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428 Cards in this Set
- Front
- Back
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cells responsible for forming the blood brain barrier
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astrocytes
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prominent glial cell in the white matter
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oligodendroglia
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cells that are destroyed in MS
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oligodendroglia
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cells that are destroyed in Guillain-Barre
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Schwann cells
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which sensory receptors in the skin are responsible for pain and temperature
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free nerve endings (via A-delta and C fibers)
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sensory receptors found in the skin, ligaments, and joints that mediate vibration and pressure
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Pacinian corpuscles
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difference in the distribution between Meissners corpuscles and Merkels disks
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Meissners corpuscles are found in hairless skin
Merkels disks are found in skin with hair follicles |
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site of synthesis for NE, dopamine, serotonin, ACh, and GABA
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NE- locus ceruleus
dopamine- substantia nigra compacta serotonin- raphe nucleus ACh- basal nucleus of Meynert GABA- nucleus accumbens |
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what nucleus of the hypothalamus makes ADH
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supraoptic
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what nucleus of the hypothalamus makes oxytocin
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paraventricular
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lateral hypothalamus control what
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hunger
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ventromedial hypothalamus controls what
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satiety
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anterior hypothalamus controls what
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parasympathetics
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posterior hypothalamus controls what
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sympathetics
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the suprachiasmatic nucleus of the hypothalamus controls what
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circadian rhythms
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thalamic nuclei thats part of the vision pathway
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LGN
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thalamic nuclei thats part of the hearing pathway
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MGN
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what thalamic nuclei is part of the facial sensation and taste pathway
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VPM
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what thalamic nuclei is part of the pain/temperature/proprioception/touch pathways
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VPL
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the 5 F's of the limbic system
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Feeding, Fleeing, Fighting, Feeling, Fucking
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the cerebellum receives contralateral cortical input via what peduncle
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middle cerebellar peduncle
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the cerebellum receives ipsilateral cortical input via what peduncle
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inferior cerebellar peduncle
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4 nuclei of the cerebellum
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dentate, emboliform, globose, and fastigial
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what makes up the striatum
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putamen and caudate
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what makes up the lentiform
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putamen and globus pallidus
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morphologic feature of Parkinsons
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Lewy bodies (made of alpha-synuclein)
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region of substantia nigra involved in Parkinsons
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pars compacta
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4 major symptoms seen in most cases of Parkinsons
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tremor (pill-rolling), cogwheel rigidity, akinesia, postural instability (TRAP)
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symptom of an STN lesion (usually via lacunar infarct)
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hemiballismus
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difference between myoclonus and dystonia
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myoclonus- sudden, brief muscle contraction (jerks, hiccups)
dystonia- sustained, involuntary muscle contractions (writers cramps) |
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characterized by hyperorality, hypersexuality, and docility
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Kluver-Bucy syndrome (bilateral amygdala lesion)
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region of the brain associated with arousal and wakefulness; lesion causes coma
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reticular formation
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region of the brain damaged in Wernicke Korsakoff syndrome
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mammillary bodies
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lesion to this region of the cerebellum causes truncal ataxia and dysarthria
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vermis
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region of the cerebellum associated with eye movements
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floculonodular lobe
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ONLY laryngeal muscle NOT innervated by the recurrent laryngeal nerve
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cricothyroid
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aphasia caused by damage to the arcuate fasciculus
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conduction aphasia
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origin of ACA
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internal carotid
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branches of the ACA (3)
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pericallosal, callosomarginal, and recurrent artery of Heubner
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anastamoses between ACA is via what artery
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ACOM
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origin of posterior cerebral artery
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basilar artery
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PCOM connects what 2 vessels
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internal carotid and posterior cerebral artery
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origin of middle cerebral artery
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internal carotid
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oculomotor nerve exits between what 2 vessels
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posterior cerebral and superior cerebellar artery
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origin of PICA
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vertebral artery
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origin of AICA
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basilar artery
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origin of basilar artery
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vertebral artery
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aneurysm/infarct of PCOM causes what
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painful CN III palsy
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aneurysm/infarct of ACOM causes what
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bitemporal hemianopsia
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arteries (2) associated with medial medullary syndrome
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anterior spinal artery and vertebral artery
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artery associated with lateral medullary syndrome (Wallenbergs)
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PICA
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characterized by contralateral hemiparesis of the lower extremities, decreased contralateral proprioception, and ipsilateral paralysis of CN XII
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medial medullary syndrome
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characterized by contralateral loss of pain/temperature, ipsilateral dysphagia, hoarseness, decreased gag reflex, vertigo, diplopia, nystagmus, vomiting, ipsilateral Horner's, ipsilateral loss of pain/temp in the face, and ipsilateral ataxia
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lateral medullary syndrome (Wallenbergs)
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artery associated with lateral inferior pontine syndrome
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AICA
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characterized by ipsilateral facial paralysis, ipsilateral cochlear nucleus damage, nystagmus, ipsilateral loss of pain/temp, and ipsilateral dystaxia
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lateral inferior pontine syndrome
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artery affected in causing contralateral hemianopia with macular sparing
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PCA
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most common location for a brain aneurysm
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ACOM
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infarct in what artery causes locked-in syndrome
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basilar
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only movements left intact in locked-in syndrome
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vertical eye movements
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special aneurysms associated with chronic hypertension
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Charcot-Bouchard microaneurysms
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3 major diseases associated with an increased risk for berry aneurysms
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adult PKD, Ehlers-Danlos syndrome, and Marfans syndrome
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artery associated with epidural hematomas
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middle meningeal artery
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origin of middle meningeal artery
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maxillary artery
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transtentorial herniation and CN III palsy are common occurences in what type of bleed
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epidural
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vessels associated with subdural hematomas
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bridging veins
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conditions where subdural hematomas are commonly seen
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elderly, alcoholics, trauma, shaken baby syndrome
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bleed associated with a yellow (xanthochromic) spinal tap
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subarachnoid
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most common location for parenchymal bleed
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basal ganglia
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time frame that needs to pass before irreversible damage occurs during a TIA/stroke
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5 minutes
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recommended treatment immediately following a stroke
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tPA (within 4.5 hours)
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amount of CSF made per day
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500ml/day
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pathway for CSF
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choroid plexus -> lateral ventricle -> foramen of monro -> 3rd ventricle -> cerebral aqueduct -> 4th ventricle -> subarachnoid space via 2 foramina of Luschka and 1 foramen of Magendie -> cisterna magna -> arachnoid granulations
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clinical triad of normal pressure hydrocephalus
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urinary incontinence, dementia, ataxia ("wet, wacky, wobbly")
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hydrocephalus ex vacuo is seen in what conditions
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Alzheimer's disease, advanced HIV, and Pick's disease
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herniations of the spinal cord occurs in what direction
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posterolaterally
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location of spinal tap
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L3-L5
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region of the dorsal column that controls the upper body
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cuneate
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region of the dorsal column that controls the lower body
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gracilis
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spinal cord tract that controls pain, temp, and crude touch
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anterolateral (aka spinothalamic)
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where does the dorsal column decussate?
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internal arcuate fibers of the caudal medulla
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where does the anterolateral (spinothalamic) pathway decussate
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anterior white commissure of the spinal cord
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where does the lateral corticospinal tract decussate
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pyramidal decussation in the caudal medulla
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signs of UMN lesion
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weakness, hyperreflexia, increased tone, positive babinski, spastic paralysis, clasp knife spasticity
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signs of LMN lesion
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weakness, atrophy, fasciculations, hyporeflexia, decreased tone
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what age group is a positive Babinski a normal finding
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less than 2 years of age because the tracts haven't completed myelination yet
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2 major diseases that affect ONLY LMNs
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Poliomyelitis and Werdnig-Hoffmann disease
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MS affects what part of the spinal cord
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white matter
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disease characterized by both UMN and LMN lesions without sensory deficits
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ALS
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vitamin B12 deficiency, vitamin E deficiency, and Friedreich's ataxia are all associated with degeneration of what part(s) of the spinal cord
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dorsal columns and lateral corticospinal tracts (pain/temp spared)
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portion of the spinal cord damaged in syringomyelia initially
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anterior white commissure
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tabes dorsalis (tertiary syphilis) affects what part of the spinal cord
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dorsal columns
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autosomal-recessive disease known to cause "floppy-baby" syndrome which is fatal before the first year
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Werdnig-Hoffman disease
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characterized by ipsilateral UMN signs, ipsilateral loss of vibration/proprioception, contralateral pain and temperature loss, and LMN signs at site of lesion
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Brown-Sequard syndrome (hemisection of the spinal cord)
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only cranial nerve that arises dorsally
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trochlear (CN IV)
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characterized by paralysis of conjugate vertical gaze due to lesion in the superior colliculi
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Parinaud syndrome
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innervation of palattoglossus
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vagus nerve
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innervation of stylohyoid
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facial nerve
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innervation of parotid gland
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CN IX (specifically via lesser petrosal nerve)
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afferent and efferent limbs of the corneal reflex
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trigeminal (V1) and facial
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afferent and efferent limbs of the lacrimation reflex
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trigeminal (V1) and facial
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branch of the trigeminal that does NOT pass through the cavernous sinus
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V3
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Right CN XI lesion would cause difficulty turning the head which way
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Left
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where does the uvula deviate in CN X lesion
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away
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where does the tongue deviate in CN XII lesion
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towards
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what organisms is characterized by causing ring-enhancing lesions in the brain
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toxoplasma gondii
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SE of acetazolamide
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hyperchloremic metabolic acidosis and hyperammonemia
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MOST common cause of primary amenorrhea in young women
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Turner syndrome
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3 symptoms of Cushing's triad
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HTN, bradycardia, and irregular respiration
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what is "triple H" therapy
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treatment for the cerebral vasospasms that occur several days after a subarachnoid hemorrhage (consists of inducing HTN, hypervolemia, and hemodilution)
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calcium channel blocker given to patients with a subarachnoid hemorrhage
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nimodipine
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arteries affected in Charcot-Bouchard microaneurysms
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lenticulostriate
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treatment of cryptococcal meningitis
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amphotericin B
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how do UMN lesions affect the face
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contralateral paralysis of lower half of face only
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how do LMN lesions affect the face
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ipsilateral paralysis of the whole half of the face
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Bell's Palsy is seen in complications of what diseases (6)
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AIDS, Lyme disease, HSV, sarcoidosis, neoplasms, and diabetes
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muscle that opens jaw
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lateral pterygoid
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type of glaucoma that is caused by obstructed outflow of aqueous humor especially in the canal of Schlemm
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open angle (wide)
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type of glaucoma that is caused by obstruction of flow between iris and lens
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close angle (narrow)
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characterized by opacification of the lens
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cataracts
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retinal detachment refers to the detachment of what 2 layers
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neurosensory layer and pigment epithelium
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pathologic cause of dry macular degeneration
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fat deposits (drusen) in Bruch's membrane
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pathologic cause of wet macular degeneration
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neovascularization
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lesion to central portion of the optic chiasm causes what
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bitemporal hemianopia
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lesion to the optic tract causes what
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contralateral homonymous hemianopia
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lesions to both superior/inferior optic radiation tracts unilaterally cause what
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contralateral homonymous hemianopia with macular sparing
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infarct of inferior division of MCA causes what eye deficit
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contralateral "pie in the sky"
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MLF syndrome (aka internuclear ophthalmoplegia) is MOST commonly seen in what disease
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MS
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patient with R MLF lesion- describe what their eyes would do when looking to the left
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L eye abducts normally with slight L nystagmus
R eye can NOT adduct |
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late onset Alzheimer's disease is caused by mutation of what gene
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ApoE4
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which lipoprotein is protective against Alzheimer's
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ApoE2
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treatment for Guillain-Barre
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plasmapheresis and IV immunoglobulins
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MOST common initiating location for partial seizures
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medial temporal lobe
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difference in the timing of nystagmus in peripheral versus central vertigo
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peripheral causes of nystagmus are delayed; central causes of nystagmus are immediate
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treatment of cluster headaches
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sumitriptan and oxygen
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treatment of migraines
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NSAIDs, sumatriptan, propranolol
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disease characterized by port-wine stains, leptomeningeal angiomas, and pheochromocytomas
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Sturge-Weber syndrome
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characterized by retardation, seizures, hamartomas in the skin, cardiac rhabdomyomas, renal angiomyolipomas, astrocytomas, "ash-leaf" spots, "shagreen patches," and "candle-guttering" of the ventricles
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Tuberous sclerosis
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disease characterized by bilateral renal cell carcinoma, cavernous hemangiomas in the skin/mucosa, and hemangioblastomas in the retina, brain, and cerebellum
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VHL
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difference in location between adult and childhood primary brain tumors
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adults are supratentorial and childrens are infratentorial
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what is a "butterfly glioma"
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when a glioblastoma multiforme crosses over the corpus callosum
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astrocytes stain positive for what
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GFAP
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from what cells do meningiomas arise from
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arachnoid cells
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morphologic feature of meningiomas
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psammoma bodies
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most common location for a schwannoma
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cerebellopontine angle
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most common form of pituitary adenoma
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prolactinoma
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MOST common childhood brain tumor overall (up to age 18)
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pilocytic astrocytoma
(medulloblastomas are the MOST common brain tumor under the age of 10) |
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morphologic feature of pilocytic astrocytomas
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rosenthal fibers
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morphologic features of medulloblastomas
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Homer Wright rosettes or pseudo-rosette pattern, desmoplastic variants, and drop metastasis
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2 morphologic features of ependymomas
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perivascular pseudorosettes and rod-shaped blepharoblasts
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morphologic feature of hemangioblastomas
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foamy cells
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hormone produced by hemangioblastomas
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erythropoietin (leads to polycythemia)
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artery damaged causing duret hemorrhages seen in uncal herniations
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paramedian artery
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drug thats contraindicated in closed-angle glaucoma
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epinephrine
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MOA of alpha agonists in treating glaucoma
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decrease aqueous synthesis
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MOA of beta blockers in treating glaucoma
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decrease aqueous secretions
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MOA of cholinomimetics in treating glaucoma
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increase outflow of aqueous humor
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SE of pilocarpine
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miosis, cycloplegia
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branches of the internal carotid (5)
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ophthalmic, PCOM, anterior choroidal, anterior cerebral, middle cerebral ("OPAAM")
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origin of lenticulostriate arteries
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middle cerebral artery
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branches of the PCA (3)
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thalamoperforators, thalamogeniculates, and posterior choroidal arteries
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location of lesion causing alien hand syndrome
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supplementary motor area
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cause of "man in the barrel" syndrome
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Watershed infarcts
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what makes up the confluence of sinuses
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superior sagittal, straight, occipital, and transverse sinuses
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most superficial veins drain to one of what 2 locations
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cavernous sinus or superior sagittal sinus
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most deep veins drain where
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great veins of galen
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sagittal sinus thrombosis produces what finding on CT/MRI
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"empty delta sign"
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what is the gait in Parkinson's called
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festinating or shuffling gait
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conditions including polio, MS, Guillain-Barre, spinal herniation, peroneal muscle atrophy, and peroneal nerve injury are all associated with what type of abnormal gait
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high-steppage
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which brain herniation is linked to Kernohan's notch and Duret hemorrhages
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transtentorial (uncal) herniation
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which brain herniation is most likely to compress the posterior cerebral artery leading to CN III palsy
|
transtentorial (uncal) herniation
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which brain herniation has the highest fatality risk
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tonsillar herniation
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this condition is characterized by a decrease in or total absence of the gyri on the brain; caused by mutations in alpha-dystroglycan
|
Lissencephaly
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condition characterized by incomplete separation of the cerebral hemispheres across midline; seen in fetal alcohol syndrome, trisomy 13 (patau syndrome), and untreated maternal diabetes
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holoprosencephaly
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this condition presents as a "batwing" deformity on imaging of the brain
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agenesis of the corpus callosum
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condition characterized by an enlarged posterior fossa; the vermis is absent or present only in rudimentary form
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Dandy-Walker malformation
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condition characterized by a small posterior fossa leading to the cerebellar tonsils extending into the vertebral canal
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Arnold-Chiari type I malformation
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condition characterized by a small posterior fossa leading to the vermis extending down through the foramen magnum
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Arnold-Chiari type 2 malformation
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condition characterized by cape-like loss of pain/temp in the UEs with touch being sparred
|
syringomyelia
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metabolic depletion of energy associated with ischemia to the brain results in the inappropiate release of what amino acid which ultimately contributes to cell damage
|
glutamate
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are watershed infarcts precipitated by HYPER or HYPOtensive episodes
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hypotension
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MOST common location for Charcot-Bouchard microaneurysms
|
basal ganglia
|
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MOST common site for a berry aneurysm
|
ACOM
|
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AV malformations are MOST common with what brain vessel
|
MCA
|
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|
3 MOST common causes of chronic bacterial meningoencephalitis
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Mycobacteria (TB), syphilis, and Lyme disease
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gene mutation causing CJD
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PRNP
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what will gel electrophoresis reveal in a person with MS
|
oligoclonal IgG bands
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|
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this disease is characterized by bilateral optic neuritis and spinal cord demyelination; antibodies are directed against aquaporins
|
neuromyelitis optica (aka Devic disease)
|
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this syndrome is characterized by acute paralysis, dysarthria, dysphagia, diplopia, and syncope; caused by demyelination of the pons secondary to rapid correction of a hyponatremia metabolic condition in alcoholics
|
Central pontine myelinosis
|
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what protein makes up the neurofibrillary tangles in Alzheimer's disease
|
tau
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AB neuritic plaques, neurofibrillary tangles, and hirano bodies are characteristic of what disease
|
Alzheimer's
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disease characterized by dementia, aphasia, changes in personality, language disturbances, and parkinsonisms; caused by lobar atrophy sparring the parietal lobes; the brain takes on a "knife's edge" appearance
|
Pick's disease
|
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what is the trinucleotide repeat in Huntington's disease
|
CAG
|
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which DTR is left intact in children with Friedreich's ataxia
|
extensor plantar reflex
|
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enzyme deficiency in ALS
|
copper-zinc superoxide dismutase I (SOD1)
|
|
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morphologic feature of Krabbe's disease
|
globoid cells
|
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deficiency in Krabbe's disease
|
B-galactocerebrosidase
|
|
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autosomal recessive disease characterized by ataxia and dementia due to demyelination and gliosis in the white matter; there is an accumulation of cerebroside sulfates
|
metachromatic leukodystrophy
|
|
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enzyme deficiency in metachromatic leukodystrophy
|
arylsulfatase A
|
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disease characterized by megalencephaly, seizures, and psychomotor retardation; Rosenthal fibers accumulate around blood vessels; caused by mutation in GFAP
|
Alexander disease
|
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disease characterized by cerebellar ataxia, ophthalmoplegia, pigment retinopathy, and cardiac conduction defects; caused by mitochondrial DNA deletion or rearrangement
|
Kearn-Sayre syndrome (aka "ophthalmoplegia plus")
|
|
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toxicity of this compound damages the retina and causes blindness
|
methanol
|
|
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DOC for methanol toxicity
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ethanol or fomepizole
|
|
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MOST common brain tumor in adults
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glioblastoma multiforme
|
|
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MAJOR morphologic feature of astrocytomas
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psuedopalisading bodies
|
|
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2 morphologic features of oligodendrogliomas
|
fried egg cells and chicken-wire capillary pattern
|
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which brain tumor is most likely to exhibit "drop metastasis"
|
medulloblastoma
|
|
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what is the MOST common CNS neoplasm in immunocomprimised people
|
CNS lymphoma (B cell)
|
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asides from retinoblastomas, what other CNS tumor is linked to RB gene mutations
|
pineoblastomas
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which brain tumor commonly expresses progesterone receptors and grows rapidly during pregnancy
|
meningiomas
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what are the 5 common primary sites for tumors that can metastasize to the brain
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lung, breast, kidney, GI, skin
|
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why do people with Von Hippel-Lindau have polycythemia
|
gene mutation causes dysregulation of erythropoietin
|
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is cerebral edema caused by acidosis or alkalosis and what is the initial treatment
|
respiratory acidosis and hypoxemia cause cerebral edema; initial treatment is to induce respiratory alkalosis by having the patient hyperventilate-- the alkalosis will cause vasoconstriction and decrease the edema
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what is pseudotumor cerebri
|
it refers to idiopathic intracranial hypertension which increases intracranial pressure withOUT any evidence of tumor or obstruction; it's MOST common in young and obese women; treatment is acetazolamide
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which artery is compressed in a subfalcine (cingulate) herniation
|
ACA
|
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MOST common cause of hydrocephalus in newborns
|
stenosis/obstruction in the aqueduct of sylvius (aka cerebral aqueduct)
|
|
|
chromosomes affected in NF1 and NF2
|
NF1- chromosome 17
NF2- chromosome 22 |
|
|
condition characterized by temporary loss of vision due to embolic material trapped at the bifurcation of the retinal vessels (usually retinal artery)
|
amaurosis fugax
|
|
|
Do atherosclerotic strokes demonstrate liquefactive or coagulative necrosis
|
liquefactive
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during a stroke, a patient demonstrates contralateral paresis, sensory loss in the face and upper extremity, and his head/eyes are deviating to the R; what vessels is MOST likely involved
|
Right MCA
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|
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where do MOST emboli that ultimately cause a stroke originate from
|
Left side of the heart (mural emboli)
|
|
|
what is the BEST test to diagnose a stroke
|
CT withOUT contrast
|
|
|
what HLA subtype and what type of hypersensitivity is associated with MS
|
HLA-DR2 and it's a type IV hypersensitivity
|
|
|
MOST common cause of neonatal meningitis
|
group B strep (S. agalactiae)
|
|
|
prophylaxis for people in close contact with meningitis patient
|
rifampin or ciprofloxacin
|
|
|
cause of cysticercosis
|
Taenia solium
|
|
|
treatment for acute and chronic MS
|
acute stages: high dose methylprednisolone (corticosteroids)
chronic stages: beta-IFN, monoclonal antibodies (natalizumab), and cytotoxic therapy (methotrexate, azathioprine, and cyclophosphamide) |
|
|
this is an X-linked recessive disease characterized by loss of myelin in the brain and adrenal insufficiency; caused enzyme deficiencies in this B-oxidation of fatty acids within peroxisomes thus leading to the accumulation of long chain fatty acids
|
adrenoleukodystrophy
|
|
|
what disease is associated with BILATERAL bell's palsy
|
Lyme disease
|
|
|
4 MOST common drugs associated with causing peripheral neuropathies
|
isoniazid, vincristine, hydralazine, and phenytoin
|
|
|
MOST common cause of bacterial conjunctivitis
|
S. aureus
|
|
|
MOST common cause of viral conjunctivitis
|
adenovirus
|
|
|
difference between a stye and chalazion
|
stye- infection of the eyelid (S. aureus)
chalazion- lipogranuloma of the eyelid due to obstruction of the sebaceous glands (no organisms involved) |
|
|
DOC for 1st line treatment of open angle glaucoma
|
timolol
|
|
|
what makes up the uvea
|
iris, ciliary body, and choroid
|
|
|
DOC for acute closed angle glaucoma
|
pilocarpine plus acetazolamide
|
|
|
what membrane is disrupted in macular degeneration
|
Bruch's membrane
|
|
|
MOST common cause of blindness
|
macular degeneration
|
|
|
infection characterized by hemorrhagic necrosis of the temporal lobes
|
HSV1 (viral meningoencephalitis)
|
|
|
does infarction of the internal capsule give rise to ipsilateral or contralateral findings
|
contralateral
|
|
|
characterized by uncontrollable bouts of laughing and crying along with incontinence
|
pseudoblubar effect (damage to brainstem nuclei of CN 7,9,10,12)
|
|
|
where does olfactory nerve exit the skull
|
cribiform plate of the ethmoid bone
|
|
|
characterized by anosmia with ipsilateral optic atrophy and contralateral papilledema; caused by meningiomas in the olfactory sulcus
|
Foster-Kennedy syndrome
|
|
|
which cranial nerves exit via the superior orbital fissure
|
CN III, IV, V(1), and VI
|
|
|
which cranial nerve exits via the foramen rotundum
|
V2
|
|
|
which cranial nerve exits via the foramen ovale
|
V3
|
|
|
what's the pathway of the pupillary light reflex (do not confuse with visual acuity pathway)
|
light -> photoreceptors -> bipolar cells -> ganglion cells -> optic nerve -> optic chiasm -> optic tracts -> brachium of superior colliculus -> pretectal area -> Edinger Westphal nucleus -> presynaptic parasympathetic fibers -> posterior commissure -> CN III -> ciliary ganglion -> postsynaptic parasympathetic fibers -> pupillary constrictor and ciliary muscles -> miosis
***visual acuity pathway: after traveling to the optic tracts -> optic radiations (Meyer's loop is inferior optic radiation, and Baum's loop is superior optic radiation) -> primary visual cortex (Broadmann's 17) |
|
|
compensation for CN IV palsy
|
head tilts down and away with eyes fixed upward
|
|
|
innervation to supratentorial dura
|
V1
(C2 innervates posterior portion of dura) |
|
|
muscles innervated by V3
|
temporalis, anterior belly of digastric, masseter, mylohyoid, medial and lateral pterygoids, tensor veli palatini, and tensor tympani
|
|
|
ONLY pathway in the body that has primary sensory neurons in the CNS
|
mesencephalic trigeminal nucleus
|
|
|
which trigeminal nucleus is analogous to the dorsal columns
|
chief (principal) trigeminal sensory nucleus
|
|
|
which trigeminal nucleus is analogous to the anterolateral pathway
|
spinal trigeminal nucleus
|
|
|
postganglionic parasympathetic fibers to lacrimal gland come from what ganglion
|
sphenopalatine (aka pterygopalatine) ganglion (via greater petrosal nerve)
|
|
|
fibers to the sublingual and submandibular glands come from what nerve of CN VII
|
lingual nerve (via chorda tympani)
|
|
|
taste fibers to anterior 2/3 of the tongue originate in what nucleus in the brainstem
|
rostral nucleus solitarius
|
|
|
sensory fibers (from CN VII) which innervate the external auditory meatus initially originate from what brainstem nucleus
|
spinal trigeminal nucleus
|
|
|
motor fibers of the facial nerve originate via what brainstem nucleus
|
facial nucleus
|
|
|
motor fibers of the facial nerve travel through what foramen (except for those to the stapedius)
|
stylomastoid foramen
|
|
|
long term complication of Bell's palsy involving the incorrect regeneration of the parasympathetic fibers (lesion must be before the geniculate ganglion)
|
crocodile tears (people salivate when they want to cry, and tear when they see food)
|
|
|
innervation of the buccinator muscle
|
facial nerve
|
|
|
innervation of the stapedius (causes hyperacusis)
|
facial nerve
|
|
|
muscle that regulates movement of the malleus
|
tensor tympani
|
|
|
origin of the labyrinthe artery
|
AICA
|
|
|
which labyrinthe contains endolymph, and which labyrinthe contains perilymph
|
bony labyrinthe contains perilymph and membranous labyrinthe contains endolymph
|
|
|
movement of the hair cells in the inner ear forms excitatory potentials that synapse at what ganglion
|
spiral ganglion
|
|
|
what detects angular acceleration of the head
|
semicircular canals
|
|
|
what detects linear acceleration of the head as well as head tilt
|
utricle (forward tilt) and saccule (backward tilt)
|
|
|
what inner ear structure contains otoliths
|
maculae
|
|
|
2 types of hearing loss
|
conductive (reversible) and sensorineural (permanent)
|
|
|
motor fibers of the glossopharyngeal and vagus nerves originate from what brainstem nucleus
|
nucleus ambiguus
|
|
|
ONLY muscle innervated by CN IX
|
stylopharyngeus
|
|
|
postganglionic parasympathetic fibers to the parotid gland come from what ganglion
|
otic (via lesser petrosal nerve)
|
|
|
preganglionic parasympathetic fibers traveling to CN III come from what ganglion
|
Edinger-Westphal
|
|
|
preganglionic parasympathetic fibers traveling to CN VII come from what nucleus
|
superior salivatory nucleus
|
|
|
preganglionic parasympathetic fibers traveling to CN IX come from what nucleus
|
inferior salivatory nucleus
|
|
|
special CN fibers that innervate the carotid bodies and aortic arch originate from what brainstem nucleus
|
caudal nucleus solitarius
|
|
|
parasympathetic fibers from the vagus nerve originate in what brainstem nucleus
|
dorsal motor nucleus
|
|
|
nerve at risk during thyroid surgery or carotid endartectomy
|
recurrent laryngeal nerve
|
|
|
MAJOR muscle that sticks on the tongue
|
genioglossus
|
|
|
morphologic feature of rabies
|
negri bodies
|
|
|
bleed characterized by "lucid intervals"
|
epidural
|
|
|
bacterial causes of meningitis in the newborn
|
Listeria, Group B strep, and E.coli
|
|
|
MOST common bacterial cause of meningitis overall
|
S. pneumoniae
|
|
|
MOST common bacterial cause of meningitis in children
|
N. meningitidis
|
|
|
bacterial causes (2) of meningitis in the elderly
|
Listeria and S. pneumoniae
|
|
|
MOST common bacterial cause of meningitis in immunocomprimised patients
|
Klebsiella
|
|
|
MOST common bacterial cause of meningitis in drug abusers
|
S. aureus
|
|
|
spinal tap characteristics in bacterial meningitis
|
increased CSF pressure, increased PMN cells (neutrophils), increased protein, decreased glucose
|
|
|
cause of Waterhouse-Friderichsen syndrome in meningitis patients
|
N. meningitidis
|
|
|
spinal tap characterstics in viral meningitis
|
increased CSF pressure, increased lymphocytes, slightly increased protein, normal glucose
|
|
|
spinal tap characteristics in TB/fungal meningitis
|
increased CSF pressure, increased lymphocytes, increased protein, decreased glucose
|
|
|
cause of progressive multifocal leukoencephalopathy
|
JC virus
|
|
|
cause of subacute sclerosing panencephalitis
|
measles virus (Rubeola)
|
|
|
MOST common cause of meningitis in AIDS patients
|
cryptococcus
|
|
|
MOST common cause of Sydenham chorea
|
S.pyogenes (in girls with rheumatic fever)
|
|
|
neurotransmitters affected in Huntington's
|
ACh and GABA (both decreased)
|
|
|
trinucleotide repeat in Friedrich's ataxia
|
GAA
|
|
|
diseases (2) associated with a cherry red spot on the macula
|
Tay-Sachs and Niemann Pick disease
|
|
|
condition associated with a white eye reflex
|
retinoblastoma
|
|
|
area of the brain that degenerates in Wilson's disease
|
lentiform nucleus
|
|
|
brain tumor associated with calcifications
|
oligodendroglioma
|
|
|
MOST common childhood tumor that occurs SUPRAtentorial
|
craniopharyngioma
|
|
|
characterized by optic nerve gliomas, Lisch nodules, inguinal/axillary freckling, and cafe-au-lait spots
|
NF type 1
|
|
|
characterized by bilateral 8th nerve schwannomas, juvenile cataracts, and meningiomas
|
NF type 2
|
|
|
eye abnormality suggested by light flashes
|
retinal detachment
|
|
|
eye abnormality suggested by rainbow halos
|
acute glaucoma
|
|
|
origin of postganglionic sympathetic fibers to the eye
|
superior cervical ganglion
|
|
|
clinical triad of Horner's
|
ptosis, miosis, anhidrosis
|
|
|
characterized by a mid-dilated pupil that doesnt react to light; caused by damage to ciliary ganglion
|
Adie's myotonic pupil
|
|
|
"setting-sun eyes" are associated with what condition
|
Parinaud syndrome
|
|
|
what's the direct pathway of the basal ganglia
|
striatum -> GPi and SNr -> thalamus
|
|
|
what's the indirect pathway of the basal ganglia
|
striatum -> GPe -> STN -> GPi and SNr -> thalamus
|
|
|
2 different pathways of the GPi that synapse with the thalamus
|
ansa lenticularis and lenticular fasciculus
|
|
|
caused by atrophy of the intermediolateral cell column; symptoms include parkinsonisms and autonomic disturbances
|
Shy Drager syndrome
|
|
|
symptoms of Gerstmann syndrome
|
acalculia, finger agnosia, R-L disorientation, and agraphia
|
|
|
location of lesion in Gerstmann syndrome
|
dominant inferior parietal lobule (angular gyrus)
|
|
|
what's the Papez circuit pathway
|
it's a cyclical pathway: starting at the hippocampal formation -> fornix -> mamillary nuclei -> mammillothalamic tract -> anterior thalamic nucleus -> cingulate gyrus -> entorhinal cortex -> back to the hippocampal formation
|
|
|
difference between a simple and complex partial seizure
|
simple maintains consciousness, and complex doesn't
|
|
|
MOST common seizure in children and whats the DOC
|
absence seizures- DOC is ethosuximide
|
|
|
tonic-clonic seizures in children are aka as what
|
febrile seizures
|
|
|
acute treatment for status epilepticus
|
diazepam/lorazepam
|
|
|
prophylaxis for status epilepticus
|
phenytoin
|
|
|
DOC for status epilepticus in children
|
phenobarbital
|
|
|
disease caused by increased dopamine
|
schizophrenia
|
|
|
DOC for OCD
|
clomipramine
|
|
|
middle meningeal artery travels through what foramen
|
foramen spinosum
|
|
|
what's Cushing's triad
|
HTN, bradycardia, and respiratory insuffciency
|
|
|
pathways (2) of drainage for the superficial veins through the cavernous sinus
|
1.) cavernous sinus -> superior petrosal sinus -> transverse sinus -> sigmoid sinus -> IJV
2.) cavernous sinus -> inferior petrosal sinus -> IJV |
|
|
food linked to botulism
|
honey, corn syrup, canned fruit
|
|
|
infectious cause of "floppy baby syndrome"
|
C. botulinum
|
|
|
MOST potent neurotoxin known to mankind
|
botulism
|
|
|
initial complication in most cases of N. meningitidis
|
DIC
|
|
|
genetic deficiency that increases risk for N. meningitidis
|
C5-C9 complement deficiency
|
|
|
long-term sequelae of meningitis in children
|
mental retardation, deafness, ischemic necrosis of the extremities (leading to amputation), and arthritis
|
|
|
mechanism of motility in Listeria seen in meningitis
|
actin rockets, tumbling motility
|
|
|
foods linked to Listeria
|
unpasteurized dairy products
|
|
|
MOST common cancer of the eye
|
melanoma of the uvea
|
|
|
characterized by saddle anesthesia, urinary retention, and impotence
|
cauda equina syndrome
|
|
|
pupils appear to dilate when light is flashed in the affected eye
|
Marcus-Gunn pupil
|
|
|
these pupils can accomodate but can't react to light
|
Argyll Robertson pupil
|
|
|
presynaptic disorder of neuromuscular transmission in which ACh release is impaired
|
Lambert-Eaton Myasthenic syndrome
|
|
|
what side does the head tilt to in trochlear nerve palsy
|
away
|
|
|
what happens when cold water is injected into the R ear
|
eyes deviate to the R
|
|
|
what happens when warm water is injected into the R ear
|
nystagmus to the R
|
|
|
location of lesion in upper altitudinal hemianopia
|
lingual gyri
|
|
|
location of lesion in lower altitudinal hemainopia
|
cunei
|
|
|
symptoms of 3rd nerve palsy
|
eye looks down and out, ptosis, blown pupil
|
|
|
which muscle intorts the eye
|
superior oblique
|
|
|
part of the brain that regulates homeostasis
|
hypothalamus
|
|
|
2 major pathways of the amygdala
|
VAFP (projects to brainstem) and striae terminalis (projects to hypothalamus and septal nucleus)
|
|
|
DOC for myoclonic seizures
|
valproic acid
|
|
|
SE of phenytoin
|
gingival hyperplasia, hirsutism, diplopia, ataxia, fetal hydantoin syndrome, and megaloblastic anemia
|
|
|
benzodiazepine used in anesthesia
|
midazolam
|
|
|
new hypnotic used for sleep disorder
|
zolpidem (ambien)
|
|
|
DOC for malignant hyperthermia
|
dantrolene
|
|
|
drug combined with L-dopa in Parkinsons treatment
|
carbidopa (inhibits dopa decarboxylase to increase levels of L-dopa)
|
|
|
rescue therapy drug for on-off phenomenom of Parkinsons
|
apomorphine
|
|
|
treatment for Alzheimers
|
tacrine, donepezil, galantamine, rivastigmine
|
|
|
treatment for Huntingtons
|
reserpine, haloperidol, and tetrabenazine
|
|
|
DOC for neuroleptic malignant syndrome
|
diphenhydramine
|
|
|
treatment for motion sickness
|
meclizine, cyclizine (1st generation antihistamines)
scopolamine (muscarinic antagonist) |
|
|
DOC for chemotherapy-induced nausea
|
ondansetron
|
|
|
vomiting area of the brain
|
area postrema near 4th ventricle (only paired circumventricular organ)
|
|
|
MOST common artery involved with trigeminal neuralgia
|
superior cerebellar artery
|
|
|
cranial nerve that exits medially in the interpeduncular fossa/cistern
|
CN III
|
|
|
what muslce is left intact in a lesion to the R side of the pons causing "one and a half" syndrome
|
left lateral rectus
|
|
|
Main blood supply to the choroid plexus
|
posterior choroidal artery
|
|
|
bilateral weakness of the extremities can be explained by an infarct to what region on the brainstem
|
caudal portion of the pyramidal decussation (cervicomedullary junction)
|
|
|
blood supply to lateral portions of midbrain
|
quadrigeminal arteries
|
|
|
if the L optic n. is transected, what will happen if light is shown in the R eye, and if light is shown in the L eye
|
If light is shown in the R eye, both the direct and consensual pupillary response will be normal
If light is shown in the L eye, neither the direct nor consensual reflex will be present |
|
|
how are prion diseases commonly transmitted
|
direct inoculation or ingestion (most commonly via corneal transplant)
|
|
|
presenting symptoms that can differentiate Alzheimer's from Pick's disease
|
Pick's disease will have hyperorality and language dysfunction
|
|
|
DOC for an acute dystonic reaction
|
benzotropine
|
|
|
serious SE of clozapine
|
agranulocytosis
|
|
|
there is an increased risk for ruptured aneursysms when taking what illegal drug
|
cocaine
|
|
|
changes in personality can be attributed to what lobe of the brain
|
frontal
|
|
|
what is seen on imaging studies in patients with Huntingtons
|
enlarged lateral ventricles and degeneration of the head of the caudate
|
|
|
DOC for ALS
|
riluzole
|
|
|
what would a LP in a patient with Guillain-Barre reveal
|
normal cell count with increased protein
|
|
|
brain waves in stage 1 sleep
|
theta
|
|
|
brain waves while awake with eyes open
|
beta
|
|
|
brain waves while awake with eyes closed
|
alpha
|
|
|
what are the highest frequency, lowest amplitude brain waves
|
beta
|
|
|
when does the brain produce beta waves
|
while awake with eyes open, and during REM
|
|
|
what sleep stage has sleep spindles and K complexes
|
stage 2
|
|
|
what sleep stage does bruxism occur
|
stage 2
|
|
|
what sleep stage represents the largest portion of sleep
|
stage 2 (45%)
|
|
|
brain waves during deep sleep
|
delta waves
|
|
|
sleepwalking, night terrors, and enuresis all occur during which stage of sleep
|
deep sleep (3,4)
|
|
|
what sleep stage is growth hormone secreted the most in children
|
deep sleep (3,4)
|
|
|
erection, dreaming, and memory formation occurs during which stage of sleep
|
REM
|
|
|
what are the physiologic effects that occur during REM
|
decreased muscle tone, increased pulse, increased metabolism, and increase oxygen use by the brain
|
|
|
what substances decrease REM
|
anticholinergics, benzodiazepines, barbiturates, and alcohol
|
|
|
brain receives what percent of the cardiac output
|
15%
|
|
|
what effects does depression have on various sleep stages
|
decreased deep sleep, decreased REM latency, increased total REM, increased nighttime awakenings, more frequent early morning awakenings
|
|
|
DOC for enuresis
|
imipramine
|
|
|
DOC for sleepwalking and night terrors
|
diazepam
|
|
|
DOC for narcolepsy
|
amphetamines or modafinil
|
|
|
treatment for neurogenic and anaphylactic shock
|
sympathomimetics
|
|
|
treatment for hypovolemic shock
|
blood/plasma replacement
|
|
|
test to confirm vertigo
|
Dix-Hallpike
|
|
|
patients complains of R contralateral hemianopia with macular sparring- what vessel is MOST likely involved
|
PCA
|
|
|
what are the paired cranial bones
|
parietal, temporal, lacrimal, nasal, palatine, inferior turbinate, maxillary, and zygomatic bones
|
|
|
portion of the skull fractured leading to epidural bleed via laceration of the middle meningeal artery
|
pterion (portion of temporal bone)
|
|
|
what does the falx cerebri separate, and what sinuses (2) does it contain
|
separates the cerebral hemispheres and contains the inferior/superior sagittal sinuses
|
|
|
what does the tentorium cerebelli separate, and what sinuses (2) does it enclose
|
separates the occipital lobe from the cerebellum, and encloses the transverse sinus and superior petrosal sinus
|
|
|
forms the roof of the sella turcica
|
diaphragma sellae
|
|
|
blood supply to dura mater
|
middle meningeal artery
|
|
|
viral causes of meningitis
|
mumps, echoviruses, coxsackievirus, EBV, HSV
|
|
|
what are the muscles of mastication
|
temporalis, masseter, lateral/medial pterygoids
|
|
|
branches of the external carotid (6)
|
superior thyroid, lingual, facial, occipital, maxillary, and superficial temporal arteries
|
|
|
branches of the maxillary artery (2)
|
middle meningeal and inferior alveolar artery
|
|
|
origin on the pontine (aka striate) arteries
|
basilar artery
|
|
|
origin of anterior/posterior spinal arteries
|
vertebral arteries
|
|
|
what veins form an anastomosis between superficial veins and the dural venous sinuses
|
emissary veins
|
|
|
what sinus drains directly into the IJV
|
sigmoid sinus
|
|
|
hyperacusis is a symptoms of what cranial nerve lesion
|
facial nerve
|
|
|
Kiesselbach's plexus involves anastomoses between what 2 vessels
|
sphenopalatine and superior labial arteries
|
|
|
damaged muscles that cause ptosis
|
superior tarsal (Muller's muscle) and levator palpebrae
|
|
|
innervation to the inner surface of the tympanic membrane
|
CN IX
|
|
|
3 nerves that innervate the external surface of the tympanic membrane
|
CN V,VII,X
|
|
|
what is the "danger zone" of the scalp
|
loose areolar tissue (contains emissary veins)
|
|
|
prostate cancer can spread to the brain via what venous plexus
|
Batson's plexus
|
|
|
where does aqueous fluid first drain to
|
posterior chamber
|
|
|
ONLY duct that drains into the inferior meatus of the nose
|
nasolacrimal duct
|
|
|
what vein is the MOST common route for spread of infection into the cavernous sinus
|
ophthalmic vein
|
|
|
MOST common location for metastasis to the brain
|
gray-white junction
|
|
|
3 anti-seizure drugs that can cause Steven-Johnson syndrome
|
Carbamazepine
Ethosuximide Lamotrigine |
