First Aid- Usmle: Neurology

Front 1

CNS/PNS Supportive Cells: What cell is responsible for physical support and repair, as well as K+ metabolism

Back 1

astrocytes

Front 2

CNS/PNS Supportive Cells: what are the phagocytic cells of the nervous system

Back 2

microglia

Front 3

CNS/PNS Supportive Cells: what cells produce myelin in the CNS

Back 3

oligodendricytes

Front 4

CNS/PNS Supportive Cells: what cells produce myelin in the PNS

Back 4

Schawnn cells

Front 5

Blood Brain Barrier : What three structures form the BBB

Back 5

Choroid plexus epithelium, Intracerebral capillary endothelium, Arachnoid (remember CIA)

Front 6

Blood Brain Barrier : Do nonpolar/lipid soluble substances or polar, water-soluble substances pass through the BBB more easily?

Back 6

Nonpolar/lipid soluble

Front 7

Blood Brain Barrier : Why is L-dopa, not dopamine, the treatment of choice in Parkinson's Disease

Back 7

L-dopa crosses the BBB

Front 8

Hypothalamus: What are the functions of the hypothalamus (7)

Back 8

Thirst, Adenohypophysis control, Neurohypophysis hormone synthesis, Hunger, Autonomic regulation (including circadian rhythms), Temperature regulation, Sexual urges (TAN HATS)

Front 9

Hypothalamus: Does the anterior hyporthalamus control cooling when hot?

Back 9

Yes, think Anterior Cooling = A/C

Front 10

Hypothalamus: Does the posterior hypothalamus control heat conservation?

Back 10

Yes, think no Posterior hypothalamus = poikilotherm (cold blooded snake)

Front 11

Hypothalamus: Which nucleus is responsible for hunger?

Back 11

Lateral nucleus

Front 12

Hypothalamus: Which nucleus is responsible for satiety?

Back 12

ventromedial nucleus (without which you grow ventrally and medially

Front 13

Posterior Pituitary: Which nuclei of the hypothalamus project axons into the posterior pituitary?

Back 13

supraoptic nuclei (ADH) and paraventricular nuclei (oxytocin)

Front 14

Functions of Thalamic Nuclei: What is the function of the lateral geniculate nucleus?

Back 14

Visual pathway (remember Lateral is needed to Look)

Front 15

Functions of Thalamic Nuclei: What is the function of the medial geniculate nucleus?

Back 15

Auditory pathway (remember Medial is to hear Music)

Front 16

Functions of Thalamic Nuclei: Function of the ventral posterior nucleus, lateral part (VPL)?

Back 16

receives body senses (proprioception, pressure, pain, touch, vibration)

Front 17

Functions of Thalamic Nuclei: Function of the ventral posterior nucleus, medial part (VPM)?

Back 17

receives facial sensations, including pain

Front 18

Functions of Thalamic Nuclei: Ventral Nuclei (VA/VL) functions?

Back 18

Motor

Front 19

Limbic System: What are the functions of the limbic system?

Back 19

Feeding, Fighting, Feeling, Flight, and Sex (the five Fs)

Front 20

Limbic System: What two areas does the hippocampus project to?

Back 20

the subiculum (mammillary nuclei) and the septal area

Front 21

Limbic System: Trace the pathway from Mammillary body to hippocampus.

Back 21

Mammillary body, anterior nucleus of thalamus, cyngulate gyrus, entorhinal cortex, hipocampus

Front 22

Limbic System: AUTHOR

Back 22

Conor Liston

Front 23

Basal ganglia: Describe the primary function fo the basal ganglia.

Back 23

The basal ganglia mediates voluntary movements and postural adjustments

Front 24

Basal ganglia: What are the roles of the direct and indirect pathways?

Back 24

Indirect pathway inhibits movement; Direct pathway facilitates movement.

Front 25

Basal ganglia: Delineate the flow of processing in the direct pathway.

Back 25

Putamen (inhibitory) => Gpi (inhibitory) => Thalamus: inhibition of Gpi => activation of thalamus

Front 26

Basal ganglia: Delineate the flow of processing in the indirect pathway.

Back 26

Putamen (inhibitory) => GPe (inhibitory) => STN (excitatory)=>GPi (inhibitory) =>Thalamus; induces excitation of Gpi => inhibition of thalamus

Front 27

Basal ganglia: What is the anatomical defect in Parkinson's Dz?

Back 27

Loss of substantia nigra pars compacta (SNc) dopamine output to putamen => activation of indirect pathway and inhibition of direct pathway

Front 28

Chorea: What is the clinical presentation and cause of chorea?

Back 28

sudden, jerky, purposeful movements; caused by basal ganglia lesionChorea= dancing, think choreography

Front 29

Athetosis: What is the clinical presentation and cause of athetosis?

Back 29

slow, writhing movements, especially of fingers; caused by basal ganglia lesion

Front 30

Hemiballismus: What is the clinical presentation of hemiballismus?

Back 30

sudden, wild flailing of 1 arm; half ballistic= as in throwing a baseball

Front 31

Hemiballismus: What is the anatomical defect in hemiballismus?

Back 31

contralateral subthalamic nucleus lesion

Front 32

Cerebral cortex functions: Where is the primary sensory cortex (S1) located?

Back 32

anterior aspect of parietal lobe

Front 33

Cerebral cortex functions: Where is the primary motor cortex (M1) located?

Back 33

posterior aspect of frontal lobe

Front 34

Cerebral cortex functions: Where is the primary visual cortex (V1) located?

Back 34

most posterior aspect of occipital lobe

Front 35

Cerebral cortex functions: What are the Brodman's Area designations for S1, M1, V1?

Back 35

S1: 3, 1, 2; M1: 4; V1: 17

Front 36

Cerebral cortex functions: What is the role of Broca's area? where is it located?

Back 36

inferior aspect of frontal lobe; mediates motor speech (production)

Front 37

Cerebral cortex functions: What is the role of Wernicke's area? Where is it located?

Back 37

superior temporal gyrus; mediates speech comprehension

Front 38

What is a consequence of a lesion in:: Broca's area?

Back 38

motor (expressive, nonfluent) aphasia; BROca's BROken speech

Front 39

What is a consequence of a lesion in:: Wernicke's area?

Back 39

sensory (fluent, receptive) aphasia; Wernicke is Wordy but makes no sense

Front 40

What is a consequence of a lesion in:: Arcuate fasciculus?

Back 40

conduction aphasia: poor repetition w/ good comprehension and fluent speech

Front 41

What is a consequence of a lesion in:: Amygdala?

Back 41

Kluver-Bucy syndrome: hyperorality, hypersexuality

Front 42

What is a consequence of a lesion in:: Right parietal lobe?

Back 42

spatial neglect syndrome (contralateral)

Front 43

What is a consequence of a lesion in:: Mammillary bodies?

Back 43

Wernicke-Korsakoff's encephalopathy: anterograde amnesia (think alcoholism)

Front 44

What is a consequence of a lesion in:: Cerebellar vermis?

Back 44

Truncal ataxia and dysarthria

Front 45

What is a consequence of a lesion in:: Cerebellar hemisphere?

Back 45

Limb ataxia and intention tremor

Front 46

What is a consequence of a lesion in:: Reticular activating system?

Back 46

Coma

Front 47

Cavernous sinus: Name five nerves and one vessel that pass through the cavernous sinus.

Back 47

CN III, IV, V1, V2, VI; internal carotid artery

Front 48

Foramina: middle cranial fossa (CN II-VI): Name three structures passing through optic canal (one nerve, two vessels).

Back 48

CN II, ophthalmic artery, central retinal vein

Front 49

Foramina: middle cranial fossa (CN II-VI): Name five structures passing through superior orbital fissure (four nerves, one vessel).

Back 49

CN III, IV, V1, VI; ophthalmic vein

Front 50

Foramina: middle cranial fossa (CN II-VI): Name the foramina of exit for each division of the trigeminal nerve (CN V).

Back 50

Standing Room Only: V1 = Superior orbital fissure; V2 = foramen Rotundum; V3 = foramen Ovale

Front 51

Foramina: posterior cranial fossa (CN VII-XII): Name four structures passing through the jugular foramen (three nerves, one vessel).

Back 51

CN IX, X, XI; jugular vein

Front 52

Foramina: posterior cranial fossa (CN VII-XII): Name structures passing through foramen magnum.

Back 52

brain stem, vertebral arteries, spinal roots of CN XI

Front 53

Foramina: posterior cranial fossa (CN VII-XII): Name two nerves passing through internal auditory meatus.

Back 53

CN VII, VIII

Front 54

Extraocular muscles and nerves: Describe the innervation of the extraocular muscles.

Back 54

LR6SO4R3 : Lateral Rectus = CN VI, Superior Oblique = CN IV, and the Rest are CN III

Front 55

Pupillary light reflex: List in sequence the nerves, brain structures, and muscles involved in the pupillary light reflex from illumination of one eye to bilateral pupillary constriction.

Back 55

Light => retina => optic nerve => optic chiasm => optic tract => prectectal nuclei (synapse) => Edinger-Westphal nuclei (synapse) => oculomotor nerve => ciliary ganglion (synapse) => pupillary constrictor muscles

Front 56

Internuclear ophthalmoplegia: What is the characteristic lesion in internuclear ophthalmoplegia?

Back 56

destruction of the medial longitudinal fasciculus (MLF) => medial rectus palsy on attempted lateral gaze

Front 57

Internuclear ophthalmoplegia: Name three characteristic clinical features of internuclear ophthalmoplegia.

Back 57

1. On attempted lateral gaze, contralateral eye fails to abduct past midline; 2. Contralateral nystagmus on attempted lateral gaze; 3. Normal convergence

Front 58

Internuclear ophthalmoplegia: What neurologic disease is commonly associated with internuclear ophthalmoplegia (aka MLF syndrome)?

Back 58

multiple sclerosis; think MLF = MS

Front 59

Visual field deficit with lesion: Name the visual field defect associated with a lesion of each of the following structures:

Back 59

0

Front 60

Visual field deficit with lesion: Right optic nerve

Back 60

Right anopsia

Front 61

Visual field deficit with lesion: Optic chiasm

Back 61

Bitemporal hemianopsia

Front 62

Visual field deficit with lesion: Rigth optic tract

Back 62

Left homonymous hemianopsia

Front 63

Visual field deficit with lesion: Right Meyer's loop (temporal lesion)

Back 63

Left uper quadrantic anopsia

Front 64

Visual field deficit with lesion: Right Meyer's loop (parietal lesion)

Back 64

Left lower quadrantic anopsia

Front 65

Visual field deficit with lesion: Dorsal optic radiation

Back 65

Left hemianopsia with macular sparing

Front 66

Cranial nerves: Classify each cranial nerve (1-12) according to its function as a sensory nerve, a motor nerve, or both.

Back 66

Mnemonic: Some Say Marry Money But My Brother Says Big Brains Matter Most

Front 67

Cranial nerves: Name the cranial nerves that innervate the eye muscles.

Back 67

Oculomotor (III), Trochlear (IV), and Abducens (VI)

Front 68

Cranial nerves: Name the cranial nerves that innervate the facial muscles (extraocular muscles excluded).

Back 68

Trigeminal (V): mastication; Facial (VII): facial movement

Front 69

Cranial nerves: Name the cranial nerves associated with sight, smell, hearing, and taste.

Back 69

sight: optic (II); smell: olfactory (I); hearing: vestibulocochlear (VIII); taste: facial (VII) for ant. 2/3 of tongue and glossopharyngeal (IX) for post 1/3

Front 70

Cranial nerves and passageways: Which cranial nerves pass through the superior orbital fissure?

Back 70

III, IV, V1, VI

Front 71

Cranial nerves and passageways: Which cranial nerves pass through the internal auditory meatus?

Back 71

VII, VIII

Front 72

Cranial nerves and passageways: Which cranial nerves pass through the jugular foramen?

Back 72

IX, X, XI

Front 73

Brain stem anatomy: Which cranial nerves exit the brainstem caudal to the pons?

Back 73

Cranial nerves VI through XII

Front 74

Brain stem anatomy: Which cranial nerves exit the brainstem rostral to the pons?

Back 74

Cranial nerves I through V

Front 75

Brain stem anatomy: Which cranial nerves are associated with the cerebellopontine angle?

Back 75

CN VII, VIII, and IX

Front 76

Dural venous sinuses: What is the main location of CSF return via the arachnoid granulations?

Back 76

superior sagittal sinus

Front 77

Dural venous sinuses: Describe the route of CSF from the superior sagittal sinus to the internal jugular vein.

Back 77

superior sagittal sinus => confluence of sinuses => transverse sinus => sigmoid sinus => internal jugular vein (via jugular foramen)

Front 78

Dural venous sinuses: Which three sinuses combine to form the confluence of sinuses?

Back 78

superior sagittal sinus, straight sinus, occipital sinus

Front 79

Dural venous sinuses: AUTHOR

Back 79

Steve Dong

Front 80

Homounculus : Homunculus is the topographical representation of the body that exists in what 2 areas of the cerebral cortex?

Back 80

Sensory and Motor areas

Front 81

Homounculus : Sensation for ____(What part of the body) is generally located superior medially on the primary sensory cortex while ____ is located more laterally

Back 81

Lower limbs, Head and neck

Front 82

Homounculus : Lesion at the anterior cerebral artery will canse deficit in sensation or movement in which part of the body?

Back 82

Lower limbs

Front 83

Circle of Willis : Which artery supplies the medial surface of the brain, leg-foot area of motor and sensory cortices?

Back 83

Anterior cerebral artery

Front 84

Circle of Willis : If you suspect a lesion in both Broca's and Wernecke's areas, a lesion in which artery could be the cause?

Back 84

Middle cerebral artery

Front 85

Circle of Willis : At which artery in the circle of willis is the most common place of aneurysm? You often see visual symptoms

Back 85

Anterior communicating artery

Front 86

Circle of Willis : This is also another common area of aneurysm. aneurysm causes CN III palsy

Back 86

Posterior communicating artery

Front 87

Circle of Willis : This artery comes off of middle cerebral artery and supply internal capsule, caudate, putamen, globus pallidus

Back 87

Lateral Striate

Front 88

Circle of Willis : In general, in stroke of anterior circle you would see what kind of deficits?

Back 88

Sensory and motor dysfunction, aphasias

Front 89

Circle of Willis : how will a stroke of posterior circle will manifest?

Back 89

Cranial nerve deficits, (vertigo, visual deficit), coma, cerabellar deficints (ataxia).

Front 90

Sounds : You would ask the patient to say this to test CN X (vagus)

Back 90

Kuh-kuh-kuh

Front 91

Sounds : "La la la" tests which CN?

Back 91

XII - Hypoglossal (innervation of the tongue)

Front 92

Sounds : "Mi mi mi" tests which CN?

Back 92

VII - Facial (innervation of lips)

Front 93

Vagal nuclei : This nuclei confers visceral Sensory information (eg: taste, gut distension)

Back 93

Nucleus Solitarius (VII, IX, X)

Front 94

Vagal nuclei : Nucleus aMbiguus confers Motor innervation of what part of the body?

Back 94

pharynx, larynx, and uper esophagus (IX, X, XI)

Front 95

Vagal nuclei : This nucleus sends parasympathetic fibers to the heart, lungs, and upper GI

Back 95

Dorsal motor nucleus

Front 96

Play this game: Where is the Lesion?? : patient's tongue deviates to the left

Back 96

left CN XII

Front 97

Play this game: Where is the Lesion?? : Patient's jaw deviates toward the left

Back 97

left CN V

Front 98

Play this game: Where is the Lesion?? : patient tends to fall toward the left side

Back 98

left lesion of the cerebellum

Front 99

Play this game: Where is the Lesion?? : Patient's uvula deviate to the left

Back 99

right CN X lesion

Front 100

Play this game: Where is the Lesion?? : Patient's shoulder droop on the left

Back 100

left CN XI lesion

Front 101

Play this game: Where is the Lesion?? : Patient has weakness turning head to the left

Back 101

right CN XI lesion

Front 102

Herniation syndromes: Which of the following herniations can cause compression on the brain stem that can result in coma and death? 1. Cingulate herniation 2. Transtentorial herniation 3. Uncal herniation 4. Cerebellar tonsillar herniation

Back 102

1 herniates under the falx cerebri and does not cause coma and death. 2. Transtectoral, 3. Uncal, and 4. tonsillar herniations can

Front 103

Uncal herniation can cause the following clinical signs, name their causes: 1. Ipsilateral dilated pupil, ptosis

Back 103

Stretching of CN III

Front 104

Uncal herniation can cause the following clinical signs, name their causes: 2. Contralateral homonymous hemianopsia

Back 104

Compression of ipsilateral posterior cerebral artery

Front 105

Uncal herniation can cause the following clinical signs, name their causes: 3. Ipsilateral paresis

Back 105

Compression of contralateral crus cerebri (Kernohan's notch)

Front 106

Uncal herniation can cause the following clinical signs, name their causes: 4. Duret hemorrhage

Back 106

Caudal displacement of brain stem

Front 107

Spinal Cord : The dorsal columns have 2 tracts. The Fasciculus ____ carries nerve fibers for _____(part of the body). The fasciculus ____ carries tract from ____ (part of the body)

Back 107

Cuneatus, uper body and extremities. Gracilis, lower body and extremities

Front 108

Spinal Cord : The lateral cortical spinal tract carries what type of fibers, and how are they arranged in the spinal cord?

Back 108

motor fibers, arms medially, legs laterally

Front 109

Spinal Cord : What tract carries pain and temperature sensation? Where is it located on the spinal cord?

Back 109

Spinal Thalamic tract, ventral part

Front 110

Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease: in grey matter, affect lower motor neuron only, cause flaccid paralysis

Back 110

Poliomyelitis / Werdnig-Hoffmann disease

Front 111

Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease: Mostly white matter of Cervical region, lesion are asymmetric and random

Back 111

Multiple sclerosis

Front 112

Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease: grey matter, and motor tracts: upper and lower motor neuron deficits

Back 112

Amyotrophic Lateral Sclerosis

Front 113

Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease: everywhere, but spares the dorsal columns

Back 113

Ventral artery occlusion

Front 114

Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease: dorsal column, impairs propioception and causes locomotor ataxia

Back 114

Tabes dorsalis (tertiary syphilis)

Front 115

Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease: Dorsal column, lateral corticospinal tracts and spinocerebellar tracts

Back 115

Vitamin B12 Neuropathy/Friedreich's ataxia

Front 116

Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease: central white commisure and ventral horns

Back 116

Syringomyelia

Front 117

Brown Sequard Syndrome, UMN, LMN, Facial Lesions : Mr. Brown-Sequard was struck on the spinal cord that resulted in the hemisection of the spinal cord at T3 level. Give me 4 symptoms that you may find in him

Back 117

1. Ipsilateral motor paralysis 2. Ipsilateral loss of tactile, vibration, proprioception senses 3. Contralateral pain and temperature loss 4. Ipsilateral loss of ALL sensation at the T3 level

Front 118

Brown Sequard Syndrome, UMN, LMN, Facial Lesions : What are the signs of Lower Motor neuron lesion?

Back 118

everything lowered: ↓ muscle mass, ↓ muscle tone, ↓ reflexes, downgoing toes

Front 119

Brown Sequard Syndrome, UMN, LMN, Facial Lesions : What are the signs of Upper Motor neuron lesion?

Back 119

Uper = everything up (tone, DTRs, toes)

Front 120

Brown Sequard Syndrome, UMN, LMN, Facial Lesions : Upper motor neuron lesion of the face motor deficit

Back 120

causes contralateral weakness of lower face only

Front 121

Brown Sequard Syndrome, UMN, LMN, Facial Lesions : Lower motor neuron lesion of the facial nerve

Back 121

weakness of both uper and lower face seen

Front 122

Brown Sequard Syndrome, UMN, LMN, Facial Lesions : A patient comes in with facial paralysis and inability to close the eye on one side of the face, suggesting Bell's Palsy. What diseases might you see in him that could have caused his condition?

Back 122

ALexanger Bell with STD: AIDS, Lyme, Sarcoid, Tumors, Diabetes

Front 123

Brown Sequard Syndrome, UMN, LMN, Facial Lesions : Upper motor neuron lesion coming from the facial nucleus result in what?

Back 123

contralateral paralysis of lower quadrant

Front 124

Spinal muscle control : What is the difference between alpha and gamma motor neurons?

Back 124

alpha fibers participates in the reflex arc and cause extrafusal contraction. Gamma neurons are stimulated by CNS to contract intrafusal fiber to increase sensitivity of reflex arc

Front 125

Brachial Plexus : What are the 5 divisions/parts of the bracial plexus?

Back 125

Roots Trunks Divisions Cords Branches (Randy Travis Drinks Cold Beer)

Front 126

Play this game: Where is the Upper Limb nerve Lesion??: Claw hang

Back 126

Trunk of C8 and T1

Front 127

Play this game: Where is the Upper Limb nerve Lesion??: Wingled Scapula

Back 127

Long thoracic nerve

Front 128

Play this game: Where is the Upper Limb nerve Lesion??: Decreased thumb function, Pope's blessing

Back 128

median nerve

Front 129

Play this game: Where is the Upper Limb nerve Lesion??: Patient comes into the ER with trauma injury that broke his humerus bone. Two weeks later when you examined him, you noticed that his wrist is dropped. Neuro exam showed that the triceps and brachioradialis reflexes of the same arm are absent. What was the injured nerve?

Back 129

radial nerve (innervates BEST!) Brachioradialis, Extensors of wrist and fingers, Supinator, and Triceps

Front 130

Play this game: Where is the Upper Limb nerve Lesion??: Patient has lost power of his arm muscles. He could not longer flex his wrist or fingers, and has trouble with thumb movements. History showed that he broke his had a suprecondylar fracture (of the humerus) What was the injured nerve?

Back 130

median nerve

Front 131

Play this game: Where is the Upper Limb nerve Lesion??: Patient has clawed hand. Exam showed that he has imparied wrist flexion and adduction, impaired adduction of thumb and last 2 fingers. He also has lost of sensation over medial palm and pinky finger. What was the injured nerve?

Back 131

ulnar nerve

Front 132

Play this game: Where is the Upper Limb nerve Lesion??: Patient dislocates his shoulder and could no longer use his deltoid.

Back 132

axillary nerve

Front 133

Play this game: Where is the Upper Limb nerve Lesion??: Patient could no longer flex at his elbow joint and supination of his forearm is weakened. Exam shows loss of biceps reflex and variable sensory loss of his forearm

Back 133

musculocutaneous nerve

Front 134

Play this game: Where is the Upper Limb nerve Lesion??: Following a blow to his shoulders, the patient presents with limb hanging by side (paralysis of abductors), medially rotated (paralysis of lateral rotators), and protonated forearm (loss of biceps)

Back 134

C5 and C6 roots. Known as Erb-Duchenne palsy

Front 135

Thoracic Outlet Syndrome : Thoracic outlet syndrome leads to loss of the compression of ____ artery and ____ trunk of brachial plexus

Back 135

Subclavian, inferior (C8. T1)

Front 136

Thoracic Outlet Syndrome : In thoracic outlet syndrome, when the patient turn his head toward the opposite side, you notice the dissapearance of _____ (what physical finding?)

Back 136

radial pulse

Front 137

Thoracic Outlet Syndrome : What muscles would you expect to be atrophied as a result of thoracic outlet syndrome?

Back 137

thenar and hypothenar eminences, innterosseous

Front 138

Thoracic Outlet Syndrome : What neurological symptoms would you see?

Back 138

sensory deficits of medial side of forearm and hand

Front 139

Clinical Reflexes: What nerve root do you test for if you illecit the following reflexes?

Back 139

0

Front 140

Clinical Reflexes: nerve root: Biceps

Back 140

C5

Front 141

Clinical Reflexes: nerve root: Triceps

Back 141

C7

Front 142

Clinical Reflexes: nerve root: Patella

Back 142

L4

Front 143

Clinical Reflexes: nerve root: Achilles

Back 143

S1

Front 144

Clinical Reflexes: What is the Babinski reflex a sign of? When is it normal?

Back 144

UMN lesion, its normal during 1st year of life

Front 145

Pneumonia: PATHOLOGY - NEUROLOGIC

Back 145

0

Front 146

Degenerative diseases: name two diseases that affect the CEREBRAL CORTEX

Back 146

1) Alzheimer's disease 2) Pick's disease

Front 147

Degenerative diseases: name two diseases that affect BASAL GANGLIA & BRAIN STEM:

Back 147

1) Huntington's disease 2) Parkinson disease

Front 148

Degenerative diseases: name 5 diseases that affect SPINOCEREBELLAR MOTOR NEURON

Back 148

1) Olivo-ponto-cerebellar atrophy 2) Friedreich's ataxia 3)ALS = amyotrophic lateral sclerosis 4)Werdnig-Hoffmann disease 5) Polio

Front 149

Degenerative diseases: what is the most common cause of elderly dementia?

Back 149

Alzheimer's

Front 150

Degenerative diseases: name two pathological findings characteristic of Alzheimer's

Back 150

1) senile plaques = intracytoplasmic inclusion bodies 2) neurofibrillary tangles (abnormally phosphorylated tau protein)

Front 151

Degenerative diseases: what is the 2nd most common cause of dementia in elderly?

Back 151

multi-infarct dementia in elderly\\

Front 152

Degenerative diseases: How can Alzheimer also affect intracranial vasculature?

Back 152

amyloid angiopathy --> intracranial hemorrhage

Front 153

Degenerative diseases: The familial form of Alzheimer's is associated with what chromosomes (name 4) and (name the allele's name in 2 of the 4)

Back 153

chromosome 1, 14, 19 (APO-E4 allele), 21 (p-Ap gene)

Front 154

Degenerative diseases: What is pathognemomic with Pick's disease upon histology?

Back 154

Pick bodies = intra-cytoplasmic inclusion bodies

Front 155

Degenerative diseases: What cortical areas does Pick's disease affect

Back 155

Frontal and temporal lobes (remember; sharp, atrophic apearance of gross specimen)

Front 156

Degenerative diseases: What is the inheritance pattern of Huntington's

Back 156

Auto Dominant

Front 157

Degenerative diseases: What are some symptoms?

Back 157

1) chorea 2) dementia

Front 158

Degenerative diseases: Huntington's is due to atrophy of _____ what? Loss of ___ ergic neurons.

Back 158

atrophy of caudate nucleus = loss of GABA-nergic neurons

Front 159

Degenerative diseases: what is the genetic abnormality of Huntington's?

Back 159

1) Chr. 4 - expansion of CAG repeats

Front 160

Degenerative diseases: Parkinson disease is associated with what pathology findings?

Back 160

1) Lewy bodies 2) depigmentation of substantia nigra (loss of dopaminergic neurons)

Front 161

Degenerative diseases: rare cases of Parkinson's have been linked to what contaminant of certain illicit drugs?

Back 161

MPTP = contaminant to street drug

Front 162

Degenerative diseases: Parkinson's can make you feel in a "TRAP" = ?

Back 162

T = tremor at rest; R = cogwheel rigidity; A = akinesia ; Postural instability

Front 163

Degenerative diseases: ALS = Lou Gehrig's disease (the Iron Horse of the Yankees, hero of Joe DiMaggio) = what signs is ALS associated with?

Back 163

Both UMN and LMN deficits

Front 164

Degenerative diseases: Werdnig-Hoffman disease - presents as birth as?

Back 164

1) flopy baby syndrome 2) note tongue fasciculations as well (also seen in ALS)

Front 165

Degenerative diseases: for Polio, what kind of signs to you see?

Back 165

predominantly LMN deficits.

Front 166

Intracranial Hemorrhage/Hemotomas: name 4 types of cranial related hemorrhages (think of layers that could possibly be involved)

Back 166

1) epidural hemorrhage 2) subdural h 3) subarachnoid h 4) parenchymal h

Front 167

Intracranial Hemorrhage/Hemotomas: what is a common site of epidural hematoma/hemorrhage

Back 167

1) rupture of MMA: middle meningeal artery, often 2ndary to fracture of temporal bone

Front 168

Intracranial Hemorrhage/Hemotomas: what does CT show for epidural h?

Back 168

biconcave disc NOT crossing suture lines

Front 169

Intracranial Hemorrhage/Hemotomas: what else do you see?

Back 169

lucid interval

Front 170

Intracranial Hemorrhage/Hemotomas: How do subdural h. most often occur?

Back 170

rupture of bridging veins (think, elderly being jolted in roller coaster)

Front 171

Intracranial Hemorrhage/Hemotomas: this is venous bleeding so how would this influence symptomatic findings?

Back 171

venous = less pressure = delayed onset of symptoms

Front 172

Intracranial Hemorrhage/Hemotomas: what types of people do you see subdural h.?

Back 172

1) elderly, 2) alcoholics 3) blunt trauma/sudden change in velocity injuries

Front 173

Intracranial Hemorrhage/Hemotomas: for SUBDURALs what do you see upon CT?

Back 173

1) crescent-shaped hemorrhage instead 2) YES IT does cross the suture lines

Front 174

Intracranial Hemorrhage/Hemotomas: subarachnoid hemorrhage is often seen where (name 2 types

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rupture of 1) aneurysm (usually Berry aneurysm) or an 2)AVM

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Intracranial Hemorrhage/Hemotomas: symptoms?

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the worst headache of my life

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Intracranial Hemorrhage/Hemotomas: since its subarachnoid, what do you see on what test?

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bloody or xanthochromic CSF on spinal tap

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Intracranial Hemorrhage/Hemotomas: name 4 risk factors for parenchymal hematoma

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1) HTN 2) amyloid angiopathy 3) diabetes mellitus 4) tumor

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Intracranial Hemorrhage/Hemotomas: AUTHOR

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Hilcias Duran

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Berry aneurysms: most common site for Berry aneurysms

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bifurcation of the anterior communicating artery (Circle of Willis)

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Berry aneurysms: berry aneurysms are associated with

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adult polycystic disease, Ehlers-Danlos s., and marfan's

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Berry aneurysms: Classic triad of Multiple Sclerosis

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SIN: Scanning speech, intention tremor, nystagmus (affect woman 20-30s)

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Berry aneurysms: Prevalence of MS

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increase prevalence w/ increased distance from the equator

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Berry aneurysms: Clinical s/s of MS

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periventricular plaques, preservation of axons, loss of oligodentrocytes, reactive astrocystic gliosis, increased protein in csf(IgG) in CSF, relapsing course, optic neuritis, MLF syndrome, hemiparesis, bladder/bowel incontinence)

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Berry aneurysms: Progressive multifocal leukoencephalopathy (PML) is associated w/

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JC virus and seen in 2-4 % of AIDS pts (reactivation or latent infect)

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Berry aneurysms: pathogenesis of Guillian-Barre syndrome

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Inflammation and demyelination of peripheral nerves and motor fibers of the ventral roots (sensory effec less severe than motor)

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Berry aneurysms: s/s of Guillian-Barre syndrome

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symmetrical ascending muscle weakness beginning in the distal lower extremities. Autonomic fxn may be severely affected (eg. Cardiac irregularities, HTN, or hypoTN) Findings: inc. csf protein w/ normal cell count ("albumino-cytologic dissociation") elevated protein may lead to papilledema

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Berry aneurysms: association between G-B syndrome and…

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herpesvirus or camplobacter jejuni infection, inoculations, and stress but no definitive link to a pathogen

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Poliomyelitis: organism causing polio and mechanism of action

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poliovirus, transmitted via fecal oral route and enters blood stream then into CNS where it causes destruction of the anterior horn of S.C. leading in turn to LMN destruction

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Poliomyelitis: s/s of polio

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malaise, HA, fever, nausea, abd. Pain, sore throats, signs of LMN signs

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Poliomyelitis: finding of polio

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csf w/ lymphocytic pleocytosis w/ slight elevation of protein, virus recovered from stool or throat

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Aphasia : describe Broca's (expressive) aphasia

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confluent aphasia w/ intact comprehension broca's is broken speech

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Aphasia : describe Wernicke's (aphasia)

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Fluent aphasia w/ impaired concentration Wernick's ="What?" W area located in superior temperal gyrus

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seizures : describe two types of partial seizures

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1.simple partial (awareness is intact)--motor, sensory, autonomic, psychic 2.Complex partial (impaired awareness)

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seizures : describe types of Generalized seizure ( diffuse)

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1.absence- blank stare (petit mal) 2.myoclonic- quick repetitive jerks 3.tonic-clonic- alternating stiffening and mvmt (grand mal) 4. Tonic- stiffening 5.atonic-"drop" seizures

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seizures : what are the causes of seizures in children?

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genetic, infection, trauma, congenital, metabolic

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seizures : adults?

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tumors, trauma, stroke, infection

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seizures : elderly?

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stroke, tumor, trauma, metabolic, infection

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Horner's syndrome: what is Horner's syndrome?

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sympathectomy of face (lesion above T1) 1.Ptosis 2.anhidrosis and flushing of affected side 3.miosis [PAM is horny]

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Horner's syndrome: Horner's syndrome is associated w/ what type of tumor?

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pancoast tumor

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syringomyelia: what is syringomyelia?

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enlargement of the central canal of the S.C. Crossing fibers of spinothalamic tract are damaged.

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syringomyelia: what are the s/s of syringomyelia?

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b/l loss of pain and temp sensation in the uper extremities w/ the touch sensation. Most common at C8-T1

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syringomyelia: commonly seen in what pts?

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pts w/ Arnold-Chiari malformation