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44 Cards in this Set

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sensory aura in migraines vs TIA
temporal difference: spreads over 10-20 mins in migraines, much faster in TIA
what type of h/a most commonly a/w mass lesion?
tension-type headache
what do you worry about in h/a preceeded by Horner syndrome?
ICA dissection
papilledema with h/a -- what to r/o?
mass lesion (causing elevated ICP)
causes of nuchal rigidity with h/a (3)
meningitis, SAH, intraparenchymal hemorrhage
1st line prophyalxis for migraines
beta-blockers, TCA, topiramate, divalproex
sidedness of tension type headaches
usu b/l (80-90%)
causes of tension type headaches
50% stress or hunger; rest: sleep deprivation, bad posture, eye strain
main therapy for chronic tension-type headaches
preventative drugs (TCAs eg amitryptyline, SSRIs, doxepin) -- generally antidepressents
where are the frontal eye fields found and what do they do?
frontal lobe; involved in initiation of eye movements (saccades and pursuit)
functions of the hypothalamus
TANHATS (Thirst and water, Adenohypophysis, Neurohypophysis, Hunger, Autonomic regulation, Temperature regulation, Sexual urges/emotions)
what nuclei make ADH and ocytocin?
supraoptic and paraventricular of the hypothalamus, respectively
roles of the limbic system
Feed her, Feel her, sex her, Fight her, Flight her, Forget her
location of wernicke's and broca's areas
WERNICKE: superior temporal lobe (remember wernicke's area = association auditory cortex); BROCA: inferior frontal lobe (remember, broca is the MOTOR speech area)
relative location of motor vs sensory cortical areas
motor is anterior to central sulcus (pre-central gyrus, frontal lobe), sensory is posterior (post-central gyrus, parietal lobe)
symptoms of anterior vs posterior circle of willis lesions
anterior: sensory/motor/aphasic symptoms; posterior: CN(vertigo, visual) / cerebellar (ataxia) / coma
what two vessels come off of vertebral arteries?
ASA and PICA
consequence of posterior communicating artery aneurysm
CN III palsy
consequence of anterior communicating artery aneurysm
visual-field defects
where do the venous sinuses lie?
*IN* the dura mater (between meningeal and periosteal layers)
what is the main location of CSF return from the brain?
superior sagittal sinus (via arachnoid granulations)
where is the area postrema / chemoreceptor trigger zone (CTZ) located?
floor of the anterior 4th ventricle
what is a dandy-walker malformation and what are the common sequelae?
failure to open of foramina of luschka and magendie --> dilated 4th ventricle, a/w agenesis of cerebellar vermis and corpus callosum
what layers do you go through to do an LP?
skin, ligaments (supraspinous, interspinous, flavum), dura, arachnoid, NOT pia
what sensations in the dorsal column? (4)
Light touch, proprioception, vibration, pressure
order of tracts in spinal cord from posterior to anterior
dorsal columns, corticospinal, spinothalamic (anterolateral)
path of neurons in the dorsal column tract
peripheral sensor --> DRG --> enters spinal cord (dorsal columns) --> ascends ipsilaterally --> synapses at NuCuneatus/NuGracilis --> decussates in medulla --> ascends in medial lemniscus --> synapses in VPL of thalamus --> ascends to sensory cortex
path of neurons in the spinothalamic tract
peripheral sensor (pain/temp) --> enters spinal cord --> body in intermediate body (gray matter) --> decussates at anterior white commissure one or two levels above entry --> ascends in contralateral anterolateral tract --> synapses at VPL in thalamus --> ascends to sensory cortex
path of neurons in the lateral corticospinal tract
UMN --> internal capsule --> pyramidal decussation (caudal medulla) --> synapses in anterior horn of spinal cord --> LMN leaves spinal cord --> NMJ
what does loss of axillary nerve cause?
deltoid paralysis (limitation on abduction of shoulder?)
what can cause damage to axillary nerve? (2)
1) fracture of surgical neck of humerus (just below superior head); 2) anterior shoulder dislocation
what does loss of radial nerve cause?
wrist drop (loss of extensors -- brachioradialis, wrist/fingers, supinator, triceps)
location of humerus fracture --> nerve damaged --> result
distal to proximal: 1) medial epicondyle / ulnar nerve / claw hand; 2) supracondyle / medial nerve / hand of benediction; 3) midshaft / radial nerve / wrist drop; 3) surgical neck (just below superior head) / axillary nerve / deltoid paralysis
roles of hypothenar/thenar muscles (3)
OAF {opponens, abductor, flexor} x {pollicis, digiti minimi}
role of gamma motor neuron in motor reflexes
regulates length of intrafusal fiber (so that stretch sensitivity is maintained if muscle is kept at a different length)
role of solitary nucleus
top half: taste (VII, IX, X); bottom half: visceral sensation (IX, X eg baro receptors, gut distention)
role of nucleus ambiguus
motor innervation of pharynx, larynx, upper esopagus (swallowing, palate elevation -- IX, X, XI)
which muscles open jaw? Which close it?
1 opens: lateral pterygoid; 3 close: Masseter, Medial pterygoid, teMporalis (Ms Munch, Lateral Lowers)
what sounds to test dysarthria
la (XII), mi (VII), kuh (X)
sleep wave forms
BATS Drink Blood (Beta, Alpha, Theta, Sleep spindles / k-complexes, Delta, Beta)
sleep stages and wave forms
awake-beta, awake_eyes_closed-alpha, 1-theta, 2-sleepspindles/kcomplexes, 3,4-delta, REM-beta
in which stage does bed wetting occur? What else happens in that stage?
stage 4 -- night terrors, sleep walking, bed-wetting
tx for bed wetting, mechanism
imipramine (TCA) or benzos --| stage 4 sleep
stimulators and inhibitors of REM sleep
NE --| REM SLEEP <-- ACh