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130 Cards in this Set
- Front
- Back
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cells destroyed in MS
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oligodendrocytes
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cells destroyed in Guillian Barre
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Schwann's
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NE made where in CNS?
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locus ceruleus
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DA made where in CNS?
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ventral tegmentum and SNc
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Serotonin made where in CNS?
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Raphe Nucleus
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ACh made where in CNS?
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Basal nucleus of Meynert
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GABA made where in CNS
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nucleus accumbens
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these cross the BBB rapidly
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nonpolar/lipid soluble substances via diffusion
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these cross BBB slowly
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glucose and AA via carrier mediated transport
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these regions are open to blood what are they and why?
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area posterma for vomiting after chemo
OVLT for osmotic sensing |
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ADH made where?
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supraoptic nucleus
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oxytocin made where?
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PVN
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lateral hypothalums?
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causes feelings of hunger
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ventromedial area of hypothalaums
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causes feelings of satiety
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Ventral Posterior Medial thalamus for?
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sensory relay for the face
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Ventral Posterior Lateral thalamus for?
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sensory relay for the body
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Ventral anterior and lateral thalamus for?
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motor
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LGN of thalamus for?
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vision and projects to occipital cortex
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MGN of thalamus for?
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sound
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lateral cerebellum problems?
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decreased voluntary movements of extremities
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medial cerebellum problems?
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decreased balance, truncal coordination, ataxia, fall TOWARD injured side
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D1 receptor on striatum?
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excitatory and excites the excitatory pathway
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D2 receptor on striatum
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negative and inhibits the inhibitory pathway
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dopamine loss in basal ganglia?
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decreased motion
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degenerative D/O w/ lewy bodies and depigmentation
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Parkinsons
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what are lewy bodies
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alpha synuclein intracellular inclusions
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what happens w/ contralateral subthalamic nucleus lesion
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hemiballismus - sudden wild flailing of one arm +/- leg
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sudden brief muscle contraction is called?
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myoclonus
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location of broca's area?
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inferior frontal gyrus
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location of wernickes
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superior temporal gyrus
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difference between brocas and wernickes aphasia
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broca's has intact comprehension just speech is nonfluent
wernickes has fluent speech but impaired comprehension |
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what is global aphasia
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combo of broca and wernicke
affected fluency and comprehension |
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conduction aphasia symptoms and problem?
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poor repititon but fluent speech, intact comprehension
arcuate fasciculus lesion |
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describe the homonculus
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medial side of the brain is the lower extremity
from the top down it is the body then arm, hand, face and inside the sylfian fissure the GI tract is located |
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thinking about homunculus what would you expect with ACA lesion
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lower extremity deficits and some of body
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thinking about homunculus what would you expect with MCA lesion
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some of body, upper extremity, hand, face, GI deficits
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spatial neglect syndrome from lesion....
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right parietal lobe
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lesion causing reduced levels of arousal and wakefulness
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reticular activating system in midbrain
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confusion, opthalmoplegia, ataxia, memory loss, confabulation, personality change
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Wernicke - Korsakoff - bilateral mamillary body problems
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cerebellar hemisphere lesion"
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fall toward the lesion, limb ataxia, intention tremor - all ipsilateral
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hippocampus lesion
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anterogreade amnesia
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paramedian pontine reticular formation lesion
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eyes look away from side of lesion
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frontal eye field lesion
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eyes look toward lesion
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acute paralysis, dysarthria, dysphagia, diplopia, loss of consciousness....
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central pontine myelinosis
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contralateral hemiparesis of lower extremities, decreased contralateral propioception, ipsilateral paralysis of hypoglossal nerve is....
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medial medullary syndrome - anterior spinal artery problem
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contralateral loss of pain and temp, ipsilateral dysphagia, hoarseness, decreased gag reflex, vertigo, diplopia, nystagmus, vomiting, ipsilateral Horner's ipsilateral facial pain and temp loss, trigem nucleus problem and ipsilateral ataxia
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PICA area - lateral medullary syndrome
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ipsilateral facial paralysis, ipsilateral cochlear nucles, nystagums, ipsilateral facial pain and temp.
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AICA - lateral inferior pontine syndrome
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PCA problems?
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contralateral homonymous hemianopia w/ macular sparing
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MCA problems?
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contralateral face/arm paralysis and sensory loss, aphasia, left neglect
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ACA problems?
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leg foot areas of motor and sensory
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aneurysm of Posterior comm. Artery - associated symptoms?
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CN III palsy
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lateral striates from where and why important?
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from MCA important as 'arteries of stroke' - supply internal capsule, caudate, putamen, globus pallidus.
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locked in syndrome form?
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basilar artery infarct
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passage way of CSF from lateral to 3rd ventricle?
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foramen of monro
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normal pressure hydrocephalus symptoms and cause
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expansion of ventricls distorts corona radiata --> wet, wobbly, whacky - urinary incontinence, ataxia, dementia
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communicating hydrocephalus cause and symptoms
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increased ICP, papilledema and herniation because of decreased CSF absorption by arachnoid villi
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spinal cord ends where?
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lower border of L1-L2
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subarrachnod space ends where?
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lower S2 border
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lumbar puncture where?
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L3-L4 or L4-L5 space which is the level of the cauda equina
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when performing lumbar puncture what are the structures the needle goes through?
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skin
fascia supraspinous ligament interspinous ligament ligamentum flavum epidural space dura mater subdural space arachnoid subarrachnoid space |
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CSF is located where?
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subarrachnoid space
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tracts of the spinal cord and what are they 'carrying'?
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dorsal columns carrying propioception and fine touch and stuff
lateral tract is corticospinal and carrying motor signals down anterior/medial is the spinothalamic tract that is carrying the pain and temp |
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where to spinal cord tracts decussate?
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pain and temperature immediately decussate via Ant. White commissure
lateral corticospinals decussate in caudal medulla at the pyramids dorsal columns decussate in the medulla at their nuclei |
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where are sympathetics located in the thoracic area for spinal cord?
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intermediate horn
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ALS?
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UMN and LMN deficits w/o sensory problems
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poliomyelitis and werdnig hoffman?
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LMN symptoms due to destruction of anterior horns
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tabes dorsalis?
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degeneration of dorsal roots and dorsal columns causing impaired propioception and locomotor ataxia only
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syringomelia?
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damages anterior white commissure of the spinothalamic tract - bilateral pain and temperature loss
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Vitamin B12 neuropathy, Vitamin E deficiency, Friedriechs ataxia?
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demyelination of dorsal columns, lateral corticospinal tract, spinocerebellar tracts causing: ataxic gait, hyperreflexia, impaired position and vibration sense
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polio virus infection pathway?
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fecal oral spread --> replicates in oropharynx --> spreads via bloodstream to the CNS
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Difference between pathogenesis of polio and werdnig hoffman?
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werdnig hoffman is a AR inherited spinal muscular atrophy - presenting at birth w/ floppy baby and tongue fasciculations death by 7
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possible defect of ALS?
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superoxide dismutase I
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friedrich's ataxia often presents when with what?
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in childhood with kyphoscoliosis
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symptoms of friedrichs
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staggering gait, frequent falling, nystagmus, dysarthria, pes cavus, hammer toes, hypertrophic cardiomyopathy
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What is Brown Sequard syndrome?
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hemisection of spinal cord - contralateral pain and temp deficit w/ ipsilateral motor and vibratory, fine touch, propio loss
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Horner's Syndrome symptoms and last common location?
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anhydrosis, ptosis, miosis
from superior cervical ganglion |
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dermatomes:
inguinal ligament kneecaps penile and anal |
inguinal ligament L1
kneecaps L4 penile and anal S2, 3, 4 |
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dermatomes:
thumb 1st/2nd fingers pinky medial arm middle of anterior arm (flexor side) |
1st/2nd fingers - C6
pinky C8 medial arm - C8 middle of anterior arm (flexor side) T1 |
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difference between muscle spindle and golgi tendon?
similarities? |
diff: muscle spindles are parallel with the muscle so if they stretch reflexive contraction - helps to monitor resistance to allow recruitment of muscle fibers
golgi tendon organs are perpendicular so if they are stretched it is signalling too much stretch and reflexive relaxation to protect muscle similar: both use alpha motor neurons to enact effects, spindle uses Ia afferent while golgi uses Ib |
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biceps refelx
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C5
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Triceps reflex
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C7
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biceps refelx
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C5
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Achilles reflex
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S1
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Triceps reflex
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C7
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Patellar reflex
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L4
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Achilles reflex
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S1
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Patellar reflex
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L4
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medial on stem CN's
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III, VI, XII
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medial on stem CN's
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III, VI, XII
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conjugate vertical gaze center located where?
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superior colliculus
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lesion in superior colliculi or pineal gland deficit?
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paralyzed conjugate vertical gase
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conjugate vertical gaze center located where?
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superior colliculus
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inferior colliculi for?
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audiotry
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lesion in superior colliculi or pineal gland deficit?
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paralyzed conjugate vertical gase
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inferior colliculi for?
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audiotry
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taste from posterior 1/3 tongue
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IX
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taste from anterior 2/3 of tongue
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facial
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taste from posterior 1/3 tongue
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IX
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taste from anterior 2/3 of tongue
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facial
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CN nuclei in the midbrain?
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III, IV
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CN nuclei in the pons?
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V, VI, VII, VIII
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CN nuclei in medulla
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IX, X, XI, XII
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afferent and efferent of corneal reflex?
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V1 and VII
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afferent and efferent of pupillary reflex?
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II and III
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afferent and efferent of gag reflex
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IX and IX, X
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CN's in the cavernous sinus?
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III, IV, V1, V2, VI
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what is bell's palsy from?
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complete destruction of facial nucleus
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peripheral ipsilateral facial paralysis w/ inability to close eye on involved side:
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bell's palsy
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muscles to close jaw
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Masseter, teMporalis, Medial pterygoid
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muscles to open jaw
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lateral pterygoid
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sound pathway through ear?
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outer ear directs -->vibrate tympanic membrane-->ossicles amplify sound-->push oval window-->vibration in fluid-->vibration of basilar membrane-->bending of hair cell cilia against tectorial membrane-->hyperpolarize or depolarize CN VIII for signal
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cornea is continuous with what layer in the posterior eye
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sclera
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Iris is continuous with what laye rin the posterior eye
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choroid
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cause of acute, painless, monocular loss of vision w/ pale retina and cherry red macula ?
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retinal artery occlusion
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pathway of aqueous humor
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from vitreous humor past suspensory ligaments-->into past the posterior chamber-->anterior chamber-->absorbed by trabecular meshwork and further drains at canal of schlemm
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receptors located on sphincter/circular/constrictor muscle and ciliary muscle of the eye? what these do?
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M3 receptor - miosis and accomodation
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receptors for mydriasis
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alpha 1
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open/wide angle glaucoma from?
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obstructed outflow -
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closed/narrow angle glaucoma from?
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obstructed flow between iris and ornea so the pressure builds up behind iris
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nutritional deficiencies/abundancies associated with cataracts?
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classic galactosemia
galactokinase deficiency diabetes |
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down and out = damaged? what else is associated?
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CN III - also ptosis, pupillary dilation and loss of accomodation
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defective downward gaze = damaged?
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CN IV damage
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medially directed eye = damage?
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CN VI
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CN's and eye movements associated with them/
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SoLR - 463
Superior Oblique - CN IV Lateral Rectus - CN VI all the rest - CN III |
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pupillary light reflex path?
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light in either retina --> signal via CN II to pretectal nuclei --> activate BILATERAL E-W nuclei and bilateral contraction
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why is a blown pupil associated with increased ICP?
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b/c the parasympathetic output is located on the outside of CN III so is first effected in increased pressure so you lose parasympathetic effect and mydriasis occurs
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meyer's loop has what info and where is it?
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Meyer's loop carries the information for the contralateral side (upper quadrant) through the temporal lobe around lateral ventricle to the primary visual cortex
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dorsal optic radiation has what info and where is it?
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information for the contralateral side (lower quadrant) through internal capsule to the primary cortex
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horizontal conjugate gaze control?
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CN VI nucleus sends out a simultaneous signal to the ipsilateral lateral rectus and the contralateral CNIII for the medial rectus of contralateral eye (MLF is the actual pathway) so that when one moves the other moves with it in the same way. if not then nystagmus in the eye that can move
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COWS - vistibular apparatus
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Cold water in ear will cause nystagmus toward lesion w/ quick phase to Opposite side
Warm water in ear will cause nystagmus opposite w/ quick phae to Same side |
