Cbn1

Front 1

what is the control center of the brain

Back 1

thalamus
part of the diencephalon

Front 2

what are the 3 main parts of the brain

Back 2

cerebellum
cerebrum
brainstem

Front 3

cerebellum
- what do
- where

Back 3

motor control

Front 4

what are the 2 parts of the diencephalon?
which is part of which of the 3 main components of the brain

Back 4

diencephalon = thalamus + hypothalamus

which is part of the cerebrum

Front 5

___________ are large groups of cells that have the same function

Back 5

ganglia = are large groups of cells that have the same function

Front 6

Basal ganglia - deals with?

Back 6

Basal ganglia - motor

Front 7

the dips in the convolutions of the cerebral hemispheres are called? peaks?

Back 7

dips = sulcus
peaks = gyrus

Front 8

__________ is a ridge in cerebral cortex surface btw adjacent sulcus

Back 8

gyrus

Front 9

ventricles are filled with?

Back 9

CSF

Front 10

what cell does these things:
- anchor neurons
- regulate external chemical environment (ions)
- recycle neurotransmitters
- building blocks of BBB

Back 10

astrocytes

Front 11

what cell type makes and have cilia that circulate CSF as well as make up the blood-CSF barrier

Back 11

ependymal cells

Front 12

name the cell type:

specialized macrophages capable of phagocytosis that protect neurons of the central nervous system.[11] They are derived from hematopoietic precursors rather than ectodermal tissue; they are commonly categorized as such because of their supportive role to neurons.

These cells are found in all regions of the brain and spinal cord. Microglial cells are small relative to macroglial cells, with changing shapes and oblong nuclei. They are mobile within the brain and multiply when the brain is damaged. In the healthy central nervous system, microglia processes constantly sample all aspects of their environment (neurons, macroglia and blood vessels).

Back 12

microglial

Front 13

what are the cells called that make the myelin sheath?

Back 13

oligodendrocytes

Front 14

upper motor neuron axons project
- from (2x)
- to (2x)

Back 14

from
- cerebral cortex
- brainstem

to
- spinal cord
- cranial nerve morot nucleus (in brainstem)

Front 15

lower motor neuron axons project from? to?

Back 15

from spinal cord or brainstem to TARGET MUSCLES

Front 16

name the 12 cranial nerves

Back 16

I - olfactory
II - optic
III - oculmotor
IV - trochlear
V - trigeminal
VI - abducens
VII - facial
VIII - vestibulocochlear
IX - glosopharyngeal
X - vagus
XI - accessory
XII - hypoglossal

Front 17

a group of mylinated axons the size of a pencil is called

Back 17

fasiculous

Front 18

a group of mylinated axons the size of a thumb (connect cerebral cortex and cerebellum) is called

Back 18

peduncle

Front 19

which side of the brain does this:
i. Spatial abilities
ii. Face recognition
iii. Music

Back 19

right

Front 20

which side of the brain does this:
i. Logic
ii. Math
iii. Language

Back 20

left

Front 21

which lobe is the
motor cortex

Back 21

frontal lobe

Front 22

which lobe is the
somatosensory cortex

Back 22

parietal

Front 23

which lobe is the center for
visual

Back 23

occipital

Front 24

which lobe is the center for
auditory

Back 24

temporal

Front 25

which lobe is the center for
emotion / memory /drive

Back 25

limbic

Front 26

which lobe is the center for
pain/gustatory/auditory

Back 26

insular

Front 27

speech area of the brain

Back 27

inferior frontal gyrus

Front 28

the primary sensory cortex?

Back 28

(purple)

postcentral sulcus and gyrus

Front 29

language processing
area of the brain

Back 29

supramarginal gyrus

Front 30

visual processing
area of the brain

Back 30

angular gyrus

Front 31

Where language is first processed

Back 31

Wernicke's area


of the superior temporal gyrus
of the temporal lobe

Front 32

function of Transverse temporal gyri (of Heschl)?
in what lobe?

Back 32

primary auditory

of temporal lobe

Front 33

what does the Lingual gyrus do?
what lobe?

Back 33

visual processing

occipital lobe

Front 34

what lobe is the calcarine sulcus in?

Back 34

occipital

Front 35

Parahippocampal gyrus
- lobe?
- function?

Back 35

limbic lobe
memory

Front 36

Subcallosal area
- lobe?
- function?

Back 36

limbic lobe
smelling

Front 37

what does the
insular cortex
do

Back 37

taste (gustatory

Front 38

primary clinical significance (function) of Broadmann's area:
4

Back 38

primary motor cortex

Front 39

primary clinical significance (function) of Broadmann's area:
17

Back 39

primary visual area

Front 40

primary clinical significance (function) of Broadmann's area:
44, 45

Back 40

production of speech - motor C
Broacca's area

Front 41

primary clinical significance (function) of Broadmann's area:
3,1,2

Back 41

primary sensory

Front 42

what are the 2 main cell types of the cerebral cortex and their cooresponding function

Back 42

pyramidal cells - agranular cortex - motor (primary output / excitatory [glutamate] neurons

nonpyramidal cells (stellate)
- principal interneurons (GAG - inhibits / glutamate excites)

Front 43

what connects the left/right cerebral cortex?

Back 43

commissural fibers

Front 44

what are the 3 parts of the corpus callosum and what do they do?

Back 44

i) Genu - connects prefrontal cortex
ii) Body - connects motor/sensory/parietal corticies
iii) Splenium - connects temporal/occipital lobes

Front 45

what does the Anterior commissure do?

Back 45

Connects olfactory and temporal structures

Front 46

what does the posterior commissure do?

Back 46

visual processing

Front 47

what do long and short association fibers (U fibers)

Back 47

short association fibers - pass from gyrus to gyrus within a lobe

long association fibers - links lobes

Front 48

what are
Fasciculi

Back 48

bundles of fibers

Front 49

what does this fasiculi (bundle of fibers) connect?
superior longitidinal fasiculus

Back 49

ant/post cortex

Front 50

what does this fasiculi (bundle of fibers) connect?
acruate fasiculus

function?

Back 50

Wernicke's area - Broca's area

language

Front 51

what does this fasiculi (bundle of fibers) connect?
unicinate fasiculus

Back 51

orbital cortex - temporal lobes

Front 52

what does this fasiculi (bundle of fibers) connect?
cinfulum

Back 52

limbic cortical areas

Front 53

what does this fasiculi (bundle of fibers) connect?
inferior longitudinal fasiculus

Back 53

occipital - temporal lobes

Front 54

Broadmann's area 22 is also called?
and is what function?

Back 54

Wenicke;s area

language comprehension

Front 55

Broadmann's areas 44,45 are also called?
and is what function?

Back 55

Broca's area

production of language

Front 56

this is the definition of what?

Disturbance in the dominant hemisphere that produces a defect in the expression or comprehension of any of the forms of language

Back 56

aphasia

Front 57

what is aphasia

Back 57

Disturbance in the dominant hemisphere that produces a defect in the expression or comprehension of any of the forms of language

Front 58

what is this called

i. NON-FLUENT
ii. Comprehension of language is normal
iii. Cant convert thought into meaningful language
iv. Inability to organize words into sentences
v. Articulation is impaired

Brodmanns area 44, 45

Back 58

Broca's aphasia

Front 59

what is
Broca's aphasia

Back 59

i. NON-FLUENT
ii. Comprehension of language is normal
iii. Cant convert thought into meaningful language
iv. Inability to organize words into sentences
v. Articulation is impaired

Brodmanns area 44, 45

Front 60

what is Wenicke's aphasia

Back 60

i. FLUENT
ii. Cant COMPREHEND language
iii. Fluent speech that is UNINTELLIGIBLE
iv. Brodmanns area 22
1) Can see on film

Front 61

what is this called:

i. FLUENT
ii. Cant COMPREHEND language
iii. Fluent speech that is UNINTELLIGIBLE
iv. Brodmanns area 22
1) Can see on film

Back 61

Wernicke's aphasia

Front 62

what is contralateral neglect syndrome?

Back 62

b. RIGHT PARIETAL cortex damage
c. Neglect left of world
d. Sx/Dx
i. Visuospatial task
ii. Personal neglect

Front 63

what are the structures called that are Between endothelial cells of capillaries

Back 63

tight junctions

Front 64

what are the 3 layers between the skull and the brain in order

Back 64

skull
dura mater
arachnoid
pia mater
brain

Front 65

what cell does this:
Regulate endothelial cell proliferation / survival / migration / differentiation / branchin

Back 65

pericyte

Front 66

what do pericytes do?

Back 66

a) Regulate endothelial cell proliferation / survival / migration / differentiation / branching
b) Allow blood vessels to function
c) Phagocytize bad molecules incoming

Front 67

what do astrocytes do?

Back 67

i) Determine BBB function / morphology / protein expression
ii) Guide vessel growth - interacts w/capillaries and neurons

Front 68

what cell does this:
i) Determine BBB function / morphology / protein expression
ii) Guide vessel growth - interacts w/capillaries and neurons

Back 68

astrocytes

Front 69

what 3 types of molecules does the BBB restrict

Back 69

- large
- low lipid soluble (water soluble)
- electrically charged

Front 70

what do Adherens junction do?

Back 70

holds the cells together - 20nm - communicate through junctional cleft

Front 71

what do occludens junctions do?
2 proteins?

Back 71

TIGHT JUNCTION
- completly occluded
made of
- occludin - binds cytoskeletons
- claudins - FORMS THE PRIMARY SEAL OF THE TIGHT JUNCTION

Front 72

what do
Zonula occludens
do

Back 72

figure out where to put the tight junctions

Front 73

what to
junctional adhesion molecules (JAM)
do

Back 73

a gene of the immunoglobulin superfamily
- promotes lymphocyte transendothelial migratio

Front 74

what is kernicterus

Back 74

when bilirubin enters the brain in newborns

Front 75

4 key differences btw peripheral and brain endothelial cells

Back 75

1 - ↑ mitochondria
2 - enzymatic barrier
3 - ↓ capillary wall thickness
4 - polarity - has charge to keep things out

Front 76

what are the 2 main molecular transport mechanisms and for 1 of them what are the 2 subtypes

Back 76

1 - lipid mediation - passive diffusion for small lipid soluble drugs

2 - catylyzed transport
2a - carrier mediated - facilitated active - miliseconds
2b - receptor mediated - specific receptor - minutes - for proteins

Front 77

what is the choroid plexus?

Back 77

blood / CSF barrier

Front 78

where is CSF made?

Back 78

choroid plexus

Front 79

where is choroid plexus and what does it do

Back 79

makes CSF

Front 80

what are the walls of the 3rd ventricle

Back 80

hypothalamus

Front 81

L-dopa
which crosses the BBB is used to Tx what?

Back 81

Parkinsons disease

Front 82

what is btw the cerebral hemispheres

Back 82

falx cerebri

Front 83

what is Btw cerebral hemispheres and cerebellum

Back 83

Tentorium cerebelli

Front 84

partially separates 2 cerebellar hemispheres

Back 84

Falx cerebelli

Front 85

space in tentorium through which brainstem passes

Back 85

Tentorial notch

Front 86

POTENTIAL space btw skull and dura

Back 86

Epidural

Front 87

POTENTIAL space btw dura and arachnoid

Back 87

Subdural

Front 88

1) CSF filled
2) Btw arachnoid and pia
3) Structural separation by arachnoid trabecula

Back 88

Subarachnoid

Front 89

tearing of meningeal artery or venous sinus results in?

Back 89

epidural hematoma

Front 90

tearing of cerebral vein as it penetrates arachnoid and enters sinus results in?

Back 90

subdural hematoma

Front 91

volume of CSF

Back 91

130mL

Front 92

what serves as a pathway for pineal secretions to reach the pituitary gland

Back 92

CSF

Front 93

what:
midline cavity in the diecephalon a) Connects lateral ventricles - through interventricular foramina
b) Connects 4th ventricle through cerebral aqueduct

Back 93

3rd ventricle

Front 94

where is the 4th ventricle

Back 94

btw cerebellum, pons, and medulla

Front 95

where is the thalmus

Back 95

in the middle of the 3rd ventricle (star)

Front 96

6 steps of CSF flow

Back 96

1 - lateral ventricles
2 - interventricular foramen
3 - 3rd ventricle
4 - cerebral aqueduct
5 - 4th ventricle (median and lateral aperture)
6 - cisterns (pontine cistern & cistern magna)

Front 97

6 steps of CSF flow

Back 97

1 - lateral ventricles
2 - interventricular foramen
3 - 3rd ventricle
4 - cerebral aqueduct
5 - 4th ventricle (median and lateral aperture)
6 - cisterns (pontine cistern & cistern magna)

Front 98

a spinal tap is at what level and into what

Back 98

L4

pia mater

Front 99

Major place / structure where CSF goes into VENOUS system

where is this located

Back 99

arachnoid villi

superior sagital sinus

Front 100

Brain
__% body mass
15% CO
__% of O2 consumption

Back 100

Brain
2% body mass
15% CO
20% of O2 consumption

Front 101

MABP (mean arterial BP) cerebral blood flow

Back 101

MABP 60-150mm Hg

Front 102

normal intracranial pressure (H2O or Hg)

Back 102

65-150 mm H20
5-15mm Hg

Front 103

what is Hydrocephalus

3 causes?

Back 103

e. Hydrocephalus
i. ↑ CSF pressure
ii. Causes
1) ↑ CSF production (papillomas - tumors)
2) CSF circulation blocked
3) Reabsorption def

Front 104

↑ ICP → herniation
what are the 3 types of hermiations in the brain

Back 104

- cingulate gyrus herniation (subdural hematoma)
- uncus herniation ) herniation through tentorial notch - presses midbrain)
- tonsil herniation (tonsil of cerebellum herniated through foramen magna - compresses medulla - shuts down cardiovascular respiration = die)

Front 105

what type of brain herniation can kill you and why

Back 105

tonsil herniation (tonsil of cerebellum herniated through foramen magna - compresses medulla - shuts down cardiovascular respiration = die)

Front 106

CPP (cerebral perfusion pressure)

CPP = ?

Back 106

CPP (cerebral perfusion pressure)

CPP = MABP - ICP

Front 107

what is Cushing reflex (triad) and what is it a sign of?

Back 107

6) Cushing reflex (triad) - signs of ↑ ICP
a) ↑ systolic BP
b) ↑ pulse pressure (S - D)

↓ HR as ICP ↑ to fatal levels

Front 108

3 types of cerebral edema

Back 108

Vasogenic edema
1) ↑ BBB permiability
2) ↑ extracellular fluid
3) Responds to steroids / diuretics

Cytotoxic edema
1) Hypoxia
2) Na/K pump failure
3) ↑ intracellular fluid / cell swelling

Interstitial edema
1) ↑ fluid in white matter around ventricles
2) Usually associated w/hydrocephalus (↑ CSF)

Front 109

Hyperventilate via respirator (24hrs)
will inc/dec ICP

Back 109

Hyperventilate via respirator (24hrs) (→ vasoconstrict and ↓ flow)

Front 110

Ischemic stroke - Caused by?

Back 110

Embolism - foreign matter carried by bloodstream

Front 111

Hemorrhagic stroke - Caused by?

Back 111

rupture of small perforating arteries

Front 112

what is a
Penumbra

Back 112

interface btw a region of permanent tissue damage and an area that will most likely not be damaged

Area of concern - where your intervention can make a difference

Front 113

name for:

interface btw a region of permanent tissue damage and an area that will most likely not be damaged

Area of concern - where your intervention can make a difference

Back 113

Penumbra

Front 114

balloon like swelling of arterial walls

Usually at site of bifurcation (branch point)

Back 114

Aneurysms

Front 115

1

Back 115

Front 116

2

Back 116

Front 117

3

Back 117

Front 118

4

Back 118

Front 119

5

Back 119

Front 120

6

Back 120

Front 121

7

Back 121

Front 122

8

Back 122

Front 123

9

Back 123

Front 124

10

Back 124

Front 125

11

Back 125

Front 126

12

Back 126

Front 127

13

Back 127

Front 128

14

Back 128

Front 129

15

Back 129

Front 130

blood to brain is via what 2 main sets of arteries and what do they supply

Back 130

internal carotid (anterior cerebrum / diencephalon)

vertebral-basilar arteries (posterior cerebrum / brainstem / cerebellum / spinal cord)

Front 131

ID

basilar a
anterior inferior cerebellar a
posterior inferior cerebellar a
vertebral a

Back 131

Front 132

5 components of the Circle of Willis

Back 132

i. Interconnects internal carotid and vertebral-basilar systems
ii. Components
1) Anterior cerebral artery
2) Anterior communicating artery
3) Internal carotid
4) Posterior communicating artery
5) Posterior cerebral artery

Front 133

Anterior spinal artery - from ?

Back 133

Anterior spinal artery - from vertebral artery

Front 134

Posterior spinal artery - from ?

Back 134

Posterior spinal artery - from posterior inferior cerebellar artery

Front 135

blood supply to the brain for the precentral gyrus (motor) and postcentral gyrus (sensory) for the arm, hand, face, tongue comes from what artery?

Back 135

middle cerebral a

Front 136

what is a
Watershed area

Back 136

2) Watershed area = area where nutrients must diffuse to

Gets bigger as brain shrinks with age - nutrients must diffuse farther

Front 137

Back 137

Front 138

Back 138

Front 139

blood supply - medulla
what is each color

Back 139

Front 140

blood supply - pons
what is each color

Back 140

Front 141

blood supply - midbrain
what is each color

Back 141

Front 142

3x blood supply to thalamus

Back 142

a) Posterior cerebral (p)
b) Posterior communicating (p)
c) Anterior choroidal

Front 143

3x supply to hypothalamus

Back 143

a) Posterior communicating (p)
b) Anterior communicating (p)
c) Internal carotid (p)

Front 144

2 structures of diencephalon

Back 144

thalamus
hypothalamus

Front 145

lenticulostriate is the perforating (of basal structures) branch of what artery?

Back 145

middle cerebral a

Front 146

what cerebral artery occludes the most causing stroke?
and it is a branch of what?

Back 146

lenticulostriate

from middle cerebral a

Front 147

fill in each line

Back 147

Front 148

flow through brain veins

Back 148

Front 149

what does the
Anterior comissure
do

Back 149

Communicates information from one side to the other

Front 150

Pyriform area

what special function

Back 150

smell

Front 151

lateral geniculate nucleus

to and from what
function

Back 151

from thalamus
to visual cortex

vision

Front 152

what are the 3 cranial nerves that move eye muscles and which muscles do they move

Back 152

III - occulomotor nerve
Medial rectus
superior rectus
inferior rectus
inferior oblique

IV - traochlear nerve - Superior oblique

VI - abducens nerve - Lateral rectus

Front 153

EYE MOVEMENT IS ESSENTIALLY CONTROLLED WITH CRANIAL NERVE NUCLEI LOCATED IN THE ____________ and one in the _____

Back 153

EYE MOVEMENT IS ESSENTIALLY CONTROLLED WITH CRANIAL NERVE NUCLEI LOCATED IN THE MIDBRAIN and one in the pons

Front 154

Edinger-Westphal nucleus
- where is it located
- main motor function

Back 154

midbrain

pupil and lens function

Front 155

which cranial nerve innervates superior rectus

Back 155

3

Front 156

which cranial nerve innervates medial rectus

Back 156

3

Front 157

which cranial nerve innervates lateral rectus

Back 157

4

Front 158

which cranial nerve innervates inferior rectus

Back 158

3

Front 159

which cranial nerve innervates superior oblique

Back 159

4

Front 160

which cranial nerve innervates inferior oblique

Back 160

3

Front 161

what is Ptosis
what nerve malfunctions to cause it

Back 161

eyelid drooping
occulomotor (3)

Front 162

if the left eye points down and out what nerve is busted and on what side

Back 162

right trochlear nerve (4)

Front 163

what innervates the lateral rectus muscle

Back 163

6 - abducens

Front 164

IF HAVE PROBLEM WITH FACIAL EXPRESSION - PROBLEM IS IN THE _______ AREA OF THE BRAINSTEM

Back 164

IF HAVE PROBLEM WITH FACIAL EXPRESSION - PROBLEM IS IN THE PONS AREA OF THE BRAINSTEM

Front 165

what is the Accommodation reflex

Back 165

Adaption of the visual apparatus of the eye for near vision

Front 166

what is the
Consensual pupillary light reflex?
explain

Back 166

response from the opposite eye being illuminated

Front 167

afferent and efferent nerves

Back 167

afferent - II - optic nerve
efferent - III - occulomotor

Front 168

what is damaged here

Back 168

right optic nerve

Front 169

what is damaged here

Back 169

right occulomotor nerve

Front 170

what does the
Paramedian pontine reticular formation
or PPRF
coordinate?

Back 170

lateral gaze

Front 171

what is
Internuclear opthalmoplegia?
where is the lesion

Back 171

paresis of adduction in one eye and horizontal nystagmus in contralateral abducting eye

MLF - medial longitudinal fasiculus

Front 172

what nerve gathers Sensory information from face and head?

Back 172

trigeminal (5)

Front 173

what are the 3 branches of CN5

Back 173

trigeminal
- opthalmic
- maxillary
- mandibular

Front 174

what does the motor aspect of the trigeminal nerve do (function) and where is its nucleus?

which branch has the motor

Back 174

chewing - small nucleus in the pons

mandibular

Front 175

dilineate on your own face where the 3 branches of the trigeminal innervate for sensory (and the names of the 3 branches

Back 175

ophthalmic
maxillary
mandibular

Front 176

where do the 3 branches of the trigeminal go through the skull

Back 176

V1 (ophthalmic) - superior orbital fissure
V2 (maxillary) - foramen rotundum
V3 (mandibular) - foramen ovale

Front 177

where do the 3 branches of the trigeminal go through the skull

Back 177

V1 (ophthalmic) - superior orbital fissure
V2 (maxillary) - foramen rotundum
V3 (mandibular) - foramen ovale

Front 178

muscles of mastication are innervated by?
which goes through?

Back 178

mandibular branch of trigeminal

which goes through foramen ovale

Front 179

FOREHEAD IS _____________, LOWER FACE IS _____________

(SAME SIDE / CONTRALATERAL - for each)

Back 179

FOREHEAD IS SAME SIDE, LOWER FACE IS CONTRALATERAL

Front 180

main 3 funcs of function of CN7

Back 180

- muscles of facial expression
- lacrimation / salvation
- taste (ant 2/3 of tongue)

Front 181

main 2 funcs of CN8

Back 181

vestibulocochlear
- balance (vestibular)
- hearing

all from pons (special sensory)

Front 182

test for CN9

Back 182

glossopharyngeal

gag reflex

Front 183

test for CN10

Back 183

vagus

gag reflex or say hi

Front 184

test for CN11

Back 184

spinal accessory

life shoulders

Front 185

test for CN12

Back 185

hypoglossal

tongue movement

Front 186

CRANIAL NERVRES 9-12 NUCLEI LOCATED IN __________ OF BRAINSTEM

Back 186

CRANIAL NERVRES 9-12 NUCLEI LOCATED IN MEDULLA OF BRAINSTEM

Front 187

carotid body
carotid sinus

each is what type of receptor
where is each exactly

Back 187

carotid body - chemoreceptor (O2, CO2) - at plit

carotid sinus - baroreceptor (BP) - internal carotid

Front 188

what innervates the carotid sinus and body
to what nucleus

Back 188

9 - glossopharyngeal

tractus soltarius

Front 189

main very general thing vagus does

Back 189

parasympathetic - brains stem to colon

Front 190

CN10 stim does what to these
cardiac
lungs
GI

Back 190

Cardiac
↓ HR

Lungs
↑ bronchiolar secretions and bronchoconstriction

GI tract
↑ secretions and motility

Front 191

how test vagus in isolation

Back 191

uvula deviation - to unaffected side

Front 192

CN 9 and 10 both use nucleus ___________ as motor output

Back 192

CN 9 and 10 both use nucleus ambiguus as motor output

Front 193

CN11 leaves skull through

along with which others

Back 193

jugular foramen

with
9, 10

Front 194

2 major functions of CN11

Back 194

spinal accessory

- contralateral trapezious
- ipsilateral sternomastoid

Front 195

what nerve innervates the muscles that allow for protrusion of the tongue

Back 195

CN 12 - hypoglossal

Front 196

UMNL (upper motor lesion) - tongue deviates _______ from lesion side

Back 196

UMNL (upper motor lesion) - tongue deviates AWAY from lesion side

Front 197

LMNL (lower motor lesion) - tongue deviates ___________ lesion side

Back 197

LMNL (lower motor lesion) - tongue deviates TOWARD lesion side

Ipsilateral side of tongue appears atrophied and fasciculations

Front 198

*** where is each of the 12 cranial nerve nuclei located

Back 198

I - olfactory []
II - optic []
III - occulmotor [midbrain]
IV - trochlear [midbrain]
V - trigeminal [midbrain, pons, medulla]
VI - abducens [pons]
VII - facial [pons]
VIII - vestibulocochlear [pons]
IX - glosopharyngeal [medulla]
X - vagus [medulla]
XI - accessory [medulla]
XII - hypoglossal [medulla]

Front 199

brain accounts for ___% of total O2 consumption

Back 199

20%

Front 200

what is "Respirator brain"

Back 200

1) Brain was dead and basically starting to decompose but was on respirator
2) Marked necrosis/edema/widespread destruction of the brain
3) From recurrent cycles of edema/vasocompression
4) → result - autolysis/softening of brain - prevents fixation in formalin

Front 201

this is Morphology of cerebral ____________
i. Swollen brain
ii. Widened gyri
iii. Narrowed sulci
iv. Possible herniation
v. Ischemia and hemmorrhage associated with herniation

Back 201

this is Morphology of cerebral ischemia
i. Swollen brain
ii. Widened gyri
iii. Narrowed sulci
iv. Possible herniation
v. Ischemia and hemmorrhage associated with herniation

Front 202

red neurons are a sign of the early stage of what

Back 202

ischemic injury to the brain

Front 203

what 2 cell types/areas of the brain are particularly susecptible to early stage ischemic injury in the brain

Back 203

a) Pyramidal cells - of the hippocampus
b) Purkinje cells - of the cerebellum

Front 204

Pseudolaminar necrosis
is seen in subacute brain ischemia (24hrs - 2 wks)
what is it

Back 204

Pseudolaminar necrosis - uncontrolled death of cells in cerebral cortex in BAND-LIKE pattern

Front 205

what micro changes happen during the subacute stage (24hrs-2wks) of ischemic brain injury

Back 205

- macrophages
- neutrophils

Front 206

what is the difference btw thrombotic and embolic strokes

Back 206

embolic (red stroke) can be lysed and bloodflow re-established

thrombotic - thrombus reforms

Front 207

what is a white stroke?
other name

Back 207

thrombotic stroke

1) ↓ oxyhemoglobin in affected area of brain (turns pale)
a) From lack of perfusion

2) Thrombus may be lysed but quickly reforms (b/c of atherosclerotic changes in the vessel)

Front 208

what is a lacunar stroke

Back 208

hyaline narrowing of small branches of blood vessels (seen w/HTN)

- small infarcts → undergo liquefactive necrosis → leaves small cavities (lacunae) in basal ganglia

Front 209

what is
Arteritis

Back 209

Small / large vessel inflammation


b) Was seen in syphilis and TB
c) Now seen in immunosuppressed

Front 210

Notch3 mutation

Back 210

iii. CADASIL (cerebral autosomal dominant arteriopathy w/subcortical infarcts and leukoencephalopathy)
1) Rare hereditary form of stroke
3) Sx
a) Recurrent strokes
b) Dementia
4) Gross
a) Abnormalities of white matter
b) Concentric narrowing of the adventitia / media of leptomeningeal arteries

Front 211

where do emboli usually infarct?

Back 211

middle cerebral arter - direct extension of internal carotid artery

Front 212

3 types of emboli

Back 212

- fat
- air (puncture or the bends - nitrogen)
- tumor

Front 213

5 kinds / causes of suffocation

Back 213

1 - entrapment (displaces O2 out of environment)
2 - smothering - occlude external airway (nose/mouth)
3 - choking - occlude inner airway
4 - mechanical asphyxia - compress chest
5 - gases - displace oxygen or inhibit O2 binding

Front 214

3 kinds of strangulation - which is a type of smothering

Back 214

hanging (own ligaments occlude)
ligature (extension cord)
manual strangulation (arm/hands)

Front 215

ruptured blood vessels in the eye may be a sign of what cause of death

Back 215

choke hold

33lbs of force
blood goes in but cant leave

Front 216

what kills via this MOA

By competing w/ferric iron of intracellular cytochrome oxidase (last stop of ETC - thing that makes ATP)

Back 216

Hydrogen cyanide

Front 217

Hydrogen cyanide
mech of killing

Back 217

By competing w/ferric iron of intracellular cytochrome oxidase (last stop of ETC - thing that makes ATP)

Front 218

Hydrogen cyanide
smells like what

Back 218

almonds

Front 219

if you smell these 2 smells you should GET OUT OF THERE because it might be what 2 gases

Back 219

almonds - hydrogen cyanide

rotten eggs - hydrogen sulfide

Front 220

put these neuro insults in order of quickness of onset

neoplastic, vascular, degenerative, infectious

Back 220

vascular (min)
infection (hrs/wks)
neoplastic (days/wks)
degenerative (months/yrs)

Front 221

neuro DDx - accronym

MITCH VINDI DO

stands for?

Back 221

metabolic
infectious
traumatic
congenital
hereditary
vascular
immune
neoplastic
drugs
idiopathic
degenerative/demyelinating
other

Front 222

what are the 6 parts of the neuro exam

Back 222

1 - mental status
2 - cranial nerves
3 - motor
4 - reflexes
5 - sensory
6 - gait / coordination

Front 223

6 parts of mental status exam (explain each)
LOC
orientation
memory
sustained mental activity
language
general knowledge

Back 223

LOC
orientation (who, where, when)
memory (3/33 min recall (give 3 objects to memorize)
sustained mental activity (spell backwards)
language (repeat/comprehend)
general knowledge (ask about something current)

Front 224

how test each of the 12 cranial nerves

Back 224

1 - alcohol wipe
2 - reactive to light / visual fields
3, 4, 6 - H test (EOMI w/o nystagmus (extra ocular movements intact)
5 - facial sensation / muscles of mastication (clench/open)
7 - facial expression + corneal reflex
8 - can you hear that
9, 10, 11 - gag reflex / say ahhhh (if soft palate deviates on side - then def)
12 - stick tongue out (is it midline)

Front 225

how test each of the 12 cranial nerves

Back 225

1 - alcohol wipe
2 - reactive to light / visual fields
3, 4, 6 - H test (EOMI w/o nystagmus (extra ocular movements intact)
5 - facial sensation / muscles of mastication (clench/open)
7 - facial expression + corneal reflex
8 - can you hear that
9, 10, 11 - gag reflex / say ahhhh (if soft palate deviates on side - then def)
12 - stick tongue out (is it midline)

Front 226

2x tests to test higher cortical function on PE

Back 226

stereognosia (ID object based on touch)
graphesthesia (write number in your hand)

Front 227

what is graphesthesia
what does it test

Back 227

write in hand - know what it is

tests higher cortical function

Front 228

what are the levels of tendon reflexes

Back 228

0 - abscent
1 - hypoactive
2 - normal
3 - hyperactive
4 - hyperactive w/clonus (twitching)

Front 229

what is the most important thing when testing tendon reflexes

Back 229

symmetry

Front 230

in a positive Babinski what happens

and this indicates what

Back 230

toe goes up

upper motor problem

Front 231

2 main differences btw upper and lower motor neuron pathology in physical exam findings

Back 231

upper - no atrophy, +Babinski

lower - atrophy, -Babinski

Front 232

this picture is more typical of an upper or lower motor neuron weakness?

Back 232

upper

Front 233

this picture is more typical of an upper or lower motor neuron weakness?

Back 233

lower

Front 234

what is
Dysdiadakokinesia

Back 234

in ability to perform rapid movements

Front 235

what is
Romberg sign

Back 235

iv. Station/balance
1) Romberg sign (Romberg 15s)
a) Close eyes
b) If break stance after 3s
c) Note wavering

Front 236

in 2-3min you should be able to find a neuro problem even in pts w/o neuro Sx - what are the 6 steps and what do you do in each step

Back 236

a. Mental status
i. Level of alertness
ii. Appropriatness of responses
iii. Orientation to date and place
b. Cranial nerves
i. Visual acuity
ii. Pupillary light reflex
iii. Eye movements
iv. Hearing
v. Facial strength (smile, eye closure)
c. Motor function
i. Gait (casual, tandem)
ii. Coordination (fine finger movements, finger-to-nose)
iii. Strength
1) Shoulder abduction
2) Elbow extension
3) Wrist extension
4) Finger abduction
5) Hip flexion
6) Knee flexion
7) Ankle dorsiflexion
d. Reflexes
i. Deep tendon reflexes
1) Biceps
2) Patellar
3) Achilles
ii. Plantar responses
e. Sensation
i. One modality at toes - can be light touch, pain/temperature, or proprioception

Front 237

what regulates the emotional state

Back 237

limbic system

Front 238

2 hey limbic structure for emotion/memory

Back 238

hippocampus
amygdala

Front 239

what has these functions

i. Functions
1) Endocrine
2) Autonomic
a) Pulse
b) BP
3) Regulates
a) Hunger
b) Thirst
c) Response to pain
d) Sleep wake cycle
e) Levels of pleasure

Back 239

hypothalamus

Front 240

what does the hypothalamus do

Back 240

regulates

autonomic - pulse / BP

hunger
thirst
pain response
sleep/wake cycle
level of pleasure

Front 241

what does the hippocampus do

Back 241

memory

Front 242

what does the amygdala do

Back 242

emotion

Front 243

Lesions in the prefrontal cortex leads to?

Back 243

i. Interrupts inhibitory control on amygdala
ii. Disinhibition of emotional responses
iii. Leads to socially inappropriate behavior and impulsivity

Front 244

what is the blue thing

Back 244

hippocampus

Front 245

what are the 3 zones of the hippocampus

Back 245

i. Hippocampus proper
ii. Dentate gyrus
iii. subiculum

Front 246

what is the
Perforant pathway

Back 246

major input to the hippocampus

i. In the entorhinal cortex
ii. Connects the hippocampus to parts of the cerebral cortex

Front 247

a lesion in what would lead to:

i. Inability to learn new information
ii. Loss of declarative memory (facts) - "amnesia"
iii. Associated w/epilepsy - partial complex seizures

Back 247

hippocampus

Front 248

[Key fiber tracks of the limbic system]

short term memory

Back 248

Fornix -- hippocampus

Front 249

[Key fiber tracks of the limbic system]

Input of emotional responses

Back 249

Stria terminalis -- amygdala

Front 250

[Key fiber tracks of the limbic system]

whats this do:
Stria terminalis -- amygdala

Back 250

Input of emotional responses

Front 251

[Key fiber tracks of the limbic system]

whats this do:
Fornix -- hippocampus

Back 251

short term memory

Front 252

whats the mammillary body do?
where / what is it?

Back 252

long term memory

nuclei of hypothalamus

Front 253

whats the fornix
whats it do

Back 253

b/l fiber track
takes short term memory from hippocampus
and puts it in mammillary body (long term memory)

Front 254

whats the
Stria terminalis
do

Back 254

brings info from amygdala (emotion) to
septal area
hypothalamus

Front 255

what is the Source of cholinergic input to the hippocampus and amygdala?

Back 255

septal nuclei

Front 256

what is Papez's circuit?

Back 256

Basic layout of how limbic system works

Front 257

Papez's ciruit describes the circle that limbic emotion goes. what are the 6 parts and their order?

Back 257

cingulate gyrus (big thing)
hippocampus
fornix
mamillary bodies
mammillothalmic tract
anterior nucleus of dorsal thalamus

Front 258

where (2x) are Declarative (explicit) facts stored such as episodic (events) and semantic (facts)

Back 258

medial temporal lobe
medial diencephalon

Front 259

where are skills and habits stored

Back 259

basal ganglia
cerebellum
neocortex

Front 260

where are long term emotional associations stored

Back 260

amygdala

Front 261

what is Korsakoff syndrome

Back 261

loss of memory and confabulation (fabricate imaginary experiences as compensation for loss of memory)

Front 262

Dx?

athology 1) ↓ neurons in hippocampus & parahippocampal cortex
2) Formation of amyloid plaques and neurofibrillary tangles
ii. Sx

Progressive loss of memory / cognition / orientation / behavior

Back 262

Alzheimer;s disease

Front 263

this syndrome is caused by
a) Chronic alcoholics
b) Thiamine (Vit B1) deficiency

Back 263

Korsakoff's syndrome

cant form new memories
intelligence fine - so fills in gaps

Front 264

what is Kluver-Bucy syndrome

Back 264

destruction of amygdala

no emotional response
Compulsion to be overly attentive to all sensory stimuli
hypersexuality

Front 265

what is
Hyperthymestic syndrome

Back 265

super memory

Front 266

Dx?

ii. Sx
1) Tremor
2) Muscle rigidity
3) Impairment of postural reflexes
4) Btadykinesia (slow movements)

Hypokinesia (few movements)

Back 266

Parkinson's disease

Front 267

what does the Basal ganglia do

Back 267

controls movement
Modulates cortical output from the primary motor cortex

Front 268

what are the 4 main components of the basal ganglia (coordinates movement)

Back 268

striatum
globus pallidus (pallidum)
subthalamic nucleus
substantia nigra

Front 269

excitatory = (molecule)?

Back 269

excitatory = glutamate

Front 270

which of the 4 main parts of the basal ganglia takes most of the basal ganglia's input (which is from the cerebral cortex)

Back 270

striatum

Front 271

inhibatory = (molecule)?

Back 271

inhibatory = GABA

Front 272

output from the basal ganglia comes from which 2 of the 4 parts? what does the ouput pass through on the way out to the cerebral cortex?

Back 272

- globus pallidus
- substantia nigra

passes through the thalamus

Front 273

output from the basal ganglia is INHIBITORY (GABA) to the thalamus which then excites/inhibits the cerebral cortex? what molecule?

Back 273

excites (glutamate)

Front 274

summarize the ins/outs of the basal ganglia

Back 274

Front 275

The basal ganglia influence is to modulate the_____________ OF THE THALAMIC NUCLEI

Back 275

The basal ganglia influence is to modulate the level of EXCITATION OF THE THALAMIC NUCLEI

Front 276

what is the difference btw direct and indirect basal ganglia pathways

Back 276

- indirect inhibits the globus pallidus (which is outside the ganglia)

- which then stims the globus pallidus (which is part of the basal ganglia)

which then INHIBITS the thalamus (same)
which then STIMS the cortex (same)

Front 277

functional difference btw direct/indirect basal ganglia pathways (in terms of the result, not how they work)

Back 277

direct - facilitates movement

indirect - inhibits/damps down movement

Front 278

what doe the
Substantia nigra (compact part of basal ganglia)
do?

what molecule does it use to do this?

Back 278

* the substantia nigra modulates the striatum - with DOPAMINE (stims direct / inhibits indirect pathways)

Front 279

If you lose dopamine - lose modulation = (disease)

Back 279

Parkinsons

Front 280

too much inhibition from the (indirect) basal ganglia results in what

Back 280

Parkinsons disease

Front 281

too much stim from the (direct) basal ganglia results in

Back 281

Huntingdon's chorea
Hemiballism

Front 282

Dx?

Back 282

Parkinsons

Front 283

direct or indirect pathway of basal ganglia

Back 283

indirect = inhibatory

Front 284

direct or indirect pathway of basal ganglia

Back 284

direct

Front 285

what does
Deep brain stimulation (DBS) - pacemakers for the brain
Tx?

Back 285

Parkinsons

restores excitation and inhibition to the thalamus
Relief from tremors/rigidity/slowness of movement/stiffness/balance

Front 286

Dx?

decreased inhibition - which leads to too much stim of cortex from basal ganglia

Back 286

Huntingdon's disease of "Chorea"

Front 287

what is
Huntingdon's disease of "Chorea"

Back 287

decreased inhibition - which leads to too much stim of cortex from basal ganglia

Front 288

how does Basal ganglia interact w/cerebellum

Back 288

through upper motor neuron

Front 289

Any abnormality of the brain resulting from a pathologic abnormality of the blood vessels or their contents

Back 289

Cerebrovascular disease

Front 290

Sudden neurologic deficit resulting from cerebrovascular disease

Back 290

Cerebrovascular accident (CVA) = stroke

Front 291

what is CVA

Back 291

Sudden neurologic deficit resulting from cerebrovascular disease

Front 292

what are the 2 types of stroke

Back 292

ischemic (white)
hemorrhagic (red)

Front 293

3 kinds(causes) of ischemic stroke

Back 293

- thrombosis (clot forms there)
- embolism (clot got stuck there - formed somewhere else)
- lacunar infarct (thrombi in small vessel)

Front 294

2 types of hemorrhagic stroke

Back 294

subarachnoid
intracerebral

Front 295

what happens

↑ pCO2 → vessel ___________

Back 295

↑ pCO2 → vessel dilates

Front 296

↓ pCO2 → vessel _______________

Back 296

↓ pCO2 → vessel constricts

Front 297

↓ SBP → vessel ____________

Back 297

↓ SBP → vessel dilates

Front 298

on the humunkulus of the motor cortex, where is face?

Back 298

lateral

Front 299

on the humunkulus of the motor cortex, what is midline before the cortex goes down

Back 299

hip

Front 300

what is the vascular supply for each color

Back 300

Front 301

language is usually dominant in the _________ hemisphere

Back 301

Language = Left

Front 302

strokes in the middle cerebral artery are more likely to cause hemisensory deficit in ________ the most

Back 302

face > arm > leg

Front 303

what is the vascular supply for each color

Back 303

Front 304

what is the blood supply (artery) for occipital and posterior temporal lobes

Back 304

posterior cerebral

Front 305

what is the blood supply (artery) for
pons
midbrain
occipital lobes

Back 305

basilar artery

Front 306

what is
Locked-in syndrome

Back 306

awake and conscious - cant move anything other than vertical eye movement

Front 307

what is a TIA (stand for and definition)

Back 307

transient ischemic attack
- old term
- < 24hrs
- recover completely
- lasts 10-15min
- > 6hrs = stroke (neuron death)

now called a stroke with resolving deficits

Front 308

for a TIA

If even within 72 hrs and ABCD2 > __ (score) → ADMIT

Back 308

If even within 72 hrs and ABCD2 > 3 → ADMIT

Front 309

what are the ABCDs of determining (score) of the risk of a stroke after a TIA?

Back 309

Front 310

what is TSI

Back 310

transient Sx associated with infarct

Front 311

Better than warfarin for cardioembolic stroke

Back 311

Dabigatran (Pradaxa) / Rivaroxaban (Xarelto)

Front 312

what is
Endarterectomy
for

Back 312

surgical Tx for atherosclerotic stroke
place shunt (tube)

Front 313

what is a
Watershed infarction

Back 313

ischemia, or blood flow blockage, that is localized to the border zones between the territories of two major arteries

iv. Watershed = most distal area - most sensitive to ↓ in blood flow
1) This why you don’t ↓ BP in hypertensive pt with signs and Sx of cerebral ischemia

Front 314

Tx - acute ischemic stroke?

Back 314

Do NOT ↓ BP acutely!
(will kill the watershed areas! - will extend dead zone)

3) Aggressive Tx of hyperglycemia and hyperthermia
a) To prevent spread of zone

Is the pt a candidate for thrombolysis?

Front 315

how work/Tx suspected embolic stroke (start with a test)

Back 315

CT to see if there is blood
if not - anticoag (heparin then coumadin long term

NOT anticoagulating this stroke - anticoag against next stroke

Front 316

Dx?

Back 316

lacunar infarct

Front 317

tPA for ischemic stroke must be given within _____hrs of Sx onset

Back 317

4.5hrs

Front 318

AHA (America heart) says that for ischemic stroke when giving statins you want LDL below what

Back 318

70mg/dL

Front 319

what 2 things can cause
Carotid / vertebral artery dissection
which can cause stroke

Back 319

trauma
sneezing

Front 320

5 kinds of stroke - fill in
Ischemic
1) ____________
2) ____________
3) ____________

Hemorrhagic
1) ____________
2) ____________

Back 320

Ischemic
1) Thrombotic
2) Embolic
3) Lacune

Hemorrhagic
1) ICH (intracerebral hemorrhage)
2) SAH (subarachnoid hemorrhage)

Front 321

name for
multiple or single small cavitary infarcts

Back 321

lacunar infarct

Front 322

what is a
slit hemorrhage

Back 322

i. Rupture of small penetrating vessels → small hemorrhages
ii. Make slit like cavity (lacunar is round lake)
1) Surrounded by brownish discoloration
iii. Micro
1) Focal tissue destruction
2) Pigment laden macrophages
3) Gliosis (remember - like fibrosis)

Front 323

Onion skinning of vessel (means malignant ___)

Back 323

Onion skinning of vessel (means malignant HTN)

Front 324

what is
Binswanger disease

Back 324

Pattern of injury - large areas of the subcortical white matter with myelin and axon loss

from
Hypertensive encephalopathy

Front 325

Caudate nucleus constitutes a system that is responsible largely for _____________________

Back 325

voluntary movement

Front 326

*what are the 3 basic structure that make up the basal ganglia

Back 326

- putamen
- globus pallidus
- caudate nucleus

Front 327

what is
* Duret's hemorrhage

Back 327

hemorrhage of the pons (midline)

2) ALWAYS secondary hemorrhages
3) When brainstem pushed down arteries at 90 rupture causing this
4) → death

Front 328

3 branches of the trigeminal

Back 328

ophthalmic
maxillary
mandibular

Front 329

facial skin infections, sinusitis, and dental abscess can cause dural sinus thrombosis where

Back 329

cavernous sinus

Front 330

birth control, malnutrition, dehydration, and cancer can cause dural sinus thrombosis where

Back 330

superior sagittal sinus

Front 331

what is the largest and most dangerous cerebral vascular malformation?

Back 331

AVM (arteriovenous malformation)

Front 332

Dx?




i. Cerebral subcortical white matter - most commonly
ii. Up to few cm in diameter
iii. Frontal lobe - most common site
iv. May be multiple
v. Well circumscribed
vi. Dar red to brown
vii. Micro
1) Vascular channels
a) Many
b) Closely packed
c) Thin fibrous walls - w/o muscularis

Back 332

Cavernous hemangiomas (malformation/tumor)

which is a
Cerebral vascular malformation

Front 333

where are berry aneurysms most commonly found

Back 333

branch points

Front 334

having what 3 things increase the incidence of berry aneurysms

Back 334

- adult polycystic kidney disease
- Ehlers-Danlos syndrome
- Marfan syndrome (collegen production)

also
- smoking
- HTN
- cocaine

Front 335

what is
CAA (cerebral amyloid angiopathy)

Back 335

superficial hemorrhage in ppl over 60 where
Amyloidogenic peptides deposit in the wall of medium/small meningeal/cortical vessels

Front 336

word for:
outside coverings of the brain

Back 336

epidural

Front 337

2 mechanisms of stroke

Back 337

- block an artery (ischemia)
- rupture an artery (hemorrhage)

Front 338

what are the components of the Circle of Willis

Back 338

Anterior communicating artery
Anterior cerebral artery (left and right)
Internal carotid artery (left and right)
Posterior communicating artery (left and right)
Posterior cerebral artery (left and right)

Front 339

what does the
pineal gland
do

Back 339

makes melatonin

Front 340

what is the most common source of the embolis in an embolic stroke

Back 340

heart

from afib
valve disease

Front 341

90% of pts who get an Intracerebral hemorrhage (ICH)
also have

Back 341

HTN

Front 342

*** most common place for ICH (intracerebral hemorrhage) is?

Back 342

PUTAMEN

Front 343

*** most common place for ICH (intracerebral hemorrhage) is?

Back 343

PUTAMEN

Front 344

study of choice for suspected ICH

Back 344

CT

Front 345

Thrombosis of small deep penetrating arteries
is called what

Back 345

lacunar stroke

Front 346

what is the
Monro-Kellie doctrine

Back 346

- volume of head is fixed

If volume ↑ must = loss or → ↑ pressure

Front 347

main Tx for ↑ ICP

Back 347

ELIMINATE THE CAUSE = SURGERY

Front 348

for increased cranial pressure - when do you remove
1) Small hemorrhages (< ___cc) DO NOT need to be removed
2) Not enough ICP to cause herniation syndromes

Back 348

dont remove if < 30cc

Front 349

what is
Decompressive hemicraniectomy

Back 349

open the box
large 10x10cm flap
to relieve pressure

Front 350

who came up with

Bio-psycho-social

Back 350

Engel (MD)

Front 351

integration of behavior and relationships =

Back 351

personality

Front 352

1st textbook about mental illness - published 1586 by Timothy Bright

Back 352

The Treatise of Melancholie

Front 353

what is
The Treatise of Melancholie

Back 353

1st textbook about mental illness - published 1586 by Timothy Bright

Front 354

what did
Benjamin Rush
do

Back 354

i. Philadelphia physician - signed declaration of independence
ii. Hospital for Tx of psych pts

Front 355

who?

i. Philadelphia physician - signed declaration of independence
ii. Hospital for Tx of psych pts

Back 355

Benjamin Rush

Front 356

who?
i. Superego?
ii. Psychoanlalysis

Back 356

Freud

Front 357

who?
i. Thought Freud overemphasized sexuality
ii. Coined "inferiority complex"
iii. Birth order
1) Oldest vs youngest sibling

Back 357

Alder

Front 358

who?
i. Unconscious - not just individual
1) Collective unconscious
a) Social / cultural group
ii. Derived idea of persona
1) How you project yourself

Back 358

Carl Young

Front 359

what did Carl Young do?

Back 359

- collective unconsious
- derived idea of persona (how you project yourself)

Front 360

* name for this theory:

Ppls behavior not determined by internal events - rather by external events

Back 360

social learning theory

Front 361

* what is the
social learning theory

Back 361

- Ppls behavior not determined by internal events - rather by external events

Ex - behavior that is rewarded or punished
- To make change (NOT by gaining insight or understanding -- But by changing their behavior)
- Not governed by the unconscious - but by something that is learned

Front 362

who?

a. How ppl react to particular stimuli
b. Salivating dogs
c. Conditioned stimulus
i. Disappears without unconditioned stimulus (ring bell enough w/o food)

Back 362

Pavlov

Front 363

what is
operant conditioning

Back 363

Behaviors are part of personality
i. Reinforced / strengthened w/ reward
ii. Go away if associated w/ something negative
b. Can use to desensitize to fears


Variable reinforcement
- Sometimes get + reinforcement - sometimes no
- Don’t know when its going to get it

Continuous reinforcement
- Always get

Observational learning
- Watching how someone else does it

Front 364

Who?

Systematic desensitization - to overcome anxiety / fears

Back 364

Wolpe

Front 365

name of this therapy:

a. Ppl react to stimuli and how they react to stimuli
b. And how they incorporate that into whats going on in their lives
c. Eric Beck
d. Ppl are depressed b/c negative view of themselves

Back 365

cognitive therapy

Front 366

what is
Catatonia

Back 366

complete cessation of motor activity

Front 367

what is the definition/difference btw
illusion
hallucination

Back 367

illusion = mistake in perception
hallucination = false perception

Front 368

what is a
Persecutory delusion

Back 368

Object of plot of someone trying to harm you

Front 369

Back 369

Body of the corpus callosum

Front 370

name the structure

a. The little brain
b.
c. 10% of brains total weight
d. Largest structure in the posterior fossa
e. Behind brainstem at level of the pons
f. Attached by peduncles:
i. Superior, middle, inferior peduncles

Back 370

cerebellum

Front 371

what coordinates voluntary movements

Back 371

cerebellum

Front 372

what does these things:

a. Coordination of voluntary movements
b. Equilibrium
c. Muscle tone
d. Postural control
e. Cognitive functions

Back 372

cerebellum

Front 373

what part of the cerebellum is most important

Back 373

midline

Front 374

Back 374

cerebellar peduncles

Front 375

Back 375

vermis

Front 376

Back 376

tonsil



1) On either side of the pyramids of the medulla
2) Herniation compresses medulla → dead

Front 377

A

Back 377

posterolateral fissure

Front 378

B

Back 378

horizontal fissure

Front 379

C

Back 379

primary fissure

- divides ant/post lobes

Front 380

A
name
what does it do

Back 380

Vestibulocerebellum or flocculonodular lobe
1) Balance and gait

Front 381

B
name
what does it do

Back 381

Spinocerebellum
1) Coordinating adjustment of limb musculature
2) Comparator btw intended and actual movements

Front 382

C
name
what does it do

Back 382

Cerebrocerebellum
1) Coordination of voluntary motor activities
2) Motor planning

Front 383

what part of the cerebellum compares btw intended and actual movements

Back 383

spinocerebellum

Front 384

what part of the cerebellum creates balance

Back 384

vestibulocerebellum or flocculonodular

Front 385

* A
- what zone (longitudinal)
- what deep cerebellar nucleus does it contain (colored structures)
- what is its function

Back 385

vermis
fastigial nucleus
- balance (eye movements)

Front 386

* B
- what zone (longitudinal)
- what deep cerebellar nucleus does it contain (colored structures)
- what is its function

Back 386

medial hemisphere (intermediate or parvermal zone)
interposed nucleus (emboliform + globose nucelus)
- adjusting limb movements

Front 387

* C
- what zone (longitudinal)
- what deep cerebellar nucleus does it contain (colored structures)
- what is its function

Back 387

lateral hemisphere
dentate nucleus
- planning initiation & control of voluntary movements

Front 388

vermis = ? *

Back 388

vermis = balance *

Fastigal nucleus

Front 389

what deep cerebellar nucleus and what is it in that does:
planning initiation & control of voluntary movements

Back 389

dentate nucleus
in the lateral hemisphere

Front 390

what is the major cell type of the cerebellum

Back 390

Purkinje cells

Front 391

what are the 3 layers of the cerebellum

Back 391

- molecular layer (axons + dentrites from the purkinje cells)
- purkinje layer (purkinje cells)
- granular layer (unmyelinated axons + interneurons)

Front 392

climbing fiber
- what structure
- where synapse
- originate from

Back 392

cerebellum
- synapse on purkinje cell dendrites (molecular layer - outer layer)
- originalte in the contralateral inferior olivary nucleus (medulla oblongata is the lower half of the brainstem)

Front 393

Mossy fibers
- what structure
- where synapse
- originate from

Back 393

cerebellum
- synapse on dendrites of the granule cells
- originate from brainstem nuclei & spinal cord nuclei

Front 394

describe the 4 steps of information flow into/out of the cerebellum
- structures
- inhibitory (GABA) or excitatory (glutamate)

Back 394

Input stim causes inhibition of deep cerebellar nuclei which causes mostly output stim

Front 395

describe the 4 steps of information flow into/out of the cerebellum
- structures
- inhibitory (GABA) or excitatory (glutamate)

Back 395

Input stim causes inhibition of deep cerebellar nuclei which causes mostly output stim

input (stims) - cerebellar cortex (inhibits - w/GABA) - deep cerebellar nuclei (which mostly stim) - output targets

Front 396

what molecule is inhibatory stimulation

Back 396

GABA

Front 397

what molecule is excitatory stimulation

Back 397

glutamate

Front 398

*********** purkinje job is to

Back 398

purkinje job is to modulate output to the deep cerebellar nuclei

Front 399

most dysfunction in the superior cerebellar peduncle (main output) is ipsilateral or contralateral?

Back 399

ipsilateral
crosses TWICE
- caudal midbrain
- pyramid

Front 400

3 brainstem and 1 spinal cord nuclei that send inputs into the cerebellar cortex

Back 400

brainstem
- pontine nuclei
- vestibular nuclei
- inferior olivary nucleus (origin of climbing fibers)

spinal cord
- Clarks nucleus (C8-> L2-3) - proprioceptive information [to spinocerebellar]

Front 401

3 brainstem and 1 spinal cord nuclei that send inputs into the cerebellar cortex

Back 401

brainstem
- pontine nuclei
- vestibular nuclei
- inferior olivary nucleus (origin of climbing fibers)

spinal cord
- Clarks nucleus (C8-> L2-3) - proprioceptive information

Front 402

output pathway from cerebellar cortex to?

Back 402

cerebellar cortex ->
deep cerebellar nuclei -> (decussation (passes to))
brainstem - travels to thalaumus ->
motor/pre-motor cortex

Front 403

[cerebellar cortex inputs]
pontocerebellar pathway
- terminates (2x)
- peduncle
- function (2x)

Back 403

pontocerebellar pathway
- terminates (2x)
[Contralateral anterior AND posterior cerebellar lobes]

- peduncle [middle cerebellar]

- function (2x)
[- Cortical info relevant to motor commands
- Planned motor activities (walking)]

Front 404

[cerebellar cortex inputs]
Olivocerebellar pathway
- terminates (2x)
- peduncle
- function (2x)

Back 404

Olivocerebellar pathway
- terminates (2x)
[Inferior olivary nuclei
accessory olivary nuclei]

- peduncle [inferior cerebellar]

- function (2x)
[Motor coordination
Motor learning]

Front 405

[cerebellar cortex inputs]
Posterior spinocerebellar pathway
- terminates (2x)
- peduncle
- function

Back 405

Posterior spinocerebellar pathway
- terminates (2x)
[Ipsilateral vermis
Intermediate zone]

- peduncle [inferior cerebellar]

- function [proprioceptive information]

Front 406

what are the 3 cerebellar input pathways and what they carry?

Back 406

- pontocerebellar (planned - walking)
- olivocerebellar (coordination)
- posterior spinocerebellar (proprioceptive)

Front 407

what are the 3 output cerebellar pathways and what information do they carry?

Back 407

- dentate nucleus (planning initiation - control voluntary)
- interposed nucleus = emboliform + globus nucleus (comparator - adjust limb position)
- fastigial nucleus (balance / gait)

Front 408

[cerebellar cortex outputs]
Dentate nucleus
- terminates (2x)
- peduncle
- function

Back 408

Dentate nucleus
- terminates (2x) [contralateral red nucleus and thalamus]
- peduncle [superior cerebellar]
- function [PLANNING inititation - control voluntary movements]

Front 409

[cerebellar cortex outputs]
Interposed nucleus = emboliform + globus nucleus
- terminates
- peduncle
- function

Back 409

Interposed nucleus = emboliform + globus nucleus
- terminates [interposesed nucleus]
- peduncle [superior cerebellar - descending limb]
- function [comparator - adjusts limb position]

Front 410

[cerebellar cortex outputs]
Fastigial nucleus
- terminates
- peduncle
- function

Back 410

Fastigial nucleus
- terminates [bilateral to vertibular nuclei - reticular formation]
- peduncle [inferior cerebellar peduncle]
- function [balance and gait]

Front 411

Most common form of ataxia (Aberrant regulation of limb movements w/poor coordination btw limbs)

- from dysfunction in cerebellum - or afferent / efferent pathways

Back 411

Cerebellar ataxia

Front 412

what is ataxia

Back 412

Aberrant regulation of limb movements w/poor coordination btw limbs

Front 413

what is
Posterior lobe syndrome

Back 413

Loss of coordination of voluntary movements
↓ muscle tone
Back-forth movements perpendicular to intended direction of movement

Front 414

what is anterior lobe syndrome

Back 414

gait messed up - all over - like your drunk

from malnutrition in chronic alcoholism

Front 415

what is
Flocculonodular lobe syndrome

Back 415

Truncal ataxia

Lesion in flocculonodular lobe AND posterior VERMIS


Seen in children w/medulloblastomas in roof of 4th ventricle

Front 416

in coordinating movement - what role do the basal ganglia and cerebellum play generally

Back 416

basal ganglia - inhibitory (via thalamus)

cerebellum - excitatory (via thalamus)

Front 417

where does the neuron that leaves the motor cortex synapse?

Back 417

anterior horn cell

Front 418

what 1950s neurosurgeon that tried to fix epilepsy make maps of the brain?

Back 418

Wilder Penfield

Front 419

Visual cortex is in what lobe

Back 419

occipital

Front 420

auditory is in what lobe

Back 420

temporal

Front 421

olfactory is in what lobes

Back 421

inferior frontal
medial temporal

Front 422

which hemisphere does language

Back 422

the dominant one

Front 423

how many layers does the cerebral cortex have?

Back 423

6

Front 424

what are the 3 formal and 2 additional parts of a mini mental status exam (Folstein exam)

Back 424

orientation (person-you / place-floor,country,state / time)

registration (remember 3 words apple/ball/tree - check in 3 min)

attention (getting what you say to them)

_____________________________________________
calculation (how many quarters in $3.75)

visuo-spatial - draw clock

Front 425

what lobe is Wenikies area in?
do?

Back 425

posterior 1/3 of superior temporal gyrus
like dictionary for word meanings

Front 426

what lobe is Broca's area in?
do?

Back 426

frontal lobe

coordinates motor parts of language (speaking)

Front 427

Wernies aphasia
- where is problem?
- what happens (Sx)

Back 427

temporal lobe
- sub in wrong word or letter
- or make up new word

Front 428

what is
apraxia

Back 428

cant do learned movement correctly

Front 429

what is
transitive apraxia

Back 429

use toothbrush instead of spoon

Front 430

what is
ideomotor apraxia

Back 430

dont know the mechanics of how to eat the corn

Front 431

what is agnosia

Back 431

no knowledge / cant recognize

Front 432

what is
Anosognosia

Back 432

doesnt know they are sick

Front 433

what is
Aprosopagnosia

Back 433

Cant ID face - ID person based on facial features

Front 434

what happens in pts w/ neglect agnosia?
what is usually caused by

Back 434

neglect one side of the body
usually from visual field defect

Front 435

what is
Asomatagnosia

Back 435

Asomatagnosia

Front 436

what is this:
i. Lesion of the NON dominant parietal lobe
ii. 4 parts to it
1) Acalculia - cant calculate anything
2) Finger agnosia - cant distinguish anything
3) Right-left confusion - cant distinguish btw right and left
4) Agraphia - cant write

Back 436

Von-gerstmann

Front 437

what is
Agraphia

Back 437

cant write

Front 438

where would the lesion be
- talk forever
- hypersexuality

Back 438

temporal lobe

Front 439

where would the lesion be
- cant get calm
- dont care how they look

Back 439

frontal lobe

Front 440

left of right brain?
musical, artistic, big picture

Back 440

right

Front 441

left of right brain?
logic

Back 441

left

Front 442

left brain is?

Back 442

logic

Front 443

right brain is?

Back 443

music / art / big picture

Front 444

the hippocampal gyrus does what

Back 444

short term memory

Front 445

what transfers information L/R btw hemispheres (structure)

Back 445

corpus callosum

Front 446

4 main parts to bedside neuro exam

Back 446

orientation
aphasia
corital sensory (put object in hand)

Front 447

match the problem (motor/cognitive)
with
cerebral palsy
mental retardation

Back 447

motor = CP
cognitive = MR

Front 448

what causes
Cerebral palsy
generally

Back 448

Brain injury btw fertilization & infancy

Front 449

sensory or motor?
anterior horn cell

Back 449

motor

Front 450

how long is the spinal cord?

Back 450

22 inches

Front 451

how many levels in each of the 5 sections of the spinal column

Back 451

cervical - 8
thoracic - 12
lumbar - 5
sacral - 5
coccygeal - 1

Front 452

ascending spinal cord tracts are long and
- do?
- project to (3x)

Back 452

- sensory
project to
- thalamus
- cerebellum
- brainstem nuclei

Front 453

descending spinal cord tracts are long and
- do?
- project from(2x)
- to?

Back 453

motor
from
- cerebral cortex
- brainstem nuclei
- spinal gray matter

Front 454

posterior columns - of spinal cord
- ascending or descending
- carry (3x)
- ipsi or contra lateral?
- how many neurons

Back 454

ascending
carries
- position
- vibratory senses
- touch sensations

ipsilateral
3 neurons

Front 455

what track?
fasiculus cuneatus (nucleus cuneatus in medulla)

what does it carrier

Back 455

posterior columns

fibers from sacral/lumbar/thoracic

legs
thorax
trunk

Front 456

what track?
fasiculus gracilis (nucleus gracilis in medulla)

what does it carrier

Back 456

posterior columns

fibers from cervical levels

hand
arms
neck

Front 457

what does the Corticospinal tract
- do?
- how many neurons?
- ipsilateral or contralateral

Back 457

corticospinal tract
- voluntary motor (descending pathway)
- 2 neurons (precentral gyrus to anterior horn to muscle)
- ipsilateral (crosses before cord - in the medulla

Front 458

where does the corticospinal tract cross?
is it ipsilateral or contralateral

Back 458

crosses in the the pyramidal decussation of the medulla

considered ipsilateral (same side) because it crosses before the cord

Front 459

where are the face fibers in the internal capsule?

Back 459

at the bend (genu)

Front 460

what is the
corticobulbar

Back 460

connects cerebral cortex and brainstem

Front 461

what are upper and lower neurons

Back 461

NOT level in spine

upper - precentral gyrus to anterior horn (in brain)
lower - anterior horn to muscle (in spinal cord)

Front 462

big MOTOR nerve to face

Back 462

CN VII - facial

Front 463

Babinski's sign - bottom of foot
if + is a sign of upper/lower motor neuron problem

Back 463

upper

Front 464

fasiculations (muscle twitch) is a sign of upper/lower motor neuron problem?

Back 464

lower

Front 465

name the tract

Back 465

spinothalamic tract

Front 466

what is
Brown Séquard syndrome

Back 466

half the spinal cord is crushed

Front 467

3 parts of the
Equilibrial triad

Back 467

1 - proprioceptive system
2 - visual system (CN II)
3 - vestibular system (CN VIII)

Front 468

what are the 3 parts of the bony labyrinth

Back 468

- vestibule
- semicircular canals
- cochlea

embeded in the petrous portion of the temportal bone

Front 469

what part of what bone does the bony labyrinth reside in

Back 469

petrous portion of the temportal bone

Front 470

A

Back 470

malleus

Front 471

B

Back 471

incus

Front 472

C

Back 472

stapes

Front 473

D

Back 473

eustachean tube

Front 474

E

Back 474

cochlear

Front 475

F

Back 475

semicircular canals

Front 476

G

Back 476

vestibular nerve

Front 477

H

Back 477

facial nerve

Front 478

I

Back 478

auditory nerve

Front 479

what is the ampulla in the semicircular ducts and where are they found

Back 479

there are 3 - one at the end of each semicircular duct
- horizontal
- anterior
- posterior

they are where the crista or actual sensors are

Front 480

A

Back 480

cochlear duct

Front 481

B

Back 481

saccule

Front 482

C

Back 482

utricle

Front 483

D

Back 483

anterior semicircular duct

Front 484

E

Back 484

posterior semicircular duct

Front 485

F

Back 485

horizontal semicircular duct

Front 486

G

Back 486

ampulla
of posterior semicircular duct

Front 487

H

Back 487

oval window

Front 488

I

Back 488

round window

Front 489

what is the bony labyrinth filled with (its like CSF)?
what electrolytes are high/low - Na / K

Back 489

perilymph
- like normal extracellular fluid
- high [Na]
- low [K]


continuous w/subarachnoid space

Front 490

what / where is the membranous labyrinth?

Back 490

closed tube inside bony labyrinth
(purple in pic)

Front 491

what is the membranous labyrinth filled with?
what are [Na and K]

Back 491

endolymph

like intracellular fluid
- high [K]
- low [Na]



bony labyrinth :
perilymph
- like normal extracellular fluid
- high [Na]
- low [K]

Front 492

what do the Semicircular ducts do?

Back 492

detect motion (by rotation in the 3 planes)

Front 493

what are the / what do they do?
- crista
- cupula

what are they in specifically? which is at the end of what? which do what?

Back 493

crista - bump that holds the receptor cells

cupula - is the thing that moves in the fluid (endolymph - high K, low Na)

this is in the ampulla which is at the end of the semicircular tubes which sense movement

Front 494

what is a tip link?
what is it on?
what does it do - specifically and as part of what generally

Back 494

connects stereocilia in the cupula which connect to the crista and sense motion in the semicircular ducts which is part of the inner ear

Front 495

what are the specific steps to the mechano-electrical transduction of movement in the ampulla of the semicircular ducts

Back 495

1 - deflection
2 - tip link pulls open K channels
3 - K enters from endolymph
4 - HAIR CELL depolarizes
5 - voltage-gated Ca channels open
6 - release neurotransmitter glutamate (CN VIII - vertibular nerve) - afferent

Front 496

the utricle and saccule detect what?

Back 496

linear motion

Front 497

what are the otoconia?

what are they part of / do?

Back 497

crystals (calcium carbonate) that sit on gel layer - gives mass to the gel and hair cells

otolithic organ - detects linear motion

Front 498

what is the actual cell type that detects the motion of the gel in the otolithic organs (linear) and semicircular ducts (rotation)?

Back 498

hair cells

Front 499

the macula of the
saccule
detects acceleration in the __________ plane

Back 499

sagittal

saccule = sagittal

Front 500

saccule = ?

Back 500

saccule = sagittal

Front 501

the macula of the
utricle
detects acceleration in the __________ plane

Back 501

horizontal

Front 502

detects motion in what plane
saccule =
utricle =

Back 502

saccule = sagital
utricle = horizontal

Front 503

what ganglion does information from the utricle / saccule (linear), and semicircular ducts (rotation) go through?

Back 503

vestibular ganglion (Scarpa's ganglion)

Front 504

what 2 things does the MVST (medial vestibulospinal tract) do

Back 504

- stabilizes head position
- coordinates eye movement

Front 505

what does the LVST (tract) - lateral vestibulospinal tract - do?

Back 505

postural compensation

Front 506

what function does the
Vestibuloocular reflex
allow for?

Back 506

Gaze can stay fixed on an object while the head is moving; Doll's Eye Movement

Front 507

what is nystagmus

Back 507

eyes keep tracking an object / movement that is no longer moving

Front 508

if you squirt COLD water into right ear (of comotose pt), which way will eyes go if brainstem intact

* if lying supine

Back 508

cold in right
think head is going left
eyes rotate right

for direction head thinks its going
COWS = cold opposite / warm same

Front 509

if you squirt WARM water into right ear (of comotose pt), which way will eyes go if brainstem intact

* if lying supine

Back 509

cold in right
think head is going right
eyes rotate left

for direction head thinks its going
COWS = cold opposite / warm same

Front 510

what is
Benign paroxysmal positional vertigo (BPPV)?

what causes it?
Tx?

Back 510

feels like moving when not

caused by
- otoconia (crystals) being dislodged - moves to semicircular ducts (usually posterior) - bumps the cupula

Tx
- canalith repositioning procedure (CRP)
- drugs for Sx

Front 511

why / how (MOA) does alcohol cause vertigo?

Back 511

changes blood density
- alcohol enters endolymph (causes cupula to float)
- then alcohol leaves - cupula sinks - feels like rotation

Front 512

what is
Proprioception

Back 512

sense of position

Front 513

what is kinesthesia

Back 513

sense of movement

Front 514

what structure
monitors the strength of muscle contraction

Back 514

golgi tendon organs

Front 515

what mechanoreceptor senses vibration and pressure

Back 515

Pacinian corpuscles

Front 516

what do Pacinian corpuscles do?

Back 516

mechanoreceptors that sense vibration and pressure

Front 517

what do Muscle spindles sense?

Back 517

STRETCH

Front 518

what is this:

a) In SERIES with muscle fibers
b) When the muscle contracts they bunch up and do nothing
c) They are STRETCH receptors

Back 518

muscle spindle fibers

Front 519

name the mechanoreceptor
- stretch
- strength of contraction

Back 519

- stretch (stretch)
- strength of contraction (golgi tendon)

Front 520

where does CONTROL of muscle movement come from

Back 520

spinal cord


regulation is farther up

Front 521

1 alpha motor unit = _____________ + ______________

Back 521

1 alpha motor unit = neuron + all muscle fibers it innervates

Front 522

describe the general steps of a spinal motor reflex

Back 522

i. Produces 1 motor response - same 1 over and over
1) Begins w/stim to a sensory receptor (ex: muscle spindle)
2) An afferent pathway to the CNS
3) 1+ synapses in the CNS
4) An efferent pathway to the periphery
5) An effector (the muscle)

Front 523

what mechanoreceptors sense
velocity
length
of stretch

Back 523

muscle spindles

Front 524

what mechanoreceptors sense
load
force
being applied to muscle

Back 524

golgi tendon organs

Front 525

how do distal limb and proximal limb motor nuclei spatial relate in the spinal cord?

Back 525

medial = proximal
lateral = distal

Front 526

what are
intrafusal muscle fibers

Back 526

all muscle fibers (cells) that are INSIDE the muscle spindle (group Ia, group II)

Front 527

what are
extrafusal muscle fibers

Back 527

all (most) muscle fibers that are outside the spindle

Front 528

what are
Group Ia fibers

where are they found?

Back 528

FAST adapting
signal RATE of stretch

Front 529

what are
Group II fibers

where are they found?

Back 529

slow / long firing

only innervates nuclear chain fibers

Front 530

for motor efferent (input)

compare alpha and gamma motorneuron input

both
- are lower motor neurons
- have cell bodies in the anterior horn

Back 530

alpha
- east to stim
- innervates EXTRAFUSAL fibers
- when fires => tension / shortens fibers

gamma
- only gets stim from HIGHER brain centers
- innervates INTRAFUSAL muscle fibers
- keep the sensing fibers taught

Front 531

what does the static stretch reflex do?

Back 531

increases muscle tonw
also - if bone grows - causes muscle to grow and activates group II sensory fibers

Front 532

what is this

Back 532

stretch reflex

Front 533

what do each measure
Group Ia

Group II

Back 533

Group Ia - Rate of stretch
Group II - Length of fiber

Front 534

what do gamma efferents do

Back 534

since the intrafusal fibers slacken when the muscle contracts - the gamma efferents tell them to tighten so they can sense changes again

Front 535

where do gamma fibers that keep the intrafusual sensory fibers taught get their stim from?

Back 535

cerebellar (CNS)

Front 536

what specific neuron types are involved in a stretch reflex like the patellar reflex

Back 536

group 1a - sends signal through posterior horn
synapses with alpha motor neuron in the anterior horn

Front 537

what is feed forward inhibition

Back 537

relaxes antagonist muscle

Front 538

what do golgi tendon organs do?

Back 538

- prevents muscle from being torn
- sensory information of heaviness/resistance to CNS

Front 539

what fiber group does golgi tendon organs use to send info to cord

Back 539

group Ib

Front 540

how does a golgi tendon reflex work

Back 540

through an inhibitory interneuron

which inhibits the alpha motor neuron telling it to relax so it doesnt tear

Front 541

where is the center of mass in the human body

Back 541

S2

Front 542

what are the 5 antigravity muscles

Back 542

- gastroc-soleus
- quadriceps
- hip extensors
- paraspinals
- neck extensors

Front 543

what is the crossed extensor reflex

Back 543

ex - step on tack

inhibits one sides hip extensor, and stims the other side

Front 544

relating to vertigo
Of those who fall (sustain hip fracture __% will die)

Back 544

relating to vertigo
Of those who fall (sustain hip fracture 49% will die)

Front 545

#1 complaint pts 70+

Back 545

vertigo

Front 546

true vertigo

Back 546

vestibular disorder
- sensation of spinning - from asymmetrical impulses from vestibular system
- nystagmus (rapid jerking of eyes)

Front 547

Most common peripheral vertigo

Back 547

Benign paroxysmal positional vertigo (BPPV)

Front 548

what is the mechanism that causes
Benign paroxysmal positional vertigo (BPPV)

Back 548

Abnormality in association of otoconia to the cupula - in the membranous labyrinth

→ resulting in abnormal responses to endolyph movement with head motion

Front 549

Dix-Hallpike test
tests for?

Back 549

Benign paroxysmal positional vertigo (BPPV)

Front 550

THE Tx for BPPV?

Back 550

Gans repositioning maneuver

brings debris back to neutral
hold each of the 3 positions for 30s

Front 551

Dx?

i. Sudden episode of vertigo
1) w/o hearing loss or tinnitus
2) Single or mult
3) Herpes simplex II virus
4) Spring/early summer
a) From/with upper respiratory tract infection
5) n-v
6) Followed by BPPV

Back 551

Vestibular neuronitis/neuritis

Front 552

Dx?

i. Sudden profound loss in
1) Auditory
2) Vestibular function
ii. Old ppl
1) Young = w/ atherosclerotic or hypercoagulation disorders
iii. Episodic vertigo - may be precede complete occlusion
iv. After complete occlusion
1) Vertigo subsides
2) Leaves unsteadiness/dysequilibrium - several months while compensates

Back 552

Labyrinthian infarction

Front 553

a Sx triad of:
- vertigo
- tinnitus
- hearing loss

suggests what disease that has too much endolymph (too much production or too little resorption)

20's and 30's

Back 553

Meniere's disease

Front 554

* how Dx Meniere's disease

Back 554

cold air into ear = opposite

Front 555

a migraine with aura - what is aura

Back 555

hallucinations
- abnormal sensory perceptions (visual most common)

Front 556

what is
Mal de Debarquement

Back 556

motion (swaying/rocking) after disembarkment

Front 557

* what is the gold standard Dx for acoustic neuroma (schwannoma of the 8th CN)

Back 557

MRI of IACs w/gadolinium

Front 558

what is #1 complaint of pts over 70 y/o

Back 558

dizziness (vertigo)

Front 559

* when you have less than 3 of the fall factors what is the changes you are going to fall?

Back 559

12%

Front 560

* spinning inside the head is/is not a vestibular problem

Back 560

is NOT
is a psych problem

Front 561

* best way to test for position vertigo (what test)?

Back 561

Hallpike test

Front 562

* best Tx for BPPV

Back 562

Gans (Canalith) repositioning maneuver

Front 563

word?
Any restriction resulting from an impairment of an ability to perform a normal activity

Back 563

disability

Front 564

what is the difference btw impairment, disability, and handicap?

Back 564

impairment - loss / abnormality of pysch / physical / anatomical function

disability - restriction from impairment

handicap - disadvantage from impairment / disability

Front 565

4 musculoskeletal uses of heat Tx

Back 565

tendonitis
tenosynovitis
bursitis
capsulitis

Front 566

what is
Contracture

Back 566

a permanent shortening of a muscle or joint.



It is usually in response to prolonged hypertonic spasticity in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like spastic cerebral palsy.

Front 567

what does each neuromuscular fiber group carry

group 1a
group 2
group 1b

Back 567

group 1a - muscle length, as well to change in velocity, rapidly adapting
group 2 - position sense
group 1b - Golgi tendon organ (tenses spindle fibers)

Front 568

compare the effects of hot and cold Tx

Back 568

Front 569

main uses of heat Tx (x)

Back 569

- chronic inflammation
- tendonitis
- tenosynovitis
- bursitis
- capsulitis

Front 570

* who (roles/titles) of the 4 team members in occupational therapy. name who does each of the listed

- hygienic factors, meds management, safety
- counseling, testing
- total living situation, coordinate return to home
- assess level of social capability / educate in leisure activities

Back 570

rehabilitation nurse - hygienic factors, meds management, safety

psychologist - counseling, testing

social worker - total living situation, coordinate return to home

recreational therapis - assess level of social capability / educate in leisure activities

Front 571

what is the difference btw an abrasion and a laceration?

Back 571

abrasion - scrape on skin
laceration - NOT cut wound - blunt object breaks / tears skin

Front 572

what is a contusion

Back 572

bruise

Front 573

name for bruise / black and blue

Back 573

contusion

Front 574

name for:
a. Blunt object tears soft tissue
b. NOT a cut wound

Back 574

laceration

Front 575

what is this

Back 575

laceration

- irregular margins
- skin torn from being hit by a blunt object

Front 576

what is a
spectacle hematoma

what is it commonly seen with

Back 576

bleeding around eyes
commonly seen w/gunshot wound to head - pressure wave from bullet blows out orbital plates

Front 577

what are
terminal fall injuries
caused by

Back 577

from the impact of a fall after LOSS OF CONSCIOUSNESS

Front 578

what are the 5 types of facial fractures

Back 578

- dentoalveolar
- LeFORT I
- LeFORT II
- LeFORT III
- sagital

Front 579

what is a dentoalveolar facial fracture?

Back 579

fragments mandible / teeth
- direct force anterior / lateral

Front 580

what is a LeFORT I facial fracture?

Back 580

TRANSVERSE fracture of the MAXILLA

above teeth
through nasal septum / maxillary sinuses / palatine bone of the sphenoid bone

[red line]

Front 581

what is a LeFORT II facial fracture?

Back 581

[blue line]

near zygomatic/maxillary suture
- inferior orbit/orbital floor
- nasal bones / septum

Front 582

LeFORT III fracture - where?

Back 582

[green line]

high transverse fracture
- maxilla
- through nasofrontal suture / medial orbital wall / frontozygomatic suture
- sphenoid bone

Front 583

where is sagital fracture

Back 583

in sagital plane
- through maxilla
- high death rate

Front 584

compare / location of
LeFORT I, II, III fractures

Back 584

I - red
II - blue
III - green

Front 585

what is this showing?

Back 585

LeFORT facial fractures
I - red
II - blue
III - green

Front 586

what is a
Subgaleal hematoma

Back 586

bleeding under the galea aponeurotica (fiberous layer on top of skull)

Front 587

name for
bleeding under the galea aponeurotica (fiberous layer on top of skull)

Back 587

Subgaleal hematoma

Front 588

battle sign
- what is it
- what does it indicate

Back 588

contusion behind the ear
- basilar skull Fx

Front 589

what is
ecchymosis

Back 589

a hematoma
- subcutaneous purpura (extravasion of blood) larger than 1 cm

Front 590

periorbital ecchymosis
- what is it
- what could it indicate

Back 590

bruising around the eye
- Fx of the orbital roof

Front 591

what is a ring Fx

Back 591

jump out of house - spinal column goes up into foramen magnum

Front 592

what is usually the source of an epidural hematoma (EDH)

Back 592

arteriole

skull fractures - meningeal artery ruptures and blood pours in

Front 593

besides above/below the dura, what is the difference(s) btw epidural and subdural hematoma

Back 593

EDH
- from skull Fx that causes arteriole bleed
- surface is FLAT

SDH
- from tears in bridging veins- slowly accumulate blood
- has UNDULATING surface

Front 594

what is
Subarachnoid hemorrhage (SAH)

Back 594

hemorrhage btw arachnoid and cerebral cortex

from berry aneurysm or trauma or AVM (arteriovenous malformation)

Front 595

what is a hemorrhage btw arachnoid and cerebral cortex called

Back 595

Subarachnoid hemorrhage (SAH)

Front 596

is a coup contusion

Back 596

stationary head is hit

Front 597

what is
contra coup contusion

Back 597

head hits stationary something (ground)

Front 598

what type of movement causes
Intermediary coup contusions

Back 598

rotation

Front 599

what type of contusion might this be

Back 599

contra coup (head hit stationary ground)

Front 600

what is the orange spot?
what might this mean

Back 600

Hemosiderin = old contra coup contusion

a) Often from falling off barstool backwards
b) May impair ability to smell

Front 601

Hemosiderin = old ____________ ______________

a) Often from falling off barstool backwards
b) May impair ability to smell

Back 601

Hemosiderin = old contra coup contusion

a) Often from falling off barstool backwards
b) May impair ability to smell

Front 602

does a concussion cause functional or structural damage to the axon

Back 602

functional

Front 603

when the brain is accelerated side to side this causes what type of injury to the axons

Back 603

diffuse axonal injury (DAI)

or

gliding contusions (glides under dura)

Front 604

Dx (name of injury type)

- axon swelling
- axonal bulbs (Cytoarchitecture and neurofilaments disturbed)
- 2-3hrs post injury - beta amyloid precusror protein

Back 604

Diffuse axonal injury (DAI)

usually in white matter tracts due to high density of axons

Front 605

Dx?
- SDH (subdural hematoma) / brain swelling
- retinal / optic nerve injury (RED FLAG if there - not always there)
- may have gripping injury from SQUEEZED
- ↑ ICP (from BBB disruption)

Back 605

shaken baby syndrome (SSS)

Front 606

Dx?

Back 606

shaken baby syndrome (SSS)



- SDH (subdural hematoma) / brain swelling
- retinal / optic nerve injury (RED FLAG if there - not always there)
- may have gripping injury from SQUEEZED
- ↑ ICP

Front 607

where / what herniates in a transtentorial herniation

why do you observe pupillary dilation on side of lesion

from ↑ ICP

Back 607

temporal compressed agains tentorum

CN III (occulomotor) compressed)

Front 608

what is respirator brain?

Back 608

hypoxia-ischemia

24-48hrs post insult - swollen necrosis

Front 609

word for:
a. Set of characteristics/traits that distinguish 1 person from the next
b. Traits seen consistently 1 day to the next
i. Traits established by late adolescence/early adult

Back 609

personality

Front 610

what is
Personality disorder

Back 610

when ones characteristic traits become MALADAPTIVE

Front 611

what is
ego syntonic

ego dystonic

Back 611

ego syntonic
- when ones maladaptive characteristic traits are NOT DISTRESSING to the individual

ego dystonic - when they ARE distressing

Front 612

what are the 3 three letter words that describe the 3 clusters of personality disorders

Back 612

MAD
BAD
SAD

Front 613

what are the 2 cluster A
MAD
personality disorders

Back 613

paranoid personality disorder

schizoid personality disorder

Front 614

what are the 4 cluster B
BAD
personality disorders

Back 614

antisocial
borderline
histionic
narcissistic

personality disorders

Front 615

what are the 3 cluster C
SAD
personality disorders

Back 615

avoidant
dependent
obsessive-compulsive

personality disorders

Front 616

If family Hx alcohol/substance abuse
more likely to have what personality disorder?

Back 616

antisocial personality disorder

Front 617

what is a typical phyiscal exam finding for pts w/personality disorders

Back 617

smooth eye pursuit - eyes shift back and forth

Front 618

name the personality disorder and name the cluster:
- inappropriate distrust of everyone
- ALWAYS guarded - hard to find friends/ significant others

Back 618

paranoid personality disorder

MAD

Front 619

name the personality disorder and name the cluster:
- loners
- cold and detached
- IT ppl
- very active fantasy life
- may have affection for pet
- if stressed - can decompensate and become psychotic

Back 619

schizoid personality disorder

MAD - cluster A

Front 620

name the personality disorder and name the cluster:
- illegal acts
- social irresponsible
- shows Sx <15yo - school late / always in trouble / rules not made for me
- criminal in adult life
- make up own rules - sopranos / godfather
- substance abuse common
M > F (3:1)

Back 620

antisocial personality disorder

BAD - cluster B for bad

Front 621

name the personality disorder and name the cluster:
- unstable mood - shifts minute to minute
- impulsive
- feel alone even if not (manipulative so not alone - aloness distressing / depressing / suicidal to get attention)
F > M (2:1)

- very common / well studied

Back 621

borderline personality disorder

BAD - cluster B
- all bad one minute
- all good the next

Front 622

name the personality disorder and name the cluster:
- focused only on self (appearance / how much attention they are getting)
- entire being based on physical attractiveness
F > M
- seductive in look and speech

Back 622

histionic personality disorder

BAD - cluster B

Front 623

name the personality disorder and name the cluster:
- self absorbed
- entranced w/own success (always need to be more successful / everyone needs to see how awesome they are)
- no apathy for anyone else (cant challenge them)

Back 623

narcissistic personality disorder

BAD - cluster B

Front 624

name the personality disorder and name the cluster:
- excessive discomfort in ANY relationship
-feel they will be humiliated / rejected if enter relationship
- seem shy / awkward
- WANTS to have relationship - just too afraid of rejection / humiliation
- like women but all fantasy - not in reality

Back 624

avoidant personality disorder

SAD - cluster C

Front 625

name the personality disorder and name the cluster:
- turns everything in life over to SOMEONE ELSE
- afraid of being alone - will stay in abusive relationship
- depressed (esp if separated)
- common in medical relationships (no doctor, you tell me what to do)

Back 625

dependent personality disorder

SAD - cluster C

Front 626

name the personality disorder and name the cluster:
- perfectionists
- standards - little room for compromise
- preoccupied w/rules and trivial details
- compulsive / organized / structure - inflexible
- cant delegate responsibilities - must do self
- too focused on 1 thing - interferes w/relationships

Back 626

obsessive-compulsive personality disorder

SAD - cluster C

Front 627

what are the 3 SAD - cluster C personality disorders
and generally what are they about

Back 627

avoidant - want relationships but fear rejection / humiliation

dependent - turn everything over to someone else / abused will stay

obsessive-compulsive - perfectionists / must do self / rules and details

Front 628

what are the 2 MAD - cluster A personality disorders
and generally what are they about

Back 628

paranoid - distrust everyone

schizoid - cold detached loner w/active fantasy life

Front 629

what are the 4 BAD - cluster B personality disorders
and generally what are they about

Back 629

antisocial - criminal / substance abuse / own rules / me 1st [M 3:1]

borderline - impulsive mood shift minute to minute [F 2:1]

histionic - focused ONLY on looks / self appearance

narcissistic - entranced w/own success

Front 630

name the personality disorder
- resists authority other people have
- EX - have deadline just not going to do it
- EX - needs to be done a certain way but does it own way anyway

Back 630

passive aggressive

Front 631

name the personality disorder
- basic personality is just down

Back 631

depressive personality

Front 632

A hydrodynamic disorder of the cerebrospinal fluid that leads to an increase in the volume occupied by this fluid in the central nervous system

Back 632

Hydrocephalus

Front 633

what is
Hydrocephalus

Back 633

CSF takes up more volume in CNS

Front 634

what are the 5 steps of CSF flow?

Back 634

lateral ventricles
→ foramen of Monro
→ 3rd ventricle
→ cerebral aqueduct
→ 4th ventricle

Front 635

how is hydrocephalus Dx? (radio/Sx)

Back 635

clinically (Sx)

ventriculomegaly can be normal (radio finding)

Front 636

what is communicating hydrocephalus

Back 636

large ventricular system
- no closed ducts
- lots of CSF

Front 637

how do pts w/obstructive hydrocephalus present

Back 637

lethargic / comatose - must be relieved (by catheter)

Front 638

*** how does normal pressure hydrocephalus present

Back 638

clinical triad
- gait disturbance
- slow thoughts / actions / dementia
- urinary incontinence


from resistance to CSF flow

Front 639

these Sx might suggest what type of hydrocephalus:

headache
nausea
ataxia
vision disturbance
neck pain

Back 639

high pressure hydrocephalus

Front 640

what is
Hydrocephalus Ex vacuo

Back 640

brain shrinks w/age - fills w/fluid
NOT hydrocephalus

Front 641

how Tx hydrocephalus

Back 641

- lumbar puncture
- 3rd ventriculostomy (endoscopic)
- remove obstruction
- shunting (catheter w/valve)

Front 642

Dx?

a. Clinical Presentation (there will likely be a question about this on the test)
i. Headache
ii. Nausea
iii. Ataxia
iv. Disturbance of vision
v. Neck pain
vi. These are the typical things, and they’re generally not focal neurologic problems that they have – patients just feel lousy

Back 642

hydrocephalus

Front 643

what is the usual cause of hydrocephalus (overproduction or underabsorption or blockage)

Back 643

underabsorption or blockage