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292 Cards in this Set
- Front
- Back
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pt. presents with decrease pain and temperature sensation over the lateral aspects of both arms: what is the lesion?
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syringomyelia- (associated with arnold-chiari malformation)
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penlight in patient's right eye produces bilateral pupillary contriction. When moved to the left eye, there is paradoxical dilation: defect?
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left optic nerve atrophy
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woman involved in motor accident cannot turn her head to the left and has right shoulder drop: what structure is damaged?
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right CN XI (runs through the jugular foramen with IX, X) innervating the SCM and trapezius
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man presents with 1 wild, flailing arm: where is the lesion?
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contralateral subthalamic nucleus (hemiballismus)
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patient with cortical lesion does not know that he has a disease: where is the lesion?
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right parietal lobe
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patient's tongue protrudes toward the left side, and patient exhibits a right-sided spastic paralysis: where be the lesion?
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left medulla, CN XII
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patient cannot blink left eye or seal lips: what is the diagnosis?
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bell's palsy, CNVII
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woman presents with headache, visual disturbance, galactorrhea and amenorrhea: diagnosis
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prolactimona
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43 year old man exoeriences dizziness and tinnitus. CT shows enlarged internal accoustic meatus: diagnosis?
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schwannoma
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25 yo woman presents w/ sudden monocular vision loss and slightly slurred speech. History of weakness and paresthesias that have resolved: diagnosis?
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MS
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10 year old "spaces out" in class. During spells, has a slight quivering of the lip: diagnosis
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absence seizures
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23 yo woman motorcycle crash. Initially feels fine, but minutes later looses consciousness. At ER, CT shows intercranial hemorrhage that does not cross suture lines: what bone and vessel were injured?
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temporal, middle menegial artery resulting in epidural hematoma
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38 yo man with history of Marfan's and HTN presents with severe headache, spinal tap reveals blood in CT: cause?
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subarachnoid hemorrhage resulting from ruptured berry aneurysm
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78 yo man with ALZ falls and presents 3 days later with severe headache and vomiting: damaged structures?
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bridging veins, resulting in a subdural hematoma
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most common brain tumor in adults (1,2,3):
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glioblastoma multiforme, astrocytoma, meningioma
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most common brain tumor in children (1,2,3)
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astrocytoma, medulloblastoma, ependymoma
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most common tumor of the spinal cord
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ependymoma
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retrograde axonal transport mediated by what protein?
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dynein- how herpes, rabies etc. get to soma.
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lewy bodies:
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parkinson's
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negri bodies:
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rabies
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hirano bodies: where found and what disease?
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eosinophilic, rodlike inclusions in hippocampus of ALZ
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neuofibrillary tangles:
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degenerated neurofilaments seen in ALZ
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Cowdy type A inclusion bodies
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neurons and glia in herpes simplex encephalitis
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most common primary tumors seen in metastatic brain cancers:
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lung 35%, breast 17%, GI and melanoma 6%, kidney 5%
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which nerve endings are free nerve endings?
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nociceptors (pain) and thermoreceptors (cold/hot)
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which nerve endings are encapsulated?
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touch (meissner's) and pressure and vibration (pacinian)
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what is the relationship between conduction velocity and axon diameter?
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increase diameter- increase velocity
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general presentation of primary brain tumors:
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mass effects (seizures, dementia, focal lesions). Adults are mostly supratentoria, childhoods are infratentorial.
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where do adult brain tumors that are metastases usually show up?
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white-gray junction
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"psuedopalisading" pleomorphic tumor cells- border central areas of necrosis and hemorrhage: what tumor?
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glioblastoma multiforme
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which primary brain tumors can you stain with GFAP?
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glioblastoma multiforme- (atrocytoma type IV) GFAP stains astrocytes
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spindle cells concentrically arranged in a whorled pattern; psammoma bodies, most often occures in convexities of hemispheres and parasagittal region. Arises from arachnoid cells : what brain tumorexternal to brain
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meningioma - 2nd most common primary brain tumor
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3rd most common brain tumor- often localized to CN VIII- resectable. What is it and what genetic disorder is it related to?
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schwannoma, bilateral schwanomma found in neurofibromatosis type 2
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well circumscribed, common in posterior fossa, good prognosis, rosenthal fibers- (eosinophilic corkscrew fibers): what tumor
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pilocytic astrocytoma (most common kids)
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highly malignant cerebellar tumor. Rosettes or perivascular psuedorosette pattern of cells. Radiosensitive. (form of primitive neuroectodermal tumor (PNET). Can compress 4th ventricle- causing hydrocephalus: what tumor
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meduloblastoma
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AFP found in the amniotic fluid indicates what?
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nerual tube defect (spina bifida, anancephaly)
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failure of closure of what structure leads to anencephaly?
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anterior neuropore- elevated AFP- polyhydramnios (no swallowing center in brain)
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failure of closure of what structure leads to spina bifida?
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posterior neuropore
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embryonic origin of the pituitary gland:
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adenohypophysis (anterior lobe) derived from ectodermal diverticulum of the primitive mouth cavity (rathke's pouch), neurohypophysis (posterior lobe) derived from ventral evagination of hypothalamus (neuroectoderm and neural tube)
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defect resulting in elongation and herniation of cerebellar tonsils through the foramen magnum- thereby blocking cerebrospinal fluid flow
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arnold-chiari malformation (TYPE 2)
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most common cause of hydrocephalus-
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stenosis of the cerebral aquaduct during development- may result from maternal infection (CMV or toxoplasmosis)
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dandy walker malformation defect?
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dilation of 4th ventricle from failure of foramina of Luscka and Magendie to open
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failure of midline cleavage of the mebryonic forebrain. ( ass with trisomy 13, fetal alcohol syndrome)
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holoprosencephaly
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cord segment and muscle tested for the muscle stretch reflex: ankle jerk
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S1, gastrocnemius
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cord segment and muscle tested for the muscle stretch reflex: knee jerk
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L2-4, quadriceps
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cord segment and muscle tested for the muscle stretch reflex: biceps jerk
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C5-6, biceps
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cord segment and muscle tested for the muscle stretch reflex: forearm jerk
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C5-6, brachioradialis
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cord segment and muscle tested for the muscle stretch reflex: triceps jerk
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C7-8 triceps
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where does the adult spinal cord terminate (conus terminalis)?
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lower border of L1 vertebra
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where does the newborn spinal cord terminate (conus terminalis)?
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extends to L3 (vs L1 adult)
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in adults, what is the range of the cauda equina?
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vertibral L2 to coccygeal vertebra
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which CNs have parasympathetic components?
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CN III (ciliary ganglion), CNVII (pterygopalatine and submandibular ganglia), CN IX (otic ganglion), CN X (terminal (intramural) ganglia)
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innervation and function: radial muscle of iris
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sympathetic: mydriasis (alpha 1)
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innervation and function: circular muscle of iris
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parasympathetic: miosis (muscarinic)
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innervation and function: ciliary muscle of iris
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parasympathetic: contraction for near vision (muscarinic)
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innervation and function: lacrimal gland
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parasympathetic: stimulation of secretion (M3)
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innervation and function: salivary glands
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sympathetic: viscous secretions, parasympathetic: watery secretions
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innervation and function: sweat gland
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sympathetic: thermoregulation and apocrine (stress) (muscarinic)
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innervation and function: SA node
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Sympathetic: acceleration (B1) parasympathetic: deceleration (vagal arrest)
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innervation and function: AV node
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Sympathetic: increase in conduction velocity parasympathetic: decrease in conduction velocity
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innervation and function: heart contractility
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sympathetic: increase, parasympathetic: decrease (atria)
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innervation and function: skin, splanchnic vessels (vascular smooth muscle)
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sympathetic: contraction
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innervation and function: skeletal muscle vessels (vascular smooth muscle)
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sympathetic: relaxation
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innervation and function: bronchial smooth muscle
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sympathetic: relaxation (B2) parasympathetic: constriction
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innervation and function: GI smooth muscle walls
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sympathetic: relaxation, parasympathetic: contriction
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innervation and function: GI smooth muscle sphincters
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sympathetic: contristion, parasympathetic: relaxation
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innervation and function: GI secretions
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sympathetic: decrease parasympathetic: increase
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innervation and function: bladder wall
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sympathetic: no/little effect parasympathetic: contraction
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innervation and function: GU sphincter
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symp: contraction, parasympathetic: relaxation
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innervation and function: penis, seminal vesicles
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symp: ejaculation, parasympathetic: erection
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innervation and function: adrenal medulla
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sympathetic: secrete E, NE - adrenla gland- ACh N receptors
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innervation and function: liver
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symp: gluconeogenesis and glycogenolysis
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innervation and function: fat cells
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symp: lipolysis
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innervation and function: kidney
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symp: increase renin release
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extreme dilation and hypertrophy of the colon, with fecal retention and ansence of ganglion cells in myenteric plexus: diseases and cause:
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megacolon (hirschsprung's or congenitial aganglionic megacolon) caused by failure of neural crest cell migration into the colon
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AR trait with abdnormal sweating, unstable BP, difficulty feeding, and progressive sensory loss - results in the loss of neurons in the autonomic and sensory ganlgia
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familial dysautonomia (riley-day syndrome)
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idopathic paroxysmal bilateral cyanosis of the digits-
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raynaud's disease- terminal arteries of extremities- triggered by cold or emotion
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excessive production of HCl due to increased parasympathetic tone or stimulation:
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PUD
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paralysis of all striated muscle, dry eyes, dry mouth, GI obstruction:
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botulism- blocks releacse of acetylcholine
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how do you tell lambert-eaton myasthenic syndrome from myasthenia gravis?
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history- lambert eaton gets better with use….
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what information does the posterior column-medial lemniscus pathway carry?
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SENSORY- tactile discrimination, vibration sensation, proprioception
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gracile fasciculus is made from first order neurons from what region?
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lower extremity- (medial on cord)
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cuneate fasciculus is made from first order neurons from what region?
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upper extremity- (lateral on cord)
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where are the gracile and cuneate nuclei located?
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caudal medulla
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second order axons of the dorsal colum give rise to what pathway?
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medial lemniscus that ascends through the CONTRALATERAL brain stem and terminates in the VPL of the thalamus
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where do the 3rd order neurons in the VPL nucleus of the thalamus project to?
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posterior limb of the internal capsule to the postcentral gyrus (broadman area 3,1,2)
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transection of the posterior (dorsal) coulumn-medial lemniscus tract above the sensory decussation results in:
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contralateral loss of vibration sensation, proprioception
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transection of the posterior (dorsal) coulumn-medial lemniscus tract below the sensory decussation results in:
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ipsilateral loss of vibration sensation, proprioception
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which tract mediates pain and temperature sensation?
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lateral spinothalamic tract
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second order axons from the Lateral spinothalamic tract decussate in what structure?
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ventral white commissure- terminate in VPL nucleus of hypothalamus
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transection of the lateral spinothalamic tract results in what?
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contralateral loss of pain and temperature below the lesion
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function of the lateral corticospinal tract:
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motor activity primarily of upper limbs.
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origin of lateral corticospinal tract:
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layer V of the cerebrall cortex from 3 cortical areas: premotor cortex (b6), primary motor cortex (b4), primary sensory cortex
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transection of the lateral corticospinal tract above the motor decussation leads to what?
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contralateral spastic paresis and babinski sign
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transection of the lateral corticospinal tract below the motor decussation leads to what?
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ipsilateral spastic paresis and babinski's sign
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where does the corticospinal tract decussate?
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pyramidal decussation in the medulla
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where does the lateral spinothalamic tract decussate?
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at level of entry in spinal cord
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where does the dorsal colum tract decussate?
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medulla
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spastic paresis results from what?
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UMN lesions (transection of corticospinal tract or cortical cells)
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flacid paralysis results from what?
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LMN lesions- also areflexia, atrophy, fasciculations, fibrillation.
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combined UMN and LMN disease:
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ALS- there are no sensory defects
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tertiary syphilis can result in this disease that results in impaired proprioception and locomotor ataxia: what is it called and what tracts are affected?
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tabes dorsalis- degeneration of dorsal roots and dorsal columns (dorsal columns of spinal cord)
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brown-sequard syndrome = what?
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spinal cord hemisection-
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ipsilateral loss of fine touch and proprioception (doral columns), ipsilateral spastic paresis (corticospinal), Contralateral loss of pain and temperature sensation below lesion (spinothalamic), T-1 and above can result in ipsilateral horner's syndrome, ipsilateral flaccid paralysis of inervated muscle (ventral horn)
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Brown-sequard syndrom- hemisection of spinal cord
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bilateral spastic paresis (corticospinal tract), bilateral loss of pain and temperature below lesion (spinothalamic), bilateral horner's syndrom (at T-2 and above), bilateral flaccid paralysis, bilateral loss of voluntary blasser and bowel control.
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ventral spinal artery occlusion- infarction of the anterior 2/3 spinal cord but spares the dorsal clumns and horns.
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bilateral loss of fine touch and propioception (dorsal colums), bilateral spastic paresis (corticospinal), bilateral arm and leg dystaxia (spinocerenellar)- diagnosis
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subacute combined degeneration- (vitamin B12 neuropathy) caused by megaloblastic anemia
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bilateral loss of pain and temperature sensation (damage to ventral white commissure), flaccid paralysis of intrinsic muscles of hands: diagnosis
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syringomyelia- cervical cord
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destruction of anterior horns can cause what (as in poliomyolitis and werdnig-hoffman disease)?
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flaccid paralysis = LMN
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most common sites (90%) of intervertebral disk herniation:
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L4-L5 or L5-S1 interspace.
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location of synthesis: DA
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ventral tegmentum and SNc
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location of synthesis: NE (brain)
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locus ceruleus
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location of synthesis: 5-HT
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raphe nucleus
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location of synthesis: Ach
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basal nucleus of meynert?
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infarction destroys endothelial cell tight junctions resulting in:
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vasogenic edema
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thirst and water balance are controlled by what nucleus of the hypothalamus
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supraoptic nucleus
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hunger(1) and satiety(2) are controlled by what areas of the hypothalamus?
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lateral area- ventromedial area (if you zap your ventromedial nucleus, you grow ventrally and medially
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what regions of the hypothalamus regulate the 2 ANS systems?
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Anterior = pArasympathetic, Posterior= sympathetic
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what region regulates circadian rhythms?
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suprachiasmatic nucleus (hypothalamus)
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what 2 regions of hypothalamus rergulates temperature?
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posterior - (heat conservation and production), anterior (cooling when hot) A/C
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Lateral geniculate nucleus of thalamus mediates what information?
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Lateral for Light (visual)
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Medial geniculate nucleus of thalamus mediates what information?
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Medical for music (auditory)
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VPL of thalamus is relay for what?
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spinothalamic tract- aka fine touch and proprioception
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VPM of thalamus is relay for what?
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facial sensation via CN V
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VA/VP of thalamus is relay for what?
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motor neurons
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5 F's of limbic system:
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feeding, fleeing, fighting, feeling, sex (cingulate gyrus, hippocampus, fornix, mammillary bodies)
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output fibers of cerebellum:
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purkinje fibers
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input fibers of cerebellum:
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mossy, climbing
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frontal lobe damage can result in what?
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disinhibition= damage think phineas gage
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stroke leading to defect in legs-feet cause by occlusion to which artery
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anterior cerebral
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stroke leading to defect in trunk-arm-hand/face caused by which artery
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middle cerebral
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stroke leading to defect in broca and wernicke's speech areas caused by which artery?
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middle cerebral
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most common site of willis aneurysm?
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anterior communicating artery
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posterior communicating artery aneurysm can lead to what CN damage:
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CNIII palsy
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laterial striate- divvisions of middle cerebral artery - (artieries of stroke) supply what structures?
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internal capsule, caudate, putamen, globus pallidus
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in general, strokes of the anterior circle result in :
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general sensory and motor dysphunction- aphasia
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in general, strokes of the posterior circle result in:
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CN deficits (vertigo, visual deficits), coma, cerebellar ataxia
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connects the lateral ventricles with the 3rd ventricle:
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foramen of monroe
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connects the 3rd ventricle with the 4th:
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cerebral aquaduct:
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4th ventricle to subarachnoid space via:
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lateral = luschka, medial = magendie
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C1-C7, nerves exit intervertebral foramina _______ the corresponding vertebra.
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above
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C8 and below nerves exit intervertebral foramina _______ the corresponding vertebra.
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below "C8 and below are below"
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landmark for pudendal nerve block:
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ischial spine
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where is McBourney's point?
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2/3 way from umbilicus to anterior superior iliac spine
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landmark for lumbar puncture:
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iliac crest
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dermatome for nipples
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T4 at the teat pore!
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dermatomes for penile and anal zones
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S2,3,4
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name reflex: extension of limbs when startled
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moro
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name reflex: nipple seeking
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rooting
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name reflex: grasps objects in palm
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palmar
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name reflex: large toe dorsiflexes with plantar stimulation
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babinski
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function superior colliculus vs inferior colliculus
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eyes above ears; superior = conjugate gaze center, inferior = auditory
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function of pineal gland:
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melatonin secretion- cricadian rhythm
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CN: smell
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CN I (only CN without relay to thalamus)
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CN: sight
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II
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CN: eye movement (damaged- eye looks down and out), accomidation, eyelid opening
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III
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CN: pupil constriction
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III
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CN: damage causes diplopia and downward gaze
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IV
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CN: mastication, facial sensation
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V
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CN: damage causes medially directed eye
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VI
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CN: can't smile
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VII
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CN: can't tast from anterior 2/3 of tongue
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VII
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CN: cant cry
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VII
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CN: can't salivate out of submandibular and sublingual glands
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VII
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CN: can't force eyelids to close
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VII
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CN: stapedius muscle in ear
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VII
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CN: hearing, balance
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VIII
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CN: taste posterior 1/3 of tongue
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IX
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CN: swallowing which 2 are needed?
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IX
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CN: parotid gland
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IX
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CN: monitors carotid body and sinus chemo/baroreceptors.
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IX
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CN: stylopharyngeus
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IX
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CN: epiglottic taste
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X
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CN: palate elevation
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X
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CN: talking
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X
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CN: coughing
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X
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CN: thoracoabdominal viscera
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X
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CN:aortic arch chemo/baroreceptors
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X
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CN: can't turn head or shrug shoulders
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XI
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CN: tongue movement
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XII
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CN mnemonic about function sensory or motor:
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S= sensory, M= motor, B= both Some Say Mary Money But My Brother Says Big Brains Matter Most
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CN nuclei in midbrain:
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III, IV
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CN nuclei of Pons
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V,VI, VII, VIII
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CN nuclei of medulla
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IX, X, XI, XII all X's in medula
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CN reflex afferent and efferent: corneal
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V1 to VII
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CN reflex afferent and efferent: lacrimation
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V1 to VII
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CN reflex afferent and efferent: jaw jerk
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V3 to V3
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CN reflex afferent and efferent: pupillary
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II to III
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CN reflex afferent and efferent: gag
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IX to IX, X
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vagal nuclei: solitarius:
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sensory
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vagal nuclei: ambiguous
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motor
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what CNs go exit through the middle cranial fossa (through the sphenoid bone)
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CN II-VI
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which CNs exit through the posterior cranial fossa (temporal or occipital bones)
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CN VII through XII
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CN(s) goes through the: superior orbital fissure
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CNIII, IV, V1, VI
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what holes do the 3 branches of V go through?
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Standing Room Only- superior orbital fissure, rotundum, ovale
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CN(s) goes through the: internal auditory meatus
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CN VII, VIII
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CN(s) goes through the: jugular foramen
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CN IX,X,XI
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CN(s) goes through the: hypoglossal canal
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CNXII
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CN(s) goes through the: foramen magnum?
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CN XI
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opthalmoplegia, opthalmic and maxillary sensory loss: diagnose me please
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cavernous sinus syndrome: CN II, IV, V1/2 and VI all pass through cavernous sinus
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Kuh-kuh-kuh tests what CN?
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CNX- palate elevation
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la-la-la-la tests what CN?
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CNXII- duh - or luh
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mi-mi-mi-mi tests what CN?
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CNVII- facial
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muscles of mastication (4) and their innervation
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closers- temporalis, masseter, medial pterygoid opens- lateral pterygoid
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rinne and weber test in conductive hearing loss
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rinne- negative (bone>air), weber localizes to AFFECTED ear
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rinne and weber test in senserineural hearing loss
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rinne- positive (bone<air), weber localizes to normal ear
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innervation of lateral rectus in eye:
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CN VI
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innervation of superior oblique
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CN IV
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interneuclear opthalmnoplegia caused by lesion in what structure?
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MLF- results in medial rectus palsy on attempted lateral gaze. Nystagmus in abducting eye. Convergence normal. Common in MS
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left MLF damage- which eye is affected?
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the left eye cannot turn medially when trying to look right.
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difference between meningocele and meningomyelocele
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miningocele- only meninges herniate, not the meninges and the spinal cord
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horner's syndrome face findings:
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PAM is Horny- ptosis, anhidrosis (absence of sweating) and flushing on affected side, miosis ---- lesion above T1
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brain lesion findings: broca's area
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broken speech- motor aphasia with good comprehension- (nonfluent/expressive speech)
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brain lesion findings: wernicke's area
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wordy, but makes no sense- sensory aphasia (fluent/receptive) with poor comprehension
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brain lesion findings: arcuate fasciculus
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conduction aphasia- poor repition with good comprehension, fluent speech (connects broca with wernicke(
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brain lesion findings: amygdala
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kluver-bucy syndrome- hyperorality, sexuality- disinhibited behavior)
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brain lesion findings: right parietal lobe
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spatial neglect syndrome (contralateral side)
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brain lesion findings: mamillary bodies
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wernicke-korsakoff syndrome
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brain lesion findings: cerebellar hemispheres
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intention tremor- limb ataxia (ipsilateral) = hemispheres are laterally located, affect lateral limbs
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brain lesion findings: cerebellar vermis
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truncal ataxia, dysarthria = vermis is central, affects central body
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brain lesion findings: hippocampus
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retrograde amniesia
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slow writhing movements- especially of fingers
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athetosis (basal ganglia lesion)
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neurofibrillary tangles are located where and compased of what?
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intracellular, abnormally phosphorylated tau proteins ALZ
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senile plaques are located where and composed of what?
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extracellular, beta-amyloid core.
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what gene is associated with familiar ALZ
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APOE4 allele on chromosome 19, also 1, 14, and 21 (pApp)
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dementia, aphasia, parkinsonian aspects, associated with bodies (intracellular, aggregated tua protein)
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Picks disease - pick bodies frontotemporal lobe atrophy
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parkinsonism with dementia and hallucinations. Defect alpha-synuclein
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Lewy body dementia
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rapidly-progressive (weeks to months) dementia with myoclonus, spongiform cortex
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Creutzfelt-jakob disease (prions)
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neurotransmitter affected in huntington's
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loss of caudate nucleus= loss of GABAergic neurons- (also Ach) presents with enlarged lateral ventricles
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risk of exposure to MPTP
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parkinson's disease
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defect in SOD1 can cause what disease?
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ALS- no sensory defects
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floppy baby- tongue fasciculations, median age death 7 months, degeneration of anterior horns, LMN only
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werdnig-hoffmann disease (infantile spinal muscular atrophy) AR
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malaise, headache, fever, nausea, abdominal pain, sore throat- signs of LMN lesions, muscle weakness and atrophy, fasciculations, fibrillation, and hyporeflexia. CSF with lymphocytic pleocytosis and slight elevation of protein (nl glucose). Virus recovered from stool or throat: dignosis
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poliomyelitis- anterior horn damage
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Scanning speech, Intention tremor, Incontinence, Internuclear ophthalmoplegia, Nystagmus:
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MS
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treatment for MS:
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beta-interferon or immunosupression
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PML associated with what virus? Progressive multifocal leukoencephalopathy
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JC virus- 2-4% of aids patients (reactivation of latent)
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elevated CSF protein with normal cell count (albuminocytologic dissociation) - elevated protein- leads to papilledema: findings of what demyelinating disorder?
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guillain-barre
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guillain-barre reatment:
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plasmaphoresis, IV immune globulins, respiratory support
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partial seizures- 2 types:
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simple partial (consciousness intact) motor, sensory, autonomic, psychic- complex partial (impaired consiousness)
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5 types of generalized seizures
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1) absence (petit mal) 2)myoclonic -quick repetitive jerks 3) tonic-clonic (grand mal) alternating stiffening and movement 4) tonic- stiffining 5) atonic - drop seizure
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common causes of seizures in children
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genetic, infection, trauma, congenital, metabolic
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common causes of seizures in adults
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tumors, trauma, stroke, infection
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|
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common causes of seizures in elderly
|
stroke, tumor, trauma, metabolic, infection
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|
most common cause of meningitis in newborn:
|
group B strep (s. agalactiae)
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most common cause of meningitis in 6mo to 6 yrs:
|
S. pneumoniae
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most common cause of meningitis in 6 yrs to 60 yrs:
|
N. meningitidis
|
|
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most common cause of meningitis 60+ years:
|
S. pneumoniae
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Viral causes of meningitis:
|
enterovirus (coxsackie), HSV, HIV, WNV, VZV
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common causes of meningitis in HIV patient
|
cryptococcus, CMV, toxo, JC virus
|
|
|
common variable? Adult PCKD, ehlers-danlos syndrom, marfan's syndrome:
|
risk of berry aneurysm also age, HTN, smoking.
|
|
|
most common complications of berry aneurysm:
|
rupture leading to hemorrhagic stroke/subarachnoid hemorrhage
|
|
|
enlarged ventricles with normal opening pressure on lumbar puncture: gait problems, urinary incontinence:
|
communicating hydrocephalus- impaired absorption of CSF by arachnoid granulations
|
|
|
congenital disorder with port-wine stains and ipsilateral leptomeningeal angioma- can cause glaucoma, seizures, hemiparesis, mental retardation:
|
Sturge-weber syndrome
|
|
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hamartomas in CNS, skin, organs, cardiac rhabdomyoma, renal angiomyolipoma, subependymal giant cell astrocytoma, MR, seizures, ash leaf spots, sebaceous adenoma, shagreen patch: wow:
|
tuberous sclerosis
|
|
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AD disorder with cavernous hemangiomas in skin, mucosa, organs, renal cell carcinoma, hemanioblastoma in retina, cerebellum, brain stem:
|
von Hippel-lindau
|
|
|
café-au-lait spots, lisch nodules (iris), neurofibromas in skin:
|
neurofibromatosis
|
|
|
low-lying cerebellum obstructs CSF flow and compresses medulla, cerebellar tonsils descend through foramen magnum :
|
chiari type I
|
|
|
cerebellar vermis and medulla descend through foramen magnum- fatal Dandy-walker large posterior fossa, absent cerebellum with cyst in place:
|
chiari II
|
|
|
small posterior fossa, downward displacement of cerebellum, medulla deformity, associated with tonsilar herniation:
|
arnold-chiari
|
|
|
tongue deviates ______ the side of lesion in CN XII
|
toward
|
|
|
jaw deviates _____ the side of lesion in CN V
|
toward
|
|
|
unilateral lesion of cerebellum results in patient falling ______ the side of leasion
|
towards
|
|
|
uvula deviates ____ from side of lesion in CN X lesion
|
away
|
|
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weakness turning head to ______ side of lesion, shoulder drop on _____ side of lesion : CNXI
|
contralateral, ipsilateral
|
|
|
UMN lesion to CNVII results in ________ paralysis of lower face only (upper face is innervated by contra and ipsilateral)
|
contralateral
|
|
|
LMN lesion to the CNVII results in ________ paralysis of upper and lower face.
|
ipsilateral
|
|
|
complication seen in AIDS, Lyme disease, Sarcoidosis, Tumors, Diabetes- resulting in peripheral ipsilateral facial paralysis with inability to close eye on involved side.
|
bell's palsy- complete destruction of the facial nucleus or its branchial efferent fibers
|
|
|
risk of cingulate herniation:
|
anterior cerebral artery compression
|
|
|
what does hypoxemia and/or respiratory acidoses do to cerebral vessels?
|
increase cerebral vessel permeability- leading to edema
|
|
|
most common cause of hydrocephalus in newborn
|
block of aqueduct of silvius
|
|
|
coup vs contracoup- where is the injury?
|
coup- site of impact, contraccoup- opposite site of impact
|
|
|
pale infarction extending to the periphery of cerebral cortex:
|
atherosclerotic stroke
|
|
|
hemorrhagic infarct extending to the periphery of cerebral cortex:
|
embolic stroke
|
|
|
MCC viral meningitis
|
coxsackievirus
|
|
|
MCC viral meningitis in aids patient
|
CMV
|
|
|
arboviruses predominantly cause what disease in CNS?
|
encephalitis WNV ie.
|
|
|
hemorrhagic necrosis of temporal lobes cause by viral infection due to :
|
HSV type 1 - meningitis or encephalitis
|
|
|
cause of SSPE?
|
measules (rubeola)
|
|
|
gram + rod found in soft cheese and hot dogs causes neonatal meningitis:
|
listeria monocytogenes
|
|
|
gram - rod , 2nd most common cause of neonatal meningitis:
|
e. coli
|
|
|
tabes dorsdalis associated with what infection:
|
treponema pallidum
|
|
|
patient ingests food or water containing eggs that develop into larva form- invade brain and produces calcified cysts causing siezures:
|
taenia solium- cystercercosis
|
|
|
bilateral internuclear ophthalmoplegia pathognomonic for:
|
MS
|
|
|
cystic degeneration of what structure in Wilson's disease?
|
putamen
|
|
|
legs have inverted bottle appearance- AD-
|
charcot-Marie-tooth
|
|
|
mcc sites of ependymoma in children and adults:
|
children- 4th ventricle adults- cauda equina
|
|
|
decreased rate of aqueous outflow into the canal of schlemm- bilateral aching eyes, cupping of optic disks, night blindness and gradual loss of peripheral vision leading to tunnel vision and blindness
|
chronic open angle glaucoma
|
|
|
narrowing of anterior chanber angle, precipitated by mydriatic agent, uveitis, lens dislocation, severe pain with photophobia and blurry vision, red eye with steamy cornea, fixed pupil- nonreactive to light
|
acute- closed angle glaucoma
|
|
|
first line drug for absence seizure: what other one can you use?
|
ethosuximide (valproic acid)
|
|
|
first line for an acute status epilepticus
|
benzodiazepines (diazepam or lorazepam)
|
|
|
epileptic drug with aplastic anemia toxicity:
|
carbamazepine inducer of -450
|
|
|
epileptic drug with risk of nystagmus, diplopia, ataxia, gingival hyperplasia, hirsuitism, megaloblastic anemia, teratogenesis, SLE, 450 inducer
|
phenytoin
|
|
|
epileptic drug with rare fatal hepatotoxicity, neural tube defects, tremor, weight gain. Contraindicated in pregnancy:
|
valproic acid
|
