Neuro Ii: Neuroscience Randoms (Brainstem, Cortex)

Front 1

Occlusion of the left PCA will result in infarction of what two important structures?
What will be the symptoms?

Back 1

infarct left primary visual cortex & splenium (of corpus callosum)
visual: Right hemianopia
SPLENIUM: alexia w/o agraphia (pt. can write but can't read his own writing)

Front 2

What interconnects the olfactory cortex and adjacent anterior temporal neocortex?

Back 2

anterior commissure

Front 3

What is the important interconnecting link of the consensual light reflex?

Back 3

posterior commisure

Front 4

Lesion of the genu of the internal capsule results in what deficit?

Back 4

corticobulbar fibers deficit --> supranuclear facial palsy

Front 5

Lesion of the posterior limb of the internal capsule results in what 2 important deficits (what fibers are involved)?

Back 5

corticospinal fibers: contralateral spastic hemiplegia
somesthetic fibers (thalamocortical): contralateral hemianesthesia

Front 6

Lesion of the retrolenticular region of the internal capsule results in what deficit?

Back 6

optic radiations --> contralateral homonymous hemianopia

Front 7

Pt presents with bilateral anesthesia & spastic paralysis of the legs and feet. What cortical lesion is most likely present?

Back 7

enlarged superior sagittal venous sinus
OR
tumor of falx cerebri

Front 8

What gyri make up the primary auditory cortex?

Back 8

transverse and superior temporal gyri

Front 9

Where is the primary gustatory cortex?

Back 9

opercular area of postcentral gyrus and adjacent insular cortex

Front 10

Where is the primary vestibular cortex?

Back 10

posterior part of superior temporal cortex or half-way down the postcentral gyrus

Front 11

Lesion of the dominant parietal lobe would result in what syndrome (signs and symptoms)?

Back 11

Gerstmann syndrome:
finger agnosia,
R-L disorientation
dysgraphia
dyscalculia

Front 12

Pt has been running into "seen" objects. Where is the lesion?

Back 12

bilateral angular gyri

Front 13

Lesion of the angular gyrus in the dominant hemisphere results in what deficits?

Back 13

receptive aphasia (alexia, visual agnosia - can't read, agraphia - can't gopy)

Front 14

Lesion in the superior parietal lobe of the dominant hemisphere results in what general deficit?

Back 14

apraxia

Front 15

Ideomotor apraxia: definition & what is affected?

Back 15

Def: inability to perform a given act correctly although old, habitual motor acts can be performed spontaneously or repititiously
Lesion: supramarginal gyrus of dominant hemisphere

Front 16

This is the loss of ability to formulate the concepts necessary to perform a complex motor activity.

Back 16

Ideational apraxia

Front 17

A lesion in this area may result in visual and auditory hallucinations and very clear recollections of past experiences (and deja vu).

Back 17

anterior temporal cortex

Front 18

Pt. is brought in to your office by family saying "He doesn't seem to care about the things he usually does. He has been saying some inappropriate things at dinner that is unlike him, and starts yelling at us out of nowhere." Diagnosis?

Back 18

Frontal Lobe syndrome

Front 19

Nausea, vomiting, postural impairment, and nystagmus indicate involvement of what special system:
vestibular
cerebellar
pyramidal
extrapyramidal
cortical

Back 19

vestibular

Front 20

Dysmetria, ataxia, dysdiadochokinesia, and intention tremor indicate involvement of what special system:
vestibular
cerebellar
pyramidal
extrapyramidal
cortical

Back 20

cerebellar

Front 21

Babinski sign, spastic paralysis, &decorticate rigidity indicate involvement of what special system:
vestibular
cerebellar
pyramidal
extrapyramidal
cortical

Back 21

pyramidal

Front 22

Dyskinesia, chorea, dystonia, ridigidity, & resting tremor indicate involvement of what special system:
vestibular
cerebellar
pyramidal
extrapyramidal
cortical

Back 22

extrapyramidal

Front 23

Aphasia, Agnosia, Apraxia, & memory impairment indicate involvement of what special system:
vestibular
cerebellar
pyramidal
extrapyramidal
cortical

Back 23

cortical

Front 24

Language, speech, writing, analytic functions, and learning skilled movements are characteristic of the dominant or non-dominant hemisphere?

Back 24

dominant

Front 25

Non-verbal expression, creativity, abstraction, and spatial discrimination are associated with the dominant or non-dominant hemisphere?

Back 25

non-dominant

Front 26

Pt. has left spastic hemiplegia, internal strabismus of right eye, drooping of right face.
Dx?

Back 26

Millard-Gubler's Syndrome

A6H + 7

Front 27

Pt. has signs of right A6H along w/ left side loss of proprioception, internuclear ophthalmoplegia, right facial nerve palsy, uvula deviates to the left, protruded tongue deviates to the right. What is the Dx?

Back 27

Syndrome of Fovile

A6H + dorsal extension

ML
MLF
Maybe CN VII
Crossed corticobulbar fibers-- ipsilateral nucleus ambiguus & hypoglossal nucleus

Front 28

Destruction of UNcrossed bulbar fibers (as occus w/ A5H w/ dorsal expansion) results in denervation of what nuclei?

Back 28

Note: fibers cross b/w 5 & 6 in pons
contralateral nerve nuclei:
Abducens nucleus
supranuclear facial palsy
hypoglossal nucleus
nucleus ambiguus

Front 29

Pt. has right eye ext. strabismus & complete ptosis, left spastic hemiplegia, left resting tremor, & many other deficits suggesting destruction of UNcrossed corticobulbar tract. Diagnosis?

Back 29

Weber's syndrome (A3H)

CN III
CST
substantia nigra
uncrossed corticobulbar tracts

Front 30

Pt. has left side hemianalgesia, right side loss of p/t on face, loss of gag reflex, uvula deviates left, Diagnosis?

Back 30

Lateral medullary syndrome (wallenberg's, PICA)

long list of possible symptoms that vary depending on source, just know the basics

Front 31

Pt. has deafness in right ear, vertigo, right side facial paralysis & loss of p/t, left side hemianalgesia of body, right side intention tremor and dysdiadochokinesia. Symptoms came on gradually. Diagnosis?

Back 31

Cerebellopontine angle (CPA) syndrome

usually a tumor (acoustic neurinoma)

CN VII & VIII
Desc. tract of V
SL
Cerebellar peduncles

Front 32

Superior cerebellar lesion. What type of tremor?

Back 32

intention tremor

Front 33

Red nucleus lesion. Main sx?

Back 33

tremor (at least... that's what my notes say)

Front 34

Pt. has right eye ext. strabismus & complete ptosis, loss of proprioception on left side of body, and left side intention tremor & chorieform movements. Diagnosis?

Back 34

Benedikt's syndrome (lesion of midbrian tegmentum)

Front 35

Pt. says he can't look straight up.
Diagnosis and likely etiology?

Back 35

Parinaud's syndrome (lesion of superior colliculus)

pineal tumor or varix of great vein of Galen

Front 36

Pt. has complete hemianesthesia, loss of proprioception/tactile from the left side of body/face. Where is the lesion?

Back 36

Thalamus

Right VPM/VPL

Front 37

Pt. keeps experiencing spontaneous, diffuse pain w/out external stimulus. He starts laughing about it and then begins to sob. Next he says that he feels like ants are crawling underneath his skin. Before you do a psych consult, what should you consider? What etiology?

Back 37

Thalamic syndrome (Dejerine-Roussy)
Thrombosis of posterior choridal or thalamogeniculate branches of PCA