Lesions

Front 1

Midline cerebrellar lesion

Back 1

truncal ataxia--inability to stand upright
tumor in 4th ventricle (medulloblastoma)

Front 2

Anterior cerebellar lobe lesion

Back 2

gait ataxia--still present with eyes open
anterior vermis syndrome--common in alcoholics

Front 3

Posterior cerebellar lobe lesion

Back 3

incoordination of voluntary movements of limbs
intention tremors
dysdiadochokinesia--difficulty with rapis alternating movements
impaired speech

Front 4

athetoid

Back 4

slow, rotating movements of distal muscles

Front 5

choreiform

Back 5

brisk, fast, dance-like

Front 6

ballistic

Back 6

fast, flailing, and rotary movements of proximal extremities

Front 7

dystonia

Back 7

sustained/repetitive muscular contractions or cramping

Front 8

tic

Back 8

brief, abrupt, spasmodic twitching and other stereotyped movement

can be suppressed

Front 9

akathisia

Back 9

movements acted out by an inner feeling for the need to move

can be suppressed

often induced by anti-psychotics

Front 10

myoclonus

Back 10

lightening-like intermittant muscle jerks

Front 11

Parkinson's Disease

Back 11

lesion in substantia nigra
dopamine
akinesia, bradykinesia, festination, anosmia, rigidity, cognitive/emotional disorders, resting tremor

herbicides, pesticides, and other chemicals

treatment = L-DOPA with Cardopa

Front 12

Huntington's Chorea

Back 12

hyperkinesia--choreiform and athetoid movements, hypotonia, and dementia

dopamine > ACh and GABA

major target--indirect (D2) striatalpallidal pathwat--lose the "braking" system

Front 13

Hemiballismus

Back 13

hyperkinesia--ballistic movements in proximal muscles

caused by inclusion of posteromedial central a.

target: subthalmic nucleus--braking system

dopamine > ACh and GABA

Front 14

Dystonia

Back 14

involuntary, sustained, cramping muscle contraction resulting in abnormal posture or repetitive twisting movements

Front 15

Basal Ganglia and eye movements

Back 15

Oculomoter loop through basal ganglia faciliatates and supresses eye movement
-GABA neurons in the pars reticulata project to VA and superior colliculi resulting in an inhibitory effect on eye movement

Results in eye fixation and abnormal eye movements

Front 16

Tardive Dyskinesia

Back 16

exhibit choreoathoid movements similar to those seen in huntington's
--may interfere with GABA (so too much dopamine)

seen in schizophrenic patients treated with older antipsychotic drugs

Front 17

Cerebral Palsy

Back 17

syndrome due to hypoxic or ischemic events in utero

results in various motor system impairments: paralysis, spasticity, rigidity, athetosis, and/or dystoni

Front 18

Gilles De La Tourette

Back 18

hereditary, males

multiple tics, rarely include corporalea

dopamine reuptake deficit and decreased serotonin in striatum

Front 19

Obsessive Compulsive Disorder

Back 19

unable to suppress repeated execution of a motor task because the striatal-frontal lobe fails to process completion of the goal

associated with Strep A

Front 20

Restless Leg Syndrome

Back 20

characterized by low iron in substantia nigra and low dopamine levels

Front 21

rubella infection (weeks 7-8)

Back 21

internal ear defects--congenital deafness

Front 22

Craniofacial Dystosis

Back 22

1st arch syndrome
Treacher-Collins
hypoplasia of mandible and maxilla

Front 23

DiGeorge Syndrome

Back 23

results from neural crest deficiency

affects Arch 1, Pouches 3 & 4
-thymus and parathyroids fail to develop resulting in immune deficiency
-wide eyes, low ears, small jaw

Front 24

Rubella infection (weeks 4-6)

Back 24

congenital cataracts, glaucoma

Front 25

Kallman Syndrome

Back 25

ineffective migration of ectoderm and neural crest cells into the hypothalamus (to become GRH cells) and base of skull (olfactory epithelium)

results in anosmia and hypogonadism

Front 26

cleft lip and primary palate

Back 26

failure of fusion between maxillary processes and medial nasal processes

Front 27

cleft secondary palate

Back 27

failure of fusion between lateral palatal shelves and septum

Front 28

bilateral cleft lip and primary palate

Back 28

failure of both maxillary processes to fuse with both medial nasal processes

Front 29

cleft lip and primary/secondary palate

Back 29

failure of fusion between medial nasal processes and maxillary processes AND the lateral palatal shelves, nasal septum, and primary palate

Front 30

oblique facial cleft

Back 30

failure of maxillary processes to fuse with lateral nasal processes

exposed nasolacrimal duct

Front 31

transverse cleft (macrostomia)

Back 31

wide mouth

failure of maxillary processes to fuse with mandible

Front 32

midline cleft

Back 32

failure of medial nasal processes to merge resulting in midline cleft lip and nasal groove

Front 33

hypertelorism

Back 33

excess neural crest cell production in the frontonasal prominence

Front 34

holoprosencephaly

Back 34

mutation in SHH resulting in defective determination of embryonic midline and right-left axis

Front 35

Diabetes Insipidus

Back 35

lesions that destroy supraoptic and paraventricular nuclei or disrupt the supraopticohypophyseal tract--low ADH

results in polyuria (excessive urination), polydipsia (excessive thirst), hypernatremia (high Na)

Front 36

Syndrome of Inappropriate Secretion of ADH (SIADH)

Back 36

due to excess secretion of ADH

results in hyponatremia

treatment = restrict water

Front 37

Wernicke-Korsakoff's Syndrome

Back 37

due to thiamine deficiency

causes degeneration of mamillary bodies (and DM) which inhibits the conversion of short term memory into long term memory

Front 38

Craniopharyngioma

Back 38

tumor in the hypothalamus

occurs in children and older males

results in obesity problems and precocious puberty

Front 39

Hypothalami Hamartomas

Back 39

mass of normal tissue in the wrong location

associated with gelastic seizures (laughing episodes) in children

Front 40

auditory agnosia

Back 40

superior temporal gyrus (left or right)

inability to recognize familiar sounds

Front 41

tactile agnosia (astereognosis)

Back 41

supramarginal gyrus lesion (left or right)

inability to recognize object by touch on contralateral side

Front 42

apperceptive agnosia

Back 42

diffuse bilateral damage to occipital cortex (2nd degree)

difficulty with visual perception
(impaired shape matching and copying ability)

Front 43

associative agnosia

Back 43

diffuse bilateral damage to occipital cortex (2nd or 3rd degree)

inability to access the meaning of what is percieved
(preserved copying ability of objects they can't recognize)

Front 44

graphesthesia

Back 44

intraparietal sulcus

inability to recognize writing on skin by touch

Front 45

right parietal lobe (2-3) lesion

Back 45

contralateral neglect--lack of awareness on one side of body
sensory extinction--loss of perception on one side (usually left) when both sides are stimulated at the same time
asomatognosia--lack of recognition of one's own body one side
dressing apraxia--inability to dress due to impaired sense of orientation and sequence

Front 46

parietal lesions (right and left)

Back 46

constructional apraxia--inability to copy, draw, or construct simple figures
dyscalculia--inability to perform arithmetic calculations

Front 47

left parietal lesions

Back 47

ideomotor apraxia: impaired performance of skilled motor acts, despite intact sensory, motor and language function
--voluntary automatic dissociation
ideational apraxia: impaired ability to carry out sequence of actions for a complex task

Front 48

expressive (broca's) aphasia

Back 48

lesion in left broca's area

non-fluent speech (w/ writing impaired)
intact comprehension
poor repetition

*frustrated--aware of disability

Front 49

receptive (wernicke's) aphasia

Back 49

lesion in left wernicke's area

fluent speech
impaired comprehension
poor repetition

*not as frustrated

Front 50

conduction aphasia

Back 50

lesion in arcuate fasciculus

fluent speech
intact comprehension
poor repetition

*aware of errors but difficult to correct

Front 51

transcortical motor aphasia (adynamia)

Back 51

lesion in MCA-ACA watershed area (frontal lobe)

inability to initiate speech (writing impaired)
intact comprehension
good repetition

Front 52

transcortical sensory aphasia

Back 52

lesion in MCA-PCA watershed area

fluent speech
impaired comprehension
good repetition (echolalia)

Front 53

mixed transcortical aphasia

Back 53

watershed areas of MCA-ACA AND MCA-PCA

impaired speech
impaired comprehension
good repetition

Front 54

global aphasia

Back 54

occlusion of left internal carotid or MCA
--damages the whole left hemisphere

virtually complete loss of language

Front 55

visual aphasia

Back 55

lesion in angular gyrus

word blindness (alexia)

inability to read
speech, writing, comprehension are unimpaired

Front 56

motor aprosodia

Back 56

lesion in right equivalent of broca's area

monotone speech without inflection

Front 57

sensory aprosodia

Back 57

lesion in right equivalent of wernicke's area

inability to comprehend speech inflections

Front 58

prosopagnosia

Back 58

2 and 3 zone temporal lesions:
occipito-temporal, fusiform gyrus
(bilateral or right sided)

face blindness
inability to visually recognize faces

Front 59

lesion in right temporal association cortex

Back 59

defects in episodic memory
-experiences, specific events

Front 60

lesion in left temporal association cortex

Back 60

defects in semantic memory
-facts, general knowledge

Front 61

lesion of medial temporal lobe (hippocampus)

Back 61

anterograde amnesia

impaired ability to form new memories

Front 62

lesion of lateral temporal lobe

Back 62

retrograde amnesia

impaired ability to recall the past

Front 63

temporal lobe epilepsy

Back 63

seizure disorder preceded by olfactory hallucinations "uncinate fits"

characterized by: anterograde amnesia, automatisms, and perseverations

Front 64

lesion in amygdala

Back 64

placidity (loss of protective response), loss of associative learning, psychic blindness (revert to oral inspection), pedophilia

Front 65

Kluver-Bucy syndrome

Back 65

bilateral ablation of anterior temporal lobes including the amygdala and hippocampus

results in psychic blindness, placidity, deviant or hypersexual behavior, anterograde amnesia

Front 66

Limbic lobe lesions

Back 66

changes in behavior and personality
--excessive uncontrollable laughter, crying or other emotions
--panic reactions

Front 67

clinical depression

Back 67

decreased hippocampus

decreased dopamine, serotonin, and norepinephrine in frontal and limbic areas

Front 68

acute stress

Back 68

locus ceruleus releases NE which stimulates hippocampus and amygdala resulting in enhanced activity and memory (flashbulb memory--AMPA)

hypothalamus stimulate sympathetics to release more NE

Front 69

chronic stress

Back 69

results in release of CRH from hypothalamus which stimulates pituitary to release ACTH which stimulates adrenal cortex to release cortisol

results in diminished activity and volume of hippocampus and enhanced stimulation of amygdala which causes fear and anxiety--amy and hippo stimulate hypo continuing the cycle

Front 70

schizophrenis

Back 70

decreased dopamine in mesolimbic system and increased dopamine in mesocortical system (frontal and cinculate lobe)

results in widened sulci in prefontal cortex, shallow left superior temporal gyrus, and enlarged ventricles

Front 71

Pick's disease

Back 71

pick intracellular inclusion bodies in frontal and temporal lobes

results in loss of inhibitions (rude, verbally, sexually aggressive)