Clinical Neuroscience LM Notebook Generated (Quiz Style) - Weeks 10, 11, 12

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Questions and Answers

If a patient exhibits difficulty coordinating rapid, alternating movements (dysdiadochokinesia) and demonstrates intention tremors, which area of the cerebellum is MOST likely affected?

  • Flocculonodular lobe
  • Vermis
  • Spinocerebellum
  • Cerebrocerebellum (correct)

A researcher is investigating the effects of a novel drug on cerebellar function. They discover that the drug selectively blocks the release of GABA from Purkinje cells. What would be the MOST likely consequence of this drug's action?

  • Increased excitation of deep cerebellar nuclei (correct)
  • Reduced climbing fiber input to Purkinje cells
  • Decreased activity of mossy fibers
  • Enhanced long-term depression (LTD) at parallel fiber synapses

A patient presents with gait ataxia, nystagmus, and postural instability. Imaging reveals a lesion affecting a specific cerebellar pathway. Which of the following pathways is MOST likely involved, given the patient's symptoms?

  • Cerebellothalamocortical pathway
  • Corticopontocerebellar pathway
  • Spinocerebellar tract
  • Vestibulocerebellar pathway (correct)

A researcher selectively stimulates the inferior olive in an animal model. What direct effect would this stimulation have on the cerebellar cortex?

<p>Increased complex spike firing rate of Purkinje cells (A)</p> Signup and view all the answers

A person is standing still on a moving bus. Which vestibular organs are MOST active in this scenario?

<p>Only the otolith organs (utricle and saccule) (A)</p> Signup and view all the answers

A patient reports brief episodes of vertigo triggered specifically by looking upwards. Which semicircular canal is MOST likely affected by BPPV in this case?

<p>Right anterior canal (D)</p> Signup and view all the answers

During a Caloric reflex test, cold water is irrigated into a patient's left ear. If the vestibulo-ocular reflex (VOR) is functioning normally, what would be the expected eye movement?

<p>Slow phase to the right, fast phase to the left (C)</p> Signup and view all the answers

If the stapedius muscle is paralyzed due to damage to the facial nerve, how would this affect a person's hearing?

<p>Increased sensitivity to loud sounds (hyperacusis) (D)</p> Signup and view all the answers

Which of the following BEST describes the role of outer hair cells in the cochlea?

<p>They amplify and refine the traveling wave, enhancing sensitivity and frequency selectivity. (C)</p> Signup and view all the answers

A genetic mutation causes a complete absence of tip links in hair cells of the cochlea. What would be the MOST likely consequence?

<p>Inability of hair cells to transduce mechanical stimulation into electrical signals (C)</p> Signup and view all the answers

A drug selectively blocks phosphodiesterase (PDE) activity in rod photoreceptors. What immediate effect would this have on the rods in dark conditions?

<p>Depolarization of the rod membrane (B)</p> Signup and view all the answers

A patient has damage to the magnocellular layers of the lateral geniculate nucleus (LGN). Which visual function would be MOST affected?

<p>Motion detection (A)</p> Signup and view all the answers

A lesion completely severs the optic radiation in the left temporal lobe. What specific visual field deficit would result?

<p>Right superior quadrantanopia (C)</p> Signup and view all the answers

A person with blindsight can accurately point to the location of a light stimulus in their blind field, even though they report not consciously seeing it. Which pathway is MOST likely mediating this behavior?

<p>Tectopulvinar pathway (superior colliculus to pulvinar to cortex) (A)</p> Signup and view all the answers

Which cellular mechanism is MOST directly responsible for light-induced hyperpolarization of photoreceptors?

<p>Decrease in cGMP levels (B)</p> Signup and view all the answers

How would the loss of the left superior oblique muscle impact vision?

<p>Inability to depress the left eye when it is adducted (B)</p> Signup and view all the answers

A patient has a lesion that damages the right parietal lobe's contribution to the dorsal stream. Which symptom would you MOST expect?

<p>Optic ataxia (difficulty reaching for objects) (D)</p> Signup and view all the answers

What specific impairment would result from bilateral damage restricted only to area V4 of the visual cortex?

<p>Color blindness (achromatopsia) (B)</p> Signup and view all the answers

What pattern of hearing loss would follow damage limited only to the right medial geniculate nucleus?

<p>Partial hearing loss primarily localized in the contralateral ear (A)</p> Signup and view all the answers

Conduction deafness can result from all of the following EXCEPT

<p>Cochlear damage (B)</p> Signup and view all the answers

If the left flocculonodular lobe of the cerebellum is lesioned, what other signs and symptoms would MOST likely be apparent?

<p>Gait ataxia, impaired saccades and difficulty with smooth pursuit (D)</p> Signup and view all the answers

A patient presents with uncoordinated gait, intention tremor, and difficulty performing rapid alternating movements with their right arm and leg, but not their left. Where is the MOST likely location of the causative lesion?

<p>Right cerebellar hemisphere (B)</p> Signup and view all the answers

Following a stroke, a patient exhibits a combination of sensorineural hearing loss and vestibular dysfunction. Which single arterial structure was MOST likely occluded?

<p>Anterior inferior cerebellar artery (C)</p> Signup and view all the answers

A patient reports difficulty perceiving the location of objects in space after suffering a stroke. Which area is MOST likely affected?

<p>Dorsal stream, specifically the posterior parietal cortex (C)</p> Signup and view all the answers

A 60-year-old patient presents with progressive difficulty recognizing familiar faces, even those of close family members. Neuroimaging reveals atrophy primarily in the anterior temporal lobe. This condition is MOST likely associated with:

<p>Damage to the ventral visual stream (B)</p> Signup and view all the answers

Which of the following correctly pairs a structure of the eye with its primary function?

<p>Lens: Focuses light on the retina for clear vision at different distances (C)</p> Signup and view all the answers

A patient has damage to the left optic nerve. What resulting sign is MOST apparent?

<p>Blindness in the left eye (D)</p> Signup and view all the answers

Compared to rods, cone photoreceptors...

<p>have greater spatial acuity and are used for daylight vision (B)</p> Signup and view all the answers

What would happen if a patient with unilateral damage to the vestibular nerve experienced loud sounds?

<p>A Tullio phenomenon type response where patients may experience dizziness, vertigo, nausea, and involuntary eye movements (C)</p> Signup and view all the answers

How is motion detected at the sensory level of hair cells in the ear?

<p>Via mechanical stimulation of the stereocilia that opens mechanically-gated ion channels and depolarizes the cell (A)</p> Signup and view all the answers

How does the basilar membrane function in hearing?

<p>It converts amplitude-encoded signals into frequency-encoded signals (C)</p> Signup and view all the answers

A patient exhibits deficits in smooth pursuit eye movements and experiences difficulty maintaining gaze stability when tracking a moving object. Damage to which cerebellar region is MOST likely contributing to these symptoms?

<p>Flocculonodular lobe (A)</p> Signup and view all the answers

A researcher discovers a novel neurotoxin that selectively destroys granule cells in the cerebellar cortex. What cascade of events would MOST likely follow this exposure?

<p>Disrupted timing of Purkinje cell activity, leading to motor incoordination (C)</p> Signup and view all the answers

A patient reports experiencing vertigo and nystagmus immediately after a forceful sneeze. What is the MOST plausible underlying mechanism for these symptoms, considering the anatomy of the inner ear?

<p>Displacement of otoconia from the utricle into the posterior semicircular canal (C)</p> Signup and view all the answers

A new drug selectively enhances the activity of prestin, a motor protein in outer hair cells. What would be the MOST likely effect of this drug on auditory function?

<p>Increased amplitude of the cochlear microphonic (B)</p> Signup and view all the answers

A patient with a history of migraines presents with transient vision loss described as a shimmering, zigzagging pattern that obscures a portion of their visual field. This is MOST likely due to:

<p>Cortical spreading depression affecting neuronal activity in V1 (D)</p> Signup and view all the answers

Flashcards

Flocculonodular lobe function?

Involved in balance and posture. Receives information from the pons and vestibular nuclei and CN VIII.

Purkinje cell function?

The only efferent (output) neuron of the cerebellar cortex.

Spinocerebellar tracts function?

Carry proprioceptive information from the body to the cerebellum.

Cerebrocerebellum function?

Responsible for visually guided movement, planning, and timing of movements.

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Dentate nucleus function?

Responsible for planning, initiating, controlling, and correcting voluntary movements. Largest of the deep cerebellar nuclei.

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Deep pontine nuclei function?

Relay indirect information from all four cortical lobes to the cerebrocerebellum (lateral zone).

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Cerebellar damage location impacts?

Information in the cerebellum is ipsilateral to its origin, so damage impacts the same side of the body.

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Semicircular canals function?

Detect angular (rotational) motion of the head.

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Utricle and Saccule function?

Detect linear acceleration and head position relative to gravity. Contain otoconia.

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Vestibulo-ocular reflex (VOR) function?

Maintains stable visual fixation during head motion by causing the eyes to move in the opposite direction of head movement.

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Vestibular 'push-pull' relationship?

Head rotation in one direction excites the vestibular organ on that side and inhibits the organ on the opposite side.

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Benign Paroxysmal Positional Vertigo (BPPV) cause?

Caused by otoconia displacing into the semicircular canals, leading to a sensation of spinning with head movements.

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Cochlea function?

Transmits the sounds heard to be interpereted

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Sensorineural hearing loss cause?

Results from damage to the cochlea or the neuronal pathway from the cochlea to the brain.

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Cornea function?

Refracts and focuses light.

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Rods function?

Provide vision in low light conditions and are sensitive to monochromatic color.

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Fovea function?

Critical for tasks that require high resolution vision, such as reading or recognizing a face.

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Nasal retina fibers cross where?

Cross over to the contralateral optic tract at the optic chiasm.

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Lateral geniculate nucleus (LGN) location?

A part of the thalamus where the optic tracts synapse before projecting to the visual cortex.

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Right optic tract lesion impact?

Results in loss of vision in the left visual field of both eyes.

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Unilateral spatial neglect cause?

Failure to attend to or respond to stimuli on the opposite side of the body, is commonly associated with a stroke or lesion in the right parietal lobe.

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Ventral processing stream function?

Involved in visual recognition, helping to identify objects.

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Optic disc characteristic?

The point where the axons of the retinal ganglion cells converge to form the optic nerve and does not contain any photoreceptors.

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Diabetic retinopathy impact?

Damage to the blood vessels within the eyes.

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Primary visual cortex location?

Primary visual cortex of the occipital lobe.

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Vestibulocochlear nerve (CN VIII) function?

Carries sensory information from the vestibular apparatus to the vestibular nuclei in the brainstem, which is essential for the VOR.

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Ataxia definition?

Uncoordinated movement, which is a common sign of cerebellar dysfunction.

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Thalamus (LGN and MGN) function?

Serves as a relay station for sensory information. The lateral geniculate nucleus (LGN) relays visual information and the medial geniculate nucleus (MGN) relays auditory information.

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Dorsal column-medial lemniscus (DCML) pathway function?

Carries light touch and proprioception, and its second-order neurons decussate in the medulla.

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Which cranial nerves help with speech?

Motor control of the muscles involved in speech, which are innervated by cranial nerves V, VII, IX, X, and XII.

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Study Notes

Cerebellum & Function

  • The flocculonodular lobe relates to the pons and vestibular nuclei.
  • Receives information from the vestibular nuclei and CN VIII.
  • Important for balance and posture.
  • The Purkinje cell is the only efferent output of the cerebellum.
  • Spinocerebellar tracts carry proprioceptive information to the cerebellum.
  • Cerebrocerebellum (lateral zone) is responsible for visually guided movement.
  • Also responsible for the planning and timing of movements.
  • The dentate nucleus is the largest of the deep cerebellar nuclei.
  • Dentate Nucleus is responsible for planning, initiating, controlling, and correcting voluntary movements.
  • The cerebrocerebellum (lateral zone) receives indirect information from all four cortical lobes via the deep pontine nuclei.
  • Damage to the cerebellum results in deficits ipsilateral to the damage.

Vestibular System

  • Semicircular canals detect angular motion of the head.
  • Otoconia are located within the utricle and saccule.
  • The utricle and saccule are responsible for detecting linear acceleration and head tilt.
  • The vestibulo-ocular reflex (VOR) maintains stable visual fixation during head motion.
  • VOR causes the eyes to move in the opposite direction of head movement during head motion.
  • In the push-pull relationship, head rotation in one direction excites the vestibular organ on that side and inhibits the organ on the opposite side.
  • BPPV is caused by otoconia displacing into one of the semicircular canals.

Auditory System

  • The cochlea transmit the sounds heard to be interpreted.
  • Sensorineural hearing loss is a disease of the cochlea or the neuronal pathway from the cochlea to the brain.

Visual System

  • The cornea is the part of the eye responsible for refracting and focusing light into the orbit.
  • Rods are highly sensitive structures in the retina that provide resolution in lower lit conditions.
  • Rods are sensitive to monochromatic color.
  • Fovea is critical for tasks that require high resolution with vision.
  • At the optic chiasm, fibers from the nasal retina of each eye decussate (cross over) to the contralateral optic tract.
  • Fibers from the temporal retina remain ipsilateral.
  • LGN is a part of the thalamus, where the optic tracts synapse before projecting to the visual cortex via the optic radiations.
  • A lesion of the right optic tract results in a loss of vision in the left visual field of both eyes, also known as left homonymous hemianopsia.
  • Unilateral spatial neglect is commonly associated with a stroke or lesion in the right parietal lobe.
  • Temporal (ventral) processing stream is involved in visual recognition, for identifying objects.
  • The optic disc is the point where the axons of the retinal ganglion cells converge to form the optic nerve.
  • Optic disc does not contain any photoreceptors.
  • Diabetic retinopathy involves damage to the blood vessels within the eyes.
  • Optic nerve ends in the primary visual cortex of the occipital lobe.

Combined Topics

  • Damage to the vestibulocochlear nerve (CN VIII) affects the VOR.
  • Ataxia is uncoordinated movement, and is a sign of cerebellar dysfunction.
  • The thalamus serves as a relay station for sensory information.
  • The lateral geniculate nucleus (LGN) in the thalamus relays visual information to the visual cortex.
  • The medial geniculate nucleus (MGN) in the thalamus relays auditory information to the auditory cortex.
  • The dorsal column-medial lemniscus (DCML) pathway carries light touch and proprioception, and its second-order neurons decussate in the medulla.
  • Cerebellum contributes to speech articulation.
  • Speech articulation motor control relies on cranial nerves V, VII, IX, X, and XII.

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