Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
334 Cards in this Set
- Front
- 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
|
