Neuro Exam 1

Front 1

Lateral Vestibular Nucleus

Back 1

Tract: Later vestibulospinal Tract
Function: ipsilater extensor for AXIAL MUSCLES part of Antigravity Reflex
Also: the only UMN with direct input to LMN

Front 2

Reticularis Pontis Oralis
Reticularis Pontis Caudalis

Back 2

Tract: Pontine Reticulospinal Tract
Function: Ipsilateral Extensor part of antigravity reflex

Front 3

Reticullogigantocellularis

Back 3

Tract: Medullary Reticulospinal Tract
Function: bilateral flexor

Front 4

Red Nucleus

Back 4

Part of mesencephalon
Tract: Rubrospinal Tract
crosses over at Ventral Tegmental Decussation
Function is Contralateral Proximal Limb Flexion

Front 5

Corticospinal Tract

Back 5

UMN is cerebral cortex
from Brodman areas to LMN
Arises from area 4, 6, (3,1,2)
Efferents leave from Lamina 5 Area 4, arise from Betz Cells

Front 6

Internal Capsule

Back 6

fibers from Corona Radiata come together here and join at the POSTERIOR LIMB.
V-Shaped, ant limb divides Caudate N. and Lentiform N
Post limb divids Thalamus and Lentiform N.

Front 7

Lateral Corticospinal Tract

Back 7

crosses at lower Medulla at Pyramidal Decussation
Function: Distal Limb flexion esp Upper limb, curls fingers toes ie. piano

Front 8

Anterior Corticospinal tract

Back 8

15% that stays ipsilateral at Pyramidal Decussation, but crosses over at Anterior White Commissure at level of LMN
Function: Head and Neck movements

Front 9

Superior And Inferior Colliculi

Back 9

Superior for Visual
Inferior for auditory
This is done via Tectospinal tract and Medial Longitudinal fasciculus

Front 10

Tectospinal Tract
Medial Longitudinal Fasciculus

Back 10

TST crossed descending pathway, coordinates head and neck movements
MLF is bidirectional, bilateral, coordinates eye movement

Front 11

Area 4

Back 11

found in telencephalon
final output for voluntary motor movement

Front 12

Area 6

Back 12

area where voluntary motor behavior is initiated
Divided into: Supplemental motor cortex (Superior)
and Premotor Cortex (lateral)

Front 13

Supplemental Motor Cortex

Back 13

Superior part of Area 6, controls motor movement of volunatary motor action

Front 14

Premotor Cortex

Back 14

Lateral part of Area 6
Orients body in position for action to occur

Front 15

Decebrate Rigidity

Back 15

midcollicular lesion
All 4 limbs Extended

Front 16

Decorticate Rigidity

Back 16

lesion superior to both colliculi
Upper proximal flexion (Red Nucleus)
Lower limb extension (LVN)

Front 17

LMN lesion

Back 17

signs include fasciculations, flaccid paralysis, hyporeflexia.
Above lesion, LMN signs, below lesion, UMN signs

Front 18

UMN lesion

Back 18

signs include spastic paresis, hyperreflexia, clonus, spasticity, Positive Babinski

Front 19

Amyotropic Lateral Scleroris

Back 19

UMN and LMN symptoms

Front 20

alternating hemiplegia

Back 20

ipsilateral losses in face
contralateral losses in body

Front 21

alternating hemiplegia of cn3(oculomotor)

Back 21

mesencephalic lesion
laterally deviated eye(abducted) ipsilateral to lesion

Front 22

Alternating Hemiplegia of cn6
Abducens

Back 22

pontine lesion
medially deviated eye (adducted)
left eye adducted, right body messed up, lesion in left area of pons

Front 23

Alternating hemiplegia of CN12

Back 23

medullary lesion,
tongue deviation towards lesion

Front 24

CVA Stroke in Middle Cerebral Artery

Back 24

contralateral UMN signs in Arm>leg

Front 25

CVA stroke in Anterior Cerebral Artery

Back 25

contralateral UMN signs in Leg>arm
In posterior capsule, supplied by middle cerebral artery, stroke here leads to complete hemiplegia

Front 26

Corticobulbar Tract

Back 26

run through genu of internal capsule
UMN tracts sent to LMN's located in Brain Stem, all proejctions are BILATERAL, except cn 7.
ie. No smile on right, Genu lesion on left

Front 27

Bell's Palsy CN 7

Back 27

mydriasis, ptosis, lacrimal and salivary gland loss, hyperacousia.
Ipsilateral LMN signs

Front 28

Striatum

Back 28

Caudate Nucleus
Putamen, telencephalic

Front 29

Athetosis

Back 29

Constant involuntary worm-like movements
Due to lesion in Basal Ganglia
Unilateral

Front 30

Striatal lesion (esp. Putamen)

Back 30

Trouette's Syndrome, not supressing unwanted motor behavior

Front 31

Striatal Lesion ( esp. caudate N)

Back 31

leads to Chorea (constant, involuntary slow movements)
Sydenham's Chorea
Chorea in right limb means lesion in left striatum

Front 32

Wilson's disease

Back 32

copper in striatum, leads to chorea, Keiser fleishcher Rings

Front 33

Hemiballismus

Back 33

Sudden flailing of one arm,
lesion is in contralateral subthalamic Nucleus

Front 34

Parkinsons Disease

Back 34

symptoms: Akinesia (movement loss) , Bradykinesia (slow movements) , festinating Gait
(shuffling steps)
Lesion in Substantia Nigra
deficiency of D2 Receptors

Front 35

Rigidity Vs Spasticity

Back 35

Rigidity is Biidirectional, Basal Ganglia
Spasticity unidirectional, UMN

Front 36

Basal Ganglia

Back 36

Suppress unwanted behavior, If lesion, leads to hyperkinetic syndrome

Front 37

Basal Ganglia Function

Back 37

cortex -->+striatum-->-GPi--> disinhibits Thalamus-->+cortex

so thalamus wants to inhibit cortex, but GPi wont let it

Front 38

Three areas of Brainstem w/ NT's

Back 38

Raphe- Serotonin
Locus Ceruleus- norepi
midbrain tegmentum- Dopamine
all three are reqd cognitive and emotional behavior

Front 39

block d2 receptors

Back 39

Striatal nigro is favored, leads to acute parkinsons

Front 40

Antipsychotic Drugs

Back 40

Target D4 receptors, cuz there are no d4 receptors in the striatum, no extrapyramidal side effects

Front 41

SSRI

Back 41

Selective Serotonin Reuptake inhibitors, used for treatment for depression, increase serotonin. ie. Prozac

Front 42

Tracts that run from GPi to Thalamus

Back 42

There are 2 of them.
Lenticular fasciculus- runs through internal capsule
Ansa lenticularis- hooks around internal capsule
they both go to all 4 nuclei of thalamus

Front 43

Nuclei in Thalamus

Back 43

Recieving input from GPi,
VL- ventralis lateralis (go to 4) purely motor. Putamen
VA- cognitive motor, go to 6, Caudate
CM-central medialis to striatum
MD- medial dorsalis. From n. accumbens to Dorsal medial nucleus of thalamus to prefrontal lobe (limbic)

Front 44

Symptoms of Cerebellar Dysfunction

Back 44

Dysmetria
Rebound Phenomenon
Dysdiadokinesis
Intention Tremor
Gait Disturbance
Nystagmus
Ataxia of speech

Front 45

Vermis

Back 45

part of cerebellum, coordination of axial muscles, nucleus associated w/ this is the Fastigial Nucleus. UMN's involved are RGC, RPO, RPC, LVN

Front 46

Paravermis

Back 46

part of cerebellum, coordination of limb muscles, contains the INTERPOSED nucleus--> which is hte emboliform and the globose combined. UMN's involved here are the Red N and Area 4

Front 47

Cerebellum

Back 47

contains the vermis, paravermis, lateral, and floccular lobe.
lateral lobe is import for programming of voluntary muscle
Flocculus imp for muscle tone, equilib. and balance. Associated w/ LVN, not w/ any Deep Nuclei!

Front 48

Lesion of the Vermis

Back 48

difficulty maintaining posture and have a motor ataxic gait

Front 49

ataxic gait

Back 49

usually a result of anterior lobe of cerebellum. patients will sway and lose theirbalance w/ their eyes open or closed-->motor ataxia

Front 50

lesion of floculonodular lobe

Back 50

patients have scanning dysarthria--> dividing words

Front 51

lesion of basal ganglia

Back 51

tremor at rest, dyskinesia

Front 52

obsessive compulsie disorder

Back 52

results from overactivity in the striatal part

Front 53

holonprosencephaly

Back 53

failure of prosencephalon to seperate into diencephalon, 4th week of development