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98 Cards in this Set
- Front
- Back
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Nissl substance… where found…
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RER of neurons found in cell body and dendrites
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When do microglia, like macrophages, fuse to form multinucleated giant cells in CNS…
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HIV
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Inflammatory infiltrate in Guillan-Barre in what layer of peripheral nerve…
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Endoneurium
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Neurotransmitter relative levels in anxiety…
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Elevated: NE, DA. Decreased: 5HT, GABA
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NT relative levels in depression…
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Decreased: NE, DA, Ser
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Leptin effects what to areas in hypothalamus and how… what happen if lesioned…
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Blocks the Lateral area- hunger. Lesion anorexia. Stimulates the ventromedial area- satiety. Lesionhyperphagia
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Nucleus that makes ADH…
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Supraoptic nucleus of hypothalamus
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Nucleus that makes oxytocin…
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Paraventricular nucleus. Goes to a PAR A’ Mammilary glands
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Area of the hypothalamus involved in cooling… stimulation regulated by…
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Anterior hypothal. Parasympathetic stimulation
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Area of the hypothalamus involved in heating… stimulation regulated by…
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Posterior hypothal. Sympathetic
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Area of hypothalamus controlling sexual urges…
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Septal nucleus
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Most common childhood brain tumor… location… distinguishing histological features…
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Astrocytoma. GFAP +. In posterior fossa or supratentorial or in hemisphere of cerebellum. Eosinophilic, corkscrew fibers (Rosenthal). Has both solid and cystic components
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Medulloblastoma features… location…
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Highly malignant, PNET tumor w/ small blue cells. Perivasclar rosette pattern. Hydrocephalus from 4th ventricle compression
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Ependyoma features… location…
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Usually in 4th ventricle and can cause hydrocephalus, have perivascular pseudorosettes and rod-shaped blepharoblasts (ciliary bodies) near nucleus
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Where does cerebellum receive input and from where…
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Ipsilateral proprioceptive info via ICP and contralateral cortical input via MCP (pontine pathway)
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Input fibers of cerebellum…
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Mossy fibers (go to granule cells- parallel fibers—Purkinje) and climbing fibers
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Output fibers and tract of cerebellum… NT used…
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Purkinje fibers project to deep nuclei of the cerebellum (DEG Fast) and release GABA. These project to the VL of the thalamus via SCP.
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Indirect pathway of basal ganglia…
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DA from SNc inhibits Striatum via D2 receptor. Striatum –I GPe –I STN GPi –I Thalamus cortex. Basically, GPi ends up NOT being stimulated so it cannot inhibit the thalamus and there is movement
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What happens to direct and indirect pathway of BG in parkinsons…
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No DA to stimulate the D1Rect pathway to directly inhibit GPi nor is the DA to inhibit the indirect pathway, thus, GPi is active in blocking thalamus
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Histological findings in Parkinson’s…
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Lewy bodies full of a-synuclein (eosinophilic cyto inclusions w/ halo) and depigmentation of SNpc
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Type of lesion that may create a hemiballism and what defines this type of lesion…
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Lacunar stroke to STN. Lacunar strokes involve penetrating arteries to putamen, thalamus, caudate, pons, post internal capsule. Defined by having hyaline arteriolosclerosis (DM, HTN)
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Neuronal death in Huntington’s due to… MOA of Huntingtons…
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NMDA-R binding to glutamate, toxic to neurons. There is a loss of GABA (no inhibition of thalamus) and Ach. Caudate is lost. CAG repeat (Caudate loses Ach and GABA)
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Tx of essential tremor…
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Alcohol or beta blockers
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W/ arcuate nucleus lesion, what happens…
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Can talk and understand okay but cannot repeat words
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If a patient has reduced levels of arousal and wakefulness and maybe in coma, what area of brain as been lesioned …
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Midbrain,
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Lesion of PPRF causes… role of PPRF…
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Eyes deviate away from side of lesion. PPRF receives input from superior colliculi and w/o it one cannot relay info to CN VI on ipsilateral side
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Central pontine myelinosis…
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Paralysis, dysarthria, dysphagia, diplopia and loss of consiousness due to rapid correction of hyponatremia. Lesions the corticospinal tract and corticobulbar tracts
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Pathophysiology of head trauma resulting in edema… how treat…
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Respiratory acidosis or hypoxemia incr activity of K channels in sm mscle hyperpolarized sm mscle sm muscle relax vasodilation and edema. Tx w/ hyperventilation to make vessels constrict
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Signs, symptoms, and areas affected in anterior spinal artery lesion…
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Affects medial medulla. Knocks out med leminiscus, pyramids, and hypoglossal nerve
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PICA lesion causes…
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Lateral medullary syn knocking out trigem tract (facial pain and temp- ipsilat) and nucleus, vestibular nucleus (vertigo), CN X exit (hoarseness, dysphagia, decr gag), Horners tract, lateral spinothalamic (contra P/T)
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AICA (ant inf cerebellar art) syndrome…
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Effects lateral pons. CN VII (facial paralysis), CN VIII (cochlear/vestibular-nystagmus), trigem tract (facial P/T), ipsi dystaxia (MCP, ICP)
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Herniation that can effect anterior cerebral artery…
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Subfalcine herniation of cingulated gyrus
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Most common site of Cir of Willis aneurism… result…
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Ant communicating artery… may result in visual defects
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Aneurism that commonly causes CNIII palsey occurs where…
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Posterior communicating artery
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What is interesting about bifurcations of arteries in circle of willis… why important…
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The junctions lack internal elastic lamina and smooth muscle, more likely to cause aneurism
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Risk factors and assoc w/ berry aneurysms…
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APCKD, ED syndrome, Marfan’s, HTN, smoking, blcks, old
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Charcot-Bouchard microaneurysms… most common locations…
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Due to chronic htn, affects small vessels in basal ganglia (lenticulostriate branches of MCA) and thalamus (small branches from PCA)
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Maxillary artery is a branch of what artery…
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External carotid artery
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Findings in subarachnoid hemorrhage… time period of these findings…
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Worst HA of life, bloody or yellow spinal tap and possible nuchal rigidity. 2-3 days later there is risk of vasospasm due to blood breakdown products, tx w/ Ca channel blockers
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Areas of brain most susceptible to ischemia…
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Hippocampus, neocortex, cerebellum, watershed areas
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Chronological pathogenesis of histo findings in cerebral infarct…
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12-48 hours: Red neurons 1-3 days: Neutrophils and Necrosis 3-5 days: macrophages 1 week: gliosis and vasc proliferation 1 month: glial scar
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Etiology of ischemic stroke due emboli… tx…
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a-fib, cartotid dissection, patent foreamen ovale, endocarditis. Treat w/ tPA w/in 3 hrs
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Tx for TIA…
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Asprin, clopidogrel, ticlopidine
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Stroke imaging on diffusion wt MRI…
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Bright within few minutes and stays bright for 10 days
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Stroke imaging on CT…
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Dark after about 24 hours
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In adults, spinal cord extends to… subarachnoid space extends to…
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L1-2. Subarachnoid space extends to S2
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L4-L5 (area of lumbar puncture) at what level anatomically…
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Iliac crests
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What is different about the DC layout of arms and legs distribution compared to lat corticospinal tract and spinothalamic…
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DC columns have feet on inner portion (gracilus) and arms outer; whereas the other are the opposite (Legs are Lateral in Lateral corticospinal, spinothalamic)
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Tract and Synapse 1 of the corticospinal tract…
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Extends down from cortex thru IC and decussates at M-cerv junxn then travels in lat corticospinal tract before synapsing for the 1st time in Cell body of anterior horn of spinal cord
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Synapse 1 of vib/proprio fibers… where decussate…
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Enter thru dorsal root and ascend before synapsing in the nucleus cutaneous or gracilus in the medulla. Decussate after that
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Neurons affected in syringomyelia 1st or 2nd order…
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2nd order because PT 1st order nerve synapses in dorsal gray matter and decussates at ant white commissure
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Where does poliovirus replicate before going to CNS…
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Replicates in oropharynx and SI before traveling in blood to CNS
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Werndig-Hoffman inheritance…
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Autosomal recessive. LMN involvement only
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MOA of Freidrich’s ataxia…
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Decreased protein translation of Frataxin gene leads to mitochondrial instability, possibly due to Fe hemostasis
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Causes of Horner’s syndrome…
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Pancoast tumor, Brown-Sequard hemidisection above T1, late-stage syringomyelia, Carotid artery dissection (superior cervical ganglion is in area of carotid bifurcation)
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Muscle spindle organization and coordination w/ CNS…
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Intrfusal fibers sense stretch and relay info to spinal cord via Ia afferent. Synapse. Alpha efferent fibers stimulate extrafusal fibers to contract (reflex contraction)
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Golgi spindle organization and coordination w/ CNS…
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Golgi tendons run perpendicular to intrafusal musle and send inhibitory feedback via Ib to block alpha efferent fibers from contracting
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Which nerve arises dorsally on brain stem and immediately decussates… sign of lesion to this nerve and action of the nerve…
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Trochlear nerve (IV) which innervates the Sup Oblique muscle (down and in). person has diplopia when walking down stairs
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Pineal gland and clinical significance of pinealoma…
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Melatonin, circadian rhythm. Pinealoma can compress the superior colliculi and impair vertical gaze
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Lacrimation reflex afferent and efferent nerves…
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Afferent: V1. Efferent: VII
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3 vagal nuclei, funxns, and other nerves associated w/ nuclei…
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Nucleus Solitarius- visceral Sensory, also gustatory (VII), baroreceptors (IX)… Nucleus aMbiguus- motor to pharynx, larynx, upper esophagus. Swallowing. Also has IX and XI… Dorsal Motor Nucleus- ANS to heart, lungs, upper GI
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Pass thru superior orbital fissure…
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CNIII, IV, V1, CI, ophthalmic vein, sympthatic fibers
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Where does central retinal vein pass thru… what else passes thru this pathway…
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Optic canal, along w/ optic nerve and ophthalmic artery (note: ophthalmic vein passes thru superior orbital fissure)
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What passes thru the foramen spinosum…
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Middle meningeal artery
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Pass thru the internal auditory meatus…
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CN VII, VIII
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Pass thru jugular foreamen…
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CN IX, X, XI (descending), jugular vein
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Pass thru foreamen magnum…
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CN XI (ascending roots), brain stem, vertebral arteries
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Cavernous sinus syndrome…
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Opthalmoplegia, V1 and V2 sensory loss, possible loss of sympathetic stimulation of sweat and pupil.
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CNV motor lesion what happens to the jaw…
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Deviates TOWARD side of lesion
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If person has Bells palsy, what portion of the face do you hope to find paralyzed and why…
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Whole face paralyzed because if pt can wrinkle forehead then you have UMN lesion. (lower face receives bilateral innervation)
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Bell’s palsy causes…
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AIDS, Lyme dx, Herpes zoster, Sarcoidosis, Tumors, Diabetes
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Muscles of mastication are innervated by what branch of trigeminal nerve…
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V3
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Tensor Veli Palatini innervated by… funxn…
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V3. funxns in mastication and opening of Eustachian tube
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Hair cells, located in Organ of Corti involved in what…
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2 things: cochlea (hearing) and vestibule (spatial orientation)
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Physiology of hearing as sound enters the middle ear beginning w/ tympanic membrane…
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Vibration on tympanic membrane ossicles oval window basilar membrane causing bending of hair cell cilia against tectorial membrane depolarization of CNVIII
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If bone conduxn is greater then air condxn in ear, where does the hearing loss lateralize to…
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That same ear
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If air condxn is greater then bone condxn (which is normal) in ear and there is hearing loss, where does the hearing loss lateralize to…
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The opposite ear
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What happens in eye to accommodate for near vision…
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Ciliary muscle contracts causing zonular fibers to relax lens relaxes and becomes more convex
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Eye pathology in aging…
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Sclerosis and decr elasticity cause lens shape to change
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What is seen in retinal artery occlusion…
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Painless, monocular vision loss w/ pale retina and cherry-red macula (has own blood supply- choroid artery
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Ciliary process does what… controlled by…
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Produces aqueous humor and is beta adrenergic
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Ciliary muscle is controlled by…
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M3, accommodates
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Two things in eye that have M3 receptors… what does each do…
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Spincter/circular/constrictor muscle which causes miosis; ciliary muscle which accommodates
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Dilator/radial mscle located lateral or medial to constrictor… type of receptors…
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Lateral to constrictor/circular/sphincter muscle. Has alpha1 receptors
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Pathology of glaucoma
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Impaired flow of aqueous humor leading to incr intraocular pressure and optic disk atrophy w/ cupping
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Open angle glaucoma caused by… assoc w/… presentation…
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Obstructed outflow, assoc w/ myopia (nearsightedness), incr age, blacks. More common and is painless
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Closed angle glaucoma caused by… presentation… drugs to avoid…
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Obstrxn of flow between iris and cornea. Very painful, decr vision, rockhard eye and frontal headache. Do not give epinephrine (contricts radial/dilator muscle and makes worse)
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RFs for cataract…
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Age, smoking, EtOH, sunlight, classic galactosemia, galactokinase def, diabetes, trauma, infxn
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SNS innervation to the eye…
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T1 pregang superior cervical ganglion postgang sympathetic long ciliary nerve
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Pathway of signal as light enters the eye…
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Sends signal down CNII to pretectal nuclei bilateral activation of EW nuclei causing pupils to contract bilaterally
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Pathology of retinal detachment…
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Separation of neurosensory layerof retina from pigment epithelium degeneration of photoreceptors vision loss. Secondary to trauma or diabetes
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Lesion where causes homonymous hemianopsia…
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Optic tract
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Lesion of what artery causes quadrantic hemianopsias and which area of brain corresponds to which…
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MCA. Upper due to temporal lobe lesion and lower due to parietal lobe lesion
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Dorsal optic radiations relay info from what part of retina… path goes thru..
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Superior retina (lower field). Goes thru internal capsule
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Genes predisposing to Alzheimers… gene that is protective…
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Early onset: APP (21), presenilin1 (14) and presenilin2 (1) Late onset: ApoE4 (19). ApoE2 (19) is protective
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Histo and gross findings in Alzheimers… describe the plaques and triangles…
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Widespread cortical atrophy, decr Ach, senile plaques consisting of extracellular beta amyloid hemorrhage), neurofibrillary triagles (intracellular phosphorylated tau- correlates w/ degree of dementia)
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Findings in Pick’s disease findings… area mainly affected… histo findings…
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Dementia, aphasia, parkinsonian aspects, personality change. Affects frontal and temporal lobe but spares parietal and posterior 2/3 of superior temporal gyrus. Have Pick bodies (intracellular Tau aggs)
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Lewy body dementia description… histo findings…
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Parkinsonism w/ dementia and HALLUCINATIONS (unlike Picks or Parkinsons). A-synuclein defect
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