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161 Cards in this Set
- Front
- Back
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When is the notocord visible by?
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3 weeks
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When is the brain fully formed?
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8 weeks
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What percent of the amniotic fluid is a filtrate of mom's plasma?
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80%
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How does the fetus subtract from the amniotic fluid?
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by swallowing
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What percent of the amniotic fluid is added by the fetus?
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20%
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What are AFI levels in polyhydramnios?
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normal
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What AFI is normal?
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5-10
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What can polyhydramnios cause?
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neuromuscular disease and GI obstruction
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What neuromuscular diseases can be caused by polyhydramnios?
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dry eyes- Riely Day Syndrome
muscle fasciculation in the newborn- Wernig-Hoffman Syndrome |
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Oligohydramnios is caused by what?
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renal agenesis or urinary outlet obstruction
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What is a horseshoe kidney caused by?
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the kidney getting caught on the inferior mesenteric artery
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What is caudal regression syndrome?
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bottom of the cord didn't develop- common cause is diabetic mother
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What does the spinal cord develop from?
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the notocord
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How far down does the spinal cord go?
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L1-L2
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What is the end of the spinal cord called?
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conus medularis
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What are the nerve roots called that come off the cord?
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cauda equina
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What is the cord that anchors the spinal cord?
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filum terminalis
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What is anencephaly?
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the brain is missing, only a medulla present- they breath at 8-10 ipm
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What is an encephalocele?
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CSF
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What is an encephalo-meningocele?
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CSF and meninges
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What is an encephalo-meningo-myelocele?
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CSF, brain, spinal cord herinates
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What are AFP levels with spinal bifida occulta?
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no elevated AFP
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What is the new marker for spina bifida aperta?
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AchE
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What does spinda bifida aperta cover?
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meningocele and meningomyelocele
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What are AFP levels in spina bifida aperta?
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elevated
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What is the most common level for spina bifida?
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L4-L5
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What is a syringomyelia?
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the brain herniates through the foramen magnum
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What vitamin does the body need to make CSF?
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Vitamin A
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Besides vitamin A, what else is needed to make CSF?
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carbonic anhydrase
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How does trauma effect CSF production?
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increased production
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Where is the chemotactic trigger zone located?
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on the floor of the 4th ventricle
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What does the CTZ respond to?
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an increase in ICP
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What does the CTZ respond to?
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dopamine
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Where is the area postrema located?
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on the blood side of the BBB next to the CTZ
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What does the area postrema respond to?
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offensive smells or taste
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What is the area postrema stimulated by?
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dopamine
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What is a non-communicating hydrocephalus caused by?
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an obstruction
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What is a communicating hydrocephalus caused by?
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overproduction of CSF
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What is the mcc of a communicating hydrocephalus in a newborn?
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intraventricular hemorrhage
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What is the mcc of a communicating hydrocephalus is children?
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meningitis
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What is the mcc of a communicating hydrocephalus is adults?
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too much vitamin A- pseudotumor cerebri- BIG CLUE is young, obese female
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What is the mcc of a communicating hydrocephalus in the elderly?
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brain atrophy- called normal pressure hydrocephalus
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What is the triad for normal pressure hydrocephalus?
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dementia, incontinence, ataxia
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What is the treatment for normal pressure hydrocephalus?
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shunt
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What is the most common cause of communicating hydrocephalus in newborns, children, adults and elderly?
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newborns- aqueductal stenosis, dandy-walker cyst
children- meningitis adults and elderly- cancer |
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What does the prosencephalon develop into?
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telencephalon and diencephalon
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What does the mesencephalon develop into?
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mesencephalon
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What does the rhombencephalon develop into?
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metencephalon and myelencephalon
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What does the telencephalon give rise to?
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cerebrum
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What does the diencephalon give rise to?
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thalamus, hypothalamus, optic nerve
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What does the mesencephalon give rise to?
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midbrain
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What does the metencephalon develop into?
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pons and cerebellum
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What does the myelencephalon develop into?
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medulla
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When must light hit the retina by or the child will go blind?
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3 months
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If a child patient has anisocoria (unequal pupil size), what should be the default diagnosis until proven otherwise?
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increase ICP
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What is amblyopia?
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difference in visual acuity
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What is isotropic strabismus?
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eye deviates in
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What is exotropic strabismus?
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eye deviates out
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What is stigmatism?
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defect in the cornea
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What vision is legally blind?
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20/200
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What is myopia?
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near sightedness
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What is hyperopia?
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far sightedness
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In myopia, what does the lens look like?
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concave
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In hyperopia, what does the lens look like?
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convex
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A white reflex indicates what disease most commonly?
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cataracts
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What is the mcc of cataracts?
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idiopathic
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Besides cataracts, what else can a white reflex indicate?
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retinoblastoma
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What gene is associated with a retinoblastoma?
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RB gene
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What does retinoblastoma have a high association with?
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Ewing's sarcoma
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What is the mcc of monocular blindness in newborns?
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cataracts or retinoblastoma
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What is the mcc of monocular blindness in children?
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optic nerve gliomas
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What is the mcc of monocular blindness in adults?
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embolism- e.g. TIA, acute retinal artery occlusion, etc
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What is the mcc of monocular blindness in elderly?
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macular degeneration
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What lesion causes bitemporal hemanopsia?
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optic chiasm lesion
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What causes bitemporal hemanopsia 90% of the time?
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pituitary tumors
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What is the mcc of contralateral homonymous hemanopia?
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cancers or tumors
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A lesion where causes contralateral superior quadrantanopia?
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a lesion to Meyer's loop
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A lesion where causes contralateral inferior quadrantanopia?
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optic radiation
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A lesion where causes contralateral homonymous hemianopia with macula sparing?
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bottom of the optic radiation
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If a patient has exaggerated reflexes, where is the lesion?
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UMN
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If a patient has hyporeflexia, where is the lesion?
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LMN
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What does all motor descend through?
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internal capsule
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What arteries supply the internal capsule?
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lenticulo striate
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What personality features is the frontal lobe responsible for?
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personality itself, abstract reasoning
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What lobe is affected in Alzheimer's?
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frontal
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What lobe is affected in Pick's disease?
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frontal an temporal
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What are the classic first symptoms of Alzheimer's?
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sundowning, short term memory loss and putting objects of value in safe places
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What happens in the frontal lobe with schizophrenia?
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loss of asymmetry in the frontal lobe
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What is the temporal lobe responsible for?
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hearing, blanace, hallucinations, and in posterior temporal lobe- wernicke's area
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What two drugs affect the temporal lobe?
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PCP and LSD- hallucinations
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Where are amphetamine taken up?
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presynaptically
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What do amphetamines cause the release of?
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catecholamines
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What is the classic clue that a patient has taken amphetamines?
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vertical nystagmus
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What 4 amphetamines are used in ADD?
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methylphenidate, pemoline, adderal, dexadrine
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What is used for narcolepsy?
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methylphenidate
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What ADD drug has been taken off market for causing hepatic necrosis?
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pemoline
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What amphetamine is used for OTC weight loss?
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dexatrim
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What illict drugs cause hallucinations?
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LSD, PCP, ecstacy
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What class of drugs is used for depression and eating disorders?
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SSRI's
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What do most of the SSRI's end in?
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xetine
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What are the 6 antidepressants?
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fluoxetine, paroxetine, luvoxetine, sertraline, nefazadone, trazadone
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What parietal lobe is dominant in 90% of people?
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left
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What is the dominant parietal lobe responsible for?
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long-term memory (since kindergarten)
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What is the non-dominant parietal lobe responsible for?
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apraxia and hemineglect
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If you want to put someone on an antidepressant, what do you have to make sure they're not already taking?
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MAOI- wait a month
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Lateral Pontine Syndrome is caused by an occlusion where?
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AICA
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In lateral pontine syndrome is associated with 2 cranial nerve deficits- what are they?
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CN 7- ipsilateral facial paralysis
CN 8- hearing loss |
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Occlusion of PICA causes what syndrome?
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lateral medullary syndrome (Wallenberg)
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Medial medullary syndrome is the occlusion of what artery?
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vertebral artery
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What cranial nerve deficit is seen with medial medullary syndrome?
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CN 12- tongue deviates toward the lesion
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An epidural hematoma is caused by what?
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middle meningeal artery- usually a blow to the head and fracture the temporal bone
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A subdural hematoma is caused by what?
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a bridging vein breaking
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Why is a subdural hematoma so slow?
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it's a vein and there is far less pressure
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What is the shape of a subdural hematoma?
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crescent shape
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What type of hematoma do shaken babies get?
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subdural
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What causes a subarachnoid hemorrhage?
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aneurysm rupture
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What head problem causes the "worst headache of your life?"
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subarachnoid hemorrhage
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Where does all sensory information go in and out of?
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thalamus
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All sensory information from the arms stays where? Legs?
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arms- lateral
legs- medial |
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Under stress, what discharge is always first? Second?
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first- parasympathetic
second- sympathetic |
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Where does acetomenophen work?
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at the level of the hypothalamus
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What do you treat an acetomenophen toxicity with?
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n-acetylcystiene
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What is the final relay station for coordinating fine motor movements?
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subthalamic nucleus
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What does a lesion to the subthalamic nucleus cause?
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ballismus and hemiballismus
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What is the substantia nigra responsible for?
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initiating movements
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What causes Parkinson's disease?
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loss of dopamine fibers from substantia nigra to the striatum (caudate and putamen)
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What is the treatment for Parkinson's?
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1st line- L-dopa/carbidopa
2nd line- bromocryptine |
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What inheritance is Huntington's?
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AD
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What nucleus is involved in Hunington's?
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caudate nucleus
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How do you treat Hunington's?
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dopamine blockers
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What inheritance is Wilson's disease?
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AR
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What nucleus is involved in Wilson's?
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lenticular nucleus
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How do you treat Wilson's?
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penicillamine
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What is the function of the reticular activating system (RAS)?
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maintain focus on one item at a time
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What is the 1st line treatment in ADD?
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methylphenidate- then pemoline, dexadrine, adderal
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What is the corticospinal tract responsible for?
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fine motor activity
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How does the corticospinal tract operate?
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it inhibits extension so that smooth flexion can occur
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Where does the corticospinal tract cross?
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at medullary pyramids
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What is the 1st sign of increased intracranial pressure?
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papilledema
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What is the 1st symptom of increased intracranial pressure?
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headache
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What are atonic seizures caused by?
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depolarization across the frontal cortex
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What is the second sign of herniation?
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decorticate posturing
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What movements are the dorsal columns responsible for?
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vibration, 2 point discrimination, position sense, conscious proprioception
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What part of the dorsal columns carries leg fibers medially?
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gracilis
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What part of the dorsal columns carries arm fibers laterally?
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cuneatus
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What is the first synapse in the dorsal columns?
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dorsal root ganglion
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What is the second synapse in the dorsal columns?
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medulla
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What is the third synapse in the dorsal columns?
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thalamus
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What is the 4th synapse in the dorsal columns?
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parietal lobe
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What is the spinothalamic tract responsible for?
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pain and temperature
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Where does the spinothalamic tract cross?
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in the spinal cord
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What pathway is responsible for depth perception?
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spinocerebellar
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Where does the spinocerebellar pathway cross?
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twice- equivalent to ipsilateral
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What is the pons responsible for?
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responding to the environment
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What area of the CNS is most sensitive to to osmotic shifts?
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PONS
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What does the medulla control?
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all basic functions
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What is the respiratory rate output of the medulla?
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8-10 imp
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What cranial nerves are associated with the PONS?
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3,4
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What cranial nerves are associated with the Pons?
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5,6,7,8
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What cranial nerves are associated with the medulla?
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9, 10, 11, 12
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The lesion is how many dermatomes above where pain and temperature loss is?
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2
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