Clinical Neurology Exam One

Front 1

________ forms neuroblasts

Back 1

neuroepithelial layer around central canal

Front 2

Hindbrain

Back 2

Metencephalon
Myencephalon

Front 3

Metencephalon

Back 3

pons, upper medulla, cerebellum, 4th ventricle

Front 4

Myencephalon

Back 4

lower medulla

Front 5

Midbrain

Back 5

midbrain, cerebral aqueduct

Front 6

Forebrain

Back 6

telencephalon
diencephalon

Front 7

telencephalon

Back 7

cerebral hemispheres (basal ganglia, cerebral cortex, lateral ventricles)

Front 8

diencephalon

Back 8

thalamus, hypothalamus, 3rd ventricle

Front 9

Spina bifida occulta

Back 9

neural tissue does not protrude through bony defect

Front 10

Meningocele

Back 10

protusion of meninges through bony defect

Front 11

meningomyelocele

Back 11

neural tissue and meninges through bony defect

Front 12

myeloschisis

Back 12

malformed spinal cord open to surface of body

Front 13

Lobes of cerebral cortex

Back 13

1. frontal
2. parietal
3. occipital
4. temporal
5. limbic
6. insular

Front 14

Lamina terminales

Back 14

end of neural tube between anterior commissure and optic chiasm

Front 15

calcarine fissure

Back 15

visual processing

Front 16

Middle Cerebral Artery
Supplies:
Infarct:

Back 16

Supplies: lateral cerebral cortex and internal capsule
Infarct:
- before striate aa. - arm, leg, head
- after striate aa. - arm head

Front 17

Anterior Cerebral Artery
Supplies:
Infarct:

Back 17

Supplies: medial aspect of brain
Infarct: leg involvement

Front 18

Anterior Choroidal Artery
Supplies:
Involved in:

Back 18

Supplies: choroid plexus of lateral ventricle, optic tract and hippocampus
Involved In: Memory

Front 19

Posterior Communicating Artery
Connects:

Back 19

internal carotid system to vertebral system

Front 20

Ophthalmic Artery
Supplies:

Back 20

eyes

Front 21

PICA
Supplies:

Back 21

Supplies: inferior cerebellum, choroid plexus of 4th ventricle, dorsal portion of medulla

Front 22

Anterior Inferior Cerebellar Artery
Supplies:

Back 22

cerebellum and medulla

Front 23

Superior Cerebellar Artery

Back 23

cerebellum

Front 24

Posterior Cerebral Artery
Supplies:

Back 24

occipital lobes, posterior parietal

Front 25

Posterior Choroidal Artery
Supplies:

Back 25

choroid plexus of 3rd ventricle

Front 26

Circle of Willis
Arteries

Back 26

1. Anterior Cerebral A. (2)
2. Internal Carotid A. (2)
3. Posterior Cerebral A. (2)
4. Anterior Communicating A.
5. Posterior Communicating A. (2)

Front 27

Vertebral Artery Dissection

Back 27

sever vertebral artery/ common in cervical manipulation

Front 28

Vertebrobasilar stroke

Back 28

ischemia/ ataxia (lack of coordination)/ affects cerebellum/ rapidly altering movements

Front 29

Anterior Cerebral stroke

Back 29

see effects in leg - contralateral

Front 30

MCA

Back 30

hands/face, possible leg involvement, affects speech and language

Front 31

PCA

Back 31

visual disturbance, bilateral, cortical blindness, can't interpret what they see, hemiplegia and hemianopsia

Front 32

Macroglia

Back 32

oligodendrocytes, Schwann cells, astrocytes

Front 33

Microglia

Back 33

phagocytes

Front 34

Myelination: motor roots

Back 34

5FM - 2 mos

Front 35

Myelination: sensory roots

Back 35

6 FM - 7 mos

Front 36

Medial Lemniscus

Back 36

- dorsal column, 2 pt differentiation, position sense, vibration, discriminative touch
- 7 FM - 2 yr

Front 37

Cerebellar Peduncles

Back 37

- Coordination of movement
- 8 FM - 4 yo

Front 38

Reticular System

Back 38

- keeps you alert
- 1 mos - 10 yo

Front 39

Corticospinal tracts

Back 39

- main motor
- 9 FM - 3 yo

Front 40

Corpus Callosum

Back 40

- connection b/w 2 hemispheres
- 3 mos - 30 yo

Front 41

Normal electrical potential of a cell

Back 41

- 60 to -80 mV

Front 42

Types of gated channels

Back 42

1. modality gated
2. ligand gated
3. voltage gated

Front 43

temporal summation

Back 43

stimulation at same place repeatedly

Front 44

spatial summation

Back 44

stimulation to multiple places at once

Front 45

Types of forces

Back 45

1. diffusion
2. electrostatic

Front 46

Diffusion

Back 46

passive, high to low concentration

Front 47

Electrostatic Pressure

Back 47

like charges repel

Front 48

axoplasmic resistance

Back 48

more resistance makes it harder to charge to travel on the membrane; many molecules that are not conductive

Front 49

Membrane resistance

Back 49

needs increased input to form action potential

Front 50

Membrane capacitance

Back 50

stored charge

Front 51

Guillan-Barre Syndrome

Back 51

peripheral; autoimmune

Front 52

Multiple Sclerosis

Back 52

central; oligodendrocytes

Front 53

Receptor Types

Back 53

1. ligand-gated: nt, direct
2. G-protein activated: 2d messenger, channels open longer

Front 54

Cholinergic: Acetylcholine

Back 54

1. muscarinic
2. nicotinic

Front 55

muscarinic

Back 55

cerebral cortex, midbrain, postganglionic parasympathetic, some postganglionic sympathetic

Front 56

nicotinic

Back 56

NMJ, all preganglionic parasympathetic and sympathetic

Front 57

Amino Acid Transport Substances

Back 57

1. GABA
2. Glutamate
3. Glycine

Front 58

GABA

Back 58

always inhibitory, all over CNS

Front 59

Glutamate

Back 59

always excitatory, all over CNS

Front 60

Glycine

Back 60

inhibitory in SC and lower brainstem

Front 61

Amines

Back 61

1. Dopamine (DA)
2. Epinephrine (Adrenaline)
3. Histamine
4. Norepinephrine (NE)
5. Serotonin (5-HT)

Front 62

Dopamine (DA)

Back 62

E or I depending on receptor; Parkinson's (lack of) or schizophrenia (too much)

Front 63

Epinephrine (Adrenaline)

Back 63

minor in brain

Front 64

Histamine

Back 64

inflammation, brain?

Front 65

Norepinephrine (NE)

Back 65

ANS - postganglionic sympathetic, alertness and wakefulness

Front 66

Serotonin (5-HT)

Back 66

raphe nucleus; mood regulation, low in depression

Front 67

Neuroactive Peptides

Back 67

1. Endorphins
2. Enkephalins
3. Substance P

Front 68

Endorphins

Back 68

analgesic system, control of perceived pain, CNS/PNS, induces general feeling of well-being

Front 69

Enkephalins

Back 69

analgesic system; dorsal gray horn, suppresses pain right as it comes to CNS, binds to opiate receptors, raphe nucleus

Front 70

Substance P

Back 70

- stimulates vasodilation
- producing pain
- irritant to some tissues

Front 71

Myasthenia Gravis

Back 71

- autoimmune against ACh receptors so less are useful
- contractions get progressively weaker
- tends to affect cranial nerve muscles

Front 72

- from cortex to ventral horn
vs
- alpha motor neuron to periphery

Back 72

- UMN
vs
- LMN

Front 73

hypotonicity
vs
hypertonicity

Back 73

- LMN
vs
- UMN

Front 74

- flaccid paralysis
vs
- spastic paralysis

Back 74

- LMN
vs
- UMN

Front 75

disuse/no atrophy
vs
true atrophy

Back 75

- UMN
vs
- LMN

Front 76

+ Babinski
vs
- Babinski

Back 76

- UMN
vs
- LMN

Front 77

No clonus
vs
Clonus

Back 77

- LMN
vs
- UMN

Front 78

Stroke
vs
Polio

Back 78

- UMN
vs
- LMN

Front 79

Innervation Ratio

Back 79

# of muscle fibers/ # of motor nerve fibers that innervate the muscle

Front 80

Efferent Axons

Back 80

1. A-alpha
2. A-delta
3. B
4. C

Front 81

A-alpha

Back 81

Large-myelinated
1. Speed: 7-130 m/s
2. Diameter: 7-22
3. Innervates: skeletal muscle fibers

Front 82

A-delta

Back 82

Medium Myelinated
1. Speed: 12-45 m/s
2. Diameter: 2-15
3. Innervates: smooth muscle fibers

Front 83

B (efferent)

Back 83

Small-myelinated
1. Speed: 4-25 m/s
2. Diameter: 1-5
3. Innervated: presynaptic autonomic

Front 84

C (efferent)

Back 84

Unmyelinated
1. Speed: 0.2-2.0 m/s
2. Diameter: 0.2-0.5
3. Innervates: postsynaptic autonomic

Front 85

Afferent Axons

Back 85

1. Ia, Ib, II
2. A-gamma
3. C

Front 86

Ia, Ib, II

Back 86

Large, myelinated
1. Speed: 7-130 m/s
2. Diameter: 7-22
3. Innervates: Spindles, Golgi tendon organs, touch and pressure receptors

Front 87

A-gamma

Back 87

Small-myelinated
1. Speed: 2-10 m/s
2. Diameter: 2-10
3. Innervates: Pain, temperature, visceral receptors

Front 88

C (afferent)

Back 88

Unmyelinated
1. Speed: 0.2-2.0 m/s
2. Diameter: 0.2-0.5
3. Innervates: pain, temperature, visceral receptors

Front 89

Classification: Primary axonopathies and myelinopathies

Back 89

1. neurapraxia
2. axonotmesis
3. neurotmesis

Front 90

Neurapraxia

Back 90

- local conduction block
- axon intact
- lasts short time
- Crutch palsy

Front 91

Axonotmesis

Back 91

- axon disrupted, endoneurium intact
- from compression, ischemia, stretching, freezing
- Wallerian degeneration (7-21 days)
- regeneration at 1" per month
- Erb's palsy, carpal tunnel

Front 92

Neurotmesis

Back 92

- axon, myelin, endoneurium damaged
- some injury to peri- and epineurium
- less likely to regenerate - neuroma

Front 93

Classification Scheme: pathology of lesion Sunderland

Back 93

1. First degree (neurapraxia)
2. Second degree (axonotmesis)
3. Third degree (mild or intra-fascicular neurotmesis
4. Fourth degree (moderate or extra-fascicular neurotmesis)
5. Fifth Degree (complete neurotmesis)

Front 94

First Degree

Back 94

- compression
- loss of proprioception, motor function
- pain and temp preserved
- transient, moderate, or severe conduction block

Front 95

Second degree

Back 95

- axon disrupted, not endoneurium
- compression, ischemia, or stretch
- recovery complete, conduit intact
- Tinnel's sign

Front 96

Third Degree

Back 96

- axon and endoneurium disrupted
- stretch or crush
- complete loss of sensory, motor, autonomics
- has to find tubule

Front 97

Fourth Degree

Back 97

- entire funiculus disrupted
- severe crush, stretch, penetration
- complete loss of function
- poor recovery with possible neuroma

Front 98

Fifth Degree

Back 98

- epineurium disrupted
- penetrating or transactional wounds
- requires surgery

Front 99

Five region response to injury

Back 99

1. Zone of trauma
2. Proximal neural segment
3. Distal neural segment
4. Retrograde transneuronal
5. Orthograde transneuronal

Front 100

Regrowth

Back 100

1. collateral: axon from another neuron
2. regenerative: new synapses with undamaged neurons

Front 101

Types of Sensory Information

Back 101

1. Touch
2. Pain
3. Temperature
4. Proprioception

Front 102

Types of Touch

Back 102

1. superficial pressure
2. vibration
3. discriminative touch

Front 103

Types of discriminative touch

Back 103

1. Two-point
2. Stereogenesis
3. Graphesthesia

Front 104

Types of Receptors

Back 104

1. mechanoreceptors
2. chemoreceptors
3. thermoreceptors
4. nociceptors

Front 105

Joint Receptors

Back 105

1. Ruffini
2. Large pacinian type cluster
3. Ligament
4. Plexiform, lattice-like
5. Free nerve endings

Front 106

Ruffini (slowly adapting)

Back 106

- superficial capsule
- posture, muscle tension, motion
- inhibits pain

Front 107

Pacinian (rapidly adapting)

Back 107

- deep capsule
- innactive when immobile
- discharge from active and passive joint motion

Front 108

Ligament (slowly adapting)

Back 108

- surface of joint ligaments
- sense tension, active at extremes of motion
- dynamic sensation

Front 109

Plexiform (non-adapting)

Back 109

- entire thickness of joint capsule
- nociceptor
- evokes pain sensation

Front 110

Free nerve endings

Back 110

- joint capsule, ligament, fat pads
- dull aching pain or burning sensation