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27 Cards in this Set
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34 year old female
difficulty reading and fatigue pins and needles in left arm, resolved without tx visual field deficits observed mild hyperreflexia noted electrophoresis of csf shows oligoclonal bands defective myelination of the axons in her CNS which are the defective cells? |
oligodendrocytes
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dye injected into lateral ventricles is unable to reach third ventricle. where is the blockage
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foramina of monro
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type 2 dm
loss of sensation in left leg thrombotic occulsin off of which branch of artery in the controlateral cerebral hemisphere would cause this? |
occlusion of anterior cerebral artery
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diplopia worse upon distant vision
inablity to move left eye laterally (abduct) rest of eye movements are normal diagnosed with isolated damage to one of the cranial nerves that control eye ball movements the motor nucleus of the cranial nerve is located where? |
cranial nerve 6
pons |
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pupillary light reaction, which is the preglangionic parasymphathetic neuron that controls the pupillary constriction
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edinger westphal nucleus, in the midbrain, in front of the cerebral aqueduct, below the superior colliculus
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what are the mechanoreceptors in the epidermosy that sense touch and pressure
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merkel cells
meissner corpuslces- position sense, fine touch located in papillary dermis langerhans cells are dendritic cells in the epidermis pacinian corpuscles are deep, detect pressure only end bulbs of krause are in the dermis, detect cold temperature |
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what are sweat glands innerated by
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postganglionic sympathetic cholinergic fibers
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car crash
right sided hemiplegia loss of pain and temp on the left side ct reveals partial transection of the cervical spinal cord at C5 the transection is likely to have involved which |
right lateral half of the spinal cord
this is brown sequard syndrome 1. controlateral loss of pain and temp below the lesion 2. ipsilateral loss of proprioception, vibration below the lesion ipsilateral upper motor neuron lesion signs below the lesion lower motor neorn lesion signs at the lesion- flaccid paralysis |
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the sensory manifestations from the above lesion result from damage to what?
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lateral spinothalamic tract
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49 Yo female
fatigue, difficulty with speech and swallowing muscle spasms occasional constipation/urinary retention physical exam- slurred speech, defective memory and nystagmus sensory responses were poor mri revealed ares of demylination and plaques in the brain stem, basal ganglia and spinal cord she died ten years later a stained sextion is likely to show demyelination where? |
the opitc nerve
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50 year old male, progressive muscle weankness in upper/lower limbs
difficulty iwth speech and swallowing PE reveals muscle wasting and fasciculations and lowered muscle strenght in all extremities upper limb reflexes are absent lower likb reflexes are risk, positive babinskis cranial nerves are intact, no sensory abnormalities detected genetic analysis shows mutation for genes that encode superoxide dismutase, what is the dx? |
ALS
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man had motorcycle accident, lost consciousness immediately
regained consciousness lost consciousness again in the ER skull x ray showed a temporal bone fracture, the symptoms are due to bleeding between the |
dura mater and the calvarium- epidural hematoma
bleeding between dura and arachnoid is subdural hematoma |
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recurrent epidosdes of loss of consciousness.falls to ground, then regains consciousness.
what type of seizure is this? |
atonic
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involuntary twitching of right foot. tonic clonic seizure. where did the seizure originate.
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primary motor cortex on the leftside
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female. weakness in lower limbs
decreased power in muscles of lower limb on both sides normal sensory system csf shows oligoclonal IgG bands mri of spinal cord shows demyelination at t9-t11 levels which tract is affected and where is it on the spinal cord |
lateral corticospinal tract, for desecind voluntary movement of contralateral limbs. located bilaterally next to dorsal horn in the white mater
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recurrent parastheisa, weakness in limbs
temporary blindess in the left eye speech unnafected decreased muscle power and spasticity in the left upper and lower limbs. exaggerated deep tendonr eflexes on the left side and extensor planter response in the left toe cranial nerves are intact except weaknes in the lower lef half of the face. cerebral angiogram would show decreased blood flow where |
right internal carotid artery
mca lesion would damage upper limb motor and sensory cortex, wernickes, and brocas ACA lesion would damage lower limb motor and sensory cortex internal carotid supplies blood to the MCA ACA and lateral striate arteries |
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progressive symmetric muscular weakness in upper extremeties.
difficulty speaking and swalling. spasicity of upper limbs and positive babinski sensory and mental systems are normal whats an additional finding? |
fasciculations of the muscles of the hand, this is ALS which shows UMN and LMN effects
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man has trouble seeing on his right side with either eye.visual acuity is normal. visual field tests shows loss of vision in the right half of the visual fields in both eyes. pupils react to light and accomodate. eye movements are normal. the symptoms of this patient are suggestive of occlusion where?
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posterior cerebral artery
if theres occlusion in posterior communicationg artery you'll see cn 3 nerve palsy |
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woman has sifficulty speaking, chwing and swallowing
has generalized weakness that increases as the day goes on. symptoms improve upon neostigmine admin the autoantibodies resposnible for this conditon are directed against? |
acetocholine receptors, this is myasthenia gravis
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headache, tonic clonic seizures
weakness in left leg weakness in upper left extremity spastic hemi paresis of the left upper and lower extremities increased tone and axaggerated deep tendon reflexes with normal muscle bulk in left extremities cranial nerves are normal skull x ray reveals an area of hyperosteosis mri shows meningioma, the tumor is likely located over the? |
right precentral cortex
post central cortex- sensory precentral cortex is motor prefrontalcortex- orchestrates thoughts and actions |
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50 plus year old male
headache, fatiuge and fever intense, constant headaches localized in the temporal regions associated with diplopia, night sweats, fever and polymyalgia aggrevated by jaw movements. firm nodular, imccopressible and tender temporal arteries that pulsate poorly PE was unremarkable labs show elevated ESR mild anemia and leukocytosis. biopsy of the temporal artery would show? |
granulomatous inlfammation of the media with lymphocytic infiltrate and multinucleated giant cells
this is temporal arteritis |
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chronic alcoholic developed incoordination of gait. confused and disoriented. walked with broad based ataxic gait. severe malnutrition. difficulty performing finger to nose test
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an additional physical finding in the patient would be dysmetria
wernickes encephaloptathy charactiized by ocular disturbances (nystagmus and paralysis of lateral rectus muscle), changes in mental state, unsteady stance and gait (cerebeller dysfunction) korsekoff syndrome- anterograde and retrograde amnesia and one of aphasia, apraxia (can't perform purposful movements), agnosia, or a deficit of executive functions brain atrophy occurs in thalamus, mamillary bodies and third ventricle, floor of fourth ventricle, cerebellum and the frontal lobe |
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stuporous man. abnormal movements of the limbs, urinary incontincen. right pupil unresponsive to flash light. fundus showed bilateral papilledema. absent gag reflex. muscle tone and deep tendon reflexes exaggerated. muscle power decreased on left side but normal on right. where is the lesion
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brainstem
cn 9 and 3 not working pyramidal tracts, corticospinal and corticobulbar not working ataxia |
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white guy, fleeting movement of extremities. unable to sustain motor activity. personality changes- inattention, poor concentration, depression. low mini mental status exam score. marked rigidity in all extremities, normal sensation. mri shows cerebral atropy and very small caudate nuclei. father died of similar illnes. dna likely to show?
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CAG repeats in chr 4- huntingtons dz
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hits his head. six hours later loses consciousness. ct scan shows biconvex shaped mass on left side of the scull. rupture of which artery
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middle meningial artery
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severe headache, sudden onset. elevated blood pressure,depressed breathing and pulse rate. dilaated unresponsive pupils, papilledema. ct scan shows a mass in the right cerebral hemisphere with midline shift. which is the likely cause
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cerebral edema with uncal herniation
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unconcsious. headache that was worst of his life, in back of his head. wet pants after losing consciousness. no hx of convulsions. hx of ht, and dm. neck stiffness and left pupil dilated and sluggishly reacting to light. what would csf look like
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have red blood cells
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