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110 Cards in this Set

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describe auditory path
SLIM41
-SON synapse (40% ipsi LDF -, 60% contra MDF +, acoustic stria bypasses this)
-travel in LL
-synapse IC
-synapse MGN
then travel in PLIC auditory radiations to Br 41 (transv gyrus of Herschel)
interpreting Webber test
sensorineural problem in silent ear or conductive problem in loud ear
interpreting Rinne
conductive longer than sensorineural
what happens in near synkinesis
1) convergence
2) pupil constrict
3) lens accomod
path of light reflex
(general CN2 to para to CN3)
light 1 hemiretina projects to both pretectal.
ea pretectal project to both EWN
then to ciliary ganglion
injury to CN4
(no SO) no depression esp when ADD,
tilt head away from damaged side
(cross eyes or look at nose)
note: both superior mscles intort (inferior extort)
injury CN6
no LR-no abduction
no CN3
down and out, blown pupil can indicate incr ICP uncal herniation
path for smooth pursuit
R Br19 projects to R PPRF which projects to R 6 and, via MLF, L3 (ipsi6, contra3).
R6 innerv R LR, L3 innerv L MR
path for saccade
L FEF projects to R PPRF which projects to R 6 and, via MLF, L3 (ipsi6, contra3).
R6 innerv R LR, L3 innerv L MR
signs/sx pinealoma
(pretectal lesion)
1) lose EWN, dilate
2) lose 3, no convergence
3) no vertical
INO
(internuclear ophthalmoplegia) plaque on MLF.
when say look R or follow to right, L eye doesn't ADD.
convergence ok (mscls ok, bypasses MLF)
pt unable to show how cut w scissors
disorder of praxis, Dominant parietal
pt hemineglect
disorder ND parietal
pt construction apraxia
disorder ND parietal
injury to arcuate
conduction aphasia (unable to repeat "no if's and's or but's"
T/F Broca and Wernicke both can't repeat
T
fxn arcuate
connects auditory assoc and wernicke's with brocas
when vestibular hair cells of R depolarized what 3 paths follow
1) contra PPRF (drift L, nystag R)
2) to R Brocas 3 causing vertigo
3) R extensors tighten (fall left)
NET: ispi nystag and vertigo, contra fall
Hypothal: preoptic
sex drive in males
with anterior: temp/osmoR behavioral response
Hypothal: paraventric
rel H (oxy to P Pit)
where circardian rhythm controlled
SCN of hypothalamus
Hypothal: supraoptic
osmo R/H2O, ADH
Hypothal: VM
stop eating
Hypo: arcuate
leptin R,
which part hypothal projects to p pit
paraventricular (directly project rel oxy and ADH)
which part hypothal projects a pit
arcuate, rel H at median eminence
CPCb path dysfxn causes
disdiakinesis
tremor
dysmetria
SCB dysfxn causes
truncal and postural instability
VCb dysfxn causes
truncal instability, equil, nausea, nystag, vertigo
fastigial of Cb impt for which path
SCb
dentate of Cb impt for
CPCb
gross layers of CB
(in to out)
granule
purkinje
molecular
dentate's location in Cb
lateral
fastigial's location in Cb
vermis
which Cb path uses floccunodular
VCb
general path of Cb paths
projection into Cb ends as mossy fiber goes to deep nucleus send collateral to granule of cortex which sends Purkinje which - deep nucleus. output is from the deep nuclei
superior visual world transmitted by what path
Meyer (in lower temporal)--optic radiations
inferior visual world transmitted by what path
superior parietal--optic radiations
macular sparing: local?
calcarine fissue
altitudinal visual field defect
what assoc condition consider?
optic n blood supply, sp ciliary effects infr visual world.
think AION w jaw pain, scalp pain
homo quadratinopsia: lesion?
optic radiations (Meyer, lower temporal, or superior temporal)
nonhomon: lesion?
optic chiasm
(below=pit tumor, above=craniophar)
monocular visual field defect could be problem in what 2 general things (and exs of ea)
1) retina (retinal detach)
2) optic n (oligodendro, MS plaque, CRAO)
path of horiz doll's eye
VN to PPRF via MLF to 3.
how INO effect doll's eye
lose both horiz and vert doll's eye bc both use MLF, but can move eyes vertically and can follow vertically
path of vertical doll's eye
VN to 3 and 4 (via MLF) from below
(so when pinealoma use this to check integrity of nerves)
when use vertical doll's eye
when pinealoma use this to check integrity of nerves 3, 4
if can't look up, but positive doll's
lesion in FEF path
water in ear-which way eyes go
COWS=cold opposite, warm same
Cushing reflex
(to increased ICP)
HTN, bradycardia, decr RR
what forms BBB
choroid plexus epithel, intracerebral capillary endotheliu,. arachnoid (BBB protected by CIA)
key: tight jxns nonfenestrated endothel
cingulate herniation
causes infarct ACA
-lower extrem weakness contralaterally
-urinary incontinence
uncal herniation causes
1) CN3-ipsi ptosis, mydriasis
2) PCA-contra homo hemianopsia
3) contra crus-ipsi paresis
central herniation (both hemi herniate transtentorially)
both pupils dilate, placcidity, coma
cerebellar tonsillar herniation into foramen magnum
complress medulla respir
-duret hemorrhages
what supplies blood for the choroid plexus
a choroidal a
medial striate comes off what?
ACA
medial striate supplies
caudate, putamen, ALIC
loss of medial striate a cause what symptoms
frontal ataxia, cb
lateral striate supplies
PLIC and genu, + caudate, putamen, GP
symptoms of loss of lateral striate a
lower contra face, hemiparesis, hemisensory
problem w anterior circle
sensory and motor problems
problem w posterior circle
Cb, vertigo, ataxia; visual defect, coma
loss of MCA results in
head/trunk motor and sensory, aphasia (Broca and Wernicke)
if lesion LS prox
total contralateral paralysis
ACA controls
leg/foot motor and sensory
lateral striate comes off of
MCA
medial striate comes off of
ACA
problem with a communicating
visual field
P communicating problem causes
CNIII palsy
(also supply hypothal and ventral thal)
PCA supplies
major supply midbrain, thal (LGN, MGN), optic radiations, visual cortex, hippocampus
central a of retina comes off
ophthalmic
what enters orbit with CNII
opthalmic a
what supplies blood to hypothalamus
p. commun (also ventral thal), 2 MC aneuryism
most common site aneuryism? causes?
a. communicating a,
bitemporal lower quadratanopia
blood supply to CNIII
P communicating
2nd MC aneuryism
P commun, supplies hypothal, ventral thal, CNIII
IC supplied by
lateral striate (off MCA), a choroidal a (part medial striate)
what does a choroidal a supply
PLIC, LGN, GP
where does a choroidal a comes from
off internal carotid (not part circle of willis)
what supplies CN 6
pontine a off basilar
cb supplied by
AICbA, SCbA, PICbA
what a supplies cochlea
SCbA
what supplies crus cerebri
CB (medial) by basilar, CS lower extremities PCA
what supplies PPRF
short basilars
what supplies MLF
short basilar
what supplies nu ambiguus
PICbA
what supplies CN7
AICbA
what are medial structures in pons
MLF, Nu6, PPRF
what order of structures brain starting at medulla/SC jxn
medulla
pons
midbrain
describe elements mid medulla
nucleus ambiguus, (9-11), with nuclei for those CN more central, tract for 5 extends down this far, olives hold DC, ST tracks are outside this,
4th vent, ICP, begin of VN
describe elements medulla/SC jxn
crossing of CS (at decussation of pyramids), nu cunneatus, faciles haven't yet crossed
where do DC paths cross
internal arcuate, medulla
where ST cross
AWC upper SC
describe low medulla
tracks: CS diffuse contra, crossing of DC to form ML/TGL man, ST man laterally,
CN: nu 12,10 medial, lateral NA
describe pons medulla
EAR SLIDE:
CN: CN 6-8 come in, Nu CN8, VN with ICP/MCP
tracks: CS diffuse contra, ML/TGL and ST men lying down,
(no 12, no NA,)
MLF present, tract 5
describe mid pons
ENTER 5--body now has head!! motor and sensory of 5
tracks: ML/TGL and ST lying down,
MLF and PPRF present
lateral: SCP/MCP
(note 6/7 in low pons)
describe upper pons
pear slide
CN4 comes in dorsally, crossing to its nucleus
MLF
CB/CS diffuse contra in pons, TGL/ML and ST lying above laterally
describe midbrain slide
CN 3 coming in at superior colliculus, cerebral aqueduct in center,
Crus!! FP,CS, POT paths
TGL/ML and ST outside crus
where does CN4 enter
upper pons (pear slide)
where find PPRF
mid pons, with connections CN6 of low pons and VN,
sends neurons via MLF to contra 3
where CN7 enter
pons medulla
where Nu 8
pons/medulla
when does TGL/ML and ST men have head
mid pons (CN5 enters)
ST secondary neurons' cell bodies are where
Rexed Lamina I,II, maringal nu, substantia gelat
fast pain uses what fiber? type mechano? releases?
A1, hi threshold mechanoR, which releases glutamate
slow pain uses what fiber, type mechanoR, releases
S1 vanilloid, uses unmyelinated C fiber, releases subP and glut
what are the triggers for slow pain path
acid, heat, capsaicin, bk
what are the cerebral targets for slow pain
cingulate gyrus, medial frontal lobe, insula