5.20 Neuro Ii

Front 1

1. What areas are just anterior and just posterior to the central gyrus of the brain?

Back 1

1. Anterior: Motor1, Posterior: Sensory1

Front 2

1. What is the function of Wernicke's Area? Where is it? What happens when there is a lesion to it?

Back 2

1. Sup. Temporal Gy; Speech perception; WORDY aphasia

Front 3

1. What is the function of Broca's area? Where is it? What happens when there is a lesion to it?

Back 3

1. Inf. Frontal Gy; Speech production; BROKEN aphasia

Front 4

1. What is the function of the arcuate fasciculus? What happens when there is a lesion to it?

Back 4

1. Connects Broca's to Wernicke's; Conductive aphasia: good comprehension, fluency, poor repetition

Front 5

1. What is Kluver-Bucy and and where is the lesion associated with it?

2. Describe a lesion to the reticular activating system? Where is the RAS?

Back 5

1. hypersexuality/inappropriate; lesion to amygdala

2. midbrain; lesion associated with ↓wakefulness/arousal

Front 6

1. If a patient has hemiballismus, where is the lesion?

2. Describe the consequences of a lesion to the mammillary bodies?

Back 6

1. Conralateral Sub-thalamic nucleus (STN)

2. Wernicke-Korsakoff

Front 7

1. Describe what happens with damage to the frontal lobe with regard to reflexes?

2. What causes a parenchymal hematoma and where is it typically seen?

3. Draw the circle of Willis and label it?

Back 7

1. Primitive reflexes re-emerge (sucklings, Alzheimers)

2. hypertension; basal ganglia

3. SEE SHEET

Front 8

1. What type of memory loss is there with damage to the hippocampus?

2. What is the difference between Wernicke and Korsakoff?

3. What types of patients get a subdural hematoma?

Back 8

1. Anterograde memory loss

2. Wernicke: confusion, ataxia, nystagmu; Korsakoff: amnesia and confabulation

3. elderly, alcoholic: blunt trauma

Front 9

1. What lesion gives spatial neglect syndrome? Describe it?

2. Where/what is Heschl's Gyrus?

3. Rupture to what artery is often a cause of epidural hematomas?

Back 9

1. RIGHT (non-dominant) parietal lobe lesion causes contralateral neglect

2. superior temporal gyrus; site of auditory cortex

3. middle meningeal

Front 10

1. What causes global aphasia and describe it?

2. Compare which brain artery would supply blood to the spots that control the arm and the leg?

3. Lesion to what artery causes "locked in" S/S?

Back 10

1. Lesions to both Wernicke's and Broca's areas; non-fluent with impaired comprehension

2. Arm: middle cerbral artery; leg: anterior cerebral artery

3. basilar artery

Front 11

1. What is meant by "watershed zones" in the brain?

2. Most common site of Willis aneurysm?

Back 11

1. areas between blood supplies that are first affected by hypotension

2. anterior communicating artery

Front 12

1. Compare the general defecits by an anterior Willis lesion and a posterior Willis lesion?

2. What areas do the lateral striate arteries supply? From what artery do they originate? What condition will affect these arteries?

Back 12

1. anterior: motor/sensory problems; posterior: CN/cerebellar deficit

2. supply basal ganglia/thalamus; middle cerebral artery; hypertensive stroke

Front 13

1. Compare Charcot-Bouchard aneurysms with Berry aneurysm?

2. Which type of hematoma can cross the falx cerebri?

Back 13

1. Berry: large artery aneurysm, Charcot-Bouchard: small artery/hypertensive aneurysm

2. epidural: can cross (above the dura); subdural: cannot cross

Front 14

1. Lesion to what artery causes: Nystagmus, N/V, Horner's and ataxia? What is this called?

2. What does a lesion to the PPRF cause?

Back 14

1. Wallenberg Syndrome: PICA

2. Eyes look away from the lesion (cannot turn towards it)

Front 15

1. What does a lesion to the Frontal Eye fields cause?

2. Diagram the circuitry inolved with a PPRF lesion?

Back 15

1. Eyes look towards lesion (cannot turn away from it)

2. SEE SHEET

Front 16

1. CNIII can be obstructed by an aneurysm in which artery?

2. Which direction does CSF flow?

Back 16

1. superior cerebellar artery

2. Lateral Ventricles → 4th ventricle

Front 17

1. What cell type is responsible for the formation of CSF?

2. Compare the causes/pressure seen in communicating versus non-communicating hydrocephalus?

Back 17

1. ependymal cells of ventricles

2. non-communicating: ↑pressure d/t obstruction; communicating: nl pressure d/t lack of reabsorption

Front 18

1. Where does CSF go from the 4th ventricle? How does it get there?

2. Which meninge is NOT pierced during a spinal tap?

Back 18

1. CSF → subarachnoid space via Luschka (lateral) and Magendi (Medial)

2. pia mater

Front 19

1. What are the S/S of hydrocephalus?

2. What structures are related to a vertebral hernia? (HINT: What IS a hernia?)

Back 19

1. Wet (incontinent), Wacky (demented), Wobbly (ataxia)

2. penetration of nucleus pulposus through annulus fibrosus

Front 20

1. What is hydrocephalus ex vacuo? What are the pressures seen in these instances?

2. Which spinal artery arises of the two vertebral arteries?

3. In which lesion is seen muscular atrophy: UMN or LMN?

Back 20

1. increase in ventricular size d/t atrophy of brain tissue

2. the anterior spinal artery

3. LMN

Front 21

1. Where is an LP performed and why is it performed there?

2. What pathway travels through the medial lemniscus?

3. In which lesion is seen spacticity: UMN or LMN?

4. Describe the somatopic orientation of the lateral corticospinal tracts?

Back 21

1. Keep it alive: L3-L5 (spinal column ends at L2 in an adult)

2. dorsal column pathway

3. UMN

4. Legs are lateral in lateral corticospinal (arms are medial)

Front 22

1. What modalities are carried in the Spinothalamic tract?

2. What pathway synapses in the anterior horn of the spinal column?

Back 22

1. pain and temperature

2. corticospinal tract

Front 23

1. What modalities are carried in the dorsal colums?

2. Where is the fasciculus cuneatus and what areas does it supply?

3. Describe the somatopic organization of the STT?

Back 23

1. pressure, vibration, touch, proprioception

2. cuneatus: arms/lateral

3. cervical is medial; sacral is lateral

Front 24

1. What modalities are carried in the lateral corticospinal tract?

2. Where is the fasciculus gracilis and what areas does it supply?

3. In which lesion is seen fasciculations: UMN or LMN?

Back 24

1. voluntary movement

2. gracilis: legs/medial

3. LMN

Front 25

1. Draw the 3 Major spinal tracts?

2. In which lesion is seen weakness: UMN or LMN?

3. Which lesion has increased muscle tone and which has decreased muscle tone: UMN or LMN?

Back 25

1. SEE SHEET

2. both

3. UMN: increased tone; LMN: decreased tone

Front 26

1. Say the nursery rhyme that deals with reflexes?

2. Where is the lesion in Brown-Sequard syndrome?

3. What are the S/S of Horner's syndrome?

4. What is dysarthria?

Back 26

1. S1,2 (ankle); L3,4 (knee); C5,6 (biceps), C7,8 (triceps)

2. hemisection of spinal cord

3. Ptosis/anhydrosis/miosis

4. difficulty speaking

Front 27

1. What dermatome level is the nipple?

2. Describe the pathway associated with Horner's syndrome?

Back 27

1. T4

2. hypothalamus to T1 (synapse) → T1 to superior cervical ganglion → SCG to pupil/eyelid/face (long ciliary n.)

Front 28

1. What dermatome level is the umbilicus?

2. Above what level is the lesion required for Horner's syndrome?

Back 28

1. T10

2. T1

Front 29

1. What dermatome level is L1?

2. What are the S/S of Freidreich's ataxia?

3. Where are the lesions with ALS? What is spared?

Back 29

1. inguinal ligament L1=IL

2. FRED: Falling down, Rounded Spine, Eye (Nystagmus), dysarthria

3. UMN/LMN lesion; sensation spared

Front 30

1. What dermatome level is the posterior skull?

2. Describe the gene involved with Freidrich's ataxia and the type of mutation seen?

Back 30

1. C2

3. Frataxin Gene: trinucleotide repeat

Front 31

1. What spinal roots provide sensation and genitals/anus?

2. Where is the lesion with an anterior spinal artery occlusion?

Back 31

1. S2, S3, S4

2. only dorsal tracks, Lissauer (afferent DRG) spared

Front 32

1. Compare the landmarks used for a spinal tap versus a pudendal nerve block?

2. Where is the lesion with Poliomyelitis?

Back 32

1. spinal tap: iliac crest, pudendal n. block: ischial spine

2. LMNs

Front 33

1. Compare an extramedullary versus and intramedullary lesion with respect to the STT?

2. Where are the lesions in Freidreich's ataxia?

3. What does the Golgi Tendon organ sense and what does it do when it senses this?

Back 33

1. Extramedullary: bottom up; Intramedullary: top down

2. Dorsal Columns, Lateral Corticospinal tracts

3. Tension; stimulates Ib nerve to inhibit α-MN

Front 34

1. What is the lesion with Syringomyelia?

2. ALS can be associated with a defect in what enzyme?

3. What does the muscle spindle sense and what does it do when it senses this?

Back 34

1. intramedullary lesion to STT: top down loss of pain/temperature sensation

2. SOD1

3. length; stimulates Ia to activate α-MN

Front 35

1. What is Wernig Hoffman disease?

2. How does VitB12 deficiency appear neurologically (HINT: Think Lesions)

3. What is the function of the Gamma-MN in the muscle servo?

Back 35

1. congenital syndrome presenting like polio: only LMN

2. Just like Freidreich's ataxia

3. keeps spindle short/sensitive during muscle contraction

Front 36

1. Describe the infantile palmar/plantar reflexes?

2. What area of the brain is responsible for conjugate vertical gazze? Conjugate horizontal gaze?

Back 36

1. either curl/flex if stroked

2. vertical: superior colliculus; horizontal: PPRF

Front 37

1. Describe the infantile sucking reflex?

2. Describe the afferent/efferent limbs of the corneal reflex?

Back 37

1. baby starts sucking if roof of mouth is touched

2. V1(afferent); VII(efferent)

Front 38

1. At what level of the brainstem are the various cranial nerve nuclei?

2. Describe the afferent/efferent limbs of the lacrimation reflex?

Back 38

1. medulla: 9, 10, 11, 12; pons: 5, 6, 7, 8; midbrain: 3,4

2. V1(afferentl); VII(efferent)

Front 39

1. What are the superior and inferior colliculi for?

2. Describe the afferent/efferent limbs of the jaw jerk reflex?

3. Where does CNI exit the skull?

Back 39

1. superior: sight; inferior: sound (eyes above ears)

2. V3(sensory afferent); V3(sensory efferent)

3. Through the cribiform plate

Front 40

1. Describe the afferent/efferent limbs of the pupillary reflex?

2. What cranial nerves exit the skull through the internal acoustic meatus?

Back 40

1. II(afferent); III(efferent)

2. CN VII, CN VIII

Front 41

1. Describe the afferent/efferent limbs of the gag reflex?

2. What cranial nerve passes through the styloid foramen?

3. Describe the test for a positive CNXII lesion?

Back 41

1. IX(afferent); IX/X (efferent)

2. CN VII

3. tongue deviates towards the side of lesion

Front 42

1. Describe where the differen branches of the trigeminal nerve exit the skull?

2. What structure passes through the Foramen Spinosum?

3. What is the dorsal motor nucleus?

Back 42

1. "SRO" V1: superior orbital fissure, V2: foramen rotundum, V3, foramen ovale

2. Middle meningeal artery

3. vagal nuclei for visceral efferents to heart/lungs

Front 43

1. What the only CN to pass through the foramen magnum?

2. What bone forms the base of the occular orbit? What bone forms the posterior of the occular orbit?

3. Describe a positive test for a CNXI lesion?

Back 43

1. CN XI

2. base: maxillary, posterior: sphenoid

3. Can't turn head to the contralateral side

Front 44

1. What structures pass through the jugular foramen BESIDES the jugular vein?

2. What is the nucleus solitarius?

3. Describe the test for a positive CNX lesion?

Back 44

1. CNIX, CNX, CNXI

2. vagal nucleus for sensory visceral information (gut/taste/baroreceptors)

3. drooping of uvula away from lesioned side (normally held up tight)

Front 45

1. What is the nucleus ambiguous?

2. Describe the test for a positive CNV lesion?

Back 45

1. vagal nucleus for motor efferents in esophagus/pharynx/palate

2. Jaw deviates toward lesioned side

Front 46

What are the contents of the cavernous sinus? Which side is lateral and medial?

Back 46

O(occulomotor), T(trochlear), O(OpthalmicV1), M(MaxillaryV2)