. Autonomic fibers of WHAT 3 CN utilize the routes of CN V to gain their target organs? 4. What CN has Parasympathetic to sphincter pupillae m. and ciliary m.? 5. #4 is via what division of what CN, What root of WHAT ganglion, and what nerves?

3. Autonomic fibers of *CN III, VII, and IX* utilize these routes to gain their target organs. 4. CN III 5. via inferior division CN III, motor root of the ciliary ganglion and short ciliary nerves (V1)

3. What does the *Inferior orbital fissure* transmit (4)? 4. What does the *Infra-orbital groove & foramen* transmit (3)? 5. What does the *Lacrimal canal* transmit (1)?

3. CN V2 zygomatic n., infraorbital n. V2 , orbital nerve, infraorbital a., inferior ophthalmic v. 4. Infraorbital a., v., n. 5. Nasolacrimal duct

*Olfactory Neuron Signaling Cascade* 3. What happens when the GPCR interacts with G-protein? 4. What happens with the rest of the G-protein? 5. What happens to the product of Q4? 6. Consequences of Q5?

3. Causes the G-protein inhibitory subunits to fall off (*α-subunit* is now activated & free!) 4. α-subunit activates *Adenylate Cyclase* (makes some *cAMP*) 5. Binds cAMP-gated Ion Channel (which opens & allows Ca++ in) 6. Depolarization!

*Lymphatic Drainage:* 3. The lymphatics from the posterior regions of the nasal cavity drain directly to WHAT nodes? or indirectly to them via WHAT nodes?

3. Directly to the Deep Cervical Nodes 4. indirectly to them via the Retropharyngeal nodes

3. 3 Actions of *Superior Rectus*? 4. 3 Actions of *Inferior Rectus*?

3. Elevation, Adduction, Intorsion (up & in) 4. Depression, Adduction, Extorsion (down & in)

(the following are numbered to match the numbering in the image) 3. *Tufted cells* are found in what layer? Have similarities to what other cell? Participate at what location? Send axons where? 4. *Granule cells* are what kind of cells? Function? What is their axon like?

3. Found in *External Plexiform Layer (EPL)*. - Similar to *Mitral Cells*. - Participate at *Glomeruli* - Send axons to *1° olfactory cortex* 4. *interneurons*. - Function to *modulate activity of output cells*. - *Don't have axon* (amacrine - not in olfactory tract)

4. What is the *Optical axis*? 5. What is the *Axis of Orbit*?

3. From lens straight back into eye 4. Angle at which line drawn medially from lens will meet (see image if confused)

3. Substantia niagra pars reticulata releases what?

3. GABA

Globe: *Ciliary Body* 3. In the absence of nerve stimulation: the ciliary muscle is {relaxed OR contracted} which means zonular fibers are {relaxed OR under tension} which means the lens is {round OR stretched thin} which allows for {near OR Long distance} vision 4. In the presence of Parasympathetic stimulation: the ciliary muscle is {relaxed OR contracted} which means zonular fibers are {relaxed OR under tension} which means the lens is {round OR stretched thin} which allows for {near OR Long distance} vision

3. In absence of nerve stimulation: → ciliary muscle is *relaxed* → zonular fibers *under tension* → lens is *stretched thin → *Long distance* vision 4. In presence of nerve stimulation: → ciliary muscle is *contracted* → zonular fibers are *relaxed* → lens is *round*(internal tension of lens) → *near* vision

*Deglutition Networks - Afferent Fibers* 3. What about fine touch information? Where would cell bodies be found for this? 4. Where is taste information going back to? 5. Through what ganglion would fibers going to #4 travel through?

3. Main sensory nucleus of V. The trigeminal ganglion (semilunar, same thing) 4. Nucleus of the Solitary tract 5. Inferior ganglion of IX and inferior ganglion of X

*CN V in Deglutition* 3. via Afferent control, there are two sensation divisions to CN V. What are they? 4. Which one is responsible for mucous membrane of anterior 2/3 of tongue, lower teeth and gums, skin of lower lip and jaw? 5. Which one is responsible for mucous membrane of the nasopharynx, soft palate, hard palate, upper teeth and gums?

3. Mandibular division and maxillary division. 4. Mandibular division 5. Maxillary division Check out this photo. I didnt add everything for #4 but you can get the gist of it by scanning over it.

*Sensory Innervation of the Nasal Cavity:* 3. What are the 3 branches of V 1? 4. Which branch of #3 innervates the Air cells and sphenoid sinus but rarely makes it into the Nasal Cavity proper? 5. Which branch from #3 *does* innervate the nasal cavity?

3. Nasociliary nerve, Posterior and Anterior Ethmoid Nerve 4. Posterior Ethmoid 5. Anterior Ethmoid

*Glossopharyngeal Nerve Fiber Types* 3. What nucleus does the pharyngeal motor information synapse in? 4. What nucleus does the visceral motor information of CN IX synapse in?

3. Nucleus ambiguus 4. Inferior salivary nucleus

*Gag Reflex* 3. What is the next nucleus that #2 talks to in order for the reflex to be completed? 4. Will fibers from #3 also travel down the spinal cord to stimulate portions of the smooth muscle in the lower esophagus?

3. Nucleus of solitary tract than sends projections to nucleus ambiguus and will use CN X in order to contract muscles. 4. Yes, yes it does. Check out the photo yo....

*Internal ear* 3. From *Otic Placode* what forms? 4. What structure is closely associated with Q3 + what's it made of? 5. What is derived from the *Otic Placode*?

3. Otic pit → Otic Vesicle 4. Statoacoustic ganglion (neural crest) 5. entire membranous labyrinth (including ganglia of CN VIII)

*Openings of Pterygopalatine Fossa* 3. What is the floor of the PPF? 4. What is the anterior opening of the PPF? What is it called when it has a roof over it? What is then called when it exits the skull?

3. Pterygopalatine canal which splits into the Greater and Lesser palatine foramen. 4. Inferior orbital fissure --> changes to inferior orbital canal --> turns into the infraorbital foramen

*Thalamic Nuclei* - *Relay nuclei* 3. *Relay nuclei* typically receive {regulatory OR specific} projections, primarily from {one OR more than one} source & connect to what? 4. A list of nuclei that are examples of relay nuclei?

3. Receive *specific* projections primarily from *one source* & connect to a *localized region of cortex* 4. Medial & lateral geniculate bodies VPL, VPM, VL, VA Anterior nuclei

4. What is the ratio of the cones to bipolar cells in the fovea? 5. Would that make them more or less sensitive? Acute?

4-5. This ratio of cones:bipolar cells is 1:1 in the fovea, where there are no rods, makes them more acute but less sensitive

*Thalamus-Nuclear Groups & Functions* - *Lateral* *Pulvinar* 3. Receive input from which areas? 4. It is part of which PW? 5. This PW may allow what ability (superpower)? 6. This PW projects where?

3. Superior colliculus & Pretectal area & retina. 4. Extrageniculate visual pathway 5. Some detectable visual associated behavior in otherwise blind individuals (but can't take over visual functions) 6. Sensory association areas in the parietal temporal & occipital lobes.

3. *Baum's loop* (medial/superior) receives info from what part of the retina? 4. *Meyer's loop* (inferior/lateral) receives info from what part of the retina?

3. Superior part of retina 4. Inferior part of retina

3. Tastants detected by? 4. Q3 located where? 5. Taste distribution on tongue?

3. Taste Buds 4. Anterior 2/3 of tongue (mostly) & lil bit on posterior 1/3 of tongue & epiglottis 5. Each taste detectable everywhere on tongue =BUT= specific tastes better detected in specific regions (image)

*Summary of Transduction in the Cochela* 3. So we established that #2 was done through a mechanical mechanism, but what does that mean? 4. So with #3 in mind, what then generates the action potentials?

3. There is a mechanical mechanism to opening and closing receptor ion channels. 4. (long answer, i am sorry!) The hair cell depolarization (which happens from #3) will cause a voltage gated Ca2+ channel-dependent release of neurotransmitter at the synapses with spiral ganglion cell dendrites and this is what produces action potentials that propagate into the cochlear nerve.

3. After synapse in the Eddinger-Westphal nuclei, where does the information go? 4. What info travels through here? 5. How will you be able to tell if there is defect?

3. Through *oculomotor* nerve to the *ciliary ganglion* 4. Parasympathetic info to control pupillary reflex 5. Light on eye will not change dilation of either or 1 eye

3. Where will it distribute this information? 4. Through what pathway does it distribute it?

3. To all mucus-secreting glands of nasal and paranasal sinuses and palate. 4. Distributes via V2 (and V1 to the lacrimal gland via the communicating branch)

*Sensory* Innervation 3. What are the 3 branches of the Opthalmic division of the Trigeminal Nerve?

3. V1 (Ophthalmic N): i: Frontal ii: Lacrimal iii: Nasociliary

*Lateral medullary syndrome* 3. Damage to *vestibular nuclei* causes what major symptom? 4. Damage to *vestibular nuclei* causes what minor symptoms?

3. Vertigo 4. - Inaccurate reaching (dysmetria) - Eyeballs 10 deg off to one side - Head tilt to same side - Fall towards same side

3. After the light hits the photoreceptors, what happens next in a vertical integration pathway? 4. What are the names of the cells at each level of integration for this pathway? 5. Is there pre-processing that takes place here in the retina to better judge the information that is being passed along? 6. What is this specific type of processing called?

3. We move from several cells (photoreceptor cells) down to 2 cells (or a lower number of cells). Then those few cells move down to just one cells. 4. Photoreceptor cells (rods/cones) --> Bipolar cells --> Ganglion cells 5. The question seems really specific, so i will answer yes. 6. Convergence. Taking a lot of visual information and converge/compact it so that we can electronically transmit it through the brain.

3. If you take visual info from the world & into your eye, where does that image land 1st? 4. Where does image from your left visual field go in the brain? 5. Where does image from your right visual field go in the brain?

3. back of the retina (whole image) 4. Just *left* visual field in *right* side of brain (upside down & backward) 5. Just *right* visual field in *left* side of brain (upside down & backward)

3. What is the shape of the Olfactory Neurons? 4. If an odorant binds to an Olfactory Neve dendrite, what happens (basically)? 5. What is the fancy, descriptive name for the Olfactory ET?

3. bipolar 4. AP is sent down the Olfactory Nerve axon 6. Ciliated Pseudostratified Columnar ET (just remember that the cilia are sensory, not motile)

*Cough Reflex* 3. Where are the efferents going in order to aide in the cough reflex? 4. Along with #3, what other nucleus will it synapse in in order to expel air?

3. going to the pharynx/larynx in order to constrict it and narrow the airway to expel air.. 4. The phrenic nucleus in order to contract the diaphragm.

Let's get more detailed... 3. The Par*a*ventricular Nucleus (PVN) sends/receives info to/from which other regions in the hypothalamus & what info is going on in each of these regions?

3. i: *Anterior* HT: Parasympathetic Pre-autonomics ii: *Posterior* HT: Sympathetic Pre-autonomics iii: *Lateral* HT: Metabolic/Homeostatic Pre-autonomics iv: *Mammillary Nucleus*: memory stuff?

Globe: *Vascular* Tunic 3. 3 parts to the vascular tunic & location of each?

3. i: *Choroid*- reddish brown highly vascularized layer b/t sclera & retina. ii: *Ciliary body*- connects choroid w/iris; iii: *Iris*- pigmented bit out front

3. *Amygdala* has what 2 PWs into the hypothalamus *&* what nuclei does it go to for each (3 + 1) 4. *Hippocampus* has what PW into the hypothalamus *&* what nuclei does it go to (3)?

3. i: *Stria Terminalis* to Medial Preoptic, Anterior, & Dorsomedial Nuclei ii: *Ventral Amygdalofugal* PW to Lateral Hypothalamic Area 4. *Fornix* to *Mammillary Body* (mostly), Lateral Preoptic Nucleus, & Lateral Hypothalamic Area

*Thalamus-Nuclear Groups & Functions* - *Intralaminar Group* 3. *Centromedian nucleus* found where? 4. *Parafascicular nucleus* found where? 5. This group receives afferents from where (1 main & many collaterals)? 6. Project to (reciprocal) where?

3. posterior medial thalamus 4. medial to centromedian (adjacent to habenulointerpeduncular tract) 5. From central group of reticular formation (ARAS) & collaterals of spinothalamic & trigeminothalamic tracts, locus coeruleus, parabrachial nuclei, cerebellum & globus pallidus. 6. To (reciprocal) broad areas of frontal & parietal lobes & striatum & other thalamic nuclei.

*Vestibular Ganglion and Nuclei:* 3. Afferents of the semicircular canals project primarily to what 2 nuclei? 4. while the otolith organs project primarily to what nuclei?

3. the superior and medial nuclei 4. The lateral, medial and inferior nuclei. -of the The vestibular nuclei

FYI: Stoke is which number of leading cause of death?

3rd! thats crazzy 1st is heart disease 2nd is cancer 85% are ischemic 15% are hemorrhagic

Hypothalamic Functions *Control Eating* 4. What is the likely nucleus in the VMH that controls satiety? 5. =This is Important=: circulating hormones that signal nutritional status (such as?) bind to neurons where? 6. What do each of the hormones from Q5 do?

4. *Arcuate* (used to think it was ventromedial only -BUT- ventromedial does assist) 5. *Leptin/Ghrelin* bind Arcuate Nucleus & alters their firing. 6. *Leptin*: diminished food drive *Ghrelin*: stimulates food drive [could provide potential therapeutic interventions (obesity or anorexia)]

4. Recall: What are the anterior boundaries (2) of the hypothalamus? 5. What is the superior boundary of the hypothalamus?

4. *Optic Chiasm* (inferior view) & *Lamina Terminalis* (sagittal view) 5. *Hypothalamic Sulcus*

4. What part of the *brainstem* does this ANS info pass through? 5. The principle behind being mindful & meditation influencing autonomic response?

4. *Tegmentum autonomic centers* 5. Cortex feeds into the hypothalamus (which controls the ANS)

*Thalamus-Nuclear Groups & Functions* - *Lateral* - VP 4. Function of *VPl*? 5. Functions of *VPm* (2)? 6. Function of Ventral posterior inferior nucleus?

4. *VPl*: body sensation 5. *VPm*: sensory to the head (subset of VPm gets gustatory input) 6. Ventral posterior inferior nucleus: vestibular sensation for conscious PWs

*Optogenetics* 4. 2 types of light activated ion channels? 5. How might you use these?

4. - Blue laser = Na+ channel (depolarization) - Yellow laser = Cl- channel (hyper-polarization) 5. Allows you to control specific neuron populations w/o destroying endogenous system. [great to study HT where many functions are concentrated in small space - like a mouse eating when he's not hungry]

*SUMMARY:* -Sympathetic Innervation 4. Postganglionic fibers leave the SCSG as what 2 nerves?

4. -External carotid n - Internal carotid n.

*Electroencephalography (EEG)* 4. The electrical differences are generated through the averaging of what? 5. This signal averaging is larger if what? 6. the signal averaging is smaller if what? 7. This creates a signal consisting of what 2 characteristics of waves?

4. Action potential generation in groups of neurons near the electrode 5. If the neurons are all firing at the same time (synchronously) 6. If the neurons are firing at different times (asynchronously). 7. Amplitude & Frequency (can be measured & analyzed) [Thalamic influences regulate much of the cortical activity]

*Pterygopalatine Ganglion Autonomics* 4. What is the function of parasympathetics along this pathway? 5. Where are the preganglionic cell bodies of the sympathetic innervation to this area? 6. Will the sympathetic fibers synapse in the PPG?

4. Allows for mucus production (Remember "Great Snot" for greater petrosal n brining parasympathetic innervation to the head) 5. Preganglionic cell bodies are found in T1-T4. 6. Nope, remember that there are no postganglionic sympathetic cell bodies found in the head

4. ALSO, Loss of olfaction is a consistent and early sign of what disease? 5. Why might this knowledge be beneficial?

4. Alzheimer's (in addition to other neurological conditions) 5. Early intervention

Hypothalamic Functions *Circadian Rhythm* 4. *Circadian Rhythm* determines what cycles? 5. Neurons of which nucleus are our internal timekeepers?

4. Arousal, Temperature, Hormone levels (all approximate day length) 5. Suprachiasmatic Nuclei (Periodicity of ≈25.5 hrs, but syncs w/environment to lock in 24 hr)

So we know that widely dispersed receptors for a particular odorant will find their way to 1 particular glomerulus... 4. What is this process called? 5. What makes this possible (near the glomerulus)?

4. Axon Pathfinding 5. Odorant receptors on axon guid it to it's particular glomerulus.

4. What happens on day 2 of neurogenesis of olfactory ET? 5. What happens on day 3 of neurogenesis of olfactory ET? 6. What happens on day 4 of neurogenesis of olfactory ET? 7. What happens between days 6 - 14 of neurogenesis of olfactory ET?

4. Day 2: Process enters cribriform & enters bulb. 5. Day 3: Differentiation begins (dendrites on 1 end) 6. Day 4: Odorant expression at both ends 7. Days 6-14: Axon can go find it's specific glomerulus (had to wait for odorant expression for this to happen)

*The Cochlear Nuclei* 4. Of the monaural pathway, which pathway has direct projections to the inferior colliculus? 5. of the monaural pathway, which pathway has multiple synapses throughout the brainstem? 6. Is there a difference in speed between the direct and indirect pathways? 7. What reflex is all of this the basis for?

4. Direct pathway 5. Indirect pathway 6. Yes. This connection pattern means that some signals form a discrete sound will travel through pathways faster than others due to fewer synapses. 7. Brainstem auditory evoked response (BAER)

Let's get more detailed... 4. We also know that 75% of our parasympathetic outflow comes through the Vagus, what nucleus does that come from? 5. ANS goes through what in order to help control/modulate pain info? 6. ANS goes through what in order to help control cardiac output?

4. Dorsal Motor Nucleus in brainstem (w/direct control from PVN of Hypothalamus) 5. Raphe Nuclei 6. Rostral, Ventral , Lateral Medulla (A5)

*Sensory Afferent Neuron Tuning and Intensity (Frequency)* 4. What happens as the sound intensity drops? 5. What is characteristic frequency when referring to these spiral ganglion neurons? 6. So do spiral ganglion cells code frequency as well? 7. Do spiral ganglion cells usually have a low background firing rate?

4. Frequency response range narrows (due to resonance properties) 5. the frequency at which its threshold (sound intensity) is lowest. 6. Yes they do! 7. Yes.

*Maxillary Artery* 4. What part of the maxillary artery does the middle superior alveolar artery branch off of? 5. From #4, what other artery branches off the artery named here? 5. What gives rise tot he greater and lesser palatine aa.? 6. What artery goes through the sphenopalatine foramen?

4. Infraorbital artery 5. anterior superior alveolar artery 6. Descending palatine a 7. Sphenopalatine a.

4. Almost all axons enter which of the 3 PWs from the last card? 5. The axons entering this PW (Q4) target the {ipsilateral or contralateral} 1° olfactory cortex (*+ what other structure?*) 6. Which of the 3 PWs is most important in humans?

4. Lateral Olfactory Stria 5. *ipsilateral* 1° olfactory cortex + *Amygdala* 6. Lateral Olfactory Stria

42

Temporal lobe Transverse temporal gyri aka Auditory association area; A2

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 4. The internal carotid artery, passing superior to the foramen lacerum, carries postganglionic [sympathetic or parasympathetic?] fibers (from WHAT plexus) from the superior cervical ganglion. A group of fibers leave this plexus to form WHAT nerve which joins the WHAT nerve to form the nerve of the WHAT canal.

4. The internal carotid artery, passing superior to the foramen lacerum, carries postganglionic sympathetic fibers *(internal carotid plexus)* from the superior cervical ganglion. A group of fibers leave this plexus to from the *deep petrosal nerve* which joins the *greater petrosal nerve* to form the *nerve of the pterygoid canal.*

*Internal Ear*: Bony Labyrinth 4. In what way is the bony part more complex than it looks?

4. There are osseous spiral lamina all throughout those cochlear ducts

*Gaining Access to the Nasal Cavity:* 4. Branches of the Ophthalmic Artery enter through what? 5. The Shpenopalatine branch of the maxillary artery enters through what?

4. Through the Cribiform Plate 5. the *Sphenopalatine Foramen*

*Trunk and limb postural adjustments:* 4. Goes to what 2 nuclei in the cerebellum? which one is from the vermis which one is from the paravermal region? 5. Output to what 2 nuclei and what formation? which one is from the fastigial nucleus and which one is from the interposed nuclei? 6. Helps in what 3 movements? 7. The paravermal region and interposed nuclei and red nucleus is part of what tract?

4. To *Fastigial nucleus*(Vermis) and *interposed nuclei* (Paravermal region) 5. Output to *vestibular nuclei* (Fastigaial nucleus from vermis) and *reticular formation* (Fastigaial nucleus from vermis), *red nucleus* (interposed from paravermal region) 6. Walking, posture, some eye movements 7. rubarspinal tract, will be important for all the tings in #6

Recall: 4. Mitral and tufted cells carry filtered info where? New: 5. Tufted cells send collaterals where? 6. Function of Q5?

4. To Olfactory Cortex 5. To *Anterior Olfactory Nucleus (AON)* 6. Feedback to ipsilateral *&* contralateral bulbs

Eyelid: *Lacrimal Apparatus* 4. After draining to the *punctum*, to where are tears then conducted? 5. After Q4, where do tears go? 6. From Q5, tears drain where? via what?

4. To lacrimal canaliculi 5. Drain into the lacrimal sac 6. to inferior nasal meatus via nasolacrimal duct.

*Endolymph vs. Perilymph* 4. Do hair cells have to maintain high levels of activity for long periods of time? 5. What benefit does having the cells in contact with both perilymph and endolymph to satisfy the demands of #4?

4. Yes, so you can hear. 5. The comparatively large fluid volumes of these compartments provide an ionic "sink" for hair cell membranes. This ensures they wont exhaust the ions necessary for action potentials.

*Sound Transduction in the Cochlea* 4. What is the range that hair cells can follow sound waves up to? 5. When the frequency is this high, can it be used for frequency discrimination? What can it be used for?

4. about 3 kHz (this means absolutely nothing to me) 5. No, while hair cells can discharge at these frequencies, this information is not directly used for frequency discrimination. It can be used to localize sound as it is going around you (will see more soon)

*Sensory Detectors: Hair Cells* 4. The tips of the stereocilia are linked in the same way as WHAT hair cells. 5. They function as WHAT gauges that transduce mechanical stimuli into electrical signals/action potentials.

4. auditory hair cells. 5. They function as *strain* gauges that transduce mechanical stimuli into electrical signals/action potentials.

*Clinical Note: Damage to Hair Cells* 4. What is used as an indicator of cochlear function? 5. The stereocilia of hair cells are attached to a [more/less] rigid cuticular plate such that they will [slide/pivot] at their base. 6. What do loud sounds do to the stereocilia? 7. What happens as a result?

4. cochlear microphonic (have to jab it in their ear, but it works) 5. more; pivot 6. Shear off stereocilia 7. They dont grow back and you can have permanent hearing loss.

4. What do the other structures release?

4. glutamate

4. How do you test for *Superior rectus* 5. How do you test for *Inferior rectus*

4. have pt *ab*duct & then *elevate* 5. have pt *ab*duct & then *depress*

4. 3 CVOs we care about?

4. i: *Subfornical Organ (SFO)* (under fornix) ii: *Vascular Organ Lamina Terminalis (OVLT)* iii: *Median Eminence* (please see the image for a couple more details)

*Thalamus-Nuclear Groups & Functions* - *Medial* - DM 4. Its afferents come from where (4)? 5. It projects (reciprocally) to which cortices?

4. i: Entorhinal cortex (anterior parahippocampal gyrus) ii: Amygdala iii/iv: Some from spinothalamic tract & substantia nigra 5. To frontal & prefrontal cortex

*Thalamus-Nuclear Groups & Functions* - *Anterior* 4. The *Anterior* group receives connections from what (2) via what (2)? 5. They project where via what? 6. The anterior nuclei & their projections are part of what circuit? 7. And what is that circuit involved in (function)?

4. i: From *mammillary bodies* via *mammilothalamic fasciculus* & ii: From *hippocampus* via *fornix* 5. To *cingulate gyrus* via *anterior limb of internal capsule* (reciprocally) 6. *Circuit of Papez* 7. Involved in *memory processing*

*Inferior Colliculus* 4. Outside of what has been covered so far, what other information is present (for the first time) in this pathway? 5. With #4 in mind, what would all of this information be important for?

4. is the first level at which some non-auditory information is added (ex. posterior column, other spinal sensory pathways, superior colliculus). 5. *This information appears to be involved in attention, multisensory integration, and auditory-motor reflexes.*

Hypothalamic Functions *Water Balance* 4. What effect does Ang II have on the brain (2)? 5. This Ang II effect is through what structure in the brian?

4. release of *ADH* (retain H2O) + *stimulate thirst* (obtain H2O) 5. *Subfornical Organ (SFO)* (under the fornix)

*Subthalamus (Ventral Thalamus)* 4. *Subthalamic* nucleus has connections with what brain structure? 5. *Subthalamic* nucleus is involved in what function? 6. *Zona incerta* is considered an extension of what brain structure?

4. the basal ganglia 5. Movement 6. reticular formation

What is the inferior opening of the facial canal? What bone is this on?

Stylomastoid Foramen *this foramen is posterior to the styloid process on the temporal bone

*Epithalamus* 5. Synthesis of melatonin through what enzyme? 6. When is this synthesis highest? Lowest? 7. In development, melatonin regulates what development & how? 8. What if you lose this gland during development? 9. What may occur to pineal gland later in life?

5. N-acetyltransferase 6. Increases at night and decreases during the day in a circadian rhythm. 7. reproductive development (inhibitory) 8. Loss may precipitate precocious puberty 9. Calcification (doesn't necessarily mean they wont sleep well)

5. Will you be able to test voluntary pathways (i.e. stick out your tongue, smile, wrinkle forehead) while your patient is unconscious? 6. How do you evaluate the integrity of the nerves at that point?

5. No (stupid i know, but im making a point so hold on) 6. This is where you use the reflex pathways! you can still use them even though the patient is knocked out

*Accommodation* PW 5. As a distant object moves closer to the eye __________ system must constantly accommodate 6. As the image moves toward your eye what is your ciliary muscle response? 7. As the image moves away from your eye what is your ciliary muscle response?

5. Parasympathetic 6. Muscle constricts → fatter lense 7. Muscle relaxes → stretched lens

Globe: *Neural* Tunic 5. Why is the *Optic Disc* often called the blind spot? 6. In which part of the sclera do the nerves & vessels pass through?

5. There are no photoreceptors on this area of retina b/c this is where CN II/vasculature enters & exits globe 6. *Lamina Cribosa* of Sclera

*Thalamocortical Projections* 5. *Regulatory* projections originate from not just the cortex, where else? 6. Function of these projections? 7. Most projections to the thalamus are {regulatory OR specific}?

5. Wide regions of cortex, *thalamic reticular nucleus* & *reticular formation* 6. Modify/Regulate output of thalamic neurons as part of processing (filter what's important & what's not) 7. Most projections to the thalamus are *regulatory* (70%)

Ear Review: The middle ear 5. The middle ear ossicles (maleus, incus & stapes) also provide amplification of sound via what system? 6. The area of the tympanic membrane compared to the footplate of the stapes on the oval window is about ___ to 1. 7. Disruption of the middle ear amplification system causes? 8. Dampening of loud sounds is mediated through what?

5. a leverage 6. *15* to 1 (allows for amplification of sound to liquid) 7. hearing deficits (conductive) 8. *Muscle connections* to ossicles (*Tensor tympani (CN V) & Stapedius (CN VII) muscles)

5. Orientation *Taste buds* of on *Circumvallate Papillae*? 6. Soluble *tastants* access the receptor cells how?

5. facing troughs that separate Papillae from tongue parenchyma 6. Through the *Taste Pore*

[We probably don't need to know the info on this card] *Thalamus-Nuclear Groups & Functions* - *Lateral* - VA 5. *Magnocellular part* receives inputs from (3)? 6. Q5: Suggests general activation from where?

5. i: *Substantia nigra* (reticular portion), ii: *Brainstem reticular formation* iii: *Parts of intralaminar nuclei* 6. Suggests general *cortical* activation.

5. If you blow out the oval window (like in a perilymphatic fisutula), will the sounds you hear be able to generate the columns of fluid needed in order to convert physical sound waves into neurological signals? 6. Will it also effect balance?

5. no.... 6. Yes, yes it does

*Medial Geniculate Nucleus* 5. Is tonotopic organization maintained at the auditory cortex? 6. Where do low frequency sounds tend to show up in the auditory cortex? 7. Where do high frequency sounds tend to show up in the auditory cortex?

5. yes. 6. low frequencies tend to be lateral 7. high frequencies tend to be medial!

Globe: *Eye Chambers* - *Anterior segment* 5. What would result if your rate of aqueous humor production exceeds that of absorption? 6. Why might that happen? 7. What does closed angle glaucoma result from?

5. ↑ pressure in ant. segment → pressure on post. segment → compromised blood flow to retina (*open angle glaucoma*) 6. Slight blockage of drainage (scleral venous sinus) by sloughed proteins. 7. When iris physically blocks iridiocorneal junction; painful & rapid onset → compromised blood flow to retina → blindness

When do kids start losing there teeth?

6-8 years old

*Gaining Access to the Nasal Cavity:* 6. The Descending Palatine branch of the Maxillary Artery enters the Oral Cavity via WHAT? 7. the Descending Palatine branch then travels [anteriorly or posteriorly?] and [superior or inferior?] to the [Hard or Soft?] Palate and enters the Nasal Cavity via WHAT? 8. The openings and vessels are found [superficial or deep?] to the mucosa.

6. *Greater Palatine Foramen* 7. Travels ANTERIORLY INFERIOR to the HARD palate and enters the Nasal Cavity via the *Incisive Foramen* 8. DEEEP. so in lab you won't see them unless you dig for them

Hypothalamic Functions *Circadian Rhythm* 6. What are the cells responsible for locking cycle into 24hr? 7. What do they express? 8. These relay external light info to what?

6. *Intrinsically Photosensitive Retinal Ganglion Cells (IPRGC)* 7. Express Melanopsin 8. Suprachiasmatic Nuclei to synchronize 24hr cycle (see image for another fun tidbit)

*Internal ear* 6. Which portion of the *Otic Vesicle* forms the semicircular canals? 7. How is Q6 formed?

6. *Utricular Portion* 7. Connection made b/w flattened outpocketings & then apoptosis in the middle bits to form canals (if this + the picture doesn't make sense, ask Jamon, he is the king)

-Salivary Glands *Submandibular and sublingual glands- parasympathetics* 6. after going through the petrotympanic fissure the chorda tympani then *joins* WHAT nerve high within the infratemporal fossa? 7. Fibers of chorda tympani pass *imperceptibly* within #6 to reach WHAT ganglion? 8. Where they synapse on post ganglionic parasympathetic neurons which innervate what 3 glands?

6. *lingual nerve* 7. *submandibular ganglion* 8. submandibular, sublingual, and lingual salivary glands

Hypothalamic Functions *Water Balance* 6. The Subfornical Organ (SFO) has what receptors? 7. The Subfornical Organ (SFO) sends projections to which nucleus? 8. Two effects when the MPN is stimulated by SFO?

6. Ang II (Obvi) 7. *Medial Preoptic Nucleus (MPN)* [dark purple in image] 8. drinking & AVP release (when dehydrated) [Also: when we are well hydrated & Ang II binding is low other neurons inhibit these 2 responses]

6. What does the *Anterior ethmoidal foramen* transmit? 7. What does the *Posterior ethmoidal foramen* transmit?

6. Ant. ethmoidal a. v. and n. 7. Post. ethmoidal a. v. and n.

*Autonomic Innervation of the Head:* -Mucous Glands of the Head 7. The parasympathetic portion of the nerve of the pterygoid canal synapses on postganglionic parasympathetic cell bodies within the WHAT ganglion. Postganglionic parasympathetic fibers pass indistinguishably within the WHAT nerve to reach the lacrimal gland, oral, palatal, nasal and ·pharyngeal mucosa! glands which, upon stimulation, [increase or decrease?] secretion?

7. The *parasympathetic portion* of the nerve of the pterygoid canal *synapses* on *postganglionic parasympathetic cell bodies* within the *pterygopalatine ganglion*. *Postganglionic parasympathetic fibers* pass *indistinguishably* within the nerves of V2 to reach the lacrimal gland, oral, palatal, nasal and ·pharyngeal mucosa! glands which, upon stimulation, *increase secretion.*

*External Ear* 7. Beginning of 3rd month, what happens to the ET at the bottom of the meatus? 8. At Month 7, what happens to Q7 + what is formed? 9. What happens if Q8 doesn't happen like it should?

7. proliferates to form *Meatal plug* 8. Meatal plug disintigrates & ET floor of meatus forms *external bit of tympanic membrane* 9. Failure of meatal plug to regress → *congenital deafness*

*Internal ear* 8. Which portion of the *Otic Vesicle* forms the Cochlear duct & Tectorial Membrane? 9. How is Q8 formed?

8. *Saccular Portion* 9. Grows out in a curly cue sorta dealy

*Properties of Sound* For volume: 8. Detectable sounds are in what range? 9. Normal conversation is about how many dB? 10. Sounds above ____ - ___ dB can elicit pain? 11. Sounds above ____ dB (repeated) can cause permanent damage?

8. 1- 2 decibels 9. 50 dB 10. 120 to 130 dB 11. 150 dB [Lower volumes for longer periods of time (e.g. 90 dB for hours) can also cause permanent damage] isnt that weird?

*Olfactory Neuron Signaling Cascade*.. So far: Odorant binds GPCR → Changes conf of GPCR to interact w/G-protein → G-protein inhibitory subunits to fall off → α-subunit now activated & free! → α-subunit activates Adenylate Cyclase → Make some cAMP → cAMP binds cAMP-gated Ion Channel Channel opens & allows Ca++ in → Depolarization begins → Ca++ gated Cl- channels open → Cl- leaves the cell (augments depolarization) 8. What happens when the depolarization gets to the axon hillock?

8. AP is generated via voltage-gated Na+ channels (on to the olfactory bulb)

*SUMMARY:* -Parasympathetic Innervation of the Head 8. Chorda Tympani recieves parasympathetics from what CN? 9. #8 sends parasympathetics to what 2 salivary glands? via what NERVE(what CN), and what GANGLION?

8. CNVII 9. Submandibular and sublingual salivary glands via lingual n.(V3) to *submandibular ganglion*

*Middle ear* 8. What is a *Congenital perilymph fistula*?

8. Connection b/w *inner ear & middle ear*

*Electroencephalography (EEG)* 8. Help establish a diagnosis of? and determine what about that? 9. Can also ID what other stuff? 10. Can also evaluate periods of what? 11. Help predict a person's chance of what? 12. Confirm or rule out what? 13. Study what disorders? 14. Monitor brain activity while a person is receiving what during surgery?

8. Epilepsy, & determine what type of seizures a person w/epilepsy is having. (EEG is the most useful and important test in confirming a diagnosis of epilepsy) 9. ID location of brain tumor (+ potential damage caused by it), inflammation, infection (eg encephalitis), or disease in brain. 10. Periods of unconsciousness or dementia 11. Predict person's chance of recovery after cardiac arrest or other major trauma 12. Brain death in a person who is in a coma. 13. Study sleep disorders. 14. Monitor brain activity while a person is receiving general anesthesia during surgery.

*Drainage of the Nasal Cavity:* 8. Some people have a nasal vein that drains the superior sinus that passes thru WHAT foramen? 9. #8 then drains into what?

8. Foramen Caecum 9. Superior Sagittal Sinus

*Thalamocortical Projections* 8. *Specific projections* to thalamic nuclei carry {organized or dissorganized} info to cortex? 9. *Specific projections* are related to {broad or particular} functions? 10. These projections and the thalamic nuclei that receive them are typically {somatotopically or topographically organized}?

8. Highly organized info (e.g. somatosensory sensory) 9. *Particular* functions (or class of functions, e.g. sensation) [so kinda both] 10. Yes. (Can be *somatotopically* [body map] OR *topographically* [just mapped] organized)

*Lateral medullary syndrome* 8. *Nucleus ambiguus* causes what symptoms? 9. *Spinothalamic tract damage* causes what symptoms?

8. Hoarseness and difficulty swallowing 9. *Contralateral* loss of pain and temp in trunk and limbs

Let's get more detailed... 7. Our King (hypothalamus) gets feedback from which bits'o the brainstem (2)? 8. Which tract is utilized for all of this ANS communication?

8. Nucleus of Solitary Tract & Trigeminal pars caudalis 9. DLF (Rob)

*CN VII in Deglutition - SVE* 8. What are the two divisions of the buccal branch? 9. Which one controls for the obicularis oris and levator anguli oris mucles? 10. Which one controls for the obicularis oris and the buccinator muscles? 11. Since this is SVE information, what nucleus will be sending out this info?

8. Superior and inferior divisions 9. The superior division 10. The inferior division 11. Again, motor nucleus of CN VII

*SUMMARY:* -Sympathetic Innervation 8. Which branch of the internal carotid n. goes to the middle ear? 9. which one goes to the lacrimal gland and mucous glands of the nasal cavity, oral cavity, pharynx, and palate? 10. Which one goes to the dilator pupillae muscle?

8. caroticotympanic branches 9. deep petrosal n 10. cavernous plexus

*Sympathetic vs. Parasympathetic Tone:* Match the following to either sympathetic or parasympathetic: 8. reduction/elimination of desire to urinate 9. salivation, lacrimation 10. pupil constriction (miosis) 11. Pupil dilation (mydrasis) 12. Decrease in HR 13. Increase in HR 14. Cutaneous vasodilation

8. sympathetic 9. parasympathetic 10. parasympathetic 11. sympathetic 12. parasympathetic 13. sympathetic 14. sympathetic

*Glutamate: The Primary Excitatory NT:* 8. What happens if we have too much glutamate? 9. is taking the glutamate up a active or passive activity? 10. so what will happen if we have less ATP? 11. Will this increase or decrease stimulation?

8. we will have excitotoxicity 9. active 10. reduced function of glutamate transporters so more glutamate will hang around in the synapse and we will have disrupted ion gradients 11. freaking stimulated bro

Ear Review: The Inner ear 9. Which bits of the cochlea are the portions of the inner ear in which sound waves are transduced into APs? 10. The cochlear complexes are in which part of the skull? 11. Which aspect of the ear allow sound vibrations conducted within the bone to activate the *cochlear apparatus* AND *sound transduction* through middle ear ossicles.

9. Bony & Membranous labyrinths 10. Petros portion of temporal bone 11. Because the labyrinths are in the bone

*Tastant Receptors* 9. Taste cells can respond to how many classes of tastants? 10. Afferent neurons interact with how many Taste cells? Selectivity? 11. 1 neuron recieves input from how many tastes?

9. Just *one* dude, c'mon 10. Afferent neurons w/*many branches* & are *non-selective* to type of taste cell 11. More than 1

*Extraocular Eye Muscles* 9. Which muscle is innervated by Abducens Nerve (VI)? 10. Which muscle is innervated by Trochlear Nerve (IV)? 11. Which muscle is innervated by Oculomotor Nerve (III)?

9. Lateral Rectus 10. Superior Oblique 11. Inferior Oblique, Superior Rectus, Medial Rectus, Inferior Rectus

Hypothalamic Functions *Temperature* So let's review... "I'm *too hot*" 9. What area facilitates heat loss? 10. What system does it inhibit? 11. What system does it recruit? 12. What are body responses?

9. Preoptic Area 10. Posterior (Heat Gain) 11. Paraventricular (ANS) 12. Vasodilation in skin, Panting, Sweating, ↓HR, ↓ activity

*Thalamic Nuclei* - *Nonspecific nuclei* 9. *Nonspecific nuclei* project where? 10. The nuclei also typically receive inputs from? 11. These nuclei & their projections are believed to have properties of general cortical {activation or depression}? 12. A list of nuclei that are examples of *Nonspecific nuclei*?

9. To wide regions of cortex (& sometimes subcortical regions w/varied functions) 10. diverse areas of the brain & spinal cord (multimodal input, reticular formation). 11. Cortical Activation (w/o these you're brain dead) 12. Intralaminar nuclei (centromedian, parafascicular)

Sympathetic (adrenergic, anticholinergic) stimulus what general affects on the following regions of the body? -cutaneous vessels -eyes -heart -kidney -glands

= Cutaneous VASODILATION = Pupil dilation (mydriasis) = INCREASED HR = reduction/elimination of desire to urinate = decreased secretion & motility

Parasympathetic (cholinergic) stimulus will cause what general effects on the following regions of the body? -glands -eyes -heart -kidneys -GI

= Salivation and lacrimation = Pupil CONSTRICTION (myosis) = DECREASED HR = Urination and defecation = Increased GI secretion and motility

Teeny Weeny

=Scroll for Answers= *A*: Insula *B*: Frontal Operculum

Lets ID again, but this time looking from the top

=Scroll for Answers= *A*: Lateral Preoptic Nucleus *B*: Medial Preoptic Nucleus *C*: Periventricular Nucleus *D*: Suprachiasmatic Nucleus *E*: Supraoptic Nucleus *F*: Anterior Nucleus *G*: Paraventricular Nucleus *H*: Lateral Hypothalamic Area w/MFB *I*: Ventromedial Nucleus *J*: Dorsomedial Nucleus *K*: Arcuate Nucleus *L*: Mammillary Nuclear Complex *M*: Posterior Nucleus

Itty Bitty

=Scroll for Answers= *A*: Solitary Tract *B*: Nucleus of Solitary Tract

CVOs

=Scroll for Answers= *A*: Subfornical Organ (SFO) *B*: Vascular Organ Lamina Terminalis (OVLT) *C*: Median Eminence *D*: Fornix *E*: Anterior Commissure *F*: Subfornical Organ (SFO) *G*: Vascular Organ Lamina Terminalis (OVLT) *H*: Optic Chiasm *I*: Median Eminence

This Table is painful...

=Scroll for Answers= NOTE: skip "M" (there are only 2 for Medial/Posterior) A: Periventricular Nucleus B: Periventricular Nucleus C: Medial Preoptic Nucleus D: Suprachiasmatic Nucleus E: Supraoptic Nucleus F: Anterior Nucleus G: Paraventricular Nucleus H: Ventromedial Nucleus I: Dorsomedial Nucleus J: Arcuate Nucleus K: Mammillary Nuclear Complex L: Posterior Nucleus M: User Error N: Lateral Preoptic Nucleus O: Medial Forebrain Bundle (MFB) P: Lateral Hypothalamic Area Q: Medial Forebrain Bundle (MFB) R: Lateral Hypothalamic Area S: Medial Forebrain Bundle (MFB) T: Lateral Hypothalamic Area U: Medial Forebrain Bundle (MFB)

What are the pathophysiologic effects of GABA?

> GABA inhibition balances excitatory activity of glutamate > GABAa receptors contain binding sites for Benzodiazepines & barbituates & alcohol -- these drugs will enhance the inhibitory effects of GABA.

What are the two grooves found on the temporal bone?

> Groove for the posterior belly of the digastrics (PBD) muscle > Groove for the occipital a.

What are the main nerves found in the oral cavity?

> Lingual n. (V3) > Hypoglossal n. (CN CII) > Glossopharyngeal n. (CN IX) > Vagus n. (CN X)

What is the action of the Lateral Pterygoid m.?

> Protrusion of mandible to assist in OPENING of the mouth (lower portion) > Stabilizes condyle & articular disk against articular eminence (upper portion) during OPENING & CLOSING of the mouth. > If only ONE side acts the jaw is moved to one side (right side moves jaw left)

What are the 4 different articulations of the temporal bone?

> Sphenoid bone > Parietal bone > Occipital bone > Mandible bone

What are the 3 main foramina associated with the Occipital bone?

>> Foramen magnum >> Condyloid Canal >> Hypoglossal canal

CN VII

A

Motor Nucleus of CN XII

A

Motor nucleus of V

A

Architecture of the olfactory bulb...

A - D? (additionally, discuss function of each cell type) =scroll for answers= A: *Glomeruli*: Synapse spheres where olfactory neuron axons interact w/output cells of bulb. B: *Mitral Cells*: 1° output cells. Their dendrites synapse w/olfactory neurons which leave cell to 1° olfactory cortex C: *Tufted Cells*: 2° output cells. Just like mitral but go to different places. D: *Granule Cells*: Inhibitory Cells. Influence which cells leave the cell.

When someone gleeks where does the fluid come out of?

Sublingual caruncle

41

Temporal lobe Transverse temporal gyri aka Primary association area; A1

Not as basic Identification

A Miserable Time =Scroll for Answers= A: Lamina Terminalis B: Optic Chiasm C: Infundibulum D: Tuber Cinereum E: Mammillary Body F: Anterior Commissure G: Hypothalamic Sulcus H: walls of 3rd Ventricle I: Corpus Colosseum (CC) Genu J: CC Body K: CC Splenium L: Fornix M: Thalamus

Innervation of all this (flip)

A beast Answers hiding ↓ A: Chorda Tympani N B: Geniculate Ganglion C: Greater Petrosal N D: Vestibular N E: Cochlear N F: Motor Root of Facial N G: Vestibulocochlear N (VIII) H: Vestibular N I: Facial Canal J: Internal Acoustic Meatus

What is responsible for the generation of the theta rythm (4-7Hz high voltage)

pre commissural fornix projections

Which of the following is most appropriate to treat this patient's symptoms? A. Acetylcholinesterase inhibitor B. Alpha receptor agonist C. Beta-2 receptor agonist D. nAChR agonist E. SNARE-complex inhibitor

A. Acetylcholinesterase inhibitor Why would it not be nAChR agonist? scroll down for answer this will cause muscle paralysis. like succinylcholine (; THIS IS an IMPORTANT concept.

Which of the following statements is *true* of the 3-structure circuit that controls *extinction of memories*? A. Amygdala contributes context info to other associations B. Hippocampus acquires emotion-laden memories, especially associated with fear C. LTD integrates hippocampal and amygdalar inputs D. In PTSD, the circuit has been broken E. LTP Underlies Extinction of Memories

A. Amygdala contributes context info to other associations - *FALSE*: *Hippocampus* contributes context info to other associations B. Hippocampus acquires emotion-laden memories, especially associated with fear - *FALSE*: *Amygdala* acquires emotion-laden memories, especially associated with fear C. LTD integrates hippocampal and amygdalar inputs *FALSE*: *Amygdala* acquires emotion-laden memories, especially associated with fear *D. In PTSD, the circuit has been broken* - TRUE - some psychological treatments try to evoke these painful memories and then try to associate them with to better new sensory experiences where you are no longer in a fearful environment. E. LTP Underlies Extinction of Memories - *FALSE* LTD Underlies Extinction of Memories

Paraventricular nucleus (ANS King) sends afferents from HT to which of the below for *Visceromotor circuits*? A. Reticular formation B. Parasympathetic cranial nerve nuclei C. Lateral horn of spinal cord D. France

A. Reticular formation (tegmentum) B. Parasympathetic cranial nerve nuclei C. Lateral horn of spinal cord (sympathetic cell bodies)

She is prescribed oxybutynin, a nonselective muscarinic antagonist. Her urinary incontinence has subsided but she now experiences a number of adverse effects. Which of the following AEs is the patient most likely to suffer from? A. Constipation B. Lacrimation C. Miosis D. Salivation E. Vomiting

A. Constipation, dry mouth/eyes, dizziness, blurred vision

A 15 y/o male presents to his ophthalmologist with complaint of diplopia. As the physician is examining the patient's eye movements, she notes that when the patient's eye is adducted, he has a complete loss of eye elevation. Which muscle is most likely affected in this patient? A. Inferior oblique B. Inferior rectus C. Lateral rectus D. Superior oblique E. Superior rectus

A. Inferior oblique

The amygdala has an *indirect and direct pathway*. Which of the following is true of the *direct pathway*. A. Involves basolateral nucleus to central nucleus B. It is a slow response in which fear association isn't immediate C. Is associated with the fear of paying student loans someday D. It is a fast response that involves visceral responses

A. Involves basolateral nucleus to central nucleus - INDIRECT B. It is a slow response in which fear association isn't immediate - INDIRECT (i.e. impending student loans/impending doom) C. Is associated with the fear of paying student loans someday - INDIRECT *D. It is a fast response that involves visceral responses - DIRECT (i.e. "what happens when I see a snake")*

What is the Sagittal suture?

Articulation b/w the individual PARIETAL bones.

Take a mo and ID something...

Don't question it, just do it... =scroll for answer= A: Paraventricular nucleus (ANS King) B: Optic Chiasm C: 3rd Ventricle

What is the rule of thumb for the activity of A1 and B2 receptors on smooth muscle?

A1-receptors = VASOCONSTRICTION B2-receptors = VASODILATION

*Parasympathetic pathways and landmarks in the brain* Function of each Parasymp nucleus below & which nerve carries that info: A: Edinger-Westfall Nucleus B: Salivatory Nucleus C: Dorsal Motor Nucleus of X D: Nucleus Ambiguus

A: Pupillary reflex & accommodation (oculomotor n) B: superior nucleus: face glads (facial n) inferior nucelus: parotid gland (glossopharyngeal n) C: 75% of body parasympathetics (vagus n) D: Upper airway (laryngeal) motor (vagus n)

corticospinal tract (UMN's) also medullary pyramids

A?

HERE is contrasts at work...

AAAAAMMMMMAAAAAAZZZZZZING!!

Pt presents w/: - Sensory and Motor deficits in Contralateral LE - Possible frontal deficits (mood/behavior) - Possible BG deficits Where is the stroke?

ACA

What stimuli promote the release of EDRF form blood vessel endothelial cells?

ACh Vasoactive production of inflammation & platelet aggregation. Physical Stimuli

b2-receptors will preferentially respond to what? Why is this important to remember?

ALBUTEROL --used as treatment for asthma to promote bronchial smooth muscle relaxation

*Norepinephrine:* from the list below what does it modulate? 1. Sleep 2. Wakefulness 3. Attention 4. Feeding Behaviors

ALL OF THEM.... WHATHATHAHTAHT

In general the function of the intrinsic muscles of the tongue are to? 2. Innervation of the intrinsic tongue muslces?

ALTER the *shape* of the tongue. 2. All are *CN XII*

What is the innervation of the Temporalis m.?

ANTERIOR & POSTERIOR Deep Temporal nn. from V3.

What provides the *taste innervation* to the: (be specific about fiber types and branches) 1. Anterior tongue 2. Posterior tongue 3. Epiglottic portion

ANTERIOR 2/3 = SVA fibers form *Chorda tympani (CN VII) via lingual nerve* POSTERIOR 1/3 = SVA fibers from *Glossopharyngeal n.* (CN IX) EPIGLOTTIC PORTION = SVA fibers from the * internal branch of superior laryngeal branch of vagus n.* (CN X)

What are the posteriorly-directed extensions of the lesser wings of the sphenoid bone?

ANTERIOR CLINOID PROCESSES

What are the boundaries of the oral cavity? -Anterior/lateral -Posterior -Superior -Floor

ANTERIOR and LATERAL: Dental arches (where your teeth are on Mandible & Maxilla) POSTERIOR: Faucial isthmus (entrance to oropharynx) SUPERIOR: Hard (& Soft?) palate FLOOR: Floor of mouth (mylohyoid and geniohyoid muscles)

What points is found at the intersection of the Parietal, Occipital, and Temporal bones?

ASTERION

How is glutamate stored in the CNS?

ATP-dependent transporter is responsible for the uptake of glutamate into synaptic vesicles.

What innervates the lateral rectus m.?

Abducens n. (VI)

What component of the temporomandibular joint (TMJ) prevent posterior-inferior dislocation?

Temporomandibular ligament (Lateral Ligament)

What is generally though of as the MAJOR neurotransmitter of the PARASYMPATHETIC nervous system?

Acetylcholine (ACh) *This is because it is found in all pre-ganglionic autonomic fibers and in all post-ganglionic parasympathetic fibers (only a few post-ganglionic sympathetic fibers)

What is responsible for the inactivation of ACh when it is in the synapse?

Acetylcholinesterase (enzymatic degradation: rapid)

What is the Parasympathetic action and ACh receptor(s) on the Endothelium?

Activation of NO synthase, VIA M3

*Swallowing* So, activation of the [upper/lower] esophagus from the [nucleus ambiguus/salivary nucleus] is [sequential/non-sequential] and [topographic/photographic].

Activation of the upper esophagus from the nucleus ambiguus is sequential and topographic

What is the corticomedial group of the amygdaloid complex important for?

Afferents connections function in the evaluation of visceral stimuli associated with reproduction, feeding and survival. Efferent connections of this pathway also suggest a feeding behavior associated function.

basolateral group projects where?

The basolateral group projections are primarily through the ventral amygdalofugal pathway.

What are the two general types of adrenergic receptors? What type of receptors are these?

Alpha adrenergic receptors Beta adrenergic receptors *both are GPCRs

Where is the pharyngeal canal?

Also known as palatovaginal. --canal is between the inferior surface of the body of the sphenoid & vertical portion of the palatine bone.

Will Neuro ever end?

Also, I know the pictures throughout the lecture suck pretty bad, BUT they can go a long way in helping us understand what Welly is talking about... so give em a chance)

1. Inferior orbital fissure 2. Inferior orbital groove 3. Inferior orbital canal 4. Infraorbital foramen 5. Pterygopalatine fossa 6. Zygomatic nerve 7. Infra-orbital nerve

Also, dont forget the infra-orbital artery, i forgot to mark it (bottom left)

1. Posterior superior alveolar nerve 2. Middle superior alveolar nerve 3. Infraorbital neve entering infraorbital canal 4. Anterior superior alveolar nerve.

Also, look for the infraorbital nerve as it exists the infraorbital foramen.

What disease affects *BOTH* the UMN and LMN systems? Cure? What muscles are most often involved early?

Amyotrophic Lateral Sclerosis (ALS) NO known cure. Death 3-5 yrs (sometimes) Tongue (fasciculations) and Thenar Eminence wasting Death often secondary to diaphragm or laryngeal failure

Lets do some ID of each *Region* (4)

And the *Posterior (Mammillary) Region* =Scroll for Answers= *A*: Lateral Hypothalamic Area & MFB *B*: Posterior Nucelus *C*: Mammillary Nuclear Complex *D*: Optic Tract

maybe check this one too....

And which ones are mostly efferent information going out? (scroll down) Oculomotor (CN III) Trochlear (CN IV) Abducens (CN VI) Hypoglossal (CN XII) Accessory (CN XI)

1. What symptoms are seen in a patient with a right MCA stroke? 2. Left

Hemineglect Agnosia (inability to recognize something ex. fingers) Aphasia

*Middle Ear*: Auditory Ossicles (flip)

Answers hiding ↓ A: Malleus (handle embedded w/in tympanic membrane = umbo) B: Incus C: Stapes

*Middle Ear* - Anterior Wall (flip)

Answers hiding ↓ A: Pharyngotympanic (Auditory Tube) B: Tubal Artery C: Tensor Tympani

*Middle Ear* - Roof (flip)

Answers hiding ↓ A) Tegmen Tympani B) Epitympanic Recess

*Middle Ear* - Floor (flip)

Answers hiding ↓ A: Internal Jugular V B: Internal Carotid A C: Carotid Sheath

What is the name of the sharp prominence at the base of the piriform aperture?

Anterior nasal spine

What is the Squamosal suture?

Articulation b/w the Squamous portion of the TEMPORAL bone and PARIETAL bone.

Main sensory nucleus of CN V

B

Motor nucleus of CN VII

B

Nucleus Ambiguus

B

Last one of these...

Dont give up on your dream (*W* - *hh*) W: Prefrontal Cortex X: Olfactory Y: Limbic structures Z: Prefrontal Cortex aa: Parietal Lobe bb: Parietal Lobe cc: Parietal Lobe dd: Occipital Lobe ee: Temporal Lobe ff: Parietal Lobe gg: Occipital Lobe hh: Temporal Lobe

A 15 y/o male presents to the clinic with a chief complaint of trouble swallowing. When speaking to him he has a muffled voice and trisumus (clenched jaw). His temp is 101.2 F and upon physical exam he has a deviated uvula to the left and you notice red, swollen palatine tonsil on the left. Which of the following is the most likely diagnosis? A. CN X lesion on right side B. Peritonsilar abscess C. Mononucleosis D. Streptococcal pharyngitis E. Viral Laryngitis

B. Peritonsilar abscess presents with fever, sore throate, dysphagsia, muffled (hot potato) voice, trismus (lock jaw) and deviated uvula. I made this question up, so the answer choices might be too close together (i figure that strep and mono could present like this), so my apologies.

What is the precursor of NE and Epi? Where are its main actions?

Dopamine (DA) > will have actions on the CNS and on renal vascular smooth muscle.

Which portion of the tongue is known as the "mobile" portion?

BODY -- will change the shape of the tongue

Which type of skin cancer is most often found with the upper lip? Lower lip?

Basal cell carcinoma Squamous cell carcinoma

What are the subtypes of dopamine (DA) receptors? What kind of receptors are these?

Dopamine (DA) receptors are ALL GPCRs -D1-D5

I don't know how he will test on this or even how to make a question about it, so I'm just going to try to explain it a bit on the other side

Basically, certain bits in your cortex prefer different angles & stimulus of light. -start with a baseline level of cell activity w/no stimulous - add light in the wrong orientation & get hyper-polarization & no cell activity. - add light in the correct orientation & get a crazy amount of cell activity - also, add in movement in different directions & cell activity goes all over the place

Where are the optic canals on the sphenoid bone? How are these canals connected on the sphenoid bone?

Beneath anterior edge of LESSER wing -- which opens into orbit as optic foramen. *Prechiasmatic Groove on the superior surface of body of sphenoid will connect canals.

if you didn't know what a berry aneurysm was, like me, the definition is on the other side

Berry aneurysm: A small aneurysm that looks like a berry and classically occurs at the point at which a cerebral artery departs from the circular artery (the circle of Willis) at the base of the brain. Berry aneurysms frequently rupture and bleed. he says they are very very common

Architecture of the olfactory bulb (3rd look)...

Bit more detail here.. (also, C has 2 parts) =scroll for answers= *A*: 1 - Olfactory Nerve Layer (ONL) *B*: 2- Glomerular Layer (GL) *C*: 3- External Plexiform Layer (EPL) (where Tufted Cells live) *D*: 4- Mitral Cell Layer (MCL) *E*: 5- Internal Plexiform Layer (IPL) *F*: Granule Cell Layer (GCL)

What part of the basal ganglia limbic circuit represents *"Wanting"*

Dopamine - Drive to get reward Ventral tegmental?

What can happen CN III is compressed? Most commonly compressed by what?

Blown Pupil b/c compression causes Parasympathetic loss Aneurysm of Posterior Cerebral or Superior Cerebellar A. Will see Blown Pupil but NORMAL fxning eye movement

What landmark on the temporal bone is directly medial to the spine of the sphenoid?

Bony portion of the Auditory Tube.

He mentions that this lecture should be a lot of review (but then he says a little bit of review... what all this means is that he is going to explain everything we didnt get the first time around)

But we'll see if that holds true

CN IX, X

C

Please observe in the image the DLF

Dorsal longitudinal fasciculus (DLF) See it reciprocally exit & head back down

What is choroid fissure?

Dorsal to the fimbria, essentially blocks the flow of CSF out of the temporal horn into the cisternal space.

The patient is prescribed an AChE inhibitor. Which of the following adverse effects is most likely? A. Anhydrosis (lack of sweating) B. Decreased urination frequency C. Diarrhea D. Dry mouth E. Mydriasis (pupil dilation)

C. Diarrhea that's crappy This is because this will cause a increase in parasympathetic affect. And increased sweating from sympathetic. basically anything that uses ACh will be up-regulated. All the answers but C are down regulated ACh things. She went on a rant saying know the BIG PICTURE not just he pieces but the big picture. but know all the pieces to so don't memorize stuff just remember everything forever. -not her exact words, words were added from OMM

What is the major artery of the submandibular region? What are its branches?

LINGUAL a. (branch from external carotid a.) > Dorsal lingual a. (posterior tongue) > Sublingual a. (floor of mouth) > Deep lingual a. (anterior tongue)

The hiatuses of which nerves are associated with the Temporal bone?

Hiatus of the GREATER PETROSAL n. Hiatus of the LESSER PETROSAL n. ---These openings are located anterior to petrous ridge, medial to tegmen tympani. *Greater hiatus is superior, medial and posterior. *Lesser hiatus is inferior, lateral and anterior.

Efferent Hypothalamic PWs...

Dr. Dub was jazzed about the fact that you can see these tracts with the nude eye. =Scroll for Answers= *A*: Anterior Nucleus (Thalamus) *B*: Mammillothalamic Tract *C*: Mammillotegmental Tract *D*: Fornix *E*: Mammillothalamic Tract *F*: DLF *G*: Mammillary Body *H*: Medial Forebrain Bundle

What do *Bertie Botts* and the *Habenula* have in common?

High expectation → picks earwax flavored jelly bean →"Alas!" inhibition by habenula → dopamine plummets

For the production of acetycholine - choline must be transported into the cell, What is this transport dependent on?

CHOLINE transporter will move both choline and Na+ --- specifically it is dependent on the EXTRACELLULAR Na+ concentration

What is the downward sloping portion of sphenoid bone that articulates with the occipital bone (basilar portion)?

CLIVUS -this is found w/n the Posterior cranial fossa and serves as a groove for the path of the BASILAR a.

What is the action of the Temporalis m.?

CLOSES jaw Retracts it after protrusion.

What is the Action of the Masseter m.?

CLOSES the jaw.

4. Medial longitudinal ascending fibers travel ipsilateral and connect cranial nerve nuclei that innervate extra-ocular muscles. What cranial nerves are they again?

CN III CN IV CN VI

What are the GSE (general somatic efferent) nuclei located in the brainstem?

CN III, IV, VI & XII *XI contains GSE, but the nuclei of this CN is found in the cervical spinal cord

Which of the cranial nerves are mixed (afferent, efferent, sensory, motor, etc.)?

CN V CN VII CN IX CN X

How will a hypoglossal n. lesion present clinically?

CN XII lesion will cause the tongue to *deviate TOWARD AFFECTED* side when it is protruded. -this is due to a paralyzed Genioglossus m.

The articulation b/w the frontal and both parietal bones is known as what?

CORONAL Suture

What cell bodies are found in the GSE nuclei of the brainstem?

Cell bodies of *Lower Motor Neurons.*

Flip for pregunta

Cerebellum is also defined by evolutionary emergence and function 1-3. Which one is the Vestibulocerebellum (archicerebellum) Which one is the Spinocerebellum (Paleocerebellum) Which one is the Cerebrocerebellum (Neocerebellum)? 4. Vestibular system talks directly to the cerebellum. From vestibular nuclei to what lobe in the cerebellum? 1. Spinocerebellum (spine to cerebellum) 2. Cerebrocerebellum (cerebrum to cerebellum) 3. Vestibulocerebellum (vestibular to cerebellum) 4. Flocculonodular lobe

check out the pic of a epidural hematoma

Check out the skull fracture where the arrow is pointing. arterial bleeds that cause herniation and death really fast In the pic check out the how the picture on the right is hernated Why is herniation bad? you can pinch off the cerebral arteries. stroke out

What catalyzes the final step of ACh synthesis?

Choline acetyltransferase (ChAT)

How do the circuit of papez and cingulate cortex interact?

Cingulate cortex is a mechanism for the diffusion of information from Papez's circuit. It is most closely associated with behavioral motivation.

Control of eye movements serves to: shift gaze or direct image to ____________.

Fovea

What is conjugate movement? Vergence?

Conjugate= using eyes in same parallel fashion to focus visual field. (*Follow target across anterior field*) Vergence= Following an *object coming toward/away from you*. Eyes converge or diverge

How does the cornea receive oxygen?

Cornea is avascular, so eye actually uses tears to trap free oxygen in the area to feed cornea

What is the insertion of the Temporalis m.?

Coronoid Process & anterior surface of the ramus of the Mandible. Also to Buccinator m. via the *Temporobuccinator band*

What is the triad found with measels?

Cough Conjunctivitis Kolpik spots -pale blue spots on buccal mucosa

CN XII

D

What is the clinical significance of the frenulum of the tongue?

Frenulum of tongue: can be tight enough that it impedes the suckling of an infant; in this case the frenulum can be clipped to allow more movement of the tongue.

1. A 75 yo man with atrial fibrillation experiences a stroke when an embolus lodges in the proximal portion of his left middle cerebral artery. He immediately loses his ability to talk and experiences paralysis of his right arm and leg. A small portion of his left cortical hemisphere has substantially reduced blood flow for several hours and is irreversibly damaged. Excess of which neurotransmitter contributes most to the cell death of neurons in this case? A. Acetylcholine B. Dopamine C. GABA D. Glutamate E. Serotonin 1. Whats going on with this patient? 2. Cell death is resulting from WHAT?

D. Glutamate 1. What's going on with this patient? Having a stroke, ischemic injury, 2. cell death resulting from overstimulation

*Case #6:* 1. An 83 y/o female resident of a nursing facility presents with urinary incontinence. Three years ago she presented with the same symptoms, which were adequately managed with adult diapers and bladder training until recently. The nursing staff are currently encouraging pharmaceutical intervention. Which of the following drug classes is most likely to alleviate her symptoms? A. Beta-2 receptor agonist B. Direct-acting cholinergic agonist C. Indirect-acting cholinergic agonist D. Muscarinic AChR antagonist E. Nicotinic AChR antagonist

D. Muscarinic AChR antagonist

1. From the case above Antibodies to which of the following would most likely cause this patient's presenting symptoms? A. Acetylcholinesterase B. Alpha-1 adrenergic receptor C. Muscarinic acetylcholine receptor D. Nicotinic acetylcholine receptor E. Vesicular monoamine transporter (VMAT-2)

D. Nicotinic acetylcholine receptor causes muscle weakness

Example: 1. Light enters little Tommy's eye and his L and M cones receive the light. The ganglion that is down stream for these cones detects that the L cone is hyperpolarized significantly more than the M cone. Which color is little Tommy most likely seeing? A. Violet B. Yellow C. Green D. Red E. Blue

D. Red Figured that if the L cone is more hyperpolarized than the M cone, than the red light would be stimulating the L cone more than the M.

*Case #1:* A 2 y/o female presents to the ED after an accidental overdose of antihistamines. Her temperature is 102.5° F and pupils are fixed and dilated. Heart rate is 160 bpm (normal 120 bpm). She shows signs of delirium and is noted to have marked cutaneous vasodilation upon physical exam. She is exhibiting symptoms of over activity of which division of the nervous system? A. Central nervous system B. Parasympathetic nervous system C. Somatic nervous system D. Sympathetic nervous system

D. Sympathetic Nervous System because of dilated pupils (done thru alpha1 receptors and pupil dilatory muscle) increased heart rate and Cutaneous vasodilation

Which of the following types of agents is most likely to reduce the patient's symptoms of diarrhea? A. AChE inhibitor B. Alpha receptor antagonist C. Beta receptor antagonist D. mAChR antagonist E. nAChR agonist

D. mAChR antagonist

Poliomyelitis and West Nile Virus are considered examples of which type of disease? Where do these invade?

LMN Disease Ventral horn

Sympathetic innervation to the parotid, submandibular & sublingual glands will cause what affect?

DECREASE gland secretion. *if sympathetic innervation to these glands is lost the effects will be negligible.

What structure in the hippocampus is from the archicortex?

DENTATE GYRUS, this has only 3 layers (archi-old).

What are the muscles of facial expression which will depress or protrude the lower lip?

DEPRESSOR labii inferioris m. -- aids in frowning and pouting Mentalis muscle

If you have a lesion in the circuit of Papez, what can happen?

Declarative memory especially is lost. In such patients, procedural memory is often intact, and intelligence testing may indicate normal or even above normal. In general, bilateral injury is required to produce appreciable deficits in this system.

How will pt's with ASA syndrome present?

Depends on the area damaged

What are the 10 major sites of drug action in the CNS?

Drugs can act on any of the 8 steps in the Synaptic transmission: > Synaptic vesicle synthesis > Neurotransmitter synthesis > AP depolarization (Ca2+ channels) > Fusion of vesicles & release in cleft > Binding/activation of post-synaptic receptors > Post-synaptic membrane response > Reuptake transporter of NT in synapse > Enzymatic breakdown of neurotransmitter Can also indirectly change action of NT receptor through modulating secondary messengers.

What do dendritic spines and drug addiction have in common?

Drugs of abuse alter physical properties of dendrites (spines) in nucleus accumbens (increase spine density along neurons) Lots of new spines means the reward pathway stimulated by these drugs is more efficiently activated unfortunately (lot less glutamate required). Can lead to addiction. Even after rehabilitation of a patient addicted to drugs, the neurons involved in the drug reward pathway will always be more easily activated because of the density of the dendritic spines that remain. (they may retract, but they will always remain). This is why familiar environments, former drugee friends, and the drug itself can drive a former addict back into an addiction (relapse).

*TEST QUESTION 1* A 35 year old man who fell down stairs and hit his head, initially losing consciousness. He tells you, "Doc, I feel a little groggy but I'm fine." His initial exam is normal except for a tender goose egg over his left temple. You should be *MOST* worried about what? A. Discharge paperwork B. Epidural Hematoma C. Subdural Hematoma D. Why this uninsured man has a nicer phone than you. E. Answer B >> answer C > A/D

E. The man could most likely have a Epidural hematoma over 90% of epidural hematomas are associated with a calvarial fracture

internal arcuate fibers sensory dessucation in PCML pathway

E? what happens here?

What is released by blood vessel endothelial cells and will modulate vascular responses?

ENDOTHELIUM-DERIVED Relaxing Factor (EDRF) --- also known as nitric oxide (NO) *this is a short-lived vasodilator.

What neurostranmitter (small-molecule) is synthesized in the adrenal medulla and in some brainstem pathways?

EPINEPHRINE (Epi) --adrenal medulla will release 80% Epi and 20% NE

The opening to what important structure is found on the Temporal bone?

EXTERNAL ACOUSTIC MEATUS --opening of the auditory canal

Match the following to either an ON Bipolar cell or an OFF bipolar cell: 1. ¾ of all bipolar cells 2. have mGluRs (*mGluR6*) 3. depolarize to glutamate 4. all rods, some cones 5. synapse with OFF ganglion cells 6. some cones 7. hyperpolarize to glutamate 8. synapse with ON ganglion cells 9. (*AMPA/kainate*)

Enjoy

What of the following has the most affect on alpha adrenergic receptors? NE, Epi and isproterenol

Epi > NE >> isoproterenol

The release of catecholamines by the adrenal medullas will cause what secondary effects?

Epi and NE release will cause depolarization of the pre-ganglionic sympathetic neuron (cholinergic) and then ACh will be released & binds to nAChRs on the Adrenal Medulla.

A brief introduction

Everyone's reaction to the last gif i posted of Micheal Scott...

on the flip side is a card is the pic with all the notes for it so you can read about the experiment and understand it more. just read it

Figure 13-10 (left): Synaptic circuitry of the visual cortex. Visual pathways that originate in the retina activate neurons in the lateral geniculate nucleus of the thalamus. These glutamate-containing neurons in turn synapse on cortical pyramidal neurons and produce some excitation. Also within the primary visual cortex, a GABA-containing neuron mediates localized inhibition. Small cells in the locus coeruleus, a brainstem nucleus, make widely divergent connections onto cortical neurons and release norepinephrine and thus produce modulation . Figure 13-12 (right): Modulatory effect of norepinephrine. A, Injecting a neuron from the hippocampus with a sustained depolarizing current pulse leads to a "phasic" action potential response: frequent spiking at the beginning but adaptation as the depolarizing current pulse is maintained. B, The application of norepinephrine causes the spiking that is elicited by the depolarizing current pulse to be sustained longer ("tonic"). C, The cell returns to its control state as in A .

So now tell me about a LMN disease. Tone? Reflexes? Anything else we would see?

Flaccid (decreased) Decreased or mute DTR Fasciculations, and atrophy in chronic disease

Through what does V3 enter the infratemporal fossa?

Foramen Ovale

The Foramina Rotundum, Ovale, & Spinosum in the sphenoid bone will open into what areas?

Foramen Rotundum: opens on medial anterior portion of the greater wind directly posterior to superior orbital fissure which opens into PTERYGOPALATINE FOSSA Foramen Ovale: posterolateral to rotundum which opens into INFRATEMPORAL FOSSA. Foramen Spinosum: posterolateral to ovale which opens into INFRATEMPORAL FOSSA

Let's start with the orbit... 7 bones that contribute to the orbit?

Frontal Ethmoid Palatine Lacrimal Maxilla Zygomatic Sphenoid

44, 45

Frontal lobe Inferior frontal gyrus (opercular and triangular parts) aka Broca's area (on the left)

4

Frontal lobe Precentral gyrus, anterior paracentral lobule aka Primary motor area; M1

6

Frontal lobe Superior and middle frontal gyri, precentral gyrus aka Premotor area, supplementary motor area

Describe the BARORECEPTOR Reflex.

Function: To control Mean arterial pressure. Increase in BP will be compensated by DECREASING peripheral vascular resistance (decreased sympathetic outflow to the hear) and increase in parasympathetic discharge to cardiac pacemaker.

What 2 neurotransmitters are generally involved in LTP and LTD of cerebellar circuitry? What does the cerebellum measure?

GABA (-) and glutamate (+) The cerebellum measures *expectation vs. outcome*

What is the primary inhibitory neurostransmitter of the CNS? How is this synthesized?

GABA (gamma-amino butyric acid) -synthesized locally from glucose, pyruvate or some amino acid precursors.

How is GABA inactivated after it has been released into the synapse?

GABA signal is terminated by RAPID uptake by several types of PLASMA MEMBRANE TRANSPORTERS GABA is also taken up by glial cells.

The centrally located elevation of the frontal bone is also known as . . . . . .

GLABELLA

What neurotransmitters work as agonists to NMDA receptors?

GLUTAMATE *Glycine will function as a co-agonist

What is the primary excitatory neurotransmitter of the CNS? How is it synthesized?

GLUTAMATE -synthesized in the brain from Glucose (does NOT cross the BB-barrier)

What are the large lateral extensions from the body of the sphenoid bone? What are the superolateral extensions?

GREATER WINGS: these are large & lateral from the body which are visible in the orbit at the pterion & in the middle cranial fossa. LESSER WINGS: more delicate superolateral extensions form the body which articulate w/ internal surfaces of frontal & parietal bones.

The lingual n. (branch of V3) will provide what type of fibers to the floor of the mouth, ant. 2/3rds of the tongue and gingivae?

GSA --- sensory innervation to the floor of the mouth.

What kind of fibers are carried in chorda tympani?

GVE-P and SVA

What 3 structures form a circuit that is involved with memory extinction?

Hippocampus contributes context info to other associations Limbic cortex integrates hippocampal and amygdalar inputs Amygdala acquires emotion-laden memories, especially associated with fear

Glycine is a inhibitory neurotransmitter that functions by effecting what? What inhibits glycine release?

Glycine will effect Ligand-gated Cl- channel. --TETANUS TOXIN inhibits Glycine release

Me IRL

Good grades = flowers me = Kelly Neuro = Ryan

Prepare yourself...

Good luck (*A* - *J*) A: Relay B: Association C: Mammilothalamic Tract D: Hippocampus E: Cingulate Gyrus F: Hippocampus G: Cingulate Gyrus H: Basal Nuclei I: Cerebellum J: Motor Areas

How do we get brain freezes?

Greater and lesser palatine nerves --> through pterygopalatine ganglion --> back through V2 and then up through the meningial branch

Great petrosal n --- (CN VII) Lesser petrosal n --- (CN IX)

Greater vs Lesser patrosal n's Which comes from which CN?

Which pterygoid plate on the sphenoid bone will contain a hamulus? Describe this.

HAMULUS of the MEDIAL PTERYGOID PLATE --hook at the extreme inferior portion of the medial pterygoid plate

How does the hypoglossal n. (CN XII) enter the oral cavity: enters the oral cavity *from submandibular region 1. Hypoglossus passes lateral to what artery? 2. What space does it enter in the oral cavity?

HYPOGLOSSAL n. (CN XII) 1. passes lateral to the *occipital a.* 2. *PARALINGUAL space.*

What provides the MOTOR innervation to the tongue?

HYPOGLOSSAL n. --GSE fibers to all mm. except palatoglossus m. VAGUS n. -- SVE fibers go to palatoglossus m.

What component of the sphenoid bone houses the pituitary gland?

HYPOPHYSEAL FOSSA -- this is the depression in the body of the sphenoid which is a part of the sella turcica.

Explain habituation

Habituation (aka synaptic depression) appears to be due to a decrease in the amount of neurotransmitter available for release due to depletion. This resolves as the synapse recovers.

Head trauma and cerebral edema can cause what to the CA1?

Head trauma and cerebral edema can also produce anoxia of this region.

What are 2 diseases in which basal ganglia is damaged?

Huntington's disease, Parkinson's

spinothalamic tract

I

Welcome to the ear

I *hear* this is a great lect*ear*

I'm not gonna lie...

I dont understand this slide (but he spent about 5 seconds on it and the main gist was that taste info is sorted out in the cortex)

Well... its that time again...

I long i feel it has taken us to get through all of this information...

1. Anterior Chamber

ID

1. Iris and Pupil

ID

Lens

ID

Retina

ID

Sclera

ID

Vitreous Body

ID

1. Disk 2. Optic Nerve - Less than 5mm wide = normal -More than 5mm could mean *Increased ICP* (intracranial pressure)

ID And, describe CC associated w/ 2

What is the way to remember this.

LR6 SO4 AR3 Lateral rectus CN VI

Flip for question

ID 1-3. What artery 4-9 what structure 10. What happens to #9 if there is a high inter cranial pressure cerebellum is labeled 1-10 for its different parts like a clock in the picture Dr. George said he will not specifically test us on those. 1. Superior cerebellar artery (SCA) 2. Anterior Inferior cerebellar artery (AICA) 3. Posterior Inferior cerebellar artery (PICA) 4. Superior cerebellar peduncle 5. middle cerebellar peduncle 6. inferior cerebellar peduncle 7. Vermis 8. Flocculonodular lobe (part X) 9. Cerebellar Tonsils 10. Cerebellar tonsils will herniate through foramen magnum.

flip for ?

ID 1-10 What are the 10 sites drugs can act on in the CNS? she said this was important so I'm making you do it again. (1) Action potential in presynaptic fiber; (2) synthesis of transmitter; (3) storage; (4) metabolism; (5) release; (6) reuptake into the nerve ending or uptake into a glial cell; (7) degradation; (8) receptor for the transmitter; (9) receptor-induced increase or decrease in ionic conductance; (10) retrograde signaling.

That was fun...

ID these guys & What each supplies: A: Supratrochlear (Scalp, forehead) B: Medial Palpebral (eyelid) C: Short Posterior Ciliary (Vascular tunic) D: Anterior Ethmoidal (Ethmoid paranasal sinuses) E: Central Retinal (Retina) F: Posterior Ethmoidal (Ethmoid paranasal sinuses) G: Dorsal Nasal (Nose) H: Supraorbital (Scalp, forehead) I: Long Posterior Ciliary (Vascular tunic) J: Lacrimal (Lateral Eyelid) K: Ophthalmic

another good summary he said we can read.

IDK I personally don't like this one.

The GVE-P fibers from the LPN (origin is CN IX) will have what action on the Parotid gland?

INCREASE parotid secretion.

What are the boundaries of the submandibular region? *Inferior *Superior *Roof *Floor

INFERIOR: anterior & posterior bellies of digastric mm. SUPERIOR: body mandible ROOF: cervical investing fascia FLOOR: mylohyoid m.

What is the groove on the orbital portion of the maxilla bone? What connects the groove to infraorbital foramen?

INFRAORBITAL GROOVE --there is a Infraorbital canal which will lead from the groove to the infraorbital foramen.

What is the large opening in the Temporal bone located posterior to petrous ridge approximately 3/4 distance of petrous ridge?

INTERNAL acoustic meatus.

1. Cornea

Identify

1. Eyelid

Identify

1. Sternomastoid 2. Sternothyroid 3. Sternohyoid

Identify

1. Thyroid Gland

Identify

Flip the Cards

Identify, then Scroll 1. Carotid A. 2. Internal Jugular Vein 3. Common Carotid A.

1. SCM 2. Thyroid 3. Trachea

Identify...

Flip the card, identify the structure, and push the sound icon to hear the answer. (Note you need to turn up your volume)

Identify? ONE OF MY FAVORITE STRUCTURES EVER!

Welcome to the Limbic system! The part of the brain responsible for PLEASURE, anger, fear, anxiety. AKA the best part of the human brain and the worst part of the female mind.

If you don't want to know everything there is to know about the limbic system, then leave.

what if there is a problem with the substantia innominata?

If you lose these cholinergic projections that extend to activate areas of the cerebral cortex, the cortex will not activate. EVEN if the cortex is in good shape. This is what happens in ALZHEIMERS DISEASE!

Explain the "retinotopic" map that the visual system creates (explain it from the perspective of the right visual field).

Images are perceived in our right visual fields, travel through the circuitry and are being projected on our left visual cortex. The area of the greatest visual acuity (where our macula is focusing) will be projected to the more posterior part of the calcarine fissure and occipital lobe. Further from that area of greatest acuity the image gets more distorted.

define immediate memory?

Immediate memory is the ability to hold ongoing experiences in mind for fractions of a second. It is very large, and each sensory modality (visual, tactile, verbal) appears to have its own register. Required to be oriented and responsive in an environment

What is *long-term potentiation (LPT)* and how does it correlate with Hebbian learning?

In long-term potentiation as a stimulus is *repeatedly applied*, more neurotransmitter receptors are added to the post synaptic membrane. This results in either a smaller amount of neurotransmitter needed to stimulate a response or the same amount of neurotransmitter is able to stimulate a much larger response. Long-term potentiation (LPT) is the *neural correlate* to Hebbian learning

QUICK DRAW OUT THE PERFORANT PATHWAY! Now why is this pathway important?

In the brain, the perforant pathway, provides a connectional route from the entorhinal cortex to all fields of the hippocampal formation (including the dentate gyrus, all CA fields (including CA1), and the subiculum. The perforant pathway is important for consolidation of new memories (long-term memory storage)

You're doing great...

Keep Going (*K* - *V*) K: Medial Lemniscus (body) L: Spinothalamic Tract (body) M: Somatosensory Cortex N: Medial Lemniscus (face) O: Spinothalamic Tract (face) P: Central Tegmental Tract (Taste) Q: Somatosensory Cortex R: Insula S: Brachium of Inferior Colliculus T: Auditory Cortex U: Optic Tract V: Visual Cortex

What can be found at the intersection of the Sagittal & Lamdoid sutures?

LAMBDA

How does a thalamic stroke occur?

Infarcts of PCA via the Thalamoperforate and Thalamogeniculate arteries Can cause sensory aberrations anywhere depending on affected nuclei

What is the origin of the Masseter m.?

Inferior border of zygomatic arch

How is glutamate inactivated after it has been released into the synaptic cleft?

Initially it is taken up by glial cells and converted into Glutamine -transported out of glia and taken up by glutamatergic nerve cells & converted back into glutamate.

What structures are innervated by the auriculotemporal n. (from posterior division of V3)?

Innervates: -TMJ -Parotid gland -Tragus -Anterior portion of Pinna -External auditory canal -Tympanic membrane -Skin anterior & superior to the ear.

*External Ear* - flip

Innervation! A-E: Name nerve & what it branches from A: Lesser Occipital N (C2, C3) B: Facial N (CN VII) C: Great Auricular N (C2, C3) D: Auriculotemporal N (CN V3) E: Auricular br. of Vagus N F: Glossopharyngeal N (Internal bit o' tympanic membrane)

Learning and Memory depend on sensory experience. Name 2 multimodal association cortices involved in this sensory experience.

Insula Orbitofrontal cortex Nearly all cortical areas feed into the basal ganglia circuitry, connect many sensory experiences with each other

To look right Put this together. FEF of the left what to look at something... with medial rectus will it activate? (Contralateral or ipsilateral?)

Ipsilateral, via contralateral superior colliculus also will activate contralatera *lateral* rectus

What articulation is found b/w both parietal bones and the Occipital bone?

LAMBDOID Suture

This'll be so much fun...

Is "fun" the right word? Answer A-G while learning!! Fun!! A: Tufted Cell (know b/c of (D)) B: Mitral Cell C: Ipsilateral Olfactory Cortex D: Tufted collateral to AON E: AON Nueron F: to ipsilateral bulb G: share info w/contralateral bulb

Check out whats on the back of here.....

Isnt this amazing? DONT LOOK TOO CLOSELY! 1. What part do GSE fibers occupy? 2. What about GSA? 3. Visceral information? 4. What about special visceral? Take a second to look at where all the nuclei are for each cranial nerve and how it coordinates with the area (med/lateral and sup/inf). 1. GSE = most central area 2. GSA = most lateral area 3. Visceral = area between GSA and GSE 4. Special Visceral = arent really visceral, column occupies a ventrolateral area in the brainstem

What is the hebbian theory?

It describes a basic mechanism for synaptic plasticity, where an increase in synaptic efficacy arises from the presynaptic cell's repeated and persistent stimulation of the postsynaptic cells. synapses that act to strengthen the connection between the synapse and neuron by some undefined process (trophic or metabolic) will be maintained, causing axons to "sprout" to form additional connections.

Pathway of Circuit of Papez?

It extends from the entorhinal area of the parahippocampal gyrus then goes to the hippocampus (primarily the subiculum) then to the mammillary bodies (medial mammillary nucleus) via the post commissural fornix then to the anterior thalamic nuclei (via the mammilothalamic tract (fasciculus). then to the cingulate gyrus (via the internal capsule) then back to the entorhinal area (via the cingulum bundle).

So what is the point of everything we have talked about up to this point?

It helps when you look at a doozy like this.... (roll tide)

Define hippocampus proper

It is the infolding of a cortical area into a spcialized area of archicortex (3 layers). It is divided into CA1-CA2-CA3-CA4 (cornu ammonis- ammons horn) *They receive dif types of info and project out to hippocampus

Stria Terminalis Again

It is the point at the tip of the caudate nucleus

What is the substantia innominata? Hint: the innominata makes you wanna be naughta

JK. sutstantia innominata gives rise to diffuse cholinergic projections that go to activate parts of the cerebral cortex. They are important in allowing the cerebral cortex to respond to behavior stimuli. These enhance levels of arousal in response to an emotional stimulus.

Here is an example of contrasts at work....

Jk this is a dog....

What forms from the lack of fusion of the temporal & occipital bones (lateral to the occipital condyles)?

Jugular Foramen

Where is MLF located relative to the nucleus of abducens nerve?

Just *medial* to it. It has prime access to it.

What is the innervation of the Masseter m.?

Masseteric branches of V3.

What fat pad is found in the infratemporal fossa?

Masticatory (buccal) fat pad

What landmark of the temporal bone serves as the superior attachment point for the SCM?

Mastoid Process

Mastoid canaliculus - Auricular br (CN X) - On the lateral aspect of jugular foramen Tympanic canaliculus - Tympanic br (CN IX) - On the ridge between jugular foramen/carotid canal "Mastoid is more lateral" - CN X innervates more lateral structures in the ear

Mastoid canaliculus vs Tympanic canaliculus Transmits what? Location of each canaliculus?

What is the alternative passage of the maxillary artery w/n the infratemporal fossa? (in approx. 50% of population)

Maxillary a. passes *deep* to a part or all of the lateral pterygoid muscle.

The pterygoid plexus of veins will eventually coalesce to form what vein?

Maxillary v.

When you see kolpik spots, what disease should you think of?

Measles

What is the innervation of the Medial Pterygoid m.?

Medial Pterygoid branch of V3

Please observe in the image the DLF & MFB

Medial forebrain bundle (MFB) Dorsal longitudinal fasciculus (DLF) See them come into the hypothalamus (he says he doesn't care about the rest of the image for this lecture)

What is the origin of the Medial Pterygoid m.?

Medial surface of Lateral pterygoid plate and tuberosity of maxilla Pyramidal process of palatine bone

What is the insertion of the Medial Pterygoid m.?

Medial surface of Ramus & Angle of Mandible

What is used to treat ADHD?

Methylphenidate Amphetamine

*middle cerebellar peduncle:* 1. information from where goes thru here? 2. what is the tract called? 3. info coming in is from the ipsilateral, contralateral, or bilateral, or laterally side? 4. before the info comes into the middle cerebellar peduncle it sometimes synapses, what nuclei does it synapse on? 5. #4 is part of what?

Middle: 1. cortical input 2. "*cortico*-*ponto*-*cerebellar*" 3. *Contralateral cortical input* 4. -synapse in pontine nuclei 5. -Part of "basis pontis" -note: also called brachium pontis

*Layers of the cerebellum:* 1. What 3 things are found in the Molecular layer? 2. What 2 things are found in the Purkinje cell layer? 3. What 2 thing are found in the Granule cell layer?

Molecular layer 1. Parallel fibers, Purkinje dendrites, stellate cells (there are some dendrites from golgi II cells here but they aren't a major player here) Purkinje cell layer 2. Cell bodies of purkinje cells, basket cells Granule cell layer 3. Densely populated layer containing granule cells, cell bodies of golgi cells

What part of the cingulate cortex is most directly involved in memory?

Most direct memory functions are associated with posterior cingulate cortex, although other areas are related to more specific functions, usually associated with the cortical regions it borders, e.g. Autonomic, executive, language/ motor, sensory.

Where do most of the fornex efferents to the mammillary nucleus arise from?

Most of the fornix efferents to the mammillary nucleus arise from the subiculum.

What are the different subtypes of nAChRs (at NMJ)?

Muscle subtype --Nm Ganglia (peripheral neuronal) --Nn CNS (central neuronal) --Nn

What is innervated by the Mylohyoid n. (from inferior alveolar n.)? (2)

Mylohyoid m. Ant. belly of digastric m.

What is the name of the mid-point intersection of the two nasal bones & the frontal bone?

NASION

We are going to start off with ID and then do all the flashcards.... weird I know. Push 2 if you so please

NAme them 1. Temporalis 2. Masseter

What is the result of NE on the baroreceptor reflex?

NE will initiate a increase in the peripheral vascular resistance and a subsequent increase in mean arterial pressure. -- this will result in a slowing of the heart rate (BRADYCARDIA)

What is responsible for the major mechanism of reuptake to catecholamines in the synapse?

NET (norepinephrine transporter) DAT (dopamine transporter) *after reuptake the catecholamines are stored in vesicles by VMAT-2

Another term for the cranial vault is what? What are the regions of this area?

NEUROCRANIUM: portion of the skull enclosing the brain & its associated meninges *Calvaria (skull cap or 'roof') *Cranial base (basicranium or 'floor')

What is the Sympathetic action and adrenergic receptor on the Endothelium?

NONE

*Lacrimal Duct:* Do all lacrimal ducts connect into the nasal cavity the same way?

NOPE check out the pic. pretty lucrative business this is. a blocked lacrimal duct is bad news bears

What is thought of as the MAJOR neurostransmitter of the SYMPATHETIC nervous system?

NOREPINEPHRINE (NE) or Noradrenaline *this is because it is found in a vast majority of post-ganglionic sympathetic fibers.

*Thalamus-Nuclear Groups & Functions* - *Lateral* Let's Review...

Name each colored dot & what goes in & out of each? =Scroll for Answers= Red: VA *A*: To Frontal Cortex (orbitofrontal, supplementary motor, premotor) *B*: From Basal Ganglia (Putamen, Caudate, Striatum) Orange: VL *E*: To 1° motor area (precentral gyrus) *F*: From Dentate & Pallidal (cerebellum) Blue: VP *G*: To somatic sensory cortex *H*: From body & trigeminal afferents & some gustatory

Cribriform plate (Ethmoid) - CN I

Name of landmark? What bone is it on? What travels through?

Foramen cecum (Frontal bone) - Nasal emissary v

Name of landmark? What bone is it on? What travels through?

Foramen lacerum - Meningeal br of Ascending pharyngeal a

Name of landmark? What bone is it on? What travels through?

Incisive canal (Maxilla) - Nasopalatine n - Greater palatine a

Name of landmark? What bone is it on? What travels through?

Mental foramen (Mandible) - Mental a.v.n. (CN V₃)

Name of landmark? What bone is it on? What travels through?

Superior orbital fissure (Sphenoid) - CN III - CN IV - CN V₁ - CN VI - Superior ophthalmic v

Name of landmark? What bone is it on? What travels through?

Anterior Ethmoidal foramen - Anterior ethmoidal a.v.n. (CN V1) I know, this isn't a great picture

Name of landmark? What travels through?

Anterior ethmoidal foramen - Anterior ethmoidal a.v.n. (CN V₁)

Name of landmark? What travels through?

Carotid canal - Internal carotid a - Internal carotid sympathetic plexus

Name of landmark? What travels through?

Condyloid canal - Condyloid emissary v This is the one exception to the "canals transmit a + n" rule

Name of landmark? What travels through?

Foramen ovale - CN V₃ - Accessory meningeal a

Name of landmark? What travels through?

Foramen rotundum - CN V₂

Name of landmark? What travels through?

Foramen spinosum - Middle meningeal a - Recurrent meningeal n (CN V₃)

Name of landmark? What travels through?

Greater palatine canal - Greater palatine a + n

Name of landmark? What travels through?

Hiatus for greater petrosal n - Greater petrosal n (CN VII) - Petrosal br. of Middle Meningeal a "the Lesser hiatus is Lateral"

Name of landmark? What travels through?

Hiatus for lesser petrosal n - Lesser petrosal n (CN IX) "the Lesser hiatus is Lateral"

Name of landmark? What travels through?

Hypoglossal canal - CN XII (GSE) - Post meningeal branch (Ascending pharyngeal a)

Name of landmark? What travels through?

Inferior orbital fissure - Infraorbital a + n (CN V₂) - Orbital n - Zygomatic n (CN V₂) - Inferior ophthalmic v

Name of landmark? What travels through?

Infraorbital foramen (Maxilla) - Infraorbital a.v.n. (CN V₂)

Name of landmark? What travels through?

Internal acoustic meatus (Petrous portion of Temporal bone) - CN VII - CN VIII - Internal labryrinthine a

Name of landmark? What travels through?

Geniohyoid m. O: I: N: A:

O: Mental spines of mandible I: hyoid N: C1 via hypoglossal A: Elevates hyoid, opens mouth when hyoid is fixed

Mylohyoid m. O I N A

O: Mylohyoid line of mandible I: midline raphe and hyoid bone N: Mylohyoid branch of V3 A: Elevates hyoid and floor of mouth

Palatoglossus m. O I A N

O: Soft palate I: Tongue A: pulls tongue and soft palate together N: Vagus n. (SVE)

Stylohyoid Muscle Origin Insertion Innervation Action

O: Styloid process I: Hyoid bone N: CN VII A: elevates and retracts hyoid

*SUMMARY:* Check out this PIC!!!!!

OMG WOWOWWOOWWOWOWWOWWOWOWWOOWOOWWOW

How would a pt present if they have an UMN palsy for face muscles? Most common cause?

ONLY drooping of contralateral Lower (below the eyes) face Most commonly caused by a stroke (order STAT CT head)

1. Where does the parotid duct open into the oral cavity?

OPENS into the *Oral Vestibule* --opposite the upper (maxillary) *2nd Molar*.

In what portion of the frontal bone can the orbital frontal gyri impression be identified?

ORBITAL PART (or PLATE) *this is in the medial superior orbit.

*Styloglossus m* Origin Insertion Action Innervation

ORIGIN: *Styloid process* INSERTION: *Superolateral tongue.* Action: *Retracts; elevates tongue* Nerve: *Hypoglossal n. (GSE)*

17

Occipital lobe Banks of calcarine sulcus aka Primary visual area; V1

18, 19

Occipital lobe Surrounding 17 aka Visual association areas; V2, V3, V4, V5

In the Rostral midbrain the MLF will be just medial to what nucleus?

Occulomotor nucleus

That wasn't so bad, right?

On to Ear-natomy!

Lets do some ID of each *Region* (2)

On to the *Anterior (Supraoptic) Region* =Scroll for Answers= *A*: Body Fornix *B*: Column Fornix (separates Medial & Lateral Shells) *C*: Paraventricular Nucleus *D*: Anterior Nucleus *E*: Supraoptic Nucleus *F*: Periventricular Nucleus *G*: Suprachiasmatic Nucleus *H*: Lateral Hypothalamic Area *I*: MFB

Lets do some ID of each *Region* (3)

On to the *Middle (Tuberal) Region* =Scroll for Answers= *A*: Body Fornix *B*: Column Fornix (separates Medial & Lateral Shells) *C*: Lateral Hypothalamic Area & MFB (lat to columns of fornix) *D*: Dorsomedial Nucleus *E*: Ventromedial Nucleus *F*: Arcuate Nucleus *G*: Periventricular Nucleus *H*: Optic Tract

What can cause appreciable deficits in long term memory?

Only diffuse damage or overactivation ( epilepsy, or using electroconvulsive therapy) will produce appreciable deficits in long term memory.

What are the two components of the oral cavity?

Oral Cavity Proper Oral vestibule

What is the most proximal part of the GI tract?

Oral region

What muscle of fascial expression will allow us to close our lips/mouth?

Orbicularis oris m.

1. Where is the Pterygoid Plexus of Veins located in relation to the pterygoid muscles?

Pterygoid Plexus of Veins on the *lateral surface of the medial pterygoid m.* & *surrounds the lateral pterygoid m.*

Which bone of the skull is a small, irregular L-shaped bone which can be found insinuated between the maxilla & sphenoid bone? What are the two parts of this bone?

PALATINE bone --This bone possesses both a horizontal part and a vertical part.

Pt presents w/: - Contralateral homonymous hemianopsia - Possible thalamic deficits Where is the stroke?

PCA

The highest point of the sphenoid in the middle cranial fossa extends as what landmark on the Temporal bone? What groove is associated with this landmark?

PETROUS Ridge *The Groove for the Superior Petrosal Sinus is located on this ridge.

The borders of the maxilla and the nasal bones will form what?

PIRIFORM APERTURE: this is the bony margin of the nose. -Maxilla will form the majority of this structure.

What are some important landmarks of the occipital bone on the posterior, inferior and internal surface of the bone?

POSTERIOR -- Internal & External protuberances, Superior & Inferior Nuchal lines INFERIOR -- Occipital condyles INTERNAL --Grooves for superior, transverse, sigmoid sinuses & cerebellar fossae.

What are the superior extensions on the dorsum sellae?

POSTERIOR CLINOID PROCESSES

What is the action of the mentalis m. (muscle of fascial expression)?

PROTRUDES the LOWER lip.

What is found at the intersection of the Frontal, Parietal, Sphenoid (greater wing), and Temporal bones?

PTERION

There are paired openings through the body of the sphenoid inferior to the sphenoid sinus at the roots of the pterygoid wings -- these openings are called what? What do they open into?

PTERYGOID canals *These will open into the Pterygopalatine fossa.

What is the action of the palatoglossus m.?

PULLS tongue and soft palate together during swallowing.

what is priming?

Priming is a phenomenon that demonstrates the continual transfer of information from working memory into long term memory, whether or not there is an intent to remember it. Priming is particularly a factor in the creation of associational biasing or creating false memories

*Case #4:* A 58 y/o male is admitted with a chief complaint of increasing shortness of breath (SOB) and a recent 17 pound weight gain. Two weeks prior to admission, he noted the onset of dyspnea on exertion (DOE) after one flight of stairs, orthopnea, and ankle edema. Since then, his symptoms have increased. He notes episodic bouts of paroxysmal nocturnal dyspnea (PND) and has only been able to sleep in a sitting position. He also notes a productive cough, nocturia (2-3 times/night) and mild, dependent edema. History Long history of heartburn 10-year history of osteoarthritis managed with various NSAIDs Depression Hypertension Strong family history of diabetes

Physical exam Dyspnea, cyanosis, and tachycardia BP - 160/100 mmHg Pulse - 90 bpm Respiratory rate - 28 breaths/min 5'11'', 172 lbs Neck vein distention is noted S3 gallop is heard on cardiac examination 3+ pitting edema of the extremities Hepatomegaly Chest examination reveals inspiratory rales and rhonchi bilaterally Current medications Hydrochlorothiazide (HCTZ) Ibuprofen (Advil) Ranitidine (Zantac) Citalopram (Celexa)

Pt presents w/ diffuse, flaccid paralysis potentially spreading to the diaphragm and muscles of respiration. What do these symptoms describe?

Poliomyelitis (LMN) Spread via fecal-oral transmission

What part of hippocampus got bigger in London cabbies?

Posterior

While looking in a patient's oral cavity you notice pale mucosa. What is wrong with this patient?

Potentially *Anemia*

Time to ID SOME STUFF!!

Press #2

good boy

Press 1

Explain sensitization

Sensitization is a non-associative learning process in which repeated administration of a stimulus results in the progressive amplification of a response. Sensitization often is characterized by an enhancement of response to a whole class of stimuli in addition to the one that is repeated.

What is responsible for the inactivation of serotonin (5-HT)?

Serotonin uptake transporter (SERT) terminates the neurotransmitter signal by rapidly pumping 5-HT back into the nerve terminal.

Name those branches

She barely talked about this but I figure it will help with the practical anyway... A: Anterior Ethmoidal N B: Infratrochlear N C: Lacrimal N D: Long Ciliary N E: Short Ciliary N F: Ciliary Ganglion G: Nasociliary N H: Supraorbital N I: Lacrimal N J: Frontal N

Many drugs lead to "anticholinergic" side effects - how does this occur?

Side effects are due to blockage of the muscarinic receptors in the CNS.

*Paranasal Sinuses*: What is the difference b/w air cells and sinus?

Sinuses are just like one big room with one entry Air cells are multiple small rooms that all have entries to the nasal cavity

What are dendritic spines and why are they important to new memory formation?

Small protrusions of dendrites. As we learn things the neurons involved grow dendritic spines in order to have more contact with other neurons. This allows for efficiency in creating new memories. You don't need to grow new neurons, you can just use the neurons you already have!

Flip the card!

So lets name these bad jacksons! 1. CN XII 2. Dorsal motor of CN X 3. Solitary Nucleus (taste fibers) 4. Vestibular nuclei 5. Spinal Trigeminal Nucleus 6. Nucleus Ambiguus

We also have a *columnar* organization to the Calcarine sulcus...

So this confused me a bit, here's what he said: "Remember, each primary cortex is receiving information from two different retina." "It reconstructs the image based on the different columns & creates a retinotopic map across the visual cortex"

Overwhelming ID of the Afferent Smelly Signals...

Solitary Tract business... =Scroll for Answers= *A*: Greater Petrosal (VII) *B*: Geniculate Ganglia *C*: VII *D*: Lingual N *E*: V *F*: Chorda Tympani *G*: IX *H*: Lingual Branch *I*: Inferior Glossopharyngeal Ganglia *J*: X *K*: Inferior Ganglia of Vagus (Nodose)

How can we utilize the veins of the mouth while giving a patient a medication?

Sublingual drugs absorb into the system and can work really fast ex. Nitroglycerine tablets

What do you find running in the paralingual space? 1 gland 1 duct 2 nerves 1 vein

Sublingual gland Submandibular duct lingual nerve hypoglossal nerve Vena comitans of hypoglossal nerve

What is the accessory motor system (nucleus) from the basal ganglia that acts upon our eye movements?

Substantia niagra pars reticulata

WE ARE DONE!!

Suck it Toby, you're the worst

All of the muscles of mastication can be divided into two portions, what are they?

Superficial Deep

In addition to inhibiting the thalamus, what else does the *substantia nigra pars reticulata* disinhibit.

Superior Colliculus

What does the trochlear nerve (CN IV) innervate?

Superior oblique m.

Destruction of UMN during prenatal or neonatal periods (can be caused by infxn, hypoxia, birth trauma) will cause UMN damage but will *NOT* always have mental deficits. What UMN disease am I describing?

Spastic Cerebral Palsy

Lets do some ID of each *Region* (1)

Start with the *Preoptic Region* =Scroll for Answers= A: Medial Preoptic Nucleus B: Lateral Preoptic Nucleus C: MFB (Medial Forebrain Bundle)

stria terminalis

Stria terminalis - connects the amygdala to the septal area in a long course near the caudate nucleus

What provides the anchoring point for many structures on the temporal bone?

Styloid Process --> this is located on the inferior surface of the temporal bone.

What are the accessory ligaments of the TMJ?

Stylomandibular ligament (accessory) Sphenomandibular ligament (accessory)

*Superior cerebellar peduncle:* 1. Info coming in from what tract? 2. info coming in is from the ipsilateral, contralateral, or bilateral, or laterally side? 3. Sends Efferent info to what 2 things? Primarily what nucleus? 4. is the efferent info going to go to the ipsilateral, contralateral, or bilateral, or laterally side? 5. Which cerebellar peduncle is the major output pathway of the cerebellum?

Superior: 1. from *ventral spinocerebellar* tracts 2. contralateral info 3. sends efferent info to the *red nucleus* and *thalamus* (primarily *VL nucleus*) 4. *contralateral* 5. Superior cerebellar peduncle note - also called the brachium conjuctivum

What are the boundaries of the infratemporal fossa? -Superior -Inferior -Anterior -Posterior -Lateral -Medial

Superior: base of skull formed by the *inferior portion of the temporal* bone & the *infratemporal portion of the greater wing of the sphenoid* Inferior: Continuous w/ the submandibular region Anterior: maxilla & buccinators muscle in masticatory space. Posterior: line drawn medially from the posterior margin of the ramus of the mandible to the lateral pharyngeal wall. Lateral: Ramus of the mandible Medial: Lateral pharyngeal wall

Where is Dopamine (DA) synthesized? How is this stored in the axon?

Synthesized in the pre-synaptic terminal from TYROSINE by enzymes; tyrosine hydroxylase and dopa decarboxylase. *DA is loaded into vesicles by the vesicular monoamine transporter (VMAT)

How and where is serotonin (5-HT) synthesized? Where is this stored?

Synthesized in the pre-synaptic terminal from Tryptophan by the enzyme tryptophan hydroxylase. -Serotonin is loaded into vesicles by a vesicular transporter.

Where is ACh synthesized? How is this stored in the axon?

Synthesized in the presynaptic terminal from Choline & Acetyl-CoA by the enzyme Choline acetyltransferase. > Vesicle-associated transporter (VAT) loads ACh into vesicles.

What is responsible for the synthesis of norepinephrine (NE)? Where is NE stored?

Synthesized inside the NE granules from DA by the enzyme Dopamine beta-hydroxylase. -NE is stored in the granules where it is produced.

The sigmoid sinus will have a groove in which bone?

TEMPORAL bone has groove for sigmoid sinus -- this is on the floor of posterior cranial fossa & opens into jugular fossa.

What are the results of D1 receptor activation (DA receptor)?

THese receptors are found on RENAL vascular smooth muscle. --causes vasodilation, natriuresis and diuresis

What is a metopic suture?

THis is also known as a FRONTAL Suture. ~ occurs in 8% of individuals where the sagittal suture will bisect the frontal bone completely.

TRUE/FALSE: Opioids add a "liking" signal that strengthens the basal ganglia limbic circuit. "Liking" is strongly evoked when opioids in: Cingulate, Orbitofrontal Cortex (OFC), Nucleus accumbens/ventral striatum Parabrachial nucleus

TRUE Opioids bind all over the CNS. They strengthen the basal ganglia limbic circuit.

What is the bony floor of the auditory canal? What bone is this part of and what is found anterior to this floor?

TYMPANIC PLATE *this is a landmark of the Temporal bone. PETROTYMPANIC FISSURE: This is anterior to tympanic plate & posterior-medial to mandibular fossa.

2 examples of Dorsal Column probs are Tabes Dorsalis and B12 Deficiency. Tell me about them both...

Tabes Dorsalis: Most common sequela of Tertiary Syphilis Infxn. Occurs years after primary syphilis infxn if not treated properly B12: After Years of low B12. Also affects Corticospinal tracts = UMN signs (Subacute combined degeneration of the spinal cord). B12 can also cause anemia

Many actions of nuclei in the thalamus have contrary actions...

Tell us what function each region of the hypothalamus has? *A*: Arousal *B*: Sleep (Medial/Lateral Preoptic) *C*: Appetite *D*: Satiety *E*: Heat Gain *F*: Heat Loss (Medial/Lateral Preoptic)

Hypothalamic Functions *Water Balance* Lets have fun with this...

Tell us what function each region of the hypothalamus has? *A*: SFO *B*: ANG II *C*: Hyperosmolarity *D*: SFO *E*: Preoptic Nucleus *F*: Paraventricular Nucleus *G*: Supraoptic Nucleus *H*: Medial Preoptic Nucleus *I*: Paraventricular Nucleus *J*: Supraoptic Nucleus *K*: Paraventricular Nucleus *L*: Supraoptic Nucleus *M*: AVP *N*: Thirst *O*: Medial Preoptic

More actions of nuclei in the hypothalamus...

Tell us what function each region of the hypothalamus has? (ALSO: for A & C tell us what nucleus) *A*: Circadian Cycle (Suprachiasmatic) *B*: Memory formation (independant of hippocampus) *C*: Output to autonomics (Paraventricular) *D*: Endocrine

What is the origin of the Temporalis m.?

Temporal Fossa Deep portion from infratemporal crest

22

Temporal lobe Superior temporal gyrus aka Auditory association area; posterior portion (on the left) = *Wernike's area*

What are the components of the Lesser petrosal n. (LPN)?

The GVE-P fibers from the tympanic branch of CN IX and the Geniculotympanic branch of CN VII.

What will the horizontal part of the palatine bone form? What both horizontal portions fuse what is formed?

The Horizontal part forms the Posterior portion of the HARD PALATE and FLOOR of the posterior nasal cavity. *fusion of the horizontal portions will form the POSTERIOR NASAL SPINE.

What will the vertical part of the palatine bone form?

The Vertical part forms a portion of the Posterior Lateral Wall of the Nasal Cavity & contributes to a small portion of the posterior orbit.

What NT are important in the basolateral part of amygdaloid complex?

The basolateral group contains GABA neurons that are sensitive to GABA agonists, which enhance GABA transmission and reduce anxiety.

What is the amygdala associated with?

The amygdala uses visceral and somatic sensory inputs to coordinate emotional responses to pleasurable, fearful, and visceral stimuli. It is best known for sympathetic autonomic and fear related responseS

Where is the amygdaloid complex?

The amygdaloid complex is located in the anterior and medial portion of temporal horn under the uncus with which part of it blends

what is memory association?

The association of random objects, words, or numbers with objects significant to the individual can dramatically increase particularly declarative memory, but also non-declarative aspects.

How is the habenula involved in the basal ganglia limbic circuit pathway?

The habenula signals a lack of reward. It inhibits dopamine release from the ventral tegmental area. Which decreases stimulus to the nucleus accumbens which increases the inhibition activity by the ventral pallidum on the MD thalamus.

According to Dr. Wells, what does habenular nuclei do?

The habenular nuclei are related to negative (as opposed to positive) affect attached to behaviors

anterograde amnesia vs retrograde amnesia?

The inability to form new memories results in anterograde amnesia, whereas difficult in retrieving memories already established is retrograde amnesia.

Why is the TMJ considered a "modified" hinge joint?

The joint *allows gliding* movement as well as hinge movements.

*CASE #2:* 1. A healthy 68 y/o male presents to an ophthalmologist complaining of double vision and droopy eyelids. He first noticed this double vision about 1 year ago and says it has been gradually worsening. He says it also gets worse during the day (he doesn't typically notice it first thing in the morning). Later in the day, particularly during a long meal such as dinner, he notices progressive difficulty with chewing as his "jaw muscles get really tired" and he even has to stop eating. The jaw fatigue doesn't go away until after 1 to 2 hours rest. His past medical history is unremarkable. He takes one aspirin (81 mg) mg daily as a precaution against developing coronary artery disease. *CONTINUES ON BACK SIDE*

The neurologic examination revealed ptosis of the left eye after a sustained upward gaze (Panel A). The movements of the extraocular muscles were normal. The ice-pack test was performed with the placement of an instant cold pack over the left eye (Panel B). After 2 minutes, the ptosis was substantially diminished (>5 mm), indicating a positive test (Panel C).

where does the nucleus accumbens lie?

The nucleus accumbens or nucleus accumbens septi lies at the junction of the caudate nucleus an the putamen and next to the septal nuclei.

Circuit of papez function?

The primary function of Papez's circuit appears to be the incorporation of new declarative memories.

consolidation is what?

The process of converting information in working memory to long term memory

T of F: the same basic machinery is used for respiration as well as swallowing.

True! The CPG (just talked about) is using the same nuclei for coordinating swallowing as well as respiration

T or F: if something is covered in mucosa, then it is referred to as an "arch" or a "fold".

True. DON'T EVER FORGET THIS!!

Where are the frontal eminences?

This are the slightly raised elevations ABOVE the SUPERCILIARY ARCHES (these are the elevated areas DEEP to location of eye brows)

Flip for question?

What is this called? Meth mouth

Flip card for question

What is wrong with this persons mouth? It might be.... oral cancer

What was determined with the Hubel and Weisel experiment?

When you look at different cells across primary & associated visual cortices you have individually mapped groups of neurons that respond to a specific orientation of an image, but also if it's moving or not

upper sacral cord

Where are we

How is the foramen lacerum formed?

This is a foramen which is formed by a LACK of fusion of the Sphenoid bone, Petrous portion of Temporal bone and Basilar portion of Occipital bone. *foramen is united by cartilage b/w these bones.

What is the tegmen tympani?

This is a landmark on the Temporal bone -- described as an elevation over middle ear anterior to petrous ridge.

T/F All are invested in fascia which is continuous

True

What is the ONLY foramen found in the parietal bone?

This is foramen is for conducting an EMISSARY vein can be located parallel to the sagittal suture (near proximity to the lambdoid suture)

Also this...

This is how you drink wine... (Can you tell that I am just so done with this set?)

What does the intermaxillary suture mark?

This is midline on the Maxilla bone and marks the primordial origin of the bone.

Where would you find the Bregma?

This is the intersection of the Sagittal & Coronal Sutures.

What is adrenergic neurotransmission?

This refers to neurotransmission in which catecholamine (NE, EPi and DA) are released upon stimulation by an action potential (AP)

Welcome to another episode of

To Catch a Pervert Ill be your host

What is the function of the zygomatic process off of the frontal bone?

To articulate with the ZYGOMATIC bone.

Today we learn about *central* control of the ANS

Tomorrow we learn about *conscious* control of the ANS... like Wim here

1. What is RIP (OPN) Raphe Interpositus (Omnipause) job?

Tonic inhibition. Keeps telling neurons to stop. So basically it's the parent of a toddler

Let's talk about West Nile.. How is it transmitted? Where does it invade? What does it cause and how does it present? Treatment?

Transmitted via mosquitos Invades Ventral Motor Horn (LMN) Causes *Meningitis*: Febrile w/ altered mentation AND Flaccid Paralysis Tx: supportive

In the caudal midbrain what nucleus will be just lateral to the MLF?

Trochlear nerve

Take a moment

Use this image to explain to the class the sympathetic & parasympathetic PWs

What is the term for the portion of the skull forming the face?

VISCEROCRANIUM --this will include the orbits, nasal cavities & mouth

What is responsible for the storage of GABA in the CNS?

Vesicular transporter is used to load GABA into synaptic vesicles.

How are most of the bones of the neurocranium (cranial vault) united?

Via SUTURES

Dorsal Column Pathology is hallmarked primarily by loss of ____________ and _____________ sensation.

Vibratory; Proprioceptive

An infarct of the PICA can cause ____________. This is a relatively common infarct of the vertebral artery system, especially common on the boards

Wallenberg Syndrome (Lateral Medullary Syndrome)

Why is all the last cards information important to our brains?

We can use the info from the last card, obtained in our visual cortex, and push it to the parietal cortex to tell us about how we should respond to that stimulus.

1. Tympanic membrane 2. Isthmus 3. Tensor veli palatini 4. Pharygneotympanic tube 5. Levator veli palatini 6. Pterygoid hamulus - the tensor veli palatini hooks around this to attach to the palatine aponeurosis

What is the importance of #6?

Condyloid canal - Transmits only condyloid v

What is the one exception to the rule "every 'canal' in the skull transmits an artery and a nerve but not a vein" ?

CN I = Cribriform plate CN II = Optic canal CN III = Superior orbital fissure CN IV = Superior orbital fissure CN V₁ = Superior orbital fissure CN V₂ = Foramen rotundum CN V₃ = Foramen ovale CN VI = Superior orbital fissure CN VII = Internal acoustic meatus CN VIII = Internal acoustic meatus CN IX = Jugular foramen CN X = Jugular foramen CN XI = Jugular foramen CN XII = Hypoglossal canal

What skull foramina do each of the CN's come through?

Foramen ovale = Accessory meningeal a Foramen spinosum = Middle meningeal a Hiatus for greater petrosal n = Petrosal br of Middle meningeal a Jugular foramen = Posterior meningeal br's of Occipital a + Ascending pharyngeal a Hypoglossal canal = Posterior meningeal br of Ascending pharyngeal Foramen lacerum = Meningeal br of Ascending pharyngeal a

What skull foramina do the various meningeal a's come through? (6)

1. Lesser palatine nerve - GSA 2. Glossopharygneal nerve - GVA

What type of fibers does #1 provide? What type of fibers does #2 provide?

What is released at the same time as norepinephrine (NE)?

When NE is released due to nerve impulses there is also a release of co-transmitters and dopamine beta-hydroxylase

Carotid Bifurcation We can measure the Thickening of the Intima. (for us dumb folks, that's the thickness of the plaque w/in the vessels) This can be tracked and recorded at each visit to see if the pt is actually following the diet you prescribed them.... (most likely not)

When scanning the neck in the long axis, what is the first major landmark that we are looking for? What can we measure at this point that would help us "track" the health of our pt's? See picture for hint**

Is sure hope you have figured out to flip these by now

Where is this? Name them Caudal Pons 1. Sup. Inf. and middle cerebellar peduncle 2. Facial colliculus 3. CN VI 4. Corticospinal tract 5. CN VII 6. 4th ventricle

*Middle Ear* - Roof (a second look Q) (flip)

Where on this skull is the Tegmen Tympani? (see next FC for answer)

On to the hypothalamus...

Which I hear controls the 4 F's - Feeding - Fighting - Fleeing - and.... Mating

Which is located on the lateral wall of the orbit (part of the zygomatic bone)?

Zygomatico-Orbital foramen *this will lead to the other foramen of the zygomatic bone (ZYGOMATICOFACIAL & ZYGOMATICOTEMPORAL)

What results from the ACh activation of nAChRs and mAChRs on the PRE-synaptic membrane?

nAChR activation will mobilize additional transmitter for subsequent release. mAChR activation will INHIBIT further release of ACh

Foramen cecum - Nasal emissary v Mastoid foramen - Mastoid emissary v Codyloid canal - Condylar emissary v

Which head holes transmit emissary veins?

dorsolateral fasciculus (lissaeurs tract)

c

Anterior ethmoidal foramen - Ant ethmoidal a.v.n Posterior ethmoidal foramen - Pos ethmoidal a.v.n. Supraorbital notch/foramen - Supraorbital a.v.n. Infraorbital foramen - Infraorbital a.v.n. Mandibular foramen - Inf alveolar a.v.n. Mental foramen - Mental a.v.n. Zygomaticofacial foramen - Zygomaticofacial a.v.n. Zygomaticotemporal foramen - Zygomaticotemporal a.v.n.

Which holes in the skull transit a.v.n. all of the same name? (8)

flop

Which is the sensory root & which is motor? A: Sensory root (V1) B: Motor (GVEP) root (CN III)

Maxillary a. angles anteriorly and superiolry and travels on the surface of what? What structure is it headed towards?

on the surface of the *lateral pterygoid muscle* towards the *pterygomaxillary fissure.*

What is the hippocampus proper sensitive to?

oxygen deprivation and corticosteroids. Can hinder memory circutiry

check the other side of this card...

Which of these nerves have just afferent information coming in to the brainstem? (scroll down) 1. Vestibulocochlear 2. Optic 3. Olfactory

4. A lesion of the connections between which thalamic nucleus and its cortical projection could produce symptoms similar to a prefrontal lobotomy? a. centromedian nucleus b. ventral anterior nucleus c. dorsomedial nucleus d. ventral lateral nucleus e. lateral posterior nucleus

c. dorsomedial nucleus

nucleus cuneateus carries primary neuron for PCML of upper limb

c? carries info for which tract?

What other receptors (aside from DA receptors) can be activated by high concentrations of DA?

can activate alpha & beta adrenergic receptors which can cause an increase in HR and general vascular vasoconstriction.

Cribriform plate --- CN I Foramen cecum --- Nasal emissary v Foramen rotundum --- CN V₂ Hiatus for lesser petrosal n --- Lesser petrosal n (CN IX) Mastoid foramen --- Mastoid emissary v Condyloid canal --- Condyloid emissary v Petrotympanic fissure --- Chorda tympani (CN VII) Stylomastoid foramen --- SVE of CN VII Tympanic canaliculus --- Tympanic br (CN IX) Mastoid canaliculus --- Auricular br (CN X) Foramen lacerum --- Meningeal br (Ascending pharyngeal a) Nasolacrimal canal --- Nasolacrimal duct

Which skull foramena have only a single structure running through them? (12)

Greater palatine a - Greater palatine canal - Incisive canal Nasopalatine n - Sphenopalatine foramen - Incisive canal Post meningeal br of Ascending pharyngeal a - Jugular foramen - Hypoglossal canal - Foramen lacerum (This is just the Meningeal branch (no POST))

Which structures passes through 2+ foramen in the skull? Which two foramen?

Nasopalatine n Greater palatine a Post meningeal br of Ascending pharyngeal a

Which structures pierce 2 holes in the skull?

check out this fool...

Who dis? 1. Hypoglossal trigone (Not my chair not my problem)

ID this yo...

Who dis? (scroll down) -Is this a GSE 1. Spinal accessory nucleus -It is not, its apart of the pharyngeal arches; will still get innervation that is similar to the SVE's

The basilar portion of the occipital bone will fuse with what bone? What can sometimes form instead of a fusion?

Will fuse with SPHENOID bone at the DORSUM SELLAE. *the two bones can sometime actually articulate rather than fuse & form a Cartilaginous joint.

what is working memory?

Working memory (aka-short term memory)- ability to hold information in mind for access for seconds to minutes after the present. Clinical test is to remember a span of digits presented. (7-9 is normal)

What is the Mammilotegmental Fasciculus

Yup, we did Papa, now we are doing Mama... The Mammilotegmental fasciculus is the best defined descending pathway out of Papez's circuit This arises from collaterals of the mammilothalamic fasciculus. It terminates primarily in the raphe nuclei of the midbrain reticular formation.

What condition results from a dysfunction of parasympathetic innervation to the submandibular & sublingual glands?

XEROSTOMIA: "dry mouth" - caused by decreased parasympathetic innervation

CN X and lesion would be on the left side (the uvula would be pointing away from lesion

You have a patient that presents with this condition upon physical exam. What nerve is involved and on what side would the lesion be?

"Pay attention to this slide"

You're gonna do great... =Scroll for Answers= *A*: Pyrogens *B*: Reset HT to High *C*: ↑ temp (shiver, vasoconstrict, ↑BMR, ↑HR, Curl up body) *D*: new high temp (feel warm) *E*: Tx to remove Pyrogens *F*: reset HT to normal *G*: ↑ heat loss (vasodilate, sweat, lethargy, extend body) *H*: to normal temp

fasiculus gracilis

a

What is the hippocampusl sulcus

a groove bt the parahippocampal gyrus (subiculum) and dentate gyri

You want to know something weird? A cough can be caused by a hair lying against the tympanic membrane. To the best of our knowledge, this is documented for the first time by our report of 3 patients with chronic cough who experienced relief after a hair was removed from the ear drum. The explanation for this observation is based on what?

a protective reflex mediated through afferent vagal nerve fibers.

What is the subiculum?

a specialized transition zone between archicortex of hippocampus and 6 layered cortex of parahippocampal gyrus. Receives major input from entorhinal cortex and other nearby cortices. *projects to mammillary bodies through fornix

*Sensory* Innervation: Trigeminal Nerve - V1 (Ophthalmic) iii: Nasociliary Branch- 5 twigs [these are the eyeball touch feeling bits]

a. Short Ciliary N b. Long Ciliary N c. Posterior Ethmoid N d. Anterior Ethmoid N e. Infratrochlear N -dont forget your awesome ciliary ganglion too

*Sensory* Innervation: Trigeminal Nerve - V1 (Ophthalmic) i: Frontal Branch- 2 twigs

a. Supratrochlear b. Supraorbital

*Sensory* Innervation: Trigeminal Nerve - V1 (Ophthalmic) ii: Lacrimal Branch- 1 twigs

a. Zygomatic nerve (communicating to lacrimal gland)

2. The olivocochlear efferent system that projects to inner and outer hair cells arises primarily from which brainstem nuclei? a. the superior olivary complex b. the inferior olivary complex c. the dorsal accessory olive d. the medial accessory olive e. the lateral accessory olive

a. the superior olivary complex

What are the different subtypes of alpha-adrenergic receptors? What will result form the activation of each?

a1-receptor: activation is result in smooth m. contraction (vasoconstriction, cardiac m. contraction) *a1 in gut will cause hyperpolarization and m. relaxation. a2-receptor: activation will result in vascular smooth muscle contraction, decreased insulin secretion and decreased release of NE

nucleus Gracilis carries primary neuron for PCML for lower limb

a? carries info for which tract?

fasciculus Gracilis lower limbs

a? this carries info for __________ limbs

what are the cortical components of the limbic system comprised of?

allocortex (paleocortex, phyogenically older), so they have 3-5 layers compared to the neocortex which had 6

Postganglionic fibers follow the course of the ______________________ nerve and leave it, after having traversed the parotid, as parotid branches.

auriculotemporal n.

dorsolateral fasiculus ( lissauer's tracts)

b

Failure of the choroid fissure to fuse will result in which of the following congenital anomalies? a. Aniridia b. Coloboma c. Persistent Iridopupillary membrane d. Aphakia

b. Coloboma

A patient with damage to her right oculomotor nerve may present with right eye ________. a. Turning in and up b. Turning out and down c. Turning in and down d. Turning out and up

b. Turning out and down

The paralingual space is the posterior region of oral cavity between what two muscles?

b/w hyoglossus & mylohyoid mm.

Which adrenergic receptors are found in the myocardium?

b1 receptors

WHat are the different subtypes of beta-adrenergic receptors? What will result from the activation of each?

b1-receptor: activation causes INCREASED force & rate of heart contraction. increases AV conduction velocity. b2-receptor: activation causes vascular, BRONCHIAL, genitourinary and GI smooth muscle to RELAX b3-receptor: activation causes lipolysis

Fasciculus Gracilis

b?

fasciculus cuneatus upper limbs

b? carries info for ____________ limbs

check out pic

bad news bears epidural hematoma. they removed the left skull but this left hemisphere stroked out and is gone :(

what info do entorhinal afferents carry?

broad cortical areas necessary for memory! includes olfactory info

What creates the bump of the facial colliculus?

bump created by abducens nucleus, but also has CN VII wrapping around it.

Huntingtons and Parkinsons are typically accompanied by the inability to learn what?

by the inability to learn motor skills (as opposed to performance). This might include mirror drawing or tracking a spot of light. Cerebellar damage can also interfere with some types of conditioned reflex learning (blink reflex to a tone and puff of air).

CN V

c

Substantia Gelatinosa

c

What is the primary output part of the hippocampus?

through the fornix

*Nasal Cavity:* What is the main goal of the nasal cavity?

to warm, moisturize, and clean the air

what is between the archicortex and neocortex?

transition areas that blend together

Nerves of the mandibular division of the trigeminal nerve distribute from what three parts? (hint: 1 trunk, 2 divisions)

undivided trunk anterior or posterior divisions

That was rough. Let's take a second to stop and smell the...

updog

How are our eye able to track the movements of a moving target?

via Smooth Movement Pursuits =Smooth, voluntary, slow, tracking movements on a moving target *uses similar neural mechanisms as saccades

how does the hippocampus connect to the contralateral hippocampus

via hippocampal commissure

fasciculus gracilis primary neuron of PCML for lower limb

what is a? what neuron runs in this track?

dorsal spinal rootlet

what is b?

dorsalateral fasciculus ( lissauer's tract) anterolateral system elevator for ascending and descending fibers

what is c? what type of primary neuron enters here?

ventral gray horn lateral corticospinal tract

what is g? what synapses here?

pyramidal decussation motor dessucation for lateral corticospinal tract

what is this? what important thing happens here?

When, if ever, is the best time to have problems or differences in the brain occur?

when you are born or early in life. CHECK IT OUT this bru doesn't have a cerebellum, he was able to function basically normal

lower cervical

where are we?

upper lumber

where are we?

upper thoracic

where are we?

Caudal Medulla motor decussation in pyramidal dessucation

where are we? major event happens?

caudal medulla; sensory decussation at internal arcuate fibers

where are we? major event?

This is a type of Subarachnoid hemorrhage.

worst headache of my life --- thunder clap. caused from trauma, drugs or ruptured aneurysm extends *INTO* the sulci

Odor info from bulb to 1° olfactory cortex... → What 5 places can it go from there?

→ Hypothalamus → Olfactory Bulb (feedback) → Orbital Cortex (frontal, decision making) → Hippocampus (memory) → Thalamus (doesn't avoid thalamus completely, just hits cortex 1st)