Neuro Block

Front 1

Chlorpromazine

Back 1

Typical Antipsychotic
Blockade of D2 (dopamine receptors)

For treating schizophrenia, bipolar, emesis

Front 2

Haloperidol

Back 2

Typical Antipsychotic
Blockade of D2 dopamine recptors

Schizophrenia, bipolar, Huntington's Tourettes

Front 3

Clozapine

Back 3

Atypical Antipsychotic
Blockade of 5HT Serotonin (2A) receptor
doesn't block dopamine as much
to treat schizophrenia

Front 4

The parts of the brain most susceptible to ischemia:

Back 4

- Sommer sector neurons (CA1) of the hippocampus
- Purkinje cells of cerebellum
- pyramidal neurons in cortical layers 3 and 5

Front 5

The most common berry (saccular) aneurysm place:

Back 5

Anterior Cerebral - Anterior communicating junction

Front 6

What is the most common cause of sub-arachnoid hemorrhage (SAH)?

Back 6

1. Trauma
2. Ruptured aneurysm (most severe)

Front 7

What is the greatest risk factor for inracerebral hemorrhage?

Back 7

Hypertension

Front 8

The Raphe nucleus is the center that produces what NT?

Back 8

Raphael was always happy

Serotinin

Front 9

This center of the brain controls wakefulness. Thus, damage to it may cause unconsciousness.

Back 9

The Reticular Formation

This is a central core of nuclei that runs through the entire length of the brain stem

Front 10

What lesion in the brain can you expect a patient to be comatose

Back 10

Think of the upper brain stem: Reticular Formation

This region uses NE, Sero, Dopa neurons to project to both cortical and subcortical structures
Neurons in this region that use ACh project to the thalamus, hypothalamus and basal forebrain

Front 11

So I took too much benadryl (diphenhydramine) and I started to become delirious. By what mechanism did this occur?

Back 11

One of the most common causes of delirium is the inhibition of muscarinic acetylcholine receptors

Thus, diphenhydramine has anti-cholinergic properties

Front 12

So I took too much medication for my GERD and now I'm delirious. What med did I take and why did this happen?

Back 12

Famotidine

It blocks histamine release in the stomach. In the brain, this can cause delirium

Front 13

A comatose patient has intact cranial reflexes except the corneal reflex. Where is the damage?

Back 13

Corneal reflex is mediated by V and VII. Trigeminal is for sensation and Facial is for motor.

The nuclei for these nerves are in the pons

Front 14

On CT, how can you differentiate between an epidural and subdural hematoma?

Back 14

The dura is sutured to the skull at the suture lines. In epidural hemorrhage, blood cannot pass the suture lines. Subdural hematoma can move freely around the brain

Front 15

Where is Wernicke's area (speech comprehension)? What artery supplies it?

Back 15

Wernicke's area is in the posterior aspect of the superior temporal gyrus

Think of temporal brain. Below the Sylvian fissure (Lateral Sulcus) ((this divides the frontal and parietal lobes from the temporal lobe)

This is supplied by the MCA

Front 16

A pt with hx of diabetes and hypertension has right sided weakness in upper and lower extremities. MRI shows damage to the basal nuclei. Where might vascular damage have occurred?

Back 16

Lentriculostriate arteries

These are branches of the initial segment of the MCA. Perfuse the basal nuclei and internal capsule

Front 17

What is Horner's Syndrome?

Back 17

- Ptosis (eyelid droop)
- Miosis (pupil constriction)
- Anhidrosis (lack of face sweating)
- can have reddness

This is seen in
- Lateral medullary syndrome (Wallenberg syndrome from PICA injury)
-compression of sympathetic nerves

Front 18

Lesion in the dorsolateral rostral pons. Result: loss pain and temperature sensation from contralateral side of body. Ipsilateral loss of mastictor reflex, diminution of hearing, Horners syndrome.

What artery supplies this region.

Back 18

Dorsolateral aspect of rostral pons contains fibers from anterolateral system, lateral lemniscus (auditory) and motor nucleus of CN-V (Trigeminal).

This is supplied by the Superior Cerebellar Artery. Basilar would be incorrect because it supplies the medulla.

Front 19

What is the mechanism of action of caffeine?

Back 19

Adenosine normally is an inhibitor of nervous activity in the CNS.

Caffeine is lipid soluble so crosses the BBB. There, it antagonizes adenosine receptors. This increases transmission of other NT (ACh, dopa, etc)

Caffeine has also been shown to inhibit acetylcholinesterase

Front 20

What tract of the trigeminal nerve carries pain and temperature information from the face?

Back 20

The primary or 1st order sensory cell bodies for discriminative touch, pain and thermal sense from the face and oral cavity have their cell bodies of origin in the trigeminal ganglion. Centrally these fibers terminate in the principal or chief sensory ganglion (discriminative touch) and the spinal trigeminal nucleus (pain and thermal sense).

Front 21

Which tract carries proprioception information from the face?

Back 21

Mesencephalic tract of the trigeminal nerve

Chief sensory nucleus becomes trigeminal meniscus for fine touch and vibration

Spinal trigeminal nucleus becomes trigeminalthalamic tract for pain and temperature

Front 22

How does the GABA neurotransmitter work?

Back 22

GABA binds to GABA-A receptors and opens chloride channels. They hyperpolarizes the neurons.

Thus, GABA is inhibitor. So is glycine.

Front 23

What drugs enhance GABA receptors?

Back 23

Benzodiazepines. They do not bind to GABA site, but rather a different part of the receptor.

Line Clonazepam

Front 24

What type of gait would you expect from L5 radiculopathy?

Back 24

think Trendelenburg gait

weakness of the abductor muscles of the lower limb, gluteus medius and gluteus minimus

Front 25

Myopathic gait

Back 25

Pelvic girdle shift

"the Fabrizio walk"

Front 26

Gait with circumduction of the foot when walking

Back 26

Trendelenburg gait

Front 27

Right superior quadrantanopia is causes by a lesion where?

Back 27

Right sided means that left retinal field is affected. So left side of brain.

Superior means that inferior retina is affected. Inferior optic tract projects from the LGN to the occipital lobe through the Meyer's loop.

Front 28

Nucleus ambiguus

Back 28

Nucleus that directs motor function for the larynx and pharynx

Front 29

Free nerve endings for pain and temperature

Back 29

A-delta = fast, myelinated for pain and temp

C = slow, unmyelinated. Think of the polymodal including chemical. this is dull, achy burn

Front 30

Meissner's Corpuscles

Back 30

-Glabrous (hairless) skin
- proprioception
- fine touch
- large myelinated

Front 31

Pacinian corpuscles

Back 31

- deep skin, ligaments and joints
- vibration and pressure
- Large myelinated

Front 32

Merkel's Discs

Back 32

- hair follicles
- prprioception, static touch
- large myelinated

Front 33

What are the 3 layers of a peripheral nerve?

Back 33

Endoneurium: invests single fiber layers
inflammation here leads to Guillain-Barre

Perineurium = Permeability barrier: surrounds fascicle of nerve fibers

Epineurium = dense connective tissue surrounding entire nerve

Front 34

Where is each synthesized?
NE
Dopamine
5-HT (serotonin)
ACh
GABA

Back 34

NE = locus ceruleus
Dopa = ventral tegmentum of Substantia nigra pars compacta
5HT = raphe nucleus
ACh = Basal forebrain (basal nucleus of Meynert) and Pedunculo-Pontine (BF / PPT)
GABA = nucleus accumbens