Medicine Notes Neurology Notes
These notes helped me achieve a mark of 76% in my neurology exam, which is the equivalent of a 1st. The notes are based on a series of 49 lectures on the subject. This is a very good, thorough and in depth review of the nervous system. They are very clearly laid out and easy to follow. They cut out unnecessary information on the topic, making the notes very concise, and fast to get through. Anyone studying medicine, or any other subject requiring knowledge of the nervous system (e.g. physiology o...
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Lecture 35, 38 & 40
Sound and Structure of the Auditory System
Properties and perception of sound
Amplitude or ‘loudness’ (dB)
Frequency or ‘pitch’ (Hz)
Conductive pathway for sound
Conductive- outer ear
External auditory canal
Tympanic membrane (eardrum)
Middle ear
Malleus; Incus; Stapes (in the oval window)
Round window (covered by secondary tympanic membrane)
Sensory-Inner ear
Semicircular canal (vestibular branch of VIII)
Cochlea (cochlea branch of VIII)
Auditory tube
The ear- structure and function
Middle ear function- impedance matching
More energy required to move fluid than air
Ossicles have lever action
Eardrum to round window surface area= 20:1 in humans
Results in 20x pressure, enough to move fluid
Without impedance matching only 0.1% energy transfer
Middle ear- ossicular reflex
Protective reflex against loud sounds (>70dB)
Stiffens lever reducing energy conduction (done by tensor tympani muscle & stapes muscle)
No role above 1 or 2kHz in man
Helps discrimination where lots of low freq. Noise
Ineffective for impulse noise (50-100ms delay)
Inner ear
1, 7 & 8= Vestibular system (semi-circular canals)
10= Oval window moved by ossicles
11= Round window
13= Cochlea
5= Basilar membrane inside cochlea
Cochlea
Spiral structure
Fluid filled, compartmentalised
Cochlear fluids
Perilymph
Resembles CSF
Bathes cell bodies of organ of Corti
K 7mM; Na 140mM; 0mV potential
Endolymph
Resembles ICF
Sealed in tight compartment
Bathes surface of organ of Conti
Maintained by stria vascularis
K 145mM; Na 1mM; +80mV potential
In mammals, organ of Corti=organ of hearing
Located on flexible basilar membrane
Inner & outer hair cells- sensory
Spiral ganglion nerve cells
Associated with supporting and non-sensory cells
Hair cells held rigidly
The specialist hair cells
Hair cells- sound to nerve impulse
Inner (IHCs- 3,500)) and Outer (OHCs- 12,000) hair cells
Afferent & efferent connections
Sensitive to damage and disease (not replaced in mammals)
Mechano-electrical transduction
The sensory hair cells
Stereocilia (hair bundle)
Mechanosensing organelles ofhair cells
Respond to fluid motion for various functions (hearing and balance)
Turn the fluid pressure and other mechanical stimuli into electric stimuli via the many microvilli that make up stereocilia rods
Lined up in theOrgan of Cortiwithin thecochleaof the inner ear
Transform the mechanical energy of sound waves into electrical signals for hair cells, leads to an excitation of theauditory nerve
Cytoplasm with embedded bundles of cross-linkedactinfilaments
Actin anchor to terminal web & top of cell membrane
Myosin, fimbrins and actin
The basilar membrane
Maximum displacement of the basilar membrane occurs at different positions depending on frequency of sound
Movement of stapes displaces fluid in scala vestibuli
Travelling wave
Displaces basilar membrane
Stimulus transduction
Bundle stimulation opens ion channels
Mechanism
Sound wave moves hair cells
Tip links-gated springs are attached to channels of adjacent hair cells, and pulls them open
Mechanically-gated transducer channels open
K ions rush in from the Endolymph, then Ca rushes in too, making the hair cell more positive
Movements are tiny
Saturation at 20nm
Perceptible sound at 0.3nm
Hair cell transduction
Hair cells move, channels open
K & Ca rush into hair cell from Endolymph (+80mV)=Depolarisation (-55mV)
This depolarisation causes Ca to rush in leading to NT release into nerves
Hyperpolarisation then takes place in the cell
Hair cells- ion channels and membrane proteins
Inner hair cells
Potential= -65 to -70mV
Most afferent innervation
Channels
Out= IK,s; IK,f (Ca)
In= L-type CA; IT
Outer hair cells
Potential=-75mV
Mostly efferent innervation
No/less Ca channels=less transmitter release
Prestin; AChR
Channels
In= IT
Out= IK(Ca); IKn
Hair cell innervation and function
OHC
Type II afferent (5%)
1:50 neurone to OHCs
Thin, unmyelinated
IHC
Type I afferent (90%)
1:1 neurone to IHCs
Each IHC many neurones
Thick, myelinated
Differences in hair cell innervation
IHC
Mainly afferent nerve connections via SGN
Efferent connections are postsynaptic
IHC= sound encoders
OHC
Mainly efferent connections from brain stem
Neural encoding in the auditory system
Encoding frequency
Stimulus, IT, receptor potential and firing
Rest= some IT
+ve stimulus= increased IT
-ve stimulus= decreased IT
Encoding frequency
Low frequencies
Sound wave come along
Causes bundle movement, back and forth (decreased/increased IT)
Receptor potential voltage (mV) goes up and down as this happens
Auditory nerve impulses with change in potential= ‘PHASE-LOCKED’
Low frequency sounds can be encoded by phase-locking up to ~1kHz
Receptor potential and nerve can follow stimulus
High frequencies
Receptor potential voltage cannot keep oscillating as frequency too high, so stays up
Auditory nerve impulses non ‘phase-locked’ (can’t keep up)
Tonotopy
General
From basilar membrane
Spatial arrangement of sound frequency
Sound waves propagate along basilar membrane
Membrane has regional variations in fibrous structure
Maximal displacement on frequency of stimulus
Base= Thin, narrow & stiff (high frequency); Apex= Wide & floppy (low)
From basilar membrane to brain
Tonotopic map maintained at all relay positions on way to auditory cortex
Stimulation of hair cells dependent on membrane displacement
Tonotopic map gives spectral analysis of sounds
Isolated bands of cortex responding to different frequencies
Spatial maps=common feature of sensory systems
Cochlear amplifier
OHCs are active
Depolarisation activates PRESTIN (motor protein) fast
Rigidly held cells contract, amplifying basilar membrane movement
When they shorten=basilar membrane narrower and stiffer= amplified movement
Gain modulated by efferent system...
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These notes helped me achieve a mark of 76% in my neurology exam, which is the equivalent of a 1st. The notes are based on a series of 49 lectures on the subject. This is a very good, thorough and in depth review of the nervous system. They are very clearly laid out and easy to follow. They cut out unnecessary information on the topic, making the notes very concise, and fast to get through. Anyone studying medicine, or any other subject requiring knowledge of the nervous system (e.g. physiology o...
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