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54 Cards in this Set
- Front
- Back
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A destructive lesion in the frontal eye fields will result in the eyes deviating towards or away from the side of lesion?
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Towards (e.g. stroke)
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What is the anatomical name of the structures comprising Broca's area?
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The pars opercularis and pars triangularis of the inferior frontal gyrus
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A lesion to which area may result in the reactivation of primitive reflexes?
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Prefrontal cortex.
Reflexes include: grasp, pucker, palmar-mental |
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A middle cerebral artery occlusion will generally produce what type of speech deficit?
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Expressive and receptive dysphasia
(MCA supplies both Broca's and Wernicke's areas) |
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An activation lesion in the frontal eye fields will result in the eyes deviating towards or away from the side of lesion?
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Away from (e.g. seizure)
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Neologisms are associated with damage to which cortical area?
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Wernicke's area
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An inferior quadrantanopia homonoymous quadrantanopia is associated with damage to which cortical area?
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Parietal lobe
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A patient that could not copy a drawing of a cube or draw a clock may be suspected of having damage to which cortical area?
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Non-dominant parietal lobe. (Constructional apraxia)
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A patient that could not show you how to use a hammer may be suspected of having damage to which cortical area?
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Dominant parietal lobe:
(Ideomotor apraxia) |
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A superior quadrantanopia homonoymous quadrantanopia is associated with damage to which cortical area?
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Temporal lobe
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Gerstmann syndrome is associated with which cortical region & what type of deficit?
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Dominant parietal lobe:
L-R disorientation, dyscalculia, dysgraphia, finger naming |
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Damage to which cortical lobe is most likely to produce memory deficit?
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Temporal lobe
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The loss of meaning of words is associated with damage to which cortical region?
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Frontotemporal:
Semantic dementia |
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Damage to which lobe is most likely to result in a homonymous hemianopia?
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Occipital > unilateral V1 lesion
Temporal > complete optic radiation lesion |
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Dressing apraxia may be associated wtih damage to which cortical region?
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Frontal, parietal and occipital lobes
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Where are the primary sensory neurons (cell bodies) for the trigeminal nerve?
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Trigeminal (Gasserian) ganglion and Vmes
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Which nerve supplies pain sensation for the supratentorial dura mater
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CNV
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Which nerve innervates the dura of the posterior fossa?
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CNX
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What is unique about the mesencephalic trigeminal nucleus?
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It is the only case in which the primary sensory neurons lie in the CNS instead of within peripheral ganglia
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Where does sensory info from the Vmes project to?
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Bilaterally to the V motor nucleus and to the VP thalamus and on to S1 & S2
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Where does Vchief project to?
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VP thalamus via contralateral ventral trigeminothalamic (aka trigeminal lemniscus) pathway. Runs with medial lemniscus.
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What sort of input does Vchief receive?
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Sensory input from thick myelinated tactile and pressure receptors in the face.
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What sort of input does the spinal trigeminal nucleus receive?
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Lightly and unmyelinated pain, temperature and crude touch input from trigeminal nerve.
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What is the pathway of pain sensed in the forehead?
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Opthalmic branch of trigeminal nerve >
trigeminal ganglion> descends with spinal trigeminal tract> synapse in CAUDAL spinal trigeminal nucleus> ascend with contralat ventral trigeminothalamic tract to VP thalamus |
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What is the spinal trigeminal tract and what will damage to the upper portion cause?
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Carries pain fibres from V, IX and X
Damage causes dermatome band to mandibular (lower facial) region |
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What pattern of sensory loss will be caused by damage to the upper spinal trigeminal nucleus?
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Ring of sensory loss around nose
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Which reflexes are dependent on the trigeminal nerve?
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Corneal (afferent), sneeze, suckling and masseter
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What colour is CSF on a T2 MRI scan?
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White
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T/F Oxygenated Hb is darker than deoxygenated Hb on BOLD T2 MRI scans
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False
Oxygenated Hb is lighter, allowing areas of local increase in neuronal activity/blood flow to appear bright |
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What are the typical features of a migraine?
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Aura
Early morning onset, peak in 30 mins, progressive Unilateral, throbbing pain Nausea/vomiting Photo/phonophobia Lasts 4-24 hours untreated |
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Pain referral to the anterior 2/3 of the head is likely originating where?
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Supratentorial structures
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Pain referred to the naso-orbital region, ear or throat is likely originating where?
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CN VII, IX, X
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Describe the vascular hypothesis for the pathogenesis of the migraine headache
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Trigeminal nerve innervates small intracranial vessels >
Cortical depression causes substance P and other algesic release > Dilation and pain and increased permeability |
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Describe the neuronal hypothesis for the pathogenesis of the migraine headache
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CN V hypersensitivity + hypothalamic feedback>
Neuropeptide release at CN V> Neurogenic inflammation> protective wave of cortical depression, vasodilation and activation of CN V (pain) |
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What are the diagnostic criteria for migraine?
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Five attacks of:
1) Lasts 4-72 hours 2) Two of: unilateral, pulsating, moderate to severe headache, aggravation by stairs of similar 3) Nausea/vomiting OR phono/photophobia 4) Other causes excluded |
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What are the common drug therapies for migraine?
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Ergot alkaloids, sumitriptan, promethazine, caffeine, antiemetic
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T/F Cluster headaches are more common than migraine
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False
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What are the typical features of a tension headache?
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Gradual onset
Temple and back of neck Bilateral Mild to moderate severity NO vomiting or photo/phonophobia |
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What are the typical features of a cluster headache?
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Pain around one eye or unilateral face
Brief and severe Nasal stuffiness sometimes associated |
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T/F Tension headaches are generally well managed with OTC medications
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True
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T/F Cluster headaches are generally well managed with OTC medications
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False
Oxygen, migraine drugs, steroids, verapamil and NSAIDs are common therapy |
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A 'thunderclap' headache, vomiting, lowered level of consciousness, meningism and sometimes seizures are typical symptoms of what?
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Subarachnoid haemorrhage
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Headache, nausea/vomiting, fever, lowered level of consciousness, photophobia, meningism and sometimes seizures are typical symptoms of what?
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Acute meningitis
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What are the main differential points for meningitis from cold/flu?
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Cold and flu:
Headache not typically the main symptom No meningism or photophobia |
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What are the red flags for headache?
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New or different headache
New headache over 40 years old Fever and meningism Abrupt onset Altered level of consciousness Persistent focal neuro signs Significant head trauma Anticoagulant use Immune suppresion Seizures |
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Which embryological layer gives rise to the lens placode?
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Ectoderm
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T/F High dose FGF in the aqueous promotes lens epithelial proliferation and maintenance
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False
Low dose FGF in the aqueous promotes lens epithelium |
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T/F Optic cup vitreous high dose FGF promotes fibre differentiation of the lens
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True
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How does the lens accommodate for distance focus?
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Ciliary muscle relaxes>
Tight zonular fibres> Flattened lens |
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Pars plicata of ciliary body produces which humour?
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Aqueous
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Pars plana of ciliary body produces which humour?
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Vitreous humour
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Where is aqueous humour drained?
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Canal of Schlemm
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What are the causes of cataracts?
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Aging
Metabolic disorder Trauma Heredity |
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What determines the polarity of the lens (i.e. epithelial and fibre poles)
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Position in optic cup>
Exposure to high or low FGF |
