Neurology Alpert Chapter 2

Front 1

transient global amnesia involves loss of (2) but preservation of (2)

Back 1

lost:

-- recent events
-- ability to retain new info

preserved:

-- immediate recall
-- remote memory

Front 2

transient global amnesia episodes typically last how long?

Back 2

< 24 hours

Front 3

a classic example of crossed brainstem findings (2)

Back 3

ipsilateral cranial nerve
contralateral long tract

Front 4

signs that indicate CNS disease but are nonlocalizing within the CNS

(7)

Back 4

hemiparesis
hemisensory loss
hemiataxia

unilateral hyperreflexia
Babinski sign

eye movement disorders of cerebral, brainstem, or cerebellar origin

position sense loss exceeding loss of vibration perception

Front 5

5 pathognomonic signs of cerebral hemisphere disease

Back 5

dementia or a confused state

abnormalities of
-- mood, personality, behavior
[with abnormal neuro signs]

aphasia
seizure
homonymous hemianopsia

Front 6

impaired rapid alternating movements have what localizing value?

can be caused by what?

Back 6

localizing value when unilateral

proprioception loss and weakness of any etiology

Front 7

a couple signs that may occur with any encephalopathy

Back 7

postural tremor
asterixis

Front 8

encephalopathy implies a _

Back 8

rapidly developing confusional state

Front 9

causes of encephalopathy

Back 9

metabolic
infections e.g. encephalitis
nutritional disorders
toxins or drugs
trauma

Front 10

radicular pain means

Back 10

pain radiated along a dermatome

Front 11

pain radiating to the shoulder may be _

and is particularly common with ___ disease

Back 11

radicular

schwannoma

Front 12

spastic hemiparesis localizes to _____

Back 12

corticospinal tract

Front 13

main probable diagnosis of spinal cord disease, and a secondary possible diagnosis

given a 2-year history of neck pain

Back 13

structural degenerative disease
neoplasm

Front 14

aphasia is often misinterpreted as _

Back 14

confusion

Front 15

aphasia suggests _

whereas confusion suggests (3)

Back 15

stroke

metabolic
toxic
hypoxic-ischemic

Front 16

perseveration may occur in (at least) two kinds of disease

Back 16

aphasia
dementia

Front 17

signs of aphasia include (4)

Back 17

paraphasias
dysnomia
abnormal fluency
poor repetition

Front 18

three motor systems and their roles

Back 18

corticospinal -- initiation of movement
extrapyramidal -- maintenance of posture
cerebellar -- coordination

Front 19

nuclei of the extrapyramidal system

Back 19

basal ganglia nuclei:

caudate
globus pallidus
subthalamus
putamen

- - - - - - - - -
in the midbrain:
substantia nigra

Front 20

atheromatous disease of the cerebral vessels may cause _ with subsequent _

and thereby it may cause a stroke

Back 20

stenosis
thrombosis

Front 21

branches of the PCA supply (5)

Back 21

subthalamic nucleus
thalamus
portions of the midbrain

inferior temporal lobe
occipital lobe

Front 22

hemiballism -- description / location

Back 22

flinging irregular movement at proximal joints

esp. shoulder and hip

Front 23

chorea affects distal vs. proximal?

Back 23

distal

Front 24

choreiform movements

description

location

Back 24

rapid, jerky

distal

Front 25

how may patients with homonymous hemianopsia present?

Back 25

may c/o visual loss in only one eye

b/c the temporal field loss is larger and more apparent to the patient

Front 26

a treatment for hemiballism

Back 26

dopamine antagonist

Front 27

the cardinal features of diseases affecting the brainstem:

(2)

Back 27

crossed findings

specific types of abnormal eye movements

Front 28

most forms of pathologic nystagmus occur with _ lesions

less often occur with _ lesions

Back 28

brainstem

cerebellar

Front 29

the direction of nystagmus refers to its

Back 29

quick phase

Front 30

describe the nystagmus associated with drug toxicity

Back 30

horizontal, gaze-evoked

i.e. left-beating nystagmus on left lateral gaze


nystagmus in the vertical plane may also occur with drug toxicity

Front 31

describe the nystagmus seen in peripheral vestibular disease

Back 31

horizontal, direction-fixed nystagmus

with a slight rotatory element

Front 32

left eight nerve lesion --> what kind of nystagmus?

Back 32

direction-fixed
contralateral (right beating)

horizontal nystagmus with a slight counterclockwise rotatory element

it is most prominent on right (contralateral) lateral gaze

Front 33

nystagmus which is of equal velocity in both directions

and has no separation into quick and slow phases

is known as

Back 33

pendular nystagmus

Front 34

Wallenberg syndrome

sxs

Back 34

ipsilateral face

-- pain
-- reduced pain and temp
-- both

contralateral limbs and body
-- loss of pain and temp

ipsilateral horner

nystagmus

incoordination of ipsilateral arm

leaning and veering / gait ataxia

in deep lesions: dysphagia and hoarseness

Front 35

the cause Alpert mentioned for

Wallenberg's syndrome

Back 35

vertebral occlusion

with ischemia in PICA

Front 36

Horner's sxs

Back 36

ipsilateral:

miosis
ptosis
anhidrosis (warmth)

Front 37

explanation for Horner's in Wallenberg syndrome

Back 37

sympathetics from hypothalamus traverse the dorsolateral medulla

Front 38

a couple examples of facial sensory deficits associated with Wallenberg's

and what their underlying lesion is

Back 38

absent corneal response

numbness in the mouth


spinal tract and nucleus of CN V

Front 39

a lesion that explains left heel to shin ataxia

in Wallenberg's

Back 39

left inferior cerebellar peduncle

Front 40

weakness of the left soft palate

may be seen in Wallenberg's


lesion?

Back 40

nucleus ambiguus

which is motor for CN X

Front 41

body sensory symptoms for Wallenberg's

and their underlying lesion

Back 41

Alpert: contralateral hypesthesia (decreased sensation)

Blueprints: loss of pain and temperature


spinothalamic tract

Front 42

what part of the cerebellum plays a role in slow eye movements?

Back 42

cerebellar flocculus and vermis

Front 43

_ eye movement when the head is turned is mediated by _

Back 43

slow visual persuit


vestibulo-ocular reflex

Front 44

what part of the cerebellum plays a role in slow eye movements?

Back 44

cerebellar flocculus and vermis