2012 Nsp Week 2

Front 1

CT scan optimal for following?

Back 1

acute blood, mass effect, bone facture

Front 2

Does a CT or MRI have good bone imaging?

Back 2

CT

Front 3

Does a CT or MRI have good soft-tissue imaging?

Back 3

MRI

Front 4

Which one can detect blood flow (CT or MRI)

Back 4

MRI

Front 5

Which one uses Xrays to make cross-sectional axial images?

Back 5

CT (right is left and left is right like the feet are coming out toward you)

Front 6

On a CT the object colors are based on what?

Back 6

density

white - hyperdense
gray - isodense
black - hypodense

Front 7

Which one is optimal test for acute blood?

Back 7

CT but MRI is getting better

Front 8

Which one has iodine-based contrast that is nephrotoxic?

Back 8

CT

Front 9

Which one is better to visualize the inferior temporal lobes and posterior fossa (brainstem, cerebellum)?

Back 9

an MRI because a CT has bone artifact interference

Front 10

Out of hypodense, isodense, and hyperdense on CT:

ocular lense

Back 10

hyperdense

Front 11

Out of hypodense, isodense, and hyperdense CT:

calcifications

Back 11

hyperdense

Front 12

Out of hypodense, isodense, and hyperdense on CT:

bone

Back 12

hyperdense

Front 13

Out of hypodense, isodense, and hyperdense on CT:

acute blood

Back 13

hyperdense

Front 14

Out of hypodense, isodense, and hyperdense on CT:

metal/bullets

Back 14

hyperdense

Front 15

Out of hypodense, isodense, and hyperdense on CT:

contrast

Back 15

hyperdense

Front 16

Out of hypodense, isodense, and hyperdense on CT:

fat

Back 16

hypodense

Front 17

Out of hypodense, isodense, and hyperdense on CT:

air

Back 17

hypodense

Front 18

Out of hypodense, isodense, and hyperdense on CT:

CSF/Water

Back 18

hypodense

Front 19

Out of hypodense, isodense, and hyperdense on CT:

gray matter & white matter

Back 19

isodense

Front 20

Which is darker on a CT, gray matter or white matter

Back 20

white matter

gray matter is more dense, so it is whiter

Front 21

What does a CT show after an ischemic stroke?

Back 21

In first few hours to day CT usually normal (though it may show blurring of gray-white jxn and sulcal effacement)

By day 2, CT shows dark area w/ mas effect (compression of surrounding structures)

Front 22

What kind of infarction (acute, subacute or chronic) is dark/hypodense on CT

Back 22

subacute

Front 23

What are watershed territories and why are they significant?

Back 23

watershed territories are the margins of the sprinklers/ blood supply

infarctions in these ares are usually from hypotension

Front 24

What is a ring enhancing lesion?

Back 24

A lesion in the brain that after adding contract a ring forms around it, usually an abscess or tumor due to leakage of dye around the lesion from a blood brain barrier disruption

Front 25

What causes vasogenic edema and what are features of it?

Back 25

causes: due to mass lesions-abscesses, tumor

represents blood-brain barrier disruption

involves only white matter

Front 26

On a CT you see layers concave to the brain like a crescent that is gray w/ sulcal effacement and a buckled cerebral cortex that does not extend to the skull. What is wrong?

Back 26

a subacute subdural hematoma

note: chronic blood (wks to mos) is black

Front 27

What does an MRI use to create cross-sectional images?

Back 27

magnet and pulses of radio waves

Front 28

what are the colors in an MRI based on?

Back 28

intensity of signal

hyperintense - white
hypointense - black

Front 29

Which one uses IV gaolinium for contrast?

Back 29

MRI

Front 30

In a T1 MRI what color is CSF?

Back 30

black

Front 31

In a T1 MRI what color are lesions (edema, water, acute infarction, gliosis)?

Back 31

Dark

poorly seen w/o IV contrast, best used for pre & post gadolinium comparisons

Front 32

On a T1 MRI what color is calcium and bone?

Back 32

black

Front 33

On a T1 MRI, what is black?

What is white?

Back 33

CSF, Lesions, Ca+ and bone

white- fat

Front 34

In a T2 MRI what color is the CSF?

Back 34

white

Front 35

In a T2 MRI what color are the lesions?

Back 35

white

lesions are well seen!!!

Front 36

ON a T2 MRI what is black?

What is white?

Back 36

white: CSF, lesions (hard to distinguish)

black: Ca and bone

Front 37

Can you distinguish new and old lesions on a T2 MRI?

Back 37

No

Front 38

On a Flair MRI what color is the CSF?

Back 38

black

standing water is black, including old lacunes

Front 39

On a Flair MRI what colors are the lesions?

Back 39

white (edema, acute infarction, gliosis)

VERY WELL SEEN

Front 40

What are the drawbacks of Flair MRIs?

Back 40

Does not visualize very new infarctions

cannot distinguish new and old lesions

Front 41

On a DWI MR what color is CSF?

Back 41

black

Front 42

On a DWI what is white?

Back 42

New infarctions (30 min to few wks)

old lesions are NOT seen

Front 43

What do you compare a DWI MR with to distinguish new and old lesions?

Back 43

compare to a T2 or Flair

Front 44

What do you compare a DWI MR with to ensure infarction is real?

Back 44

compare to ADC

DWI may show lesions due to other conditions such as seizure or T2 shine through phenom

Front 45

What's characteristic of the DWI image?

Back 45

it's fuzzy

Front 46

What color is CSF on a ADC map MRI

Back 46

white

Front 47

What color are new infarctions on ADC map MRI?

Back 47

black

hemorrhages may also be black, so must compare to other MR images

Front 48

Are ADC map MRIs picture clear or fuzzy?

Back 48

fuzzy

Front 49

What MRI is the most senstive technique for detecting intraparenchymal blood and what color is it?

Back 49

black
T2*GRE

Front 50

A Spin Echo involves T1, T2 and FLAIR. What color are normal vessels on an SE?

Back 50

black

no or low flow gray and white

Front 51

A Gradient Recall Echo uses GRE images. What color is normal flow on this image?

Back 51

normal flow is white

no or low flow black

Front 52

Does MR Angiography use contrast?

Back 52

no, its MRI w/ software changes/GR technology

Front 53

Can a MRA differentiate between low flow vs. occlusion?

Back 53

no

Front 54

Can a MRA differentiate between veins vs arteries?

What about anterior circuation vs posterior circulation?

Back 54

yes and yes

Front 55

What color is normal flow on a MRA?

Back 55

normal = white

no or low flow is black

Front 56

What type of MRI is acute heme gray?

Back 56

only T1, the rest it is black (T2, Flair, DWI)

Front 57

What type of MRI is subacute heme white?

Back 57

all (T1, T2, Falir, DWI)

chronic blood is all black on these too

Front 58

What color is vasogenic edema on a DWI?

What color is cytogenic edema?

Back 58

vasogenic- gray

cytogenic - white

Front 59

What kind of technology does MRV use?

Back 59

GRE technology

saturation of arterial flow eliminates arteries

Front 60

In MRV what relationship should there be with blood flow?

Back 60

perpendicular - coronal acquisition

Front 61

What kind of technology does MRV use?

Back 61

GRE technology

saturation of arterial flow eliminates arteries

Front 62

In MRV what relationship should there be with blood flow?

Back 62

perpendicular - coronal acquisition

Front 63

What is FLAIR MRI?

Back 63

T2 with standing water turned black

Front 64

How can one tell if a lesion is new using MRI?

Back 64

Can be seen on both DWI and ADC

Front 65

Infarcton - hemiparesis, hemisensory ?

Back 65

AChA (anterior chorodial artery)

Front 66

Infarction - Crossed pin sensory loss, ipsi face-contra body ?

Back 66

PICA (posterior inferior cerebellar art.), lateral medullary syndrome, Wallenburg syndrome

Front 67

MS lesions on MRI?

Back 67

hyperintense, perpendicular to ventricles (Dawson's fingers), seen on FLAIR and T2

Front 68

Migraine with aura on MRI?

Back 68

UBO's, not distributed like MS lesions

Front 69

Gliablastome Multiforme on MRI?

Back 69

Lesions hyperintense, finger like BBB disruption, central necrosis

Front 70

Which superficial sensations are transmitted via the spinothalamic tract?

Back 70

1. Warmth/ cold
2. Pain
3. Itch

Front 71

Which superficial sensations are transmitted via the Dorsal Column-Medial Lemniscus Pathway?

Back 71

1. Touch, pressure
2. Flutter, vibration
3. Tickle

Front 72

Which deep sensations are transmitted via the Dorsal column-medial lemniscus pathway?

Back 72

Position, kinesthesia

Front 73

Which deep sensations are transmitted via the Spinothalamic tract?

Back 73

1. Deep pressure
2. Deep pain

Front 74

What visceral sensation is sensed by the Dorsal column-medial lemniscus pathway?

Back 74

Distention

Front 75

What visceral sensation is sensed by the Spinothalamic tract?

Back 75

Visceral pain

Front 76

What kind of stimuli is sensed by bare nerve endings?

Back 76

1. Temperature
2. Pain
3. Itch

Front 77

Which 2 nerve fibers have bare nerve endings?

Back 77

1. A-delta fibers
2. C fibers

Front 78

What do A-alpha fibers sense?

Back 78

Proprioception

Front 79

What do A-beta fibers sense?

Back 79

1. Proprioception
2. Superficial touch
3. Deep touch
4. Vibration

Front 80

What is the biggest difference between A and C fibers?

Back 80

A fibers are myelinated, C fibers are NOT

Front 81

Which fibers have the largest diameter?

Which have the smallest diameter?

Back 81

Largest --> A-alpha fibers

Smallest --> C-fibers

Front 82

What kind of sensory modalities do muscle spindles detect?

Back 82

Proprioception

(A-alpha, A-beta fibers)

Front 83

What kind of sensory modalities do Meissner's corpuscles detect?

Back 83

Superficial touch
(A-beta fibers)

Front 84

What kind of sensory modalities do Merkel's receptors detect?

Back 84

Superficial touch
(A-beta fibers)

Front 85

What kind of sensory modalities do Pacinian corpuscles detect?

Back 85

1. Deep touch
2. Vibration

(A-beta fibers)

Front 86

Ruffini endings detect what kind of sensation?

Back 86

1. Deep touch
2. Vibration

(A-beta fibers)

Front 87

A-alpha fibers have which 2 receptors?

Back 87

1. Muscle spindles
2. Golgi tendon organs

Front 88

A-beta fibers have which 6 receptors?

Back 88

1. Muscle spindles
2. Meissner's corpuscle
3. Merkle's receptor
4. Pacinian corpuscle
5. Rufini ending
6. Hair receptor

Front 89

Describe the various types of receptor proteins involved in transduction of mechanical or chemical stimuli

Back 89

1. Ion channels that are selective for Na+ or K+
2. Receptors coupled to ion channels

Front 90

Describe the difference in adaptation between phasic and tonic receptors

Back 90

Phasic receptors adapt rapidly to a constant stimulus
Tonic receptors show little to no adaptation to a constant stimulus

Front 91

The size of a sensory neuron receptive field is a function of...?

Back 91

Innervation density

Front 92

What does the spatial discrimination threshold depend on?

Back 92

Innervation density of the sensory receptors

Front 93

Are Merkel's discs and Ruffini endings rapidly adapting or slowly adapting mechanoreceptors?

Back 93

Slowly adapting

Front 94

Are Meissner's corpuscles rapidly adapting or slowly adapting mechanoreceptors?

Back 94

Rapidly adapting

Front 95

Which receptors signal location, intensity, and duration of the stimulus?

Are these rapidly or slowly adapting?

Give 2 examples

Back 95

Touch receptors (intensity receptors)

*Slowly adapting

*Ex: Merkel and Ruffini receptors

Front 96

Which type of receptors respond to velocity of displacement, and signal flutter, low frequency vibration, and movement of the stimulus?

Are these slowly or rapidly adapting?

Give 2 examples

Back 96

Touch receptors (velocity detectors)
(MOVEMENT)

Rapidly adapting

Meissner's corpuscles, hair follicles

Front 97

Give an example of a receptor that signals high frequency vibration

Back 97

Pacinian corpuscle

Front 98

Which type of receptors respond to a change in velocity (acceleration) of the stimulus?

Are these slowly or rapidly adapting?

Give an example?

Back 98

Vibration receptors (acceleration detectors)

*Rapidly adapting

*Pacinian corpuscle

Front 99

What is a dermatome?

Back 99

An area of skin innervated by a single dorsal root

Front 100

Which dermatomes are located over the "cape area" of the shoulder?

Back 100

C3-C4

Front 101

Which dermatome is located in the nipple area?

Back 101

T4

Front 102

Which dermatome is located at the umbilical area?

Back 102

T10

Front 103

Which dermatome covers the big toe?

Back 103

L5

Front 104

Which dermatome covers the small toe?

Back 104

S1

Front 105

Which dermatomes cover the perianal region?

Back 105

S4, S5

Front 106

Describe the posterior column sensory pathway

Back 106

Sensations: vibration, proprioception, fine touch

1. Signal enters dorsal root
2. Ascends spinal cord through Posterior column (either Gracile or Cuneate tract)
3. Synapses at level of medulla (in Gracile or Cuneate nuclei)
4. Crosses over in medulla
5. Ascends to thalamus via medial lemniscus
6. Synapses in ventral posterior lateral nucleus of thalamus
7. Ascends to primary somatosensory cortex

Front 107

In the Dorsal Column Medial Lemniscus pathway, where does the 1st order neuron enter and where does it synapse?

Back 107

Enters spinal cord via dorsal root
Synapses in dorsal column nucleus (gracile or cuneate nucleus) at level of medulla

Front 108

In the Dorsal Column Medial Lemniscus pathway, where does the 2nd order neuron begin and end?

Back 108

Begins in dorsal column nucleus at level of medulla
Ends in the thalamus (ventral posterior lateral nucleus)

Front 109

In the Dorsal Column Medial Lemniscus pathway, where does the 3rd order neuron begin and end?

Back 109

Begins in ventral posterior lateral nucleus of thalamus
Ends in primary somatosensory cortex (postcentral gyrus)

Front 110

What kind of sensory information does the Dorsal Column-Medial Lemniscus pathway provide?

Back 110

1. Location
2. Quality
3. Intensity
4. Pattern
5. Position of the body

Front 111

The thalamic ventrobasal nucleus includes which two nuclei?

Back 111

1. Ventral posterior lateral nucleus (VPL)
2. Ventral posterior medial nucleus (VPM)

Front 112

What is the difference in synaptic security of Somatosensory Area 1 (S1) and Somatosensory Area 2?

Back 112

S1 --> high synaptic security
S2 --> low synaptic security

Front 113

Where does the Somatosensory Area 1 receive its primary input from?

Back 113

Ventrobasal nuclei (VPL & VPM)

Front 114

Does joint rotation activate Somatosensory Area 2?

Back 114

NO.

Front 115

Where is Somatosensory area 2 located?

Back 115

Superior bank of Sylvian fissure of the parietal cortex

Front 116

Are flutter vibrations low or high frequency vibrations?

Back 116

Low frequency

Front 117

List 2 receptors for flutter vibrations

Back 117

1. Hair follicles
2. Meissner's corpuscles

Front 118

Vibrations made by a tuning fork will stimulate which skin receptors?

Back 118

Pacinian corpuscles
(high frequency vibrations)

Front 119

What kind of deficits will result from dorsal column lesions?

What are the particular effects?

Back 119

Deficits in:
1. Tactile discrimination
2. Vibratory sense
3. Position sense

Effects:
1. Graphesthesia
2. Stereognosis

Front 120

What are the 4 subdivisions of the postcentral gyrus?

Back 120

Broadmann's areas 3a, 3 b, 1 and 2

3a --> proprioceptors (primarily muscle spindles)
3b --> cutaneous stimuli
1 --> rapidly adapting cutaneous receptors (Meissner's)
2 --> golgi tendon organs and joint afferents

Front 121

What is the only modality that does not synapse in thalamus?

Back 121

Olfactory

Front 122

What are circumventricular organs?

Back 122

fenestrated capillaries, open BBB, chemoreception and neuropeptide secretion

Front 123

Stroke of internal capsule involving arm and leg ?

Back 123

in internal capsule or lower

Front 124

Stoke with problems involving face and arm but NOT leg ?

Back 124

MCA

Front 125

Stoke with problems involving leg but NOT face and arm ?

Back 125

ACA

Front 126

Thalamic parcellation -VA ?

Back 126

motor, Input: basal ganglia

Front 127

Thalamic parcellation -VL ?

Back 127

motor, Input: cerbellum

Front 128

Thalamic parcellation - VPL ?

Back 128

somatosensory, Input: medial lemniscus

Front 129

Thalamic parcellation - VPM ?

Back 129

somatosensory, Input: Trigeminal

Front 130

Thalamic parcellation - MG ?

Back 130

auditory sensory

Front 131

Thalamic parcellation - LG ?

Back 131

visual sensory

Front 132

Thalamic parcellation - A ?

Back 132

components of behavior, part if Papez circuit

Front 133

Thalamic parcellation - LD ?

Back 133

components of behavior

Front 134

Thalamic parcellation - DM ?

Back 134

personality, memory, damage causes Wernicke-Korsakoff syndrome

Front 135

Thalamic parcellation - LP, Pulvinar ?

Back 135

general intellect, visual

Front 136

Thalamic parcellation - CM (interlaminar nuc.)?

Back 136

ARAS, arousal, consciousness

Front 137

loss of sensation on opposite side, thalamic lesion, continued repeated activity ?

Back 137

Thalamic syndrome

Front 138

Associated with alcoholism, degeneration of MD, hallucinations, bizarre explanations ?

Back 138

Korsakoff's syndrome