Neuroscience Final

Front 1

Circle of Willis

Back 1

LOOK AT IT!!!!!
-Vertebral Arteries > Basilar Artery > Posterior Cerebral Arteries (Continue) > Posterior Communicating Arteries > Internal Cartoid Arteries > Anterior Cerebral Arteries

-Anterior Communicating Artery - Joins Anterior Cerebral Arteries
-Middle Cerebral Artery (Internal Carotid)
-Anterior Spinal Artery (Basilar or Vertebrals)
-Posterior Inferior Cerebellar Arteries (Vertebral)
-Anterior Inferior Cerebellar Arteries (Basilar)
-Superior Cerebellar Arteries (Basilar)

Front 2

Which Artery supplies the Anterior Circulation of the Brain? What are the main arteries of the Anterior Circulation of the Brain?

Back 2

-Internal Carotid
-ACA and MCA

Front 3

Which Arteries supply the Posterior Circulation of the Brain?

Back 3

Vertebral and Basilar Arteries

Front 4

Where do the Anterior and Posterior Circulations of the brain meet?

Back 4

Circle of Willis

Front 5

What types of Disturbances would we expect to see with an ACA Lesion? Why? Which side?

Back 5

-Leg and Foot
-Homunculus
-Contralateral

Front 6

What types of Sensory and Motor (Homuncli) Disturbances would we expect to see with an MCA Lesion? Why? Which side?

Back 6

-Hand, Arms, Face
-Homunculus
-Contralateral

Front 7

What types of Disturbances would we expect to see with an PCA Lesion? Why? Which side?

Back 7

-Visual Disturbances
-Affecting the Occipital Lobe
-Contralateral

Front 8

The artery that supplies the Somatosensory cortex near the superior sagittal fissure is fucked up. Which artery is this? What types of problems would you expect?

Back 8

-Anterior Cerebral Artery
-Sensory Impairment (Parathesia or Anesthesia) involving CONTRALATERAL foot

Front 9

A patient is experiencing sensory problems on the right side of his face. You suspect it is a problem with blood supply. Which artery is likely involved? Which side?

Back 9

-Middle Cerebral Artery
-Left Side

Front 10

What is Locked-In Syndrome? A Lesion to which artery can cause this?

Back 10

-Patient is aware and awake
-Cannot move or Communicate due to complete paralysis of nearly all voluntary muscles in the body except for the eyes
-Basilar Artery

Front 11

A patient has interruption of Basilar Artery flow. What syndrome might they present with? What happens in this syndrome?

Back 11

-Locked-In Syndrome
-Patient is aware and awake
-Cannot move or Communicate due to complete paralysis of nearly all voluntary muscles in the body except for the eyes

Front 12

What is the Internal Capsule? What does it contain?

Back 12

-Sheet of White Matter Lateral to the Thalamus
-Contains Axons from the Corticospinal Tract (CST)

Front 13

Which artery is responsible for supplying the Internal Capsule?

Back 13

MCA

Front 14

What is the Genu of the Internal Capsule? What are its fibers responsible for?

Back 14

-Bend
-Face

Front 15

What are the Posterior Limb Fibers of the Internal Capsule responsible for?

Back 15

Lower Body

Front 16

-Falx Cerebri
-Falx Cerebelli
-Tentorium Cerebelli

Back 16

-Falx Cerebri
-Falx Cerebelli
-Tentorium Cerebelli

Front 17

Slide 19 - Imaging Vasculature

Back 17

Slide 19 - Imaging Vasculature

Front 18

What are some easy ways to recognize the MCA in an image?

Back 18

-Huge
-Coming off the Internal Carotids
-Going Laterally

Front 19

If an individual has a visual loss due to ischemia in the left occipital lobe, what major artery is likely compromised?

Back 19

Left PCA

Front 20

Slide 24 - Give the Arteries

Back 20

Slide 25 - Answers
-A - MCA
-B - ACA
-C - Internal Carotid
-D - Basilar

Front 21

Given an Image on the final, which side is right and which side is left?

Back 21

Flipped from normal

Front 22

MRI on Slide 26
-Identify Structures
-DON'T BE LAZY, GO LOOK AT THIS YOU PIECE OF SHIT

Back 22

Answers on Slide 27

Front 23

Where is the VPL found? VPL damage results in what type of deficits?

Back 23

-Thalamus
-Interrupts Somatosensory Pathway and may lead to loss of conscious sensation of the contralateral side of the body

Front 24

What is just medial to the Thalamus? Lateral?

Back 24

-3rd Ventricle
-Internal Capsule

Front 25

A stroke involving a Thalamogeniculate Artery will result in what?

Back 25

-Loss of Sensation from the Opposite side of the Body
-Episodes of Spontaneous, Excruciating Pain on the Opposite Side

Front 26

A patient comes in with Paralysis of his right leg and foot. He also has some sensory impairment of leg and foot. Ischemia from which artery could be the cause?

Back 26

Left ACA

Front 27

You are about to see a patient with Ischemia of his ACA. What types of symptoms would you expect to see?

Back 27

-Paraesis or Paralysis of the Contralateral Leg and Foot
-Sensory Impairment Involving the Contralateral Leg and Foot

Front 28

You are told that a patient's motor cortex for his upper body is experiencing ischemia. Which artery supplies this? What about for the lower body?

Back 28

-Upper Body - MCA
-Lower Body - ACA

Front 29

A patient comes in with Paralysis of his left face, hand, arm. He also has some sensory impairment in the same locations. Ischemia from which artery could be the cause?

Back 29

Right MCA

Front 30

If there is an Infarct in the Left Superior Division of the MCA, what can result?

Back 30

Broca's Aphasia
-Expressive Aphasia
-Related to Speech Production

Front 31

If there is an Infarct in the Left Inferior Division of the MCA, what can result?

Back 31

Wernicke's Aphasia
-Receptive Aphasia
-Related to Interpretation of Speech

Front 32

What is Broca's Aphasia? An Infarct in which artery can lead to Broca's Aphasia?

Back 32

-Expressive Aphasia
-Difficulty saying what you want to say
-Dysarthria - Slow, Labored Speech
-Superior Division of Left MCA

Front 33

What is Wernicke's Aphasia? An Infarct in which artery can lead to Wernicke's Aphasia?

Back 33

-Receptive Aphasia
-Deficit of Auditory Comprehension
-Cannot monitor their own conversation
-Inferior Division of Left MCA

Front 34

A patient comes in with slow, dysarticulated speech. Their words are slurred and they are aware of their problem. What's wrong? Infarct of what artery may have caused this?

Back 34

-Broca's (Expressive) Aphasia
-Superior Division of Left MCA

Front 35

A patient comes in with a deficient of auditory comprehension. They cannot monitor their conversation and they are unaware of their problem. What's wrong? Infarct of what artery may have caused this?

Back 35

-Wernicke's (Receptive) Aphasia
-Inferior Division of Left MCA

Front 36

What is Gerstmann's Syndrome? How does it result? Which artery is involved? Where in the brain? What are some symptoms?

Back 36

-Lesion to Dominant (usually Left) Posterior Association Area
-Left MCA
-Parietal Lobe
-Finger Agnosia
-Agraphia (can't write)
-Alexia (can't read)
-Agnosia (can't synthesize, correlate, or recognize multisensory perceptions)
-Dyscalculia (problems with numbers)

Front 37

A patient has a lesion to their Left Posterior Association Area in their Parietal Lobe. They exhibit finger agnosia, agraphia, alexia, agnosia, and dyscalculia. How old is Tom.

Back 37

7

Front 38

A patient has a lesion to their Left Posterior Association Area in their Parietal Lobe. They exhibit finger agnosia, agraphia, alexia, agnosia, and dyscalculia. What syndrome might they have?

Back 38

Gerstmann's Syndrome

Front 39

If a patient has language problems, what artery is likely affected? On which side? Why?

Back 39

-MCA
-Dominant (Usually Left)
-Dominant side contains Language association areas

Front 40

What will damage to the Posterior Association of the Dominant side lead to? Nondominant side?

Back 40

-Gerstmann's Syndrome
-Hemineglect, Constructional Apraxia (drawing), Awareness of Body Image, Anosognosia (Denial or lack of awareness that there is anything wrong)

Front 41

You are told that a patient has a Problem with their Posterior Assocation Area in their Parietal Lobe on their nondominant side. Which artery is likely involved? What symptoms might you see?

Back 41

-Right MCA
-Hemineglect
-Constructional Apraxia
-Disturbances in the Awareness of the Body Image
-Anosognosia - Denial or lack of awareness that there is anything wrong

Front 42

Which artery provides Blood Supply to the Pons?

Back 42

Superior Cerebellar Arteries

Front 43

Which arteries provide Blood Supply to the Medulla?

Back 43

-Anterior Spinal Artery
-Posterior Inferior Cerebellar Arteries

Front 44

What does the Corticospinal Tract (CST) do? Above the Caudal Medulla, what side?

Back 44

-Controls Body Movement
-Contralateral

Front 45

What does the Dorsal Column Medial Lemniscus (DCML) do? Above the Caudal Medulla, what side?

Back 45

-Fine touch, proprioception, vibration--Contralateral

Front 46

What does the Spinothalamic Tract (STT) do? Above the Caudal Medulla, what side?

Back 46

-Crude touch, pain, and temperature
-Contralateral

Front 47

Look at Slide 46 for Rostral Medulla Locations of:
-STT
-DCML
-CST
-CN VIII
-CN IX
-CN X
-CN XII

Back 47

GO FUCKING LOOK

Front 48

Where does the Vestibulocochlear Nerve (CN 8) emerge from?

Back 48

-Caudal Medulla on the Dorsal Side

Front 49

Where does the Glossopharyngeal (CN 9) emerge from?

Back 49

-Caudal Medulla on the Lateral Side
-Comes out near the Vagus Nerve (CN 10) and the STT

Front 50

Where does the Vagus Nerve (CN 10) emerge from?

Back 50

-Caudal Medulla on the Lateral Side
-Comes out near the Glossopharyngeal Nerve (CN 9) and the STT

Front 51

Where does the Hypoglossal Nerve (CN 12) emerge from?

Back 51

-Caudal Medulla on the Ventrolateral Side
-Fibers run along the Medial Lemniscus
-Emerge near the CST

Front 52

Which artery supplies the Medial Medulla?

Back 52

ASA

Front 53

If the Anterior Spinal Artery was occluded, which Spinal Tracts would be affected? Which side would the patient experience problems??

Back 53

-DCML and CST
-Contralateral Side

Front 54

What the fuck does the Hypoglossal Nerve (12) do?

Back 54

Muscles of the Tongue

Front 55

A Patient comes in with tongue problems. They've been experiencing these problems for a long time and the muscles on the right side of their tongue seem to atrophied. The patient tells you that the problems started initially with paralysis of the right side of the tongue. What is the problem? Where? Which artery could be Involved?

Back 55

-Hypoglosal Nerve Nucleus or Tract Lesion
-Medulla
-Anterior Spinal Artery

Front 56

What is Medial Medullary Syndrome? How does it Occur? What is affected? What results?

Back 56

-Problems with Medial Medulla
-Anterior Spinal Artery Occlusion
-Hypoglossal Nucleus or Nerve - Paralysis an Eventual Atrophy of the Tongue Ipsilateral to the Lesion
-CST (Medullary Pyramids) - Paralysis of Contralateral Arm and Leg
-Medial Lemniscus - Loss of Tactile Sense and Proprioception from Contralateral Arm and Leg

Front 57

Which tracts are affected by Medially Medullary Syndrome? Which ones are not? What does this mean?

Back 57

-Hypoglossal Nerve, DCML, CST
-SST
-Patient will still have crude touch, pain, and temperature sensation

Front 58

What is another name for Lateral Medullary Syndrome?

Back 58

Wallenburg Syndrome

Front 59

What is another name for Wallenburg Syndrome?

Back 59

Lateral Medullary Syndrome

Front 60

What is Horner's Syndrome? How can it result? What other stuff happens? What artery could cause this?

Back 60

-Loss of Pupil Dilation on Ipsalateral Side
-Due to Descending Sympathetic Fibers being hit
-Miosis, Ptosis, Anydrosis
-PICA

Front 61

A patient comes in with ptosis, miosis, and lack of sweating (anhydrosis). What is wrong? Which nerve fibers are involved? What artery is likely involved?

Back 61

-Horner's Syndrome
-Descending Autonomic Sympathetics on Ipsalateral Side
-PICA

Front 62

What is the Nucleus Ambiguas? Where is found?

Back 62

-A Motor Nucleus for CN9 and CN10
-Medulla - Next to STT

Front 63

A patient has a Dysphagia, Dysarthia, and loss of gag reflex on the right side. Which cranial nerve(s) and nucleus/nuclei are involved? Which other tract might be involved due to its close proximity?

Back 63

-CN9 and CN10
-Nucleus Ambiguas
-STT

Front 64

A patient is experiencing hearing loss. Which cranial nerve is affected? Which artery might be involved?

Back 64

-CN8 - Vestibulocochlear
-AICA

Front 65

Where does the Trigeminal Nerve (CN 5) Emerge?

Back 65

Lateral Pons

Front 66

Where does the Abducens Nerve (CN 6) Emerge?

Back 66

Ventromedial Pons

Front 67

Where does the Facial Nerve (CN 7) Emerge?

Back 67

Lateral Pons

Front 68

What does the Abducens Nerve (CN 6) do?

Back 68

Motor Innervation to Lateral Rectus

Front 69

LOOK AT SLIDE 51 for CN V, VI, VII, and VIII

Back 69

GOOOOOOO

Front 70

What are some things that can cause Locked-In Syndrome? In the Pons, what is Hit? What is Spared?

Back 70

-Bilateral Ventral Pontine Infarcts, Central Pontine Myelinolysis
-Hit - CST, Lower Corticobulbar, Abducens
-Spared - Medial Lemniscus, STT, Spinal Trigeminal, Facial Motor

Front 71

What is Central Pontine Myelinolysis? What can you notice on an MRI? What types of patients is it often associated with?

Back 71

-Demyelinating Condition associated with Rapid Correction of Hyponatremia
-Dark "I" in the Pons
-Alcoholics, Malnourished, Transplant Patients

Front 72

Lesion to the Facial Motor Nucleus or Nerve. What Results?

Back 72

Paralyzed Ipsalateral Face

Front 73

Lesion to the Abducens Nerve and Lateral Gaze Center. What Results?

Back 73

-Paralyzed Ipsalateral Eye with Loss of Lateral Gaze
-Loss of Ispalateral Conjugate Gaze

Front 74

Lesion to the Medial Lemniscus that extends Anteriorly. Lesion is above the Caudal medulla. What Results?

Back 74

Loss of FIne Touch, Bivration, and Proprioception from CL body

Front 75

Lesion to the STT that extends medially and laterally. Lesion is above the caudal medulla. What Results?

Back 75

Loss of Paint and Temp from CL Face and Body

Front 76

Lesion to the main Trigeminal Nucleus that extends rostrally. What Results?

Back 76

Loss of Fine touch and Vibration of Ipsalateral Face

Front 77

Lesion to the Spinal Trigeminal Tract that extends laterally. What Results?

Back 77

Loss of Pain and Temp from Ipsalateral Face

Front 78

What is Nystagmus?

Back 78

Involuntary Eye Movement

Front 79

What is Involuntary Eye Movement known as?

Back 79

Nystagmus

Front 80

Lesion to Vestibular Division of CN8.

Back 80

-Vertigo
-Nystagmus

Front 81

Lesion to Cochlear Division of CN8.

Back 81

-Tinnitus
-Hearing Loss

Front 82

Lesion to Facial Nerve.

Back 82

-Facial Weakness
-Loss of Taste Sensation, Salivation, and Tearing,

Front 83

Go Look at Slide 56!
-CST
-Trochlear Nerve (CN 4)
-Occulomotor Nerve (CN 3)

Back 83

-3 Comes out Anteriorly
-4 Crosses and goes Posteriorly

Front 84

What the fuck does the Occulomotor Nerve do?

Back 84

-Parasympathetics - Pupillary Sphincter and Ciliary Muscles
-Eye Muscles

Front 85

What does the Trochlear Nerve do?

Back 85

Superior Oblique Muscle

Front 86

Where is the lesion site for Weber Syndrome? What happens?

Back 86

-Oculomotor Nerve Palsy
-Contralateral Hemiparesis or Hemiplegia

Front 87

A patient comes in with a Right Oculomotor Nerve Palsy. They also have Contralateral Hemiparesis or Hemiparesis. What do they have?

Back 87

Weber Syndrome

Front 88

Parinaud Syndrome Lesions. What results?

Back 88

-Compression on Posterior Midbrain
-Vertical Gaze Center - Loss of Vertical Gaze, Eyes deviate downward
-Vergence Center - Nystagmas on Eye Convergence
-Posterior Commissure and Tectum - Loss Pupillary light of response, possibly with accomodation intact

Front 89

A patient comes in with loss of vertical gaze. They exhibit nystagmous on eye convergence. They also have lost their pupillary light response. What's wrong with them?

Back 89

Parinaud Syndrome

Front 90

Meninges

Back 90

Bad ass

Front 91

Look at slide 62 for hematomas

Back 91

Look at slide 62 for hematomas

Front 92

Describe an Epidural Hematoma.

Back 92

-Lens Shaped - Doesn't follow brain
-Middle Meningeal Artery

Front 93

Describe a Subdural Hematoma.

Back 93

-Crescent Shaped - Follows Brain
-Tearing of the Bridging Veins

Front 94

Describe a Sub-Arachnoid Hematoma.

Back 94

-"Worst Headache of my Life"
-Blood from Arteries within Pial Membrane
-Caused by Head Trauma or Aneurysm

Front 95

A patient comes in with a Texaco Star shaped pattern in their MRI of brain. What the fuck is going on?

Back 95

Sub-Arachnoid Hematoma

Front 96

A patient has CSF displaced into the spinal canal, blood volume is reduced in the brain, displacement of brain tissue

Back 96

Intracranial Mass

Front 97

What is CPP?

Back 97

That stupid class people took

Front 98

What is CPP? How is it calculated?

Back 98

-Cranial Perfusion Pressure
-CPP = MAP (Mean Arterial Pressure) - ICP (Intracranial Pressure)

Front 99

What are the 2 major classes of herniation?

Back 99

Based on Tentorial Notch
-Supratentorial
-Infratentorial

Front 100

What is indicated by RBCs in the CSF? WBCs?

Back 100

-Subarachnoid Hematoma or Traumatic Spinal Tap
-Infection

Front 101

A patient comes in and complains of head pain. You take a CSF sample and that shit looks cloudy. What do you suspect?

Back 101

Bacterial Meningitis

Front 102

What are the Non-Neuronal Cells in the PNS? What do they do?

Back 102

-Satellite Cells - Support Cell Bodies
-Schwann Cells - Secrete Neurotrophic Factors

Front 103

What are the Non-Neuronal Cells in the CNS? What do they do?

Back 103

-Oligodendrocytes
-Astrocytes
-Microglia - Scavengers
-Ependymal - Form Barrier between Compartment

Front 104

What does the CST do? Where are its Neurons? Describe the Path. Look at Slide 77 for location of tracts.

Back 104

-Motor
-UMN - In Motor Cortex, Crosses over at Caudal Medulla
-LMN - Cell Body is in the Anterior Horn of the Spinal Cord

Front 105

What happens with an UMN Lesion of the Hypoglossal Nerve? What happens with an LMN Lesion of the Hypoglossal Nerve? What does this mean?

Back 105

-Contralateral Atrophy and Deviation
-Ipsalateral Atrophy
-UMN Crosses

Front 106

Where are the Cell bodies of LMNs located?

Back 106

Anterior Horn of the SC

Front 107

What are Alpha Motor Neurons? Why are they called Alpha Motor Neurons?

Back 107

-LMNs
-Alpha Fibers are found on LMNs

Front 108

What is a Fasciculation? What causes it?

Back 108

-Spontaneous Firing of a Motor Neuron
-LMN dying

Front 109

What is a Deep Tendon Reflex?

Back 109

Stretch Reflex

Front 110

What happens with a LMN Lesion to Deep Tendon Reflexes? What happens with an UMN Lesion?

Back 110

-LMN - Hyporeflexia or Areflexia due to broken reflex circuit
-UMN - Hypereflexia

Front 111

Muscle Spindle
-What happens when muscle is stretched?
-What happens when muscle is contracted?

Back 111

-AP Frequency Increases
-Alpha + Gamma Neuron Coactivation (Tightens Spindle to continue detection)

Front 112

What types of shit will you see with an UMN if its Acute? Chronic?

Back 112

-Acute - Flaccid Paralysis
-Chronic - Hyperreflexia

Front 113

What is a Clonus?

Back 113

Rapid Alternating Contraction/Relaxation of a stretched muscle

Front 114

What is Clasp Knife Rigidity? How does it work? What time of damage might be suspected?

Back 114

-Describes resistant to passive movement of a joint when spasticity is present
-Muscles first resistant to the Movement (due to increased DTR)
-Resistance melts away rapidly (GTO-based reflex kicks in)
-Chronic UMN Damage

Front 115

If a patient comes in and has a tough time initially moving their muscles that slowly melts away, what is this called? What type of damage would you expect?

Back 115

-Clasp Knife Rigidity "Spastic Catch"
-Chronic UMN damage

Front 116

What is ALS? What happens in ALS? What are some symptoms? Who is typically affected?

Back 116

-Amyotrophic Lateral Sclerosis
-Progressive Degeneration of CSTs and Alpha Motor Neurons (Both UMNs and LMNs)
-Symmetric gait disturbance, limb weakness, change in reflexes
-Older patients

Front 117

You have a new patient who is older. He complains of symmetric gait disturbance, limb weakness, and change in reflexes. He also has dysarthia and dysphagia with respiratory complications. What do you suspect?

Back 117

Amytrophic Lateral Sclerosis (ALS)

Front 118

Describe an Epidural Hematoma.

Back 118

-Lens Shaped
-Doesn't go into Grooves
-Tearing of Middle Meningeal Artery

Front 119

Describe a Subdural Hematoma.

Back 119

-Tearing of the Bridging Veins
-Crescent-Shaped
-Follows grooves of brain

Front 120

Describe a Sub-Arachnoid Hematoma

Back 120

-"Worst headache of my life"
-Blood in the CSF
-Arteries within the Pial Membrane

Front 121

What are the major causes of Neuropathy?

Back 121

-Diabetes
-Alcohol

Front 122

What is going on In Guillain-Barre Syndrome?

Back 122

-Inflammatory Neuropathy
-Acute Paralytic Illness

Front 123

What is a Polyradiculoneuropathy?

Back 123

Neuropathy that affects Nerve Roots

Front 124

What is a Neuropathy?

Back 124

Functional Disturbances and/or pathological changes in the PNS

Front 125

What type of Neuropathy is Carcot-Marie-Tooth Disease? How does a patient present?

Back 125

-Hereditary
-Pes Cavus - High Plantar Arches with Hammer Toes and Atrophy of Foot Muscles
-Stork Leg (Inverted Wine Bottle) due to Weakness/Wasting in Lower Leg and Foot
-Foot Drop and Stepped Gait

Front 126

A patient walks in Pes Caveus (High Plantar Arches and weak foot muscles), weak legs, and their foot looks like an inverted wine bottle (Stork Leg). What do they probably have?

Back 126

Charcot-Marie-Tooth Disease

Front 127

What is an Acoustic Neuroma? What symptoms would a patient with this shit have?

Back 127

-Vestibular Schwannoma
-Tinnitus and Hearing Loss

Front 128

Presynaptic Disorders are usually caused by what? What are they characterized by?

Back 128

-Decrease in ability to release NT or Uncontrolled release of NT
-Warm Up Phenomenon

Front 129

You suspect that a patient has a Disorder of NMJ. They exhibit warm up phenomenon which is characterize of what type?

Back 129

Presynaptic

Front 130

Postsynaptic disorders are usually caused by what? What are they characterized by?

Back 130

-Decrease in Availability of ACh on Motor Endplate
-Fatigueability

Front 131

What causes Lambert-Eaton Myasthenic Syndrome (LEMS) ? What are the symptoms associated with it? What is the treatment for it?

Back 131

-Prevents Calcium entry and NT Release
-Autoimmune Disorder - Abs against VCCCs
-Symptoms - Muscle weakness, fatigue, diminished reflexes, autonomic dysfunctions
-Treatment - Plasmaphoresis to remove IgGs, suppress immune system, treat tumor

Front 132

You are told about a patient who has a difficult time with calcium entry and NT release. He was muscle weakness and fatigue.

Back 132

LEMS - Lambert-Eaton Syndrome

Front 133

What type of disorder is LEMS? What about is Myasthenia Gravis?

Back 133

-Presynaptic
-Postsynaptic

Front 134

What the fuck is going on in Myasthenia Gravis?

Back 134

-Muscle Weakness
-Due to Abs against AChR Receptos
-Increased Degradation of Receptors

Front 135

A patient produces Abs to his ACh Receptors. What disorder does he have?

Back 135

Myasthenia Gravis

Front 136

At what level do CN 3 and 4 emerge? Which side? Which side do they Innervate?

Back 136

-Midbrain
-3 - Anterior, Ipsalateral
-4 - Posterior, Contralateral

Front 137

Which Cranial Nerve Emerges at the Level of the Midbrain and does Contralateral Innerveration

Back 137

Trochlear Nerve (CN 4)

Front 138

What are the only 2 Cranial Nerves that do Contralateral Innervation?

Back 138

Optic and Trochlear

Front 139

Which Cranial Nerves Emerge at the Level of the Pons?

Back 139

5, 6, 7 (maybe 8)

Front 140

Which Cranial Nerves Emerge at the Level of the Medulla?

Back 140

9, 10 , and 12

Front 141

What is the Edinger Westphal Nucleus? Where is it found?

Back 141

-Parasympathetic Nucleus for CN III
-Medial to the Occulomotor Nucleus in the Midgrain

Front 142

What is the Parasympathetic Nucleus for the Occulomotor Nerve? Where is found?

Back 142

-Edinger-Westphal Nucleus
-Midbrain

Front 143

Where is the Abducens Nucleus located?

Back 143

Medial Pons

Front 144

Where is the Nucleus Ambiguus? Which Cranial Nerves are involved?

Back 144

-Medial Medulla
-9 and 10

Front 145

Where is the Nucleus of the Solitary Tract? Which Cranial Nerves are involved?

Back 145

Sensory Nucleus of 8, 9, and 10

Front 146

What is the Nucleus that controls sensory innervation of 8, 9, and 10?

Back 146

Nucleus of Solitary Tract

Front 147

Which nucleus is responsible for parasympathetic innervation of CN 9 and 10?

Back 147

Nucleus Ambiguus

Front 148

What types of Symptoms would you expect with a Cranial Nerve 4 Lesion?

Back 148

-Difficulty walking down steps
-Double Vision
-Come in with a head tilt

Front 149

A patient comes in with double vision, head tilted, difficulty walking down steps. What do you suspect?

Back 149

Trochlear Nerve Lesion

Front 150

What types of Symptoms would you expect with a CN III Compression?

Back 150

-Eye Down and Out - Can't counter Lateral Rectus and Superior Oblique
-Dilated Pupil - Loss of Parasympathetics
-Eyelid Droop

Front 151

A patient comes in with their left eye looking down and out and it stuck in this position. Their pupils are dilated, and their eyelid is drooped. WTF is going?

Back 151

CNIII Compression

Front 152

Which Cranial Nerves are responsible for taste sensation?

Back 152

-Glossopharyngeal Nerve (9) - Posterior 1/3 of Tongue
-Facial Nerve (7) - Anterior 2/3 of Tongue

Front 153

Which Cranial Nerve is responsible for Taste Sensation to the Posterior 1/3 of the Tongue?

Back 153

Glossopharyngeal Nerve 9

Front 154

Which Cranial Nerve is responsible for Taste Sensation to the Anterior 2/3 of the Tongue?

Back 154

Facial Nerve 7

Front 155

What would you expect to happen due to a CN III Lesion?

Back 155

-Eye would be Down and Out (ABducted)
-Ptosis
-Pupil Dilation

Front 156

A patient has a dilated and unresponsive pupil What is this a sign of?

Back 156

Occulomotor Nerve Compression

Front 157

Which Cranial Nerve is most susceptible to problems due to increased ICP?

Back 157

Abducens Nerve (CN6)

Front 158

Describe the function of the MLF during looking left.

Back 158

The Left Abducens Nuclei causes the Left Lateral Rectus to ABduct. Fibers from the right MLF (named for where it goes) connect to the right Occulomotor Nerve which causes the Right Medial Rectus to ADduct.

Front 159

What is found in the PPRF (Paramedian Pontine Reticular Formation)?

Back 159

Abducens Nucleus and MLF

Front 160

If the Right MLF is damaged, what would you expect? What is this called?

Back 160

-Loss of Conjugate Eye movement. The Right eye cannot ADduct.
-INO

Front 161

What is INO (Internuclear Opthalmoplegia)? How does it happen?

Back 161

-DIsorder of Conjugate Gaze
-MLF Lesion

Front 162

A dinosaur walks into your office. He tells you that all of his internal anatomy above his head is human. He has a difficult time looking at you (down and in). What do you suspect?

Back 162

Trochlear Nerve Lesion

Front 163

What is responsible for Voluntary Saccades? Which side?

Back 163

-Frontal Eye fields and Superior Colliculi
-Contralateral

Front 164

What is a saccade?

Back 164

quick, fast eye tracking like

Front 165

Voluntary Saccades

Back 165

Contralateral FEF

Front 166

What is the Vestibulo-Ocular (VOR) Reflex? What function does it serve?

Back 166

-Vestibular Nuclei Input
-Generates Eye Movements Equal and Opposite to Head Movements
-Keeps Images steady during head movement?

Front 167

What reflex helps us keep images steady during eye movement? How?

Back 167

-VOR (Vestibulo-Ocular Reflex)
-Generates Eye Movements Equal and Opposite to Head Movements

Front 168

You brush a patients eye with a q-tip. What happens? What is this reflex called?

Back 168

-Corneal Reflex
-Sensory - Opthalmic Division (V1) of the Trigeminal Nerve (V)
-Motor - Branch of Facial Nerve (VII) which causes contraction of the orbicularis Oculi muscles

Front 169

Describe the Corneal Reflex.

Back 169

-Sensory - Opthalmic Division (V1) of the Trigeminal Nerve (V)
-Motor - Branch of Facial Nerve (VII)

Front 170

What is Bells Palsy? How does it happen? How might it happen?

Back 170

-Loss of Muscles of Facial Expression
-Facial Nerve
-HSV-1

Front 171

Patient has loss of muscles of facial expression. What might they have? What is this caused by?

Back 171

-Bell's Palsy
-Facial Nerve

Front 172

What results from a UMN Lesion of the Facial Nerve? Why? What about a LMN lesion?

Back 172

-Contralateral Effects on the Lower Quadrant only - Upper Quadrant is controlled bilaterally from the cortex
-Ipsilateral Effects

Front 173

What are the shared functions of Glossopharyngeal and Vagus Nerves?

Back 173

Speech and Swallowing

Front 174

Which 2 Nerves are Involved in the Gag Reflex? Which Nucleus?

Back 174

-9 and 10
-Nucleus Ambiguus

Front 175

What is the DCML responsible for? Go through all the neurons.

Back 175

-1 - Dorsal Root Ganglion, Ascend in the Fasciculus Gracilis
-2 - Nucleus Gracilis in the Caudal Medulla, Internal Arcuate
-3 - VPM of Contralateral Thalamus. Projects to the SS Cortex

Front 176

LOOK at SLIDE 140 for DCML!!!!!

Back 176

GOOOOOOO

Front 177

What is the Romberg Test?

Back 177

Close eyes, see if they fall

Front 178

What causes a positive Romberg test?

Back 178

DCML problem

Front 179

Describe the STT Neurons.

Back 179

-1 - Dorsal Root Ganglion. Goes up or down a 1-2 levels
-2 - Dorsal Horn of SC. Cross at Anterior White Commissure, Ascend in CTT
-3 - VPL of Contralateral Thalamus, projects to Contralateral SS Cortex

Front 180

What is the DCML responsible for? Go through all the neurons.

Back 180

-1 - Dorsal Root Ganglion, Ascend in the Fasciculus Gracilis
-2 - Nucleus Gracilis in the Caudal Medulla, Internal Arcuate
-3 - VPM of Contralateral Thalamus. Projects to the SS Cortex

Front 181

LOOK at SLIDE 140 for DCML!!!!!

Back 181

GOOOOOOO

Front 182

What is the Romberg Test?

Back 182

Close eyes, see if they fall

Front 183

What causes a positive Romberg test?

Back 183

DCML problem

Front 184

Read Slide 158

Back 184

No Sympathetics in the brain. Come from lower. Pupil Dilation is Sympathetic. Patient will have Miosis (Pupil Constriction)

Front 185

What is Horner Syndrome?What are some symptoms?

Back 185

-Damage to Sympathetic Out-flow to the face.
Loss of Sweating
Pupil Constriction
Lid Droop

Front 186

What is Syringomyelia? What are some typical findings?

Back 186

-Damage to Central Cavity of SC
-Bilateral loss of Pain and Temperature Sensation - Due to STT crossing at Anterior White Commissure

Front 187

What does the Basal Ganglia do?

Back 187

Selection and Suppression of Movements

Front 188

How does the Basal Ganglia Increase Motor Output?

Back 188

-DIrect Pathway
-Decreases Basal Ganglia Output
-Increases Thalamic Activity

Front 189

How does the Basal Ganglia Decrease Motor Output?

Back 189

-Indirect Pathway
-Increases Basal Ganglia Output
-Decreases Thalamic Activity

Front 190

What is the Basal Ganglia's effect on the Thalamus?

Back 190

Inhibitory

Front 191

What goes wrong in Parkinsons? What are some symptoms?

Back 191

-Loss of Da Producing Neurons in Substantia Nigra
-Parkinson's patients are TRAPD
-Tremor (resting)
-Rigidity
-Akinesia (Hypokinesia, Bradykinesia)
-Posteral Instability (Flexed Posture, Festinating Gate)
-Dementia

Front 192

A patient exhibits all of the following. What do they have?
-Tremor (resting)
-Rigidity
-Akinesia (Hypokinesia, Bradykinesia)
-Posteral Instability (Flexed Posture, Festinating Gate)
-Dementia

Back 192

Parkinson's

Front 193

Which pathway is disrupted in Parkinson's? What types of Neurons?

Back 193

-Nigro-Striatal Pathways
-Dopamine Neurons

Front 194

Drug Induced Parkinsons involved what drug?

Back 194

MPTP - Synthetic Heroine COntaminant

Front 195

What is Huntington's Disease? How does it result? What are its effects?

Back 195

-Inherited disease of the CNS
-Degeneration of the Caudate and Putamen
-Progressive Dementia and Involuntary Choreic Movements

Front 196

What causes the Dementia in Huntingtons?

Back 196

Degeneration of Neurons in the Cerebral Cortex

Front 197

What causes the Chorea in Huntingtons?

Back 197

Degeneration of the Basal Ganglia

Front 198

Patient has Dementia, Cognitive Personality Changes, and Chorea. What the fuck is their problemsssss?

Back 198

Huntingtons

Front 199

What will the brain of a Huntington's patient look like?

Back 199

Decreased Caudate, Putamen, and Cerebral Volume with Increased Ventricles

Front 200

What is Hemiballismus? What causes it?

Back 200

-Unintentional, Forceful Flinging Movements of the arms and leg
-STN Hit

Front 201

What is Unintentional, Forceful Flinging Movements of the arms and leg?

Back 201

Hemiballismus

Front 202

STN Hit + Unintentional Forceful flinging movements = what?

Back 202

Hemiballismus

Front 203

What is Dystonia?

Back 203

-Persistence of a Postural Abnormality
-Sustained Posture or Position of any part of the boyd

Front 204

What is Wilson Disease a disorder of? What is affected? What is its hallmark? What can result?

Back 204

-Disorder of Copper Metabolism
-Affects Brain and Liver
-Kayser-Fleischer Ring (Copper Colored Ring) around the Cornea

Front 205

Disorder of Copper Metabolism affecting brain and liver.

Back 205

Wilson Disease

Front 206

What are the Normal functions of the Cerebellum?

Back 206

-Execution of Planned Motor Acts
-Establishes direction, timing, and force of planned motor acts
-Compares intended movements with ongoing movement
-Involved in motor learning

Front 207

Which brain structure is involved in the following:
-Execution of Planned Motor Acts
-Establishes direction, timing, and force of planned motor acts
-Compares intended movements with ongoing movement
-Involved in motor learning

Back 207

Cerebellum

Front 208

If a patient has a cerebellar dysfunction, on which side will their symptoms manifest?

Back 208

Ipsalateral

Front 209

What are some symptoms of Cerebellar Dysfunction?

Back 209

-Intention Tremor
-Disequilibrium - Loss of balance, gate and trunk dystaxia
-Dyssnergia - loss of coordination, nystagmus

Front 210

A patient comes in exhibit all of the symptoms below. Which brain structure might be malfunctioning?
-Intention Tremor
-Disequilibrium - Loss of balance, gate and trunk dystaxia
-Dyssnergia - loss of coordination, nystagmus

Back 210

Cerebellum

Front 211

Which part of the Cerebellum is selectively damaged in alcoholics? What symptoms result?

Back 211

-Vermis
-Gait Ataxia without Limb Ataxia

Front 212

Gait Ataxia without Limb Ataxia

Back 212

Vermis Cerebellum David Wong

Front 213

Monkey

Back 213

Banana

Front 214

Which part of the Cerebellum is selectively damaged in alcoholics? What symptoms result?

Back 214

-Vermis
-Gait Ataxia without Limb Ataxia

Front 215

Gait Ataxia without Limb Ataxia

Back 215

Vermis Cerebellum David Wong

Front 216

Monkey

Back 216

Banana

Front 217

Where in the brainstem do Serotenergic pathways originate from?

Back 217

Raphe Nuclei

Front 218

Where in the brainstem do NE pathways originate from?

Back 218

Locus Ceruleus and Lateral Tegmental Area

Front 219

Where in the brainstem do Dopaminergic pathways originate from?

Back 219

SNc (Substania Nigra Compacta) and VTA (Ventral Tegmental Area)

Front 220

What is an EEG? What does in measure? What types of stuff is it usually used for?

Back 220

-Electroencephalogram
-Cortical Activity
-Sleep States and Seizure evaluation

Front 221

What does a Normal EEG taken from a quiet, awake individual look like?

Back 221

Asynchronous, Low Voltage, Fast Activity

Front 222

How many different stages of sleep are they? How are they characterized on an EEG?

Back 222

-1 - Theta Rhythms
-2 - Sleep Spindles
-3 and 4 - Delta Rhythms
-5 - REM Sleep - Beta Rhythm, which is characteristic of a waking state

Front 223

Which stage (#) is REM sleep? What type of sleep rhythm is seen? What is this characteristic of?

Back 223

-5
-Beta Rhythm
-Waking State

Front 224

In which stage of sleep does dreaming typically occur?

Back 224

REM

Front 225

Why do you only go through all the sleep stages once when you sleep?

Back 225

You usually don't. You usually go through them multiple times since you sleep more than 2 hours a night.

Front 226

Why is REM Sleep called "Paradoxical Sleep"?

Back 226

Because in some ways REM Sleep is deeper than stage 4 sleep but in others it closely resembles the awake state

Front 227

During which stage of sleep is Sleep-Walking typically seen? Which stage (#) is this?

Back 227

-Deep Slow Wave Sleep (SWS)
-3 and 4

Front 228

What are the names of each stage of sleep?

Back 228

-1 - Drowsy Sleep
-2 - Light Sleep
-3 and 4 - Deep Slow Wave Sleep
-5 - REM Sleep

Front 229

What is Insomnia?

Back 229

Can't Sleep or fall asleep

Front 230

What are some causes of Insomnia?

Back 230

-Anxiety, Depression, STRESS, Pain
-Fear of David Wong
-Side effects of meds, alcohol, poor sleep habits
-Disruption of circadian rhythms?
-Age?

Front 231

What are some effects that result from insomnia?

Back 231

-Problems with Memory and Concentration
-Potential Link with CV Disease
-4x Increase in Likelihood of Depression
-Impaired Job and Home Performance

Front 232

A patient exhibits all of the following. What might they be suffering from?
-Problems with Memory and Concentration
-Potential Link with CV Disease
-Depression
-Impaired Job and Home Performance

Back 232

Insomnia

Front 233

What is Obstructive Sleep Apnea? What happens? What can cause it?

Back 233

-Brief Periods of Interrupted Breathing During Sleep
-Woken up all the fucking time during sleep
-Overweight, Heavy Snoring

Front 234

What is Narcolepsy? What causes it?What are some symptoms?

Back 234

-Enter REM SLeep Directly from the Waking State
-Loss of Orexin (Hypocretin)
-EDS - Excessive Daytime Sleepiness
-Cataplexy - Sudden loss of muscle tone in awake state
-Hallucinations while falling or awakening from sleep
-Sleep Paralysis

Front 235

Loss of Orexin can lead to what?

Back 235

Nacrolepsy

Front 236

What is Cataplexy? Which disorder is it associated with?

Back 236

-Sudden Loss of Muscle Tone in awake state
-Narcolepsy

Front 237

What are the Ascending Pathways of the Reticular System Associated with? Descending Pathways?

Back 237

-Attention, Arousal, and Consciousness
-Motor, Reflex, and Autonomic Function

Front 238

Which pathways of the Reticular Formation are associated with the following:
-Attention
-Arousal
-Consciousness

Back 238

Ascending Pathways

Front 239

Which pathways of the Reticular Formation are associated with the following:
-Motor Function
-Reflex Function
-Autonomic Function

Back 239

Descending Pathways

Front 240

What are the Functions of the Reticular Formation?

Back 240

-Activates the Cerebral Cortex (Arousal and Wakefulness)
-Integrates Cranial Nerve Reflexes
-Modulates Pain (Intrinsic Analgesic System)
-Influences Voluntary Movements
-Regulates Autonomic Nuclei
-Integrates Respiration and Sleep

Front 241

Which brain structure is responsible for the following:
-Activates the Cerebral Cortex (Arousal and Wakefulness)
-Integrates Cranial Nerve Reflexes
-Modulates Pain (Intrinsic Analgesic System)
-Influences Voluntary Movements
-Regulates Autonomic Nuclei
-Integrates Respiration and Sleep

Back 241

Reticular Formation

Front 242

What 3 things are involved in consciousness?

Back 242

Alertness
Attention
Awareness

Front 243

What causes the Persistent Vegetative State? What is lacking?

Back 243

-Severe, Diffuse Cerebral Cortical Damage with Brainstem Function Intact ("Cerebral Death")
-No Evidence of awareness, responsiveness, or interaction with environment

Front 244

What the fuck is going on in a Coma? What can cause it?

Back 244

-Unconscious
-NOT Sleep, Fainting/Syncope, Innattention
-Diffuse Axonal Injury

Front 245

What is the Decorticate Posture in Coma? How does it result?

Back 245

-Arms up and chest
-Damage above the Red Nucleus

Front 246

What is the Decerebrate Posture in Coma? How does it result?

Back 246

-Arms down
-Damage below the Red Nucleus - Rubrospinal Tract (Flexor Bias ) is now Offline

Front 247

Based on the information that the Decorticate and Decerebrate postures result from damage above and below (respectively) the red nucleus, what type of shit is the red nucleus likely contain?

Back 247

Descending Motor Pathways

Front 248

What is the Reticulospinal Tract involved in?

Back 248

-Motor Tract
-Feed forward
-Extensor Bias

Front 249

What is the Vestibulospinal Tract involved in?

Back 249

-Motor Tract
-Feedback adjustments
-Arm and Leg Extension Bias
-Damage Seen in Decerebrate Rigidity

Front 250

Which tract is likely cut during Decerebrate position? How do you know this?

Back 250

-Rubrospinal Tract
-Arm and Leg Extension Bias in the Tract
-Dr. Best's slides said so

Front 251

Which tract?
-Motor Tract
-Feed forward
-Extensor Bias

Back 251

Reticulospinal

Front 252

Which tract?
-Motor Tract
-Feedback adjustments
-Arm and Leg Extension Bias
-Damage Seen in Decerebrate Rigidity

Back 252

Vestibulospinal Tract

Front 253

Glasgow Coma Scale

Back 253

-3 - out
-3-8 - Severe Head Injury, Coma
-9-12 - Moderate Head Injury
-13-15 - Mild Head Injury

Front 254

If a patient has absence of Grimacing or Eye Opening, which Cranial Nerves might you suggest a problem with?

Back 254

Afferent 5 (Trigeminal)
Efferent 7 (Facial)

Front 255

If a patient has absence of the Corneal Reflex, which Cranial Nerves might you suggest a problem with?

Back 255

5 and 7

Front 256

If a patient has absence of the Light Reflex, which Cranial Nerves might you suggest a problem with?

Back 256

2 and 3

Front 257

If a patient has absence of the Oculovestibular Response, which Cranial Nerves might you suggest a problem with?

Back 257

3, 4, 6, 8

Front 258

If a patient has absence of their Gag Reflex, which Cranial Nerves might you suggest a problem with?

Back 258

9 and 10

Front 259

Based on the information that the Decorticate and Decerebrate postures result from damage above and below (respectively) the red nucleus, what type of shit is the red nucleus likely contain?

Back 259

Descending Motor Pathways

Front 260

What is the Reticulospinal Tract involved in?

Back 260

-Motor Tract
-Feed forward
-Extensor Bias

Front 261

What is the Vestibulospinal Tract involved in?

Back 261

-Motor Tract
-Feedback adjustments
-Arm and Leg Extension Bias
-Damage Seen in Decerebrate Rigidity

Front 262

Which tract is likely cut during Decerebrate position in coma? How do you know this?

Back 262

-Vestibulospinal
-Arm and Leg Extension Bias in the Tract
-Dr. Best's slides said so

Front 263

Which tract?
-Motor Tract
-Feed forward
-Extensor Bias

Back 263

Reticulospinal

Front 264

Which tract?
-Motor Tract
-Feedback adjustments
-Arm and Leg Extension Bias
-Damage Seen in Decerebrate Rigidity

Back 264

Vestibulospinal Tract

Front 265

Based on the information that the Decorticate and Decerebrate postures result from damage above and below (respectively) the red nucleus, what type of shit is the red nucleus likely contain?

Back 265

Descending Motor Pathways

Front 266

What is the Reticulospinal Tract involved in?

Back 266

-Motor Tract
-Feed forward
-Extensor Bias

Front 267

What is the Vestibulospinal Tract involved in?

Back 267

-Motor Tract
-Feedback adjustments
-Arm and Leg Extension Bias
-Damage Seen in Decerebrate Rigidity

Front 268

Which tract is likely cut during Decerebrate position in come? How do you know this?

Back 268

-Rubrospinal
-Arm and Leg Extension Bias in the Tract
-Dr. Best's slides said so

Front 269

Which tract?
-Motor Tract
-Feed forward
-Extensor Bias

Back 269

Reticulospinal

Front 270

Which tract?
-Motor Tract
-Feedback adjustments
-Arm and Leg Extension Bias
-Damage Seen in Decerebrate Rigidity

Back 270

Vestibulospinal Tract

Front 271

Glasgow Coma Scale

Back 271

-3 - out
-3-8 - Severe Head Injury, Coma
-9-12 - Moderate Head Injury
-13-15 - Mild Head Injury

Front 272

If a patient has absence of Grimacing or Eye Opening, which Cranial Nerves might you suggest a problem with?

Back 272

Afferent 5 (Trigeminal)
Efferent 7 (Facial)

Front 273

If a patient has absence of the Corneal Reflex, which Cranial Nerves might you suggest a problem with?

Back 273

5 and 7

Front 274

If a patient has absence of the Light Reflex, which Cranial Nerves might you suggest a problem with?

Back 274

2 and 3

Front 275

If a patient has absence of the Oculovestibular Response, which Cranial Nerves might you suggest a problem with?

Back 275

3, 4, 7

Front 276

If a patient has absence of their Gag Reflex, which Cranial Nerves might you suggest a problem with?

Back 276

9 and 10

Front 277

If someone shoots cold water in your right ear what normally happens? Due to what reflex? What happens if there is bilateral compromise of the reflex? How is this tested?

Back 277

-Brain thinks you turned your head left
-Eyes move right and then return to middle
-Vestibulo-Ocular Reflex
-Eyes and Head go the same way
-Calorics testing

Front 278

What does Calorics testing test?

Back 278

-VOR
-Water in Ear - Left Ear as example
-Cold Water - Brain interprets as head movement away from cold water (to the right); Eyes move left and then back to midline
-Warm Water - Brain interprets as head movement toward warm water (to the left); Eyes move right and then back to midline

Front 279

What is the normal response to cold water in the left ear? What about warm water?

Back 279

-Cold - Brain thinks you turned your head to the right. Result - Saccade back to left
-Warm - Brain thinks you turned your head to the left. Result - Saccade back to right

Front 280

If 1 Eye does not ADduct on Spontaneous Eye Movements or in response to Reflex Maneuvers, what type of lesion would you suspect?

Back 280

MLF

Front 281

How can you tell the difference between brain death and coma?

Back 281

Presence of Brainstem reflexes

Front 282

What is a Simple Partial Seizure? How do they occur? What are some symptoms?

Back 282

-Small but Local Progress to Generalized Vague Locations
-Aura-Auditory or Visual Hallucinations
-Emotional Experience
-Legs or face may Twitch
-DOES NOT IMPAIR CONSCIOUSNESS

Front 283

How long is conscious lost for in a Simple Partial Seizure?

Back 283

It isn't lost

Front 284

What happens in a Complex Partial Seizure? What is affected? What are some symptoms

Back 284

-ALTERED CONSCIOUSNESS
-Psychomotor or Temporal Lobe
-Sensory, Motor and ANS Symptoms
-Blank stare, Confusion, no recollection of seizure

Front 285

What is the main difference between a Simple and Complex Partial Seizure?

Back 285

Loss of Consciousness in Complex

Front 286

Different types of Generalized Seizures - Describe:
-Absence (petit mal)
-Myclonic
-Tonic Clonic
-Atonic

Back 286

Different types of Generalized Seizures - Describe:
-Absence (petit mal) - Occur in children, last seconds, loss of activity and not responsive
-Myclonic - Large jerky movements
-Tonic Clonic - Alternating Intense Contraction and Relaxation, Hoarse cry out, confused, sore
-Atonic - Drop attacks

Front 287

Which type of Generalized Seizure is described?
1) Alternating Intense Contraction and Relaxation, Hoarse cry out, confused, sore
2) Drop attacks
3) Occur in children, last seconds, loss of activity and not responsive
4) Large jerky movements

Back 287

1) Tonic Clonic
2) Atonic
3) Absence (petit mal)
4) Myclonic

Front 288

What does "Generalized" in Generalized Seizure refer to?

Back 288

-Seizure of both hemispheres
-Not local

Front 289

Where do Sympathetics come off the CNS?

Back 289

T1-L2

Front 290

Where do Parasympathetics come off the CNS?

Back 290

CNS and S2-S4

Front 291

Describe the Preganglionics and Postganglionics in the Sympathetic Nervous System. Length? NT? Synapse?

Back 291

Preganglionics
-Short
-ACh
-In Ganglia

Postganglionics
-Long
-NE (usually)
-Target Organ

Front 292

Describe the Preganglionics and Postganglionics in the Parasympathetic Nervous System. Length? NT? Synapse?

Back 292

Preganglionics
-Long
-ACh
-On Organ

Postganglionics
-Short
-ACh
-Target Organ

Front 293

What NT is typically used in Somatic Motor Neurons? What type of receptor

Back 293

-ACh
-Nicotinic

Front 294

What type of Receptor do Preganglionic Sympathetics act on? Postganglionics?

Back 294

-Preganglionic - Nicotinic
-Postganlgionic - Adrenergic

Front 295

What type of Receptor do Preganglionic Parympathetics act on? Postganglionics?

Back 295

-Preganglionic - Nicotinic
-Postganlgionic - Muscarinic

Front 296

Describe the different components of Urinary Bladder Control and what each one does.

Back 296

-Pontine Micturition Center (via Reticulospinal Tract) - General Coordination, like UMN
-Sympathetic (T10-L2) - Stop Pee
-Parasympathetics (S2-S4) - Pee
-Somatic Motor (S2-S4) - Stop Voluntarily

Front 297

What role does the Pontine Micturition Center play in Urinary Bladder Control? How?

Back 297

-General Coordination, like UMN
-via Reticulospinal Tract

Front 298

What role do Sympathetics play in Urinary Bladder Control? Where do they come from?

Back 298

-Stop Peeing
-T10-L2

Front 299

What role do Paraympathetics play in Urinary Bladder Control? Where do they come from?

Back 299

-Pee
-S2-S4

Front 300

What role do Somatic Motor Fibers play in Urinary Bladder Control? Where do they come from?

Back 300

-Stop Voluntarily
-S2-S4

Front 301

What is Lower Motor Neuron Bladder? What causes it? Why? What results?

Back 301

-Nonreflex or Autonomous Bladder
-Sacral Spinal Cord or Cauda Equina Lesion (Similar to LMN)
-No Parasympathetic to start Peeing
-Urinary Retention - Fills to Max Capacity and then Dribbles
-Overflow Incontinence

Front 302

A patient comes in complaining about peeing. They feel pressure in their bladder and when they pee, they only pee a little bit. What the fuck is going on? Why?

Back 302

Lower Motor Neuron Bladder
-Nonreflex or Autonomous Bladder
-Sacral Spinal Cord or Cauda Equina Lesion (Similar to LMN)
-No Parasympathetics to start Peeing
-Urinary Retention - Fills to Max Capacity and then Dribbles
-Overflow Incontinence

Front 303

What is Upper Motor Neuron Bladder? What causes it? Why? What results?

Back 303

-Autonomic Reflex Bladder
-Loss of Pontine Micturition Center (Similar to UMN Lesion)
-Loss of General Coordination
-Hyperactive Bladder - Empties Reflexively and not completely

Front 304

A patient comes in complaining about peeing. They are peeing all the time but they don't seem to fully empty their bladder. You suspect some type of nerve problem. What would it be?

Back 304

Upper Motor Neuron Bladder
-Autonomic Reflex Bladder
-Loss of Pontine Micturition Center (Similar to UMN Lesion)
-Loss of General Coordination
-Hyperactive Bladder - Empties Reflexively and not completely

Front 305

What would you suspect is wrong in an individual with an Atonic Bladder? How would you treat them?

Back 305

-Spinal Shock Immediately following Injury
-MUST Catheterize

Front 306

What type of Bladder problem is associated with Overflow Incontinence?

Back 306

Lower Motor Neuron Bladder

Front 307

What causes Uninhibited Bladder?

Back 307

-Loss of Cortical Input

Front 308

Describe the Micturation Reflex.

Back 308

1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing
3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes

Front 309

What initiates the Micturation Reflex?

Back 309

Stretch Receptors fire

Front 310

Describe the Micturation Reflex.

Back 310

1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing
3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes

Front 311

In the Micturation Reflex, what happens after stretch receptors are activated?

Back 311

-Parasympathetic Neurons Fire (Pee)
-Motor Neurons Stop

Front 312

In the Micturation Reflex, what happens after Parasympathetic Neurons Fire and Motor Neurons Stop Firing?

Back 312

-Smooth Muscle Contracts the Internal Sphincter and it is passively pulled opne
-External Sphincter Relaxes
-YOU PEE!!!!!

Front 313

What is the main function of the Hypothalamus?

Back 313

Homeostasis

Front 314

What is Leptin? What is its function? What happens when it is lost?

Back 314

-Hormone Produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure
-Obesity, Diabetes, Sterility

Front 315

How could decreased Leptin result in Obesity?

Back 315

-Leptin is produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure
-Loss of Leptin - Eat More, Get Fat

Front 316

Which part of the Hypothalamus is the Heat Dissipation Center?

Back 316

Anterior Hypothalamic Nuclei

Front 317

Which part of the Hypothalamus is the Heat Conservation Center?

Back 317

Posterior Hypothalamic Nuclei

Front 318

What is the function of the Anterior Hypothalamic Nuclei?

Back 318

Heat Dissipation Center

Front 319

What is the function of the Posterior Hypothalamic Nuclei?

Back 319

Heat Conservation Center

Front 320

What might a lesion to the Anterior Hypothalamic Nuclei cause? Why?

Back 320

-Hyperthermia
-Loss of Heat Dissipation Center

Front 321

What might a lesion to the Posterior Hypothalamic Nuclei cause? Why?

Back 321

-Inability to raise core temperature
-Loss of Heat Conservation Center

Front 322

Describe the Micturation Reflex.

Back 322

1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing
3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes

Front 323

What initiates the Micturation Reflex?

Back 323

Stretch Receptors fire

Front 324

Describe the Micturation Reflex.

Back 324

1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing
3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes

Front 325

In the Micturation Reflex, what happens after stretch receptors are activated?

Back 325

-Parasympathetic Neurons Fire (Pee)
-Motor Neurons Stop

Front 326

In the Micturation Reflex, what happens after Parasympathetic Neurons Fire and Motor Neurons Stop Firing?

Back 326

-Smooth Muscle Contracts the Internal Sphincter and it is passively pulled opne
-External Sphincter Relaxes
-YOU PEE!!!!!

Front 327

What is the main function of the Hypothalamus?

Back 327

Homeostasis

Front 328

What is Leptin? What is its function? What happens when it is lost?

Back 328

-Hormone Produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure
-Obesity, Diabetes, Sterility

Front 329

How could decreased Leptin result in Obesity?

Back 329

-Leptin is produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure
-Loss of Leptin - Eat More, Get Fat

Front 330

Which part of the Hypothalamus is the Heat Dissipation Center?

Back 330

Anterior Hypothalamic Nuclei

Front 331

Which part of the Hypothalamus is the Heat Conservation Center?

Back 331

Posterior Hypothalamic Nuclei

Front 332

What is the function of the Anterior Hypothalamic Nuclei?

Back 332

Heat Dissipation Center

Front 333

What is the function of the Posterior Hypothalamic Nuclei?

Back 333

Heat Conservation Center

Front 334

What might a lesion to the Anterior Hypothalamic Nuclei cause? Why?

Back 334

-Hyperthermia
-Loss of Heat Dissipation Center

Front 335

What might a lesion to the Posterior Hypothalamic Nuclei cause? Why?

Back 335

-Inability to raise core temperature
-Loss of Heat Conservation Center

Front 336

Describe the Pupillary Reflex. Neurons/Nerves in the pathway? What is the Direct Reflex? What is the Consensual Reflex?

Back 336

-Constriction of both pupils when light is shone
-Optic Nerve is Sensory --> Projects to Edinger-Westphal Nucleus --> Motor is Occulomotor Nerve
-Direct - Each Pupil constricts when light is shone directly into that eye
-Consensual - each pupil constricts when light is shone into the other eye

Front 337

What is the direct pupillary reflex?

Back 337

Each Pupil constricts when light is shone directly into that eye

Front 338

What is the consensual pupillary reflex?

Back 338

Each pupil constricts when light is shone into the other eye

Front 339

What happens to the Direct and consensual Pupillary Light Reflexes when the Optic Nerve is lesioned?

Back 339

-Direct Reflex - Disappears - No Sensory for the light
-Consensual Reflex - Remains intact since sensory from other eye

Front 340

What happens to the Direct and consensual Pupillary Light Reflexes when the Occulomotor Nerve is lesioned?

Back 340

-Direct Reflex - Lost (Only contralateral eye constricts)
-Consensual Reflex - Lost for same reasons

Front 341

Which Nerve is responsible for hearing? Be specific.

Back 341

Cochlear division of Vestibulocochlear Nerve

Front 342

What is an Acoustic Neuroma? What results?

Back 342

-Schwann Cell Tumor of the COchlear Nerve
-Deafness, Vertigo, nausea, tinnitus, nystagmus

Front 343

What is an Acoustic Neuroma? Which Nerves are affected?

Back 343

-Schwann Cell Tumor of the COchlear Nerve
-Vestibulocochlear (both divisions) and Facial

Front 344

Which Cranial Nerve regulates COmpensatory Eye Movements?

Back 344

Vestibulocochlear Nerve

Front 345

Describe how the Ear recognizes changes in position?

Back 345

-Otolithic Membrane (crystals) respond to gravity
-Connected to the Utricle via the Macula
-Deflection of Macula causes Hyperpolarization
-Utricle is sensitive to changes in motion

Front 346

How does the Ear recognizes changes in position?

Back 346

-Otolithic Membrane (crystals) respond to gravity
-Connected to the Utricle via the Macula
-Deflection of Macula causes Hyperpolarization
-Utricle is sensitive to changes in motion

Front 347

What allows the Ear to recognize position? Which portion detects Angular Movements? Which portion defects Linear Acceleration?

Back 347

Cochlea
-Semicircular Canals - Angular Acceleration
-Utricle and Saccule - Linear Acceleration

Front 348

A patient is experiencing disequilibrium, vertigo, and nystagmus. Which cranial nerve might have a lesion?

Back 348

Vestibulocochlear

Front 349

What are some symptoms that may result from a Vestibulocochlear Nerve Lesion?

Back 349

Disequilibrium
Vertigo
Nystagmus

Front 350

What is Conductive Hearing Loss? What can cause it?

Back 350

-Problems that impair the ability of vibrations to reach the organ of corti
-Middle Ear Infection, Obstruction

Front 351

What is Sensorineural Hearing Loss? What can cause it?

Back 351

-Problems that impair the ability of the hair cells or the cochlear nerve to respond
-Damage from Noise Exposure, Vestibulocochlear Nerve Tumor, Degeneration of Hair Cells

Front 352

What is Central Hearing Loss?

Back 352

-Lesion of Primary Auditory Cortex or Wernicke's Area

Front 353

Describe the Weber Test? What happens with Conductive Loss? What about Sensorineural Loss?

Back 353

-Tuning fork on head
-Lateralizes Hearing problems
-Conductive - The bad ear is louder because conductive problem masks ambient noise in room
-Sensorineural - The good ear is louder because it can't be detected in the bad ear

Front 354

Describe the Weber Test? What happens with Conductive Loss? What about Sensorineural Loss?

Back 354

-Tuning fork on head
-Lateralizes Hearing problems
-Conductive - The bad ear is louder because conductive problem masks ambient noise in room
-Sensorineural - The good ear is louder because it can't be detected in the bad ear

Front 355

Describe the Rinne Test. How does it work? What happens with Conductive Loss? What about Sensorineural Loss?

Back 355

-Compares Air Conduction vs. Bone Conduction in an ear
-Conductive - Good Ear AC >BC, Bad Ear BC > AC because it can't be conducted normally
-Sensorineural Loss - AC > BC for both

Front 356

Describe the Rinne Test. How does it work? What happens with Conductive Loss? What about Sensorineural Loss?

Back 356

Describe the Rinne Test. How does it work? What happens with Conductive Loss? What about Sensorineural Loss?

Front 357

Increases in Engolymph.

Back 357

Affects Vestibular and Cochlear Systems

Front 358

What is Meniere's Disease? What symptoms result?

Back 358

-Increased Pressure in the Membranous Labyrinth of the Ear
-Hearing Loss and Vertigo

Front 359

Which disorder results in increased pressure in the membranous labyrinth of the ear? What symptoms result?

Back 359

-Meniere's Disease
-Hearing Loss and Vertigo

Front 360

What is Dementia? How is it characterized? How can you tell the difference between Dementia and Delirium?

Back 360

-"Deprived of ind")
-Serious loss of cognitive ability in a previously-unimpaired person, beyond what might be expected from normal aging
-Slow Insidious Onset and Progressive Course
-Dementia - Patient can cell whats going on; Delirium - cannot

Front 361

What is Delirium?

Back 361

-Fluctuating Consciousness and Impaired Attention
-Acute Onset

Front 362

How is Dementia due to Normal Pressure Hydrocephalus treated?

Back 362

-Shunt to divert CSF
-Reverse Dementia
-DUH

Front 363

What type of disorder is Alzeheimer's? What are its major features? How is it diagnosed?

Back 363

-Neurodegenerative Disorder
-Progressive Memory Impairment, Disordered Cognitive Function, Altered Behavior, Progressive Decline in Language Function
-Sufficient Numbers of Plaques and Tangles

Front 364

A patient exhibits Progressive Memory Impairment, Disordered Cognitive Function, Altered Behavior, and Progressive Decline in Language Function. What the fuck is wrong with them?

Back 364

They are either:
A) A Cubs Fan
B) Suffer from Alzheimer's Disease

Front 365

What are the Neurofibrillary Tangles in Alzheimer's due to?

Back 365

-Intraneuronal Bundles of Tau Protein

Front 366

Which mutations are commonly associated with Alzheimer's Disease?

Back 366

-APP (Amyloid Precursor) Gene on Chromosome 21
-Presenilin 1 (PS1) Gene on Chromosome 14
-Presenilin 2 (PS2) Gene on Chromosome 1

Front 367

Certain APOE genotypes play a role in Alzheimer's. Which one(s) are protective and which one(s) are risk factors?

Back 367

-Risk Factor - APOE4
-Protective - APOE e2

Front 368

What happens to neurons in AD? Which Neurons?

Back 368

-Selective Loss of ACh Neurons
-From Deep Nuclei in the Septum to Hippocampus and Basal Nucleus of Meynert to the Cerebral Cortex

Front 369

Which neurodegenerative disorder usually exhibits Selective Loss of ACh Neurons from Deep Nuclei in the Septum to Hippocampus and Basal Nucleus of Meynert to the Cerebral Cortex?

Back 369

Alzheimers

Front 370

Compared to Healthy brain, what effects are seen in a brain of an individual with severe AD?

Back 370

Severely enlarged ventricles, cortical, and hippocampal shrinkage

Front 371

You perform a brain scan and your patient shows severely enlarged ventricles and degeneration of the caudate and putamen. What da problem is?

Back 371

Huntingtons

Front 372

What is the general function of the Frontal Lobe?

Back 372

-Personality
-Higher Centers for Voluntary Motor Activities

Front 373

What is the general function of the Parietal Lobe?

Back 373

Peripheral Sensations

Front 374

What is the general function of the Temporal Lobe?

Back 374

-Smell
-Taste
-Hearing

Front 375

What is the general function of the Occipital Lobe?

Back 375

Vision

Front 376

In which lobe of the brain is the primary motor cortex located?

Back 376

Frontal Lobe

Front 377

Which lobe of the brain is responsible for general functions including:
-Personality
-Higher Centers for Voluntary Motor Activities

Back 377

Frontal Lobe

Front 378

In which lobe of the brain is the somatosensory cortex located?

Back 378

Parietal Lobe

Front 379

Which lobe of the brain is responsible for general functions including:
-Smell
-Taste
-Hearing

Back 379

Temporal Lobe

Front 380

Which lobe of the brain is responsible for general visual functioning?

Back 380

Occipital Lobe

Front 381

What the shit do Broca's Area and Wernicke's area play a role in?

Back 381

Language

Front 382

What do the Anterior Cingulate Gyrus, Amygdala, and Hippocampus form together?

Back 382

Limbic Lobe

Front 383

What type of stuff is the Anterior Cingulate Gyrus (Anterior Cingulate Cortex) involved in?

Back 383

Pain

Front 384

What type of stuff is the Amygdala involved in?

Back 384

Anger and Fear Response

Front 385

What type of stuff is the Anterior Hippocampus involved in?

Back 385

Memory and Emotion

Front 386

Which portion of the LImbic Lobe is involved in Pain processing?

Back 386

Anterior CIngulate Gyrus (Anterior Cingulate Cortex)

Front 387

Which portion of the LImbic Lobe is involved in anger and the fear response?

Back 387

Amygdala

Front 388

Which portion of the LImbic Lobe is involved in memory and emotion?

Back 388

Hippocampus

Front 389

What is Sensitization?

Back 389

-Receptors respond more easily - Threshold has decreased
-Respond mot strongly to a given stimulus

Front 390

What is called when receptors respond more strongly to a given stimulus?

Back 390

Sensitization

Front 391

What is Hyperalgesia?

Back 391

Increased response to painful inputs

Front 392

What is Allodynia?

Back 392

Pain resulting from normally non-nocioceptive stimuli

Front 393

What is pain resulting from normally non-nocioceptive stimuli?

Back 393

Allodynia

Front 394

What are some Endogenous Pain Control Mechanisms?

Back 394

-Enkephalinergic Interneurons
-Noradrenergic Projections
-Canniboid Receptors
-Sertonergic Projections
-Endogenous Opiods

Front 395

What is Referred Pain?

Back 395

-Pain of Visceral or Parietal Origin perceived as Somatic Pain
-Somatic Region to which the pain is referred is always a dermatome innervated by the same dorsal roots that supply the irritated structure

Front 396

What types of symptoms will one experience with Normal Pressure Hydrocephalus?

Back 396

Delirium

Front 397

How the heck is Normal Pressure Hydrocephalus normal?

Back 397

Pressure is increased but normalizes