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79 Cards in this Set

  • Front
  • Back
hydrocephalus
-desc
-MCC
dilation of cerebral ventricles d/t blocked CSF pathways

MCC stenosis of cerebral aquaduct during development, d/t maternal infxn with Toxoplasmosis or CMV
noncommunicating hydrocephalus d/t
blockage within ventricles (e.g. congenital aquaductal stenosis)
communicating hydrocephalus
bocklage ithin subarachnoid space (e.g. adhesions after meningitis)
normal-pressue hydrocephalus
-occurs when CSF not absorbed by arachnoid villi

-"wacky wobbly wet" (triad of dementia, ataxia, & urinary incontinence)
hydrocephalus ex vacuo d/t
loss of cells in caudate nucleus,

e.g. Huntington's dz
transtentorial herniation
=uncal herniation
-incr supratentorial pressure (e.g.tumor) forces hippocampal uncus thru tentorial notch
==>compress CN3
==>dilated, fixed pupil ("blown pupil")
tonsillar herniation
-AKA
AKA transforaminal herniation

-brainstem and cerebellar tonsils herniates thru foramen magnum
subfalcine herniation
herniate below falx cerebri
internal capsule
-section
-contains what
-perfused by what
white matter (myelinated axons) that separate the caudate nucleus and thalamus medially from lentiform nucleus laterally

A. ant limb:
-separates caudate from lentiform nucleus
-perfused by ACA & lateral striate (lenticulostriate) branches of MCA

B. genu:
-contains corticobulbar fibers
-perfused by int carotid A

C. post limb:
-b/w thalamus & lentiform nucleus
-contains corticospinal fibers (pyramid)
-contains sensory fibers:
*spinothalamic (pain & temp)
*touch (dorsal column)

-perfused by lateral striate (lenticulostriate) branches of MCA
medial striate arteries
br's of ACA
-supply:
*putamen (ant portion)
*caudate (ant portion)
*IC (anteroinferior part)
what A supplies visual cortex
PCA
lateral striate arteries
AKA lenticulostriate arteries

-br's of MCA

"arteries of stroke"
-supply:
IC
globus pallidum
caudate
putamen
"arteries of stroke"
-AKA
-supplies what
lateral striate A
AKA lenticulostriate arteries

-br's of MCA

"arteries of stroke"
-supply:
IC
globus pallidum
caudate
putamen
which hemorrhage causes brain damage
subdural hematomas ALWAYS cause brain damage
high alpha-FP suggests
NT defects (spina bifida, anencephaly)
low alpha-FP suggests
Down's syndrome
from what embryologic structure do cerebral hemispheres derive?
telencephalon<==prosencephalon (forebrain)
from what embryologic structure does thalamus derive
diencephalon<==prosencephalon (forebrain)
from what embryologic structure does midbrain derive
mesencephalon
from what embryologic structure does pons derive
metencephalon<==rhombencephalon (hindbrain)
from what embryologic structure does cerebellum derive
metencephalon<==rhombencephalon (hindbrain)
from what embryologic structure does medulla derive
myelencphalon<==rhombencephalon
from what embryologic structure do lateral ventricles derive
telencephalon<==prosencephalon (forebrain)
from what embryologic structure does 3rd ventricle dervice
diencephalon<==prosencephalon (forebrain)
from what embryologic structure does cerebral aquaduct derive
mesencephalon
from what embryologic structure does upper 4th ventricle derive
metencephalon<==rhombencephalon (hindbrain)
from what embryologic structure does lower 4th ventricle derive
myelencphalon<==rhombencephalon (hindbrain)
anecephaly d/t
failure of ant neuropore to close
spina bifida d/t
failure of post neuropore to close
optic nerve and chiasm derived from what
diencephalon
coloboma iridis
failure of choroid fissure (contains optic N fibers) to close

-this is what Dr Johnson's niece has
embryologic origin of pituitary gland
note: "hypophysis"=pituitary

A. Adenohypophysis (ant pit) derived from Rathke's pouch (ectodermal diverticulum of primitive mouth cavity)

remnants of Rathke's pouch==>craniopharyngioma (congenital cystic tumor)

B. Neurohypophysis (post pit):
derives from ventral outpouching of hypothalamus (neuroectodern of neural tube)
craniopharyngioma
remnant of Rathke's pouch (ectodermal diverticulum of primitive mouth cavity)

craniopharyngioma (remnants of Rathke's pouch, the ectoderm of primitive mouth cavity)

Craniopharyngioma lies just above sella (where pituitary sits)==>can destroy pituitary==>hypopit

It also lies near optic chiasm==>bitemporal hemianopsia
cranium bifidum
defect in occipital bone thru which meninges, cerebellum, and 4th ventricle can herniate

cranium bifidum (head) ~ spina bidifa (s.c.)
Fetal Alcohol syndrome
-Sx
MCC of MR

-microcephaly
-congenital heart dz
-holoprosencephaly (most severe, =cyclops): failure of midline cleaveage of embryonic forebrain==>no corpus callosum, single ventricle
holoprosencephaly
=cyclops:

failure of midline cleaveage of embryonic forebrain==>no corpus callosum, single ventricle
MC supratentorial tumor in kids
craniopharyngioma (remnants of Rathke's pouch, the ectoderm of primitive mouth cavity)
MCC hypopituitarism
craniopharyngioma (remnants of Rathke's pouch, the ectoderm of primitive mouth cavity)

Craniopharyngioma lies just above sella (where pituitary sits)==>can destroy pituitary==>hypopit

It also lies near optic chiasm==>bitemporal hemianopsia
Arnold Chiari malformation
Post fossa is small, thus not enough room for brain structures
→Cerebellar vermis squishes down thru foramen magnum (makes sense that the cerebellar vermis is what herniates b/c the cerebellum is located in the post fossa, which is too small)
==>when cerebellar vermis goes thru foramen magnum, it then covers dorsal portion of cervical sc
→kink in dorsal, upper portion of cervical cord

-Fusion of colliculi→”beaking of tectum”

*Aquaductal stenosis
*Myelomeningocele (100% Chiari Type II malformations are assoc w/myelomeningoceles; 50% of myelomeningoceles are assoc w/Chiari Type II)
Dandy Walker syndrom
-post fossa too large (d/t cysts covering exit from 4th ventricle==>huge 4th ventricle & hydrocephalus

-agenesis of cerebellar vermis
lipofuscin granules
-pigmented granules in cytoplasm
-lysosome remnants
-accumulate w/aging
Hirano bodies
(intraneuronal inclusions)

-Alz dz
cowdry Type A inclusion bodies
(intranuclear incluusions

herpes simplex encephalitis
cauda equina
motor and sensory roots (from L2 to coccyx) that extend past the conus medullaris (which ends at L1 in adults, L3 in newborn)
conus medullaris
the terminal end of the spinal cord

-ends at L1 in adults, L3 in newborns
brown-sequard syndrome
=hemisection of s.c.

-ipsilateral dorsal column
-ipsilateral corticospinal (spastic paralysis (UMN) + pyramidal signs)
-contralateral spinothalamic
Vit B12 deficiency==>what neurologic sx
infarcts ant 2/3 of spinal cord, but spares dorsal columns (pic HY p. 70)

-lateral corticospinal
==>bilateral spastic paresis (UMN) + pyramidal signs below the lesion

-spinothalamic-bilateral loss
guillan barre syndrome
-PNS lesion==>LMN Sx
-post-infectious
-demyelination

often:
-upper cervical root involvement
-caudal CN involvementw/facial diplegia
what does the cavernous sinus contain
ICA
CN 3,4,V1,V2,6
post-ganglionic sympathetics en route to visual orbit
what do these results indicate:

Weber Test: lateralizes to left ear

Rinne Test:
BC>AC on left
AC>BC on right

(BC=bone conduction,
AC=air conduction)
conduction deafness in left ear

(note: nl response is for AC>BC; remember when do Rinne test (put tuning fork on mastoid process behind ear and then move in front of ear, you should hear vibration in air (AC) after bone conduction is gone (BC))

-conduction deafness=middle ear deafness (e.g. otosclerosis, otitis media)

-nerve deafness=sensorineural deafness (e.g. presbycusis)
what do these results indicate:

Weber Test: lateralizes to right ear

Rinne Test:
BC>AC on right
AC>BC on left

(BC=bone conduction,
AC=air conduction)
conduction deafness in right ear

(note: nl response is for AC>BC; remember when do Rinne test (put tuning fork on mastoid process behind ear and then move in front of ear, you should hear vibration in air (AC) after bone conduction is gone (BC))

-conduction deafness=middle ear deafness (e.g. otosclerosis, otitis media)

-nerve deafness=sensorineural deafness (e.g. presbycusis)
what do these results indicate:

Weber Test: lateralizes to right ear

Rinne Test:
AC>BC on both ears

(BC=bone conduction,
AC=air conduction)
nerve deafness in left ear

(note: nl response for Rinne Test is for AC>BC; remember when do Rinne test (put tuning fork on mastoid process behind ear and then move in front of ear, you should hear vibration in air (AC) after bone conduction is gone (BC))

-conduction deafness=middle ear deafness (e.g. otosclerosis, otitis media)

-nerve deafness=sensorineural deafness (e.g. presbycusis)
what do these results indicate:

Weber Test: lateralizes to left ear

Rinne Test:
AC>BC on both ears

(BC=bone conduction,
AC=air conduction)
nerve deafness in right ear

(note: nl response for Rinne Test is for AC>BC; remember when do Rinne test (put tuning fork on mastoid process behind ear and then move in front of ear, you should hear vibration in air (AC) after bone conduction is gone (BC))

-conduction deafness=middle ear deafness (e.g. otosclerosis, otitis media)

-nerve deafness=sensorineural deafness (e.g. presbycusis)
what is nl Weber Test and nl Rinne result
Weber: no lateralization
Rinne: AC>BC for both ears

(note: nl response for Rinne Test is for AC>BC; remember when do Rinne test (put tuning fork on mastoid process behind ear and then move in front of ear, you should hear vibration in air (AC) after bone conduction is gone (BC))

-conduction deafness=middle ear deafness (e.g. otosclerosis, otitis media)

-nerve deafness=sensorineural deafness (e.g. presbycusis)
conduction deafness
middle ear deafness (e.g. otosclerosis, otitis media)

vs. -nerve deafness=sensorineural deafness (e.g. presbycusis)
what is nerve deafness
-nerve deafness=sensorineural deafness (e.g. presbycusis)

vs. conduction deafness: middle ear deafness (e.g. otosclerosis, otitis media)
results of calorics in unconscious subjects
-no nystagmus
-when brainstem intact==>deviation of eyes to the side of cold irrigation
-when bilateral MLF lesion==>deviation of the abducting eye to the side of cold irrigation
-when lower brainstem lesion==>no deviation of eyes
what causes vertical diploplia that worsens when looking down (i.e. walking down the stairs, reading)

& improvees w/head tilting?
CN 4 palsy
what causes horizontal diploplia
CN 6 palsy
pupillary dilation pathway
-mediated by SNS
-interruption of any point in pathway==>ipsilateral Horner's syndrome

A. Hypothalamus: Hypothalamic neurons of paraventricular nucleus project directly to ciliospinal center (T1-T2) of IMLCC

B. Ciliospinal Center of Bulge (T1-T2): projects preganglionic symp fibers to sup cerv gang

C. Superior Cervical ganglion: projects postganglionic sympathetic fibers thru tympanic cavity & cavernous sinus
==>superior orbital fissure
==>enter orbit
==>dilator muscle of iris
Horner's syndrome
d/t transection of oculosympathetic pathway at any level (thus, less SNS stuff)

-miosis
-ptosis
-apparent enopthalmos
-hemianhidrosis (no sweating)
communicating rami
White communicating rami:
-myelinated
-found b/w T1-L3

Gray communicating rami
-unmyelinated
-found at all spinal levels (T1-coccyx)
what innervates lacrimal and nasal glands
2-neuron path from CN 7:

lacrimal nucleus sends out CN 7
==>pterygopalatine ganglion
==>lacrimal and nasal glands
what innervates submandibular and sublingual glands
2 neuron path of CN 7:

superior salivatory nucleus sends out CN 7
==>submandibular ganglion
==>submandibular and sublingual glands
what innervates parotid gland
2 neuron path of CN 9:

inferior salivatory nucleus sends out CN 9
==>otic ganglion
==>parotid gland
what innervates bladder
pelvic splanchnic nerves (S2, S3, S4)
what innervates genital erectile tissue
pelvic splanchnic nerves (S2, S3, S4)
pelvic splanchnic nerves
-what levels
-what do they innervate
-S2,S3,S4
-innervate bladder & genital erectile tissue
which area in hypothalamus regulates release of gonadotropic hormones?
preoptic area of hypothalamus
destruction of what in hypothalamus can cause diabetes insipidus
paraventricular and supraoptic nuclei (these produce ADH and oxytocin)
which area in hypothalamus produces hypothalamic releasing factors
arcute nucleus
which area in hypothalamus contains DOPA-ergic neurons that inhibit PRL release
arcute nucleus
Kluver Bucy syndrome
d/t bilateral destruction of anterior temporal lobes, including amydala

*hypersexuality
*hyperphagia
*docility (placidity) [amygdala~emotion/rate)
*psychic blindness (visual agnosia)
memory loss d/t
hippocampal pathology
what causes anterograde amnesia (inability to learn and retain new info)
=amnestic (confabulatory syndrome)

d/t bilateral infarction of hippocampus
what nucleus degenerates in Alz Dz
basal nucleus of Meynert
pathway for synthesizing catecholamines
Phenylalanine
==>L-DOPA
==>dopamine
==>NE
==>Epi
Substance P
-pain transmission

-decreased levels in Huntington's
decreased Substance P levels
Huntington's