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114 Cards in this Set
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- Back
- 3rd side (hint)
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dorsal motor nucleus
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vagus nerve parasympathetics
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solitary nucleus
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visceral sensation (inc taste) 7, 9, 10
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nucleus ambiguous
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branchial motor for 9, 10, 11
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cribiform plate. which cn
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1
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middle cranial foss. which cn, which bones, which foramen
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2-6. sphenoid bone. optic canal, superior oblique fissure, foramen rotundum, foramen ovale, foramen spinosum
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optic canal
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2, opthalmic artery, central retinal vein
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superior oblique fissure
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3, 4, 5-1, 6
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foramen rotundum
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V2
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Formane ovale
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V3
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Foramen spinosum
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middle meningeal artery
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Posterior cranial fossa. which cn, which bones, which foramen
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temporal or occipital bones. 7-12. internal acoustic meatus, jugular foramen, hypoglossal canal, foramen magnum
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internal acoustic meatus
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7,8
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jugular foramen
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9,10,11
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hypoglossal canal
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12
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foramen magnum
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spinal roots 11, brain stem, vertebral arteries
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canvernous sinus is… contains…
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venous sinus, drains to internal jugular vein. CN 3, 4, V1, V2, 6. not V3. Internal carotid. 6 is free floating
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which CN in the cavernous sinus is free floating
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6
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what is cavernous sinus syndrome
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mass effect. opthalmoplegia, sensory loss with ophthalmic, maxillary distribution. maybe 6 first b/c free floating.
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None
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pretectal nucleus
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CN2 => pretectal =>edinger-westphal => CN3 => ciliary ganglion
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"kuh" tests
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palate elevation: CN10
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"la" tests
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tongue: CN12
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"mi" tests
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lips: CN7
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stages of sleep and their wave forms
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awake beta, close eyes alpha, stage 1 theta, stage 2 sleep spindles and K complexes, stage 3-4 delta, REM beta
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what NT initiates sleep, from where
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raphe nucleus: seratonin
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extraocular eye movements during REM are caused by
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PPRF (paramedian pontine reticular formation/conjugate gaze center)
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night terrors and sleep walking. when? tx?
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stage 4. benzos shortern
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enuresis. when? tx?
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stage 4. imipramine shrotens
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which NT during REM?
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ACh
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how often does REM occur? change with age?
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90 mins. down with age.
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what is the emrbyological cause of neural tube defects
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failure of neuropore to close. if cephalic: anencephale or encephalocele
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poor verbal repitition. lesion?
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arcuate fasciculus
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Kluver Bucy syndrome. lesion? sx?
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bilateral amygdala. hyperorality/sexuality, disinhibited
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reemergance of primitive reflexes. where's the lesion
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frontal lobe
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lesion to the reticular activating system
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coma
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bilateral lesion to the mamallary bodies
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Wernicke-Korsakoff
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intention tremor. leison?
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cerebellar hemispheres
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cerebellar vermis lesion
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truncal ataxia, dysarthria
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basal ganglia lesion
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resting tremor (eg PD), chorea (eg huntingtons/caudate), athetosis
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athetosis vs. chorea
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slow writhing movements esp fingers. chroea = sudden jerky movements
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senile plaques. what where
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AD. extracellular, beta amyloid
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neurofibrillary tangles. what where.
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AD. intracellular, abnormally posphorylated tau protein
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amyloid angiopathy =>
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intracranial hemorrhage
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Pick's disease. histo? location?
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pick bodies (intracellular tau protein) in forntal and temporal lobes. dementia, aphasia, parkinsonian aspects.
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inheritance of huntington's disease
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AD
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NT and anatomical defect in HD
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GABA (and ACh. caudate
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Lewy Bodies
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PD.
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what drugs can cause parkinsomism
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MPTP
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what chromosome and genetic defect in Huntington's
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4. CAG repeats. (Caudate, ACh loss, Gaba loss)
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degeneration of spinocerebellar tracks
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olivopontocerebellar atrophy. friedreich's ataxia
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which neurons degenerate in ALS
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UMN + LMN
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which mutation in ALS. Chromo/
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21. SOD1
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treatment for ALS
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riluzole (NMDA antag)
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Werdnig-Hoffman
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degeneration of LMN/anterior horn => floppy baby, tongue fasciculations, death < 1yo. AR. same lesion as polio!
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my baby's floppy
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werdnig-hoffman
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Polio
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anterior horn cells. Picorna/enterovirus
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how is polio spread
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fecal/oral. Picorna/enterovirus
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polio sx
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1) non specific sx (h/a, fever s/t, ab pain, nausea 2) LMN: weakness, hyporeflexia, fasciculations, atrophy
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polio CSF
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leukocytosis, (protein)
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MS who
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women 20-30. inc risk further from equator.
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MS histo
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oligodentrocyte loss => reactive gliosis w/ axons remaining => paraventricular plaques
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MS labs
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CSF: inc protein (IgG)
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MS Sx
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1) Scanning speech 2) intention tremor 3) nystagmus. Also: optic neuritis, internuclear ophthalmoplegia (MLF syndrome, hemiparalysis/sensory loss, incontinence. Relapsing/remitting.
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MS Tx
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beta interferon. or immunosuppression
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Progressive Multifocal Leukoencephalopathy
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demyelination. reactivation of JC virus in im comp (AIDS) or leukemia/lymphoma
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Subacute Sclerosing Panencephalitis
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altered measles virus (lack M component) CSF: Ig vs virus but no anti-M component
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None
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Acute disseminated encephalomyelitis
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postinfectious demyelination. delayed hypersensitivity to MMR, VZV
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Name the demyelinating diseases
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MS, Progressive multifocal leukencephalopathy, acute disseminated encephalomyelitis, metachromic leukodystrophy (lysosomal storage dz), guillain-barre
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defect in metachromic leukodystrophy
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sulfatide sulfatase (arylsulfatase) or it's activating proten
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guillain barre. happens after…
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CMV, EBV, Campylobacter, inoculation, stress
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guillain barre. pathophys? sx?
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demyelination of ventral roots => ascending muscle weakness. albumino-cytologic dissociation = papilledema (edema of optic disk)
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albumino-cytologic dissociation
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CSF: inc protein but no inc in cells. Guillain barre. => papilledma.
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define partial seizure. what types
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localized. simple, complex
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None
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define complex seizure
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includes dec consciousness
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define simple seizure
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no dec consciousness
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define generalized seizure. types?
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not focal (both hemispheres). absence, tonic, myoclonic, tonic-clonic (grand mal), atonic
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define tonic-clonic seizure
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alternates myoclonic (repetitive jerks) and tonic (stiff)
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what fracture leads to epidural hematoma
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temporal bone => middle meningeal artery
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what does CT show in epidural
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biconvex disk. does not cross suture lines
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what does CT show in subdural hematoma
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crescent. crosses suture lines
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lucid interval with
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epidural
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ruptured AVM
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subarachnoid hemorrhage
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xanthochromic spinal tap
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subarachnoid hemorrhage
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mc site berry aneurysm
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anterior communicating artery
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berry aneurysm a/w
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APKD, ehlers-danlos, marfans. (also: age, hypertension, smoking, black)
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name common adult brain tumors in ~ order of frequency
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glioblastoma multiforme (astrocytoma), meningioma, schwannoma, oligodendroglioma, pituitary adenoma
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common childhood brain tumors
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Pilocytic astrocytoma, medulloblastoma, ependymoma, hemangioblastoma, craniopharyngioma
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glioblastoma multiforme: cell? location? stain? histo? prognosis?
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most common. astrocytes (GFAP), hemispheres (butterly glioma = crosses corpus collosum), pseudopalisades around necrosis. bad
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meningioma: cell? histo?
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second most common. aracnoid cell. whorled pattern + psammoma bodies. good.
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schwannoma: where, a/w
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3rd most common. acoustic schwannoma, a/w NF2 (bilateral)
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oligodentroglioma: where? histo? prognosis
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frontal lobes. fried egg (round nuc w/ clear cyto), often calcified. slow growing, rare.
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anterior pituitary is derived from
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rathke's pouch
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pilocytoic astrocytoma. where? stain? histo? prognosis?
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posterior fossa. gfap. rosenthal fibers (eosinophilic corckscrews). good (but diffusely infiltrating?)
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medulloblastoma. where? what happens? histo? prog? tx?
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cerebellum => compress 4th ventricle => hydrocephalus. pseudorosette. poor but radiosensitive
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ependymoma. where? histo? prog?
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4th ventricle => hydrocephalus. pseduorosette w/ blepharoplasts (intracellular rod shaped basal bodies).
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hemangioma. where? a/w? produce? histo?
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cerebellar. VHL if w/ retinal angiomas. EPO. foamy cells w/ high vascularity.
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Craniopharyngeoma. where? p/w? from? prog?
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supratentorial. bitemporal hemianopia (mitaken for pit ad). rathke's pouche remnant. benign. calcification is common.
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UMN vs. LMN. weakness, atrophy, fasciculations, reflexes, tone, babinski
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UMN: weak, no atrophy (disuse), no fascic, hyperreflex, inc tone, upgoing babinski. LMN: weak, atrophy (neurotrophic), fasciculations, hyporeflexia, no babinski (downgoing)
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ventral artery occulsion. result?
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lose everything except dorsal colums and tracts of lissauer
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tabes dorsalis. lesion?
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dorsal columns + dorsal roots => ataxia, poor proprioception
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b12 neuropathy. what's damaged, similar distribution to…?
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dorsal columns, lateral corticospinal tracts, spinocerebellar. Friedreich's ataxia.
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Syringomyelia what is it and a/w
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enlarged central canal. crossing fibers of 2° spinothalamics damaged => bilateral loss of pain/T, usu uper extremities (C8-T1). touch ok. often in pt w/ Arnld-Chiari malformation. us
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brown-sequard syndrome. what causes it? describe the findings? what happens if it's above T1?
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hemisection of the spinal cord. 1) below: isplateral lose of pressure/vibration/touch/proprio 2) below: contralateral loss of pain and temp 3) at the level: ipsilateral level of all sensation. 4) motor: ipsilateral UMN at the level, LMN below. Horner's syndrome if above T1.
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location of lesions causing horner's syndrome
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above T1
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sympathetics/horner's syndrome. where in spinal cord
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interomedial cell column
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common peroneal nerves splits into what? what do they do?
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deep peroneal nerve: anterior compartment (dorsiflexion) + sensation anterior medial foot. superficieal peroneal nerve: lateral compartment (eversion) + sensation lateral foot, dorsum foot, ant lower leg. PED = Peroneal everts and dorsiflects, lesion => foot dropPED.
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tibial nerve does what?
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TIP = stand on tip toes, Tibial Inverts and Plantarflexes. sensation on medial posterior dorsum foot.
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draw out the superinnervation of the dorsum of the foot
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hurry up
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what's thoracic outlet syndrome
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embryological defect => compress 1) lower trunk of brachial plexus (C8, T1 = Klumpke's palsy) 2) compress subclavian esp when turn away from lesion
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CN12 LMN lesion tongue to the
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same side as lesion
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CN12 UMN lesion tongue to the
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oppoiste side from lesion
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CN5 lesion, when you open your jaw, it deviates…
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toward the lesion. you push your jaw out when you open it
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unilateral lesion of cerebellum. pt falls to which side
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toward lesion
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CN10 lesion. uvula deivates
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away from lesion
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CN11 lesion. what happens
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ipsilateral shoulder drop. can't turn head to contralateral side.
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