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334 Cards in this Set

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  • Back
Injury to what nerve causes loss of dorsiflexion of foot
common peroneal (L4-S2) (PED = Peroneal Everts and Dorsiflexes)
Injury to what nerve causes loss of plantar flexion
tibial (L4-S3) (TIP = Tibial Inverts and Plantarflexes; if injured, can't stand on TIPtoes)
Loss of Knee Jerk?
Femoral (L2-L4)
Loss of hip adduction?
Obturator (L2-L4)
In adults, where does the spinal cord end?
L1-L2
Where does the subarachnoid space end?
S2
divide the 31 spinal nerves into their divisions
8Cs, 12Ts, 5Ls, 5Ss, 1 coccygeal
What cell is responsible for physical support and repair, as well as K+ metabolism
astrocytes
what are the phagocytic cells of the nervous system
microglia
what cells produce myelin in the CNS
oligodendricytes
what cells produce myelin in the PNS
Schawnn cells
What three structures form the BBB
1 Tight junctions between nonfensestrated capillary endothelial cells 2. Basement membrane 3. Astrocyte processes
Do nonpolar/lipid soluble substances or polar, water-soluble substances pass through the BBB more easily?
Nonpolar/lipid soluble
Why is L-dopa, not dopamine, the treatment of choice in Parkinson's Disease
L-dopa crosses the BBB
What are the functions of the hypothalamus (7)
Thirst, Adenohypophysis control, Neurohypophysis hormone synthesis, Hunger, Autonomic regulation (including circadian rhythms), Temperature regulation, Sexual urges (TAN HATS)
Does the anterior hyporthalamus control cooling when hot?
Yes, think Anterior Cooling = A/C
Does the posterior hypothalamus control heat conservation?
Yes, think no Posterior hypothalamus = poikilotherm (cold blooded snake)
Which nucleus is responsible for hunger?
Lateral nucleus
Which nucleus is responsible for satiety?
ventromedial nucleus (without which you grow ventrally and medially
Which nuclei of the hypothalamus project axons into the posterior pituitary?
supraoptic nuclei (ADH) and paraventricular nuclei (oxytocin)
What is the function of the lateral geniculate nucleus?
Visual pathway (remember Lateral is needed to Look)
What is the function of the medial geniculate nucleus?
Auditory pathway (remember Medial is to hear Music)
Function of the ventral posterior nucleus, lateral part (VPL)?
receives body senses (proprioception, pressure, pain, touch, vibration)
Function of the ventral posterior nucleus, medial part (VPM)?
receives facial sensations, including pain
Ventral Nuclei (VA/VL) functions?
Motor
What are the functions of the limbic system?
Feeding, Fighting, Feeling, Flight, and Sex (the five Fs)
What two areas does the hippocampus project to?
the subiculum (mammillary nuclei) and the septal area
Trace the pathway from Mammillary body to hippocampus.
Mammillary body, anterior nucleus of thalamus, cyngulate gyrus, entorhinal cortex, hippocampus
Describe the primary function fo the basal ganglia.
The basal ganglia mediates voluntary movements and postural adjustments
What are the roles of the direct and indirect pathways?
Indirect pathway inhibits movement; Direct pathway facilitates movement.
Delineate the flow of processing in the direct pathway.
Putamen (inhibitory) => Gpi (inhibitory) => Thalamus: inhibition of Gpi => activation of thalamus
Delineate the flow of processing in the indirect pathway.
Putamen (inhibitory) => GPe (inhibitory) => STN (excitatory)=>GPi (inhibitory) =>Thalamus; induces excitation of Gpi => inhibition of thalamus
What is the anatomical defect in Parkinson's Dz?
Loss of substantia nigra pars compacta (SNc) dopamine output to putamen => activation of indirect pathway and inhibition of direct pathway
What is the clinical presentation and cause of chorea?
sudden, jerky, purposeful movements; caused by basal ganglia lesionChorea= dancing, think choreography
What is the clinical presentation and cause of athetosis?
slow, writhing movements, especially of fingers; caused by basal ganglia lesion
What is the clinical presentation of hemiballismus?
sudden, wild flailing of 1 arm; half ballistic= as in throwing a baseball
What is the anatomical defect in hemiballismus?
contralateral subthalamic nucleus lesion
Where is the primary sensory cortex (S1) located?
anterior aspect of parietal lobe
Where is the primary motor cortex (M1) located?
posterior aspect of frontal lobe
Where is the primary visual cortex (V1) located?
most posterior aspect of occipital lobe
What are the Brodman's Area designations for S1, M1, V1?
S1: 3, 1, 2; M1: 4; V1: 17
What is the role of Broca's area? where is it located?
inferior aspect of frontal lobe; mediates motor speech (production)
What is the role of Wernicke's area? Where is it located?
superior temporal gyrus; mediates speech comprehension
What is a consequence of a lesion in:
Broca's area?
motor (expressive, nonfluent) aphasia; BROca's BROken speech
Wernicke's area?
sensory (fluent, receptive) aphasia; Wernicke is Wordy but makes no sense
Arcuate fasciculus?
conduction aphasia: poor repetition w/ good comprehension and fluent speech
Amygdala?
Kluver-Bucy syndrome: hyperorality, hypersexuality
Right parietal lobe?
spatial neglect syndrome (contralateral)
Mammillary bodies?
Wernicke-Korsakoff's encephalopathy: anterograde amnesia (think alcoholism)
Cerebellar vermis?
Truncal ataxia and dysarthria
Cerebellar hemisphere?
Limb ataxia and intention tremor
Reticular activating system?
Coma
Name five nerves and one vessel that pass through the cavernous sinus.
CN III, IV, V1, V2, VI; internal carotid artery
Name three structures passing through optic canal (one nerve, two vessels).
CN II, ophthalmic artery, central retinal vein
Name five structures passing through superior orbital fissure (four nerves, one vessel).
CN III, IV, V1, VI; ophthalmic vein
Name the foramina of exit for each division of the trigeminal nerve (CN V).
Standing Room Only: V1 = Superior orbital fissure; V2 = foramen Rotundum; V3 = foramen Ovale
Name four structures passing through the jugular foramen (three nerves, one vessel).
CN IX, X, XI; jugular vein
Name structures passing through foramen magnum.
brain stem, vertebral arteries, spinal roots of CN XI
Name two nerves passing through internal auditory meatus.
CN VII, VIII
Describe the innervation of the extraocular muscles.
LR6SO4R3 : Lateral Rectus = CN VI, Superior Oblique = CN IV, and the Rest are CN III
List in sequence the nerves, brain structures, and muscles involved in the pupillary light reflex from illumination of one eye to bilateral pupillary constriction.
Light => retina => optic nerve => optic chiasm => optic tract => prectectal nuclei (synapse) => Edinger-Westphal nuclei (synapse) => oculomotor nerve => ciliary ganglion (synapse) => pupillary constrictor muscles
What is the characteristic lesion in internuclear ophthalmoplegia?
destruction of the medial longitudinal fasciculus (MLF) => medial rectus palsy on attempted lateral gaze
Name three characteristic clinical features of internuclear ophthalmoplegia.
1. On attempted lateral gaze, contralateral eye fails to abduct past midline; 2. Contralateral nystagmus on attempted lateral gaze; 3. Normal convergence
What neurologic disease is commonly associated with internuclear ophthalmoplegia (aka MLF syndrome)?
multiple sclerosis; think MLF = MS
Name the visual field defect associated with a lesion of each of the following structures:
Right optic nerve
Right anopsia
Optic chiasm
Bitemporal hemianopsia
Rigth optic tract
Left homonymous hemianopsia
Right Meyer's loop (temporal lesion)
Left upper quadrantic anopsia
Right Meyer's loop (parietal lesion)
Left lower quadrantic anopsia
Dorsal optic radiation
Left hemianopsia with macular sparing
Classify each cranial nerve (1-12) according to its function as a sensory nerve, a motor nerve, or both.
Mnemonic: Some Say Marry Money But My Brother Says Big Brains Matter Most
Name the cranial nerves that innervate the eye muscles.
Oculomotor (III), Trochlear (IV), and Abducens (VI)
Name the cranial nerves that innervate the facial muscles (extraocular muscles excluded).
Trigeminal (V): mastication; Facial (VII): facial movement
Name the cranial nerves associated with sight, smell, hearing, and taste.
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
Which cranial nerves pass through the superior orbital fissure?
III, IV, V1, VI
Which cranial nerves pass through the internal auditory meatus?
VII, VIII
Which cranial nerves pass through the jugular foramen?
IX, X, XI
Which cranial nerves exit the brainstem caudal to the pons?
Cranial nerves VI through XII
Which cranial nerves exit the brainstem rostral to the pons?
Cranial nerves I through V
Which cranial nerves are associated with the cerebellopontine angle?
CN VII, VIII, and IX
What is the main location of CSF return via the arachnoid granulations?
superior sagittal sinus
Describe the route of CSF from the superior sagittal sinus to the internal jugular vein.
superior sagittal sinus => confluence of sinuses => transverse sinus => sigmoid sinus => internal jugular vein (via jugular foramen)
Which three sinuses combine to form the confluence of sinuses?
Homunculus is the topographical representation of the body that exists in what 2 areas of the cerebral cortex?
superior sagittal sinus, straight sinus, occipital sinus
Sensory and Motor areas
Sensation for ____(What part of the body) is generally located superior medially on the primary sensory cortex while ____ is located more laterally
Lower limbs, Head and neck
Lesion at the anterior cerebral artery will canse deficit in sensation or movement in which part of the body?
Lower limbs
Which artery supplies the medial surface of the brain, leg-foot area of motor and sensory cortices?
Anterior cerebral artery
If you suspect a lesion in both Broca's and Wernecke's areas, a lesion in which artery could be the cause?
Middle cerebral artery
At which artery in the circle of willis is the most common place of aneurysm? You often see visual symptoms
Anterior communicating artery
This is also another common area of aneurysm. aneurysm causes CN III palsy
Posterior communicating artery
This artery comes off of middle cerebral artery and supply internal capsule, caudate, putamen, globus pallidus
Lateral Striate
In general, in stroke of anterior circle you would see what kind of deficits?
Sensory and motor dysfunction, aphasias
how will a stroke of posterior circle will manifest?
Brain Stem, cranial nerve, cerebellar disfunction
You would ask the patient to say this to test CN X (vagus)
Kuh-kuh-kuh
"La la la" tests which CN?
XII - Hypoglossal (innervation of the tongue)
"Mi mi mi" tests which CN?
VII - Facial (innervation of lips)
This nuclei confers visceral Sensory information (eg: taste, gut distension)
Nucleus Solitarius (VII, IX, X)
Nucleus aMbiguus confers Motor innervation of what part of the body?
pharynx, larynx, and upper esophagus (IX, X, XI)
This nucleus sends parasympathetic fibers to the heart, lungs, and upper GI
Dorsal motor nucleus
Play this game: Where is the Lesion??
patient's tongue deviates to the left
Left CNXII
Patient's jaw deviates toward the left
left CN V
patient tends to fall toward the left side
left lesion of the cerebellum
Patient's uvula deviate to the left
right CN X lesion
Patient's shoulder droop on the left
left CN XI lesion
Patient has weakness turning head to the left
right CN XI lesion
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
1 herniates under the falx cerebri and does not cause coma and death. 2. Transtectoral, 3. Uncal, and 4. tonsillar herniations can
Uncal herniation can cause the following clinical signs, name their causes
1. Ipsilateral dilated pupil, ptosis
Stretching of CN III
2. Contralateral homonymous hemianopsia
Compression of ipsilateral posterior cerebral artery
3. Ipsilateral paresis
Compression of contralateral crus cerebri (Kernohan's notch)
4. Duret hemorrhage
Caudal displacement of brain stem
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)
Cuneatus, upper body and extremities. Gracilis, lower body and extremities
The lateral cortical spinal tract carries what type of fibers, and how are they arranged in the spinal cord?
motor fibers, arms medially, legs laterally
What tract carries pain and temperature sensation? Where is it located on the spinal cord?
Spinal Thalamic tract, ventral part
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
Mostly white matter of Cervical region, lesion are asymmetric and random
Multiple sclerosis
grey matter, and motor tracts: upper and lower motor neuron deficits
Amyotrophic Lateral Sclerosis
dorsal column, impairs propioception and causes locomotor ataxia
Tabes dorsalis (tertiary syphilis)
central white commisure and ventral horns
Syringomyelia
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
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
What are the signs of Lower Motor neuron lesion?
everything lowered: ↓ muscle mass, ↓ muscle tone, ↓ reflexes, downgoing toes
What are the signs of Upper Motor neuron lesion?
Upper = everything up (tone, DTRs, toes)
True or False: Upper motor neuron lesion of the face causes contralateral weakness of lower face only
TRUE
True or False: Lower motor neuron lesion of the face causes contralateral weakness of lower face only
FALSE: weakness of both upper and lower face seen
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?
ALexanger Bell with STD: AIDS, Lyme, Sarcoid, Tumors, Diabetes
Upper motor neuron lesion coming from the facial nucleus result in what?
contralateral paralysis of lower quadrant
What is the difference between alpha and gamma motor neurons?
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
What are the 5 divisions/parts of the bracial plexus?
Roots Trunks Divisions Cords Branches (Randy Travis Drinks Cold Beer)
Play this game: Where is the Upper Limb nerve Lesion??
Claw hang
Trunk of C8 and T1
Wingled Scapula
Long thoracic nerve
Decreased thumb function, Pope's blessing
median nerve
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?
radial nerve (innervates BEST!) Brachioradialis, Extensors of wrist and fingers, Supinator, and Triceps
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?
median nerve
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?
ulnar nerve
Patient dislocates his shoulder and could no longer use his deltoid.
axillary nerve
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
musculocutaneous nerve
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)
C5 and C6 roots. Known as Erb-Duchenne palsy
Thoracic outlet syndrome leads to loss of the compression of ____ artery and ____ trunk of brachial plexus
Subclavian, inferior (C8. T1)
In thoracic outlet syndrome, when the patient turn his head toward the opposite side, you notice the dissapearance of _____ (what physical finding?)
radial pulse
What muscles would you expect to be atrophied as a result of thoracic outlet syndrome?
thenar and hypothenar eminences, innterosseous
What neurological symptoms would you see?
sensory deficits of medial side of forearm and hand
What nerve root do you test for if you illecit the following reflexes?
1. Biceps
C5
2. Triceps
C7
3. Patella
L4
4. Achilles
4. s2
What is the Babinski reflex a sign of? When is it normal?
UMN lesion, its normal during 1st year of life
Where is the most common place for vertebral disk herniation
L5 and S1
Where do you put the needle for a lumbar punctur
between L3 and L5
What dermatome covers the following areas:
xiphoid process
t7
inguinal ligament
L1
kneecaps
L4
nipple
T4
High turtleneck shirt
C3
Low collar shirt
C4
posterior half of skull "cap"
c2
umbilicus
T10
erection and sensation of penile and anal zones
S2-S4
What are the following primitive reflexes:
Moro reflex
extension of limbs when startled
Rooting reflex
Nipple Seeking
Palmar Reflex
grasps objects in palm
babinski reflex
large toe dorsiflexes with plantar stimulation
Function of the following cranial nerves:
CN1- Olfactory
Smell
CN2- Optic
Sight
CN3-Oculomoter
Eye movement, pupil constriction, accommodation, eyelid opening
CN4- Trochlear
Eye Movement (Superior Oblique)
CN5- Trigeminal
Mastication, facial sensation
CN6- Abducens
Eye Movement (lateral rectus)
CN7-facial
facial mov't, taste from anterior 2/3 of tongue, lacrimation, salivation, eyelid closing
CN8-vestibulocochlear
Hearing, balance
CN9- Glossopharyngeal
Taste from post. 1/3 of tongue, swallowing, salivation (parotid gland), monitering carotid body and sinus chemo- and baro receptors
CN10- Vagus
Taste from epiglttic region, swallowing, palate elevation, talking, thoracoabdominal viscera, monitering aortic arch chemo and baro receptors
CN 11- Accessory
Head Turning, shoulder shrugging
CN12-Hypoglossal
Tongue mov't
What goes through the foramen spinosum
Middle meningeal artery
what goes through the internal audiory meatus
CN VII and VII
What goes through the jugular foramen
CN IX,X, XI, and jugular vein
What 3 muscles close the jaw and what is there innervation
Masseter, temporalis, Medial pterygoid
V3 innervation
What muscle opens the jaw. What is innervation
Lateral pterygoid
V3
What nerve innervates all muscles with the root of -glossus? What is the exception
Hypoglossal nerve, expept for palatoglossus, which is innerated by the vagus
What nerve innervates all muscles with the root of -palat? What is the exception
Vagus nerve, except for tensor veli palatini, whch is innervated by V3
What are the eye movements of the superior oblique
abducts, introverts, and depresses
What innervates the levator palpebrae superioris
oculomoter nerve
What is the classic picture of of CNIII lesion
Down and out
Regarding Sleep stages:
In what two phases of the day are Beta wave forms present
1. Awake-eyes open, active mental concentration
2. REM sleep
What type of waveform is present at the following sleep stages? what is the pnumonic?
Awake(eyes open), Awake(eyes close),1(Light Sleep),2(deeper sleep),3-4(deepest, non-rem sleep)REM
at nignt, BATS Dring Blood
Beta (hightest frequency, lowest amplitude),Alpha, Theta, Sleep spindles and K complexes, Delta(lowest frequecy, highest amplitude), Beta
What occurs during phase 3-4 sleep
sleepwalking, night terrors, bed wetting
What occurs during rem sleep
dreaming, loss of motor tone, memory processing, erections, in c brain o2 use
What drugs shorten phase 4 sleep and are therefor useful for night terrors and sleepwalking
Benzodiazepines
What drug is used to treat enuresis because it decreases phase 4 sleep
imipramine
What neurotransmitter reduces REM sleep
NE
How often does REM sleep occur
90 minutes, but duration increases throughout the night
What is the principle neurotransmitter involved in REM sleep
ACh
Neural tube defects are associated with low levels of what during pregnancy
Folic Acid
What is elevated in the amniotic fluid and maternal serum of most babies with neural tube defects
alpha-fetoprotein
What is a meningocele
meninges herniate through spinal canal defect
What is a meningomyelocele-
meninges and spinal cord herniate through spinal canal defect
What is a partial seizure
1 area of the brain affected
What is a Simple partial
partial with consciousness intact
What is a complex partial
partial with impaired consciousness
What characterizes the following seizures
Absence
Blank Stare
Myoclonic
Quick, repetative jerks
Tonic-Clonic(grand mal)
alternating stiffening and movement
Tonic
Stiffening
Atonic
"drop" seizures
What are the causes of seizures in children
genetic, infection, trauma, congenital, metabolic
What are the cuases of seizures in adults
tumors, trauma, stroke, infection
What are the causes of seizures in the elderly
Stroke, tumor, trauma, metabolic, infection
What are histological findings on Alzheimer's disease
senile plaques(extracellular, B-amyloid core) and neurofibrillary tangles (intracellular, abnormally phosphorylated tau proteins)
What is the classic shape of the phosphorylated tau protens
flame shaped, paired helical formation
what chromosomes is the familial form of Alz. associated with
1,14,19 (APOE4 allele) and 21(p-App)gene
What area of the brain is one of the earlies and most severely affected regions
Hippocampus
What disease is associated with alz. in people over the age of 35.
Downs syndrome
What can cause intracranial hemmorrhage in Alz patients
amyloid angiopathy
What are Pick bodies
intracellular, aggregated tau proteins
What are the symptoms of pick's disease
dementia, aphagia, and parkinsonian aspects
where do the pick bodied go to in pick's disease
fronal and temporal lobes
Huntingtoms is a loss of what type of neurons
GABAergic neurons as well as ACh
What atrophys in huntingtons
caudate
In what disease are Lewy bodies found
Parkinson's
What are the 4 classic symptoms of parkinson'
TRAP
Tremor, cogwheel Rigidity, Akinesia, and Postural instability
What 2 diseases are associated with Spinocerebeller degeneration
Olivopontocerebellar atropy, Friedreich's ataxia
What is an epidural hematoma. What bone is usually broken. What does the CT show
rupture of middle meningeal artery, often after fracture of temporal bone. CT shows "biconcave disk" not crossing suture line
Shat is a subdural hematoma
rupture of bridging veins
Are symptoms immediate of delayed
delayed
Who gets subdurals
eldery, alcoholics, blunt trauma, shaken baby
What is seen on Ct
Crescent shaped hemorrhage that crosses suture line
What usally causes a subarachnoid hemmorrage
Rupture of an aneurysm (usaually berry)
What do patients usually complain of
worst headace of my life
What usually causes parenchymal hematomas
hypertension, amyloid angiopathy, diabetes mellitus, and tumor
What is the most frequent area of an intraparenchymal hemmorage due to hypertension
basal ganglia and internal capsulue
Are most adult primary brain tumors infratentorial or supratentorial
Supratentorial
How about childhood primary brain tumors
Infratentorial
What do the cells look like in Glioblastoma multiforme (grade IV astrocytoma)
"psuedopalisading" tumor cells- they border central areas of necrosis and hemorrhage
What is the prognosis
< 1 year
What do the cells look like in a meningioma
spindle cells concentrically arranged in a whorled pattern- psammoma bodies are present(laminated calcifications)
Where do most menigiomas occur
convexities of hemispheres and parasagittal region
What cells do meningiomas arise from
arachnoid cells external to brain
What nerve do schwannomas often localize to
CN 8
In what disease do you often see bilateral schwannomas
Neurofibromatosis 2
Where are oligodendrogliomas most often found
frontal lobe
What do the cells look like
"fried egg" cells- round nuclei wigh clear cytoplasm
What is the most common symptom of a pituitary adenoma
bitemporal hemianopia (due to pressue on optic chiasm)
In what population are pilocytic astrocytomas found
low grade tumor of children
what do the cells look lik
Rosenthal fibers- eosinophilic, corkscrew fibers
Where in the brain is a medulloblastoma found
cerebellum
What do cells look like
Rosettes of perivasecular pseudorosettes
Why can you get hydrocephalus
b/c it can compress 4th ventricle
Where are cpendymomas usually found
4th ventricle, can cause hydrocephalus
What do the cells look like
perivascular pseudorosetts.
Where are hemangioblastomas usually found
cerebellum
What disease are they associated with
Von Hipple Lindau syndrome when found with retinal angiomas
What can they produce
EPO- leads to secondary plycythemia
What do the cells look like
foamy cells and high vascularity
What childhood tumor is often confused for a pititary ademoma b/c of location
craniophyarygioma
What is it derived from
remenants of Rathke's pouch
What is the most common supratentorial tumor
craniophyngioma
What are they symptoms of Horner's syndrome? Pnumonic
Ptosis(drooping of Eyelid), Anhidrosis(absence of sweating)and flushing of affected side. and Miosis (pupil constriction)
PAM is Horny
What is anosognosia
Unaware that one is ill
What is Autotopagnosia
Unable to locate one's own body parts
What is Depersonilization
body seems unreal or dissociated
What is Anterograde amnesia
no new memory
What is Korsakoff's amnesia
anterograde amnesia caused by thiamine deficiency (bilateral destruction of mamillary bodies), usually seen in alcoholics along with confabulations
What is retrograde amnesia
inability to remember things before CNS insult
What is Arnold-Chiari malformation and what is it associated with
congenital condition when part of cerebellum herniates through foramen magnum- associated with syringomyelia
Whow do Glucose and AA cross the BBB
Carrier-mediated transport
What are 2 areas of the brain that have no BBB and why are they important
1. Are Postrema- vomiting after chemo
2. Neurophypohysis- ADH release
What do microglia arise from. why is this interesting
Like macrophages they arise from mesoderm. all other CNS/PNS supportive cells arise from ectoderm
Where are Meissner's Corpuscles found. What type of sensation do they deal with
dermis of palms, soles, and digits of skin. light descriminatory touch of hairless skin
Where are Pacinian Corpuscles found. what type of sensation
lagaments, joint capsules, serous membranes, mesenteries. pressure, coarse touch, vibration, and tension
Where are Merkel's corpuscles found? What type of sensation
dermis of fingernales, hair follicles, hard palate. light, crude touch
Which of the above three are encapsulated
Meissner's and Pacinian
Microglia are CNS --------------
phagocytes
Embryonic origin of microglia?
mesodermal
True/False: Microglia are readily seen with Nissl stain
FALSE
In response to tissue damage, microglia transform into ------------
large, ameboid phagocytic cells
HIV-infected microglia form ----------------------- in the CNS
multinucleated giant cells
Function of oligodendroglia?
To myelinate multiple CNS axons
In Nissl stain, oligodendroglia appear as -------------
small nuclei with dark chromatin and relatively little cytoplasm
Oligodendroglia are the predominant type of glial cell in --------- matter
white
Oligodendroglia are destroyed in --------------------
Multiple sclerosis
Each Schwann cell functions to myelinate how many PNS axons?
One
What is the function of Schwann cells?
To promote axonal regeneration
Name an example of a schwannoma
acoustic neuroma
3 components of bony labyrinth
cochlea, vestibul and semicircular canals
Site and composition of endolymph
membranous labyrinth, high potassium (like ICF)
site and composition of perilymph
bony labyrinth, high sodium (like ECF)
site of cochlear duct, utricle, saccule, and semicircular canals
membranous labyrinth
what frequency does base of cochlea pick up?
Where are ampulla located and what do they detect
High Frequency

in semicircular canals, for angular acceleration
site and function of maculae
in utricle and saccule, for linear acceleration
which frequency is lost first in hearing loss in elderly
high-frequency
site of endolymph production
stria vascularis
what part of the cochlea picks up low frequency sound?
the apex
What 2 degenerative diseases are associated with spinocerebellar degeneration
Olivopontocerebellar atropy
Freidricch's ataxia
What 2 diseases are associated with degeneration of the anterior horns
Wednig-Hoffman disease and Poliomyelitis
How does Werdnig-Hoffman disease present
"Floppy baby" wigh tongue faciculations
How is Poliovirus spread
Fecal-Oral
Does prevelance of MS increase or decrease as you get closer to the equator
Decrease
What is increased in CSF in MS
IgG
What is the classic triad of MS symptoms
SIN
Scanning Speech
Intention tremor
Nystagmus
How else do MS patients present
Optic Neuritis (sudden vision loss), MLF syndrome, hemiparesis, hemisensory symptoms, or bladder/bowel incontinence
What demylinating disease is associated with the JC virus (a papovavirus)
Progressive mulifocal leukoencephalopathy
In what disease is PML most commonly seen
seen in 2-4% of AIDS patients
What viruses are known to cause postinfectious encephalitis, leading to acute disseminated encephalomyelitis
measles & mumps (both paramyxovirusus, rubella( a togavirus) and chickenpox(a herpes virus)
What types of nerves are effected in Guillain Barre syndrome
Inflammation and demylination of peripheral nerves adn motor fibers of ventral roots
What is affected more in Guillain Barre, sensory or motor fibers
Motor
How does the muscle weakness typically spread
ascending muscle weakness, beginning in distal lower extremities
Is autonomic function affected
Yes, you can get cardiac irregularities, hyper/hypo tension
Is Guillain Barre associated with any etiology
Associated with post infectious state, and thought to be an immune attack of peripheral myelin.
What is found in the CSF
elevated protein with normal cell count (albuminocytologic dissociation)
What fibers are damaged in syringomyelia. At what spinal cord level does this usually occur
Crossing fibers of spinothalamic tract
C8-T1
what is the sensory defecit
bilateral loss of pain and temperature sensation in upper extremities with preservation of touch sensation
What congenital malformation is Syringomyelia associated with
Arnol-Chiari malformation (herniation of cerebellar tonsils through foramen magnum)
Vitamin b12 deficiency and friedrichs ataxia lead to demylination of what tracts
dorsal colums, lateral corticospinal tracs, adn spinocerebellar tracts
What change in neurotransmitters are associated with the following diseases
Anxiety
inc NE, dec GABA, dec seratonin
Depression
dec NE, dec serotonin
Alzheimer's dementia
dec ACh
Huntington's
dec GABA, dec ACh
Schizophrenia
inc Dopamine
Parkinson's
dec dopamine (and inc ACh)
What eye movement does the following muscles cause
Lateral Rectus
Abduction
Medial Rectus
Adduction
Superior Rectus
Elevation and intortion
Inferior Rectus
Depression and extorsion
Inferior oblique
Abduction, Elevation and extorsion
Superior oblique
Abduction, depression, and intorsion
what is dandy walker syndrome
congenital atresia of lushka and magendie, leading to hydrocephalus
what nerve deals with hip abduction
superior gluteal
What nerve is to be avoided by giving an injection to the upper, outer quadrant of the buttock
sciatic
Between what 2 tendons do you want to anesthatize the median nerve for carple tunnel surgery
parlamris longus and flexor carpi radialis
what does a central scotoma indicate
macular lesion
What muscles are mainly responsible for the following actions
hip flexion
psoas
hip extension
gluteus maximus
hip abductors
gluteus medius and maximus
hip adductors
adductor longus, brevis, adn magnus
hip internal rotators
gluteus minimus, pectineus, gracilus
hip external rotators
psoas