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Summary McTimoney College of Chiropractic - Neuroscience $34.17   Add to cart

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Summary McTimoney College of Chiropractic - Neuroscience

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This is a full summary of all lecture notes and slide decks from neuroscience relating to the written exam. With these notes you are guaranteed for a high grade!

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  • May 1, 2023
  • 80
  • 2021/2022
  • Summary
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Neuroscience (NS) - Written Exam
Table of contents
1 – Introduction to Neuroscience 4

1.1 Relation to chiropractic 4

1.2 NS in a nutshell 4

1.3 Other communication systems 5

2 – Meninges & Cerebrospinal Fluid 6

2.1 The brain 6

2.2 Meninges 6

2.2.1 Dura mater 7

2.2.2 Arachnoid Mater 7

2.2.3 Pia mater 7

2.2.4 Intracranial haemorrhage 8

2.2.5 Spinal cord 8

2.2.6 Clinical connection 9

2.3 Cerebrospinal fluid (CSF) 9

2.3.1 CSF production 9

2.3.2 Clinical connection 10

3 – Cerebral Cortex 11

3.1 Anatomical divisions 11

3.2 Cerebral cortex 12

3.2.1 Cerebral hemispheres 12

3.2.2 Cytoarchitecture 12

3.2.3 Clinical connection 13

3.2.4 Lobes 13

3.2.5 Gender differences 14

4 – Diencephalon & Limbic System 15

4.1 Thalamus 15

4.1.1 Nuclei 16

4.1.2 Clinical connection 16

4.2 Hypothalamus & pituitary glands 16

4.2.1 Hypophyseal portal system 17

4.3 Pineal gland 18

4.4 Limbic system 18

4.4.1 Amygdala 18

4.4.2 Cingulate cortex 19

4.4.3 Hippocampus 19

5 – Brainstem 20

5.1 Midbrain (Mesencephalon) 21

5.2 Pons 21

5.3 Medulla oblongata 21

5.4 Reticular formation 21

5.4.1 Clinical connection 22

6 – Cellular Neuroscience 23

6.1 Glial cells 23

6.1.1 Astrocytes 23

6.1.2 Ependymal cells 23

6.1.3 Microglia 24




Page 1 of 80

, 6.1.4 Oligodendrocytes & Schwann cells 24

6.2 Blood-brain barrier (BBB) 24

6.3 Neurons 25

6.3.1 Structure specialisations/adaptations 26

6.3.2 Neuron signalling 26

6.3.3 Neuron types 27

7 – Electrophysiology 28

7.1 Recording electrical activity 28

7.2 Resting membrane potential 28

7.2.1 Maintenance 29

7.3 Action potential (AP) / Impulse / Electrical Signal 29

7.3.1 AP propagation 30

7.3.2 AP properties 30

7.3.3 Clinical connection 31

8 – Neurotransmission 32

8.1 Neurotransmission 32

8.2 Neurotransmitters (NT) 32

8.2.1 NT receptors 33

8.3 Postsynaptic processes 33

8.3.1 Summation 34

8.4 Plasticity 35

8.5 Neuromuscular Junction (NMJ) 35

12 – Sensory inputs to spinal cord 36

12.1 Basic spinal neuroanatomy 36

12.1.1 Transverse structures 37

12.1.2 Review questions 38

12.2 Peripheral nerves 38

12.3 Sensory inputs 40

12.4 Proprioception & Kinaesthesia 40

12.4.1 Muscle spindles 40

12.4.2 Golgi tendon organs 42

12.4.3 Clinical connection 42

13 – Ascending somatosensory tracts 43

13.1 Dorsal Column Medial Lemniscus (DCML) 43

13.1.1 Lower body drawing example 45

13.1.2 Upper body drawing example 46

13.1.3 DCML Testing & Lesions 47

13.2 Lateral Spinothalamic Tract (LST) 47

13.2.1 Drawing example 49

13.2.2 LST Testing & Lesions 49

13.3 DCML vs. SLT 50

13.4 Primary somatosensory cortex (S1) 50

13.4.1 Posterior Parietal Cortex (PPC) 51

13.5 Spinocerebellar Tract (SCT) 51

14 – Pain Physiology 52

14.1 Pain 52

14.2 Pain receptors 52

14.2.1 Nociceptors 52

14.2.2 Sensory receptors 53

14.3 Pain theories 53

14.4 Clinical pain subtypes 55




Page 2 of 80

, 14.5 Pain modulation & facilitation 55

14.6 Visceral pain 56

15 – Motor control: spinal cord outputs 57

15.1 Voluntary movements 57

15.2 Hierarchical motor system organisation 57

15.2.1 Motor neurons 58

15.2.2 Motor unit 58

15.3 Reflexes & involuntary movement 59

15.3.1 Spinal reflexes 59

15.3.2 Reflex problems 60

15.3.3 Functional application of reflexes 61

15.4 Muscle tone 61

16 – Motor control: descending tracts 62

16.1 Motor cortical areas 62

16.1.1 Clinical connection 62

16.2 Descending motor tracts 63

16.2.1 Lateral Corticospinal Tract (LCST) 63

16.2.2 Motor neuron lesions 65

20 – Blood supply of CNS 66

20.1 Blood supply systems 66

20.2 Posterior circulation 68

20.2.1 Vertebrobasilar insufficiency (VBI) 68

20.2.2 PICA occlusion 68

20.2.3 AICA occlusion 68

20.2.4 Lesion to other posterior circulation arteries 69

20.3 Anterior circulation 69

20.3.1 Anterior cerebral artery (ACA) 70

20.3.2 Middle cerebral artery (MCA) 70

20.4 Circle of Willis 71

20.5 Spinal cord blood supply system 71

20.6 Venous outflow 72

20.7 Clinical connections & red flags 72

20.8 Stroke risk factors 73

21 – Functional anatomy of the brain & neurological impairment 74

21.1 Dysfunction of lobes 74

21.2 Disorders of memory 75

21.3 Language deficits 76

21.3.1 Dysphasia 76

21.3.2 Dysarthria 76

22 – Nerve injury 77

22.1 Nervous system injury 77

22.2 Nerve injury grading scales 77

22.3 Nerve repair 79

22.3.1 Axotomy 79

22.3.2 PNS regeneration 79

22.3.3 CNS regeneration 80




Page 3 of 80

,1 – Introduction to Neuroscience
The nervous system (NS) enables the following (with examples without that function):
● Perception of environment
o Prosopagnosia (face blindness)
o Post-stroke neglect (1 side blindness with stroke in 1 side of parietal lobe)
● Involuntary function
o Ondine's curse (sleep-associated hypoventilation)
● Voluntary function
o Parkinson’s (shaking & balance/coordination problems)
o Huntington’s (movement & cognitive problems)
● Alert & responsive interactions
o Alzheimer’s (memory & thinking problems)
o Schizophrenia (psychosis episodes – what is real?)
● Emotional response to world
o Autism (social interaction & communication problems + repetitive behaviour)
o Depression (mood problems)
o PTSD (trauma)
● Makes you who you are

1.1 Relation to chiropractic
Neuroscience is relevant to chiropractic:
● Safety & risk assessment ➔ multiple causes for pain symptoms possible
● Diagnosis & management ➔ Treat/co-manage/refer? Urgent or not? What treatment, what
area to work on?
● Prognosis ➔ How many treatments? Effective? Progression?

Known effects of chiropractic on NS:
● Direct nerve impact
● Pain gating ➔ reduction of pain perception through reducing brain’s attention to
nociception by stimulation soft tough & proprioception
● Golgi tendon activation ➔ muscle relaxation & reduced pain through stimulation of stretch
receptors

Possible effects of chiropractic on NS (from limited studies):
● Increased proprioception in muscles relating to adjusted spinal segment
● Increased strength in muscle relating to adjusted spinal segment
● Positively alter CNS pain perception
● Parasympathetic effects (reduced BP)

1.2 NS in a nutshell
Divisions:
● CNS = brain & spinal cord ➔ nuclei = neuron cell body clusters
● PNS = 12 cranial & 31 spinal nerve pairs ➔ ganglia = neuron cell body clusters
o Sensory afferent = receptor detects stimuli (external/internal/nociceptive)
o Motor efferent = brain contracts muscle (skeletal/cardiac/smooth) or glands
▪ Autonomic glands to viscera
⮚ Sympathetic = fight or flight
⮚ Parasympathetic = rest and digest
▪ Somatic skeletal muscle


Page 4 of 80

,Info in NS flows bi-directionally:
● Input (senses) to brain ➔ bottom-up system = afferent
● Output (cerebral cortex) from brain to effector ➔ top-down system = efferent

Behaviour is a response to stimuli ➔ 3 divisions control & coordinate: sensory, motor, integration
(cognitive):




Neurons are organised into local circuits to form modules that perform specific tasks. Local circuits
perform calculations from received info and send results to other circuits via projection neurons ➔
leads to excitation or inhibition. Multiple circuits form a cytoarchitecture (= structural network) in
distinct brain regions to achieve a purpose. Brain regions are distinguished by neuron density &
interconnection patterns and connect with each other to form a functional region.

Functional CNS system:
● Project in orderly sequence ➔ same determined route = topography
● Hierarchical organisation
● Are connected:
o Association fibres = interconnect areas of cortex within 1 hemisphere
▪ Arcuate fasciculus connects major language centres (thought & action)
o Commissural fibres = interconnects areas of cortex to same area in opposite cortex
▪ Corpus callosum connects parietal & frontal lobes together for
communication

Integrative function within CNS is neither sensory nor motor ➔ cognitive function (recognition,
learning, behaviour selection) = give meaning to sensory input.

1.3 Other communication systems
Endocrine & immune systems work together with NS to maintain homeostasis.
Nervous communication Hormonal communication
Transmission Along nerve fibres Bloodstream
Signal Electrical + chemical Chemical
Speed Fast (<130m/s) Slow (s/min)
Effect Localised Widespread
Duration Usually short (ms) Usually sustained (min/wks)

The NS also works together with the enteric NS within the gut.


Page 5 of 80

, 2 – Meninges & Cerebrospinal Fluid
⇨ Anatomical features of the meninges of brain & spinal cord
⇨ Meninges functions
⇨ Functions & flow of CSF
⇨ Draw & discuss ventricles

2.1 The brain
Everything above foramen magnum = brain.
Everything between foramen magnum & 1st/2nd Lx = spinal cord.

All body activities are designed to protect or facilitate the brain:
● Facilitate ➔ 2% of total body weight (largest organ) & 16-20% of blood supply
● Protect ➔ rigid bony case that forms around brain = skull
o 2 bone layers with air cells inside (less weight)
o Round shape for object deflection
● Brain death = clinical death = when the brain stem is no longer able to activate the
respiratory & cardiovascular centres

Frontal brain & head view:




Galea aponeurotica = a tough layer of dense fibrous tissue that covers upper part of cranium to
connect muscles.

2.2 Meninges
● Dura mater = tough layer for support
● Arachnoid mater = spider/network layer with subarachnoid space for CSF & blood flow
● Pia mater = delicate layer that covers CNS




Page 6 of 80

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