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77 Cards in this Set

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neural tube defects
assoc with low folic acid intake
elevated APF
spina bifida occulta
failure of bony spinal canal to close, but no structural herniation
meningocele
meninges herniate through spinal canal defect
meningomyelocele
meninges and spinal cord herniate through spinal canal defect
broca's
motor (nonfluent/expressive) aphasia with good comprehension
broken speech
wernicke's
sensory (fluent/receptive) aphasia with poor comprehension
wordy, makes no sense
arcuate fasiculus
conduction aphasia; poor repetition with good comprehension, fluent speech
amygdala (bilateral)
Kluver-Bucy (hyperorality, hypersexuality, disinhibited behavior)
frontal lobe
personality changes and deficits in concentration, orientation and judgement; may have reemergence of primative reflexes
reticular activating system
coma
mamillary bodies (bilateral)
Wernicke-Korsakoff syndrome
basal ganglia
may result in tremor at rest, chorea or athetosis (hypo/hyperkinesia)
cerebellar hemisphere
intention tremor, limb ataxia
cerebellar vermis
truncal ataxia, dysarthria
subthalamic nucleus
contralateral hemiballismus
chorea
sudden, jerky purposeless movements
characteristic of basal ganglia lesion (Huntingtons)
sydenhams
athetosis
slow writhing movements esp of fingers
characteristic of basal ganglia lesion
hemiballismus
sudden wild flailing of 1 arm
characteristic of contralateral subthalamic nucleus lesion
loss of inhibition of thalamus through globus pallidus
brocas aphasia
nonfluent aphasia with intact comprehension
inferior frontal gyrus
wernicke's aphasia
fluent aphasia with impaired comprehension
superior temporal gyrus
Alzheimers
most common cause of dementia in eldery
assoc with senile plaques (extracellular, b-amyloid core) and NF tangles (IC, phosphorylated tau protein
tx of alzheimers
AChE inhibitors, vit E, NSAIDS, mimantidine
APOE4
chaperone- beta sheet formation
APP
amyloid precursor protein, Down's pts
Pick's disease
dementia, aphasia, parkinsoniam aspects- assoc with pick bodies (intraceullar aggregated tau protein)
specific for frontal and temporal lobes
early personality change
Huntingtons
AD inheritance, chorea, dementia
atrophy of caudate (loss of GABA neurons)
CAG repeat
Parkinsons
assoc with Lewy bodies and depigmentation of substantia nigrans PC (loss of DA neurons)
tremor, rigidity, akinesia, postural instab
Lewy bodies seen in...
PD, diffuse Lewy body dz (dementia, Parkinsons, hallucinations, repeated unexpected falls), Lewy body type Alz
Fredrich's ataxia
B12 def
ALS
assoc with both UMN and LMN signs; no sensory defects
Werdig Hoffman
AR; presents at birth as floppy baby, tongue fasciculations
median age of death- 7 months
degen of anterior horns
Polio
LMN
degen of anterior horns
fecal-oral transmission
sxs: malaise, HA, fever, nausea, ab pain, sore throat
flaccid paralysis
Polio findings
CSF with lymphocytic pleocytosis with slight elevation of protein
virus recovered from stool or throat
MS
incr prevalence with incr distance from eq; periventricular plaques (oligo loss, reactive gliosis) with preservation of axons
incr IgG in CSF
tx: b-ifn, high dose steroids
MS sxs
optic neuritis (sudden loss of vision), MLF syndrome (INO), hemiparesis, hemisensory sxs, bladder/bowel incontinence
PML
assoc with JC virus
seen in AIDS
acute disseminated (postinfectious) encephalomyelitis
VZV, MMR
metachromatic leukodystrophy
AR
def in aryl sulfatase A; cerebroside sulfate accumulates in brain, liver, kidney and peripheral N
demylination, ataxia, dementia
Guillan-Barre
inflammation and demylination of peripheral nerves and motor fibers of ventral roots (sensory effect less severe than motor) causing symmetric asc muscle weakness beginning in distal lower extremities
autonomic function may be affected
most completely recover
GB findings
elevated CSF protein with nl cell ct
may be assoc with PAST infection (within 30d)
Simple partial sz
consciousness intact, motor, sensory, autonomic, psychic
complex partial sz
impaired consciousness
absence sz
blank stare (DOC: ethosuxamide)
myoclonic sz
quick repetitive jerks
tonic-clonic sz
alternating stiffning and movement
tonic sz
stiffening
atonic sz
drop sz
causes of sz in children
genetic, infection, trauma, congenital, metabolic
causes of sz in adults
tumors, trauma, stroke, infection
causes of sz in elderly
stroke, tumor, trauma, metabolic, infection
epidural hematoma
rupture of MMA; secondary to fx of temporal bone
lucid interval
lens shaped- does not cross suture lines
hypertensive hemorrhage
multiple tiny infarcts of putamen
subdural hematoma
rupture of bridging veins; venous bleeding with delayed onset of sxs
seen in elderly individuals, alcoholics, blunt trauma, shaken baby
crescent shaped, can cross suture lines
subarach hemorrhage
rupture of aneurysm (usually berry) or an AVM; pts complain of worst headache of life
blood or xanthrochromic spinal tap
parenchymal hematoma
caused by HTN, amyloid angiopathy, DM, tumor, cocaine
usually at lenticulostriate arteries- supply BG and internal capsule
berry aneurysms
occur at bifurcations in circle of willis; most common is ant comm
rupture leads to hemorrhagic stroke/subarach hemorrhage
berry aneurysm assoc
APKD, EDS, Marfans
other r/f: advanced age, HTN, smoking, race (higher in blacks)
herpes infection
temporal lobe
brain abscess
staph infection, immunocompromised, IVDA, embolus
tb meningitis
affects the base of the brain
Horner's syndrome
ptosis (slight dropping of eyelid), anhidrosis (absence of sweating) and flushing (rubor) of affected side
miosis (pupil constriction)
assoc with lesion of SC above T1- pancoasts, hemisection, late stage syringomyelia
CN XII lesion (LMN)
tongue deviates toward side of lesion
CN V motor lesion
jaw deviates toward side of lesion
unilateral lesion of CBL
pt falls toward side of lesion
CN X lesion
uvula deviates away from side of lesion
CN XI
weakness turning head to contralateral side of lesion
shoulder droop on side of lesion
facial UMN
lesion of motor cortex or connection between cortex and facial nucleus
contralat paralysis of lower face only
facial LMN
ipsilateral paralysis of upper and lower face
Bell's palsy
complex destruction of facial nucleus itself or efferent fibers
ipsilateral facial paralysis with inability to close eye on involved side; can occur idiopathically; gradual recovery
Bell's palsy causes
AIDS, Lyme disease, sarcoid, tumors, diabetes
LMN lesion
weakness, atrophy, fasciculation
decr reflexes and tone
UMN lesion
weakness, babinski
incr reflexes and tone
cingulate herniation under falx cerebri
can compress ACA (not leg, foot stuff)
downward transtentorial herniation
coma and death (compress reticular activating system)
uncal herniation
medial lobe goes through tentorium
cerebellar tonsillar herination into foramen magnum
Arnold Chiari
Uncal signs
ipsilateral dilated pupil/ptosis (stretching of CN III), contralat homonymous hemianopia (compression of ipsilat PCA - occipital lobe)
ipsilat paresis- compression of contralat crus cerebri; duret hemorrhages- paramedian artery rupture (caudal displacement of brainstem)