Neurology

Front 1

Which part of the vertebral column does the notochord become?

Back 1

nucleus pulposus

Front 2

What is gastrulation?

Back 2

Ectodermal cells detach from the epiblast, the surface layer of the embryo, invaginate inward into a groove known as teh primitive streak

Front 3

What is Rachischisis?

Back 3

Failure of the neural folds to form the neural tube.

Front 4

What does the alar plate give rise to?

Back 4

sensory neurons

Front 5

Basal Plate gives rise to?

Back 5

Motor neurons

Front 6

What does the sulcus limitans do?

Back 6

separates the basal and alar plates

Front 7

The great vessel deformity is due to what NC cells?

Back 7

Aortic arch, aorticopulmonary septum.

Front 8

DiGeorge's syndrome is in part due to failure of what NC cells?

Back 8

pharyngeal arch 3

Front 9

Hirschsprungs disease, achalasia is due to what NC cell derivative?

Back 9

enterochromaffin cells

Front 10

albinism is due to what NC cell derivative to form?

Back 10

Melanocytes

Front 11

Forebrain (prosencephalon) becomes ____1_____ and _____2_____ which become___1a, 1b, ___ and _____2a____ and ____2b______

Back 11

1. Telencephalon
1a. cerebral hemispheres (walls)
1b.Lateral ventricles (cavity)
2. Diencephalon
2a. Thalamus (wall)
2b. third ventricle (cavity)

Front 12

Midbrain (mesencephalon) becomes ____1____ which becomes (1a, 1b)

Back 12

1. midbrain (mesencephalon)
1a. Midbrain
1b. aqueduct

Front 13

Hindbrain (rhombencephalon) becomes ____1____ and ____2____ which become (1a, 1b, 1c) and (2a, 2b.)

Back 13

1. metencephalon,
1a. cerebellum,
1b. upper part of 4th ventricle
1c pons
2. Myelencephalon
2a. medulla
2b lower part of 4th ventricle

Front 14

Syringomyelia ?

Back 14

fluid filled cavity (cyst) within the spinal cord.

Front 15

platybasia, noncommunicating hydrocephalus, Caudal extention of medulla and cerebellar vermis through the foramen magnum? what is tx?

Back 15

Arnold Chiari malformation,

Front 16

arnold chiari malformation type 1 clinical presentation?

Back 16

asymptomatic

Front 17

difficulty swallowing, loss of pain and temp along back of neck and shoulders secondary to syringomyelia. Mental retardation, with visible cyst protruding from dorsum of spine.

Back 17

arnold chiari malformation 2, difficulty swallowing due to loss of nucleus ambiguus compression. the cerebellar tonsillar herniation presses on the rostral medulla causing this.

Front 18

failure of foramen lushka and magendie to open possibly due to a viral infection, posterior fossa trauma or B2 deficiency. presents with ataxia and severe mental retardation, increased ICP, slow fusion of cranial sutures.

Back 18

Dandy walker

Front 19

agenesis of cerebellum due to a dilation of 4th ventricle causing a occipital meningocele?

Back 19

dandy walker

Front 20

Sincle incisor can be a clinical presentation of what?

Back 20

holoprosencephaly (failure of midline cleavage of midbrain)

Front 21

Holoprosencephaly?

Back 21

Failure of midline cleavage ofthe forebrain. This can be seen in severe fetal alcohol syndrome and Patau's syndroine (trisomy 13). The forebrain may lack midline features, including the corpus callosum, resulting in a single ventricle in the middle ofthe brain rather than bilateral ventricles

Front 22

is the most common cause of mental retardation. It is characterized by microcephaly, congenital heart disease, and in severe cases, holoprosencephaly.

Back 22

Fetal alcohol syndrome

Front 23

sylvian fissure?

Back 23

lateral sulcus, seperates temporal lobe, parietal and frontal lobes

Front 24

charactenzed by holoprosencephaly, microcephaly, Polydactyly, deft palate, narrow fingernails, and
apneic spells. It is the most rare
form of the viable trisomies (21, 18, and 13). Death occurs within 1 year.

Back 24

Patau's syndrome (trisomy 13)

Front 25

where are bridging veins located in the brain?

Back 25

sub-dural space

Front 26

Lucid interval in 50% affected?

Back 26

epidural hematoma

Front 27

What type of hematoma always causes brain damage?

Back 27

subdural hematoma

Front 28

why are SAH's associated with marfans and ehlers danlos?

Back 28

Marfans = fibrillin defect
Ehlers danlos = collagen defect type 1

Front 29

deceleration injuries do what to head?

Back 29

can cause rupture of bridging veins leading to a subdural hemorrhage. this is venous bleeding and accumulates slowly

Front 30

high fever, headache, nuchal rigidity, Kernig and Brudzinski signs present? all same but less acute in onset and less severe?

Back 30

bacterial meningitis, viral meningitis

Front 31

Kernig's sign?

Back 31

inability to straighten leg when lying on back.

Front 32

Brudzinski sign?

Back 32

pain with passive neck flexion while laying down

Front 33

BBB permeability.
1. non-polar/lipid soluble?
2. how is glucose and AA's moved across?

Back 33

1. more permeable than polar non lipid soluble
2. carrier mediated transport

Front 34

BBB total permeability in what two areas?

Back 34

area postrema and neurohypophysis and hypothalamus.

Front 35

Non-communicating hydrocephalus?

Back 35

blockage between ventricles

Front 36

Kernig's sign?

Back 36

inability to straighten leg when lying on back.

Front 37

Communicating hydrocephalus?
3 possibilities

Back 37

1. CSF over-secretion (choroid papilloma)
2. CSF circulation blockage. tumor in subarachnoid space
3. poor CSF absorption (meningitis, post meningitis adhesions, dural venous sinus thrombosis).

Front 38

Brudzinski sign?

Back 38

pain with passive neck flexion while laying down

Front 39

Normal pressure hydrocephalus clinical presentation?

Back 39

wet wacky wobbly, wet = urinary incontinence, wacky = progressive dementia, wobbly = ataxic gait.
All due to decreased absorption of CSF from subarachnoid mater

Front 40

BBB permeability.
1. non-polar/lipid soluble?
2. how is glucose and AA's moved across?

Back 40

1. more permeable than polar non lipid soluble
2. carrier mediated transport

Front 41

hydrocephalus ex-vacuo?

Back 41

overall loss of brain tissue (alzheimers) leading to larger lateral ventricles but still normal pressure.

Front 42

BBB total permeability in what two areas?

Back 42

area postrema and neurohypophysis and hypothalamus.

Front 43

young obese female presenting with headache and vision changes, you see slit-like ventricles on MRI?

Back 43

pseudotumor cerebri, you will also see papilledema (increased ICP) this is benign intracranial hyptertension. detected by lumbar puncture.

Front 44

Non-communicating hydrocephalus?

Back 44

blockage between ventricles

Front 45

Communicating hydrocephalus?
3 possibilities

Back 45

1. CSF over-secretion (choroid papilloma)
2. CSF circulation blockage. tumor in subarachnoid space
3. poor CSF absorption (meningitis, post meningitis adhesions, dural venous sinus thrombosis).

Front 46

Normal pressure hydrocephalus clinical presentation?

Back 46

wet wacky wobbly, wet = urinary incontinence, wacky = progressive dementia, wobbly = ataxic gait.
All due to decreased absorption of CSF from subarachnoid mater

Front 47

hydrocephalus ex-vacuo?

Back 47

overall loss of brain tissue (alzheimers) leading to larger lateral ventricles but still normal pressure.

Front 48

young obese female presenting with headache and vision changes, you see slit-like ventricles on MRI?

Back 48

pseudotumor cerebri, you will also see papilledema (increased ICP) this is benign intracranial hyptertension. detected by lumbar puncture.

Front 49

dilated lateral ventricles is a block where?

Back 49

foramen of monro

Front 50

dilated 3rd and lateral ventricles is a block where?

Back 50

blockage of the aquaduct

Front 51

dilated aquaduct, third ventricles and lateral ventricles is a block where?

Back 51

blockage in the 4th ventricle

Front 52

what is the first branch of the internal carotid artery? if occluded what do you see?

Back 52

opthalmic artery, which gives rise to the central artery of the retina, occluded you get sudden onset blindness in that eye.

Front 53

What is the anterior choroidal artery?

Back 53

second branch of internal carotid. supplies lateral geniculate bodies (and is assoc. with visi), globus pallidus, internal capsule

Front 54

where is the most common site of aneurysm in the circle of willis? aneurysm can give rise to what type of vision changes?

Back 54

anterior cerebral atery, bitemporal lower quadrantanopia

Front 55

Posterior cerebral artery supplies the?

Back 55

occipital lobe.

Front 56

posterior communicating artery is what?

Back 56

another common aneurysm site and is associated with 3rd nerve palsy.

Front 57

ACA stroke = (think homunculus)

Back 57

lower extremity weakness

Front 58

MCA stroke =

Back 58

aphasia if dominant hemisphere. apraxia if non-dominant hemishere. Face and upper extremity weakness

Front 59

PCA stroke =

Back 59

visual field deficit with macular sparing

Front 60

What arteries are in the vertebrobasilar system?

Back 60

Anterior spinal artery
PICA
AICA
Pontine arteries
superior cerebellar arteries

Front 61

anterior spinal artery supplies what? 1

Back 61

ventral portion of the spinal cord

Front 62

PICA supplies what? 2

Back 62

medulla and posterior cerebellum

Front 63

AICA supplies what? 3

Back 63

pons, CN 7, inferior surface of cerebellum

Front 64

pontine arteries supplies what? 3

Back 64

base of pons including corticospinal fibers, and CN 6

Front 65

superior cerebellar artery supplies what? 4

Back 65

pons, superior surface of cerebellum, and CN 7, 8

Front 66

pt. presents with opthalmaplegia and facial sensory loss?

Back 66

cavernous sinus syndrome (increased pressure in the cavernous sinus)

Front 67

what structures are contained in the cavernous sinus?

Back 67

CN 3, 4, 5 (1,2), 6, post ganglionic sympathetic fibers that supply the orbit.

Front 68

What is a Betz cell?

Back 68

layer 5 in primary motor cortex with large motor neurons of corticospinal tract.

Front 69

brodman area 44?

Back 69

broca's language production

Front 70

What is Gerstmann's syndrome?

Back 70

lesion to inferior parietal lobe of dominant hemisphere. pt. presents with R & L confusion, finger agnosia, dysgraphia, alexia (inability to write and read), dyscalculia

Front 71

what types of vision loss do you see if the optic tract is lesions as it passes through the parietal lobe.

Back 71

contralateral hemianopia and lower quadrantic hemianopia (lower 1/4 of pie)

Front 72

dominant parietal lobe lesion?

Back 72

apraxia, inability to carry oul learned movements. Patients oflen are unable to perform an action when commanded to, bul arc able to imitate or perform the action in response to other triggering stimuli.

Front 73

Balint's syndrome?

Back 73

a form of visual agnosia, in which patients are unable to scan visual space and to grasp an object in space.

Front 74

dyslexia and alexia which is congenital and which is acquired?

Back 74

Alexia is Acquired, dyslexia is congenital. (alexia: inability to perceive written words

Front 75

Parietal lobe blood supply?

Back 75

MCA ACA

Front 76

Most common Embolic stroke site?

Back 76

MCA at branch point of internal carotid artery in circle of willis

Front 77

Describe the visual pathway from Retinal to Brodmans 17.

Back 77

Retina —>fiberscross at the optic chiasm -> synapse at the lateral geniculate nucleus (LGN) -> primary visual cortex wilhin the occipital lobe then to the primary association cortex in the occipital lobe

Front 78

occipital lobe blood supply?

Back 78

PCA, Calacrine cortex is PCA, macula is supplied by the MCA

Front 79

Major areas of temporal lobe? (4)

Back 79

primary auditory cortex, hippocampus, amygdala, wernicke's area

Front 80

Describe the auditory pathway?

Back 80

Cochlea -* CN VIII —> medullary cochlear nuclei —> fibers cross just prior lo the superior olivary nuclei, along the laleral lem- niscus tract -4 medial geniculate nucleus (MCN) —> primary auditor}' cor- tex

Front 81

lesion of auditory pathway before Ihe CN VIII decussation proximal to the superior olivary nucleus?

Back 81

unilateral hearing loss, even deafness

Front 82

Lesion dislal to the CN VIII decussation, dislal to the medullary cochlear nuclei

Back 82

bilateral diminished hearing without deafness

Front 83

hippocampal lesion =

Back 83

anterograde memory loss (inability to form new memories) the hippocampus integrates short term memory before and if it is stored in long term memory

Front 84

wernicke's area does what and what number?

Back 84

language comprehension, 22

Front 85

Conduction aphasia?

Back 85

inability to repeat after hearing a sentence.

Front 86

Transcortical aphasia?

Back 86

inability to produce words or coherent speech, however repetition is spared

Front 87

Global aphasia?

Back 87

all language function is impaired

Front 88

what does dopamine do to the direct pathway in the basal ganglia?

Back 88

activates the pathway

Front 89

What does dopamine do to the indirect pathway in the basal ganglia?

Back 89

inhibits it

Front 90

what nucleus is affected in Huntingtons disease?

Back 90

Striatum (Caudate and Putamen)
Cholinergic neurons.

Front 91

What nucleus is affected in Athetosis?

Back 91

Striatum (caudate and putamen)

Front 92

What nucleus is affected with Hemiballismus?

Back 92

subthalamic nucleus

Front 93

What nucleus is affected with parkinsons disease?

Back 93

Substantia nigra pars compacta Dopaminergic neurons

Front 94

what does the Ventral posterior-lateral (VPL) nucleus of the thalamus do?

Back 94

relay sensory input from entire body except head via the spinothalamic tract, output to sensory cortex

Front 95

What does the Ventral posterior-medial (VPM) nucleus of the thalamus do?

Back 95

relay sensory input from head via Trigeminothalamic tract (that recieves input from: Trigeminal, facial, glossopharyngeal and vaus nerves) that then sends info to sensory cortex

Front 96

What does the Ventrolateral (VL) nucleus of the thalamus do?

Back 96

relays motor information from the cerebellum and basal gangia to the primary motor cortex.

Front 97

What does the Ventroanterior (VA) nucleus of the thalamus do?

Back 97

Relay motor planning information from frontal cortex and sends it to the premotor cortex

Front 98

What does the Anterior Nuclei of the Thalamus do?

Back 98

relay emotion/memory (part of papez circuit from the mammillary bodies and then sends it to Cingulate gyrus.

Front 99

What does the Medial Dorsal nucleus of the thalamus do?

Back 99

relays cognitive information from the amygdala, substantia nigra and temporal cortex and sends it to prefrontal cortex

Front 100

Anterior limb of internal capsule has what?

Back 100

Ascending sensory fibers

Front 101

Genu of internal capsule contains what?

Back 101

Descending corticobulbar tracts fibers

Front 102

Posterior limb of internal capsule contains?

Back 102

Descending corticospinal tract fibers

Front 103

Anterior internal capsule lesion leads to what type of deficit?

Back 103

Sensory deficit and will most likely involve many areas of body

Front 104

What does Tectum mean? Compression of the Tectum is what?

Back 104

Roof (like roof of the brainstem). Parinauds syndrome is compression of the dorsal tectum lesion at the pre-tectum and superior colliculus= paralysis of upward and downward gaze, pupillary disturbances and convergence. Lesion of the tectum at the cerebral aqueduct = can lead to obstruction, which can lead to non-communicating hydrocephalus.

Front 105

What does Tegmentum mean?

Back 105

Floor (like floor of the brainstem

Front 106

What are the lesions of the midbrain? 3

Back 106

Parinauds syndrome, Benedikt's and Webers syndromes.

Front 107

What is Charcot's triad of MS?

Back 107

Scanning speech, intention tremor and nystagmus (due to MLF syndrome)

Front 108

Describe Benedikt's syndrome. (3 areas of lesions and deficits)

Back 108

CN3 NUCLEUS/ROOT: ptosis, ipilateral fixed and dilated, complete ipsi. occulomotor paralysis(down and out) due to CN4 and 6 nerve innervations LR6(SO4)3.
DENTOTHALAMIC FIBERS: contralateral cerebellar dystaxia and intention tremor.
MEDIAL LEMNISCUS: contralateral loss of tactile sensation from extremities.

Hint 108

pope benedikt standing with L eye down and out and ptosis. right hand shaking at shoulder while blessing a large bush of spikes because he doesn't feel them

Front 109

Describe Weber's syndrome. (3 areas of lesions with deficits)

Back 109

CN3 NUCLEUS/ROOT: ptosis and down and out due to occulomotor nerve palsy.
CORTICOSPINAL TRACTS: contralateral spastic paralysis of extremities.
CORTICOBULBAR FIBERS: CN7contra. weakness of lower face, tounge (CN12), and palate (CN10), Uvula points toward normal side, tounge points toward bad side.

Hint 109

pope benedikt (from benedikts syndrome) has a guy making a web (webers) with ptosis and down and out in right eye, he is sticking his tongue out as he is building it deviates to the right and his uvula is sticking out to the left.

Front 110

Medial pons lesion due to occlusion of what arteries?

Back 110

paramedian branches of basilar arteries and AICA.

Front 111

lesion to medial pons due to occlusion of AICA and paramedian branches of basilar artery lead to what deficits? (5 areas)

Back 111

1. MLF: MLF syndrome INO.
2. abducens nerve (CN6) LR palsy
3. CN7 lower motor neuron: bells palsy
4. Medial lemniscus: loss of facial pain and temp
5. Corticospinal: hemiparesis

Front 112

Locked in syndrome due to what?

Back 112

At the base of pons: infarct, trauma, tumor, demyelination. patient only able to communicate with vertical eye movement due to sparing of occulomotor and trochlear nerves. total bilateral paralysis.

Front 113

Central Pontine Myelinolysis: ?

Back 113

Lesion of the base of the pons, associ- ated with alcoholism or rapid correclion of hyponatremia.
Affects the corticospinal and corticobulbar tracts -* spastic quad- riparesis, pseudobulbar palsy, mental changes; may progress to "locked-in" syndrome.