Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

158 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
which NT mediates opiod tolerance
NMDA antagonist, like PCP (can be used to prevent dev of opiod tolerance)
codeine derivative used as a cough suppressent (robutussin)
physical exam findings in tetanus
masseter muscle spasms (lockjaw), facial grimacing (risus sardonicus), other muscle spasms
internuclear ophthalmoplegia (INO)
common initial manifestation of MS -- degradation of MLF (medial longitudinal fasciculus), responsible for coordination of lateral gaze
dx of MS
scattered sclerotic plaques detectable on MRI
personality disorder of "low self esteem"
microscopic changes in prion disease
spongiform transformation of gray mater (Creutzfield-Jakob, Bovine Spongiform Encephalopathy)
cytoplasmic inclusions in oligodendrocytes
PML (progressive multifocal leukoencephalopathy)
microglial nodules + multinucleated giant cells
HIV encephalopathy
rosenthal fibers
pilocytic astrocytoma
cystic tumor in cerbellum of kid
pilocytic astrocytoma
morphology of pilocytic astrocytoma
well-differentiated neoplasm comprised of spindle cells w/ hair-like glial processes a/w microcysts
2 most common brain tumors in kids
1) pilocytic astrocytoma; 2) medulloblastoma
most common location of ependymomas
infratentorial, roof of 4th ventricle in kids; spinal in adults
histo appearnce of ependymomas
ependymal pseudorosettes w/ GFAP=positive processes tapeirng toward BV
2 most common brain tumors in adults
1) glioblastoma multiforme (GBM); 2) meningioma (often adjacent to falk cerebri)
first brain area damaged by global systemic ischemia (aka hypoxic-ischemic encephalopathy)
hippocampus, followed by neocortex and cerebellum
csf findings in MS
increased IgG (oligoclonal band on protein electrophoresis)
rapid involuntary eye movements and bring, involuntarily twitching muscles; a/w NEUROBLASTOMA
neurofibromas of neurofibromatosis
tumors of schwann cells -- skin/pink-colored nodules w/ pathognomonic "buttonholing" ("buttonhole" down thru skin with gentle pressure)
small yellow retinal lesions clustered in the macula
macular degeneration (progressive loss of central vision due to deposition of fatty tissue behind retina -- dry MD, and neovascularization of the retina -- wet MD)
CNS origin of 5-HT
raphe nuclei of brain stem -- involved in sleep-wake cycle, arousal level; lesions --> insomnia, depression
CNS origin of NE
nucleus ceruleus
CNS origin of ACh
nucleus basalis of Meynert (deficient in Alzheimer disease)
abnormally slow relaxation of muscles (characteristic of myotonic muscular dystrophy)
myotonic dystrophy genetics
AD, CTG repeats (anticipation), presents childhoood->late adulthood
myotonic dystrophy findings
Type I fibers more affected; skeletal myotonia (inability to release handshake, doorknob); CATARACTS in almost all pts. Frontal balding, gonadal atrophy
role of gamma loop in reflex control
CNS stims gamma motor neuron, contracts intraufusal fiber -- increases sensitivity of reflex arc if muscle length changes
achilles reflex -- what nerve root
patellar refelx -- what nerve root
what causes primative reflexes to return?
frontal lobe lesion
moro reflex
startle reflex
which cranial nerves lie medially at BS?
3, 6, 12 (3x2=6x2=12)
which CNs control salivation?
7: submaxillary and sublingual glands; 9: parotid gland
which CNs are in the midbrain
3 and 4
which CNs are in the pons
5, 6, 7, 8
which CNs are in the medulla
9, 10, 12
what makes endolymph
stria vascularis
motor and sensory nuclei of CN 9 and 10
Sensory = Solitary nucleus (taste, baroreceptor, visceral sens from 7,9,10); Motor = nucleus aMbiguus (motor innervation to pharynx, larynx, and upper esophagus for 9,10,11)
autonomic motor nucleus of vagus
DORSAL MOTOR NUCLEUS: autonomic fibers to heart, lungs, upper GI
holes in middle cranial fossa (sphenoid bone) (5), and which CNs
Optic canal, Superior orbital fissure, Foramen Rotundum, Foramen Ovale, Foramen spinosum; CNs 2-6
holes in posterior cranial fossa (temporal or occipital bone) (4), and which CNs
Internal auditory meatus, Jugular foramen, Hypoglossal canal, Foramen magnum; CNs 7-12
hypothalamic nuclei that modulate hunger and satiety
hunger: LATERAL; satiety: VENTROMEDIAL (when you lesion your ventromedial nucleus, your ventromedial area [gut] grows)
what goes through optic canal
CN 2, ophthalmic artery, central retinal vein
what goes through superior orbital fissure
CN 3, 4, 5.1, 6; ophthalmic vein
what goes through foramen rotundum
CN 5.2
what goes through ovale
CN 5.3
what goes through spinosum
Middle meningeal artery
what goes through internal auditory meatus
CNs 7, 8
what goes through jugular foramen
CNs 9, 10, 11; jugular vein
what goes through hypoglossal canal
CN 12
what goes through foramen magnum
spinal roots of CN 11; vertebral arteries; brain stem
tx for trigeminal neuralgia
what nerves/vessels do you find in cavernous sinus?
internal carotid; CNs 3, 4, 5.1, 5.2, 6; OTHERS: pit gland
which nerve is "free-floating" in the cavernous sinus?
CN VI (others are attached to lateral walls)
mastication muscles
Masseter, Medial pterygoid, teMporalis all close jaw (Munch); Lateral pterygoid Lowers jaw (opens)
which "glossus" has a different innervation?
palatoglossus (10 vagus), others are all 12
which "palat" has a different innervation?
tensor veli palatini (5, along w/ tensor tympani), rest are 10
actions of superior oblique muscle and its innervation
down and out (CN 4)
how does trochlear nerve lesion present
CN IV -- superior oblique muscle -- vertical diplopia when looking at nose (eg trying to walk down stairs)
how to test oral muscles with sounds?
Lick My Cock (Li = 12, hypoglossal; My = 7, face; Co = 10, vag)
what NT initiates sleep, and from where?
5-HT from raphe nucleus
transient attack of extreme gernalized weakness, often precipitated by emotion state; often seen in narcolepsy
hypnagogic vs hypnopompic hallucinations
hypnagogic: when FALLING ASLEEP; hypnopompic: when WAKING ("gogic = gone, pompic = poppin")
with which sleep stage is teeth grinding (bruxism) associated?
stage 2 (sleep spindles, k complexes); pt usually unaware
physiologic changes in REM
inc pulse and BP, penile/clitoral erection -- state of AROUSAL, decreases with age
csf findings in meningitis from bacteria vs fungus
BOTH have inc cells, dec glucose, inc proteins, inc pressure; BACTERIA have PMNs, FUNGUS have LYMPHOCYTES
causes of viral encephalitis
Arthropod (St. Louis, California, Toga [WEE, EEE, VEE]); HSV; RABIES; HIV
sx of acruate fasciculus lesion
"conduction aphasia:" poor repetition with good comprehension and fluent speech
cerebellar lesions: hemisphere vs. vermis
hemispheres located LATERALLY, cause ataxia of LATERAL limbs; vermis located CENTRALly, causes ataxia of CENTRAL body (trunk)
basal ganglia lesions presentation (2)
1) CHOREA: sudden jerky purposeless movements, dance-like; 2) ATHETOSIS: slow, writhing movements, esp of fingers
NT changes in Alzheimer's and Tx
dec ACh (from nucleus basalis of Meynert); Tx with AChEi
pick's disease
like alzheimer's dz -- dementia; intracellular aggregated tau protein (Pick bodies); FRONTAL and temporal lobe atrophy, aphasia, parkinsonian aspects
NT changes in Huntington's
loss of ACh and GABA (from caudate nucleus atrophy)
opiod contaminant in street drugs -- causes destruction of dopaminegic cells in s.nigra --> parkinsons
sx of parkinson's dz
"TRAPped in your own body:" Tremor (resting), Rigidity (cogwheel), Akinesia, Postural instability
alpha-synuclein in damaged cells
Lewy bodies, found in Parkinson's disease
friedreich's ataxia
AR dz w/ trinucleotide expansion on 9q; causes ataxia, dysarthria, scoliosis, muscle paralysis (lower extremities); a/w hypertrophic cardiomyopathy
ALS (amyotrohpic lateral sclerosis)
aka Lou Gherig's Dz; loss of both UMN (lateral corticospinals) and LMN, no sensory deficit
werdnig-hoffman disease
degeneration of ANTERIOR HORNS; AR, "floppy baby" -- tongue fasciulations, death < 1y;
which neurons affected by polio?
LMN (anterior horn)
polio: transmission and replication
transmitted fecal-oral ==> replicates in oropharnyx / small intestines --> blood --> CNS spread
csf changes in MS
oligoclonal spikes (IgG)
albumino-cytologic dissociation
seen in GUILLAIN-BARRE: greatly increased protein conc with only moderatly increased cell count
viral infection of oligodendrocytes --> demyelination
progressive multifocal leukoencephalopathy (PML), caused by JC virus (a polyoma virus of the Papova family)
neuro: lucid interval
epidural hematoma: skull fracture --> temporary imporvement --> brain damage after minutes/hrs
causes of subdural hematoma
rupture of bridging veins; predisposing factors: brain atrophy (pulls brain from dura --> stretched veins), shaking, whiplash
cause / presentation of subarachnoid hemorrhage
rupture of aneurysm (usu berry) or AVM; "worst headache of life," blood in spinal tap
charcot-bouchard aneurysms
dilations at small artery bifurcations, formed by chronic HTN; prone to rupture --> PARENCHYMAL/INTRACRANIAL HEMORRHAGE (often in basal ganglia/thalamus)
MCC severe viral encephalitis
most common site of berry aneurysm
anterior communicating artery of circle of willis
dzs a/w berry aneurysm
adult polycystic kidney disease, ehlers-danlos, marfan's
hemorrhagic lesions of temporal lobes -- what infectious cause?
herpes simplex virus
toxo vs cryptococcus
both cause CNS infection in AIDS pts; cryptococcus causes meningioencephalitis, toxoplasma causes parenchymal abscesses
cerebellar tumors in kids
MEDULLOBLASTOMA (v. malignant, rosettes/pseudorosettes, can cause hydrocephalus, primitive neuroectoderm tumors [PNET]); HEMANGIOBLASTOMA (foamy cells w/ high vascularity, a/w VHL, produces EPO); PILOCYTIC ASTROCYTOMA (rosenthal fibers, low-grade tumors, better prog than medulloblastoma)
tumors that cause hydrocephalus
MEDULLOBLASTOMA and EPENDYMOMA (both also have perivascular pseudorosettes and carry a poor prognosis);
spinal cord lesion in complete occlusion of ventral artery
spares dorsal columns and tract of lissauer
spinal cord deficit in Vit B12 deficiency
demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts
spinal cord deficit in Friedreich's ataxia
same as vit b12: dorsal columns, lateral corticospinals, spinocerebellars
most common site and functional deficit in syringomyelia
most common at C8-T1, causes b/l loss of pain/temp in upper extremities (preservation of touch)
with what dz is syringomyelia associated?
Arnold-Chiari malformation
brown-sequard syndrome
hemisection of spinal cord --> IPSILATERAL {UMN, dorsal column, sensation loss} below lesion; CONTRALATERAL pain/temp loss below lesion; LMN signs AT LEVEL of lesion
causes of horner syndrome
lesion of spinal cord above T1 (Pancoast's tumor, hemisection [brown-sequard], late-stage syringomyelia)
what nerve needed for forearm pronation
action and roots of obturator nerve
adduction of hip; L2-L4 (same as femoral n)
presentation of CN XII lesion (LMN)
tongue deviates TOWARD side of lesion
presentation of CN V motor lesion
jaw deviates TOWARD side of lesion
presentation of unilateral cerebellar lesion
fall TOWARD side of lesion
presentation of CN X lesion
uvula deviates AWAY from side of lesion
presentation of CN XI lesion
weakness turning head AWAY from lesion, should droop ON SIDE of lesion
causes of bell's palsy
ALexander bell with an STD (AIDS, Lyme disease, Sarcoid, Tumor, Diabetes)
arnold-chiari malformation associations
syringomyelia + thoracolumbar meningomyecele
complications of cingulate herniation
herniation under falx cerebri, can compress anterior cerebral artery
where is the uncus?
medial temporal lobe
complications of uncal herniation
1) CN III (ipsilateral mydriasis from parasympathetic interruption, eventual "down and out"); 2) PCA (contralateral visual field loss); 3) vessel stretch --> DURET hemorrhages (advanced stages); 4) contralateral CRUS CEREBRI (descending corticospinal fibers --> ipsilateral paresis)
how does INO present
NYSTAGMUS during lateral gaze of abducting eye; lesion to MLF (often first sign of MS); medial rectus palsy on attempted lateral gaze (lateral looking eye initiates movement, syncs medially looking eye via MLF; with INO, medially looking eye never gets the signal)
NT changes in anxiety
inc NE, dec GABA, dec 5-HT
NT changes in depression
dec NE, dec 5-HT
NT changes in Huntington's
dec GABA and ACh
NT changes in schizophrenia
inc DA (antipsychotics are DA antagonists)
order of loss of orientation
1) time 2) place 3) person
unaware that one is ill (nosos = disease)
unable to locate one's own body parts (topos = place)
body seems unreal or dissociated
substance abuse
maladaptive behavior as a result of use -- obligations, personal safety, legal problems
substance dependence
withdrawl/tolerance (physical dependence), increasing amounts, failed attempts to cut down, signifcant time/energy spent (at expense of activities) using/acquiring substance, continued use despite knowledge
sensitive indicator of alcohol use
flu-like sx with what withdrawal?
pcp intox
VIOLENCE, horizontal nystagmus, homicidality, delrium, HYPERACUSIS
pcp withdrawal
actually RECURRENCE of tox sx due to reabsorption in GI tract --> sudden onset homocidal violence
LSD intox
delusions, visual hallucinations, flashbacks
alcohol withdrawal
1) "the shakes"; 2) seizures; 3) hallucinations; 4) delirium; 5) DEATH
delrium tremens, onset and tx
2-5 days after last drink; tx w/ benzos; life-threatening
wernicke's encephalopathy
triad: confusion, ophthalmoplegia, and ataxia
mallory-weiss vs esophageal varices
both produce blood loss, but mallory-weiss is PAINful
naloxone vs nalterxone
both competitively inhibit opiods; naloxone works faster (fewer letters in name)
delirium vs dementia
DELERIUM: acute, attention deficit, agitation, ALTERETED CONSCIOUSNESS (waxing/waning), reversible; DEMENTIA: aphasia, agnosia, apraxia, amnesia, NO CHANGE in consciousness, gradual onset, irreversible
depression in elderly patients that presents like dementia
sleep patterns in depressed patients
1) dec stage 4 sleep; 2) dec REM latency (enter REM earlier); 3) early morning awakenings (impt screening q)
somatoform vs factitious vs malingering
SOMATOFORM: neither sx nor motivation is conscious; FACTITIOUS: conscious production of sx without conscious knowledge of motivation; MALINGERING: both sx and motivation are conscious
somatization vs conversion disorders
SOMATIZATION: MULTIPLE organ systems; CONVERSION: MOTOR/SENSORY sx, "la belle indifference:" pt not concerened not concerned about sx;
false belief of being pregnant
rett disorder
x-linked disorder only seen in FEMALES; MR at age 4, sterotyped hand-wringing (sometimes confused with autism)
tx for ADHD
amphetamine-like substances!! METHYLPHENIDATE (ritalin) or MODAFINIL
tx for Tourette's
bulemia vs anorexia
ANOREXIA is egosyntonic, <85% IBW, 15-19yo, AMENORRHEA/low t'one; BULEMIA is ego-dystonic, >= 100% IBW, 19-24yo
hallucinations vs illusions
hallucinations are perceptions in ABSENCE of external stimuli; illusions are MISINTERPRETATIONS of actual external stimuli
visual/auditory vs olfactory hallucinations
visual/auditory in schizophrenia; olfactory in aura of psychomotor epilepsy
symptoms of narcolepsy, tx
hypnagogic/hypnopompic hallucinations; direct to REM sleep; CATAPLEXY: loss of all muscle tone following strong emotional stim; TX w/ AMPHETAMINES
5 types of schizophrenia
1) disorganized; 2) catatonic; 3) paranoid; 4) undifferentiated; 5) residual
time criteria for schizophrenia
psychosis and disturbed behavior > 6 mos (1-6mos = schizophreniform, < 1mo = brief psychotic disorder)
what do craniopharyngiomas look like macroscopically and microscopically?
MACRO: cystic; MICRO: cysts lined with stratified squamous epithelium, filled with yellow viscous fluid rich in cholesterol crystals
rare dz assumption
odds ratio approximates relative risk for rare diseases
best way to prevent neonatal tetanus
immunize mother --> protective IgGs will cross placenta
source of beta-endorphin
derived from POMC (same polypeptide precursor for ACTH and MSH)
first signs of normal pressure hydropcephalus (NPH)
gait abnormality and urinary incontinence ==> eventually leads to progressive dementia and emotional blunting; order of sx helps distinguish NPH from alzheimers
normal pressure hydrocephalus (NPH) vs parkinsonism
BOTH have gait disturbance and emotional bluting, but NPH doesn't have tremor